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Legal Holds & Terms
California involuntary hold framework (Lanterman-Petris-Short Act). Verify specifics against current code and facility policy.
5150 — 72-Hour Hold
An involuntary psychiatric hold of up to 72 hours for a person who, due to a mental health disorder, is deemed a danger to self, a danger to others, or gravely disabled. Initiated by authorized personnel.
5250 — 14-Day Hold
A certification for up to 14 days of additional intensive treatment following a 5150, when the person continues to meet criteria. Requires a certification review hearing to protect patient rights.
5270 — 30-Day Hold
An additional period of intensive treatment (up to 30 days) for certain gravely disabled patients who continue to meet criteria after a 5250, where authorized.
5260 — Additional 14 Days (Suicidality)
A further certification of up to 14 days for a person who remains a danger to self after an initial 5250.
5585 — Minor Hold
The provision addressing involuntary crisis holds for minors experiencing a mental health crisis.
Gravely Disabled
A condition in which a person, due to a mental health disorder, is unable to provide for their basic personal needs for food, clothing, or shelter. One of the criteria for an involuntary hold.
LPS Act
The Lanterman-Petris-Short Act — the California law governing involuntary civil commitment and the rights of people with mental health disorders.
5150 Designation
The authorization, granted to specific trained personnel, to write (initiate) an involuntary hold.
Riese Hearing
A hearing to determine a patient’s capacity to refuse antipsychotic medication; addresses treatment over objection in non-emergency situations.
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Legal & Deposition Terms
Terms nurses may encounter in chart review, litigation, or Legal Nurse Consulting (LNC) work. Not legal advice — consult an attorney for guidance on a specific matter.
Legal Nurse Consultant (LNC)
A nurse who applies clinical expertise to legal cases — reviewing medical records, assessing standard of care, and supporting attorneys in litigation. A recognized specialty and certification path (LNCC) for experienced RNs.
Deposition
Sworn, out-of-court testimony given under oath and recorded by a court reporter, used to gather evidence before trial. A nurse may be deposed as a fact witness (about care they provided) or an expert witness (about standard of care generally).
Discovery
The pre-trial process in which both sides in a lawsuit exchange evidence — records, documents, and testimony — relevant to the case.
Subpoena
A legal order requiring a person to appear and testify. A subpoena duces tecum specifically compels production of documents or records.
Interrogatories
Written questions sent by one party to another during discovery, which must be answered in writing and under oath.
Standard of Care
The level and type of care a reasonably prudent nurse, with similar training, would provide under similar circumstances. Central to most nursing malpractice claims.
Fact Witness vs. Expert Witness
A fact witness testifies only about what they personally observed or did. An expert witness offers a professional opinion — such as whether the standard of care was met — and generally must be separately qualified to do so.
Negligence
A legal claim requiring proof of four elements: a duty of care existed, that duty was breached, the breach caused harm, and the patient suffered actual damages.
Malpractice
Professional negligence by a licensed provider — a failure to meet the standard of care that results in patient harm.
Plaintiff / Defendant
The plaintiff is the party bringing the lawsuit (often the patient or their family); the defendant is the party being sued (which may include the nurse, provider, or facility).
Statute of Limitations
The legal time limit within which a lawsuit must be filed. Varies by claim type and jurisdiction — missing it generally bars the claim entirely.
Affidavit
A written statement of facts, signed and sworn to be true under penalty of perjury, often submitted as evidence.
Voir Dire
The process of questioning a potential witness (or juror) to establish their qualifications or credibility before they're permitted to testify or serve.
Spoliation
The destruction, alteration, or failure to preserve evidence — including medical records — that a party knew or should have known was relevant to a potential legal claim. Can carry serious legal consequences.
Litigation Hold
A formal notice requiring an organization to preserve all records and documents relevant to anticipated or ongoing litigation, and to suspend routine destruction or overwriting of that data.
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Assessment Scales & Tools
Common screening and rating instruments used in psychiatric nursing practice.
PHQ-9 — Patient Health Questionnaire
A 9-item self-report tool that screens for and measures the severity of depression.
GAD-7 — Generalized Anxiety Disorder scale
A 7-item self-report tool used to screen for and measure the severity of generalized anxiety.
C-SSRS — Columbia Suicide Severity Rating Scale
A structured tool used to assess the severity and immediacy of suicidal ideation and behavior.
AIMS — Abnormal Involuntary Movement Scale
A tool used to screen for and monitor tardive dyskinesia, especially in patients on antipsychotics.
CIWA-Ar — Clinical Institute Withdrawal Assessment for Alcohol
A scale used to assess and manage the severity of alcohol withdrawal.
MMSE / MoCA
Brief cognitive screening tools (Mini-Mental State Exam; Montreal Cognitive Assessment) used to assess cognition.
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Medication Categories
Broad drug classes only. Always confirm dosing, indications, and warnings with current prescribing information.
Antipsychotics (Typical & Atypical)
Medications used to treat psychosis, schizophrenia, and bipolar disorder. “Typical” (first-generation) and “atypical” (second-generation) differ in side-effect profiles.
LAIs — Long-Acting Injectables
Antipsychotic medications given by injection at intervals (e.g., every 2 weeks to 3 months) to support adherence.
Mood Stabilizers
Medications used to manage mood episodes in bipolar disorder (e.g., lithium and certain anticonvulsants). Several require blood-level or organ monitoring.
Antidepressants (SSRIs, SNRIs, etc.)
Medications used to treat depression and anxiety disorders, grouped by mechanism (e.g., SSRIs, SNRIs, atypicals, TCAs, MAOIs).
Anxiolytics / Benzodiazepines
Medications used for acute anxiety and agitation; benzodiazepines carry dependence and sedation risks and require careful use.
Stimulants & ADHD Medications
Medications used to treat attention-deficit/hyperactivity disorder, including stimulant and non-stimulant options.
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Clinical Terms & Abbreviations
Frequently used terminology in psychiatric nursing.
EPS — Extrapyramidal Symptoms
Movement-related side effects (e.g., dystonia, akathisia, parkinsonism) associated with antipsychotic medications.
NMS — Neuroleptic Malignant Syndrome
A rare, life-threatening reaction to antipsychotics marked by high fever, rigidity, and autonomic instability. A medical emergency.
Tardive Dyskinesia
Involuntary, repetitive movements that can develop with long-term antipsychotic use; monitored with the AIMS.
SI / HI
Suicidal Ideation / Homicidal Ideation — documented components of a mental status and risk assessment.
MSE — Mental Status Exam
A structured assessment of a patient’s appearance, behavior, mood, affect, thought process, thought content, cognition, insight, and judgment.
Affect vs. Mood
Affect is the observed, moment-to-moment emotional expression; mood is the patient’s sustained, self-reported emotional state.
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Therapy Modalities
Common evidence-based approaches referenced in psychiatric care.
CBT — Cognitive Behavioral Therapy
A structured, goal-oriented therapy focused on identifying and changing unhelpful thought and behavior patterns.
DBT — Dialectical Behavior Therapy
A therapy combining acceptance and change strategies; emphasizes mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
ACT — Acceptance and Commitment Therapy
An approach that promotes psychological flexibility through acceptance, mindfulness, and values-based action.
Motivational Interviewing
A collaborative, patient-centered method for strengthening a person’s own motivation and commitment to change.
Trauma-Informed Care
An approach that recognizes the widespread impact of trauma and emphasizes safety, trust, and avoiding re-traumatization.
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Common Psychiatric Diagnoses
Plain-language summaries, not diagnostic criteria. Based on DSM-5-TR (2022), the current edition — always defer to a qualified clinician and the full manual for actual diagnosis.
Major Depressive Disorder (MDD)
Persistent depressed mood and/or loss of interest or pleasure most of the day, nearly every day, for at least two weeks — along with changes in sleep, appetite, energy, concentration, or self-worth severe enough to impair daily functioning.
Generalized Anxiety Disorder (GAD)
Excessive, difficult-to-control worry across multiple areas of life, present more days than not for at least six months, along with physical symptoms like restlessness, fatigue, or muscle tension.
Bipolar I Disorder
Marked by at least one manic episode — a period of abnormally elevated or irritable mood and increased energy lasting at least a week and severe enough to disrupt functioning — often accompanied by depressive episodes as well.
Bipolar II Disorder
A pattern of at least one hypomanic episode (a milder, shorter version of mania that doesn’t cause severe impairment) and at least one major depressive episode, without a full manic episode.
Schizophrenia
A chronic psychotic disorder involving a mix of hallucinations, delusions, disorganized thinking or speech, and/or negative symptoms (such as flattened affect or reduced motivation), present for a significant portion of time over at least six months.
Schizoaffective Disorder
Features of both schizophrenia and a major mood episode (depressive or manic) occurring together, with psychotic symptoms also present independent of the mood episode.
Posttraumatic Stress Disorder (PTSD)
Persistent re-experiencing, avoidance, negative shifts in mood or thinking, and heightened arousal following exposure to a traumatic event, lasting more than a month and impairing functioning.
Obsessive-Compulsive Disorder (OCD)
Recurrent, intrusive thoughts (obsessions) and/or repetitive behaviors or mental acts (compulsions) performed to reduce distress, consuming significant time or causing impairment. Distinct from Obsessive-Compulsive Personality Disorder.
Panic Disorder
Recurrent, unexpected panic attacks — sudden surges of intense fear with physical symptoms — followed by persistent worry about future attacks or their consequences.
Social Anxiety Disorder
Marked, persistent fear of social situations involving possible scrutiny by others, leading to avoidance or significant distress.
Attention-Deficit/Hyperactivity Disorder (ADHD)
A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning, with symptoms present before age 12.
Delirium
An acute, fluctuating disturbance in attention and awareness with an underlying medical cause. Often reversible, and distinct from dementia, which has a more gradual onset.
Major Neurocognitive Disorder (Dementia)
A significant decline from a previous level of cognitive functioning in one or more domains — such as memory, language, or executive function — that interferes with independence.
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Personality Disorders
The 10 personality disorders recognized in DSM-5-TR, grouped by cluster. Plain-language summaries, not diagnostic criteria.
Cluster AParanoid Personality Disorder
A pervasive pattern of distrust and suspicion of others’ motives, often interpreting others’ actions as threatening or malicious without clear evidence.
Cluster ASchizoid Personality Disorder
A persistent pattern of detachment from social relationships and a limited range of emotional expression, with little apparent desire for closeness.
Cluster ASchizotypal Personality Disorder
Acute discomfort in close relationships, along with eccentric behavior, odd beliefs, or perceptual distortions that fall short of true psychosis.
Cluster BAntisocial Personality Disorder
A pervasive disregard for and violation of the rights of others, typically beginning in childhood or early adolescence, often involving deceit, impulsivity, or lack of remorse.
Cluster BBorderline Personality Disorder
A pattern of instability in relationships, self-image, and emotions, along with marked impulsivity — often including fear of abandonment and difficulty regulating intense emotions.
Cluster BHistrionic Personality Disorder
A pattern of excessive emotionality and attention-seeking behavior across a variety of contexts.
Cluster BNarcissistic Personality Disorder
A pervasive pattern of grandiosity, a need for admiration, and a lack of empathy for others.
Cluster CAvoidant Personality Disorder
Social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, leading to avoidance of interpersonal contact despite a desire for connection.
Cluster CDependent Personality Disorder
An excessive need to be taken care of that leads to submissive, clinging behavior and fear of separation from those depended upon.
Cluster CObsessive-Compulsive Personality Disorder
A preoccupation with orderliness, perfectionism, and control, often at the expense of flexibility and efficiency. Distinct from OCD, which involves true obsessions and compulsions.