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Psych Nursing Complete Edited Royal Pentagon
Psych Nursing Complete Edited Royal Pentagon
Psych Nursing Complete Edited Royal Pentagon
Psychiatric Nursing
D
mpulsive
want to
want PLEASURE
eat
drink
urinate
defecate
PLEASURABLE PRINCIPLE
Pain Avoidance
Its all I
UPER EGO
hould not
mall voice of God
Dominant ID
Mania
Antisocial
Narcissistic
CONSCIENCE PRINCIPLE
GO
Xecutive Secretary
I
E
Impaired Reality
Schizophrenia
REALITY PRINCIPLE
LIBIDO sexual energy responsible for survival
PSYCHOSEXUAL THEORY
1. ORAL STAGE
0 18 Months old
Survival
I want to eat, sleep, urinate, defecate
Psychiatric Nursing
ID formation
Cry & Suck mouth
Child Cries
Feed the Infant
Successful
Unsuccessful
Narcissistic
Defense Mechanism:
o FIXATION when a person is stuck in a certain developmental
stage
o REGRESSION return to an earlier developmental stage
2. ANAL STAGE
Ateen 3 years old (18 mos 3 y.o.)
Toilet training
Super Ego develop
Toilet Training
Good Mother
Successful
Bad Mother
Unsuccessful
SE
BIG
SE
Clean
Organized
Obedient
OBSESSIVE COMPULSSIVE
(Anal Retentive)
Dirty
Disorganized
Disobedient
ANTISOCIAL
(Anal Expulsive)
Small
S
E
3. PHALLIC
3 6 y.o.
Penis/ Vagina
Parents is the significant person
Called as Preschooler
Jomar Anthony D. Maxion, BSN, RN
Psychiatric Nursing
Level of Awareness
o Conscious highest level of awareness
o Preconscious Tip of the tongue
o Unconscious deepest level of awareness
4. LATENCY STAGE
6 12 years old
SCHOOlatency
5. GENITAL STAGE
Psychiatric Nursing
12 y. o. above
Gising
Genital
PHARMA MOMENTS
ANTIANXIETY
VLAST ME VAIB
Valium ate V
Miltown - Meal
Libreum - L
Equanil Aqua Kneel
Ativan - Ate Guy
Seraks Sera Ulo
Tranxene - Transit
Vistaril - largavista
Attarax Mga bato (rocks)
Inderal hindi ralph
Busfar sasakay ng bus
ERIK ERIKSON
PSYCHOSOCIAL THEORY OF DEVELOPMENT
+
Age
0-18 mos.
18 mos. 3 y.o.
3 6 y.o.
6 12 y.o.
12 20 y.o.
20 25 y.o.
25 45 y.o.
45 y.o. and above
Trust
Autonomy
AU nal
TO ilet training
NO favorite word
MY
Initiative
Industry
Identity
Intimacy
Generativity
Ego Integrity
Mistrust
Shame/ doubt
Affecting Major
Factor
Feeding
Toilet Training
Guilt
Inferiority
Role confusion
Isolation
Stagnation
Despair
Independence
In da-school
Peer
Love
Parenting
Reflection
Psychiatric Nursing
Voluntary
Motor
Involuntary
RR
GI
Constipation
GU
Urinary
Jomar Anthony D. Maxion, BSN, RN
Parasympathetic
Diarrhea
Urinary
College of Nursing Batch 2009
retention
Epi/ Nor
Neuro
Psychiatric Nursing
Frequency
Acetyl Choline
PHARMA MOMENTS
M
N
P
PLAN
DIL
NATE
ANTIPARKINSON
CAPABLES
Cogentin
Artane
Parlodel
Akineton
Benadryl
Larodopa
Eldepryl
Symmetryl
THERAPEUTIC COMMUNICATION
Therapeutic
Offer your self Ill stay with
you
Silence
Making observations
o You seem sad
Active listening
o Nodding
o Eye contact
o Lean forward
Who, what, when, where
General leads
o Go on, Im listening,
what else?
Broad opening - best Opening
line
o How are you today?
Non-Therapeutic
Dont worry be happy
Everythings gonna be alright
Ignoring the client
Changing the subject
Nice weather were having
o Adjectives value
based perception,
should not be use
You are the most beautiful
client
Why
Arguing
Flattery
You should do this now
In my opinion
Psychiatric Nursing
SUPPRESSION
Conscious forgetting of an anxiety
provoking concept
SUBLIMATION
Placing sexual energies toward a
more productive endeavors
CONVERSION
Repressed angers put towards
physical symptoms affecting
Boss shouts at
you, you shout at
your subordinate
Im not an
alcoholic
Sino ka, Sino
ako?
Return to
thumbsucking
Hindi ko maalala
I drink because I
dont want to
waste the beer in
the ref
sasabunutan
kita. . . ay
kuklulutin lang kita
ay pinatid kita,
halika punta kita
sa clinic
Tulad niya
hindi ako
alcoholic, sila yon
ako din
Not just you, me
too
Hindi ko alam yan
Angry at life, put
anger in singing
Biglang mangingig
COMPENSATION
SUBSTITUTION
Psychiatric Nursing
Pilay pero
magaling kumanta
Gusto ko
Disneyland.
Enchanted
nalang.
SNS
ANXIETY
Within 1 week
Rebound
phenomenon
Seizure
Abrupt
Anti-Anxiety
Dependence
Withdrawal
Drowsy
No Alcohol
No Coffee
Develop Orthostatic
Hypotension
Prevetion of O.H.
1. Sit Down
2. Dangle feet
3. Stand Up Gradually
Gradually
Tapered Dose
RELAXED
ANXIETY
Mild
+1
Widened
Moderate
+2
acing
Severe
+3
ont know what
Panic
+4
uicide
College of Nursing Batch 2009
to say/do
IRECTIVE
Psychiatric Nursing
afety
Assess
Nx Dx
: Level of Anxiety
: Ineffective Individual Coping
Powerlessness
Impaired Skin Integrity
Planning/ Implementation:
level of anxiety
environmental Stimuli
Relaxation Technique
Showing pictures of flower, waterfalls
Hearing sounds of chirping birds
Evaluation : Effective individual coping
PANIC DISORDER
Psychiatric Nursing
Flashbacks
VICTIMS Survivors
Nightmares
Anxiety
I am sick
6 years old
Assignments/
Homeworks
No Assignments/
Homeworks
You Think
Teacher may
get angry
SOMATOFORM
> no pretension
> no organic
basis
MALINGERING
pretending to be sick
(Conscious)
Absent
Escape from
Teacher
PRIMARY GAIN
(Behavior anxiety)
> unconscious
PSYCHOSOMATIC
> Real pains/ illness
> Real symptoms
> 4 major types
* Hypertension
* Migraine
* Stress Ulcer
* Asthma
Mama Care
Attention
SECONDARY GAIN
SOMATOFORM DISORDERS
SOMATOFORM
Nervous System
CONVERSION DISORDER
La Belle Indifference
emotional disattachment
from disability
Minor Discomfort
Psychiatric Nursing
PSYCHOSOMATIC DISORDERS
Anxiety
SNS
BP
Hypertension
PNS
Vasoconstriction
Bronchoconstriction
Cerebral Artery
Left Gastric Artery
Asthma
Migraine
Stress Ulcer
OBSESSIVE COMPULSIVE
Belief/ thought
Door Open
Burglar may go inside
Feelings
Anxiety
Obsession anxiety
(thought)
Returns to house
(Action)
Anxiety Compulsion
PHOBIA
Irrational fears
Etiology
o Knowledge
o Experience
Immediate Nursing Intervention remove the stimuli
SYSTEMATIC DESENSITIZATION
o Gradual exposure to feared object
Psychiatric Nursing
PHARMA MOMENTS
ANTIPSYCHOTIC AGENT
SSTTCMHP
Stelazine - sexy star
Serentil serena
Thorazine babaeng Tora
Trilafon - tri-band phone
ALCOHOLISM
Etiology:
Intergenerational Transmission
From one generation to another generation
Alcohol
B1 Vitamin Deficiency
Psychiatric Nursing
Complications
AUTISM
Autistic Savant autistic with a special talent
Assess
Appearance flat affect, consistent movement
Behavior repetitive, ritualistic
Communication echolalia, incomprehensible
Nx Dx
Impaired verbal communication
Impaired social interaction
Self mutilation
Risk for injury
Planning/ Implementation
Maslows hierarchy of needs
Constancy, promote safety
Evaluation
Expressive therapy drawing, muscic etc
Enhanced communication
Improved social interaction
Safety
Onset
Duration
Settings
Id Dominant
Psychiatric Nursing
Appearance dirty
Behavior clumsy, impatient, easily distracted, hyperactive
Communication talkative, blurts out in class
Nx Dx
Risk for injury
Impaired social interaction
Planning/ Implementation
tructure separate room for eating, playing, sleeping and etc
chedule time for everything
et limits
afety
Evaluation
Minimize Risk for Injury
Improved social interaction
Safety
Residual ADHD grows up not antisocial
Meds: Ritalin, dexedrin, pemoline, adderal
Best time to give: once a day: AFTER MEALS: prevent lost of appetite
Dont give at bedtime STIMULANT causes insomnia
Give 6 hours prior bedtime if bid
EATING DISORDERS
18 mos. 3 y.o.
Toilet Training
Clean
Obedient
Organized
Thought
I Am Fat
social inactive/ no BF
weighing
Feeling
Behavior
Self Esteem Diet, Diet, Diet
Anorexia Nervosa
Diet, diet, diet
<85% of expected body
3 mos. ammenorhea
Eating Disorders
Eating Pattern
Weight
Menstruation
Bulimia
Eat, eat, vomit
Normal weight
Irregular menstruation
College of Nursing Batch 2009
Psychiatric Nursing
Karen Carpenter
Dao Ming Xi
Da Ming Sugat/ suka
Vomiting
Dental caries
Wounded knuckles
Metabolic alkalosis
Metabolic acidosis
Vomiting
Fluid Volume Deficit ARRHYTHMIA (fatal complication)
Diarrhea
Interventions
Restore fluid and electrolyte balance
Collaborative regarding menu contract
Target weight gain
After meals: stay 30 mins 1 hour
PHARMA MOMENT
LITHIUM
Kidney
ANTIPARKINSON
ANTICHOLINERGIC
ABC
Artane
Akineton
Benadryl
Cogentin
DOPAMINERGIC
PLSE
Parlodel
Larodopa
Symmetyl
Eldepryl
SCHIZOPHRENIA
Ego disintegration
Impaired reality perception
Psychiatric Nursing
Genetic vulnerability
Stress Diathesis Model
o Too much stress in the reality will lead client to escape it and go to
the fantasy world
Biological Theory
o Dopamine level is High
The exact cause is unknown
ffect appropriate, inappropriate, flat, blunt (incomplete emotion)
mbivalence torn between 2 opposing forces
utism
ssociative Looseness
Symptoms
Negative
Hypoactive
Withdrawn
Apathy
Positive
Hyperactive
Sociable
Flight of Ideas
Talkative
Assess
: Content of Thought
Nx Dx
: Disturbed thought process
Planning/ Implementation:
Present reality
Provide safety
Evaluation : Improve thought process
Assess
: Hallucination/ Illusions
Nx Dx
: Disturbed sensory perception
Planning/ Implementation:
Present reality
Provide safety
Evaluation : Improve sensory perception
Assess
: Suspicious
Nx Dx
: Risk for other directive behavior
Planning/ Implementation:
Present reality
Provide safety
Evaluation : Eliminate/ minimize risk for other-directed violence
Psychiatric Nursing
Assess
: Suicidal
Nx Dx
: Risk for self directive behavior
Planning/ Implementation:
Present reality
Provide safety
Evaluation : Eliminate/ minimize risk for self-directed violence
Flight or Looseness
I am going to the mall.
Magical Thinking
Believes to have a magical power
I can turn you into a frog
Echolalia I repeat what you say Parrots
Echopraxia I repeat what you do
Word Salad words, no rhyme
Clang Association words with rhyme : Dunk, plank, sunk
Neologism creation of new words Plinking, hustash
Clarification done in case of neologism
Delusion:
Persecutory NBI is out to get me/ someone will harm the client
Religious I am Jesus Christ
Grandeur I am the queen of the world.
Ideas of reference Nurses are talking about me.
Concrete Association pilosopo what will you wear? clothes
Thought Blocking
Stimulus
Visual
Auditory
Halucinations
Absent
X
X
Illusion
Present
Tactile
Psychiatric Nursing
Hallucinations
Acknowledgment
Reality orientation
Diversion
Disorganized
Sad but smiles
o Inappropriate affect
No reaction
o Flat affect
Flight of ideas
o HEBEPHRENIC
Giggling
Positive
and Negative
classified
S/Sx differentiated
Catatonic
Ambivalence
Waxy Flexibility
o Iniwan na posture,
ganun forever
No favorite word
Negativism
Cant be classified
1st paranoid, then
No more positive s/sx,
disorganized then
just withdrawn
catatonic, etc etc
Paranoid
Suspicious
Tendency to be violent
MistrustScaredWithdraw
n
Nrsg. Int:
Develop trust
1 to 1
short interaction
frequent visit
foods in sealed
container
meds wrapped
for violent pt.
Doors open
Near the door
Dont touch the pt.
Eye contact
1 arms length away
call reinforcement
Normally
Acetylcholine = ON
Psychiatric Nursing
Dopamine = OFF
Your always ON
With parkinsON
Psychiatric Nursing
o Hyperthermia among client
taking antipsychotic
o Hyperthermia with muscle
rigidity
PHARMAMOMENTS
ANTIDEPRESSANTS
ANTSAAVE PPZ
Asendin ascending
Norpramin sabaw ng knorr
Tofranil Tofu
Sinequan nood ng Sine Quan ang title
Anafranil kina Ana Praning
Aventyl kina Aven Til Midnight tayo
Vivactil Bye Back till next week
Elavil Eh love mo ba ako
Prozac Pero saka na
Paxil - Taksil
Zoloft mag Solo ka
BIPOLAR DISORDER Mania more common
Female
20 years old and above
Stressful life
Obese
Self Actualization
Self Esteem
TASK
Caregiver Role Strain
College of Nursing Batch 2009
Psychiatric Nursing
Sleep
Private room
Hyperactive
Safety
Safety
Sex
Anxiety
randiose
light of ideas
leeplessness
ressured speech
xagerated SE
xtraneous stimuli (easily distracted)
istractibility
PERSONALITY DISORDERS
SCHIZOID
Jomar Anthony D. Maxion, BSN, RN
Psychiatric Nursing
AVOIDANT
I avoid people, I fear criticism
Have talent but no confidence
ANTISOCIAL
I break the law as motto
As a child,: steal, lie, always get reprimanded
Adult grand robbery, illegal activitist against the law, drug addiction,
drives fast, unsafe sex, thrill seeker
Good talker, charmer, witty manipulator
Dependent
I cant live without you
self esteem
poor decision making skills
Histrionic
excited, dramatic but manipulative
center of attention
Narcissistic
I love myself
Insensitive, arrogant
I am the best
Psychiatric Nursing
Obsessive Compulsive
I am organized
Perfectionist
Provide time to do rituals
Paranoid
Suspicious
Passive Aggressive
Always say yes but resistance is hidden
Serotonin
MAO kills Serotonin
MAO Serotonin
MAO Serotonin
Serotonin
Psychiatric Nursing
ANTIDEPRESSANTS
wo 4 weeks
wo neurotransmitter
RI
ONO
CYCLIC
MINE
EUPTAKE
NTIDEPRESSANT
XIDASE
afest
ELECTIVE
to 4 weeks
NHIBITOR
PPZ
MNP
SSRI
TCA
MAOI
Antidepressant
ickles
reserved Foods
oy Sauce
Psychiatric Nursing
Psychiatric Nursing
ELECROCONVULSIVE THERAPY
Pre
o Informed consent
o NPO 6 8 hours prior
Meds
o Atropine dry mouth
o Barbituate Sedative
o Succinylcholine muscle relaxant, prevent seizure
Post
o Side-lying lateral
o S/E
headache, dizziness,
TEMPORARY MEMORY LOSS distinct sign
70 110 volts
20 30 seconds
hour asleep post
PHARMAMOMENTS
SUBSTANCE ABUSE
Downers (ABONM INE)
Alcohol
Barbituates
Opiates
Narcotics
Marijuana
Morph
Code
Hero
NARCAN antidote
Uppers (CHA)
Cocaine
Hallucinogen
Amphetamines
OVERDOSE
Alcohol
Bradycardia
Coma
Bradypnea
Cocaine
HR
RR
BP
LOC
Seizure
Pupil constriction
Moist mouth
Constipation
Hypotension
Coma
Asleep
Weight gain
EUPHORIA
Tachycardia
Tachypnea
Pupil Dilation
Dry mouth
Hypertension
Seizure
Awake
Weight Loss
Psychiatric Nursing
C TASK
Stay
Self Esteem
withdrawn
Sleep
Hypoactive
Sex
Psychiatric Nursing
SUICIDE
Verbal
I wont be a problem anymore
This is my last day on earth
Ill soon be gone
Non Verbal
Take this ring, its yours (giving of
valuable)
Sudden change in mood
Psychiatric Nursing
Psychiatric Nursing
atsing
u hu hu
CRITICAL REVIEW
TEST TAKING TECHNIQUES
1. Assess the answer, use circle
2. Initial priority
TRUST
3.
4.
5.
6.
7.
ABC
Good Word/ Bad Word
air
S Technique
eek support
it
tay
upervised
ee = observed
eem = notice
assi
t
feeling
2 same answer/ 2 same mistake
Words to watch out for
Inappropriate
Most
Not included
Except
All but one
Umbrella
ASSESS
RELATIONSHIP
Preorientation
Self awareness
Orientation
Trust
Setting Contract
Resistance
Working
Termination
Discussion
Evaluation
Psychiatric Nursing
PRACTICE OF NURSING
Level of Prevention
1
Healthy
Ill
Community Demog. Crisis Intervention
Relapse
AA
Reactive
external
Psychiatric Nursing