Ch. 9: Intervening in Crisis

Question 1

intro to intervening with a crisis

Answer 1

Assistance with problem solving during the crisis period preserves elf-esteem and promotes growth with resolution

Question 2

Definition of crisis

Answer 2

Crisis is defined as a sudden event in one’s life, during which usual coping mechanisms cannot resolve the problem; the crisis disturbs homeostasis.

Question 3

Characteristics of a crisis

Answer 3

• Crisis occurs in all individuals at one time or another and is not necessarily equated with psychopathology
• Precipitated by specific identifiable events
• Doesn’t always cause mental illness
• Unique to each person, and crisis will eventually resolve.
• We either grow or deteriorate from crises.

Question 4

Phases in the development of a crisis

Answer 4

1. The individual is exposed to precipitating event. Hopefully problem solving helps them.
2. When previous problem solving techniques do not relieve the stressor, anxiety increases more.
3. All possible resources, both internal and external are called on to resolve the problem
4. If resolution does not occur in previous phases, the tension mounts beyond a further threshold or its burden increases over time to a breaking point. Major disorganization occurs with the person. Sometimes people might not even speak.

Question 5

Phases in the development of a crisis continued.

Answer 5

• Whether individuals experience a crisis in response to a stressful situation depends on three factors.
  1. Perception of event
  2. Availability of support system.
  3. Availability of good coping mechanisms.

Question 6

Dispositional Crisis:

Answer 6

An acute response to an external situational stressor. Maybe a job loss.

Question 7

Crisis of anticipated life transitions:

Answer 7

Normal life-cycle transition that may be anticipated but over which the individual may feel a lack of control.

Question 8

Crisis resulting from traumatic stress:

Answer 8

Precipitated by an unexpected, external stressor over which the individual has little or no control and from which they feel emotionally overwhelmed and defeated.

Question 9

Maturational/developmental Crisis:

Answer 9

Occurs in response to a situation that triggers emotions related to unresolved conflicts in one’s life. Example –> Could be due to retiring.

Question 10

Crisis reflecting psychopathy:

Answer 10

• An emotional crisis in which preexisting psychopathology has been instrumental in precipitating the crisis or in which psychopathology significantly impairs or complicates adaptive resolution.
• Like if isolation makes your depression worse.

Question 11

Psychiatric emergency:

Answer 11

A crisis situation in which general functioning has been severely impaired and the individual is rendered incompetent or unable to assume personal responsibility. Like if their or another’s life is in danger.

Question 12

Assessing for anger

Answer 12

• You can usually just tell. Frowning, clenched fist, etc.
• We watch
• Walk away if ur a student nurse
• De-escalate if you’re a nurse

Question 13

Assessing for aggressiveness

Answer 13

• u can just tell usually. Tense body language, pacing, restless, slamming door, etc.

Question 14

Preventing crisis in the inpatient unit: three factors to identify extent of crisis

Answer 14

1. Past history of violence
2. Client diagnosis
3. Current behaviors.

Question 15

Crisis intervention: minimum therapeutic goal

Answer 15

• psychological resolution of the individual’s immediate crisis, and restoration to at least the level of functioning that existed before.
• A maximum goal is improvement in functioning above the pre-crisis level.

Question 16

Phases of the crisis intervention: phase 1

Answer 16

• Always asses first. What stressor caused this. What prompted individual to seek help.

Question 17

Phases of the crisis intervention: phase 2

Answer 17

• Select nursing diagnoses from assessment.
• Set goals: goal for the day? What can we actually help with?
• Take appropriate nursing actions. Give resources for support.

Question 18

Phases of the crisis intervention: phase 3

Answer 18

• Implement interventions
• Reality oriented approach. Never argue with them but give them reality.
• Working relationship is established.

Question 19

Phases of the crisis intervention: phase 4

Answer 19

• Reassessment to see how interventions are going.
• Plan of action for how patient should deal with stressor in the future.

Question 20

Disaster nursing

Answer 20

• A common feature of disasters is that they overwhelm local resources and threaten the function and safety of the community
• Disasters cause varying amounts of emotional trauma
• Grieving is a natural response. Many mood disturbances can occur. Nightmares in children sometimes.