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Nursing 2100H > Crisis, Grief, and Disaster Management > Flashcards

Crisis, Grief, and Disaster Management Flashcards

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1
Q

Crisis

A

time-limited challenge/threat that overwhelmed the person’s ability to cope
–> turning point w/positive or negative outcomes

  • time limited: 4-6 weeks
  • when we reach dysequilibium from stressful situaton a crisis will occur if any of these following balancing factors are absent
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2
Q

Crisis Balancing Factors

A
  1. realistic perception
  2. adequate situational support
  3. adequate coping skills
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3
Q

Types of Crises

A

Developmental
Situational
Traumatic

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4
Q

Developmental Crisis

A

significant events that are a normal part of growth/require role changes

ex: marriage, leaving for college
* developmental crisis and situational crisis may be very similar

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5
Q

Situational Crisis

A

occur when a specific life even upsets and individuals psychological equilibrium

*situational crisis and developmental crisis may be very similar

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6
Q

Traumatic Crisis

A

unexpected/unusual events affecting a person/group

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7
Q

Assessment

A

support systems

physical condition

  • emotions/strengths
  • mental status
  • suicide/homicide ideation
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8
Q

Diagnosis

A
  • ineffective coping
  • powerlessness
  • impaired communication
  • risk for violence/self harm
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9
Q

Psychological First Aid

A

ABCs of first aid focus on:

A: arousal
B: behavior
C: cognition

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10
Q

Intervention

A
  • may need to be directive if problem-solving abilities are strained
  • first arrange for safety/to meet basic needs (treat life-threatening injuries, arrange food/shelter, provide care for suicidal/homicidal ideation or plans)
  • do not give unrealistic or false reassurance of positive outcomes
  • Lorazepam (Ativan): benzo, anti-anxiety may be used
  • mobilize social support
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11
Q

Grief

A

an intense, biopsychosocial reaction to loss of loved one, spontaneous expression of pain, sadness, and desolation

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12
Q

Bereavement

A

process of mourning and coping

begins immediately, but can last months/years

*anniversary reactions may occur (emotions and grief may reappear on anniversary of death…etc.)

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13
Q

Phases of Bereavement

A
  1. Shock/Disbelieve
    - hours to weeks
    - varying degrees
  2. Acute Mourning
    - becomes gradually aware of loss (intense feeling, social withdrawal, identification w/deceased)
    - -includes crying
  3. Resolution
    - the return of feelings of well-being
    - acceptance of loss
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14
Q

Dual Process Model of Grieving

A

another explanation of how people deal w/loss is between loss-oriented coping (preoccupation w/deceased) and restoration-oriented copying (preoccupation w/other life events)

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15
Q

Uncomplicated Grief

A
  • physical responses
  • feeling of unreality (upset stomach, headaches, feeling of unreality…)
  • Intense preoccupation with deceased
  • Exaggerated guilt for any small negligence
  • Yearnings disbelief
  • 6 months may have signs of limited impairment in new situations
  • May grieve more over other situations like “empty nest”
  • Self esteem & competency intact & do NOT need counseling
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16
Q

Traumatic Grief

A

-More difficult & prolonged grief, benefits from treatment

Worse if it’s sudden (lack of anticipation)

External factors influence reactions & outcomes:

1) Suddenness and lack of anticipation
2) Violence, mutilation, and destruction
3) Preventability and/or randomness of the death
4) Multiple deaths (bereavement overload)
5) Mourner experienced significant threat to personal survival, or a massive and shocking confrontation with the deaths (and/or mutilation) of others

  • Reliving the traumatic death of the loved one
  • Suicide survivors may feel stigma, blame, shame, guilt & rejection
  • Women are more likely to confront & express negative emotions
17
Q

Complicated Grief

A
  • Occurs in 10-20% of people when the grieving person is stuck in a chronic state of mourning.
  • Intense longing & grieving for a person who died over 6 months ago.
  • Feelings of bitterness, lack of trust, life is meaningless without the deceased person.
18
Q

Nursing Management

A

Assess for suicide/self-harm

assess level of coping

listen –> intervene/link support systems

refer to therapist/psychiatrist

facilitate the development of positive coping skills

19
Q

Outcomes

A

return to previous/higher level of functioning

20
Q

Disaster/Terrorism

A

Disaster: sudden, overwhelming, catastrophic even that causes GREAT damage/destruction

may involve mass casualties/human suffering

requires assistance from all available resources

21
Q

Phases of Disaster

A
  1. Prewarning of Disaster
  2. Disaster event occurs
  3. Recuperative effort
22
Q

Prewarning of the Disaster

A

preparing victims for possible evacuation of environment, mobilization of resources, and review of disaster plans

23
Q

Disaster Event Occurs

A

rescuers provide resources, assistance, and support as needed to preserve the biopsychosocial functioning/survival of victims

24
Q

Recuperative Effort

A

implement strategies for healing sick

prevent complications

repair damage

reconstructing the community

25
Q

Types of Disaster Victims

A
  1. severe physical trauma
  2. professional rescuers
  3. everyone else
26
Q

Nursing Management of Disaster

A
  • mental status and panic reactions
  • physical condition
  • suicidal and homicidal ideation/plans
  • unexplained physical symptoms
27
Q

Diagnosis of Disaster

A

could be almost any Dx depending on situation/person’s reaction

  • insomnia
  • risk for self harm
  • relocation stress syndrome
  • fear
28
Q

Disaster Crisis Intervention

A

Similar to crisis interventions strategies w/following additions:
-help victims prioritize and match available resources with their needs

-the type/severity of the disaster will affect needs/resources

29
Q

When balancing factors are absent, what occurs?

A
  1. Distorted perception
  2. Inadequate support
  3. Inadequate coping skills
30
Q

ABC’s of psychological first aid: A

A

Arousal

when arousal is present, decrease excitement by providing safety, comfort, and consolation

31
Q

ABC’s of psychological first aid: B

A

Behavior

when irrational behavior is present, assist survivors to function more effectively in the disaster

32
Q

ABC’s of psychological first aid: C

A

Cognition

when cognitive disorientation occurs, reality testing and clear information should be provided

Nursing 2100H (28 decks)

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