Anger/Agression & Violence Flashcards
What is anger?
Anger is an emotional response to frustration of desires, A threat to one’s needs (emotional or physical), or a challenge.
What is aggression?
An action or behavior that results in verbal or physical attack.
What are the pharmacological intervention’s for a pre-assault stage patient?
Identify anxiety and aggression signs early, talk with the patient to help become calmer, if anxiety increases and talking is not effective assess the need for a PRN medication.
What are the pharmacological interventions for an assault stage patient?
Have staff ready to assist you, use atypical antipsychotic, IM injections for treatment of acute symptoms of anger and aggression.
What is the best treatment choices for medications for the aggressive behavior of the patient?
Olanz’apine
Zyprexa
Seclusion and restraint are used when?
Only when there is a clear danger to self or others
To seclude and restrain a patient what is required?
A dr’s order
If a doctor is not present can the nurse still use seclusion and restraint’s?
Yes but the nurse must call the physician immediately after placing the patient in seclusion or Restraints
How is anger a learned response?
Model in the home, Imitate others.
What three areas of the brain contribute to anger?
The limbic system, the amygdala, and the cortex.
How does the limbic system contribute to anger?
Be afraid of triggers agression for survival sake.
How does the amygdala function in anger?
Judges events for potential danger to keep us safe
How does the cortex function and anger?
Helps us decide whether or not to shoot
What is the biological etiology of anger?
Aggression result of decreased transmitter especially serotonin
How do brain abnormalities affect behavior?
They can cause violent behavior
Define IED
Intermittent explosive disorder
What are the two best predictors of violence?
A history of violence and impulse
What is the most important sign proceeding violence?
Hyperactive/agitation
If the patient’s behavior escalates what do you do?
Provide feedback. “You seem very upset”. This allows you to open discussion of the patients feelings.
What is the single best predictor of violence?
Previous history of violence
What is a nursing outcome for aggression?
Aggression self control
What are short term nursing outcomes for the patient with aggression?
Identify went angry, express anger verbally and not act out, refrain from physical aggression of person or property, use specific techniques to control anger, identify situations that precipitate anger.
What are intermediate nursing outcomes for the patient with aggression?
Upholds contract to restrain aggressive behavior, maintains control without supervision.
Is anger normal?
Yes
What is the first nursing intervention for clients with cognitive defects such as dementia?
Oriented person place time and event
What is the second nursing intervention for clients with cognitive defects such is dementia?
Repeat the clients name don’t touch the client offer use of bathroom, don’t give client food if they are acting out
What is the third nursing intervention for clients with cognitive defects such as dementia?
Validation of the patients emotions.
How do you validate the patients emotions?
- Use the patients name
- Repeat some of what patient says focusing on patients feelings.
- Let patient tell you more, empathize
What must you try before you secluded and or restrain a patient?
Least restrictive method to reduce aggression and prevent violence.
Define seclusion.
Involuntary confinement alone in a room that the patient is physically prevented from leaving.
Define restraints.
Any manual method, physical or mechanical device, material, or equipment that restricts freedom of movement; don’t remove all restaurants at the same time.
What must the patient first do before they are allowed to reintegrate back into the unit after being restrained or secluded?
Reintegration must be gradual the patient must first be able to follow commands and control behavior.
Define positional asphyxia.
Inability to breeze, do not put person on abdomen especially a obese or young children because they cannot expand their lung cage.
Sudden death from positional asphyxia has occurred in what age groups?
Children and teens
Define post exercise peril.
Physiological changes in patient from the struggle may result in cardiac arrhythmias that do not respond to CPR.
What is the acronym ENPS used for?
Preventing aggression with an upset person who has healthy coping.
Defined the acronym ENPS.
E- empathize
N- normalize
P- problem solve
S- set limits if necessary
What does anger protect us from?
Danger
Define hostile anger.
It is when we hold on to anger and we want revenge.
What is forgiveness?
Not forgetting or condoning but choosing not to take revenge and to let it go.
What are the four ways of dealing with anger?
Aggressive, passive aggressive, nonassertive, assertive.
Give an example of the aggressive way of dealing with anger.
My needs are most important. (You win)
Give an example of the passive aggressive way of dealing with anger.
I’ll agree but not follow through. (Loose-loose)
Give an example of the nonassertive way of dealing with anger.
My needs are not important. (Loose)
Give an example of the assertive way of dealing with anger.
Both of our needs are important. (Win-win)
Define cognitive restructuring and reframing
Reinterpret behavior by using positive assumptions, it reduces own anger.
Define “I” Messages.
Using assertiveness for interpersonal conflict
What are DESC Scripps used for?
For interpersonal conflict, never give a consequence it won’t carry out.
