Psychosocial Integrity Flashcards
List Maslow steps
Physiological- oxygen,water,food,sleep Safety-physical,security, Love and belonging- affection,companion Esteem- status,success Self actualization- self fulfillment
What are examples some therapeutic response? Give examples
Using silence- eg remain seated,maintain eye contact
Using general leads- “what can you tell me about your family”
Clarification- “ tell me more”
Reflecting- “It sound like you ‘re feeling angry
Responses to avoid in therapeutic communication
Closed ended Giving advice Responding to question related to ones personal life Arguing Reassuring Asking why Judgemental responses
Type of treatment modalities
Biological Psychoanalytical Milieu therapy Group therapy Family therapy Activity therapy Play therapy Behavioral therapy
Focus of treatment
Biological- medication,ect
Psychoanalytical- aware of unconscious thought
Milieu- structured group,one on one intervention
Group- members learn new ways to cope with stress
Family- therapist treat whole family
Activity- organized group activity to promote socialization
Pllay- observe plays, toys to interact with child
Behavioral- desentization(treat phobias)
Anxiety assessment
Inc pulse,BP and resp Cold hands and feet Nausea and vomitting Inc musle tension and tendon reflex Poor comprehension Poor concentration Unable to communicate Feeling of helplessness Feeling of inc threat,anger, Withdrawal
What are predisposing conditions?
Prolonged unmet needs of dependency,love,attention
Stress threatening security or self esteem
Unacceptable thoughts to consciousnes
Levels of anxiety
Mild- high degree of alertness, mild uneasiness
Moderate- heart pounds,cold skin and poor comprehension
Severe- hallucination,delusion
Panic- severe anx plus inability to see and hear
Nursing intervention in anxiety
Assess level of anxiety- look at body lang,facial express,defence mech
Low environmental stimuli- brief orientation, unclutterd environ,
Assess client to cope with anxiety
Maintain accepting and helpful attitude
Dont attempt to remove a defence mech
Types of anxiety disorders
Phobia
OCD
Functional neurologic disorder
Anxiety assessment
Apprehension,anxiety helplessness when confronted with phobic object
Obsession- repetitive uncontrollable thoughts. Compulsion uncontrollable act
Physical symptoms with no organic basis
Implementation
Decrease anxiety Recognize anxiety Identify precipitants of anxiety Coping mechanism Inc self esteem Institute measure to dec anxiety Adm antanxiety meds Use realistic measurable objectives
Stages of dying
Denial Anger Bargaining Depression Acceptance
Depressive disorder assessment
Low señf esteen,feeling of hopelessness Unkept appearance,lack of energy Insomnia Weightloss,poor appetite,weightgain Constipation amenorrhea,lackbof sex drive Dec attention span Withdrawan
Suicide potential
Has plan and means to carry out plan
Identifies others who may be involve in plan
Implementation for suicide
Look out for signs of destructive behavior
Report all behavior to team especially inc energy or agitation
Provide companionshipvdyring meals
Give frequent feeding
Medicate for constipation and encourage fluids
Medicate for insomnia
Listen to and explore feelings
Provide a warm supportive environment
Group therapy to inc self esteem
Adverse effect of ECT
Confusion and memory loss
Transient headache
Muscle soreness
Drowsiness
Post op care of ECT
Orient client
Take Bp,resp
Stay with client during confusion state
Signs of deminished depression appear 6-12 treatment
Nursing consideration for ECT
Explain procedure and tell client about potential memory loss
Inform consent physical exam,labwork
Npo
Void before ECT
Remove dentures,glasses,jewelry
Give muscle relaxant
Give atopine 30min before to dec secretion
Have oxygen and suction
After procedure take vitals and orient client
Observe for sudden improvement and indication of suicidal threats after ECT
Behavioral clues of impending suicide
Sudden change in client behavior Becomes energetic after a period od severe depression Improved mood 10to14 days after taking antidepressant Finalizes personal affairs Give away personal valuable or pets Withdraws from social activities Appears emotionally upset Leaves a note May direct or indirect statement
Predispising factors of suicide
Male over 50 Age range 15-19 Clients with poor social skills Clients with previous attempts Clients with personality disorders Degenerative disease Death or loss
Implementation
Be alert for destructive behavior Remove all dangerous items One on one observation Discuss all behavior with team Observe for sudden inc in energy Assist with decision making Provide family therapy Avoid judgemental remarks
