Glossary of psych nursing 2
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- cardio: increased pulse/BP, palpitations, perspiration, cold hands and feet
GI: N&V, diarrhea, cramps
Muscle: increased muscle tension and tendon reflexes, unsteady voice
Intellectual: poor comprehension/concentration, impaired pb solving
Emotional: helplessness, hopelessness
- S/Sx: apprehension, anxiety, helplessness when confronted with phobic situation or feared object.
NI: avoid confrontation/humiliation, systematic desentization, relaxation techniques, antidepressants.
- S/Sx: obsession (repetitive, uncontrollable thoughts), compulsion (repetitive, uncontrollable acts, rituals, rigidity, inflexibility).
NI: accept ritualistic behavior, provide for physical needs, limit choices, encourage socialization, group therapy, clomipramine (Anafranil), focus on client rather than the symptoms.
- Conversion hysteria
- S/Sx: unconscious behavior, could include blindness, paralysis, convulsions w/o loss of consciousness, "la belle difference".
NI: diag. evaluation to rule out physical pb, discuss feelings rather than symptoms, avoid secondary gain.
- Stage of crisis
4.Attempts to reorganize
5.Attempts to escape the pb
- Precipitating factors of crises
- 1.Developmental/maturational: birth, adolescence, midlife, retirement.
2.Situational: natural disasters, financial loss.
3.Threats to self-concept/adventitious: loss of job, failure at school, onset of serious illness.
- Situational crises
- 1.grieving patient
- Grieving patient
- S/Sx: Stages of grief: shock and disbelief, awareness of pain of loss, restitution.
NI: Focus on here and now, provide support to family, provide privacy, encourage verbalization of feelings, emphasize strengths, increase ability to cope.
- Dying patient
- S/Sx: stages of dying: denial, anger, bargaining, depression, acceptance.
NI: keep communication open, allow expression of feelings, focus on here and now, let patient know he/she is not alone, provide comforting environment, provide physically comforting care, give sense of control and dignity.
- Rape trauma patient
- S/Sx: self-blame, embarassment, fear of violence, anxiety, insomnia, wish to escape/move/relocate, psychosomatic disturbances.
stages of crisis: acute reaction lasts 3-4 wk, reorganization is long-term.
NI: focus on here and now, write out tx and apptmts, give referrals for legal assistance, follow up regularly.
- Post-traumatic stress syndrome
- Exposure to trauma event
Recurrent/distressing recollection of event
Acting/feeling like trauma is recurring (flashbacks).
- Low self-esteem
Changes in self-care
Changes in cognitive/mental functioning
- Sudden change in behavior
Gives away valuables
Withdrawal from social activities and plans
Presence of weapons
Has death plan
Leaves a note
Predisposing factors: Male > 50y.o, 15-19y.o, isolation, poor social attachments, personality disorders, overwhelming precipitating events
- Situational role changes
- S/Sx: death spouse/sig other, divorce/separation, marriage, illness/injury, job loss, new baby, child leaving home.
NI: discuss resolution to previous changes, determine what was helpful in the past, use learned coping strategies (establish and maintain routine, regular exercise, humor, good nutrition, rest/sleep, relaxation techniques).
- S/Sx: HA, sleep pb, restlessness, GI upset, palpitations,crying, frequent urination.
Stressors: family, job, environment, lifestyle, body image changes, situation role changes.
NI: ID source of stress, ID past success, support, provide control, inform, biofeedback, progressive muscle relaxation, meditation, guided imagery.
- S/Sx: emot. exhaustion, depersonalization, decreased effectiveness, ineffective usual coping strategies, overwhelmed, helpless, at risk for physical/mental illness.
NI: social support, counseling, employee assistance program.
- Sudden infant death syndrome (SIDS)
- S/Sx: usually found by mother, during first year of life, peaks at two to four months, 12am-9am, increased incidence in winter/peaks in january, premies, black infants, multiple births, infants of addicted mothers, infants who sleep on abdomen.
NI: prevention is no.1, home apnea monitor, supine position to sleep, family/parent support, referral to SID foundation, give time to say goodbye to infant.
- Bipolar disorder
(signs and symptoms)
- labile, persecutory delusions, delusions of grandeur, flight of ideas, inappropriate dress, lack inhibition, sarcams, talks excessively, hyperactive, weight loss, insomnia.
- Bipolar disorder
- simplify environment and decrease stimuli
Distract and redirect energy
Institute measures to deal with manipulation (limit, consistency in enforcing rules).
Meet physical needs first (fluids, high-cal finger foods and drinks)
Lithium (1-1.5mEq; SE: polyuria, mild thirst; toxicity: N&V, drowsiness, ataxia).
Help decrease denial and increase client's awareness of feelings
- Assess level of anxiety
Control environmental stresses/stimulation
Assist to cope more effectively
Maintain accepting and helpful attitude toward client.
- Be alert to signs of self-destructive behavior
Meet physical needs
Be brief and simple
Give tasks to relieve guilt and increase self-esteem
Help decrease social withdrawal
Introduce to others when ready
use other tx modalities
Help with anger and fear of losing control
- Post Traumatic Stress Syndrome
- Encourage talk about painful stored memories
Use empathic responses
Assist client to challenge existing ideas about event and substitute more realistic thoughts and expectations
Help label feelings
Teach stress mgmt techniques
Involve client in anger mgmt
Regular physical exercise
Use empowering strategies
Methods to reduce sleep disturbances
- Remove dangerous items
Increase client self-worth
Assist with pb-solving/decision making
Intervene quickly and calmly during actual attempts
Stay with client
Contract with patient
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