Download - Psyche Nursing
-
8/13/2019 Psyche Nursing
1/31
-
8/13/2019 Psyche Nursing
2/31
- 2 -
Cry < Suc% mouthChild Cries
Feed the Infant Ignore the Infant
Successful )nsuccessful&arcissistic
Defense Mechanism:
o FI3$TI.& 'hen a person is stuc% in a certain developmental
stage
o */*SSI.& return to an earlier developmental stage
EGO is develop in the 6thmonth
=8 $&$ ST$/ $teen : > years old (7; mos : > y8o8!
Toilet training
Super go develop
Toilet Training
/ood #other Bad #other
Successful )nsuccessful
Too *igid Training "irty
"isorgani4edClean "iso0edient
.rgani4ed
.0edient $&TIS.CI$
($nal 2pulsive!.BSSSI? : C.#P)SSI?
($nal *etentive!
>8 P6$IC
> : @ y8o8
PenisA ?agina
Parents is the significant person
Called as Preschooler
SE
BIG SE
SmallSE
-
8/13/2019 Psyche Nursing
3/31
- 3 -
.edipus Comple2 little 0oy loves mommy
lectra Comple2 little girl loves daddy
Identification 0oy associates 'ith daddy, girl assoc8 'ith mommy
Castration fear of the little 0oy to daddy Penis nvy envy of little girl to'ards daddy
"r8 aren 6orney opposition to penis envy
evel of $'areness
o Conscious highest level of a'areness
o Preconscious Tip of the tongue
o )nconscious deepest level of a'areness
Birth Trauma First traumatic e2perience of child
*P*SSI.& unconscious forgetting of an an2iety provo%ingconcept
S)P*SSI.& conscious forgetting of an an2iety provo%ingconcept
8 $T&C5 ST$/
@ : 7= years old
SC6..latency
Se2ual energy is dormant
*eading, *iting, *ithmetic
S)BI#$TI.& placing se2ual energies to'ard a moreproductive endeavors
D8 /&IT$ ST$/
7= y8 o8 : a0ove
/ising
/enital
-
8/13/2019 Psyche Nursing
4/31
- 4 -
PHARMA MOMENTS
$&TI$&3IT5 ?$ST # ?$IB?alium : ate ? #ilto'n 1 #eal ?istaril 1 largavista
i0reum 1 quanil : $qua neel $ttara2 : #ga 0ato (roc%s!$tivan 1 $te /uy Inderal : hindi ralphSera%s : Sera )lo Busfar : sasa%ay ng 0usTran2ene 1 Transit
*I *IS.&
PS5C6.S.CI$ T6.*5 .F "?.P#&T
$ge E 1 $ffecting #aorFactor
917; mos8 Trust #istrust Feeding
7; mos8 : > y8o8 $utonomy
$) nalT. ilet training&. favorite 'ord#5
ShameA dou0t Toilet Training
> : @ y8o8 Initiative /uilt Independence
@ : 7= y8o8 Industry Inferiority In da1school
7= : =9 y8o8 Identity *ole confusion Peer
=9 : =D y8o8 Intimacy Isolation ove
=D : D y8o8 /enerativity Stagnation Parenting
D y8o8 and a0ove go Integrity "espair *eflection
#$S.W+S 6I*$*C65 .F &"S
78 Physiologic &eedso $ir, food, 'ater, shelter, rest, sleep, activity and temperature
maintenance that are crucial for survival=8 Safety and Security &eeds
o Safe in physical and psychological aspects
>8 ove and Belonging &eedso /iving and receiving affection, attaining a place in a group,
maintaining the feeling of 0elonging8 Self : esteem &eeds
o Self esteem : feelings of independence, competence and self
respecto steem from others : recognition, respect, appreciation
-
8/13/2019 Psyche Nursing
5/31
- 5 -
D8 Self $ctuali4ationo .ne+s ma2imum potential and reali4e one+s a0ilities and qualities
B6$?I.*$ #."S78 Ivan Pavlov
Classical Conditioning #odel
$ll 0ehavior are learned Food dog Salivation
Bell Food "og Salivation
Bell Salivation=8 B8F8 S%inner
.perant Conditioning
$ll 0ehaviors are unlearned
*e'ard (E reinforcement! and Punishment (1*einforcement!
B*$I& .BS $CTI.&
Frontal anguage, earning, Personality, Gudgment
Temporal hearing, smelling
Parietal Taste, touch
.ccipital ?ision
SensoryIntegration ?oluntary
#otorInvoluntary
?.)&T$*5 &*?.)S S5ST# Somatic &ervous System $cetylCholine
Brain Spinal Cord #otor &erve #uscle Fi0er
I&?.)&T$*5 &*?.)S S5ST#
$utonomic &ervous System
Sympathetic Parasympathetic
6* **
/I Constipation
"iarrhea
/) )rinary
retention
)rinary
Frequency
&euro piA &or $cetyl Choline
-
8/13/2019 Psyche Nursing
6/31
- 6 -
PHARMA MOMENTS
#.&.$#I& .3I"$S I&6IBIT.*S $*
# P$&& "IP &$T
$&TIP$*I&S.& C$P$BS
Cogentin$rtaneParlodel
$%inetonBenadrylarodopaldeprylSymmetryl
T6*$P)TIC C.##)&IC$TI.&Therapeutic &on1Therapeutic
.ffer your self I+ll stay 'ithyou
Silence #a%ing o0servations
o 5ou seem sad
$ctive listeningo &odding
o ye contact
o ean for'ard
Who, 'hat, 'hen, 'here
/eneral leadso /o on, I+m listening,
'hat elseH
Broad opening 1 0est .peningline
o 6o' are you todayH
o 6o' are youH
*estating
Clarrification
*efocusing 'e are tal%ing
"on+t 'orry 0e happy
verything+s gonna 0e alright
Ignoring the client Changing the su0ect
&ice 'eather 'e+re havingo $dectives : value
0ased perception,should not 0e use
5ou are the most 0eautifulclient
Why
$rguing
Flattery
5ou should do this no' In my opinion
-
8/13/2019 Psyche Nursing
7/31
- 7 -
a0out the e2am
Focusing tell me a0out
"F&S #C6$&IS#S Fight for stress
"ISP$C#&T Transfer of feelings to a lessthreatening o0ect rather than the
one 'ho provo%e it
Boss shouts atyou, you shout at
your su0ordinate"&I$ Failure to ac%no'ledge an
unaccepta0le trait or situation I+m not an
alcoholic-
"ISS.CI$TI.& Psychological flight from self
$ type of amnesia
Sino %a, Sinoa%oH-
*/*SSI.& *eturn to an earlier developmentalstage
*eturn tothum0suc%ing
*P*SSI.& )nconscious forgetting of anan2iety provo%ing concept
6indi %o maalala
*$TI.&$I$TI.& Illogical reasoning for a socially
unaccepta0le trait sayang ang 0eer sa ref, %aya %oininum-
I drin% 0ecause I
don+t 'ant to'aste the 0eer inthe ref
*$CTI.&F.*#$TI.&
doing the opposite of yourintention
plastic
sasa0unutan%ita8 8 8 ay%u%lulutin lang %ita
)&".I&/ "oing the opposite of 'hat youhave done due to guilt
orocan, plastic, Tupper'are
ay pinatid %ita,hali%a punta %itasa clinic-
I"&TIFIC$TI.& $ssume trait for personal, social,occupational role
Tulad niya
P*.GCTI.& $ttri0uting to others one+saccepta0le trait
Pasa load
hindi a%oalcoholic, sila yon-
I&T*.GCTI.& $ssume another person+s trait asyour o'n
a%o din-
&ot ust you, metoo
S)PP*SSI.& Conscious forgetting of an an2ietyprovo%ing concept
6indi %o alam yan
S)BI#$TI.& Placing se2ual energies to'ard amore productive endeavors
$ngry at life, putanger in singing
C.&?*SI.& *epressed angers put to'ardsphysical symptoms affectingnervous system leading to sensorynum0ness and motor paralysis
Biglang mangingig
C.#P&S$TI.& .verachievement in one area tocover a defective part
Pilay peromagaling %umanta
S)BSTIT)TI.& *eplacing a difficult goal 'ith amore accessi0le one
/usto %o"isneyland8
-
8/13/2019 Psyche Nursing
8/31
-
8/13/2019 Psyche Nursing
9/31
-
8/13/2019 Psyche Nursing
10/31
- 10 -
arthqua%eSoldier
@ years old $n2iety S.#$T.F.*#
K no pretension
$ssignmentsA I am sic%- K no organic6ome'or%s 0asis
#$I&/*I&/ K unconscious&o $ssignmentsA pretending to 0e sic%6ome'or%s (Conscious! PS5C6.S.#$TIC
K *eal painsA illness5ou Thin% $0sent K *eal symptomsTeacher may K maor typesget angry- L 6ypertension
L #igraine
scape from #ama Care L Stress )lcer Teacher L $sthma
P*I#$*5 /$I& $ttention
(Behavior an2iety! SC.&"$*5 /$I&
S.#$T.F.*# "IS.*"*S
S.#$T.F.*#
&ervous System Illusion of structural defectC.&?*SI.& "IS.*"* B."5 "5S#6.*PIC "IS.*"*a Belle Indifference
emotional disattachmentfrom disa0ility
#inor "iscomfort
Interpreted as maor illness65P.C6.&"*I$SIS
#aliit na 0utas, pinalala%i-
Favorite Past TimeJ "octor 6opping &ursing FocusJ Feelings
-
8/13/2019 Psyche Nursing
11/31
- 11 -
PS5C6.S.#$TIC "IS.*"*S
$n2iety
S&S P&S
BP ?asoconstriction Bronchoconstriction
6ypertension Cere0ral $rtery eft /astric $rtery $sthma
#igraine Stress )lcer
.BSSSI? : C.#P)SI?
BeliefA thought Feelings
"oor .pen $n2ietyBurglar may go inside
.0session an2iety
(thought! *eturns to house ($ction!
$n2iety Compulsion
P6.BI$ Irrational fears
tiologyo no'ledge
o 2perience
Immediate &ursing Intervention remove the stimuli
S5ST#$TIC "S&SITI$TI.&o /radual e2posure to feared o0ect
PHARMA MOMENTS
$&TIPS5C6.TIC $/&T SSTTC#6P
Stela4ine 1 se2y star Clo4aril : closed reelSerentil : serena #ellaril : maraming reelThora4ine : 0a0aeng Tora 6aldol : hahahaTrilafon 1 tri10and phone Proli2in : pero lic% scene
-
8/13/2019 Psyche Nursing
12/31
- 12 -
$C.6.IS#
tiologyJ
Intergenerational Transmission From one generation to another generation
$lcohol
Blac%out a'a%e 0ut una'are
Confa0ulation inventing stories to self1esteem
"enial I am not an alcoholic-"ependence I can+t live 'ithout it-
na0ling significant other tolerates a0users$nother term C. : "P&"&C5
T.*$&C Su0stance to achieve a previous effect
"T.3IFIC$TI.&
Withdra'al 'ith #" supervision
Chec% $lcohol, #outh'ash, li2er
void alcohol version therapy
lcoholics $nonymous self help group
nta0use "IS)FI*$# &ever drin% alcohol
7= hour intervalA 7= h last alcohol inta%e
B7 ?itamin "eficiency or elseJ nausea, vomiting and hypotension Wernic%e+s ncephalopathy motor
Complications
orsa%off+s Psychosis
memory"elirium Tremens = : M= h after last dose of alcohol
untreated 'ithdra'al syndrome
ormocation 0ugs cra'ling under the s%in
amily Therapy mother, father, 0rother
-
8/13/2019 Psyche Nursing
13/31
- 13 -
$)TIS#$utistic Savantautistic 'ith a special talent
$ssess
$ppearance flat affect, consistent movement Behavior repetitive, ritualistic Communication echolalia, incomprehensi0le
&2 "2
Impaired ver0al communication
Impaired social interaction
Self mutilation
*is% for inuryPlanningA Implementation
#aslo'+s hierarchy of needs
Constancy, promote safetyvaluation
2pressive therapy dra'ing, muscic etc
nhanced communication
Improved social interaction
Safety
$TT&TI.& "FICIT 65P*$CTI? "IS.*"* .nset J M y8o8 and 0elo'
"uration J @ months and a0ove
Settings J = 6ouse and school
Id "ominant J #om or *& 'ill act as superego
$"6" /lucose Frontal o0e impaired udgement $"6" SAS2
*italin Frontal o0e Gudgement $"6" SAS2(stimulant!
$ssess
$ppearance dirty Behavior clumsy, impatient, easily distracted, hyperactive Communication tal%ative, 0lurts out in class
&2 "2
*is% for inury
Impaired social interactionPlanningA Implementation
tructure separate room for eating, playing, sleeping and etc
chedule time for everything
-
8/13/2019 Psyche Nursing
14/31
- 14 -
et limits afety
valuation
#inimi4e *is% for Inury
Improved social interaction
Safety
*esidual $"6" gro's up not antisocial
#edsJ *italin, de2edrin, pemoline, adderalBest time to giveJ once a dayJ $FT* #$SJ prevent lost of appetite
"on+t give at 0edtime STI#)$&T causes insomnia /ive @ hours prior 0edtime if 0id
$TI&/ "IS.*"*S
7; mos8 : > y8o8 @ y8o8 class valedictorianA model student
Toilet Training social inactiveA no BF
Clean 'eighing .0edient .rgani4ed
Thought Feeling Behavior
I $m Fat Self steem "iet, "iet, "iet
$nore2ia &ervosa ating "isorders Bulimia
"iet, diet, diet ating Pattern at, eat, vomit
N;DO of e2pected 0ody Weight &ormal 'eight
> mos8 ammenorhea #enstruation Irregular menstruation
aren Carpenter "ao #ing 3i"a #ing SugatA su%a
?omiting"ental caries
Wounded %nuc%les#eta0olic al%alosis#eta0olic acidosis
?omiting
Fluid ?olume "eficit $**65T6#I$ (fatal complication!
-
8/13/2019 Psyche Nursing
15/31
- 15 -
"iarrhea
Interventions
*estore fluid and electrolyte 0alance
Colla0orative regarding menu contract
Target 'eight gain $fter mealsJ stay >9 mins : 7 hour
PHARMA MOMENT
IT6I)#
evel 98@ : 78= mqA ausea, vomiting, diarrhea Increase urination ithium To2icity
Tremors, fine hand aE
6ydration > Aday Increase
idney )u diarhea #outh, dry
$&TIP$*I&S.&$&TIC6.I&*/IC
$BC".P$#I&*/IC
PS
$rtane Parlodel
$%ineton arodopa
Benadryl SymmetylCogentin ldepryl
SC6I.P6*&I$ go disintegration
Impaired reality perception
/enetic vulnera0ility
Stress : "iathesis #odelo Too much stress in the reality 'ill lead client to escape it and go to
the fantasy 'orld
Biological Theoryo "opamine level is 6igh
The e2act cause is un%no'n
ffect appropriate, inappropriate, flat, 0lunt (incomplete emotion!
m0ivalence torn 0et'een = opposing forces
-
8/13/2019 Psyche Nursing
16/31
- 16 -
utismssociative ooseness
Symptoms
&egative Positive
6ypoactive 6yperactiveWithdra'n Socia0le
$pathy Flight of Ideas
Tal%ative
$ssess J Content of Thought&2 "2 J "istur0ed thought processPlanningA ImplementationJ
Present reality
Provide safetyvaluation J Improve thought process
$ssess J 6allucinationA Illusions&2 "2 J "istur0ed sensory perceptionPlanningA ImplementationJ
Present reality
Provide safetyvaluation J Improve sensory perception
$ssess J Suspicious
&2 "2 J *is% for other directive 0ehaviorPlanningA ImplementationJ
Present reality
Provide safetyvaluation J liminateA minimi4e ris% for other1directed violence
$ssess J Suicidal&2 "2 J *is% for self directive 0ehaviorPlanningA ImplementationJ
Present reality
Provide safetyvaluation J liminateA minimi4e ris% for self1directed violence
Flight or ooseness
I am going to the mall8 I am going to the mall8
-
8/13/2019 Psyche Nursing
17/31
- 17 -
Where is the lightH The mall is 0ig8/o here8 Big is the tree8#ineral Water8 The tree is tall8
#agical Thin%ing
Believes to have a magical po'er
I can turn you into a frog
cholalia I repeat 'hat you say Parrots
chopra2ia I repeat 'hat you do
Word Salad 'ords, no rhyme
Clang $ssociation 'ords 'ith rhyme J "un%, plan%, sun%
&eologism creation of ne' 'ords Plin%ing, hustash
Clarification done in case of neologism"elusionJ
Persecutory &BI is out to get meA someone 'ill harm the client
*eligious I am Gesus Christ
/randeur I am the queen of the 'orld8
Ideas of reference &urses are tal%ing a0out me8
Concrete $ssociation pilosopo 'hat 'ill you 'earH- clothes-
Thought Bloc%ing
6alucinations
Illusion
Stimulus $0sent Present
?isual 3 $uditory 3
Tactile 3
In case of hallucinations doJ
6allucinations$c%no'ledgment
I %no' you the voices are real to you
*eality orientation But I don+t hear them
-
8/13/2019 Psyche Nursing
18/31
- 18 -
"iversion ets go to the garden
Bt if nothin! in the p"eceedin! inte"vention a"e seenAssess #hat the voices a"e sa$in!
SC6I.P*&I$
&ormally$cetylcholine .& "opamine .FF
5our al'ays .& 6igh "opamine Schi4ophreniaWith par%ins.&
Disorganized
Sad 0ut smileso Inappropriate affect
&o reactiono Flat affect
Flight of ideaso HEBEPHRENIC
/iggling
Positive and &egativeSAS2
Catatonic$m0ivalence
Wa2y Fle2i0ilityo Ini'an na posture,
ganun forever
&o : favorite 'ord
&e ativism
Paranoid Suspicious
Tendency to 0e violent
#istrustScaredWithdra'n&rsg8 IntJ"evelop trust
7 to 7 short interaction
frequent visit
foods in sealedcontainer
meds 'rappedfor violent pt8
"oors open
&ear the door
"on+t touch the pt8
ye contact
7 arms length a'ay
call reinforcement
Residual
&o more positive sAs2,ust 'ithdra'n
classifieddifferentiated
#i2ed classification
Can+t 0e classified
7stparanoid, thendisorgani4ed thencatatonic, etc etc
-
8/13/2019 Psyche Nursing
19/31
- 19 -
$ntipsychotics ma%es "opamine goes do'n
.& 2trapyramidal Side ffects
$$T6ISI$o *estless, ina0ility to sit
o #a%ati siya, ahh %ati siya
$I&SI$o #uscle rigidity
o $hh %iniss siya
"5ST.&I$o > features
T.*TIC.IS
Wry nec%
.C)./5*IC C*ISIS
Fi2ed stare
.PIST6.T)&.S
$rched 0ac%
T$*"I? "5SI&SI$o Irreversi0le side effects of
antipsychoticso ip smac%ing
o Tongue protruding
o Chee%s puffing
&)*.PTIC #$I/&$&TS5&"*.#
o 6yperthermia among client
ta%ing antipsychotico 6yperthermia 'ith muscle
rigidity
.ther Side ffects Photosensitivity
o Sunscreen
o Wide 0rimmed hat
$granulocytosiso *eport immediately Sore throat
7stsign to appear
Anticholinergic
D"!s that #ill ma%e theAcH do#n
o $rtane
o $%ineton
o Benadryl
o Cogentin
Dopaminergic
Dopamine !oes po Parlodel
o arodopa
o Symmetryl
o ldepryl
-
8/13/2019 Psyche Nursing
20/31
- 20 -
PHARMAMOMENTS
$&TI"P*SS$&TS$&TS$$? PP
$sendin : ascending&orpramin : sa0a' ng %norrTofranil : TofuSinequan : nood ng Sine Quan ang title
$nafranil : %ina $na Praning$ventyl : %ina $ven Til #idnight tayo?ivactil : Bye Bac% till ne2t 'ee%lavil : h love mo 0a a%oPro4ac : Pero sa%a naPa2il 1 Ta%siloloft : mag Solo %a
BIP.$* "IS.*"* : #ania more common
Female
=9 years old and a0ove Stressful life
.0ese
T$S Caregiver *ole Strain
Safety Safety
ithium : = : 'ee%s 0efore effect
Self $ctuali4ation
Self steem
Impaired social interaction
*is% for inuryA other directed violence
ating Sleep 6yperactive Se2finger food Private room $n2iety
-
8/13/2019 Psyche Nursing
21/31
- 21 -
S Compensation interfere $"s, harm others
S Compensation interfere $"s, harm others
T$S increases client+s self esteem
/ross motor s%ills via su0limation
scorted 'al% outdoors
Punching 0ag
&o group games compition 'ill increase an2iety
> or more signs confirms disorder
/FSP
"
randioselight of ideasleeplessnessressured speech2agerated S2traneous stimuli (easily distracted!
istracti0ility
P*S.&$IT5 "IS.*"*S
SC6I.I"
I don+t 'ant people
Believes he can stand on his o'n
&ever had a 0est friend
$void groups and social activitiesno enoyment
Cares more a0out computers and pets
$?.I"$&T
I avoid people, I fear criticism
6ave talent 0ut no confidence
$&TIS.CI$
I 0rea% the la' as motto
-
8/13/2019 Psyche Nursing
22/31
-
8/13/2019 Psyche Nursing
23/31
- 23 -
Serotonin
#$. %ills Serotonin
#$.
Serotonin
#$. Serotonin
T5*$#I& *IC6 F.."S
vocadoged Cheese
eer
hocolate
SSRI TCA MAI
$ntidepressant
$nticholinergic Side ffects
(Syphathetic!
#ale rectile "ysfunction
Serotonin $&TI"P*SS$&TS
7stine of "rug Prescri0ed 'o : 'ee%s'o neurotransmitter
afest RI ! E"ECTI#E
ide effects lo' C$C"IC MI!E ERT!I!
E%PTA&E !TIDEPRESSA!T 'IDASE
6igher incidence of Side effects to 'ee%s SerotoninA pi affected !(IBITR !(IBITR
PP) A!TSA#E M!P
$ll neurotransmitter affected6ighest Side effects
$void tyramine rich food
may lead to
-
8/13/2019 Psyche Nursing
24/31
- 24 -
ermented Foods
ic%lesreserved Foods
oy Sauce
-
8/13/2019 Psyche Nursing
25/31
- 25 -
$ntidepressantno effect CT
C*.C.&?)SI? T6*$P5
Preo Informed consent
o &P. @ : ; hours prior
#eds
o $tropine dry mouth
o Bar0ituate Sedative
o Succinylcholine muscle rela2ant, prevent sei4ure Post
o Side1lying : lateral
o SA
headache, di44iness,
T#P.*$*5 ##.*5 .SS distinct sign
M9 : 779 volts
=9 : >9 seconds
R hour asleep post
PHARMAMOMENTS
S)BST$&C $B)S
"o'ners ($B. I&!$lcohol #orph
Bar0ituates Code &$*C$& antidote.piates 6ero&arcotics
#ariuana
)ppers (C6$!Cocaine6allucinogen
$mphetamines
-
8/13/2019 Psyche Nursing
26/31
- 26 -
.?*".S$lcohol Cocaine
6***BP
Coma .C Sei4ure
Psych 'ell 0eing
&$*C$& &arcotic $ntagonist narcotic overdose
"T.3IFIC$TI.& 'ithdra'al 'ith #" Supervision#T6$".&
Withdra'al reverse of effect or opposite of overdose
"P*SSI.& Serotonin, if unresponsive to drugs, CTThe /rief Process
"enial no this can+t 0e true
$nger'hy me, 'hy me, 'hy no'
Bargaining if something happens, then I+ll give something 0ac%
"epression I+m do'n = 'ee%s or more sAs2 maor depression
$cceptance client acts according to situation
BradycardiaBradypnea
Pupil constriction
#oist mouthConstipation6ypotension
Coma$sleep
Weight gain
Tachycardia
TachypneaPupil "ilation
"ry mouth6ypertension
Sei4ure$'a%e
Weight oss
)P6.*I$
-
8/13/2019 Psyche Nursing
27/31
- 27 -
C T$SStay
Sensitivity to client needs
S)ICI"
?er0al &on ?er0al
I 'ont 0e a pro0lem anymore
This is my last day on earth
I+ll soon 0e gone
Ta%e this ring, its yours (giving ofvalua0le!
Sudden change in mood
Who 'ill commit SuicideHSe2 : #ale (more successful!A female (hesitant!
$ge : 7D := yAo or a0ove D"epressionPatient 'ith previous attemptT.6 : ethanol 1 alcoholics*irrationalSocial support lac%ing
.rgani4ed plan greater ris%&o familySic%ness, terminal
S)ICI" T*I$"
oss of spouse
oss of o0
$loneness
Is Patient is S)ICI"$ nurse shouldJ "I
"irect question : $re you going to commit suicideH-
Irregular interval of visit to pt8 room
arly $# and period of endorsement : the time pt+s commit suicide
Best approach for suicidal pt8 J "irect approach&ursing #anagementJ Close surveillance
6ospital area maority sucide 'ill happens atJ
'ee%ends 71 > am Sunday
Wee%end less staff personnel
arly $# every one is asleep
Self $ctuali4ation
Self steem
'ithdra'n
*is% for self directed violence
ating Sleep 6ypoactive Se2
-
8/13/2019 Psyche Nursing
28/31
- 28 -
/ive simple tas%8 "on+t give comple2 may cause depression e28 Gigsa'
Water plants
Wash the dishes e2cept sharps
C6I" $B)S &thin% B' Burns, 0ruise, 0one fractures, B)&/I
"on+t 0athe the child, don+t 0rush teet8 Body of evidence 'ill 0e lost
Bantay Bata 7@>?S .F #&T$ *T$*"$TI.&
Profoundo N =9
o thin%s li%e an infants
o can+t 0e trained
o stay 'ith the patient
Severe
o =9 : >D
#oderateo >D : D9
o can 0e train
o mental age is = : M yAo
o pre1operational stage
#ildo D9 : M9
o meantal age is M : 7=
o educa0le
o can go to school
Borderlineo M9 1 U9
&ormalo U9 : 799
G.6& PI$/T+S C./&ITI? T6.*5
9 : = Sensorimotor Ba0y can sense, see, perceive and hear8 .0ectpermanence
= : Preconceptual anguage
: M Intuitive )nidimentional classification characteristic8 Child can
fi2 toys according to si4e, color, height one at a timeM : 7= ConservationConcrete
$ssociation
#ultidimensional
7= Formal.peration
/ood a0stract thin%ing8 Can interpret 'ords
ero : = yAo ensorimotor
evere
#odera e hirtyfive : D9
raina0le 'o : M yAo
-
8/13/2019 Psyche Nursing
29/31
- 29 -
$6I#*
&.#I$ don+t %no' name of o0ects
/&.SI$ pro0lem 'ith senses
P6$SI$ can+t say it
P*$3I$ can+t do it
Cocaine &asal Septum perforation#ariuana impaired ung Structure
eroine 'ithdra'ali%a0atsingu hu hu
CRITICAL REVIEW
TST T$I&/ TC6&IQ)S78 $ssess the ans'er, use circle
2. Initial priority T*)ST
$BC $SSSS>8 /ood WordA Bad Word
8 S Techniqueee% supportittayupervisedee o0servedeem notice
assi t feeling
D8 = same ans'erA = same mista%e@8 Words to 'atch out for
Inappropriate#ost&ot included2cept
$ll 0ut oneM8 )m0rella
$ir food, 'ater
air
-
8/13/2019 Psyche Nursing
30/31
- 30 -
*$TI.&S6IPPreorientation .rientation Wor%ing Termination
Self a'areness Trust "iscussion valuation Setting Contract *esistance
P*$CTIC .F &)*SI&/evel of Prevention
7 = >
6ealthy Ill *elapseCommunity "emog8 Crisis Intervention $$
SF 6P /*.)PSnique
niversality r not alone
*ST$T e2act 'ords
*FCT use other 'ords"P*SSI.&
ndogenous *eactiveInternal e2ternalChemical
Bar0ituate 'ithdra'al IB*I)# (Chloridia4epo2ide!
T.F*$&I $ntidepressantA $nticholinergic pupil dilation midriasis
Catharsis Feelings
Free $ssociation Ideas
$TTIT)" T6*$PIS
$ctive friendlinessas% permissionassive Friendlinessaranoidanipulativenicatter of Fact
-
8/13/2019 Psyche Nursing
31/31
- 31 -
&o "emand "epressed
ind Firmness $nore2ic
Crisis : @ 'ee%s
/oal *eturn the client to the pre1crisis level of functioning
PSCPerception 'hat do you thin% a0out itH
Coping 'hat 'ill you do a0out itH
Support 'ho 'ill 0e there for youH
ulit %ulit %ulit %ulit Perseveration stic% to 7 topic
)lit )lit )lit ?er0igeration"ISS.CI$TI.&
"issociative $mnesia don+t %no' themselves
Fugue Far"issociative Identity "isorder #ultiple Personality "8.8