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psych exam #1 > crisis intervention > Flashcards

crisis intervention Flashcards

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1
Q

goal when a person is in crisis

A
  • maintain system stability
  • mobilize resources required to assist the person
  • restore the person to adaptive function (cog. ability is diminished, they cannot function)
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2
Q

stress

A

state of disequilibrium in response to environmental stressors

  • if overwhelming and cannot cope = disequilibrium occurs = crisis
  • can be positive or negative
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3
Q

adaptive response to stress

A
  • healthy
  • maintains individual integrity
  • person is able to cope
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4
Q

maladaptive response to stress

A
  • unhealthy
  • disrupts individual integrity and homeostasis
  • unable to cope
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5
Q

general adaptation syndrome

A
  • stress as a biological response
    1. alarm reaction stage
    2. stage of resistance
    3. stage of exhaustion
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6
Q

alarm reaction stage

A
  • stage 1
  • “fight or flight”
  • emergency systems activate, glands enlarge
  • increased catecholamines cortisol leads to increased glycogenolysis
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7
Q

stage of resistance

A
  • 2nd stage
  • physiological response of first stage are used as a defense in an attempt to adapt
  • successful adaptation = delayed 3rd stage
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8
Q

stage of exhaustion

A
  • 3rd stage
  • prolonged exposure to the stressor
  • adaptive energy is depleted
  • ind. can no longer draw from resources for adaptation in first 2 stages
  • diseases of adaptation can ensue: decreased immune response, hyperglycemia, ulcers, HA, mental disorders)
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9
Q

anxiety

A
  • most common emotional response to stressors

- vague feeling of dread which is not reality bases and a major component of crisis

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10
Q

crisis

A
  • acute and time limited state of disequilibrium r/t perceived threat
  • usual coping skills cannot resolve the problem
  • threat doesn’t have to be real
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11
Q

crisis characteristics

A
  • occurs in everyone, does not mean you have a mental illness
  • personal, a crisis is a crisis to the person who is in it
  • acute and will be resolved in one way or another within a brief period
  • contains potential for psychological growth or deterioration
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12
Q

phase I of crisis development

A
  • impact phase
  • ind is exposed to a precipitating stressor = increased anxiety
  • person starts using the usual problem solving skills
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13
Q

phase 2 of crisis development

A
  • event is perceived as a threat

- usual problem solving skills are unsuccessful, leading to helplessness, confusion, and disorganization

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14
Q

phase 3 of crisis development

A
  • all resources and new problem solving skills are used but fail
  • total disorganization, severe anxiety, depression, and withdrawal
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15
Q

phase 4 of crisis development

A
  • if problem remains unresolved, anxiety increased to panic
  • cognitive functions are disordered
  • emotions are labile
  • behavior may reflect the presence of psychotic thinking and violent behavior
  • crisis ensues
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16
Q

emotional responses during crisis

A
  • high anxiety
  • denial
  • anger
  • remorse
  • grief
17
Q

active s/s of crisis

A
  • agitated
  • screaming
  • crying
  • rapid speech
  • emotional out of control
  • n/v
  • wringing hands
  • hyperactive
  • flushed face
18
Q

passive s/s of crisis

A
  • fainting
  • inactivity
  • weak pulse
  • diaphoresis
  • pale face
  • emotionally subdued
19
Q

variables in crisis development

A
  • individual’s perception of the event
  • availability of situational support
  • adequacy of coping mechanisms
  • *whether or not an ind. experiences a crisis in response to a stressful situation depends on these variables
20
Q

realistic/accurate perception of event

A
  • greater success at problem solving efforts

- individual more likely to draw upon adequate resources to restore equilibrium

21
Q

distorted/inaccurate perception of event

A
  • problem solving fails, leading to disequilibrium
  • ineffective attempts to problem solve
  • restoration of equilibrium goes unresolved
22
Q

risk factors for crisis development

A
  • intense & multiple concurrent threats
  • pre-existing psychological & psychiatric problems increase vulnerability to crisis development
  • family hx of psychiatric problems
  • lack of nurturing and childhood guidance
23
Q

availability of situational support

A
  • provide assistance in coping
  • parents, siblings, friends, clergy, counselor
  • without anyone, a person becomes vulnerable and overwhelmed
24
Q

developmental crisis

A
  • transitional changes in predictable life events that occur gradually in the course of a life cycle
  • when the pattern of predictable life events break, a dev. crisis can occur
25
Q

maturational crisis

A

-failure to meet expectations of development can lead to crisis (Erikson’s)

26
Q

situational crisis

A
  • external situations mostly unpredictable and threatens one’s well being
  • material: natural disasters, environmental
  • personal: physical, disfigurement
  • interpersonal/social: divorce, death
27
Q

crisis intervention

A
  • short term therapeutic process that focuses on immediate crisis using support system, professional help, and environmental resources
  • primary goal: re-establish a level of functioning equal or higher to pre-crisis state and regain emotional balance
  • immediate attention to problems = healthy adaptation
28
Q

role of nurse in crisis

A
  • talk in a reassuring tone
  • use person’s name
  • talk directly and keep language simple
  • warn client when something is going to be done
29
Q

assessment in crisis

A
  • assess situation first
  • observe first, listen carefully, don’t talk, obtain as much background and hx as possible
  • as if the pt knows what he or she needs at this moment
  • ask individual to describe event that precipitated the crisis
  • asses the individual’s physical and mental status
  • determine if individual has experienced this stressor before
  • assess for SI and homicide
30
Q

planning/implementation in crisis

A
  • offer assistance: “what can I do to help?”
  • touch gently
  • provide concrete directions
  • cut down on stimuli around the ind.
  • do not rush
  • talk calmly and slowly
  • be prepared to repeat information
  • they take things literally
  • offer reasonable alternatives
  • don’t argue
  • don’t leave pt alone
31
Q

evaluation in crisis

A
  • is the client able to maintain system stability
  • is the client able to recognize events that lead to the crisis
  • are the client’s problem solving skills improved as a result of the crisis

psych exam #1 (6 decks)

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