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NRSG 126: Mental Health > [Exam 2] Chapter 13: Trauma and Stressor-Related Disorders > Flashcards

[Exam 2] Chapter 13: Trauma and Stressor-Related Disorders Flashcards

1
Q

What is PTSD?

A

Disturbing pattern of behavior demonstrated by someone who has experienced, witnessed, or been confornted with a traumatic event such as a natural disaster, combat, or an assault

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2
Q

PTSD: A person with PTSD was exposed to an event that posed what?

A

Actual or threatened death, or serious injury and responded with intense fear, helplessness, or terror

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3
Q

PTSD & Clinical Course: What are the four subcategories of PTSD?

A

Reexperiencing the trauma through dreams or recurrent and intrusive thoughts

Avoidance

Negative congitions or thoughts being on guard

Hyperarousal

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4
Q

PTSD & Clinical Course: How does a person reexperience the truma?

A

Through memories, dreams, flashbacks, or reactions to external cues about the events

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5
Q

PTSD & Clinical Course: How does the client feel or react?

A

Feels numbing of general responsiveness and shows persistent signs of increased arousal such as insomnia, hyperarousal, or hypervigilance, irritability, or angry outbursts

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6
Q

PTSD & Clinical Course: When do PTSD symptoms appear?

A

3 months or more after a truma, which distinguishes this from acute stress disorder

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7
Q

PTSD & Clinical Course: At what time frame does acute stress disorder appear?

A

Lasts 3 days to 1 month .

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8
Q

PTSD & Clinical Course: How long can this be delayed for?

A

Months or even years.

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9
Q

PTSD & Clinical Course: Those with PTSD develop other psychiatric disorders such as what?

A

Depression, anxiety disorders, or alcohol and drug abuse

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10
Q

PTSD & Clinical Course: What percentage of people are at risk for this?

A

Up to 60%, such as combat veterans and victims of violence and natural distasters

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11
Q

PTSD & Clinical Course: Complete recovers occurs how quikcly in 50% of people?

A

3 months

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12
Q

PTSD & Clinical Course: What percentage of those with physical assault develop PTSD?

A

25%

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13
Q

PTSD & Clinical Course: What percentage of rape victims develop PTSD?

A

70%

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14
Q

PTSD & Related Disorders: What is Adjustment disorder?

A

Reaction to a stressful event that causes problems for the individual.PErson ha more than the expected difficulty coping with or assimilating the event into his or her life

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15
Q

PTSD & Related Disorders: What are the most common events for adjustment disorder?

A

Financial relationship and work-related stressors

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16
Q

PTSD & Related Disorders - Adjustment DisordeR: Symptoms develop with what time frmae?

A

within a month, and last no more than 6 months

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17
Q

PTSD & Related Disorders - Adjustment DisordeR: At the time, the adjustment has been successful and the person does what?

A

Moves on to another diagnosis

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18
Q

PTSD & Related Disorders - Adjustment DisordeR: What is the most successful treatment?

A

Outpatient counseling or therapy

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19
Q

PTSD & Related Disorders - Acute Stress DisordeR: When does this occur?

A

After a traumatic event and is characterized by reexperiencing, avoidance, and hyperarousal that occur 3 days to 4 weeks following trauma

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20
Q

PTSD & Related Disorders - Acute Stress DisordeR: This can be a precurosr to what?

A

PTSD

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21
Q

PTSD & Related Disorders - Acute Stress DisordeR: What helps prevent the progression to PTSD?

A

Cognitive- behavioral therapy involving exposure and anxiety management

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22
Q

PTSD & Related Disorders - Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED): When does this occur?

A

Before the age of 5 in response to the trauma of child abuse or neglect, called grossly pathogenic care.

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23
Q

PTSD & Related Disorders - Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED): What signs does teh child show?

A

Disturbed inappropriate social relatedness in most siutations.

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24
Q

PTSD & Related Disorders - Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED): What does a child with RAD exhibit?

A

Minimal social and emotional responses to others, lacks a positive effects, and may be sad, irritable, or afraid for no apparent reason

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25
Q

PTSD & Related Disorders - Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED): What does a child with DSED exhibit?

A

Unselective socialization, allowing or tolerating social interaction with caregivers and strangers alike. They lack the hesistation in approaching or talking to strangers

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26
Q

PTSD & Related Disorders - Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED): What leads ot the DSESD disorder?

A

Grossly deficient parenting and institutionalization

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27
Q

PTSD & Etiology: What has to occur prior to the development of PTSD?

A

Causative trauma or event that occurs prior to this, which is not the case with anxiety disorders

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28
Q

PTSD & Etiology: PTSD is a disorder associated with what?

A

Event exposure , rather than personal characteristics

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29
Q

PTSD & Etiology: What are the most powerful predictors of PTSD for most poele?

A

Effects of trauma at the time, such as being directly involved, experiencing physical injury, or loss of loved ones int he event

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30
Q

PTSD & Etiology: What can increase risk of PTSD?

A

Lack of social support

Peri-Trauma Dissociation

Previous Psychiatric history or personality factors

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31
Q

PTSD & Etiology: What can decrease the risk of PTSD?

A

People who participate in posttrauma counseling right after the event

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32
Q

PTSD & Etiology: Adolescents with PTSD are at a higher risk for what?

A

Suicide, substance abuse, por social support, academic problems, and poor physical health

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33
Q

PTSD & Etiology: Why is Trauma-Focused CBT used?

A

Beneficial and can be delivered in school or community. Positive long-term effects bothw ith PTSD and other comorbid conditions

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34
Q

PTSD & Etiology: What may PTSD disrupt?

A

Biologic maturation process contributing to long-term emotional and behavioral problems experienced by adolescents with this didosrder would require ongoing or episodic therapy

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35
Q

PTSD & Etiology: What are teh Criteria for this?

A

Exposure to the violence

Having symptoms associated with this

Persistent avoidance of stimuli associated withe vent

Negative alterations in cognitions and mood

Marked alterations in arousal and reactivity associated with traumatic events

Duration of disturbance ( > 1 month)

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36
Q

PTSD & Etiology: When are children most likely to develop PTSD?

A

Where there is a history of parentla major depression and chilhood abuse

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37
Q

PTSD & Cultural Considerations: People leaving their countries for reasons of political oppression experience what?

A

Mental defeat and alienation and lower levels of resilence, along with poorer outcomes

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38
Q

PTSD & Cultural Considerations: People with what are less likely to be diagnosed with PTSD??

A

People with a stronger sense of self and cultural identity and have better outcomes when PTSD present

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39
Q

PTSD & Treatment: What could be done for people with acute stress disorder to prevent turning this into PTSD?

A

COunseling or therapy, individually or ing roups

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40
Q

PTSD & Treatment: What is the indicated tx for PTSD?

A

Therapy on an outpatietn basis

41
Q

PTSD & Treatment: Thoughts about inpatient tx and PTSD?

A

Not indicated, unless in times of severe crisis. Usually occurs when client is suicidal or is being overwhelmed

42
Q

PTSD & Treatment: What are the most common adn successful types of formal tx?

A

CBT and specialized therapy programs incorporating elements of CBT

43
Q

PTSD & Treatment: What is Exposure Therapy?

A

Treatment approach designed to combat the avoidance behavior that occurs with PTSD, help the client face troubling thoughts and feelings, and regain a measure of control over his or her thoughts and feelings

44
Q

PTSD & Treatment - Exposure Therapy: What does the client do here?

A

Confront the feared emotions, situations, and thoughts associated with the trauma rather than attempting to avoid them.

45
Q

PTSD & Treatment - Exposure Therapy: How is anxiety response managed?

A

Through various relaxation techniques

46
Q

PTSD & Treatment - Exposure Therapy: Example of how this is done?

A

May confront the event in reality, returning to the place where one was assaulted. Prolonged exposure therapy effective in both active and veterans

47
Q

PTSD & Treatment - Adaptive Disclosure: What is this?

A

Specialized CBT approach developed by the military to offer an intense, specific, short-term therapy for active duty military personal with PTSD

48
Q

PTSD & Treatment - Adaptive Disclosure: How is this done?

A

Incorporates exposure therapy a well as empty chair technique, in which participant says whatever he or she needs to say to anyone, alive or dead

49
Q

PTSD & Treatment - Adaptive Disclosure: How long is this?

A

Six short sessions. Is wel tolerated and effective in educing PTSD symptoms and promoting post-trauma growth

50
Q

PTSD & Treatment - Cognitive Processing Therapy: Who has this been used on?

A

With rape survivors with PTSD as well as combat vetrans

51
Q

PTSD & Treatment - Cognitive Processing Therapy: How is this done?

A

Involves structured sessions that focus on examining beliefs that are erroneous or interefere with daily life, such as guilt or self-blame

52
Q

PTSD & Treatment - Cognitive Processing Therapy: Example of this therapy?

A

“It was my fault, I should have fought harder” or “I should have died with my fellow marines”.

53
Q

PTSD & Treatment: What is most effective for clients with PTSD experiencing insomnia, anxiety, or hyperarousal?

A

SSRI and Serotonin and Norepinephrine Reuptake Inhibitor Antidepressants
2nd. 2nd gen antopsychotic such as risperidone

54
Q

PTSD & Elder Considerations: Chronic PTSD may be associated with what?

A

Premature aging and dementia

55
Q

PTSD & Community-Based Care: Most care provided in aftermath provided where?

A

Outpatient basis.

56
Q

PTSD & Community-Based Care: What kidn of treatment is provided?

A

Individual therpy, group therapy, and self-help groups

57
Q

PTSD & Community-Based Care: Client and Family Education for this?

A

Ask for support from others

Avoid social isolation

Join support group

Share emotions and expeirences with others

Se small, specific, achievable goals

Get adequate sleep

58
Q

PTSD & Mental Health Promotion: One of the most effective ways of avoiding pathologic responses to trauma is what?

A

Effectively dealing with the trauma soon after it occurs

59
Q

PTSD & Mental Health Promotion: Difference between acute stress disorder and PTSD

A

Stress immediately after event is acute stress disorder, while PTSD is delayed in onset

60
Q

Dissociative Disorders: What is Dissociation?

A

Subconscious defense mechanism that helps a person protect his or her emotional self from recognizing the full effects of some horrific or traumatic event by allowing the mind to forget or remove ittself from painful memory or situation

61
Q

Dissociative Disorders: When can this occur?

A

During and after event

62
Q

Dissociative Disorders: What features do these have?

A

Feature of disruption in the usually integrated functions of consciousness, memory, identity, or environmental perception

63
Q

Dissociative Disorders: This often interferes with what?

A

Persons relationships, ability to function in daily life, and ability to cope with the realities of the abusive or traumatic event

64
Q

Dissociative Disorders: These symptoms are seen in what type of person?

A

Clients with PTSD

65
Q

Dissociative Disorders: What is Dissociative Amnesia?

A

Client cannot remmber important personal information (traumatic or stressful nature).

66
Q

Dissociative Disorders: What does the Dissociative Amnesia category include?

A

Fugue experience where client suddenly moves to a new geograpgic location with no memory of poast events and often the assumption of new identity

67
Q

Dissociative Disorders: What is Dissociative Identity Disorder (Formely multiple personality disorder)

A

Client displays two or more distint identities or personality states that recurrently take control of his or her behavior

68
Q

Dissociative Disorders: Dissociative Identity Disorder is accompanied by what?

A

Inability to recall important personal information

69
Q

Dissociative Disorders: What is Depersonalization / Derealization Disorder?

A

Client has a persistent or recurrent feelings of being detached form his or her mental processes or body (Depersonalization) or sensation of being in a dream - like state in which the environment seems foggy or unreal (derealization).

70
Q

Dissociative Disorders: Client is not what is depersonalization / Derealization disorder?

A

Not psychotic nor out of touch iwth reality

71
Q

Dissociative Disorders: Prevalent in who?

A

Those with histories of childhood physical and sexual abuse

72
Q

Dissociative Disorders: What do professionals feel abotu repressed memories?

A

Believe that memories of childhood abuse can be buried deeply in the subconscious mind or repressed because they are too painful for the victim to acknowledge that victims can be helped to recover such painful memories

73
Q

Dissociative Disorders: Some mental health members believe there is a danger of inducing false memories of children through imagination why?

A

Because this so-called false memory syndrome has created problems in families when clients made groundless accusations of abuse

74
Q

Dissociative Disorders & Treatment and Interventions:Survivors of abuse with this often involved with what tx?

A

Group or individual therapy in the community to address the long-term effects of their experiences

75
Q

Dissociative Disorders & Short Hospital Tx: When is the nurse most likely to run into someone like this?/

A

Acute care settings only when there are concerns for personal safety or the safety of others or when acute symptoms have become intense or overwhelming

76
Q

What is Posttrauma Syndome?

A

Ongoing, maladapptive pattern of behavior in response to a traumatic event that posed a threat to the well-being of the individual

77
Q

Dissociative Disorders & Assessment: Health history reveals what?

A

That the client has a history of trauma or abuse. It may be abuse as a child or recent relationship

78
Q

Dissociative Disorders & Assessment - General Appearance: How does clieetn appear?

A

Hyperalert and reacts to even small environment noises with a stratle response. May be uncomfortable if nurse too close.

79
Q

Dissociative Disorders & Assessment - Mood and Affect: How may client look?

A

Frightened or scared or agitated and hostile depending on his or her experience.

80
Q

Dissociative Disorders & Assessment - Thought Process and Content: How do those who have been abused or traumatizeed report trauma?

A

Relive it through nightmares or flashbacks

81
Q

Dissociative Disorders & Assessment - Thought Process and Content: Intrusive, persistent thoughts about the trauma interefere with clients ability to do what?

A

Think about other things or to focus on daily living

82
Q

Dissociative Disorders & Assessment - Thought Process and Content: What do some clients report?

A

Hallucinations or buzzing voices in their heads

83
Q

Dissociative Disorders & Assessment - Sensorium and Intellectual Processes: What can nurse do here?

A

Finds that client is oriented to reality except if the client is experiencing a flashback or dissociative episode

84
Q

Dissociative Disorders & Assessment - Sensorium and Intellectual Processes: Nurse may find that a client who has been abused has what?

A

Memory gaps

85
Q

Dissociative Disorders & Assessment - Judgement and Insight: Insight of client often related to what?

A

Duration of his or her problems with dissociation or PTSD

86
Q

Dissociative Disorders & Assessment - Judgement and Insight: In early tx, client may report what?

A

/Little idea about the relationship of past trauma to his or her current symptoms or problems

87
Q

Dissociative Disorders & Assessment - Self-Concept: Nurse finds that these clinets have low what?

A

Self-Esteem. They believe they are bad people who somehow deserve or probole the abuse

88
Q

Dissociative Disorders & Assessment - Roles and Relationships: Problems with authority figures often leads to what?

A

Problems at work, such as being unable to take direction from another or have another person monitor performance

89
Q

Dissociative Disorders & Assessment - Roles and Relationships: Close relationships difficult why?

A

Because of client’s ability to trust others is severelly compromised. Often client has quit work or has been fired.

90
Q

Dissociative Disorders & Intervention: How can a nurse promote safety?

A

Talking with clieent about differnt b/w having self-harm thoughts and taking actions on those thoughts

Having thoughts does not mean client acts on them

91
Q

Dissociative Disorders & Intervention: How can a nurse help client cope with stress and emotions?

A

Using grounding techniques

Validating client’s feelings or fear

Use supportive touch if client responds well to it

Use distraction technique such as physical exercise

92
Q

Dissociative Disorders & Intervention: How to help client promote self esteem

A

Refere to them as survivor rather than victim

Establish social support system

93
Q

Dissociative Disorders & Intervention: What do grounding techniques do?

A

Remind the client that they are present, is an adult, and is safe

94
Q

Dissociative Disorders & Intervention: How can a nurse help a client focus on their experiences?

A

What are you feeling?

Are you hearing something

Do you feel your feet on the floor?

95
Q

Dissociative Disorders & Intervention: Example is trying to use grounding technique to focus the client on present?

A

“Hello Janet. Im here with you. My name is Kevin. Im the nurse working with you today. Today is Wednesday. Youre in the hospital. This is your room at the hospital”

96
Q

Dissociative Disorders & Intervention: Getting hte client to stand up and walks helps with what?

A

Dispel the dissociative or flashback experience

97
Q

Autism spectrum disorder can be a precursor to

A

PTSD

98
Q

Symtoms of PTSD?

A

Feelingso f guilt and shame, low self-esteem, reexperiencing events, hyperarousal, and insomnia

99
Q

Important nursing interventions for usrvivors of abuse and trauma include

A

protecting the clients safety

helping the client elarn to manage stress and emotions

Working with clients ot build a network of community support

NRSG 126: Mental Health (24 decks)

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