Psych Nursing
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| Somatoform disorder | show 🗑
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| To qualify as Somatoform disorder, each of the following criteria must be met, occurring at any time during the disturbance: | show 🗑
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| show | Excessive preoccupation with an imagined defect in appearance
Preoccupation causes clinically significant distress or impairment
Usually begins in adolescence
Preoccupation is not better accounted for by another mental disorder
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| Conversion Disorder | show 🗑
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| show | pt2.Symptoms cause clinically significant distress or impairment in social, occupational, or other areas of functioning
Symptoms usually remit within 2 weeks
Often secondary gain from the symptoms
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| show | Preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms
Duration of disturbance is at least 6 months
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| show | Intentional production of physical or psychological symptoms
Motivation is to assume the sick role
External incentives such as in Malingering are absent
Often have repeated hospitalizations in numerous cities, states, countries
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| Malingering | show 🗑
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| What are the four Dissociative Disorders? | show 🗑
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| show | 1 or more episodes of inability to recall important personal information, usually traumatic or stressful, that is too extensive to be explained by ordinary forgetfulness.
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| show | Amnesia may be:
Localized (certain time period)
Selective (some recall)
Generalized (whole life)
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| Dissociative Fugue | show 🗑
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| show | Presence of 2 or more distinct identities or personality states,with enduring pattern of perceiving, relating to, & thinking about the environment & self
At least 2 of these identities or personality states recurrently take cntrl of the person’s behavior
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| Depersonalization Disorder | show 🗑
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| Personality Disorders pt1 | show 🗑
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| show | pt2.Pattern is stable & of long duration
Pattern is manifested in 2 or more of the following:
Cognition
Affectivity
Interpersonal functioning
Impulse control
Onset in adolescence or early adulthood
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| show | Cluster A: appear odd, eccentric
Paranoid, Schizoid, Schizotypal
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| Personality Disorder Clusters:B | show 🗑
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| Personality Disorder Clusters:C | show 🗑
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| Dissociative Identity Disorder terms: | show 🗑
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| Splitting | show 🗑
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| Idealization | show 🗑
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| show | devalues (demonizes) person when needs are not met
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| Feeling of abandonment: | show 🗑
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| Projective Identification: | show 🗑
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| Paranoid personality disorder: pt1 | show 🗑
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| Paranoid personality disorder: pt2 | show 🗑
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| show | reads hidden demeaning or threatening meanings into benign remarks or events
persistently bears grudges, unforgiving of insults or slights
perceives attacks on their character or reputation that are not apparent to others & is quick to react angrily
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| Paranoid personality disorder: pt4 | show 🗑
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| show | Pervasive pattern of detachment from social relationships & restricted range of expression of emotions in interpersonal settings, in a variety of contexts, indicated by 4 or more of the following:
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| show | neither desires nor enjoys close relationships, including being part of a family
almost always chooses solitary activities
little, if any, interest in having sexual experiences with another person
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| Schizoid personality disorder: pt3 | show 🗑
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| Schizotypal Personality Disorder pt1 | show 🗑
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| show | ideas of reference (non-delusional; incorrect interpretation of events)
odd beliefs or magical thinking that influences behavior & are inconsistent with culture
unusual perceptual experiences, including bodily illusions
odd thinking & speech
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| Schizotypal Personality Disorder: pt3 | show 🗑
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| Schizotypal Personality Disorder: pt4 | show 🗑
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| Antisocial Personality Disorder: pt1 | show 🗑
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| show | deceitfulness, indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
individual is at least 18 years of age
impulsivity or failure to plan ahead
irritability & aggressiveness, repeated physical fights or assault
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| Antisocial Personality Disorder: pt3 | show 🗑
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| Antisocial Personality Disorder: pt4 | show 🗑
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| Borderline Personality Disorder: pt1 | show 🗑
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| Borderline Personality Disorder: pt2 | show 🗑
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| Borderline Personality Disorder: pt3 | show 🗑
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| show | inappropriate, intense anger or difficulty controlling anger, especially at any hint of abandonment
can be very sarcastic, often followed by guilt
more comfortable with transitional objects (i.e.: pets) than in relationships
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| show | Pervasive pattern of excessive emotionality & attention-seeking, in a variety of contexts, indicated by 5 or more of the following:
uncomfortable in situations when not the center of attention
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| Histrionic Personality Disorder: pt2 | show 🗑
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| Histrionic Personality Disorder: pt3 | show 🗑
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| show | Pervasive pattern of grandiosity ( in fantasy or behavior), need for admiration, & lack of empathy in a variety of contexts, indicated by 5 or more of the following:
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| show | grandiose sense of self-importance
preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
believes they are “special” & unique, & can only be understood by, or should associate with, other special or high-status people
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| Narcissistic Personality disorder: pt3 | show 🗑
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| show | is exploitative, takes advantage of others to achieve their own ends
lacks empathy, is unwilling to recognize or identify with the feelings & needs of others
often envious of others or believes that others are envious of them
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| show | Pervasive pattern of social inhibitions, feelings of inadequacy, hypersensitivity to negative evaluation, as indicated by 4 or more of the following:
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| Avoidant personality Disorder: pt2 | show 🗑
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| show | shows restraint within intimate relationships because of fear of being shamed or ridiculed
preoccupied with being criticized or rejected in social situations
inhibited in new interpersonal situations due to feeling inadequate
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| Avoidant personality Disorder: pt4 | show 🗑
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| Dependent Personality Disorder: pt1 | show 🗑
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| show | pt2.difficulty in making everyday decisions without an excessive amount of advice & reassurance from others
needs others to assume responsibility for most major areas of their lives
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| Dependent Personality Disorder: pt3 | show 🗑
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| Dependent Personality Disorder: pt4 | show 🗑
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| show | pt5.urgently seeks another relationship as a source of care & support when a close relationship ends
unrealistically preoccupied with fears of being left to take care of themselves
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| show | pt1.Pervasive pattern of preoccupation with orderliness, perfectionism, & mental & interpersonal control, at the expense of flexibility, openness, & efficiency, as indicated by 4 or more of the following
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| Obsessive Compulsive Personality Disorder: pt2 | show 🗑
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| show | pt3.excessively devoted to work & productivity to the exclusion of leisure activities & friendships
over-conscientious, scrupulous, & inflexible about matters of morality, ethics, or values
unable to discard worn-out or worthless objects
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| Obsessive Compulsive Personality Disorder: pt4 | show 🗑
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| show | Anxiety
Ineffective coping
Social isolation
Disturbances in thought process
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| Nursing Diagnosis: Antisocial, Borderline, Histrionic, Narcissistic (B) | show 🗑
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| Nursing Diagnosis: Avoidant, Dependent, Obsessive-Compulsive (C): | show 🗑
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| Common complaints to physician from a patient with anxiety disorder: | show 🗑
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| show | Mild, +1, warning of danger
- Moderate, +2, tension
- Severe, +3, fight/flight, pupils dilated, lowered problem solving, selective attention
- Panic, +4, helpless, complete disorganization
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| 3 Types of Anxiety | show 🗑
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| Agoraphobia | show 🗑
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| Panic Disorder | show 🗑
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| show | marked & persistent fear of clearly discernible objects or situations
exposure to the phobic stimulus provokes immediate anxiety response
patients recognize the fear is unreasonable (not always for children)
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| Specific subtypes of specific phobias | show 🗑
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| Social Phobia | show 🗑
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| Obsessive-Compulsive Disorder | show 🗑
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| Posttraumatic Stress Disorder pt1 | show 🗑
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| show | pt2.persistent re-experiencing of traumatic event; flashbacks, intrusive thoughts & dreams
persistent avoidance of stimuli associated with the event
persistent symptoms of increased arousal; hypervigilence & increased startle reflex
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| show | pt3.Symptoms present for more than 1 month
causes significant distress or impairment in functioning
specified as “acute”, “chronic”, or “delayed onset”
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| show | Exposure to traumatic event of actual or threatened death or serious injury, or threat to physical integrity of self or others
response was intense fear, helplessness, or horror
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| show | 3 or more dissociative symptoms within 1 month of exposure to the trauma:
numbing,
detachment
“in a daze”
derealization
depersonalization
dissociative amnesia
Avoidance of stimuli
flashbacks, intrusive dreams
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| show | excessive anxiety& worry occurring more days than not, lasting at least 6 months
- difficult to control the worry, yet recognized by patient as excessive.
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| Generalized Anxiety Disorder pt2 | show 🗑
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| Trichotillomania | show 🗑
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| show | 312.3 Pathological Gambling
312.33 Pyromania
312.32 Kleptomania
312.34 Intermittent Explosive Disorder
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| show | Medications
anxiolytics
SSRIs
Cognitive Behavioral Therapy (CBT)
Relaxation Techniques
Behavioral techniques
exposure
systematic desensitization, especially with Specific Phobias
Skill training
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| Nursing Assessments for anxiety disorders | show 🗑
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| show | Impairment in adjustment
Ineffective coping strategies
Disturbance in body image/self-concept
Hopelessness
Noncompliance
Powerlessness
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| Nursing Interventions for patients with Anxiety Disorders | show 🗑
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| Nursing Interventions for patients with Anxiety Disorders pt2 | show 🗑
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| show | Major Depressive Disorder
Dysthymic Disorder
Adjustment Disorder
Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder
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| show | Mood Disorder Due to General Medical Condition
Substance-Induced Mood Disorder
Depressive Episode with Post-Partum Onset or Psychosis
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| show | Depressed mood & sadness OR anhedonia must be present
At least 5 symptoms present over 2 weeks
Irritability, anger, rage
Hopelessness
Worthlessness (most important symptom toward suicidality)
Difficulty in concentration, focus
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| Symptoms of Depression pt2 | show 🗑
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| Symptoms of depression pt3 | show 🗑
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| Symptoms of Mania pt1 | show 🗑
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| Symptoms of Mania pt2 | show 🗑
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| show | psychomotor agitation
excessive involvement in high risk pleasurable activities
marked impairment in social or occupational functioning
may have psychotic features
may require hospitalization
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| show | Similar to manic symptoms but never reaching same severity or duration, for at least 4 days:
happy
congenial
humorous
productive
must represent a change in usual functioning, but without interference in social or occupational functioning
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| Symptoms of Hypomania pt2 | show 🗑
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| Symptoms of Mixed Episode | show 🗑
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| 296 Major Depressive Episode | show 🗑
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| show | Similar to Depressive symptoms, but never reach same intensity
Must have 2 or more depressive symptoms
Never without S&S for more than 2 months at a time
Must have low level of depression for at least 2 years
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| show | Development of emotional or behavioral symptoms in response to an identifiable stressor(s)
symptoms occur within 3 months of the onset of the stressor(s)
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| Adjustment Disorder pt2 | show 🗑
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| 296.0 Bipolar I Disorder pt1 | show 🗑
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| show | pt2.Mood swings can last for weeks/months
Cycle back and forth from Manic to Depressive & baseline S&S
Cycles vary in duration
Can be rapid cycling, within a day
Can be weeks or months in each cycle
Important to determine patient’s pattern of cycling
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| 296.89 Bipolar II Disorder | show 🗑
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| 301.13 Cyclothymic Disorder pt1. | show 🗑
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| show | pt2.Depressive symptoms never meet criteria for a Major Depressive Episode
Never without symptoms for more than 2 months during the 2 years (or 1 year if under 18 years of age)
Symptoms cause clinically significant distress in soc/occ. functioning
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