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Psychiatric > Anger/Abuse/ NCD > Flashcards

Anger/Abuse/ NCD Flashcards

1
Q

Anger is not necessarily a negative emotion.
Anger becomes negative when?

A

Denied
Suppressed
Expressed inappropriately

It can be control

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2
Q

Anger is not a a__________ emotions, it is b__________.

A

a) primary
b) learned behavior

response to hurt, frustration, or fear
feeling/emotion

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3
Q

Aggression is?

A

One way of expressing anger

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4
Q

Anger/ aggression
a) What is one of the strongest forms of learning anger?

A

a) Role-model
Can be positive or negative

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5
Q

Anger and Aggression
Who would be the role model?

A

Primary caregivers

-Children
How parents express anger
-TV and video violence later aggressive factor

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6
Q

Anger and Aggression
Operant Conditioning

A

A specific behavior is positively or negatively reinforced

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7
Q

A mom tells her child to pick up her toys. The child cries, the mom thinks “this isn’t worth it” and picks up the toys herself

A

Negative reinforcement

The child’s anger is negatively reinforced (the child was rewarded by not having to pick
up her toys)

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8
Q

Anger and Aggression
Neurophysiological Disorders

A

Brain tumors
Brain trauma
Stroke, dementia, alcohol intoxication

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9
Q

Anger and Aggression
Biochemical Factors

A

Alterations in brain chemical
Cushing syndrome
hyperthyroidism

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10
Q

Anger and Aggression
Socioeconomic factors

A

poverty

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11
Q

Anger and Aggression
Environmental Factors

What factors are the best predictors of violent behavior?

A

alcohol intake
history of childhood abuse
substance use

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12
Q

A nurse in caring pt who is aggressive.
Which statements is example of aggressive?

a) I wish you would not make me angry
b) I feel angry when you leave me
c) It makes me angry when you interrupt me
d) You’d better listen me

A

d
Because this is threat and a lack of respect

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13
Q

A nurse is caring pt who is preassaultive stage of violence.
Which are expect findings?

a) Lethargy
b) Defensive responses to question
c) Disorientation
d) Facial grimacing
e) Agitation

A

B, D, E

Lethargy / leh·thr·jee /無気力
more like pt who depression

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14
Q

A nurse is caring for pt who screaming at staff and other clients.
Which one is a therapeutic response?

a) Stop screaming, and walk with me outside.
b) Why are you so angry and screaming?
c) You will not get your way by screaming
d) What was going through your mind when you started screaming?

A

a
Setting limits and the use of physical activity to deescalate anger

d
The client is NOT reedy for discuss this issue yet

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15
Q

Survivors of Abuse
Profile of Victim

A

low self-esteem
Inadequate support systems
Grown up in abusive homes

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16
Q

Survivors of Abuse
Perpetrator Characteristics
pur·puh·tray·tr

A

Used threats and intimidation for control
low self-esteem
poor coping skill
views partner/spouse as a possession

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17
Q

Cycle of Violence
Phase 1

A

He becomes angry easily
He fears she leaving him
Battering incidents become more intense

This phase lasts for a few weeks to months, even a year

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18
Q

Cycle of Violence
Phase 2

A

The acute battering incident

Most violent and shortest
Usually up to 24hr

He justifies his behavior, but in the end, he cannot understand what has happened.

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19
Q

Cycle of Violence
Phase 3

A

Clam, loving Honeymoon

Batterer becomes extremely loving
He promise abuse will never recur
He afraid she may leave him

Woman bears her reason for remains relationship

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20
Q

Survivors of Abuse
Why do victims stay?

A

– Fear of losing custody of children
– Fear of retaliation by the partner 報復

– Lack of financial resources
– Lack of support network

– Religious reasons
– Having the hope that the partner will change

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21
Q

What kind are intimate partner violence?

A

coercive control　強制的な
kow·ur·suhv

“You are mine, you do not belong to anyone”
physical and sexual violence
A threat, intimidation 脅迫

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22
Q

Child Abuse/Neglect
Texas law

A

Professionals must make a report no later than the 48th hour after first suspecting

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23
Q

Rape
Victim Responses

2 responses for the first stage

A

Expressed response pattern

Controlled response pattern

24
Q

What is a Expressed response pattern?

A

The survivor expresses fear, anger, and anxiety through such behaviors as crying, sobbing, restlessness and tension

25
Q

What is a Controlled response pattern?

A

The feelings are masked or hidden, and a calm composed, or subdued affect is seen”

26
Q

What is a Compounded rape reaction?

A

Additional symptoms of depression and suicide, substance abuse, and even psychotic behaviors may be noted

27
Q

Rape
Victim Responses

2 response will developed after the event

A

Compounded rape reaction
Silent rape reaction

28
Q

What is a Silent rape reaction?

A

The victim tells no one of the assault, will suppress the anxiety and the emotional burden becomes overwhelming

29
Q

From a biological theory perspective, which of the following predisposes individuals to be abusive? 素因

A. Unmet needs for security resulting in an
underdeveloped ego and a weak super ego
B. Imitation of individuals who have a predisposition
toward aggressive behavior
C. Various levels of norepinephrine, dopamine, and serotonin
D. The influence of culture and social structure

A

C

Various components of the neurological
system in both humans and animals have been implicated in both the facilitation and the
inhibition of aggressive impulses.

One biological theory suggests that
norepinephrine, dopamine, and serotonin may
play a role in aggressive behavior.

30
Q

A young mother in a severely abusive relationship is admitted to the psychiatric unit after an attempted suicide. The client tells the nurse, “I’m sure things will be better between us once I go home.” Which is the most appropriate nursing response?

A. “Research shows that men who batter get worse than improve.”
B. “Aren’t you concerned about your children?”
C. “You really should not return home to that violent situation.”
D. “Let’s develop a safety plan in case he becomes violent in the future.”

A

D

It is critical to stress to the client the importance of safety.
The client must be made aware of the variety of resources that are available to her.

Most major cities in the United States now have safe houses or shelters where women can go to be assured of protection for them and their children.
Helping the client develop a safety strategy will increase her sense of control and decrease her sense of powerlessness.

31
Q

After an examination and treatment for rape, the nurse prepares to discharge a client from the emergency department (ED). Which discharge teaching should the nurse provide?

A. Information on available community resources
B. The names and phone numbers of local attorneys who defend rape victims
C. When to return to the ED for follow-up care
D. The phone number of the battered women’s shelter or safe house

A

A

The client must be made aware of the variety
of resources that are available to her.
These may include crisis hotlines, community
groups for women who have been abused,
and counseling services.
Knowledge of available community resources
decreases the victim’s sense of powerlessness.

32
Q

A client has not received what was expected for lunch and directs an angry verbal outburst at the nurse. What is an accurate description of this display of emotion?

A. Anger is a primary emotion that is automatically experienced.
B. Anger is a psychological arousal.
C. Expression of anger can come under personal control.
D. Expression of anger and aggression are closely related.

A

C
The expression of anger can come under
personal control and is a learned behavior.

33
Q

After repeated requests for a patient to unpack and get settled on the psychiatric unit, the patient states, “I have no intention of unpacking and staying on this unit.” To avoid a confrontation, the nurse unpacks the patient’s belongings. Which nursing behavior is exemplified?

A. Positive role modeling
B. Negative operant conditioning
C. Assertiveness
D. Aggressiveness

A

B
This situation illustrates negative operant
conditioning.
The patient’s negative behavior has been
reinforced and rewarded by the nurse’s action
of unpacking for the patient.

34
Q

An angry patient states to the nurse, “You red-headed skinny witch. You can’t tell me what to do.” Which appropriate intervention would the nurse implement during this outburst?

A. Reprimand the patient for poor judgment and derogatory remarks.
B. Respond to angry expressions with matching verbalizations.
C. Offer support by the use of empathy and
therapeutic touch.
D. Ignore initial derogatory remarks.

A

D
During expressions of anger and aggression,
ignoring initial derogatory remarks can be an
appropriate nursing intervention.
Lack of feedback often extinguishes an
undesirable behavior.

35
Q

Type of neurocognitive disorder? 3

A

Delirium
Mild NCD
Major NCD

36
Q

What is delirium?

A

disturbance in attention and awareness
rapidly over short period of time

37
Q

Delirium
symptoms

A

short-term confusion
ability to focus
Hallucinations
Tachycardia (excitement)

38
Q

Delirium
Risk factors

A

Infections
Surgery
Substance use
Older age
Head trauma
HIV

39
Q

Delirium
duration

A

1 week
Symptoms usually diminish over 3- to 7-day when underlying causes are eliminated

40
Q

Delirium
Priority nursing assessment

A

Promote early detection!!

Accesses risk factor
History of mental/physical changes
Thinking process
Recent/remote memory
Assess medication use
Substance use, previous

41
Q

Interventions for pt with memory deficits living at home

A

Safety!
- Store frequently used items in the pts reach
- mattress to the floor to prevent falls
- Keep dim light in pts room at night

42
Q

Nursing intervention(s) for an Alzheimer’s patient unable to perform ADLs

A
  • Provide a simple/structured
  • Allow for plenty of time to complete tasks
  • step-by-step guide
  • Keep a consistent day-to-day schedule
43
Q

Nursing intervention(s) in late stage of Alzheimer’s disease

A

Safety!
Around-the-clock assistance with ADLs

44
Q

What are the symptoms pt will have late stage of AD?

A

Symptoms of dementia are severe
Loss of awareness of recent experiences as well as their environmental surroundings
Experience changes in physical abilities like walking, sitting and eventually swallowing
Increased difficulty communicating
Increased risk for developing infections (pneumonia)

45
Q

Hospitalized and diagnosed in the fourth stage of NCD due to AD, a client, when asked about the previous evening, describes a wonderful evening spent on a cruise. Which symptom is the client exhibiting?

A. Aphasia
B. Confabulation
C. Delirium
D. Apraxia

A

B
Confabulation is a behavioral reaction to
memory loss in which the patient fills in
memory gaps with information about events
that have not occurred.
During the fourth stage of AD, a patient will use confabulation in an effort to maintain self-esteem.

46
Q

A client is newly diagnosed with second
stage NCD due to AD. Which cognitive
change would a nurse observe?

A. Memory disturbance
B. Confabulation
C. Apraxia
D. Inability to plan or organize

A

A
In the second stage of the illness, losses in short -term memory are common and the individual may begin to lose things or forget names of people.
It’s at this stage that a diagnosis may be
considered.

47
Q

Which statement is true about vascular
dementia?

A. Vascular dementia is reversible.
B. Vascular dementia is characterized by plaques and tangles in the brain.
C. Vascular dementia involves a gradual, progressive cognitive deterioration.
D. Vascular dementia involves a variable pattern of cognitive functioning.

A

D
In vascular dementia, patients suffer the
equivalent of small strokes that destroy many
areas of the brain. The pattern of deficits is
variable, depending on which regions of the
brain have been affected.

48
Q

A home health nurse is making a visit to a client who has Alzheimer to assess the home for safety.
Which of the following suggestion should the nurse make to decrease the client’s risk for injury?

a) Install extra locks at the top of exit doors
b) Place rug over electrical cords
c) Put cleaning supplies on the top of a shelf
d) Place the client’s mattress on the floor
e) Install light fixtures above stairs

A

a, d e

Rug is fall risk
Cleaning supplies are should be placed in lock

49
Q

A nurse is making a home visit to a client who is in the late stage of AD.
The client partner who is the primary caregiver wishes to discuss concerns about the client nutrition and the stress of providing care.
Which of the following actions should the nurse take?

a) Verify that current power of attorney document is on file
b) Instruct the pt’s partner to offer finger food to inc oral intake
c) Provide information on resources for respite care
d) Schedule the pt for placement of enteral tubing feed

A

C
「レスパイト」は小休止の意》介護の必要な高齢者や障害者のいる家族へのさまざまな支援。家族が介護から解放される時間をつくり、心身疲労や共倒れなどを防止する

50
Q

A nurse is preforming an admission assessment for a pt who has delirium related to an acute UTI.
Which of the following findings should the nurse expect?

a) history if gradual memory loss
b) Family report of personality change
c) Hallucination
d) Unaltered level of consciousness
e) Restlessness

A

b,c,e

Hallucination
幻覚
Restlessness
落ち着きのなさ

51
Q

NCD
What is the common form?
What is the major NCD?

A

Alzheimer
Dementia

52
Q

Which comes first dementia or Alzheimer’s?

A

Alzheimer’s
It leads to dementia symptoms that gradually worsen over time.

53
Q

Prodromal syndrome in anger

A

Rigid posture
Clenched fists and jaws
Taking in a rapid
Agitation and pacing

54
Q

Neurocognitive
cognitive functions closely linked to particular areas of the brain that have to do with?

A

Thinking, reasoning,
memory, learning, and speaking

55
Q

NCD due to AD
Onset?

A

Slow and progressive

Psychiatric (21 decks)

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