Trauma Stressor-Related Disorders Flashcards
Historical aspects
known as shell shock, battle fatigue, accident neurosis, posttraumatic neurosis. Had little research & documentation of disorder prior to 1970 until after Vietnam war.
Epidemiological stats
*PTSD mostly affects 45-59 yr old (9.2%)
30-44 have a 8.1%
18-29 have a 6.3%
Different types of Trauma and Stressor related disorders (3)
Trauma
Acute stress disorder
Posttraumatic stress diorder
Trauma
extremely distressing experience, triggers emotional shock
Acute Stress Disorder (ASD)
traumatic event causes anxiety symptoms are limited, 3 days to 1 month.
Posttraumatic Stress Disorder (PTSD)
extreme trauma, characterized by pervasive distress, symptoms last longer than 1 month- may last yrs.
Adjustment disorder
Stressor triggers a reaction causing changes in mood &/or dysfunction in performing usual activities. Less severe than ASD or PTSD
Predisposing Factors in the development of trauma-and stressor-related disorders
Psychosocial theory, Learning theory, Cognitive theory
Psychosocial Theory
childhood trauma, dependency, arrested development, constitutional factor, developmental stage and timing of the stressor, available support system, dysfunctional grieving process (client doesn’t have developmental maturity, available support systems, or adequate coping strategies to adapt, normal functioning is disrupted, resulting in psychological or somatic symptoms.)
Learning Theory
negative reinforcement, avoidance behavior, psychic numbing
Cognitive Theory
cognitive appraisal of an event, world is benevolent and a source of joy, its meaningful and controllable, the self is worthy.
Psychic Numbing
a psychological phenomenon that causes us to feel indifferent to the suffering of large numbers of people
Formulate Nursing Dx for clients with PTSD
Using info collected during the assessment, the nurse completes pt database from which selection of appropriate nursing diagnosis is determined.
Post-trauma syndrome related to distressing events considered to be outside the range of usual human experience evidenced by flashbacks, intrusive recollections, nightmares, psychological numbness related to the event, dissociation, or amnesia.
What is this ?
Nursing Dx
Formulate goals of care for clients by
helping client verbalize feelings associated w/ trauma & verbalizing a sense of optimism and hope for future.
Goals of care are evaluated by if they can….
Can acknowledge the traumatic event and its impact on the patient’s life.
Experiencing fewer flashbacks, intrusive recollections, and nightmares than the patient was experiencing on admission.
Can demonstrate adaptive coping behaviors.
Can concentrate and has made realistic goals for the future.
Pppropriate Nursing Interventions for behaviors associated with trauma-and stressor-related disorders.
Establishing a trusting relationship, obtaining an accurate hx about the trauma, encouraging the client to talk about the trauma and assisting in comprehending the trauma.
Medications
Evaluate nursing care of clients
Determine if actions have been successful in achieving objective of care. Ask following questions:
o Does the client voluntarily discuss the traumatic event?
o Does client have “flashbacks?”
o Can clients sleep without medication?
o Does client have nightmares?
o Can clients demonstrate the use of new coping strategies?
Discuss various modalities relevant to the treatment of trauma-and stressor-related disorders.
Cognitive behavioral therapy
Prolonged exposure therapy
Psychodynamic psychotherapy: psychological roots of emotional suffering
Eye movement desensitization & reprocessing (EMDR)
Group/family therapy
Somatic therapy for dissociative disorders
Hypnotherapy
Biofeedback
Neurofeedback
Discuss the basic principles of trauma-informed care.
HINT: 4 Rs
Realization about trauma and how it can affect people and groups, recognizing the signs of trauma, having a system which can respond to trauma, and resisting re-traumatization.
