Crisis Flashcards
Exam 4 (FINAL)
Crisis
Perceived challenge or threat that overwhelms the capacity of the individual to cope effectively with the event
How long does crisis last?
Generally lasts no more than 4 to 6 week.s
Why do crises usually only last a short time?
The individual will come to grip with the event and begin to harness resources to cope with long term consequences.
People who live in constant turmoil are in
People who live constant turmoil are not in crisis but in chaos.
Examples of Maturational crisis?
Marriage
Birth of a child
Leaving home for the first time
Situational crisis examples
Entering a new situation without adequate coping skills
Disease process
Move to another city
Job promotion
Traumatic crisis examples
National disasters
violent crimes
environmental disasters
covid-19
Phases of Crisis: Phase 1
A problem arises that contributes to increase in anxiety levels.
The anxiety initiates the usual problem-solving techniques of the person
Phases of Crisis: Phase 2
The usual problem-solving techniques are ineffective.
Anxiety levels continue to rise.
Trial and error attempts are made to restore balance
Phases of Crisis: Phase 3
The trial and error attempts fail.
The anxiety escalates to severe or panic levels.
The person adopts automatic relief behaviors.
Phases of Crisis: Phase 4
When these measures do not reduce anxiety, anxiety can overwhelm the person and lead to serious personality disorganization, which signals the person in crisis
A person in crisis is at high risk for what?
A person in crisis may be at high risk for suicide or homicide.
Nursing Management Human Response to Crisis: What is the goal?
Goal: return to precrisis level of functioning
Nursing Management Human Response to Crisis: What should you assess?
Assess the level of effectiveness of coping capabilities
Assess for suicidal or homicidal risk*
Assess for evidence of self-mutilation activities
Assess the client’s perception of the problem and the availability of support mechanisms
Nursing Management: Physical Health Assessment
Changes in health practices, biologic function (sleep and eating patterns)
Changes in body function: tachycardia, tachypnea, profuse perspiration, nausea, vomiting, extreme shakiness
Nursing Management: Physical Health- Interventions
Treat life-threatening physical injuries
Do not give unrealistic or false reassurances of positive outcomes
Anticipate pharmacologic interventions to help reduce emotional intensity
Nursing Management: Psychological Domain- What do you assess
Emotions and coping strengths
Changes in presentation agitation, anxious, depressed
Loss of feelings of well-being and safety
Nursing Management: Psychological Domain- Interventions
Safety
Psychosocial aspects
Counseling
What is involved in safety interventions for nursing management of psychological domain?
Preventing suicide or homicide
Arranging for food and shelter (if needed)
Mobilizing social support
What is involved in Psychosocial aspects interventions for nursing management of psychological domain?
Encouraging report of any depression, anxiety, or interpersonal difficulties
Nursing Management Interventions: ABCs of psychological first aid
A—arousal
B—behavior
C—cognition
Nursing Management Interventions: ABCs of psychological first aid– A- Arousal
A—arousal, when present, the intervention goal is to decrease excitement by providing safety, comfort, and consolation
Nursing Management Interventions: ABCs of psychological first aid– B-behavior
B—behavior, when abnormal or irrational behavior present, survivors should be assisted to function more effectively in the disaster
Nursing Management Interventions: ABCs of psychological first aid– C- cognition
C—cognition, when cognitive disorientation occurs, reality testing and clear information should be provided
Grief responses
Intense, emotional reaction to the loss of a loved one; biopsychosocial response that often includes spontaneous expression crying, anger and expressions of guilt
Kubler-Ross Grief Cycle phases
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
Kubler Ross Grief Cycle: Denial phase
Avoidance
Confusion
Elation
Shock
Fear
Kubler Ross Grief Cycle: Anger phase
Frustration
Irritation
Anxiety
Kubler Ross Grief Cycle: Bargaining
Struggling to find meaning
Reaching out to others
Telling one’s story
Kubler Ross Grief Cycle: Depression phase
Overwhelmed
Helplessness
Hostility
Flight
Kubler Ross Grief Cycle: Acceptance
Exploring options
New plan in place
Moving forward
Grief definition
Natural, intense, physical, emotional, social, cognitive, or social reaction to the death of a loved one.
Responses to Grief include:
Spontaneous expressions to loss can include subbing, crying, anger, and expressions of guilt
Bereavement
Process of healing and learning how to cope with the loss. It begins immediately after the loss, and can last months or years.
Bereavement expressions
Individual differences, age, religious, and cultural practices, and social support influence grief and bereavement.
Persistent Complex Bereavement Disorder: What is the DSM-V criteria
A. Individual had a close relationship with the deceased
B. Persisted at 12 months after the death of bereaved adults and 6 months for bereaved children.
Persistent Complex Bereavement Disorder in addition to DSM-5 Criteria, one of the following symptoms must be present:
- persistent yearning/longing for the deceased
- Intense sorrow of emotional pain
- Preoccupation with the deceased
- Preoccupation with circumstances of the death
C. Six of the following symptoms: (In addition to DSM-V criteria and 1 of 4 symptoms)
- Marked difficulty accepting the death
- Experiencing disbelief and emotional numbness
- Difficulty with positive reminiscing about the deceased
- Bitterness or anger related to the loss
- Maladaptive appraisal of oneself i.e. self blame
- Excessive avoidance of reminders of the loss
- A desire to die*
- Difficulty trusting others after the death
- Feeling alone or detached from others
- Feeling that life is meaningless or empty
- Confusion about one’s role in life
- Reluctance to pursue interests
