ANGER AND AGGRESSION - FINAL EXAM Flashcards
anger
emotional response to frustration, threat or challenge
aggression
action or behavior resulting in verbal or physical attack
violence
intentional use of force causing harm
violence is most frequent in
ED, ICU, geriatric, psych
comorbidity
PTSD, substance use, bipolar, chronic illness including hypertension, inflammation, cardio disease
risk factors
genetics, brain abnl or TBI, behavioral(learned) and social learning(imitate) theory
safety assessment
observe pt mannerisms, stance and verbal ques
trauma informed care
explain everything to pt as if everyone has had trauma
ensuring safety
avoid wearing dangling items, dont stand in front of pt or door, know layout, ensure extra staff, have one person talk to, avoid confrontation, provide feedback
manage escalating pt
consider behaviors that cause harm to self and others, avoid over and under reaction, asses acting out
proxemics
observant, avoid aggressive positioning/hand placement, personal space, communication
deescalation techniques
maintain vigilance, calm and non judgemental, simple communication, eye contact, person space, silence, remove audience, limit setting, DONT argue
seclusion
involuntary confinement preventing pt from leaving that requires doctor orderr
restraints
immobilizing and restricting movement that requires doctors order
manual restraints
holding someone down
mechanical restraints = B52
diphenhydramine 50mg, haloperidol 5 mg, lorazepam 2 mg PO or IM, always offer PO first
physical 4 point restraints
never tie to movable piece and get 2 fingers underneath, must sit with pt entire time and check q 15 mins for circulation, movement, and skin integrity
order renewal for restraints
4 hrs for 18 and up, 2 hrs for 9-17, 1 hr for under 9
documenting restraints
incident, alternatives, least restrictive method, rational, explanation, behaviors, treatment plan, understand behaviors and cause
discontinuation of restraints
must meet least restrict mean and when behavior subsides
alternative to restraint
increase staff, verbal deescalation, relaxation techniques, meds, decrease stimuli
pt debrief
situation, past behavior, triggers, staff involvement, consequences
debrief staff
interventions, safety, prevention, types of restraints, feedback
death reporting requirements
death occurs in restraints, 24 hrs after removal, 1 wk after restraints
