Problems r/t Crisis

Question 1

Crisis: Characteristics

• Acute (1-3 mos) NOT chronic
• Occur in all individuals
• Precipitated by spec identifiable events
• Personal in nature
• Potential for psychological growth or deterioration

Answer 1

Assessment

• Feel helpless to change
• Do not believe they have the resources to deal w/the precipitating stressor
• Lvls of anxiety rise - overwhelmed, nonfunctional, thoughts are obsessional, behavior aimed @ relief of anxiety
• May affect physical & psychological well-being

Question 2

Phases in the Development of a Crisis

1. Exposure to precipitating event - anxiety increases, previous problem-solving techniques are employed
2. Anxiety increases further - defense responses fail, disorganization

Answer 2

3. All resources are called upon - possible resolution
4. Tensions mount - panic lvl anxiety, disordered cognitive functions, labile emotions, possible psychotic thinking

Question 3

Factors Affecting Crisis Response

1. Individuals’ perception of the event
2. Availability of situational supports

Answer 3

3. Availability of adequate coping mechanisms

Question 4

Types of Crises

✧ Dispositional crises

✧ Crises of anticipated life transitions

✧ Crises resulting from traumatic stress

Answer 4

✧ Maturational/developmental crises

✧ Crises reflecting psychopathology (e.g., bipolar disorder, schizophrenia)

✧ Psychiatric emergencies

Question 5

GOAL of crisis intervention = resolution of an immediate crisis

Question 6

Robert’s 7-Stage Model of Crisis Intervention

1. Psychosocial & Lethality Assessment
2. Rapidly establish rapport
3. Identify the major problems or crisis precipitants

Answer 6

4. Deal with feelings and emotions
5. Generate and explore alternatives
6. Implement an action plan
7. Follow-up

Question 7

Phases of Crisis Intervention: The Role of the Nurse [Aguilera]

Assessment

• identify current problem
• risk factors
• protective factors

Answer 7

Planning of Therapeutic Intervention

• type of crisis
• individual’s strengths
• desired choices
• available resources for support
• goals

Question 8

Nursing Diagnoses

✱ Ineffective coping
✱ Anxiety
✱ Disturbed thought processes

Answer 8

✱ Risk for self or other directed violence
✱ Rape-trauma syndrome
✱ Post-trauma syndrome
✱ Fear

Question 9

Intervention

• Reality-based
• Rapid working relationship
• Firm limits on aggressive/disruptive behaviors
• Clarify problem
• Acknowledge & explore feelings
• Provide for safety
• Identify & teach coping skills

Answer 9

Evaluation of Crisis Resolution & Anticipatory Planning

• Reassessment is to determine if the stated objective was achieved

Question 10

Disaster Nursing

! Risk for injury (from trauma/suffocation/poisoning)
! Risk for infection
! Anxiety (panic)
! Fear
! Spiritual distress
! Risk for post-trauma synd
! Ineffective community coping