Anger and At risk for other directed violence Unit 3 (1) Flashcards
1
Q
Risk Factors Violence
A
- Being cruel to animals
- Setting fires
- Witnessing family violence
- Past convictions
- Violent behavior
- Frequent psychiatric hospital admissions
- Aggressive behavior
- Emotional deprivation in childhood
- Substance abuse
- Impulsive behavior/poor impulse control
- Earlyage ofonset of psychiatric symptoms
- Unpredictable behavior
- Helplessness
- Inability to express anger to the person he/she is dependent upon for survival
- Poor frustration tolerance
- Ineffective coping skills
- Feelings of personal threat, rage, fear
- Intoxication
- Homicidal ideation
- Severe psychopathology
- Halluncination
- Delusions
- Suspicious agitation
- Escalating signs of anger
- Space and location problems
- Architectural design problems
- Activity level problems
- Staffing patterns
- Strong needs for attention
- Ruminates
2
Q
Primary prevention Violence
A
Attempts to alleviate illnesses before they occur by removing possible causes and risk factors
- Conflict resolution programsin schools
- Stress management classes
- Parent training classes
- Lifestyle counseling programs
- Encourage zero-tolerance policies
- Educate that violence is not a normal aspectof healthy relationships
3
Q
Secondary Prevention Violence
A
The early identification and treatment of violent behavior. Focus is on pro-active treatment because prognosis is affected by the duration of the mental disorder
- Inpatient units
- Outpatient groups (anger managment)
4
Q
Tertiary Prevention Violence
A
The elimination or reduction of the aftermath of illness; rehabilitation (anger management)
- Case management
- Support services
- Probation
- Parole
5
Q
Nursing Diagnosis Angry Client
A
- Risk for Other-Directed Violence
- Ineffective coping
- Impaired social interaction
6
Q
Verbal Assessment
A
- Threats of harm
- Loud, demanding voice tone
- Abrupt silence
- Negative responses to staff requests
- Sarcastic remarks
- Pressured speech
- Illogical responses
- Yelling, screaming
- Statements of fear and/or suspicion
7
Q
Behavior Assessment
A
- Clenched jaws
- Frowning, glaring
- Intense staring
- Flushing of face and neck
- Lip biting
- Smirkinggrin
- Dilated pupils
- Pacing
- Pounding fists
- Heightened vigilance
- Confrontational stance
- Aggession toward objects (slamming doors)
- Possession of a weapon
8
Q
Specific times a client is likely to become aggressive
A
- On Admission
- Change of shift
- Meal times
- Evenings
- Visiting hours
- In elevators
- During periods of change
9
Q
Safety Interventions
A
- Violence precautions
- Assign client to private room
- Do not touch client
- Be sure that you are between the client and the door
- Stand at a 45 degree angle to the client
- Maintain eye contact but do not stare
- Limit setting - be consistent and firm
- Establish the expectation that the client will remain in control
- Pharmacologic management
10
Q
Expressing Feelings Interventions
A
- Therapeutic Relationship
- Promote interaction that increase theclient’s sense of trust
- Stateto the client what you see him doing and how you think he may be feeling
- Determine if you understand the client correctly
- Encourage the client to describe the experience to increase awareness
- Give positive verbal feedback when client uses words to express his feelings
11
Q
Assist with Problem Solving Interventions
A
- Use show of force instead of approaching alone
- Allow for more personal space
- Talk down the client
- Make short, concise statements
- Make contact right away with an angry client
- Validate the client’s feelings, help the client address the unmet need
- Avoid using “always” and “never”
- Helpful verbal wording
- Avoid threats
- When client has calmed down, offer choices and options for diversional activities
