Topic 10 Flashcards
Dispositional
Attributes thought to be caused by internal characteristics that reside within the individual, as opposed to external (situational) influences that stem from the environment or culture in which that individual is found
eustress
Good stress that helps us cope with daily challenges
mild stress
Heightens one’s awareness of surroundings and fosters learning and decision making. Communicating with clients helps to relieve stress
moderate stress
Occurs as people experience frustration or conflict. This can cause anxiety for the client and/or the nurse and hinders appropriate communication and opportunities for a therapeutic relationship between nurse and client
severe stress
Seriously interferes with a person’s ability to function. Severe chronic stress weakens the immune system and contributes to stress related illnesses
acute stress
REQUIRES IMMEDIATE ATTENTION and once the situation is resolved, homeostasis is re-established (depending on the magnitude and ones coping abilities and resilience), acute stress may become a crisis
chronic stress
Manifests over an extended period of time as a result of repeated exposure to stressors
different tolerance level fro stress
o Adult (Stress response is usually dependent on gender): Male: “fight or flight” Female: “tend and befriend” (need nurturing activities to reduce stress and promote safety for self and others)
o Children: Express through BEHAVIOR (ex: hit, scream, cry)
Conflict communication skills:
Be assertive
Demonstrate respect
Use “I” statements
Make clear statements
Use proper pitch and tone
crisis
o Extreme acute stressful situation for which coping mechanisms fail and the person is unable to function normally (often 4-6 weeks)
adaptive crisis
o Is a normal recovery response to stress and crisis (dealing with it)
maladaptive crisis
o Prolonged responses and many lead to a crisis state (not coping well, may go into depression
o Can lead to development of acute or chronic psychiatric symptoms
crisis state
o An acute normal human response to severely abnormal circumstance (A crisis state is NOT a mental illness)
developmental crisis
§ Erik Erikson identified 8 stages of “crisis” in personal growth and development
§ Ages 5-21 and 65+ are most likely to go into depression
situational crisis
§ Events that are unexpected unusual, overwhelming, can include illness, injury, losses, a diagnosis, withdrawal from alcohol, finances, etc.
in a stressful situation what is the nurses response
o Understand the client’s personal response to crisis to provide successful intervention
o Communicate with client and help with coping strategies
o In a stress situation, nurse’s goal is to de-escalate
behavioral emergency
o Occurs when a crisis escalates to the point that the situationREQUIRES IMMEDIATE INTERVENTION TO AVOID INJURY OR DEATH
o Always an emotionally charged unpredictable situation (suicide, psychotic crisis, homicide, violence, sexual assault)
mental health emergencies
o A bad reaction to medication can cause this as well as the patient viewing the treatment as an attack (may become combative so be alert)
§ Keep communication, calm, short, well defined, additional space
o Present danger to self or others
o May have chaotic distress behaviors
o May have a co-occurring disorder such as mental illness ad substance use disorder (SUD)
o May have drug induced delirium
o ALWAYS HAVE AN ESCAPE ROUTE
dangerous to self or others…
o Depression/suicidal
o Anger/agitation, aggressive
o Noncompliance with requests (taking medication)
o General appearance, inappropriate dress or poor hygiene
o Evidence of self-inflicted harm
o Respond/reflect to delusion/ hallucination
o Owns/displays weapons
o Unorganized thoughts/appearance
o Speech patterns/substance/rate (too fast or too slow)
o Paranoid
o Erratic or fearful behavior
o Recent loss of job/loved ones/home
o Substance abuse
o Orientation to date/time/location/situation
o Number and type of pervious contact with police and crisis worker
Crisis intervention response
o Strategies should be adapted to fit a client’s preference, values, and circumstances
o Strategies are PRESENT FOCUSED AND GOAL ORIENTED
o Intervention is TIME LIMITED
o Return client to PRE-CRISIS LEVEL FUNCTIONING
disaster
o A calamitous event of slow or rapid onset that results in large scale physical destruction of property, social infrastructure and human life
BICEPS of disaster
§ Brevity
§ Immediacy
§ Contact
§ Expectancy
§ Proximity
§ Simplicity
triage
o Describes how healthcare workers sort out severity of clients injures and needs during a crisis
·3 Question of triage
o How urgent is this clients condition
o Do we have the adequate resources to meet this patients needs
o Assuming we admit this patient and provide level of care requires, will the patients life be saved?
4 phases of community response
heroic phase
honeymoon phase
disillusionment phase
reconstruction phase
heroic phase
§ Direct emotions focusing on helping people survive (“they are coming to help us!!”)
honeymoon phase
§ Drawing people together who simultaneously experienced the catastrophic event (organize people and provide help)
disillusionment phase
§ Feeling of DISAPPOINTMENT OF DELAYS or failures when promises of aids are not fulfilled (“why can’t they do more”)
reconstruction phase
§ Reaffirmation of belief in the community when new buildings are constructed (“it’s all coming together)
debreifing
o Used to help a group of people who have witnessed or experienced a mass trauma crisis event to externalize and process the experience (emote!! Don’t bottle it up)
TJC and disaster management
o Requires hospitals to develop and exercise disaster management plans at regular intervals
5 stages of grief/loss
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
patterns of grieving
acute grief
anticipatory grief
chronic sorrow
complicated grief
anticipatory grief
a period of mourning when the dying person or his family is expecting the death
§ Knowing and anticipating the end will come depending on a diagnosis
chronic sorrow
grief-related feelings that occur periodically throughout the lives of those left behind
§ Cannot get past the loss
complicated grief
a reaction to loss characterized by persistent intense grief and persistent distracting or impairing concerns about the consequences or circumstances of the loss
§ Ex: alz. Patient who isn’t really who they are anymore
end of life care
o Planning for the end is planning for the unknown
o Death is more than a biological event
o Spiritual, social and cultural factors are important for people to make sense of death
o Nurses are the resource of providing support
palliative care
§ Care aimed at primarily relieving symptoms associated with a treatments as well as proving support for seriously ill patient and their families
§ Can have surgery, no cure but are kept comfortable, still can receive treatment for their illness
hospice care
§ No surgery, kept comfortable with pain killers
§ Less than 6 months to live
end of life communication
o Pain management assessment
o Conversation with client
o Communicate with the family
o Provide information
o Incorporate cultural differences, attend to spiritual needs
De-escalation
§ Techniques used to escape escalations of conflict
crisis intervention
§ Time limited treatments that helots the patient return to pre-crisis functional level
violence
§ Mental health emergency which challenges, safety, wellbeing and health of patient and others in the environment
sexual assault
§ Rape and sexual assault are serious forms on interpersonal victimization which violate core of self
psychosis
§ Pt. has disorganized thinking, reduced insight limited personal judgement (hallucinations)
suicide
§ Self injurious behavior resulting in death
disaster and mass trauma
§ A calamitous event of slow or rapid onset with mass destruction of property and human life
critical incident debreifing
§ Helps to strengthen emotional coping skills of a staff
