WESTERN NEVADA COMMUNITY COLLEGE
Mental Health and Illness Theory & Lab
NURSING 149-150
Revised: SPRING 2011
Professor Cheryl E. Moreland, RN, MS, APN
E-mail address: moreland@wnc.edu
Cell phone: (775) 721—3216
Office Phone: (775) 445—4295
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Table of Contents
Class Schedule…………………………………………………………………………………………………… 3
Theory Course Description & Objectives …………………………………………………………………….. .5
Textbooks…………………………………………………………………………………………………………6
Methods of Instruction……………………………………………….........................………………………….6
Grading System ………………………………………………………………………………………………….6
Disability Support………………………………………………………………………………………………..6
Lab Course Description & Objectives…………………………………………………….…………………....7
Lab Methods of Instruction……………………………………………………………………………….…….8
Attendance Policy………………………………………………………………………………..........................8
Lab/Clinical Grading……………………………………………………………………………………………8
Written Assignment Guidelines…………………………………………………………………………………9
Orientation: Nursing Process and Standards of Care…………………………………………………..……………10
Therapeutic Relationships.................................................................................................................…...11
Communication & Clinical Interviewing………………………..……………………….….……11
Class 1— Suicide & Anger, Aggression and Violence………………………………………….………….....12
Class 2—Bipolar Disorders & Schizophrenia………………………………………………………………...13
Class 3—Exam 1………………………………………………………………………………………………..13
Class 4—Foundations in Theory………………………………………………………………………………14
Class 5—Foundations for Practice……………………………………….……………………………………16
Class 6—Exam 2………………………………………………………………………………………………..17
Class 7—Serious Mental Illness……………………………………….……………………………………….18
Therapeutic Groups…………………………………………………………………………………….18
Personality Disorders………………………………………….………………………………………..18
Class 8—Responses to Stress…………………………………………………………………………………..19
Anxiety and Anxiety Disorders………………………………...………………………………………19
Depressive Disorders…………...………………………………………………………………………19
Class 9—Spring Vacation………………………...……………………………………………………………19
Class 10—Exam 3………………………………………………………………………………………………19
Class 11—Eating Disorders……………………………………………………………………………………20
Cognitive Disorders…………………………………………………………………………………….20
Sleep Disorders………………………………………………………………………………………….20
Class 12— Addictive Disorders………………………………………………………………………………..21
Class 13—Sexual Dysfunction & Sexual Disorders…………………………………………………………..22
Somatoform, Factitious, and Dissociative Disorders…………………………………………….…...22
Crisis and Disaster……………………………………………………………………………………..22
Class 14—Exam 4………………………………………………………………………………………………22
Class 15—Trauma Interventions……………………………………………………………………………...23
Class 16— Interventions for Special Populations……………………………………………………………24
Class 17—Final Exam……………………………………………………………………………………….…24
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CLASS SCHEDULE Spring 2011
Cedar Building Room 207
Assigned reading from Text: Varcarolis, Foundations of Psychiatric Mental Health Nursing, 6th Ed.
Date:
2011
Thursday
Class Topic
Welcome!
All Students
Clinical Orientation
Jan. 21
10:00 am to
4:30 pm
Bring your
lunch 
Practical safety tips for working
with clients in the acute care
setting; Nursing Process and
Standards of Care; Therapeutic
Relationships; Communication &
Clinical Interviewing
Class 1
Jan.24-28
Suicide; Anger, Aggression &
Violence
Class 2
Jan. 31—Feb.
4
Bi-Polar; Schizophrenia;
Mania & Psychosis
Reading
Assignments
Chapters
8, 9 & 10
57 pages
Chapters
24—25
36 pages
Chapters
14—15
63 pages
Video/Lab/Clinical Learning Activities
10:00 am — Orientation at Northern Nevada
Adult Mental Health Services (NNAMHS).
Mental Health Letter
Psycho-Social Assessment, page 144;
Process Recording, page 191;
Genogram, page 759;
DSM—IV—TR Exercise, page 5, 12-14 &784;
GAF Scale, page 15; Physical Assessment
DVD: Mental Health & Nursing: Verbal and
Physical Aggression
SAD Persons Scale, page 554;
Management of Assaultive Behavior
DVD: The Client Experiencing Mania;
DVD: A Beautiful Mind-- video Care Plan
Case Study on Psychosis & Schizophrenia;
Discussion; Role Playing
Class 3
Wednesday
Exam 1
Feb. 9
8am—10am All Groups
Computer Lab
Class 4
Feb.14-18
Foundations In Theory;
Mental Health & Illness;
Biological Basis
Chapters
1—2—3
74 pages
Class 5
Feb.21-25
Foundations for Practice in the
Acute Care and Community
Setting; Cultural Implications;
Legal and Ethical Guidelines
Chapters
4—5—6—7
62 pages
Class 6
Exam 2
Wednesday
March 2
8am—10am All Groups
Computer Lab
Class 7
Personality Disorders
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DVD: Down the Rabbit Hole
Discussion
Video: Mental Status Assessment
Abnormal Involuntary Movement Scale (AIMS)
Page 332; Discussion; Role Playing
Video: Mental Status Assessment;
Exploring Roadblocks: Basic Counseling
Skills; Legal 2000 Group Work
Case Study; Discussion; Role Playing
DVD: Girl Interrupted-- video Care Plan
Case Study on Depression with Suicidal
Ideation & Personality Disorders
Chapters
DVD: Group Work
Page 3
March 7-11
Serious Mental Illness
Group Therapy
19—30—34
58 pages
Class 8
March 14-18
Stress, Anxiety and Depression
Chapters
11—12—13
85 pages
Class 9
March 21--25
Class 10
Spring Vacation
Spring Vacation
Exam 3
Wednesday
March 30
8am—10am All Groups
Computer Lab
Class 11
April 4-8
Eating Disorders & Cognitive
Disorders &
Sleep Disorders
DVD: The Notebook—video Care Plan
Case Study on Alzheimer’s Disease
Chapters
16—17 & 20
75 pages
Class 12
April
11-15
Addictive Disorders
Chapter 18
31 pages
Class 13
April
18—22
Class 14
Sexual Disorders, Somatoform,
Factitious & Dissociative
Disorders; Crisis & Disaster;
Chapters
21—22—23
67 pages
Wednesday
April 27
8am—10am All Groups
Computer Lab
Class 15
May 2-6
Child, Older Adult, & Intimate
Partner Abuse; Sexual Assault;
Class 16
May 9-13
Class 17
Exam 5
Wednesday
8am—10am All Groups
Computer Lab
May 18
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DVD: Thin—video Care Plan
Case Study on Eating Disorders
Mental Status Exam, page 143;
Guest Speaker: Chemically Impaired Nurse;
DVD: 28 Days—video Care Plan
Case Study on Alcoholism
Screening Tools: CAGE-Aid (pg. 657) &
MAST (pg.658); Co-Dependent Behaviors,
page 405. Role Playing--Breaking the Chains on
the Cycle of Addiction
DVD: United States of Tara
Group work; Discussion
DVD: Boys Don’t Cry—video Care Plan
Case Study on Sexual Assault & Gender
Identity Issues
Exam 4
Forensic Nursing; Family
Interventions; Integrative Care
Life Auction—Values Clarification Group,
Role Playing; Discussion
DVD: Depressed/Suicidal Client;
Recent Life Changes Questionnaire, page 202
Guided Imagery Experience, page 205;
Deep Breathing, page 205;
Hamilton Anxiety Rating Scale, page 228;
Patient Health Questionnaire-9 Depression
Rating Scale, page 253
Chapters
26—27
42 pages
Chapters
33 & 35—36
45 pages
Guest Speaker from S.A.N.E.
Rape Trauma Kit
Group Work; Discussion
DVD: Yoga for Stress Relief
DVD: Tia Chi; Massage; Group Work;
Discussion; Role Playing
No Lab! Good Luck!
Page 4
NURS 149: Mental Health and Illness Theory
Revision Date: January 2011
Number of Credits: 2 (30 clock hours)
Transferability of course within Nevada: General Elective
Prerequisite courses: Successful completion of the first semester of the nursing program.
Co-requisite courses: NURS 150 & Nurs.151
Students must pass NURS 149, 150 and 151 to continue on in the program. This series of courses must be
repeated if the student is unsuccessful with any of the three courses.
Course Description
This course assists students to gain knowledge of nursing care for patients across the lifespan experiencing
common alterations in psychosocial health. The course examines the principles and practice of psychiatric
nursing through a variety of theoretical frameworks and legal and ethical values that guide its practice. The
course is organized by the nursing process and emphasizes the use of culturally relevant therapeutic
communication skills, development of therapeutic nurse/patient relationships, and interventions that are
grounded in evidence-based practice.
Course Objectives
Upon successful completion of the course the student will be able to:
1. Discuss a variety of theoretical frameworks used in the provision of culturally competent care to patients
experiencing common alterations in psychosocial health.
2. Utilize knowledge grounded in evidence-based practice to utilize the nursing process in a classroom
setting for patients experiencing anxiety disorders, stress, mood disorders, personality disorders,
substance abuse, aggression and violence, thought disorders, disorders of self-regulation, psychosomatic
disorders, and psychiatric emergencies.
3. Articulate nursing responsibilities associated with carrying out a medical plan of care.
4. Prioritize appropriate therapeutic modalities that are designed to promote healthy
bio/psycho/social/cultural and spiritual functioning while maintaining patient safety.
5. Explain how the ethical and legal rights of patients guide the practice of psychiatric nursing.
6. Analyze psychopharmacological issues important in the provision of safe patient care.
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Textbooks:
The following textbooks are required for NURS 149
Varcarolis, E., & Halter, M., (2010) Foundations of Psychiatric Mental Health Nursing, (6th Ed.). ST. Louis:
Saunders Elsevier.
Methods of Instruction
Methods of instruction include lecture, required readings, discussion, student presentations, and video materials.
Grading System
1. Five examinations will constitute 75% of the final grade.
Student must achieve at least a 75% cumulative average on the five examinations to successfully complete
this course. Students who do not earn a 75% cumulative average on examinations will not be allowed to
continue in the nursing program, and will receive the earned average of examinations as the grade for the
course.
Students should consult the Nursing Program Student Handbook for additional information regarding the
grading system.
2. Calculation of Theory Grade
Clinical Relationship Study (submit to clinical instructor)
Clinical Care Plans (submit to clinical instructor)
Group Video Care Plans (submit to lab instructor)
Exam 1
Exam 2
Exam 3
Exam 4
Exam 5
5%
10%
10%
15%
15%
15%
15%
15%
Total 100%
If you have a disability for which you will need to request accommodation, please contact Disability
Support Services office (Bristlecone Building, Room 103) as soon as possible to arrange for appropriate
accommodations.
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Western Nevada College
NURS 150: Mental Health & Illness Laboratory
Revision Date: Jan. 2011
Number of Credits: 1 (45 clock hours)
Transferability of course within Nevada: General Elective
Prerequisite courses: Successful completion of the first semester of the nursing program
Co-requisite courses: NURS 149 and NURS 151
Students must pass NURS149, 150 and 151 to progress in the nursing program. This series of courses must be
repeated if the student is unsuccessful with any of the three courses.
Course Description
This course provides the opportunity for students to utilize the nursing process in a simulated laboratory setting
to understand the care of patients experiencing common alterations in psychosocial health. Through the use of
active learning modalities, including classroom presentations and group work, students are encouraged to
scrutinize their beliefs regarding alterations in psychosocial health. Students will explore nurse/patient
relationships, the importance of therapeutic communication, and examine psychotherapeutic approaches
designed to meet the bio/psycho/social/cultural and spiritual needs of patients.
Course Objectives
Upon successful completion of the course the student will be able to:
1. Apply the nursing process in a laboratory setting in the provision of culturally relevant care to patients
across the lifespan experiencing common alterations in psychosocial health.
2. Compare and contrast a variety of treatment modalities.
3. Evaluate the degree to which the student was able to achieve a therapeutic use of self.
4. Analyze thoughts, feelings and behaviors commonly encountered in the care of patients that illustrate
healthy and unhealthy psychosocial functioning.
5. Compare and contrast the primary roles of nurses as they provide and direct nursing care that promotes
and supports the bio/psycho/social/cultural and spiritual needs of patients.
6. Utilize therapeutic communication skills while role-playing simulated patient scenarios.
7. Analyze how the nurse uses ethical values and knowledge of legal parameters in the provision of care to
patients experiencing common alterations in psychosocial health.
8. Demonstrate competency in the application of the nursing process to the care of patients with common
alterations in psychosocial health by developing appropriate outcome criteria based on an understanding
of pathology and prognosis of the alteration.
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Methods of Instruction
Teaching/learning modalities utilized in this course include lecture, clicker questions, student presentations,
discussion groups, audio-video, required readings, guest speakers, case studies, field trips, role playing and
video tape of data collection for the completion of a genogram, with self-critique and peer critique.
Attendance Policy
Students are expected to be on time and attend all laboratory experiences. Students missing more than one
laboratory experience will make arrangements with the instructor for a make-up assignment. Failure to do so
will result in a grade of failure (F) for the course.
Grading System
Students will earn a grade of pass (P) or fail (F) in the course. Students must complete all lab assignments at a
satisfactory level (75% or higher) in order to pass the course.
Lab/Clinical Assignments include:

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
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
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
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Lab attendance and participation
Mental Health letter
Process Recordings
Psycho-Social Assessment
AIMS Test (Abnormal Involuntary Muscle Scale)
Mini-Mental Status Exam
Student group presentations on Video Care Plans
MAST Test (Michigan Alcoholism Screening Test)
DSM—IV—TR Exercise
Zung Depression Scale
SAD Persons Screening Tool (Suicide Assessment Tool)
Values Clarification Group Therapy
Life Changing Events Questionnaire
Legal 2000 Group Work
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Written Assignment Guidelines:
Clinical assignments are due the next regularly scheduled clinical day following the day that you worked
with your patient. All clinical assignments are due by the final week of the clinical rotation.
(Requirements and forms for written assignments are included in your clinical forms packet)
The nursing student will:
1. Submit a reflective journal recording following each clinical experience of your thoughts and
feelings about the clinical experience. The journal must be submitted the next clinical shift following
your clinical experience.
2. Attend a self-help 12 step program meeting (AA or NA) and provide a brief write-up of the meeting.
This will be documented in the student’s Journal and must be submitted the next clinical shift following
your clinical experience. This assignment is due no later than the last clinical day of the rotation.
3. Develop two nursing care plans/case studies, including a medication teaching plan, genogram,
psycho-social assessment and one or two process recordings on your selected patient, using the
Psychiatric Nursing Care Plan form in your Clinical Forms Packet.
4. Develop, implement and document a medication teaching plan for your selected care plan patient,
based on an identified patient teaching need. Submit with your care plan.
5. Complete a Genogram on your selected care plan patient. Submit with your care plan. (see page 759
for an example)
6. Complete in writing, one Nursing Psycho-Social Assessment for your selected care plan patient,
using the Comprehensive Nursing Assessment tool in your Clinical Packet. Submit with your care
plan.
7. Using the Process Recording form, conduct, document and analyze, four therapeutic interviews
lasting approximately 15 minutes each. One is to be completed each clinical shift of the rotation and
must be submitted the next scheduled clinical day. Form can be found in your Clinical Forms Packet.
8. Complete one Patient Relationship Study after developing a relationship with your selected care plan
patient, using the Patient Relationship Study guidelines in your Clinical Packet. Submit with your
care plan.
9. Complete 4 Video Care Plans on selected “Patients” in the assigned videos using your care plan form
or submit the group clinical care planning forms in your Clinical Packet.
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Orientation
All Students must attend Orientation
*Meet in the Parking Lot of Northern Nevada Mental Health Services
Welcome: Practical Safety Tips
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Compare and contrast a social relationship and a therapeutic relationship regarding purpose, focus,
communications style, and goals.
2. Complete a genogram on a fellow student.
3. Discuss the 5 Axises used in the diagnosis of a patient with mental health problems.
4. Explain the components of a psychosocial assessment.
5. Examine personal beliefs about mental health and mental illness.
6. Identify behaviors that increase student and client safety in the clinical setting.
7. At a beginning level, understand the symptoms of mania and psychosis.
8. Discuss the importance of maintaining patient confidentiality with patients experiencing alterations in
mental health.
9. Discuss the role of the student in the psychiatric acute care inpatient setting.
10. Differentiate between transference and counter transference.
11. Explain appropriate therapeutic boundaries when working with clients with alterations in mental health.
12. Describe the process of dealing safely with an assaultive patient.
13. Differentiate among techniques that facilitate and obstruct therapeutic communication.
14. Discuss ways to address the mental health client that the student knows from the community.
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Psychosocial Nursing Tools
LEARNING ACTIVITIES: Read: Varcarolis: 68 pages
 Chapter 8: The Nursing Process and Standards of Care, pp. 138
 Chapter 9: Therapeutic Relationships, pp. 156
 Chapter 10: Communication and the Clinical Interview, pp. 174
1. Compare the different approaches you would consider when performing an assessment with a child, an
adolescent, and an older adult.
2. Differentiate between the use of an interpreter and a translator when performing an assessment with a
non–English speaking patient.
3. Conduct a mental status examination (MSE).
4. Explain three principles a nurse follows in planning actions to reach agreed-upon outcomes criteria.
5. Construct a plan of care for a patient with a mental or emotional health problem.
6. Compare and contrast the three phases of the nurse-patient relationship.
7. Identify at least four patient behaviors a nurse may encounter in the clinical setting.
8. Explore qualities that foster a therapeutic nurse-patient relationship and qualities that contribute to a
non-therapeutic nursing interactive process.
9. Define and discuss the roles of empathy, genuineness, and positive regard on the part of the nurse in a
nurse-patient relationship.
10. Identify two attitudes and four actions that may reflect the nurse’s positive regard for a patient.
11. Analyze what is meant by boundaries and the influence of transference and counter-transference on
boundary blurring.
12. Understand the use of attending behaviors (eye contact, body language, vocal qualities, and verbal
tracking).
13. Discuss the influences of disparate values and cultural beliefs on the therapeutic relationship.
14. Identify three personal and two environmental factors that can impede communication.
15. Discuss the differences between verbal and nonverbal communication, and identify five examples of
nonverbal communication.
16. Identify two attending behaviors the nurse might focus on to increase communication skills.
17. Demonstrate the use of four techniques that can enhance communication, highlighting what makes them
effective.
18. Demonstrate the use of four techniques that can obstruct communication, highlighting what makes them
ineffective.
19. Identify and give rationales for suggested (a) setting, (b) seating, and (c) methods for beginning the
nurse-patient interaction.
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Class 1
Trauma Interventions
LEARNING ACTIVITIES: Read: Varcarolis: 36 Pages
 Chapter 24: Suicide, pp. 547
 Chapter 25: Anger Aggression, and Violence, pp. 565
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Describe the profile of suicide in the United States, noting psychosocial and cultural factors that affect
risk.
2. Identify three common precipitating events of suicide.
3. Describe risk factors for suicide, including coexisting psychiatric disorders.
4. Name the most frequent coexisting psychiatric disorders.
5. Use the SAD PERSONS scale to assess suicide risk.
6. Describe three expected reactions a nurse may have when beginning work with suicidal patients.
7. Give examples of primary, secondary, and tertiary interventions.
8. Describe basic-level interventions for suicidal patients/clients that take place in the hospital or
community.
9. Identify key elements of suicide precautions and environmental safety factors in the hospital.
10. Compare and contrast three theories that explore the determinants for anger, aggression, and violence.
11. Compare and contrast interventions for a patient with healthy coping skills with those for a patient with
marginal coping behaviors.
12. Apply at least four principles of de-escalation with a moderately angry patient.
13. Describe two criteria for the use of seclusion or restraint over verbal intervention.
14. Discuss two types of assessment and their value in the nursing process.
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Class 2
Psychobiological Disorders
LEARNING ACTIVITIES: Read: Varcarolis: 64 Pages
 Chapter 14: Bipolar Disorders, pp. 280
 Chapter 15: Schizophrenia, pp. 306
OBJECTIVES: After completion of the objectives the student will be able to:
1. Assess a patient with mania for (a) mood, (b) behavior, and (c) thought processes, and be alert to
possible dysfunction.
2. Formulate three nursing diagnoses appropriate for a patient with mania, and include supporting data.
3. Explain the rationales behind five methods of communication that may be used with a patient
experiencing mania.
4. Distinguish between signs of early and severe lithium toxicity.
5. Compare and contrast basic clinical conditions that may respond better to anticonvulsant therapy with
those that may respond better to lithium therapy.
6. Evaluate specific indications for the use of seclusion for a patient experiencing mania.
7. Discuss the use of electroconvulsive therapy for a patient in specific situations.
8. Review at least three of the items presented in the patient and family teaching plan (see Box 14-2) with a
patient with bipolar disorder.
9. Distinguish the focus of treatment for a person in the acute manic phase from the focus of treatment for
a person in the continuation or maintenance phase.
10. Describe the progression of symptoms, focus of care, and intervention needs for the pre-psychotic
through maintenance phases of schizophrenia.
11. Discuss at least three of the neurobiological-anatomical-genetic findings that indicate that schizophrenia
is a brain disorder.
12. Differentiate among the positive and negative symptoms of schizophrenia in terms of
psychopharmacological treatment and effect on quality of life.
13. Discuss how to deal with common reactions the nurse may experience while working with a patient with
schizophrenia.
14. Compare and contrast the conventional antipsychotic medications with atypical antipsychotics.
15. Create a nursing care plan that incorporates evidence-based interventions for key areas of dysfunction in
schizophrenia, including hallucinations, delusions, paranoia, cognitive disorganization, anosognosia, and
impaired self-care.
16. Role-play intervening with a patient who is hallucinating, delusional, and exhibiting disorganized
thinking.
Class 3:
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Class 4
FOUNDATIONS IN THEORY
LEARNING ACTIVITIES: Read: Varcarolis: 74 pages
 Chapter 1: Mental Health and Mental Illness, pp. 2
 Chapter 2: Relevant Theories and Therapies for Nursing Practice, pp. 24
 Chapter 3: Biological Basis for Understanding Psychotropic Drugs, pp. 45
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Discuss some dynamic factors (including social climate, politics, myths, and biases) that contribute to
making a clear-cut definition of mental health elusive.
2. Explain how epidemiological studies can improve medical and nursing care.
3. Compare and contrast a DSM-IV-TR diagnosis with a nursing diagnosis.
4. Give examples of how personal norms and other cultural influences can affect making an accurate DSMIV-TR diagnosis.
5. Define psychiatric mental health nursing and discuss the patient population served by the psychiatric
nurse.
6. Compare and contrast the nursing actions of the basic level psychiatric mental health nurse with those of
the advanced level psychiatric mental health nurse.
7. Describe recent developments that have increased the biological emphasis in psychiatric mental health
nursing.
8. Explore emerging and future roles for psychiatric mental health nursing related to scientific and social
trends.
9. Identify Peplau’s framework for the nurse-patient relationship.
10. Discuss at least eight functions of the brain and the way these functions can be altered by psychotropic
drugs.
11. Describe how a neurotransmitter functions as a neuro-messenger.
12. Identify how specific brain functions are altered in certain mental disorders (e.g., depression, anxiety,
and schizophrenia).
13. Describe how the use of imaging techniques can be helpful for understanding mental illness.
14. Develop a teaching plan that includes side effects from dopamine blockage, such as motor
abnormalities.
15. Describe the result of blockage of the muscarinic receptors and the 1 receptors by the standard
neuroleptic drugs.
16. Briefly identify the main neurotransmitters affected by the following psychotropic drugs and their
subgroups:
a. Antianxiety agents
b. Sedative-hypnotic agents
c. Antidepressants
d. Mood stabilizers
e. Antipsychotic agents
f. Anticholinesterase drugs
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17. Identify special dietary and drug restrictions in a teaching plan for a patient taking a monoamine
oxidase inhibitor (MAOI).
18. Identify specific cautions you might incorporate into your medication teaching plan with regard to:
a. Herbal medicine
b. Genetic pharmacology (i.e., variations in effects and therapeutic actions of medications among
different ethnic groups)
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Class 5
FOUNDATIONS FOR PRACTICE
LEARNING ACTIVITIES: Read: Varcarolis: 62 Pages
 Chapter 4: Psychiatric Mental Health Nursing in Acute Care Settings, pp. 76

Chapter 5: Psychiatric Mental Health Nursing in Community Settings, pp. 87


Chapter 6: Cultural Implications for Psychiatric Mental Health Nursing, pp. 101
Chapter 7: Legal and Ethical Guidelines for Safe Practice, pp. 118
OBJECTIVES: After completion of the objectives the student will be able to:
1. Describe the population served by inpatient psychiatric care.
2. Identify funding options for acute care of psychiatric conditions and legislation related to insurance
reimbursement.
3. List the criteria for admission to inpatient care.
4. Identify the rights of hospitalized psychiatric patients.
5. Explain how the multidisciplinary treatment team collaborates to plan and implement care for the
hospitalized patient.
6. Explain the importance of monitoring patient safety during hospitalization.
7. Discuss the role of the nurse as advocate, provider of care, and manager of care for the patient on an
inpatient acute care unit.
8. Discuss the process for preparing patients to return to the community for ongoing care.
9. Discuss the continuum of psychiatric treatment.
10. Discuss barriers to mental health treatment.
11. Explain the evolution of the community mental health movement.
12. Identify elements of the nursing assessment that are critically important to the success of community treatment.
13. Discuss the continuum of psychiatric treatment.
14. Describe the role of the community psychiatric mental health nurse in disaster preparedness.
15. Describe the role of the psychiatric nurse in four specific settings: partial hospitalization program, psychiatric
home care, assertive community treatment, and community mental health center.
16. Discuss barriers to mental health treatment.
17. Examine influences on the future of community psychiatric mental health nursing.
18. Explain the importance of culturally relevant care in psychiatric mental health nursing practice.
19. Compare and contrast Western nursing beliefs, values, and practices with the beliefs, values, and
practices of patients from diverse cultures.
20. Develop culturally appropriate nursing care plans for patients of diverse cultures.
21. Identify the steps nurses are advised to take if they suspect negligence or illegal activity on the part of a
professional colleague or peer.
22. Apply legal considerations of patient privilege (a) after a patient has died, (b) if the patient tests positive
for human immunodeficiency virus, or (c) if the patient’s employer states a “need to know.”
23. Provide explanations for situations in which health care professionals have a duty to break patient
confidentiality.
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24. Discuss a patient’s civil rights and how they pertain to restraint and seclusion.
25. Develop awareness of the balance between the patient’s rights and the rights of society with respect to
the following legal concepts relevant in nursing and psychiatric mental health nursing: (a) duty to intervene,
(b) documentation, and (c) confidentiality.
26. Identify legal terminology (e.g., torts, negligence, and malpractice) applicable to psychiatric nursing,
and explain the significance of each term.
Class 6 Exam 2
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Class 7
Psychosocial Nursing Tools
LEARNING ACTIVITIES: Read: Varcarolis: 58 pages
 Chapter 30: Serious Mental Illness, pp. 667
 Chapter 34: Therapeutic Groups, pp. 736
 Chapter 19: Personality Disorders, pp. 433
OBJECTIVES: After completion of the objectives the student will be able to:
1. Discuss the effects of serious mental illness on daily functioning, interpersonal relationships, and
quality of life.
2. Describe three common problems associated with serious mental illness.
3. Discuss five evidence-based practices for the care of the person with serious mental illness.
4. Explain the role of the nurse in the care of the person with serious mental illness.
5. Discuss the causes of treatment non-adherence, and plan interventions to promote treatment
adherence.
6. Identify basic concepts related to group work.
7. Describe the phases of group development.
8. Define task and maintenance roles of group members.
9. Discuss the therapeutic factors that operate in all groups.
10. Discuss four types of groups commonly led by basic level registered nurses.
11. Describe a group intervention for (1) a member who is silent or (2) a member who is monopolizing
the group.
12. Analyze the interaction of biological determinants and psychosocial stress factors in the etiology of
personality disorders.
13. Identify the three clusters of personality disorders as currently defined.
14. Describe the major characteristic of one personality disorder from each cluster and give an example.
15. Formulate two nursing diagnoses for cluster B personality disorders.
16. Describe the emotional and clinical needs of nurses and other staff when working with patients who
meet criteria for personality disorders.
17. Discuss two nursing outcomes for patients with borderline personality disorder.
18. Plan basic interventions for a patient with impulsive, aggressive, or manipulative behaviors.
19. Identify interventions the advanced practice nurse can employ when working with nursing staff
caring for patients with personality disorders.
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Class 8
Psychobiological Disorders
LEARNING ACTIVITIES: Read: Varcarolis: 85 Pages
 Chapter 11: Understanding Responses to Stress pp. 195
 Chapter 12: Anxiety and Anxiety Disorders, pp.212
 Chapter 13: Depressive Disorders, pp. 246
OBJECTIVES: After completion of the objectives the student will be able to:
1. Recognize the short- and long-term physiological consequences of stress.
2. Compare and contrast Cannon’s (fight-or-flight), Selye’s (general adaptation syndrome), and psycho-neuroimmunological models of stress.
3. Describe how responses to stress are mediated through perception, personality, social support, culture, and
spirituality.
4. Compare and contrast the four levels of anxiety in relation to perceptual field, ability to learn, and
physical and other defining characteristics.
5.
6.
7.
8.
Identify defense mechanisms, and consider one adaptive and one maladaptive use of each.
Identify genetic, biological, psychological, and cultural factors that may contribute to anxiety disorders.
Describe clinical manifestations of each anxiety disorder.
Formulate four appropriate nursing diagnoses that can be used in treating a person with an anxiety
disorder.
9. Name three defense mechanisms commonly found in patients with anxiety disorders.
10. Describe feelings that may be experienced by nurses caring for patients with anxiety disorders.
11. Propose realistic outcome criteria for a patient with (a) generalized anxiety disorder, (b) panic disorder,
and (c) posttraumatic stress disorder.
12. Describe five basic nursing interventions used for patients with anxiety disorders.
13. Discuss three classes of medications appropriate for anxiety disorders.
14. Describe advanced practice and basic level interventions for anxiety disorders.
15. Compare and contrast major depressive disorder and dysthymic disorder.
16. Discuss the links between the stress model of depression and the biological model of depression.
17. Assess behaviors in a patient with depression in regard to each of the following areas: (a) affect, (b)
thought processes, (c) feelings, (d) physical behavior, and (e) communication.
18. Formulate five nursing diagnoses for a patient with depression, and include outcome criteria.
19. Name unrealistic expectations a nurse may have while working with a patient with depression, and
compare them to your own personal thoughts.
20. Evaluate the advantages of the selective serotonin reuptake inhibitors (SSRIs) over the Tricyclic
antidepressants (TCAs).
21. Explain the unique attributes of two of the atypical antidepressants for use in specific circumstances.
22. Describe the types of depression for which electroconvulsive therapy (ECT) is most helpful.
Class 9
Class 10
1 /11/2011
Nurs. 149-150
Spring Vacation
Exam 3
Enjoy!
Good Luck!
Page 19
Class 11
Psychobiological Disorders
LEARNING ACTIVITIES: Read: Varcarolis: 75 Pages
 Chapter 16: Eating Disorders, pp. 344
 Chapter 17: Cognitive Disorders, pp. 369
 Chapter 20: Sleep Disorders, pp. 461
OBJECTIVES: After completion of the objectives the student will be able to:
1. Discuss four theories of eating disorders.
2. Compare and contrast the signs and symptoms of anorexia nervosa and bulimia nervosa.
3. Identify three life-threatening conditions, stated in terms of nursing diagnoses, for a patient with an
eating disorder.
4. Identify three realistic outcome criteria for (a) a patient with anorexia nervosa and (b) a patient with
bulimia nervosa.
5. Describe therapeutic interventions appropriate for anorexia nervosa and bulimia nervosa in the acute
phase and long-term phase of treatment.
6. Explain the basic premise of cognitive-behavioral therapy in the treatment of eating disorders.
7. Differentiate between the long-term prognoses of anorexia nervosa, bulimia nervosa, and binge eating
disorder.
8. Compare and contrast the clinical picture of delirium with that of dementia.
9. Discuss three critical needs of a person with delirium, stated in terms of nursing diagnoses.
10. Identify three outcomes for patients with delirium.
11. Summarize the essential nursing interventions for a patient with delirium.
12. Recognize the signs and symptoms occurring in the four stages of Alzheimer’s disease.
13. Give an example of the following symptoms assessed during the progression of Alzheimer’s disease:
(a) amnesia, (b) apraxia, (c) agnosia, and (d) aphasia.
14. Formulate three nursing diagnoses suitable for a patient with Alzheimer’s disease, and define two
outcomes for each.
15. Compose a list of appropriate referrals in the community—including a support group, hotline for
information, and respite services—for persons with dementia and their caregivers.
16. Discuss the impact of inadequate sleep on overall health and well-being.
17. Describe the social and economic impact of sleep disturbance and chronic sleep deprivation.
18. Recognize the risks to personal and community safety imposed by sleep disturbance and chronic sleep
deprivation.
19. Describe normal sleep physiology, and explain the variations in normal sleep.
20. Differentiate between dys-somnias and para-somnias, and identify at least two examples of each.
21. Identify the predisposing, precipitating, and perpetuating factors for patients with insomnia.
22. Identify and describe the use of two assessment tools in the evaluation of patients experiencing sleep disturbance.
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Class 12
Addictive Disorders
LEARNING ACTIVITIES: Read: Varcarolis: 31 Pages
 Chapter 18: Addictive Disorders, pp. 402
OBJECTIVES: After completion of the objectives the student will be able to:
1. Compare and contrast the terms substance abuse and substance dependence, as defined by the
Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR).
2. Discuss four components of the assessment process to be used with a person who is chemically
dependent.
3. Describe the difference between the behaviors of a person with alcoholism and a nondrinker in relation
to blood alcohol level.
4. Discuss the symptoms of alcohol withdrawal and alcohol delirium and the recommended treatments for
each.
5. Describe the signs of alcohol poisoning and the appropriate treatment based on the individual’s
presentation.
6. List the appropriate steps to take if one observes an impaired co-worker.
7. Describe aspects of enabling behaviors and give examples.
8. Compare and contrast the signs and symptoms of intoxication, overdose, and withdrawal for cocaine and
amphetamines.
9. Distinguish between the symptoms of narcotic intoxication and those of narcotic withdrawal.
10. Identify two short-term goals for a person who abuses alcohol in terms of (a) withdrawal, (b) active
treatment, and (c) health maintenance.
11. Analyze the pros and cons of the following treatments for narcotic addictions: (a) methadone or l-αacetylmethadol (LAAM), (b) therapeutic communities, and (c) abstinence-oriented self-help programs.
12. Recognize the phenomenon of relapse as it affects people who abuse substances during different phases
of treatment.
13. Evaluate four indications that a person is successfully recovering from substance abuse.
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Class 13
Psychobiological Disorders
LEARNING ACTIVITIES: Read: Varcarolis: 73 pages
 Chapter 21: Sexual Dysfunction & Sexual Disorders, pp. 480
 Chapter 22: Somatoform, Factitious, and Dissociative Disorders, pp. 502
 Chapter 23: Crisis and Disaster, pp. 528
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1.
Describe the four phases of the sexual response cycle.
2. Define at least three areas of sexual dysfunction, and describe the treatment of each.
3. Consider the impact of medical problems and treatments on normal sexual functioning.
4. Examine the importance of nurses being knowledgeable about and comfortable discussing topics pertaining to
sexuality.
5. Describe treatments available for sexual dysfunction.
6. Apply assessment techniques by role-playing with a classmate the taking of a sexual history. Discuss how you feel
and how your feelings influence your ability to perform this assessment.
7. Identify sexual preoccupations considered to be sexual disorders.
8. Discuss personal values and biases regarding sexuality and sexual behaviors.
9. Compare and contrast essential characteristics of the somatoform, factitious, and dissociative disorders.
10. Give a clinical example of what would be found in each of the somatoform disorders.
11. Describe five psychosocial interventions that would be appropriate for a patient with somatic complaints.
12. Plan interventions for a patient with conversion disorder who is receiving a great deal of secondary gain
from his or her “blindness.”
13. Describe disorders that are conscious attempts to deceive health care professionals.
14. Explain the key symptoms of the four dissociative disorders.
15. Compare and contrast dissociative amnesia and dissociative fugue.
16. Identify three specialized elements in the assessment of a patient with a dissociative disorder.
17. Identify nursing interventions for patients with somatoform and dissociative disorders.
18. Differentiate among the three types of crisis.
19. Delineate six aspects of crisis that have relevance for nurses involved in crisis intervention.
20. Develop a handout describing areas to assess during crisis.
21. Discuss four common problems in the nurse-patient relationship that are frequently encountered by
beginning nurses when starting crisis intervention.
22. Identify interventions for problems in nurse-patient relationships.
23. Compare and contrast the differences among primary, secondary, and tertiary intervention, including
appropriate intervention strategies.
24. List at least five resources in the community that could be used as referrals for a patient in crisis.
Class 14—Exam 4
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Class 15
Trauma Interventions
LEARNING ACTIVITIES: Read: Varcarolis: 68 pages
 Chapter 26: Child, Older Adult, and Intimate Partner Abuse, pp. 584
 Chapter 27: Sexual Assault, pp. 609
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Identify three indicators of (a) physical abuse, (b) sexual abuse, (c) neglect, and (d) emotional abuse.
2. Discuss the epidemiological theory of abuse in terms of stresses on the perpetrator, vulnerable person,
and environment that could escalate anxiety to the point at which abuse becomes the relief behavior.
3. Compare and contrast three characteristics of perpetrators with three characteristics of a vulnerable
person.
4. Describe four areas to assess when interviewing a person who has experienced abuse.
5. Identify two common emotional responses the nurse might experience when faced with a person
subjected to abuse.
6. Formulate four nursing diagnoses for the survivor of abuse, and list supporting data from the
assessment.
7. Write out a safety plan with the essential elements for a victim of intimate partner abuse.
8. Compare and contrast primary, secondary, and tertiary levels of intervention, giving two examples of
intervention for each level.
9. Describe at least three possible referrals for an abusive family, including the telephone numbers of
appropriate agencies in the community.
10. Discuss three psychotherapeutic modalities useful in working with abusive families.
11. Define sexual assault, attempted rape, and rape.
12. Discuss the underreporting of sexual assault.
13. Describe the profile of the victim and the perpetrator of sexual assault.
14. Distinguish between the acute and long-term phases of the rape-trauma syndrome, and identify some common
reactions during each phase.
15. Identify and give examples of five areas to assess when working with a person who has been sexually assaulted.
16. Formulate two long-term outcomes and two short-term goals for the nursing diagnosis Rape-trauma syndrome.
17. Analyze one’s own thoughts and feelings regarding the myths about rape and its impact on survivors.
18. Identify six overall guidelines for nursing interventions related to sexual assault.
19. Describe the role of the sexual assault nurse examiner to a colleague.
20. Discuss the long-term psychological effects of sexual assault that might lead to a survivor’s seeking
psychotherapy.
21. Identify three outcome criteria that would signify successful interventions for a person who has suffered a sexual
assault.
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Class 16
Interventions for Special Populations
LEARNING ACTIVITIES: Read: Varcarolis: 45 Pages
 Chapter 33: Forensic Nursing, pp. 725
 Chapter 35: Family Interventions, pp. 749
 Chapter 36: Integrative Care, pp. 767
OBJECTIVES: Upon completion of the objectives, the student will be able to:
1. Define forensic nursing, forensic psychiatric nursing, and correctional nursing.
2. Describe the educational preparation required for the forensic nurse generalist and the advanced practice forensic
nurse.
3. Identify the functions of forensic nurses.
4. Discuss the specialized roles in forensic nursing.
5. Identify three roles of psychiatric nurses in the specialty of forensic nursing.
6. Discuss the differences between a fact witness and an expert witness.
7. Compare and contrast the roles of forensic nurses and correctional nurses.
8. Discuss the characteristics of a healthy family using clinical examples.
9. Differentiate between functional and dysfunctional family patterns of behavior as they relate to the five
family functions.
10. Compare and contrast insight-oriented family therapy and behavioral family therapy.
11. Identify five family theorists and their contributions to the family therapy movement.
12. Analyze the meaning and value of the family’s socio-cultural context when assessing and planning
intervention strategies.
13. Formulate seven outcome criteria that a counselor and family might develop together.
14. Identify some strategies for family intervention.
15. Explain the importance of the nurse’s role in psycho-educational family therapy.
16. Define the terms integrative medicine, integrative care, and complementary and alternative medicine.
17. Identify trends in the use of nonconventional health treatments and practices.
18. Explore the category of alternative medical systems, along with the four domains of integrative care:
mind-body approaches, biologically based interventions, manipulative approaches, and energy therapies.
19. Discuss the techniques used in major complementary therapies and potential applications to psychiatric
mental health nursing practice.
20. Discuss how to educate the public in the safe use of integrative modalities and avoidance of false claims
and fraud related to the use of alternative and complementary therapies.
21. Explore information resources available through literature and online sources.
Class 17—Final Exam
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Page 24