Why Worry?
Is this normal anxiety, acute anxiety, pathological or chronic anxiety?
Differs from normal anxiety in terms of duration, intensity, and disturbance in a person’s ability to function
What is Pathological anxiety
Sudden onset of extreme apprehension or fear, usually with a feeling of impending doom.
• Terror is so severe that normal function is suspended
• Physical symptoms may resemble a heart attack
What is Panic Disorders (PD)
What Crisis is this Maturational, Situational, or Adventitious (disasters)?
occur when a person is unable to cope with the natural process of development usually occurring at times of transition, such as when the first child is born, when a child reaches adolescence, and when the head-of-the- household retires.
What is Maturational Crisis
An emotional response to frustration of desires, a threat to one’s needs (emotional or physical), or a challenge.
is a normal and not always logical human
emotion.
varies in intensity from mild irritation to intense
fury and rage.
What is Anger?
Resembles schizophrenia
Odd thinking and beliefs
Magical thinking and rituals, ideas of reference, and
unusual perceptual experiences that are not consistent with cultural norms
May have an inappropriate effect and an odd, eccentric, or peculiar appearance
May become suspicious of others and eventually develop paranoid thinking
Some individuals later develop schizophrenia
Up to 10% of suicide
What is Schizotypal Personality Disorder?
PG 170
Is this normal anxiety, acute anxiety, pathological or chronic anxiety?
Healthy life force necessary for survival.
What is Normal Anxiety
is a common, chronic and long-lasting disorder in which a person has uncontrollable recurring thoughts and behaviors that the person feels the urge to repeat over and over.
OCD- Obsessive-Compulsive Disorder
What Crisis is this Maturational, Situational, or Adventitious (disasters)?
Is not a common part of everyday life and much larger in scale and impacts the community not just an individual. unplanned and tend to be catastrophic. examples: tsunamis, fires, hurricanes, earthquakes, flooding and terrorist attacks.
What is an adventitious Crisis?
The unjust, unwarranted, or unlawful display of verbal threats, intimidation, or physical force with the intent of causing property damage, personal injury, or even death to another individual.
does not always have its roots in anger, but it
does have the discrete intention of doing harm to a
specific person or group.
is defined as an unjust, unwarranted, or
unlawful display of verbal threats, intimidation, or
physical force.
Its intent is to inflict harm, damage, or violate.
What is Violence?
Pervasive, persistent, inappropriate suspiciousness and distrust of others
May present with hostile, irritable, angry mood and affect
Frequently suspect that others are exploiting or deceiving them
Reads hidden meanings into benign remarks and
perceives attacks that are not apparent to others
What is Paranoid Personality Disorder (PPD)?
Is this normal anxiety, acute anxiety, pathological or chronic anxiety?
Precipitated by imminent loss or threat.
What is Acute anxiety?
Excessive anxiety and worry about a number of events and activities
Symptoms may include restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep disturbance
What is Generalized anxiety disorder (GAD)
What Crisis is this Maturational, Situational, or Adventitious (disasters)?
is the result of unexpected trauma such as losses, illness, or displacement.
Examples: external source, unanticipated
loss of job/change job, death of a loved one
unwanted pregnancy, a move, change in financial status, divorce, severe physical or mental illness
response to the situation depends on support from family, friends, or support groups
crisis that threatens a person's self-esteem and self-concept
What is Situational Crisis?
Anger’s motor counterpart
Goal-directed action or behavior that results in a verbal or physical attack.
is not the same as violence.
maybe appropriate.
Self-protective, as in protecting oneself or one’s family
Protective, as in protecting self from being bullied
Is the act of initiating hostilities.
Is hostility that arouses thoughts of attack
and/or a disposition to behave aggressively.
What is Aggression?
Disregard for and violation of the rights of others
Lack of remorse for actions or hurting others
Sense of entitlement
History of persistent lying, deception, and conning others for profit or pleasure
May be charming and engaging
Behavior can be described as manipulative and
irresponsible
May engage in risky activities to “feel alive”
More common in males
What is Antisocial Personality Disorder?
Is this normal anxiety, acute anxiety, pathological or chronic anxiety?
Long-term; thought to be associated with increased risk for cardiovascular morbidity; usually begins at a young age.
What is Chronic Anxiety?
Is severe anxiety provoked by exposure to a social or performance situation
Fear of saying something foolish, not being able to answer questions in a classroom, eating in the presence of others, and performing on a stage, among others.
Fear of public speaking is the most common.
What is SAD- Social Anxiety Disorders/
Social Phobias
Ms. T., a single mother of four, comes to the crisis
center 24 hours after an apartment fire in which
all the family’s household goods and clothing
were lost. Ms. T. has no family in the area. Her
efforts to mobilize assistance have been
disorganized, and she is still without shelter. She
is distraught and confused. The nurse assesses
the situation as which of the following types of
crisis?
A. Maturational crisis
B. Situational crisis
C. Adventitious crisis
D. Evidence of an inadequate personality
C. Adventitious crisis
An adult with paranoia becomes agitated and threatens to assault a staff person. Select the best initial nursing intervention.
A. Tell the patient, “If you do not calm down, seclusion will be needed.”
B. Address the patient with simple directions and a calming voice.
C. Help the patient focus by rubbing the patient’s shoulders.
D. Offer the patient a dose of antipsychotic medication.
E. Reorient the patient to the time and place.
B. Address the patient with simple directions and a calming voice.
Trouble with instability in mood, thinking, behavior,
and personal relationships
Unstable self-image and marked impulsivity
Maladaptive behaviors
Unstable and intense relationships alternating
between idealization and devaluation
Desperately seek relationships to avoid feelings of
abandonment and chronic feelings of emptiness
Frantic efforts to avoid real or imagined abandonment
Inappropriate, intense anger or poor anger control
What is Borderline Personality Disorder?
Name four levels of anxiety.
Mild
Moderate
Severe
Panic level
Rene, a restaurant manager, is hospitalized after working 15-hour days for several weeks. Her anxiety level is severe upon admission. She has not slept well during the past 2 weeks. Her psychiatrist has ordered amitriptyline (Elavil) 25 mg, to be administered orally, three times daily. Rene asks you, her nurse, why she is so drowsy. What is your best response?
A. “Drowsiness is a side effect of this medication.”
B. “Don’t worry about being drowsy at this time.”
C. “Aren’t you glad you will finally get to sleep?”
D. “I will tell the doctor. I don’t want you to fall.”
A. “Drowsiness is a side effect of this medication.”
For a nurse working in crisis intervention, which belief would be least helpful?
A. A person in crisis is incapable of making his or her
own decisions.
B. The crisis counseling relationship is one between
partners.
C. Crisis counseling helps the patient refocus to gain
new perspectives on the situation.
D. Anxiety reduction techniques are used to enable the patient’s inner resources to be accessed.
A. A person in crisis is incapable of making his or her own decisions.
Mrs. H, 87, is anxious. She tells you she must go home immediately, saying: “My twins need me. They’re barely a year old!” Select the best response.
A. Help reorient her by explaining patiently that she is too old now to still have babies.
B. Ask her questions to describe her need to go home and sympathize with how hard it can be to be away from home.
C. Implement withdrawal and promise to return in 10 minutes when she is calmer and more rational.
D. Reward her with attention when she focuses on reality.
B. Ask her questions to describe her need to go home and sympathize with how hard it can be to be away from home.
Grandiose sense of self-importance
Preoccupation with fantasies of unlimited success
Demeanor may be arrogant and haughty
Require excessive admiration
Lack empathy for the needs or feelings of others
Exploit others to meet their own needs
Often envious of others’ successes or possessions
Believe others are envious of them
What is Narcissistic Personality Disorder?