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NRSG 126: Mental Health > [Exam 2] Chapter 11: Anger, Hostility, and Aggression > Flashcards

[Exam 2] Chapter 11: Anger, Hostility, and Aggression Flashcards

1
Q

When does anger result?

A

When a person is frustrated, hurt, or afraid.

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2
Q

When anger is handled appropriately, it can be a positive force that causes what?

A

helps a person resolve conflicts, solve problems, and make decisions

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3
Q

What is hostility?

A

Also called verbal aggression, is an emotion expressed through verbal abuse, lack of cooperation, violation of rules or norms, or threatening behavior

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4
Q

What is physical aggression?

A

Behavior in which a person attacks or injures another person or destroys property.

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5
Q

Anger: This can be a normal and healthy reaction when?

A

Situation or circumstances are unfair or unjust

Personal rights are not respected

Realistic expectations are not met

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6
Q

Anger: When does anger become negative?

A

When the person denies, suppresses, or expresses it inappropriately

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7
Q

Anger: Consequences of holding in anger include hwat?

A

Physical problems such as migraines, ulcer, or coronary diseases

Emotional problems like depression and low self-esteem

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8
Q

Anger: Nurses can help client by role-playing ssertive communication techniques. What are these?

A

Uses “I” statements that express feelings and are specific to the siutation. “I feel angry when you interrupt me” This shows appropriate expression

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9
Q

Anger: What is catharsis?

A

When some poeple express their angry feelings by engaging in aggressive but safe activities like hitting a punching bag

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10
Q

Anger: Wht is the problem with catharsis?

A

Can increase rather than alleviate angry feelings

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11
Q

Anger: What can be effective in managing situations or problems that provoke angry feelings?

A

Distraction, problem-solving, and changing one’s perspective or reframing

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12
Q

Anger: What is high hostility and anger associated with?

A

Increased risk of coronary artery disease and hypertension

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13
Q

Anger: Anger suppression common in what demographic?

A

Women, who have been socialized to maintain and enhance relationships with others and avoid the expression or negative emotions

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14
Q

Anger: WOmens anger often results when?

A

People deny them power or resources, treat them unjustly, or behave irresponsibly toward them

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15
Q

Hostility and Aggression: What are teh stages in aggressive incidents?

A

Triggering Phase (Incident or situation that initiates an aggressive response)

Escalation Phase

Crisis Phase

Recovery Phase

Post-crisis Phase

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16
Q

Hostility and Aggression: As clients behavior escalates toward crisis phase, what happens?

A

He /she loses ability to perceive events accurately, solve, problems, express feelings appropriately, or control their behavior

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17
Q

Hostility and Aggression: How do violent patients tendn to act when compared with nonviolent patients?

A

More symptomatic, have poorer functioning, and have a marked lack of insight

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18
Q

RElated Disorders: SOme clients with depression have what happen?

A

Anger attacks. Sudden intense spells of anger typically ocur when depressed person feels emotionally trapped

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19
Q

RElated Disorders: Anger attack involves what?

A

Verbal expressions of anger or rage but no physical aggression . Is uncharacteristic and is followed by remorse

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20
Q

RElated Disorders: What iis intermittent explosive disorder (IED)?

A

Rare psychiatric diagnosis chcaracterized by discrete episdoes of aggressive impulses that result in serious assaults or destruction of property

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21
Q

RElated Disorders: When is IED diagnosis made?

A

Only if the client has no other comorbid psychiatric disorders.

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22
Q

RElated Disorders: When does IED develop?

A

BEtween late adolescnce and 30s. More often males with dependent personality feaures who respond to feelings of usefulness with violent outbursts

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23
Q

RElated Disorders: What is Acting out?

A

Immature defense mechanism by which person deals with emotional conflicts or stressors through actions rather than reflection

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24
Q

Neurologic Theories: What plays a role in aggressive behavior?

A

Serotonin plays a major inhibitory role

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25
Q

Neurologic Theories: Low serotonin levels may lead to what?

A

Aggressive behavior

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26
Q

Neurologic Theories: Increased activity of dopamine and norepinephrine in brain associated with

A

increased impulsively violent behavior

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27
Q

Neurologic Theories: Damage to what part of the brain can lead to aggressive behavior?

A

Damage to limbic system, frontal, and temporal lobes

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28
Q

Psychosocial Theories: AS a child matures, they develop impulse control.. what is this?

A

Ability to delay gratification

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29
Q

Psychosocial Theories: What can increase a childs risk for failing to develop socially appropriate behavior?

A

Children in dysfunction families with poor parenting, children who receive inconsistent responses to their behaviors, and children in poor families

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30
Q

Psychosocial Theories: Lack of develop in children can lead to what behaviors?

A

Impulsive, easily frustrated, and prone to aggressive behavior

31
Q

Cultural Considerations: How do Native Americans and Asian culture view expressing anger?

A

As rude or disrespectful and to avoid it at all costs

32
Q

Cultural Considerations: What is Hwa-Byung or Hwabyeong?

A

Culture-bound syndrome that literally translates as anger syndrome or fire illness, attributed to the suppression of anger

33
Q

Cultural Considerations: Where is Hwa-Byung predominately seen?

A

In Korea with women

34
Q

Cultural Considerations: What is Hwa-Byung characteriszed by?

A

Sighing, abdominal pain, insomnia, irritability, anixetty, and depression

35
Q

Cultural Considerations: What is Bouffee Delirante?

A

Condition observed in West Africa and Haiti characterized by sudden outbursts of agitated and aggressive behavior, marked confusion, and psychomotor excitment

36
Q

Cultural Considerations: Episodes of Bouffee Delirante may include what?

A

Visual and Auditory hallucinations and paranoid idealization that resemble brief psychotic episodes

37
Q

Cultural Considerations: What is Amok?

A

Dissociative episode characterized by a period of brooding, following by an outburst of biolent, aggressive, or homicidal behavior directed at other people

38
Q

Cultural Considerations: What is Amok precipitated by?

A

Slight or insult and is seen only in men .

39
Q

Treament: Treatment of aggressive clienets often focuses on treating what?

A

The underlying or comorbid psychiatric diagnosis such as schizophrenia or bipolar disorder

40
Q

Treament: What has Lithium been useful for?

A

Treating aggressive clients with bipolar, conduct disorders in children, and intellectual disability

41
Q

Treament: What has Carbamazepine (Tegretol) and Valproate (Depakote) been used for?

A

Treat aggression associated with dementia, psychosis, and personality disorders

42
Q

Treament: What has Clozapine (Clozaril), Risperidone (Risperdal), and Olanzapien (Zyprea) been effective for?

A

Treating aggressive clients with dementia, brian injury, intellectual disability and personality disorders

43
Q

Treament: What are Benzoodiazepines used for?

A

Reduce irritabiltiy and agitation in older adults with dementia, but can result in loss of social inhiition for other aggressive clients

44
Q

Treament: Haloperidol (Haldol) and Lorazepam (Ativan) commonly used in combination to decrease

A

agitation or aggression and psychotic symptoms .

45
Q

Treament: PAtietns who are agitated and aggressive but not psychotic benefit from what?

A

Lorazepam, which can be given 2mg doses every 45-60 mins

46
Q

Treament: Atypical antipsychotics are more effective than conventional antipsychotics for what?

A

Aggressive, psychotic clients

47
Q

Treament: What should you be careful of with antipsychotic meds?

A

They require careful assessmetn for development of extrapyramidal side effects, that can be treated with benztropine

48
Q

Five Phase Aggression Cycle: TRiggering Definition

A

An event or circumstance in the environment initiates the client’s response , often anger or hostility

49
Q

Five Phase Aggression Cycle: Triggering S&S

A

Restlessness, anxiety, irritability, paacing, muscle tension, rapid breathing, anger

50
Q

Five Phase Aggression Cycle: Five Phase Aggression Cycle: Escalation Definition

A

Client’s responses present escalating behaviors that indicate movement toward a loss of control

51
Q

Five Phase Aggression Cycle: Escalation S&S

A

Pale or flushed face, yelling, swearing, agitation, threatening, demanding, clenched fists

52
Q

Five Phase Aggression Cycle: Crisis definition

A

During an emotional and physical crisis, client loses control

53
Q

Five Phase Aggression Cycle: Crisis S&S?

A

Loss of emotional and physicl control, throwing objects, kicking, hitting

54
Q

Five Phase Aggression Cycle: Recovery definition

A

Client regains physical and emotional control

55
Q

Five Phase Aggression Cycle: Recovery S&S

A

Lowering of voice, decreased muscle tension, clearer, more rational communication

56
Q

Five Phase Aggression Cycle: Postcrisis definition

A

Client attempts reconcillation with others and returns to the level of functioning before the agressive incident and its antecedents

57
Q

Five Phase Aggression Cycle: Postcrisis S&S

A

Remorse, apologies, crying, quiet, withdrawn behavior

58
Q

Nursing Process - Intervention: Intereventions are most effective and least restrictive when?

A

Implented early in the cycle of aggression

59
Q

Managing the Environment: : What gives clients the chance to talk about events or issues when they are calm?

A

Group or planned activites such as playing card games, watching and discussing movies or participating in information discussions

60
Q

Managing the Environment: If client has conflict or dispute with one naother, what can the nurse offer?

A

The opportunity for problem-solving or conflict resolution.

61
Q

Managing Aggressive Behavior: In the trigger phase, nurse should approach client how?

A

In a nonthreatening, calm manner in order to deescalate the client’s emotion and behavior

62
Q

Managing Aggressive Behavior: As the client’s anger subsides, nurse can help the client use what?

A

Relaxation techniques and look at ways to solve any problems or conflicts that may exist

63
Q

Managing Aggressive Behavior: What should the nurse do if the client progresses toward the escalation phase?

A

Provide directions in a calm, firm voice. Client should be directed to take time-out for cooling off and that aggressive behavior is not acceptable.

64
Q

Managing Aggressive Behavior: How many staff members should remain close initially?

A

4-6, also called a show of force.

65
Q

Managing Aggressive Behavior: How many staff members needed to restrain an aggressive client?

A

4-6 staff members

66
Q

Managing Aggressive Behavior: How do the 4-6 staff members take control?

A

Ech take a limb, one proteects clients head, and other helps control clients torso

67
Q

Managing Aggressive Behavior: What is the goal for the patient?

A

To teach angry, hostile, and potentially aggressive clients to expres their feelings verbally and safely without threats or harm to others or destruction of property

68
Q

Workplace Hostility: What did the JCAHO release in 2008?

A

Issued a sentinel event alert concerning “intimidating and disruptive behaviors” that undermine a culture of safety and lead to errors, decreased patient satisfactions, preventable outcomes, and loss of qualified personnel

69
Q

Workplace Hostility: What di the JCAHO add in 2016?

A

Workplace bullying. This included abusive conduct, and verbal abuse as well which prevents things from getting done

70
Q

Community-Based Care: What helps a client achieve stability?

A

Regular follow-up appointments, compliance with prescribed medication, and participation in community support programs

71
Q

Community-Based Care: Assasults by clients in the community were caused partly by

A

stressful living situations, increased access to alcohol and drugs, availability of lethal weapons, adn noncompliance with medications

72
Q

Community-Based Care: Clients who were assaultive were most likely to be who?

A

Older male clients with schizophrenia and younger clients with personality disorders

73
Q

Community-Based Care: What was Assaulted Staff Action Program (ASAP) established for?

A

To help staff victims cope with the psychological sequelae of assaults by clients in community-based residental program s

74
Q

Community-Based Care: Aggressive behavior is less common and less intense on units with what?

A

Strong psychiatric leadership, clear staff roles, and planned and adequae events such as staff-client interaction, group interaction, and activities

NRSG 126: Mental Health (24 decks)

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