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objective 5 Flashcards

1
Q

Distinctive set of traits, behavior styles, and patterns that
make up our character and individuality

A

personality

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2
Q

Individuals display significant challenges in self-identity or
self-direction and have problems with empathy or
intimacy within their relationships

A

personality disorder’s

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3
Q

paranoid, schizoid, and schizotypal

A

cluster A

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4
Q

antisocial, borderline, histrionic, narcissistic

A

cluster B

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5
Q

avoidant, dependent and obsessive-compulsive

A

cluster C

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6
Q

Every developmental stage has a series of conflicts a
person must handle

A

erikson

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7
Q

Each person has certain amount of psychic energy to
cope with everyday problems

A

Freud

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8
Q

what are clinical symptoms of personality disorders?

A

Changes in cognition
Fluctuation in emotional responses (affect)
Changes in interpersonal functioning
Fluctuating impulse control

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9
Q

what are the diagnostic characteristics of personality disorders?

A

Evidence of an enduring pattern of behavior and inner
experience in at least two of the areas above (clinical
symptoms)
 Stable, long lasting pattern exhibited as a marked deviation
from which is expected in the individual’s culture
 Onset most likely traceable to adolescence or early adulthood
 Pattern widespread, occurring over personal and social
situations
 Resultant distress in important areas of functioning
 Pattern not associated with or due to a medical condition or
another mental disorder

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10
Q

what are the characteristics of cluster A PD’s?

A

Suspicious/mistrust of others
 Fear others will exploit, harm, or deceive them
 Fear of confiding in others (fear personal information
will be used against them)
 Misread compliments as manipulation
 Hypervigilant
 Prone to counterattack
 Hostile and aloof

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11
Q

what are the nursing guidelines for cluster A PD’s

A

To counteract patient fear, nurses should give
straightforward explanations of tests, history taking,
procedures, adverse effects of drugs, changes in
treatment plan, and possible further procedures

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12
Q

what are the characteristics of schizoid PD?

A

Ideas of reference
Anxiety
Cognitive and perceptual distortions
Avoids close relationships, is socially isolated
Social ineptness
Social awareness is lacking, and relationships generate
fear and confusion in the patient
Has poor occupational functioning, and appears cold,
aloof, and detached

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13
Q

what are the nursing guidelines for schizoid PD?

A

Respect patient’s need for social isolation
Be aware of patient’s suspiciousness
Perform careful diagnostic assessment as needed to
uncover any other medical or psychological symptoms
that may need intervention (i.e. suicidal thoughts)

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14
Q

what are the characteristics of schizotypal PD?

A

A lifelong pattern of social isolation
Ideas of reference
Magical thinking or odd beliefs
Perceptual distortions; vague, stereotyped speech;
Blunted or inappropriate affect; distant and strained
Social relationships - patients tend to be frightened

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15
Q

what are the characteristics of cluster B PD’s?

A

Unstable, intense relationships
Identity disturbances; impulsivity; self-mutilation
rapid mood shifts; chronic emptiness
Intense fear of abandonment & anger
Major defense – splitting (alternating between idealizing &
devaluing)
Self-mutilation and suicide-prone behaviour
Anger is intense and pervasive

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16
Q

what are the nursing guidelines for cluster B PD’s?

A

Set realistic goals; use clear action words
Be aware of manipulative behaviors
Provide clear and consistent boundaries and limits
Use clear and straightforward communication
Behavioral problems - calmly review the therapeutic goals and
boundaries of the treatment
Avoid rejecting or rescuing
Assess for suicidal and self-mutilating behaviours
Relationship building, safety, & limit setting are other foci

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17
Q

what are the characteristics of histrionic PD?

A

Centre of attention; flamboyant
 Seductive or provocative behaviours
 Shallow, rapidly shifting emotion
 Dramatic expression of emotions
 Overly concerned with impressing others
 Exaggerates degree of intimacy with others
 Self-aggrandizing; preoccupied with own appearance

18
Q

what are the characteristics of narcissistic PD?

A

Grandiosity, fantasies of power or brilliance
Disparaging (judgmental)
Need to be admired, sense of entitlement, arrogant,
patronizing, rude, overestimates self and underestimates
others
Patient demands the best of everything
Sensitive to rejection, criticism
Filled with rage

19
Q

what are the nursing guidelines for narcissistic PD?

A

Remain neutral
Avoid engaging in power struggles or becoming
defensive in response to the patients disparaging
remarks
Convey unassuming self-confidence

20
Q

what are the characteristics of antisocial PD?

A

Ability to seem normal
No anxiety or depression
Manipulative
Exploitive of others
Aggressive
Seductive
Callous toward others
Expects immediate gratification

21
Q

what are the nursing guidelines for antisocial PD?

A

Try to prevent or reduce untoward effects of
manipulation
Set clear and realistic limits on behavior; provide clear
boundaries and consequences
Ensure limits are adhered to by all staff
Document signs of manipulation or aggression (times,
dates, and circumstances)
Be aware that antisocial patients can instill guilt when
they are not getting what they want (manipulation)
Substance abuse is best handled through well-organized
treatment program before any other form of therapy
starts

22
Q

what are the characteristics of cluster B PD’s?

A

Excessively anxious in social situations
Hypersensitive to negative evaluation
Desiring of social interaction

23
Q

what are the nursing guidelines for cluster C PD’s?

A

Friendly, accepting, reassuring approach
Being pushed into social situations can cause extreme
and severe anxiety

24
Q

what are the characteristics of dependent PD

A

Inability to make daily decisions without advice and
reassurance
Need of others to be responsible for important areas of
life
Anxious and helpless when alone
Submissive (passive, obedient)
Solicit caretaking by clinging
Fear abandonment if they are too competent
Experience anxiety and may have coexisting
depression

25
Q

what are the characteristics of obsessive-compulsive PD?

A

Perfectionistic
Has need for control
Inflexible, rigid
Preoccupied with details
Highly critical of self and others

26
Q

what are the nursing guidelines for Obsessive-compulsive PD?

A

Guard against power struggles with patient
Most common defense mechanisms are
intellectualization, rationalization, reaction
formation, isolation, and undoing

27
Q

Exhibit covert (hidden) obstructionism through
manipulation, procrastination (finds excuses for delays),
stubbornness
 Inefficiency due to dependence on others
 Lacks self confidence
 Pessimistic about the future

A

passive-aggressive or negativistic PD

28
Q

Exhibit life-long depressive symptoms
 Chronically unhappy
 Low self esteem
 Self critical
 Characteristics include, poor posture, raspy or hoarse
voice, flat or blunted affect, psychomotor
retardation/delay

A

depressive personality disorder

29
Q

Assessment tools
Semi-structured interview by clinicians
Patient history
suicidal or homicidal ideation
current use of medications & other substances, food,
and money
involvement with the courts
current or past physical, sexual, or emotional abuse
Self-assessment

A

assessment

30
Q

Ineffective coping
Anxiety
Risk for other-directed violence
Risk for self-directed violence
Impaired social interaction
Social isolation; Fear
Disturbed thought processes
Defensive coping
Self-mutilation
Chronic low self-esteem
Ineffective therapeutic regimen management

A

diagnosis

31
Q

Patients with personality disorders are usually admitted
to psychiatric institutions for reasons other than their
PD
Most often seen - borderline & antisocial PD’s
BPD - impulsive, suicidal, self-mutilating, aggressive,
manipulative, and even psychotic under stress.
ASPD - manipulative, aggressive, and impulsive

A

planning

32
Q

Safety and teamwork
* Pharmacological interventions
* Case management

A

implementation

33
Q

Establishing parameters of desirable and acceptable
personal behavior

A

limit setting

34
Q

Facilitation of expression of anger in adaptive, nonviolent
manner

A

anger control assistance

35
Q

Assisting the person to mediate impulsive behavior through
the application of problem-solving strategies to social and
interpersonal situations

A

impulse-control training

36
Q

The goal of milieu therapy is affect management within
a group context
Nurses must help patients verbalize feelings rather than
act them out
See Table 19.5: Dialogue with a person with
manipulative, aggressive, and impulsive traits

A

Milieu management

37
Q

Broad array of psychotropic agents, all geared toward
maintaining cognitive function and relieving symptoms.
Antipsychotics may be useful for brief periods to control
agitation, rage, and brief psychotic episodes
Compliance is usually an important issue
Patients with PD are fearful about taking something over
which they have no control

A

pharmacological interventions

38
Q

ow dose atypical antipsychotic agents

A

schizotypal personality disorders

39
Q

Mood-Stabilizing Meds

A

ASPD

40
Q

Anticonvulsant Mood-Stabilizing Meds, low-dose
antipsychotic meds, and omega-3 supplements (mood
and emotion)

A

BPD

41
Q

SSRI (Celexa), SNRI’s (Cymbalta)

A

avoidant PD

Mental Health (13 decks)

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