Ch 19 Flashcards
PTSD is more common in who
women than men
Individuals who have difficulties with stress reactions to more “normal” events may be diagnosed with
adjustment disorder
adjustment disorders…
quite common and can occur at any age.
A reaction to an extreme trauma, which is likely to cause pervasive distress to almost anyone, such as natural or man-made disasters, combat, serious accidents, witnessing the violent death of others, being the victim of torture, terrorism, rape, or other crimes
PTSD
symptoms of PTSD
depression, survivor’s guilt, nightmares, hypervigilence, anger, aggression, substance abuse, increased anxiety, relationship problems, amnesia to certain aspects of trauma, numbing of responsiveness, re-experiencing traumatic event
when do symptoms of PTSD begin
can begin within first 3 ms to yrs after trauma
Similar to PTSD in terms of precipitating traumatic events and symptomatology
acute stress disorder
what is the time line for acute stress disorder
Symptoms are time limited: up to 1 month following the trauma.
If the symptoms last longer than 1 month, the diagnosis is PTSD.
Seeks to explain why some individuals exposed to massive trauma develop PTSD while others do not
psychosocial theory
Negative reinforcement leads to the reduction in an aversive experience, thereby reinforcing and resulting in repetition of the behavior.
Avoidance behaviors
Psychic numbing
learning theory
A person is vulnerable to PTSD when fundamental beliefs are invalidated by experiencing trauma that cannot be comprehended and when a sense of helplessness and hopelessness prevail.
cognitive theory
symptoms related to the trauma are maintained by the production of endogenous opioid peptides that are produced in the face of arousal, and which result in increased feelings of comfort and control.
When the stressor terminates, the individual may experience opioid withdrawal, the symptoms of which bear strong resemblance to those of PTSD.
biological aspects
what are the biological factors of PTSD
Disregulation of the opioid, glutamatergic, noradrenergic, serotonergic, and neuroendocrine pathways may also be involved in the pathophysiology of PTSD.
generally describes a philosophical approach that values awareness and understanding of trauma when assessing, planning, and implementing care.
trauma informed care
nursing diagnoses for trauma related disorders
Post trauma syndrome
Complicated grieving
client outcomes for trauma related disorders
Can acknowledge the trauma and the impact on his life
Can demonstrate adaptive coping strategies
Has made realistic goals for the future
Has worked through feelings of survivor’s guilt
Attends support group of individuals recovering from similar traumatic experiences
Verbalizes desire to put trauma in the past and progress with his or her life
implementation for trauma related disorder
Reassurance of safety
Decrease in maladaptive symptoms
Demonstration of more adaptive coping strategies
Adaptive progression through the grieving process
Characterized by a maladaptive reaction to an identifiable stressor or stressors that results in the development of clinically significant emotional or behavioral symptoms
adjustment disorder
time line for adjustment disorders
Symptoms occur within 3 months of the stressor and last no longer than 6 months.
Exception: The “related to bereavement” subtype
types of adjustment disorders
With depressed mood With anxiety With mixed anxiety and depressed mood With disturbance of conduct With mixed disturbance of emotions and conduct Related to bereavement
adjustment disorder nursing diagnoses
Complicated grieving
Risk-prone health behavior
Anxiety
implementation for adjustment disorder
Adaptive progression through the grief process
Helping the client achieve acceptance of a change in health status
Assisting with strategies to maintain anxiety at a manageable level
trauma related disorders treatments
Cognitive therapy Prolonged exposure therapy Group/family therapy Eye movement desensitization and reprocessing Psychopharmacology
psychotherapy developed in 1989
this causes distraction which helps client to discuss trauma
biological mechanisms is unknown
very effective
EMDR (eye movement desensitization and reprocessing)
what are the medications used for PTSD
SSRIs (antidepressants)- Paxil and Zoloft
these are the only FDA approved drugs for PTSD
what is another med frequently prescribed for those struggling with PTSD
prazosin (Minipress)
effective for nightmares(helps with sleeping)
BP med that is not addictive
what is NOT recommended for PTSD
benzos
Which of the following medications is considered to be a first-line medication of choice in the treatment of PTSD?
paroxetine
