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Psychosocial > Crisis, loss, grief, bereavement, and disaster management > Flashcards

Crisis, loss, grief, bereavement, and disaster management Flashcards

1
Q

Crisis

A

Time-limited event that triggers adaptive or nonadaptive responses to maturational, situational, or traumatic experiences

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2
Q

When does a crisis occur?

A

From stressful events when previous coping mechanisms fail to provide adequate adaptive skills to address the perceived problem. Adaptation to crisis occurs in 6 weeks

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3
Q

Example of positive and negative outcomes of a crisis

A

Pos: growth, change
Neg: suicide, homelessness, depression

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4
Q

Types of crises

A

Developmental, situational, traumatic

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5
Q

Developmental crisis

A

AKA maturational crises; Erikson; successfully resolving crisis at one stage allows one to move to the next stage. Kid develops positive characteristics after crisis is resolved. Leaving home, completing school, accepting adulthood

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6
Q

Situational crisis

A

Specific stressful event threatens a persons integrity and results in a degree of psychological disequilibrium. Internal (disease) or external (moving cities)

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7
Q

Traumatic crisis

A

Unexpected, unusual event that can affect the person or multiple people. Riots, war, rape, murder, kidnapping, earthquake, flood

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8
Q

What is the goal for people experiencing a crisis?

A

To return to precrisis functioning level

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9
Q

Nurses first priority for the patient in a crisis

A

Determining the extent of the physical injury or trauma

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10
Q

Safety and physical consequences of the crisis are the ____ priority

A

1st

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11
Q

Nursing a crisis the body reacts in different ways, name a few

A

Tachycardia, hyperventilation, suicidal ideation, body systems can change (diarrhea, incontinence)

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12
Q

T/F: food, shelter, fear, and extreme distress should be addressed by the nurse

A

T

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13
Q

Nurses should keep what in mind with therapeutic communications?

A

Be patient, listen, empathy, don’t give unrealistic or false reassurances of positive outcomes

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14
Q

Immediate goals in a crisis for nurses

A

Treat life-threatening physical injury, asses for suicide, arrange food and shelter, mobile social support

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15
Q

After the safety needs are met, the nurse can move towards…

A

Reestabilising self-care routines and using positive coping strategies

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16
Q

T/F medication can’t solve a crisis, they can reduce the emotional intensity

A

T

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17
Q

The nurse should refer anyone who cannot cope with a crisis to who?

A

A mental health specialist

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18
Q

Lorazepam (Ativan)

A

-Benzo
-management of anxiety
- drowsy, sedation, lethargy, hypoTN

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19
Q

Bereavement

A

Mourning; process of healing after a perceived loss. Begins immediately after loss and can last months to years

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20
Q

What year after a loss is the most difficult?

A

The 1st due to holidays and birthdays

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21
Q

Grief

A

A natural, intense, physical, emotional, social, cognitive, or social reaction to the death of a loved one. Crying, sobbing, anger, guilt

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22
Q

Predeath grief

A

When someone has a terminal illness and mostly occur in caregivers. Dementia for example. This type of grief is associated with depressive symptoms, caregiver burden, and less communication within families

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23
Q

Acute grief

A

Occurs immediately after the death of a loved one and normally evolves to a permanent state of integrated grief

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24
Q

Integrated grief

A

Long-term process where there continues to be mild yearning and memories but they aren’t intrusive.

25
Q

Prolonged grief disorder

A

PGD; intense longing for or persistent preoccupation w/the deceased that lasts more than 6 months

26
Q

Dual process model

A

Explains how grieving people come to terms with their loss over time (coping). People go the the process of confronting (loss-oriented coping) and avoiding ( restoration oriented coping)

27
Q

In loss-oriented coping, what do the emotions relate to?

A

The relationship with the deceased

28
Q

In restoration-oriented coping, what do the emotions relate to?

A

The stressful events associated with the responsibilities and changes as a result of the loss (paying the dead bills, etc)

29
Q

Uncomplicated bereavement

A

Painful and disruptive, but there is always movement. “Why my loved one?”, empty nest syndrome. Don’t need clinical interventions, they move on w/their lives, don’t benefit from therapy, most common

30
Q

Traumatic grief

A

Suddenness and lack of anticipation, violence/mutilation/destruction, degree of preventability, multiple deaths, mourners personal encounter with the death, COVID-19

31
Q

Complicated bereavement

A

PGD; person is frozen/stuck in a state of chronic mourning and lasts more than a month to 6 months after the loss. No movement in the thought processes. Bitter feelings, lack ability to trust others, feeling meaningless

32
Q

What do you expect physically with grief?

A

Sleep difficulty, lack of appetite, weight loss, asses for substance use

33
Q

The nurse should watch for maladaptive thoughts when assessing cognition, what are some examples

A

Protesting the death (“its not fair” or could have prevented the death), having a negative view of the world (nobody is safe), and needing the person (life is unbearable w/out them)

34
Q

The nurse should always consider depression and suicide, as well as access to food/shopping, living arrangements, ADLs

A

yep

35
Q

What is the goal of bereavement interventions?

A

Help with person adapt and re-stabilize biopsychosocial systems as the pain and sadness lessens with time

36
Q

What medications can be used to aid in bereavement?

A

Antidepressants or sleep aids; monitor use to prevent long-term use

37
Q

When is the risk of suicide highest with bereavement?

A

After the funeral, loneliness sets in and full impact of loss is realized.

38
Q

What are positive outcomes of bereavement?

A

Adaption to life w/out the deceased, learning to live w/reminders of deceased, attending to self-care, and enjoying activities again

39
Q

Disaster

A

Sudden overwhelming catastrophic even that causes great damage and destruction that may involve mass casualties and human suffering requiring assistance from all available resources

40
Q

Examples of disasters

A

Terrorism and pandemics

41
Q

How has history portrayed disasters?

A

Fatalistic perspective that humans have little control over catastrophic events. Some cultures say “its an act of God”,

42
Q

Natural disasters

A

Hurricane Harvey and Maria highlighted the importance of government preparedness for natural disasters and terrorism.

43
Q

Terrorism

A

Before 9/11 govt agencies did not incorporate mental health into overall response plans, now they do

44
Q

COVID-19 pandemic

A

WHO declared it a national emergency. ICU was overloaded, lack of prepared health care workers. Time-limited nature disaster. Health care workers are reporting PTSD, depression, insomnia, and anxiety. Patients report mental health probs, isolation, stigma

45
Q

Phases of disaster

A

1) prewarning
2) disaster event occurs
3) recuperative effort

46
Q

3 types of disaster victims that psychiatric nurses encounter

A

1) may/not survive. If they do, they have severe physical injuries; PTSD
2) professional rescuers; psychological stress, report PTSD
3) everyone else; altered sense of safety, travel less, increase smoking

47
Q

Primary public health concern during disasters

A

Drinking clean water, food, shelter, and medical care

48
Q

Medications to help with psychological consequences of disasters

A

Anti-anxiety or sedatives

49
Q

ABCs of psychological aid

A

A- arousal
B- behavior
C- cognition

50
Q

When arousal is present, what should you do?

A

Decrease excitement by providing safety, comfort, and consolation

51
Q

When cognition disorientation occurs, what should you do?

A

Reality testing and clear information should be provided

52
Q

Debriefing

A

Reconstruction of the traumatic events by the victim. Not useful for everyone

53
Q

How can the nurse prepare the victim of disaster for recovery?

A

Teach abt effects of stress and help the person identify strengths and coping skills.

54
Q

Psychoeducation

A

Nurse explains anticipated reactions and behaviors to help victims gain control and improve coping. Education on natural recovery process to the public b/c information gaps can increase anxiety and stress.

55
Q

FEMA

A

Federal emergency management agency; provides counseling and mental health services

56
Q

SAMHSA

A

Substance abuse and mental health services administration assists both victims and responders of the disaster

57
Q

SAMHSA

A

Substance abuse and mental health services administration assists both victims and responders of the disaster

58
Q

Stage theories propose that grief and bereavement follow ___/___ and that process models explain bereavement as ____

A
  • Stages/phases
  • nonlinear

Psychosocial (5 decks)

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