Trauma Disorders
Being mindful of patient’s trauma history while providing care, recognizes the impact of trauma and paths to recovery
What is Trauma-Informed Care?
Maladaptive response to stressor that occurs within 3-6 months
What is adjustment disorders?
Symptoms include gross distortion of body image, preoccupation with food, and refusal to eat
What is Anorexia Nervosa?
The priority nursing intervention for a 19 year-old admitted to the psychiatric unit with the diagnosis of adjustment disorder, who was found crying during rounds with one wrist bleeding from a self-inflicted cut made by an unknown source.
What is scene safety and/or assess the wound site?
First-line medication treatment for PTSD
What are SSRIs (Antidepressants)
Example: Paroxetine (Paxil) & Sertraline (Zoloft)
Extremely distressing event, causing emotional shock with potentially long-lasting psychological effects
What is Trauma?
A disorder that occurs after the death of a significant other or any loss perceived as significant to the individual, in which the experience of distress accompanying bereavement fails to follow normative expectations and manifests in functional impairment.
What is complicated grieving?
Related to loss of self as perceived before the trauma or other actual or perceived losses incurred during or after the event evidenced by irritability and explosiveness, self-destructiveness, substance abuse, verbalization of survival guilt, or guilt about behavior required for survival.
BMI > 30, affects ~40% of American population, can be associated with binge-eating disorder
What is Obesity?
3 nursing interventions for trauma-related disorders.
What is:
Safe environment; 1:1, trusting relationship; Cognitive restructuring; Counseling & therapy; Stress management; Sleep hygiene; Teach coping skills; Anger management; Administer medications; Assess substance abuse
Integrative psychotherapy approach with a theoretical model that emphasizes brain’s information processing system and memories of disturbing experiences as the basis of pathology
What is Eye Movement Desensitization & Reprocessing (EMDR)?
Maltreatment of one person by another
What is Abuse?
Includes: Dispositional/Situational, Crisis Resulting from Trauma/Adventitious, Crisis of Anticipated Life Transitions, Maturational/Developmental, Psychiatric Emergencies, Crises Reflecting Psychopathology
What is Baldwin’s Classes of Emotional Crises
Disorder characterized by episodic, rapid indigestion of large quantities of food, followed by purging.
What is Bulimia Nervosa?
Most are within a normal weight range and do not have a severely distorted self-image
Establish a healthy dietary plan, structured meals, and implementation of food journals
What are nursing interventions for eating disorders?
This is used as management for PTSD related nightmares.
What is Prazosin, an Alpha-1 adrenergic blocker?
Exposure to trauma, symptoms include anxiety and detachment, lasts greater than 1 month
What is PTSD?
Sudden event or situation that disturbs homeostasis, during which usual coping mechanisms cannot resolve the problem
What is crisis?
Disorder characterized by rapid, excess caloric intake and lack of control over eating, especially when not hungry
What is Binge Eating Disorder
Occurs in Development of a Crisis Phase - To achieve functioning above the pre-crisis level, to rise above
What is maximum goal?
Drug of choice when treating binge eating with obesity and treating bingeing and purging with a diagnosis of bulimia nervosa.
What is Topiramate (Topamax)?
Anticonvulsant used in the long-term treatment of binge-eating disorder with obesity. The use of Topamax results in a significant decline in mean weekly binge frequency and significant reduction in body weight. With the use of this medication, episodes of bingeing and purging were decreased in clients diagnosed with bulimia nervosa.
The capacity to withstand stress
Disorder where exposure to trauma can cause symptoms like PTSD, however, symptoms are time limited - last 3 days but not more than 1 month.
What is Acute Stress Disorder?
Top 2 priority nursing diagnoses
What is imbalanced nutrition? What is fluid-volume deficit?
List 2 nursing interventions in assessing a victim
What is keep the victim safe, interview victim alone, assess injuries, identify available resources
A morbidly obese client is prescribed an anorexiant medication. The nurse would expect to see an order for what medication?
What is Lorcaserin (Belviq)?
First approved by the FDA in 2012. It suppresses the appetite by altering various 5-HT2C serotonin receptors. Withdrawal from anorexiants can result in rebound weight gain, lethargy, and depression.