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Psychiatric Nursing > Dissociative Disorders > Flashcards

Dissociative Disorders Flashcards

1
Q

Removal from conscious awareness of painful feelings, memories, thoughts, or aspects of identity

A

Dissociation

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2
Q

Mainly characterized by disturbance in identity, memories, thoughts, or aspects of identity

A

Dissociative Disorders

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3
Q

Precipitated by extreme stress or trauma

A

Dissociative Disorders

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4
Q

Types of Dissociative Disorders

A

-Dissociative Amnesia
-Dissociative Fugue
- Dissociative Identity Disorder

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5
Q

loss of memory or inability to recall important personal information

A

Amnesia

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6
Q

Inability to form new memories after onset of amnesia

A

Anterograde

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7
Q

Inability to recall memories before amnesia

A

Retrograde

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8
Q

Characteristics of Dissociative Amnesia

A

-One or more episodes of the inability to recall important personal information that is beyond ordinary forgetfulness
-Lost information is usually stressful or traumatic in nature
-(+) wandering, disorientation, confusion
-Psychosocial stressors: threat of physical injury or death

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9
Q

(+) wandering, disorientation, confusion

A

Dissociative Amnesia

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10
Q

What’s the Psychosocial Stressors of Dissociative Amnesia?

A

Threat of physical injury or death

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11
Q

Nursing Diagnosis of Dissociative Amnesia

A

-Impaired Memory
- Ineffective Coping

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12
Q

Goals for Dissociative Amnesia

A

-Help the person to remember forgotten or traumatic events in a controlled way & to accept & integrate them
-Resolve distressing situations
-Strengthen coping skills

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13
Q

Interventions for Dissociative Amnesia

A

-Involvement of family member/significant other to remember what happened
-Trauma work (CISM)
-Hypnosis

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14
Q

Characteristics of Dissociative Fugue

A

-Sudden, unexpected travel away from home or some other location with the assumption of a new identity or a confusion about one’s identity
-(+) amnesia
-Unable to recall events during fugue state

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15
Q

(+) Amnesia

A

Dissociative Fugue

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16
Q

Psychosocial stressors of Dissociative Fugue

A

-Marital quarrels
-Personal rejections
- Military conflict
- Natural disasters
- Financial difficulty
- suicidal ideation

17
Q

Nursing Diagnosis of Dissociative Fugue

A

-Risk for Injury
- Impaired Memory
- Ineffective Coping

18
Q

Interventions for Dissociative Fugue

A

Fugue states usually end rather abruptly on their own

Supportive psychotherapy- to help person identify & resolve stressors leading to fugue state and to learn better coping skills, so that fugue does not happen again.

19
Q

Existence of two or more personalities that take control of the person’s behavior

A

Dissociative Identity Disorder (D.I.D)

20
Q

Has a Host & Alters

A

Dissociative Identity Disorder (D.I.D)

21
Q

Original Personality

A

Host

22
Q

Dissociative Personality/-ies

A

Alters

23
Q

Precipitated by abuse (Sexual)

A

Dissociative Identity Disorder (D.I.D)

24
Q

Initially, unaware of the existence of alters

A

Host

25
Q

Experiences amnesia while alters takes over

A

Host

26
Q

Has an awareness of the existence of alters

A

Alters

27
Q

Each has its own name, behavior traits, memories, emotional characteristics, and social relations

A

Alters

28
Q

Represents fragments of the host’s sense of identity with different identity states remembering distinct information

A

Alters

29
Q

Management-Milieu

A

Psychotherapy

-Long- term, intensive, out- patient
-Directed toward uncovering the underlying psychological conflicts, helping him or her gain insight into these conflicts, and striving to synthesize the various identities into one integrated personality.

30
Q

Part of psychotherapy that involves mental re-experience of trauma/abuse that caused the illness

A

Abreaction

31
Q

Part of Psychotherapy that blending of all personalities into one

A

Integration

32
Q

Used to look into each personalities

A

Hypnosis

33
Q

Part of Psychotherapy that recommends when an aggressive or suicidal alter is in a dominant role

A

Hospital admission

34
Q

Psychopharmacology Management of Dissociative Identity Disorder (D.I.D)

A

-Anxiolytics, as ordered
- Anti-depressants, as ordered

35
Q

This drug is used if client becomes hostile

A

Anxiolytics

36
Q

This drug is used to control anxiety

A

Anti-depressants

37
Q

Nursing Management of Dissociative Identity Disorder (D.I.D)

A

-Establish trust and rapport
- Facilitate physiologic and neurology work ups to rule out organic causes
- Assist in slowly helping patients deal with anxiety and conflicts in their lives and improve coping skills
-Treat an adult patients as an adult even if an alter is a child
- Be consistent with approach to develop a caring and supportive environment
-If patient has suicidal tendencies, facilitate initiation of no-harm contract
- If patient becomes aggressive, deal with aggression while observing the principle of least restrictive treatment.

38
Q

Dealing with Aggressive Patients

A

-Ensure scene safety, when in doubt do not act alone
- Attempt verbal de-escalation (use a calm, firm voice)
- Direct the patient to take a voluntary time-out in a quiet area
- Inform the patient aggressive behavior is not acceptable
-Offer PRN medications to help the patient return to a calm state (e.g., Lorazepam)
- Provide a “show of force/strength” (gather 4-6 team members to remain in sights with patient interactions

39
Q

Involves debriefing

A

Dealing with aggressive patients

Psychiatric Nursing (16 decks)

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