Includes positive reframing, de-catastrophizing, thought-stopping, and distraction. It is typically successful.
Escalation Phase in Aggressive Patients
Include shouting, swearing, agitation, threatening, demanding, clenched fists, threatening gestures, hostility, loss of ability to problem solve or think clearly. The nurse should calmly, suggest retreating to a quiet area, conveying empathy, and offering PRN meds
Tricyclic Antidepressants
Oldest treatment for depression. They relieve symptoms of hopelessness, anhedonia, inappropriate guilt, suicidal ideation, and daily mood variations. They have a lag period of 10-14 days before effectiveness. SHOULD BE ADMINISTERED AT BEDTIME, ensure adequate fluids and nutrition. Assist in rising slowly (orthostatic hypotension)
Activity in Depression
May experience Anhedonia (loss of any sense of pleasure from any activities that were once enjoyed). Apathetic (not caring about themselves, activities, or much of anything). May have loss interest in sexual activities, may neglect personal hygiene for lack of interest or energy.
Risk Factors for Self-Mutilation
Impulsive, inability to express feelings, attention-seeking behavior, ineffective coping skills
De-Escalation Techniques in the Escalation Phase
Take control. Provide directions in a firm, calm voice. Direct client to time-out in a quiet room or area. Communicate that aggressive behavior is not acceptable. Offer medication if refused in triggering phase. Show of force by calling for assistance.
Assessing for Self-Mutilation Risks
Include assessing for behaviors that indicate potential for deliberate physical harm to self, that is not intended to be fatal.
Active Suicidal Ideation
When a person thinks about and seeks ways to commit suicide. They are the more potentially lethal
Reframing
Turning a negative message into a positive message. May say things like... instead of thinking "I think I'm going to die" you should think "I can stand this, it is just my anxiety"
