Trauma Stressor-Related Disorders

Question 1

Historical aspects

Answer 1

known as shell shock, battle fatigue, accident neurosis, posttraumatic neurosis. Had little research & documentation of disorder prior to 1970 until after Vietnam war.

Question 2

Epidemiological stats

Answer 2

*PTSD mostly affects 45-59 yr old (9.2%)
30-44 have a 8.1%
18-29 have a 6.3%

Question 3

Different types of Trauma and Stressor related disorders (3)

Answer 3

Trauma
Acute stress disorder
Posttraumatic stress diorder

Question 4

Trauma

Answer 4

extremely distressing experience, triggers emotional shock

Question 5

Acute Stress Disorder (ASD)

Answer 5

traumatic event causes anxiety symptoms are limited, 3 days to 1 month.

Question 6

Posttraumatic Stress Disorder (PTSD)

Answer 6

extreme trauma, characterized by pervasive distress, symptoms last longer than 1 month- may last yrs.

Question 7

Adjustment disorder

Answer 7

Stressor triggers a reaction causing changes in mood &/or dysfunction in performing usual activities. Less severe than ASD or PTSD

Question 8

Predisposing Factors in the development of trauma-and stressor-related disorders

Answer 8

Psychosocial theory, Learning theory, Cognitive theory

Question 9

Psychosocial Theory

Answer 9

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.)

Question 10

Learning Theory

Answer 10

negative reinforcement, avoidance behavior, psychic numbing

Question 11

Cognitive Theory

Answer 11

cognitive appraisal of an event, world is benevolent and a source of joy, its meaningful and controllable, the self is worthy.

Question 12

Psychic Numbing

Answer 12

a psychological phenomenon that causes us to feel indifferent to the suffering of large numbers of people

Question 13

Formulate Nursing Dx for clients with PTSD

Answer 13

Using info collected during the assessment, the nurse completes pt database from which selection of appropriate nursing diagnosis is determined.

Question 14

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 ?

Answer 14

Nursing Dx

Question 15

Formulate goals of care for clients by

Answer 15

helping client verbalize feelings associated w/ trauma & verbalizing a sense of optimism and hope for future.

Question 16

Goals of care are evaluated by if they can….

Answer 16

 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.

Question 17

Pppropriate Nursing Interventions for behaviors associated with trauma-and stressor-related disorders.

Answer 17

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

Question 18

Evaluate nursing care of clients

Answer 18

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?

Question 19

Discuss various modalities relevant to the treatment of trauma-and stressor-related disorders.

Answer 19

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

Question 20

Discuss the basic principles of trauma-informed care.
HINT: 4 Rs

Answer 20

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.