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Nursing > Personality Disorders > Flashcards

Personality Disorders Flashcards

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1
Q

What are the cluster A d/o

A

(APSS) Paranoid, Schizoid, Schizotypal - Odd or eccentric

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2
Q

What is Paranoid PD

A

(Cluster A) Distrust, suspicion, short temper, argumentative, jealous, unable to forgive or adjust to change. Lack of tender feelings for others

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3
Q

What is Schizoid PD

A

(Cluster A) Brief psychotic episodes in response to stress, loner, passive, detached, self absorbed, lack of strong emotions, lack of trust, difficulty expressing anger

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4
Q

What is Schizotypal PD

A

(Cluster A) Magical thinking, incorrect interpretation of external events and belief that all events refer to self, constricted/inappropriate affect, social anxiety (poor/moderate functioning)

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5
Q

What are the cluster B d/o

A

(NAHB) Narcissistic, Antisocial, Histrionic, Borderline - Dramatic, emotional, erratic

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6
Q

What is Antisocial PD

A

(Cluster B) charming at first, lack of conscience, empathy or responsibility, manipulative, involved in criminal acts or substance abuse

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7
Q

What is Borderline PD

A

(Cluster B) Anger, suicidal thoughts, self mutilation, cutting intense stormy relationships, impulsive acts, people as all good or all bad, feel abandoned, difficulty identifying self

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8
Q

Intervention for Borderline PD

A

Dialect behavioral therapy - dialogue to rework destructive ways to deal with crisis, teaches there are choices to decrease suicidal thoughts, learn new patterns of thinking and behaving

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9
Q

What is Narcissistic PD

A

(Cluster B) Grandiose view of self, lack of empthty for others, needs admiration, preoccupation with fantasies of success, brilliance, beauty, perfect love, conceded

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10
Q

What is Histrionic PD

A

(Cluster B) Fluctuations of emotions, suicidal threats when feeling abandoned, attention seeker, sexual seduction, flamboyance, somatization, dramatic speech, attentive to physical appearance, shallow, DRAMA QUEEN

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11
Q

What are cluster C d/o

A

(ADOC) Avoidant, Dependent, Obsessive Compulsive

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12
Q

What is Avoidant PD

A

(Cluster C) Fears criticism, disapproval or rejection, avoid social interactions, hold in thoughts and feelings, low self-esteem - intermediate functioning

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13
Q

What is Dependent PD

A

(Cluster C) Submissive, clingy, can’t make decisions on own, cant follow through on tasks, cant express negative feelings

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14
Q

What is Obsessive Compulsive PD

A

(Cluster C) Preoccupied with structure/organization/perfection/control, workaholics, cant relax, self critical, rule conscious, insistence that others go with their methods, cant get rid of things, cant delegate, procrastination, wont spend money

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15
Q

Freud’s perspective of PD

A

Comes from unresolved conflicts

1) Oral- probs trusting others, self centered, dependent, jealous (Paranoid,borderline, histrionic)
2) Anal- probs making decisions, cannot share, full of rage (antisocial,borderline, histrionic dependent)
3) Phallic- probs with superego, guilt (antisocial/borderline, histrionic, narcissistic)
4) Latency- probs with too little (borderline) or too much (OCD) control
5) Genital- probs with sense of self (various PD)

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16
Q

Separation - Individuation (Margaret Mahler)

A 
Childhood process of developing sense of self separate from mother (4 stages)
Differentiation
Practicing
Rapprochement
Beginning of object constancy
17
Q

Otto Kernberg

A

2 tasks of object relations - child can distinguish between self and another, can integrate good and bad images of self and of others
Borderline PD - splitting (cant integrate good and bad of self and others), idealization of those who meet needs, devaluation of those who don’t meet needs, lack of object constancy (cant hold memory of another, love one is absent is viewed as abandonment) ALWAYS AT NURSES STATION

18
Q

Masterson - Object Relations

A

4 defenses block growth and autonomy (Projection, Denial, Clinging, Avoidance)
Borderline PD develops when person is ‘stuck’ (frustration in every day living, cant maintain relationships, anger and rage when ignored, inability to have images of another when absent, cannot mourn) CENTER OF ATTENTION

19
Q

What is splitting of staff, and how can we reduce it

A

No equality of the staff, always the ‘good nurse’ and others are ‘bad nurse’ images
Open communication in staff meetings, ongoing clinical supervision

20
Q

Splitting behaviors of patients

A

Primary defense with borderline PD, labels people as ‘all good’ or ‘all bad’, creates conflict with staff members

21
Q

Therapies for PD

A

Milieu - recreation of a community setting
Movement - learning relaxation
Music/art - helps express feelings
Occupational - helps development of life skills
Group - problem solving
Family - family dynamics
Medication- control symptoms

22
Q

Medications of PD

A

Benzos - short term
Antipsychotics to treat aggressiveness and impulsivity
Mood stabilizers to treat rage, violence, impulsivity, feelings of losing control
Antidepressants
Antianxiety agents

23
Q

Nursing Diagnosis for Cluster A

A

Anxiety
Ineffective Coping
Social Isolation
Disturbed thought process

24
Q

Nursing Diagnosis for Cluster B

A 
Ineffective Coping
Disturbed personal identity
Chronic low self-esteem
Risk for self mutilation
Risk for suicide
Impaired social interaction
Risk for self.other directed violence
25
Q

Nursing Diagnosis for Cluster C

A

Anxiety
Ineffective Coping
Chronic low self-esteem
Impaired social interaction

26
Q

Interventions for manipulative, aggressive, or impulse behaviors

A

Calm nonjudgmental approach
Communication with tx team to prevent splitting
Teach alternative ways to manage feelings
Frequent short interactions
Encourage journaling
Encourage group participation
Close watch for escalation in anger
Redirection
Time out
Seclusion/restraint per protocol - LAST RESORT

27
Q

Discharge Criteria for PD

A

Consider risk factor of safety for client and others
Have follow-up plan
Provide psycho-education

Nursing (5 decks)

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