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Pysch NUR 329 > Week 7 Anger, Aggression, Violence > Flashcards

Week 7 Anger, Aggression, Violence Flashcards

1
Q

Define anger.

A

An emotional response to frustration of desires, a threat to one’s needs

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2
Q

Define aggression.

A

Action or behavior that results in a verbal or physical attack

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3
Q

Define seclusion.

A

the involuntary confinement of a patient alone in a room, or area from which the patient is physically prevented from leaving

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4
Q

Anger is a __ human emotion

A

normal

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5
Q

How can experiencing anger help a person?

A

When expressed assertively and handled appropriately, can provide an individual with a positive force to solve problems and make decisions concerning life.

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6
Q

Anger does not need to be a __ __

A

negative expression

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7
Q

An emotional response to frustration of desires, a threat to one’s needs, or a challenge

A

Anger

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8
Q

When does anger become a problem?

A

When it is not expressed and when it is expressed aggressively

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9
Q

How can anger be channeled into health productive persuits?

A

Exercise, art, meditation, etc

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10
Q

Anger is an emotional state that varies from…

A

mild irritation to intense fury and rage

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11
Q

Anger is capable of being under __ __

A

personal control

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12
Q

An action or behavior that results in a verbal of physical attack

A

Aggression

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13
Q

__ tends to be used synonymously with violence

A

Aggression

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14
Q

What is the intent of aggression?

A

To threaten or injure the victim’s security or self-esteem

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15
Q

Aggression is not always __

A

inappropriate

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16
Q

When is aggression necessary?

A

Sometimes for self-protection

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17
Q

Aggression is an __. Anger is an __.

A

action; emotion

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18
Q

An objectionable act that involves intentional use of force that results in or has the potential to result in injury to another person

A

Violence

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19
Q

Violence is __ an objectionable act

A

ALWAYS

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20
Q

Define violence.

A

An objectionable act that involves intentional use of force that results in or has the potential to result in injury to another person

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21
Q

Crisis = __ + __

A

danger + opportunity

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22
Q

Crisis moments can be both…

A

dangerous and frightening

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23
Q

How can a crisis become an opportunity?

A

Can cause you and person in crisis to grow and strengthen you relationship with one another

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24
Q

In the hospital setting, where is violence most frequently seen?

A

Psychiatric units, emergency departments, geriatric units

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25
Q

What are 3 biological factors that contribute to the etiology of violence/anger/aggression?

A

Specific area of the brain
Neurotransmitters
Predisposition

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26
Q

What are 4 psychological factors that contribute to the etiology of anger/aggression?

A

Behavior theory
Learned response
Social learning theory
Imitate others

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27
Q

What are 4 brain conditions associated with anger/violence?

A

Brain tumors
Alzheimer’s disease
Temporal lobe epilepsy
TBI

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28
Q

What is behavioral theory?

A

Emotions including anger are learned responses to the environment

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29
Q

What is social learning theory?

A

Believes that anger, aggression, and violence are behaviors that are imitated from others

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30
Q

There is always a __ behind anger

A

Feelings

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31
Q

__-__ is one of the strongest forms of learning

A

Role-modeling

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32
Q

What are neurophysiological disorders?

A

Several disorders of, or conditions within, the brain that have been implicated in episodic aggression and violent behavior

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33
Q

What are 6 types of neurophysiological disorders that can lead to aggression?

A

Temporal or frontal lobe epilepsy
Brain tumors
Brain trauma
TBI
Encephalitis
Psychosis

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34
Q

A specific behavior is positively or negatively reinforced

A

Operant conditioning

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35
Q

Define operant conditioning.

A

A specific behavior is positively or negatively reinforced

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36
Q

What type of behavior change occurs with operant conditioning?

A

Voluntary behavior change

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37
Q

Define positive reinforcement.

A

A response to the specific behavior that is pleasurable or produces the desired results

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38
Q

A response to the specific behavior that is pleasurable or produces the desired results

A

Positive reinforcement

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39
Q

Define negative reinforcement.

A

A response to the specific behavior that prevents an undesirable result from occurring

40
Q

A response to the specific behavior that prevents an undesirable result from occurring

A

Negative reinforcement

41
Q

Appropriate or aggressive expressions of anger can be learned through __ __

A

operant conditioning

42
Q

What are biochemical factors that predispose someone to anger and aggression?

A

Hormonal dysfunction
Low serotonin
Thiamine and niacin in ETOH abuse

43
Q

What are serotonin receptors called?

A

5HT receptors

44
Q

How do low serotonin levels cause predisposition to anger and aggression?

A

May increase pain sensitivity, impulsiveness, and aggression

45
Q

What type of hormonal dysfunction is associated with a predisposition to anger/aggression?

A

Hyperthyroidism

46
Q

What two vitamin deficiencies are associated with a predisposition to anger and aggression?

A

Thiamine and niacin

47
Q

How do thiamine and niacin predispose someone to anger and aggression?

A

May cause irritability and disorientation

48
Q

What medical factors are associated with a predisposition to anger and aggression?

A

UTIs
Infections
Dehydration
Electrolyte imbalances
Blood sugar imbalances
Sensory changes

49
Q

When someone is expressing anger and aggression, you should always look for…

A

a potential medical etiology

50
Q

What socioeconomic factors are associated with a predisposition to anger and aggression?

A

Poverty
Perceived or actual injustice, unfairness, inequality

51
Q

How does poverty put someone at risk for anger and aggression?

A

Associated deprivation
Disruption of families
Unemployment

52
Q

What environmental factors have been associated with an increase in aggressive behavior?

A

Physical crowding of people
Availability of firearms
Discomfort associate with moderate increase in environmental temperature
Use of alcohol and drugs

53
Q

What drugs are associated with an increase in aggressive behavior?

A

Cocaine
Amphetamines
Hallucinogens
Minor tranquilizers/sedatives

54
Q

What are common comobidities with anger/aggression/violence?

A

PTSD
Substance use d/o
Psychiatric d/o
CVD
Strokes

55
Q

What type of psychiatric disorders does anger/aggression/violence coexist with?

A

Depression
Anxiety
Psychosis
Personality disorders

56
Q

What does anger look like?

A

Increased demands
Irritability
frowning
Redness in face
Pacing
Twisting of hands
Clenching and unclenching of fists
Speech increased rate and volume may be slowed

57
Q

What is the single best predictor of future violence?

A

History of violence

58
Q

Who is at higher risk for violence?

A

Delusional
Hyperactive
Impulsive
Non-adherent to medications

59
Q

What questions would you ask a patient to assess major factors associated with violence?

A
  1. Does the individual have a wish or intent to cause harm?
  2. Does the individual have a plan?
  3. Does the individual have the means available to carry out the plan?
  4. Does the individual have demographic risk factors?
60
Q

What are demographic risk factors associated with violence?

A

Male
Age 14-24
Low socioeconomic status
Inadequate support system
Prison time

61
Q

When does aggression most often occur when interacting with a nurse?

A

Limit setting by the nurse

62
Q

What psychological factors indicates a higher risk for violence?

A

History of limited coping skills
Lack of assertiveness
Use of intimidation

63
Q

What assessment findings would indicate risk for aggression?

A

Agitation
Restlessness
Escalating anxiety
Resistance to suggested treatment

64
Q

What cognitive changes put a patient at risk for aggression?

A

Anything that may cause the person to misinterpret things…
Confusion
Disorientation
Delirium
Psychosis
Hallucinations
Delusions

65
Q

What assessment findings in the patient’s history would indicate risk for aggression?

A

Aggression management required at time of transfer
History of assault or threatening behavior
Known history of drug or alcohol abuse

66
Q

History of assault or threatening behavior is a high indication for aggression especially if…

A

It occurred within the last 12 months or hours

67
Q

What are signs/symptoms that usually precede violence?

A

Hyperactivity
Increased anxiety/tension
Verbal abuse
Loud or very soft voice
Stone silence
Intense eye contact
Avoiding eye contact
Recent acts of violence
Possession of a weapon
Isolation that is uncharacteristic

68
Q

The nurse’s ability to intervene during an act of aggression depends on…

A

Self-awareness of strengths, needs, concerns, and vulnerability

69
Q

Without self-awareness, nursing interventions can end up being…

A

Impulsive or emotion based

70
Q

What must the nurse consider when intervening during an act of aggression?

A

Choice of words
Tone of voice
Non-verbal communication
Body posture
Facial expressions

71
Q

What must you keep in mind when a patient is expressing verbal abuse towards the nurse?

A

It is not personal, it is nothing against you

72
Q

What can aid in developing a therapeutic relationship to prevent acts of aggression?

A

Having numerous, brief, nonthreatening, nondirective interactions

73
Q

What can aid in developing a therapeutic relationship to prevent acts of aggression?

A

Having numerous, brief, nonthreatening, nondirective interactions

74
Q

How should the nurse approach a potentially violent patient?

A

In a controlled, nonthreatening, caring manner

75
Q

What can the nurse do to be perceived as less of a threat when approaching a patient?

A

Allow the patient enough space

76
Q

How much space should the nurse give the patient?

A

Always stay approximately 1 foot farther than the patient can reach with arms or legs

77
Q

What else should the nurse be aware of when approaching a potentially violent patient?

A

Make sure you have an escape route

78
Q

What should the nurse do when a patient invaders her space or is verbally abusive?

A

Do not take it personally or respond in kind

79
Q

Ideally, interventions should begin…

A

Prior to any signs of escalation

80
Q

When a nurse starts her shift, she should do an assessment so she can…

A

Get a baseline for what their behavior is

81
Q

How should the nurse speak to a patient who is potentially aggressive?

A

Slowly and in short sentences using a calm voice

82
Q

What type of conversation should the nurse use to speak to a patient who is potentially aggressive?

A

Use open ended questions rather than challenging statements

83
Q

What should the nurse do when a patient expresses angry feelings or behaviors?

A

Find out what is behind these emotions. Ask “tell me what you are feeling.”

84
Q

When a patient is expressing aggressive behaviors, what should the nurse do about the environment?

A

Choose a quiet place to talk to the patient and make sure other staff members are aware of the situation and are available to assist if needed

85
Q

The nurse should not ever __ patients

A

Challenge

86
Q

What intervention can the nurse use to give the patient control?

A

Identify patient’s options and encourage the individual to assume responsibility for choices made. “Do you want to go to your room or to the quiet room?”

87
Q

When the nurse is using deescalating techniques, she must never…

A

Take chances. Always maintain personal safety

88
Q

If the nurse sees a patient escalating, she should…

A

Intervene immediately, not later

89
Q

When is it appropriate to use a PRN medication for aggression?

A

To alleviate symptoms and in conjunction with psychosocial interventions

90
Q

How is long-term aggression treated?

A

The focus is based on treating the underlying psychiatric disorder

91
Q

Don’t stand in front of…

A

the patient or in front of the doorway

92
Q

Why should the nurse not block the doorway?

A

Patient may view this as confrontational

93
Q

If a patient’s behavior starts to escalate, what should the nurse do?

A

Provide feedback, possibly allowing the patient to explore feelings and hopefully deescalate

94
Q

When should the nurse use verbal confrontation?

A

Should be discussed when the patient is calm

95
Q

The presence of security may…

A

escalate the patient

96
Q

What is considered a supportive stance?

A

Posture must be confident but not confrontational
Stand at an angle, not toe to toe
Hands visible
Always stay about 1 foot further than the patient can reach

97
Q

What non-verbal and verbal cues should the nurse display during an escalation in behavior?

A

Maintain appropriate eye contact
Keep facial expression even, caring, confident, engaged
Try to get patient to talk to you

Pysch NUR 329 (9 decks)

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