Anger, Aggression, & Violence Flashcards (These Are Brayden’s Flashcards, Just Reformatted)
Anger is an emotional response to -
Frustration of desires, a threat to one’s life, or a challenge
What is aggression defined as?
An act or behavior that results in a verbal / physical attack
What is violence defined as?
An objectionable act that involves intentional use of force that results in (or has the potential to result in) injury to another person
What are the manifestations of anger?
Increased Demands
Irritability
Frowning
Redness of the Face
Pacing
Twisting of the Hands
Clenching & Unclenching of the Fist
Speech when angry may be-
Either increased in rate and volume or may be slow, pointed, and quiet
What is essential in caring for an angry pt?
Identify the pt’s triggers, awareness of the personnel, and cultural norms
What are the predictors of violence?
History of violence, family violence, substance abuse, verbal abuse
Ridged Posture
Clenched Fists or Jaw
Hyperactivity
Pacing
Possession of a Weapon
What are some things that you should assess when assessing for anger & violence?
Any intent or plan to harm
Demographic Risk Factors
What are some Demographic Risk Factors of anger and violence?
Men (Aged 14-24)
Low Socioeconomic Status
Inadequate Support System
When approaching an angry pt, should your eyes be on the same level as theirs?
Yes
A pt is verbally abusive, should you end the conversation?
No
How should you speak to an angry pt?
Speak slowly in short sentences in a low and calm voice, use open ended questions and never respond with ok
What are the 6 essential considerations for staff safety?
No dangling ear rings or neckless
Ensure there is enough staff for back up do not stand
Always know the layout of the area
Stand directly in front of the pt or doorway, provide feedback if pt’s behavior escalates
avoid confrontation with the client
What is Seclusion defined as?
Involuntary confinement of a pt alone in a room, or area room, which the pt is physically prevented from leaving
When should Seclusion or Restraints be used?
Whenever all other options are exhausted
What must be assessed prior to putting a pt into Seclusion?
Assess for contraindications for Seclusion
What are the contraindications for seclusion?
Pregnancy
COPD
Head / Spinal Injury
Seizure Disorder
Abuse
Morbid Obesity
History of Surgery / Fracture
Sleep Apnea
Once a pt is placed into restraints, what must be assessed?
Level of awareness & activity + Safety within the restraints + Hydration + Toileting Needs + Nutrition + Comfort + Vitals + Cap Refill
Aside from assessing your pt and exhausting all other options, what must you always do before placing a pt in restraints or putting them into seclusion?
Obtain a prescription or order from the provider
What is the best way to discontinue restraints and return a pt to the unit?
Structural Reintegration
After a pt is regenerated from seclusion or restraints, what should we ask them?
If they learned from the situation
In an inpatient setting, what are the two most accurate predictors of violence?
A history of violence & impulsivity
What is the best intervention for Delirium?
Find and treat the medical cause
What is the second best intervention for Delirium?
Low Dose Anti-Psychotic
What is crucial to respond to an episode of agitation?
Identify the antecedents (what occurred before agitation?)
When dealing with an agitated pt, what should be done instead of attempting to reorient the pt?
Ask the pt to further describe the setting or situation that’s reported to be the problem
What does Sedation do to a pt with Cognitive Deficits?
Further clouds a pt’s senses, which worsen disorientation + increases the risk of falls and injuries
(It’s better to examine alternative interventions)
List some de-escalation techniques:
Maintain clients dignity and self esteem
Maintain calmness
Assess the client and situation
Identify stressors
Respond early
Use a calm/clear voice
Invest time
Remain honest
Determine client need
Identify goals
Avoid invading personal space
Avoid arguing
Use empathy
What things should be documented about violence?
Any behavior that occurred whenever the pt was escalating
Nursing Interventions + The Pt’s Response
Observations of the pt
How the pt was reintegrated into the unit
What’s a healthy coping skill?
Validation
What’re some marginal coping skills?
Externalize Blame
Provide comfort items before they’re requested
