Trauma-Related and Stressor-Related Disorders

Question 1

How can clients develop a trauma-or stressor-related disorder?? What are the examples??

Answer 1

1. Experiences that are EXTRAORDINARY in Intensity or Severity.
2. ## Stressors are WELL BEYOND the stress of daily life.
3. Military combat
4. Interpersonal violence (like abusive household, rape, etc..)

Question 2

What is PTSD (Post Traumatic Stress Disorder)??

Answer 2

1) Exposure to traumatic events causing
1. Anxiety
2. Detachment and other manifestations that last for longer than 6 months!!!
2) Manifestations can last for yearssss

Question 3

How long can you experience PTSD????

Answer 3

Should be LONGER THAN 6 MONTHS!!!!

Question 4

What are the manifestations of PTSD?????

Answer 4

1. Intense memories of the trauma
2. Nightmares
3. Flashbacks
4. Intense, Recurrent, Intrusive thoughts
5. EMOTIONAL NUMBNING – don’t feel anything
6. Increased IRRITABILITY
7. HYPERAROUSAL– Overreactive fight/flight response that keep you on high alert!

Question 5

What is Acute Stress Disorder??

Answer 5

Exposure to traumatic events causing Anxiety, Detachment, and other manifestations that last for AT LEAST 3 DAYS but NOT more than ONE MONTH

Question 6

How long should Acute Stress Disorder last??

Answer 6

AT LEAST 3 DAYS, but NOT more than ONE MONTH!!

Question 7

What is the difference between Acute Stress Disorder and PTSD??

Answer 7

1. ASD disorder <3 months, last at least 3 days or up to 1 month
2. PTSD is CHRONIC, with periods of Exacerbation (worsening) during increased stress!!
3. PTSD can lead to other psychiatric disorder such as DEPRESSION, ANXIETY, and PHYSICAL ABUSE

Question 8

PTSD can lead to other psychiatric disorder such as what???

Answer 8

DEPRESSION, ANXIETY, and PHYSICAL ABUSE

Question 9

Adolescents with PTSD are at increased risk for what????******* (Exam)

Answer 9

INCREASED RISK FOR SUICIDE!!!!!

Question 10

What are the PTSD Treatment options?????***** (Exam)

Answer 10

1. Psychotherapy: Cognitive Behavior Therapy assist the client in CHANGING DISTORTED appraisal of EVENTS And NEGATIVE THOUGHTS.
2. Prolonged Exposure Therapy: Use of RELAXATION TECHNIQUES with EXPOSURE to the traumatic situation. Can either be imagined through related discussion of the traumatic event OR practiced in real-world situations.

Question 11

What are the medications and ‘4 other interventions’ for PTSD and ASD????

Answer 11

1. Antidepressants:
   - SSRI: Paroxetine and Sertraline
   - SNRI: Venlafaxine
2. Anxiolytics: Benzos –> CAN CAUSE DEPENDANCY!!
3. Sleep Aides: Hydroxyzine and TadraZone
4. PRAZOSIN –> helps with nightmares!
5. ## PROPRANOLOL (Beta-blocker) to decrease elevated vital signs, and manifestations of Panic, Anxiety, Hypervigilance, and insomnia!
6. Group or Family Therapy
7. EMDS – Eye movement Desentization and Reprocessing
8. Crisis Intervention – immediately after a traumatic event
9. Mental Health Promotion

Question 12

What med would you give someone with PTSD to treat their nightmares ????

Answer 12

PRAZOSIN!!!!!

Question 13

What beta blocker do you give for PTSD and ASD? What is it used for????****

Answer 13

PROPRANOLOL (Beta-blocker) to decrease elevated vital signs, and manifestations of:
- Panic,
- Anxiety,
- Hyper-vigilance, and
- Insomnia!

Question 14

What is Adjustment Disorder??? The symptoms?? And examples???

Answer 14

1) A stressor: triggers a reaction causing CHANGES IN MOOD AND DYSFUNCTION IN PERFORMING TASKS. The stressors and affects ARE less severe than ASD or PTSD!
2) The symptoms: Develop WITHIN A MONTH, Lasting NO more than 6 months!!:
- Depressed Mood
- Anxiety
- Disturbance of Conduct
- Increased Irritability
- Hyperarousal
3) EX: Getting married, getting divorced, going away to college. It can be positive or negative events in life.

Question 15

How long should Adjustment Disorder last?????**

Answer 15

Develop WITHIN A MONTH, Lasting NO more than 6 months!!

Question 16

What are the symptoms for Adjustment Disorder???

Answer 16

1. Depressed Mood
2. Anxiety
3. Disturbance of Conduct
4. Increased Irritability
5. Hyperarousal

Question 17

Do you need meds for adjustment disorder OR dissociative disorder???

Answer 17

NOPE!! unless they show signs of depression and anxiety

Question 18

What are the Screenings for PTSD and ASD??????

Answer 18

1. PTSD Screening checklist
2. Test for Anxiety and Depression
3. PHQ-9 Scale –> FOR DEPRESSION
4. Hamilton Anxiety Scale!

Question 19

What is Dissociation Disorders??? What is depersonalization and Derealization??

Answer 19

Detachment from reality, rather than loss of reality as in psychosis.
1. Depersonalization – the feeling that a person observes one’s personality/body FROM a DISTANCE.
2. Derealization – outside events are UNREAL or part of a DREAM or that objects appear shrinking or larger.

Question 20

What is Dissociative Amnesia??

Answer 20

Inability to recall particular time or specific details related to traumatic events!!

Question 21

What is Dissociative Identity Disorder???

Answer 21

(Think of Multiple Personality Disorder)
1. With stressful even, they change from one personality to another!

Question 22

What is the Nurse’s role??

Answer 22

1 . Promote patient’s safety INCLUDING Screening for suicidal Ideation and, a safe therapeutic environment
2. Multiple strategies to decrease anxiety, such as:
- Grounding techniques: clapping hands, deep breathing, touching an object
- Music Therapy
- Guided imagery
- Relaxation therapy
3. Promote the client’s SELF ESTEEM and Help client SHARE THEIR FEELINGS!!

Question 23

What is the nursing role for dissociative disorder??

Answer 23

1. During disassociate periods, Help client MAKE DECISIONS TO LOWER STRESS
2. Use grounding Techniques: clapping hands, deep breathing, touching an object
3. AVOID giving too much information about past events to prevent increased stress

Question 24

What are client education to give????

Answer 24

1. Ways to reduce stress
2. • VERBALIZE NEGATIVE FEELINGS
3. • AVOID ALCOHOL AND CAFFEINE (STIMULANTS)
4. Teach client grounding techniques