week 7 Flashcards
types of grief:
normal grief: consists of normal behaviors, reactions to loss, and symtpoms
anticipatory grief: process of “letting go” before an actual death has occurred
complicated grief: individual has trouble progressing through the normal (generally accepted) phases or stages of grieving
disenfranchised grief: people experience grief when a loss is experienced and cannot always be openly acknowledge, socially sanctioned, or publicly shared
causes of complicated grieving:
negative, pessimistic outlook on life, multiple losses in a short time, dependent personality traits, previous incidence of mood disorders, isolation and lack of a strong social support network, death was entirely unexpected, survivors guilt
what are the 5 stages of grief according to kubler-ross?
1) denial: avoidance, confusion, elation, shock
2) anger: frustration, irritation, anxiety
3) bargaining: overwhelmed, helplessness, hostility
4) depression: struggling to find meaning, reaching out to others, telling ones story
5) acceptance: exploring options, new plans, moving on
characteristics of someone who is angry, hostile and aggressive?
clenched jaw, pacing, clenched fists, raised voices, irritability
what are the 5 phases of aggression?
triggering: an event or circumstances in the environment initiates the clients response, which is often anger or hostility
escalation: clients responses represent escalating behaviors that indicate movement toward a loss of control
crisis: during a period of emotional and physical crisis, client loses control
recovery: client regains physical and emotional control
postcrisis: client attempts reconciliation with others and returns to the level of functioning before the aggressive incident and its antecedents
tips to improve listening skills with an angry patient:
make sure patient feels heard, no interrupting, full attention, repeat back what they say to understand, ask related questions, empathy
de-escalation techniques:
respect personal space, do not be provocative, establish verbal contact, be concise, identify wants and needs, listen closely, agree to disagree, set clear limits, offer choices/ optimism, de-brief client and staff
what is DEFUSE?
the art of verbal de-escalation:
decide: safety
ensure safety: personal space,
form relationship: introduce urself, ask
utilize interest: wants and feelings
set limits: offer choices, repetition
enforce/evaluate: get help, debrief
what is the intimate partner violence cycle? (abuser behavior)
honeymoon stage: apologetic, respectful, attentive, promises, improved communication, helpful, gift giving/compliments, spends time
tension stage: insults, threats, sarcasm, jealousy, accusations, fault finding, controlling actions, quick mood changes, emotional distance
explosion stage: intimidating body language, keeps them from leaving, throwing things, slamming doors, silent treatment, name calling, swearing, yelling
what is elder abuse? and examples of them.
the abuse and neglect of older people, it takes many froms:
physical: hitting, pushing, kicking, inappropriate use of drugs or restriants
emotional: insults, threats, humiliation, controlling, isolation
sexual: sexual contact without consent
financial exploitation: misusing or stealing a persons money or assets
neglect: not providing basic needs to elder
medication: misuse of an older persons medications and prescriptions on purpose or by accident
acute distress disorder:
severe, few days to maximum 4 weeks, maximum one month duartoin for symtpoms
adjustment disorder:
mild/moderate, up to 3 months, 6 months after end of stressor duration for symptoms
PTSD:
sever, sometimes years, >1 month duration for symptoms
what are the 4 types of dissociative disorders?
dissociative amnesia: sudden memory loss cause by an event
depersonalization disorder: person feels detachment from ones mind or body
dissociative fugue: forgetting personal info and taking on a new identity and including moving, but forget fugue state when it ends
dissociative identity: existence of two or more distinct personalities within a distinct individual
what are some nursing interventions for trauma and stressor related disorders?
promote safety-assess for self harm, provide safe space, grounding techniques, during flashbacks change position, change gaze, “survivor” not victim, establish support system
