ACTIVE LEARNING TEMPLATE:
Therapeutic Procedure
STUDENT NAME _____________________________________
PROCEDURE NAME ____________________________________________________________________ REVIEW MODULE CHAPTER ___________
Description of Procedure
Indications
CONSIDERATIONS
Nursing Interventions (pre, intra, post)
Outcomes/Evaluation
Potential Complications
ACTIVE LEARNING TEMPLATES
Client Education
Nursing Interventions
ACTIVE LEARNING TEMPLATE:
System Disorder
STUDENT NAME _____________________________________
DISORDER/DISEASE PROCESS __________________________________________________________ REVIEW MODULE CHAPTER ___________
Alterations in
Health (Diagnosis)
Pathophysiology Related
to Client Problem
Health Promotion and
Disease Prevention
ASSESSMENT
SAFETY
CONSIDERATIONS
Risk Factors
Expected Findings
Laboratory Tests
Diagnostic Procedures
PATIENT-CENTERED CARE
Nursing Care
Therapeutic Procedures
ACTIVE LEARNING TEMPLATES
Complications
Medications
Client Education
Interprofessional Care
THERAPEUTIC PROCEDURE
A11
ACTIVE LEARNING TEMPLATE:
System Disorder
STUDENT NAME _____________________________________
DISORDER/DISEASE PROCESS __________________________________________________________ REVIEW MODULE CHAPTER ___________
Alterations in
Health (Diagnosis)
Pathophysiology Related
to Client Problem
Health Promotion and
Disease Prevention
ASSESSMENT
SAFETY
CONSIDERATIONS
Risk Factors
Expected Findings
Laboratory Tests
Diagnostic Procedures
PATIENT-CENTERED CARE
Nursing Care
Therapeutic Procedures
ACTIVE LEARNING TEMPLATES
Complications
Medications
Client Education
Interprofessional Care
THERAPEUTIC PROCEDURE
A11
ACTIVE LEARNING TEMPLATE:
Basic Concept
lenia leyva
STUDENT NAME _____________________________________
Maintaining Client Confidentiality
2
CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Related Content
Underlying Principles
(E.G., DELEGATION,
LEVELS OF PREVENTION,
ADVANCE DIRECTIVES)
A nurse who works in the
mental health setting is
responsible for practicing
ethically, competently,
safely, and in a manner
consistent with all local,
state, and federal laws!
Specific mental health
issues where health care
professionals can break
confidentiality include the
duty to warn and protect
third parties, and the
reporting of child and
vulnerable adult abuse.
ACTIVE LEARNING TEMPLATES
Nursing Interventions
WHO? WHEN? WHY? HOW?
Nurses must have an
understanding of ethical
principles and how they apply
when providing care for
clients in mental health
settings!
Nurses are responsible for
understanding and protecting
client rights
The client’s right to privacy is
protected by the Health
Insurance Portability and
Accountability Act (HIPAA)
Privacy Rule of 2003
The nurse should share
information about the client,
either verbal or written, only
with those who are
responsible for
implementing the client’s
treatment plan. The nurse
should not discuss client
information in public places,
and social media should
never be used to discuss
clients or their information!
Only if the client provides
consent should the nurse
share information with other
persons not involved in the
client treatment plan.
If the nurse becomes aware
that a client’s right to
privacy is being violated, for
example if a conversation in
the elevator is overheard,
they should immediately
take action to stop the
violation.
ACTIVE LEARNING TEMPLATE:
Basic Concept
lenia leyva
STUDENT NAME _____________________________________
Identifying Ethical Principles
2
CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Related Content
Underlying Principles
(E.G., DELEGATION,
LEVELS OF PREVENTION,
ADVANCE DIRECTIVES)
Nurses are frequently
confronted with ethical
dilemmas regarding client
care (bioethical issues)!
Because ethics are
philosophical and involve
values and morals, there is
frequently no clear-cut,
simple resolution to an
ethical dilemma.
ACTIVE LEARNING TEMPLATES
Nursing Interventions
WHO? WHEN? WHY? HOW?
Nurses must have an
understanding of ethical
principles and how they apply
when providing care for
clients in mental health
settings!
Nurses are responsible for
understanding and protecting
client rights
The nurse can also
experience situations where
there will be a conflict
between two or more
courses of action, known as
an ethical dilemma. The
nurse should respond to
these situations using the
bioethical principles.!
The nurse must use ethical
principles to decide ethical
issues
ACTIVE LEARNING TEMPLATE:
Basic Concept
lenia leyva
STUDENT NAME _____________________________________
Suicide
2
CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Related Content
Underlying Principles
(E.G., DELEGATION,
LEVELS OF PREVENTION,
ADVANCE DIRECTIVES)
A client contemplating
suicide believes that the act
is the end to problems.
Little concern is given to the
aftermath or the
ramifications to those left
behind.
ACTIVE LEARNING TEMPLATES
Nursing Interventions
WHO? WHEN? WHY? HOW?
Suicide is the intentional act
of killing oneself. A client who
is suicidal can be ambivalent
about death; interventions
can make a difference. !
Long-term therapy is needed
for the survivors Suicidal
ideation occurs when a client
is having thoughts about
committing suicide.
Clients can have feelings of
hopelessness, helplessness
and inner pain.
-Assess carefully for verbal
and nonverbal clues. It is
essential to ask the client if
they are thinking of suicide.
This will not give the client
the idea to commit suicide.
-Suicidal comments usually
are made to someone that
the client perceives as
supportive.
-Assess for potential suicide
risk using a standardized
assessment tool
-Assess the client’s
suicide plan.
-Initiate one-on-one
constant supervision
around the clock, always
having the client in sight
and close. Documentation
should indicate which staff
member is accountable for
the client, with specific start
and stop times. There is an
increased risk for suicide
during staff rotation times.
-Document the client’s
location, mood, quoted
statements, and behavior
every 15 min or per facility
protocol.
-Search the client’s
belongings with the client
ACTIVE LEARNING TEMPLATE:
Basic Concept
lenia leyva
STUDENT NAME _____________________________________
Guidelines for the Use of Mechanical
Restraints
2
CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Related Content
Underlying Principles
(E.G., DELEGATION,
LEVELS OF PREVENTION,
ADVANCE DIRECTIVES)
-Restraints are either
physical or chemical
(neuroleptic medication to
calm the client).!
•In general, the provider
should prescribe seclusion
and/or restraint for the
shortest duration necessary,
and only if less restrictive
measures are not sufficient.
They are for the physical
protection of the client and/
or the protection of other
clients and staff!
ACTIVE LEARNING TEMPLATES
Nursing Interventions
WHO? WHEN? WHY? HOW?
-Nurses must know and
follow federal/state/facility
policies that govern the use
of restraints.!
-Use of seclusion rooms and/
or restraints can be
warranted and authorized for
clients in some cases.
- A client can voluntarily
request a temporary timeout
in cases in which the
environment is disturbing or
seems too stimulating. A
timeout is different from
prescribed seclusion because
a timeout is by the request of
the clients
The provider must prescribe
the seclusion or restraint in
writing.!
-Time limits for seclusion or
restraints are based upon
the age of the client.
-Age 18 years and older: 4
hr
-Assessed (including for
safety and physical needs),
and the client’s behavior
documented
-Offered food and fluid
-Toileted
-Monitored for vital signs
-Monitored for pain
-complete documentation
every 15 to 30 minutes
-restraints must be
discontinued with the client
is exhibiting behavior that is
safer and quieter
ACTIVE LEARNING TEMPLATE:
Basic Concept
lenia leyva
STUDENT NAME _____________________________________
2
CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Related Content
(E.G., DELEGATION,
LEVELS OF PREVENTION,
ADVANCE DIRECTIVES)
Depressive disorders affect
many clients and are a
leading cause of disability.
Advise clients starting
antidepressant medication
therapy for a depressive
disorder that relief is not
immediate, and it can take
several weeks or longer to
reach full therapeutic
benefits. Encourage
continued compliance.
ACTIVE LEARNING TEMPLATES
Underlying Principles
Clients who have major
depression can require
hospitalization with the
implementation of close
observation and suicide
precautions until
antidepressant
medications reach their
peak effect.
Nursing Interventions
WHO? WHEN? WHY? HOW?
Antidepressant
medications are
classified into five
main groups: tricyclic
antidepressants
(TCAs), selective
serotonin reuptake
inhibitors (SSRIs),
serotonin
norepinephrine
reuptake inhibitors
(SNRIs), monoamine
oxidase inhibitors
(MAOIs), atypical
antidepressants. A
combination of
antidepressant
medications can be
required to alleviate all
manifestations
ACTIVE LEARNING TEMPLATE:
Basic Concept
lenia leyva
STUDENT NAME _____________________________________
2
CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Related Content
(E.G., DELEGATION,
LEVELS OF PREVENTION,
ADVANCE DIRECTIVES)
Depressive
disorders affect
many clients and are
a leading cause of
disability. Advise
clients starting
antidepressant
medication therapy
for a depressive
disorder that relief is
not immediate, and it
can take several
weeks or longer to
reach full therapeutic
benefits. Encourage
continued
compliance.
ACTIVE LEARNING TEMPLATES
Underlying Principles
Nursing Interventions
WHO? WHEN? WHY? HOW?
Clients who have
major depression
can require
hospitalization
with the
implementation of
close observation
and suicide
precautions until
antidepressant
medications reach
their peak effect.
• Clients who are
experiencing a
complicated grief
response
commonly
experience a loss
of self-esteem and
a sense of
worthlessness not
associated with
normal grief.
• Assess the
client for risk
factors and identify
a normal versus a
complicated grief
response
ACTIVE LEARNING TEMPLATE:
Basic Concept
lenia leyva
STUDENT NAME _____________________________________
2
CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Related Content
(E.G., DELEGATION,
LEVELS OF PREVENTION,
ADVANCE DIRECTIVES)
Bereavement
includes both grief
and mourning (the
outward display of
loss) as a person
deals with the death
of a significant
individual.
Bereavement can
result in depression.
A bereavement
exclusion was
previously used
when a client
experienced
manifestations of
depression within the
first 2 months after a
significant loss. Now,
a client can receive a
diagnosis of
depression during
this time so that
needed treatment is
not delayed.
ACTIVE LEARNING TEMPLATES
Underlying Principles
Nursing Interventions
WHO? WHEN? WHY? HOW?
End-of-life care is an
important aspect of
nursing care that
attempts to meet the
client’s physical and
psychosocial needs.
End-of-life issues
include decisionmaking in a highly
stressful time during
which the nurse must
consider the desires
of the client and the
family. End-of-life
care can include
palliative interventions
which promote
comfort.
ACTIVE LEARNING TEMPLATE:
Basic Concept
lenia leyva
STUDENT NAME _____________________________________
2
CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Related Content
(E.G., DELEGATION,
LEVELS OF PREVENTION,
ADVANCE DIRECTIVES)
Adaptive use of
defense
mechanisms
helps people to
achieve their
goals in
acceptable ways
and reduce
anxiety.
ACTIVE LEARNING TEMPLATES
Underlying Principles
Nursing Interventions
WHO? WHEN? WHY? HOW?
Individuals can use
defense
mechanisms as a
way to manage
conflict in response
to anxiety. Defense
mechanisms are
reversible, and the
client can use them
in either an
adaptive or
maladaptive
manner.
Defense
mechanisms
become
maladaptive when
they interfere with
functioning,
relationships, and
orientation to
reality and are
used in excess. It
is important that
the defense
mechanism used
is appropriate to
the situation, and
that an individual
uses a variety of
defense
mechanisms,
rather than having
the same reaction
to every stressful
situation
ACTIVE LEARNING TEMPLATE:
Basic Concept
lenia leyva
STUDENT NAME _____________________________________
2
CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Related Content
(E.G., DELEGATION,
LEVELS OF PREVENTION,
ADVANCE DIRECTIVES)
Neurocognitive
disorders are a
group of conditions
characterized by
the disruption of
thinking, memory,
processing, and
problem-solving.
Treatment of clients
who have
neurocognitive
disorders requires a
compassionate
understanding of
both the client and
family
ACTIVE LEARNING TEMPLATES
Underlying Principles
Nursing Interventions
WHO? WHEN? WHY? HOW?
It is important to
distinguish between a
cognitive disorder and
other mental health
disorders that can
have similar
manifestations.
Depression in the
older adult can mimic
the early stages of
Alzheimer’s disease
Impairments in
memory,
judgment, speech
(aphasia), ability to
recognize familiar
objects (agnosia),
executive
functioning
(managing daily
tasks), and
movement
(apraxia);
impairments do
not change
throughout the
day.
Level of
consciousness is
usually
unchanged.
Restlessness and
agitation are
common;
sundowning can
occur.
Personality
change is gradual.
Vital signs are
stable unless other
illness is present
ACTIVE LEARNING TEMPLATE:
Basic Concept
lenia leyva
STUDENT NAME _____________________________________
2
CONCEPT ______________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Related Content
(E.G., DELEGATION,
LEVELS OF PREVENTION,
ADVANCE DIRECTIVES)
Periods of normal
functioning
alternate with
periods of illness,
though some
clients are not able
to maintain full
occupational and
social functioning.
Clients can exhibit
psychotic,
paranoid, and/or
bizarre behavior
during periods of
mania
Bipolar disorders
are mood
disorders with
recurrent episodes
of depression and
mania
ACTIVE LEARNING TEMPLATES
Underlying Principles
Nursing Interventions
WHO? WHEN? WHY? HOW?
Bipolar disorders
usually emerge in
early adulthood, but
early-onset bipolar
disorder can be
diagnosed in
pediatric clients.
Because
manifestations can
mimic expected
findings of attention
deficit hyperactivity
disorder (ADHD), it is
more difficult to
assess and diagnose
bipolar disorders in
children than in other
client age groups
• Provide a safe
environment during
the acute phase.
•
• Assess the client
regularly for suicidal
thoughts, intentions,
and escalating
behavior.
• Decrease stimulation
without isolating the
client if possible. Be
aware of noise,
music, television, and
other clients, all of
which can lead to an
escalation of the
client’s behavior. In
certain cases,
seclusion might be
the only way to safely
decrease stimulation
for the client.
•
• Follow agency
protocols for
providing client
protection (restraints,
seclusion, one-to-one
observation) if a
threat of self-injury or
injury to others
exists.
• Implement frequent
rest periods
ACTIVE LEARNING TEMPLATE:
Medication
STUDENT NAME _____________________________________
MEDICATION __________________________________________________________________________
REVIEW MODULE CHAPTER ___________
CATEGORY CLASS ______________________________________________________________________
PURPOSE OF MEDICATION
Expected Pharmacological Action
Complications
Therapeutic Use
Medication Administration
Contraindications/Precautions
Nursing Interventions
Interactions
Client Education
Evaluation of Medication Effectiveness
ACTIVE LEARNING TEMPLATES
ACTIVE LEARNING TEMPLATE:
Medication
STUDENT NAME _____________________________________
MEDICATION __________________________________________________________________________
REVIEW MODULE CHAPTER ___________
CATEGORY CLASS ______________________________________________________________________
PURPOSE OF MEDICATION
Expected Pharmacological Action
Complications
Therapeutic Use
Medication Administration
Contraindications/Precautions
Nursing Interventions
Interactions
Client Education
Evaluation of Medication Effectiveness
ACTIVE LEARNING TEMPLATES
ACTIVE LEARNING TEMPLATE:
System Disorder
lenia leyva
STUDENT NAME _____________________________________
Psychotic Disorders: Planning Care for a REVIEW MODULE CHAPTER ___________
DISORDER/DISEASE PROCESS __________________________________________________________
Client Who Has Schizophrenia
Alterations in
Health (Diagnosis)
disturbed thought process &
sensory perception
Pathophysiology Related
to Client Problem
neurodegenerative disorder
resulting in the gradual
impairment of cognitive
Health Promotion and
Disease Prevention
caregiver teaching
ASSESSMENT
SAFETY
CONSIDERATIONS
Risk Factors
Expected Findings
delusions
hallucinations
disorganized speech
negative symptoms
genetics
brain structure abnormalities
enviromental stressors
Laboratory Tests
Diagnostic Procedures
CBC count
liver,thyroid, and renal function
tests
electrolyte levels
MRI
CT
physical exam
PATIENT-CENTERED CARE
Nursing Care
assess for hallucinations
establish a trusting
relationship
asses for substance use
Therapeutic Procedures
drug therapy
pet therapy
individual psychotherapy
ACTIVE LEARNING TEMPLATES
Provide increased
supervision when
risk of self or other
directed violence is
present
-Ensure that patient
is taking
medications as
prescribed
-Provide safe
outlets
for physical energy
Complications
Medications
haldol
chlorpromazine
dopamine
clozapine
Client Education
Know early warning signs
of relapse !
- develop a relapse plan
Interprofessional Care
psychiatrist
psychologist
counselor
command
hallucinations!
paranoia
impaired executive
functioning
ACTIVE LEARNING TEMPLATE:
System Disorder
lenia leyva
STUDENT NAME _____________________________________
Client indications of Acute mania
DISORDER/DISEASE PROCESS __________________________________________________________
REVIEW MODULE CHAPTER ___________
Alterations in
Health (Diagnosis)
recurrent episodes of
depression & mania
Pathophysiology Related
to Client Problem
mimic ADHD, alternate
episodes of illness, psychotic
behavior
Health Promotion and
Disease Prevention
more recurrent stable
behaviors
ASSESSMENT
SAFETY
CONSIDERATIONS
Risk Factors
Expected Findings
liabile mood
agitation
restlessness
flight of ideas
genetics
physiological
enviromental stress
Laboratory Tests
Diagnostic Procedures
blood & urine to monitor for lithium
toxcitiy
mood disorder questionnaire
PATIENT-CENTERED CARE
Nursing Care
milieu therapy, monitor
sleep, reminders for
hygiene & fluid intake &
nutrition
Therapeutic Procedures
ECT therapy
ACTIVE LEARNING TEMPLATES
self-harm
suicide
improper nutrition
and fluids
Complications
Medications
lithium
anticonvulsant
antipsychotic
antidepressant
Client Education
follow-up appointments
therapy
indications of relapse
sleep schedule
Interprofessional Care
therapy
physical
exhaustion &
possible death
ACTIVE LEARNING TEMPLATE:
System Disorder
tenia
STUDENT NAME _____________________________________
Leyva
Disease
Alzheimers
DISORDER/DISEASE PROCESS __________________________________________________________
REVIEW MODULE CHAPTER ___________
Alterations in
Health (Diagnosis)
Pathophysiology Related
to Client Problem
Accumulation of beta amyloid
plagues and Cerebrocortical
progressive neurological
-
disease
degenerative
atrophy
brain
of the
Health Promotion and
Disease Prevention
in the brain
Eating
healthybrain
keeping your
activities
ASSESSMENT
SAFETY
CONSIDERATIONS
Risk Factors
>
65
yrs
of
Expected Findings
age
Poorly
Family history
women
lack
of
controlled
Diabetes
exercise
cog
Laboratory Tests
.
MMSE
clock
available
mentally
socially
and
stimulating
impairment
can
activities
reduce the
risk
Diagnostic Procedures
laboratory
test
carry
Disorientation
cholesterol
no
Inability
out
Anomia
amnesia
Aphasia
smoking
HTN
a
→
to
ADL 's
drawing
→
stimulating
→
mentally
challenging
leisure
job
activities
MRI
CT
PATIENT-CENTERED CARE
Complications
Nursing Care
Patient safety
Anticetylcholi
self
nesierase
-
cane
activities
Medications
-
drugs
Antipsychotics
malnutrition
Client Education
Attention
and
to
nutrition
hydration
is
needed
dehydration
Bladder
Bowel
Falls
Therapeutic Procedures
validation
therapy
music
art
reminiscence
therapy
ACTIVE LEARNING TEMPLATES
Interprofessional Care
→
Occupational
therapists
→
neurologist
+
problems
ACTIVE LEARNING TEMPLATE:
System Disorder
STUDENT NAME _____________________________________
Anxiety disorders
DISORDER/DISEASE PROCESS __________________________________________________________ REVIEW MODULE CHAPTER ___________
Alterations in
Health (Diagnosis)
Pathophysiology Related
to Client Problem
Elevated or perstitent anxiety
states cause behavioral
changes
and impairment of functioning.
Mild anixety can be a healthy
response to stress that is essential for
survival. recurrent anxiety states may
lead to ineffective coping and anxiety
disorders.
Health Promotion and
Disease Prevention
Practice healthy
coping skills
ASSESSMENT
SAFETY
CONSIDERATIONS
Risk Factors
Expected Findings
women
Events/stressors
relationships
Uncontrollable/excessive
anxiety
restlessness
Palpitations
Laboratory Tests
Diagnostic Procedures
blood tests to rule out other
causes
CT
MRI
PATIENT-CENTERED CARE
Nursing Care
Complications
Medications
Road safety and comfort antidepressant
Teach relaxation
benzos
techniques
beta blockers
antihistamines
Therapeutic Procedures
Relaxation techniques
breathing techniques
cognitive therapy
CBT
ACTIVE LEARNING TEMPLATES
Assess
patient for
clear airway,
especially
with
increased
respirations
and
HR, risk for
suicide or
harm
Client Education
suicide
Warn against
abrupt stop In
medications
Interprofessional Care
Psychologist
Nutritionist
THERAPEUTIC PROCEDURE
A11
ACTIVE LEARNING TEMPLATE:
Medication
STUDENT NAME _____________________________________
MEDICATION __________________________________________________________________________
REVIEW MODULE CHAPTER ___________
CATEGORY CLASS ______________________________________________________________________
PURPOSE OF MEDICATION
Expected Pharmacological Action
Complications
Therapeutic Use
Medication Administration
Contraindications/Precautions
Nursing Interventions
Interactions
Client Education
Evaluation of Medication Effectiveness
ACTIVE LEARNING TEMPLATES
ACTIVE LEARNING TEMPLATE:
Medication
STUDENT NAME _____________________________________
MEDICATION __________________________________________________________________________
REVIEW MODULE CHAPTER ___________
CATEGORY CLASS ______________________________________________________________________
PURPOSE OF MEDICATION
Expected Pharmacological Action
Complications
Therapeutic Use
Medication Administration
Contraindications/Precautions
Nursing Interventions
Interactions
Client Education
Evaluation of Medication Effectiveness
ACTIVE LEARNING TEMPLATES