HB-burn victims Flashcards
What are the 3 stages of recovery for burn victims?
- Resuscitative or Critical Stage
- Acute Stage
- Long Term Rehabilitation Stage
What are the psychological issues associated w/ the resuscitative or critical stage? Where is the patient at this point?
Patient in the ICU. Stressors of the ICU (under or overstimulation) Hallucinations or psychotic issues Cognitive Challenges Intubation Pain Sleep Disturbance Family Anxiety
What are the cognitive challenges associated w/ the critical stage?
drowsiness
confusion
disorientation
What are some causes of hallucinations or psychotic reactions during the critical stage?
infections
drugs
alcohol withdrawal
metabolic complications
Why might intubation be a problem?
b/c you can’t speak, say “I love you” to his loved ones.
Why is a particularly big problem that family members are anxious?
b/c this response from family members fosters the same response in the patient. Comfort & calm is vital.
What is the primary goal during the critical stage?
physical survival
What treatment issues are there during the critical stage?
pts will use defense mechanisms to deal w/ ICU stressors
use meds for pain
use hypnosis or relaxation methods to handle pain
family members need to be educated
comfort patient!!
T/F If a patient is in denial, they should be discouraged from using this defense mechanism during the critical stage.
False. People should use whichever defense mechanisms they want to…just want them to survive & keep fighting!!
What should you educate the family members about?
you should let them know that they need to be comforting rather than anxious b/c that will transmit to the patient.
You should also let them know what to expect w/ burn issues.
What is the focus of the acute stage?
focus is on restorative care
What is the patient experiencing during the acute stage?
resting & procedural pain (cleaning of wounds-retraumatizing; skin grafts)
What are the psychosocial issues during the acute stage?
patients begin to process what has happened to them
patient & family members start to feel guilt & anger
grief sets in
spiritual struggles: how could God have this happen?
depression
anxiety
sleep disturbance
premorbid psychopathology
acute stress disorder
Many burn victims are children who experienced ___ ____.
parental neglect
Explain the grief that patients might feel during the acute period.
perhaps the fire came from a car accident or house fire: could have lost close friends or pets or other things…
T/F Mental health professionals should not be used in the acute stage as patients still need to process through things themselves.
False: Mental health professionals are quite helpful during this stage.
What are examples of premorbid psychopathology? Burn victims often have higher rates of this. What are the implications of this?
Substance use disorders
Personality disorders
**these patients cope in more dysfunctional ways & have longer hospitalizations
What percentage of burn victims experience depression? What does the severity of this depression depend on?
23-61%
Level of resting pain & level of social support
What percentage of burn victims experience generalized anxiety?
13-47%
What is the difference between acute stress disorder & post traumatic stress disorder?
Acute: lasts less than 30 days involves dissociate symptoms flashbacks of trauma PTSD: lasts more than one month negative alterations to cognition intrusion symptom avoidance symptom increased arousal
T/F ASD always turns into PTSD.
False. It doesn’t always remain & progress to that.
What should be involved in terms of psychoeducation during the acute stage treatment?
tell patients that often symptoms can resolve on their own (things such as anxiety, ASD…)
premorbid psychopathology can be more challenging…
What would psychotherapy be used to treat during the acute stage treatment?
depression anxiety anger grief pain
What are the pain management techniques that are taught during psychotherapy in the acute stage?
drugs relaxation imagery hypnosis virtual reality CBT
