NR 473 Mental Health Exam 2024

Acute stress d/o
exposure to trauma that causes anxiety, detachment and other symptoms, lasts 3 days -1 month following trauma
PTSD
exposure to trauma causes anxiety, detachment and other symptoms and can last for 1 month- many years

Trauma
extremely distressing event causing emotional sock with potentially long lasting psychological effects
Resilience
the capacity to withstand stress and catastrophe, develops overtime, association with positive feelings
Trauma-informed care
realizes the widespread impact of trauma and various paths for recovery, recognizes s&s of trauma, informed about how to deal with trauma victims in a successful manner, seeks to resist re-traumatization
What is one of the most traumatic events for children?
loss of loved ones, especially parents, and can lead to psychiatric d/os
Trauma preceding PTSD
this kind of trauma is not something you can experience everyday
PTSD symptoms begin...
may begin within first 3 months after trauma, may be a delay of several months or even years,
Intrusion symptoms of PTSD
intrusive thoughts, dreams, nightmares, dissociative reactions (flashbacks), distress at exposure to cues about trauma, psychological reactions to cues about trauma (basically all reactions of anxiety)
PTSD causes negative alterations in cognition and mood like
inability to recall traumatic event, negative beliefs of self, distorted thoughts
Other PTSD symptoms
avoidance of stimuli associated with event, alterations in arousal/reactivity, duration of 1 moths, impairment in social, occupational, or other functioning
Nursing Dx and Care for trauma-related d/os
Dx: post-trauma syndrome, complicated grieving, ineffective coping
care: assure safety, decrease maladaptive symptoms, demonstrate adaptive coping strategies, adaptive progression through the grieving process
Nursing interventions for trauma d/os
safe environment, 1:1 trusting relationship, cognitive restructuring, critical incident debriefing, discuss risk taking behavior, counseling and therapy (EMDR, cognitive-behavioral), stress management, sleep hygiene, teach coping skills, anger management, administer meds, address substance abuse
Psychopharmacology for PTSD
acts upon serotonin, norepinephrine, GABA, and dopamine, and include antidepressants, SSRIs, Alpha-1 adrenergic blocker, beta-adrenergic blocker
nursing outcomes/evals for trauma-related d/os
-Can acknowledge the traumatic event and the impact it has had on his or her life
-Is experiencing fewer flashbacks and nightmares
-Demonstrate adaptive coping strategies
-Includes others in the recovery process and accepts their support
-Verbalizes no ideas or intent of self-harm
-Can client discuss the traumatic event without experiencing panic anxiety?
-Does client voluntarily discuss the traumatic event?
-Can client sleep without medication?
Abuse
The maltreatment of one person by another
Neglect
physical neglect (refusal or delay of physical care), emotional neglect (chronic failure of caregiver to provide child with hope, love, and support necessary for a successful development)
Battering
pattern of coercive control founded on and supported by physical or sexual violence or threats to an intimate partner
Rape
expression of power and dominance by means of sexual violence
Incest
sexual contact or interaction and exploitation of relatives
Cycle of Violence
phase 1 (tension building phase), phase 2 (acute battering incident), phase 3 (calm, loving respite)
Colorado mandatory arrest laws
if there is a call for domestic violence, someone will get arrested
Profiles of victims
largest percentage of victims are women, effects all races, ages, religious, cultural, educational and socio economic groups, some victims grew up in abusive homes, the phenomena of "learned helplessness" lead women to not act on their own behalf
profile of perpetrator
presents a dual personality, people who desire power and control, military, law enforcement, MDs, lawyers, athletes, usually step on boundaries and have poor coping skills