Personality Disorders
Grief & Loss
Cognitive Disorders
Neurodevelopmental disorders

What are the traits of Borderline Personality Disorder?

-Anger/Hostility   -Mistrust

-Risk-Taking    -Labile moods

-Lack of Guilt


-Negative behavior 


What are the 5 types of losses?

-Physiological loss

-Safety Loss

-Loss of security, sense of belonging

-Loss of self-esteem 

-Loss related to self-actualization



Syndrome involving disturbance of consciousness with change in cognition


-usually from an identifiable disturbance or disease / drug intoxication or withdrawal

-can be treated with treatment for underlying cause


Types of Autism Disorders

–Autism (classic autism)

–Rett’s disorder

–Childhood disintegrative disorder

–Asperger’s disorder


Positive and Negative effects of psychosis 

–Positive (hard)

•Delusions, hallucinations; grossly disorganized thinking, speech, behavior

–Negative (soft)

•Flat affect, lack of volition, social withdrawal, or discomfort


What is Avoidant Personality Disorder?

(Cluster C)

Having social discomfort, low self-esteem, hypersensitivity to negative evaluation. 


Kubler-Ross's Five Stages








-Irreversible, Multiple cognitive deficits; primarily memory plus any of the following:–Aphasia (echolalia, palilalia) –Apraxia –Agnosia –Disturbance in executive function                        -Stages: Mild, Moderate, Severe

Medications: cholinesterase inhibitors. 

•Etiology: variable causes; decreased metabolic activity found postmortem

Symptomatic treatment: antidepressants, antipsychotics, mood stabilizers

•Research to identify risk factors for dementia (elevated levels of plasma homocysteine)



–Present by early childhood (18 months to 3 years); boys five times more than girls

-Little eye contact.  - few facial expressions   -limited gestures to communicate. -lack of spontaneous enjoyment.  -inability to engage in play.   -stereotyped motor behaviors

–Genetic link; controversy with MMR vaccine

–Goals: reduce behavioral symptoms, promote learning and development

–Special education, language therapy; medications for target symptoms



•Distorted and bizarre thoughts, perceptions, emotions, movements, behavior

•The peak incidence of onset is 15 to 25 years of age for men and 25 to 35 years of age for women.

psychotic and mood symptoms

Genetics or –Neuroanatomic and neurochemical factors (less brain tissue and cerebrospinal fluid; dopamine excess and serotonin modulation of dopamine or excess)


What is Narcissistic Personality Disorder?

(Cluster B)

Grandiosity, need for admiration, lack of empathy, arrogant or haughty attitude, superior view, vulnerable, ambitious. 


What is disenfranchised grief?

Grief over loss that is not or cannot be openly acknowledged, mourned publicly, or supported socially

–A relationship has no legitimacy.

–The loss itself is not recognized.

The griever is not recognized


Korsakoff's syndrome

disturbance in memory due to long-term use of alcohol


Intellectual disability

•Below-average intellectual functioning

IQ less than 70 accompanied by significant limitations in 

-communication skills. -self-care.   -home living.  -social interpersonal skills.  -work.   -leisure.   -health & safety


Conventional antipsychotics/Atypical antipsychotics

Conventional: dopamine antagonists

–Targeting positive symptoms

–No observable effect on negative symptoms

Atypical antipsychotics dopamine, serotonin antagonists

–Diminish positive symptoms

–Lessen negative symptoms


What is Histrionic Personality Disorder?

(Cluster B)

Excessive emotionality and attention-seeking, insincerity, center of attention, exaggeration of relationships


What is complicated grief?

Person devoid of emotion; grieving for prolonged periods; expressions of grief seem disproportionate to event


Nursing interventions for Delirium

–Promoting patient safety

–Managing patient’s confusion: orienting cues; speaking in low, clear voice; avoiding sensory overload

–Promoting sleep, proper nutrition



•Inattentiveness, overactivity, impulsiveness; persistent pattern of inattention and/or hyperactivity and impulsivity

-Diagnosed usually when a child starts school

-Fidgeting, noisy, disruptive, unable to complete tasks, failure to follow directions, blurting out answers, lost or forgotten homework


Six antipsychotics available in depot injection forms:

–Fluphenazine in decanoate and enanthate

–Haloperidol in decanoate





•Effects vary in length of time; eliminate need for daily oral antipsychotic medication


What is Dependent Personality Disorder?

(Cluster C)

Need to be taken care of; submissive; clinging


Grief & Mourning

-Subjective emotions and affect; normal response to loss 

-Grieving/bereavement: process by which person experiences grief; content, process

-Mourning: outward expression of grief, including rituals


Nursing interventions for Dementia


–Sleep, proper nutrition, hygiene, activity

–Environmental, routine structure

–Emotional support (supportive touch)

–Interaction, involvement (reminiscence therapy, distraction, time away, going along)


ADHD Stratagies and Medications

Home and School stratagies. -Behavior -Environmental -Parental education (rewards/consequences, daily report cards/point systems)

methylphenidate (Ritalin) amphetamine compound (adderal) *monitor for appetite suppression or growth delays* S/E in children:decreased appetite, nausea, vomiting, tiredness, and upset stomach S/E in adults: insomnia, dry mouth, urinary retention, decreased appetite, nausea, vomiting, dizziness, and sexual side effects

Second choice: antidepressants

Nonstimulant: atomoxetine (SNRI)

Antihypertensives: clonidine (Kapvay), guanfacine (Intuniv)


Nursing interventions fo schizophrenia 

–Safety of patient, others

–Therapeutic relationship; therapeutic communication

–Interventions for delusional thoughts (focus on reality; no confrontation or reinforcement)

–Interventions for hallucinations

–Management of socially inappropriate behavior

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