Anxiety Disorders
What medication is used for anxiety that is non-habit forming and takes a few weeks to be therapeutic
Buspirone
What is depersonalization disorder and how does it manifest?
daily double
A feeling of detachment from one's body or mental processes
Depersonalization is characterized by a sense of unreality or self-estrangement.
Deficits in voluntary motor or sensory functions, including paralysis, blindness, movement disorder, gait disorder, numbness, paresthesia, loss of vision or hearing, or episodes resembling epilepsy.
Conversion Disorder
Name three impulse control disorders
ODD, Conduct, Intermittent Explosive
Job loss or change, the death of a loved one, a change in financial status, divorce, and psychiatric or physical illness.
Situational Crisis
Members realize that they are not alone with their problems, feelings, or thoughts.
Universality
Helps patients clarify their own thoughts and maximize mutual understanding between nurse and patient.
Seeking clarification
Gathering further data
• Identifying problem-solving skills and self-esteem
• Providing education about the disorder
• Promoting symptom management
• Providing medication education
• Evaluating progress
Working Phase
A 4-year-old boy with a new baby brother temporarily starts sucking his thumb and asking for a baby bottle.
Regression
Therapeutic technique that Lessens feelings of isolation
Empathic listening.
A woman suddenly finds she cannot see but seems unconcerned about her symptom and tells her husband, “Don’t worry, dear. Things will all work out.” Her attitude is an example of what process?
La belle indifference
La belle indifference is an attitude of unconcern about a symptom that is unconsciously used to lower anxiety.
Use a flat neutral tone of voice when correcting behavior
Use nonthreatening body posture
Speak matter-of-fact in easy to understand words.
Consistently set limits
Avoid personal terms such as "I" or "you" when setting limits
Ways to communicate with a potentially hostile patient
leaving home for the first time, marriage, the birth of a child, retirement, and the death of a parent.
Maturational crisis
The leader shares optimism about the successes of group treatment, and members share their improvements.
Installation of hope
Repeats the main idea expressed. Gives the patient an idea of what has been communicated. If the message has been misunderstood, the patient can clarify it.
Restating
Summarizing the goals and objectives achieved
• Reviewing patient education and providing handouts
• Discussing ways for the patient to incorporate new coping strategies
Termination Phase
A shorter-than-average man becomes assertively verbal and excels in business.
Compensation
Symptoms of this disorder includes
Depression
Guilt
Anger
Social withdrawal
Adjustment disorder
The primary difference between unconscious and conscious somatic disorders are?
Unconscious not under the patients voluntary control
Somatic symptoms (headache, N/V, sweating, GI etc.)
Conscious disorders have a symptomatology that is actually controlled by the client.
Factitious disorders & malingering in contrast to other somatic disorders, are under conscious control.
Angry/irritable mood.
Argumentative defiant behavior.
Vindictiveness.
Despite behavior, the person recognizes that others have rights and that there are rules
Oppositional Defiant Disorder
Defense mechanisms fail and the threat persists, anxiety will continue to rise, producing increased discomfort. Trial and error fails
Phase 2
A genuine expression of feelings that can be interpreted by both the patient and the group. Overexpression can be detrimental to group processes.
Catharsis
Expressing uncertainty regarding the reality of the patient’s perceptions or conclusions, especially in hallucinations and delusions.
Voicing doubt
The initial, brief, and adaptive response (fight or flight) to the stressor. It begins with the eyes or ears sending information, such as the sight of car headlights or the sound of a fire alarm, to the brain’s amygdala.
Alarm Stage
Experience of terror
Immobility, severe hyperactivity, or flight
Unintelligible communication or inability to speak
Amplified or muffled sounds
Somatic complaints increase (numbness or tingling, shortness of breath, dizziness, chest pain, nausea, trembling, chills, overheating, palpitations)
Severe withdrawal
Hallucinations or delusions
Likely out of touch with reality
Panic level anxiety
Childhood physical, sexual, or emotional abuse and other traumatic events are associated with adults experiencing what disorder?
Dissociative
Nursing assessment for patients with Somatic Symptom Disorders
1. Assess for nature, location, onset, characteristics and duration of symptoms
2. Explore past history of adverse childhood events
3. Identify symptoms of anxiety, depression & past trauma
4. Determine current quality of life, social support & coping skills.
5. Identify any secondary gains
6. Explore the patients cognitive style & ability to communicate feelings/needs
7. Assess current psychosocial and biological needs
8. Screen for misuse of prescribed medications and or substance use
Unimpulsive violation of the rights of others, aggression to people and animals, destruction of property, deceitfulness, violates rules.
Conduct Disorder
New coping skills are ineffective, anxiety can overwhelm the person and lead to serious personality disorganization, depression, confusion, violence against others, or suicidal behavior.
Phase 4
Provide the group member with a reminder that all members have an equal chance to contribute and members can evaluate a group members dominance.
Intervention for monopolizing member
Assumes the nurse knows best and the patient can’t think for oneself. Inhibits problem solving and fosters dependency.
Giving Advice
When attempts to resist the stressor prove futile. At this point, resources are depleted, and the stress may become chronic.
Exhaustion stage
A fear of open spaces and name a therapeutic intervention
Agoraphobia/Exposure Therapy
Trauma interventions for a child with PTSD
- Establish trust and safety
- Use developmentally appropriate language to explore feelings
- Teach relaxation techniques before trauma exploration
Help identify and cope with feelings through the use of art & play to promote expression
Involve the parents or caregivers in 1:1 unless they are the cause of trauma
Educate child & parents about the grief process and response to the trauma
Assist parents in resolving their own emotional distress about the trauma.
Coordinate with social work for protection as needed.
Which disorder is characterized by the client’s misinterpretation of physical sensations or feelings?
Illness anxiety disorder
Previously known as hypochondriasis, illness anxiety disorder results in the misinterpretation of physical sensations as evidence of a serious illness. Illness anxiety can be quite obsessive, because thoughts about illness may be intrusive and difficult to dismiss, even when the patient recognizes that his or her fears are unrealistic.
Planned ignoring
Physical distance and touch control
Redirection positive feedback
Clarification as intervention
Restructuring
Limit Setting
Simple restitution
Physical Restraint
What are techniques for managing disruptive behaviors?
Teach the patient specific coping skills, such as decision making, problem solving, assertiveness skills, meditation, and relaxation skills.
Primary Prevention
Exerts control over the group and do not directly encourage much interaction among members. For example, staff leading a daily community meeting for patients in a psychiatric hospital with a fixed, time-limited agenda
Autocratic leadership
1. Communication style.
2. Use of eye contact.
3. Perception of touch.
4. Cultural filters.
Cultural Considerations
People are taught to focus on pleasant images to replace negative or stressful feelings. May be self-directed or guided by practitioner