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Royal: The Pentagon Review Specialist, Inc
Royal: The Pentagon Review Specialist, Inc
Royal: The Pentagon Review Specialist, Inc
Psychiatric Nursing
Sigmund Freud
Father of Psychoanalysis
Structure of Personality (Id, Ego, Superego)
Dominant ID
I Mania
D eat Antisocial
mpulsive drink Narcissistic
want to urinate
want PLEASURE defecate
PLEASURABLE PRINCIPLE E
Pain Avoidance
It’s all “I”
CONSCIENCE PRINCIPLE E
GO
Xecutive Secretary Impaired Reality
Schizophrenia
REALITY PRINCIPLE
PSYCHOSEXUAL THEORY
1. ORAL STAGE
0 – 18 Months old
Survival
I want to eat, sleep, urinate, defecate
ID formation
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
SE
Too Rigid Training Dirty
Disorganized
Clean Disobedient
Organized Small
Obedient ANTISOCIAL S
BIG E
(Anal Expulsive)
SE
OBSESSIVE – COMPULSSIVE
(Anal Retentive)
3. PHALLIC
3 – 6 y.o.
Penis/ Vagina
Parents is the significant person
Called as Preschooler
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
Sexual energy is dormant
Reading, Riting, Rithmetic
5. GENITAL STAGE
12 y. o. – above
Gising
Genital
PHARMA MOMENTS
ANTIANXIETY
VLAST ME VAIB
Valium – ate V Miltown - Meal Vistaril - largavista
Libreum - L Equanil – Aqua Kneel Attarax – Mga bato (rocks)
Ativan - Ate Guy Inderal – hindi ralph
Seraks – Sera Ulo Busfar – sasakay ng bus
Tranxene - Transit
ERIK ERIKSON
PSYCHOSOCIAL THEORY OF DEVELOPMENT
Age + - Affecting Major
Factor
0-18 mos. Trust Mistrust Feeding
18 mos. – 3 y.o. Autonomy Shame/ doubt Toilet Training
AU nal
TO ilet training
NO favorite word
MY
3 – 6 y.o. Initiative Guilt Independence
6 – 12 y.o. Industry Inferiority In da-school
12 – 20 y.o. Identity Role confusion Peer
20 – 25 y.o. Intimacy Isolation Love
25 – 45 y.o. Generativity Stagnation Parenting
45 y.o. and above Ego Integrity Despair Reflection
1. Physiologic Needs
o Air, food, water, shelter, rest, sleep, activity and temperature
maintenance that are crucial for survival
2. Safety and Security Needs
o Safe in physical and psychological aspects
3. Love and Belonging Needs
o Giving and receiving affection, attaining a place in a group,
maintaining the feeling of belonging
4. Self – esteem Needs
o Self esteem – feelings of independence, competence and self
respect
o Esteem from others – recognition, respect, appreciation
5. Self Actualization
o One’s maximum potential and realize one’s abilities and qualities
BEHAVIORAL MODELS
1. Ivan Pavlov
Classical Conditioning Model
All behavior are learned
Food dog Salivation
Bell Food Dog Salivation
Bell Salivation
2. B.F. Skinner
Operant Conditioning
All behaviors are unlearned
Reward (+ reinforcement) and Punishment (-
Reinforcement)
Sensory
Integration Voluntary
Motor
Involuntary
PHARMA MOMENTS
MONOAMINE OXIDASE INHIBITORS
AR
M PLAN
N DIL
P NATE
ANTIPARKINSON
CAPABLES
Cogentin
Artane
Parlodel
Akineton
Benadryl
Larodopa
Eldepryl
Symmetryl
THERAPEUTIC COMMUNICATION
Therapeutic Non-Therapeutic
Offer your self I’ll stay with Don’t worry be happy
you Everything’s gonna be alright
Silence Ignoring the client
Making observations Changing the subject
o You seem sad Nice weather we’re having
Active listening o Adjectives – value
o Nodding based perception,
o Eye contact should not be use
o Lean forward You are the most beautiful
Who, what, when, where client
General leads Why
o Go on, I’m listening, Arguing
what else? Flattery
Broad opening - best Opening You should do this now
line In my opinion
o How are you today?
o How are you?
Restating
Clarrification
Refocusing we are talking
Enchanted
nalang.
GO Epinephrine/ Norepinephrine
SNS Exitatory
Anti-Anxiety Dependence
Withdrawal
Drowsy
No Alcohol
No Coffee
Develop Orthostatic
Hypotension
Prevetion of O.H.
1. Sit Down
2. Dangle feet Gradually
3. Stand Up Gradually Tapered Dose
RELAXED
ANXIETY
Vague sense of impending doom
PANIC DISORDER
15 – 30 Minutes escalation of SNS
AGORAPHOBIA fear of open space/ public places
SOCIAL PHOBIA fear of public
Trauma
Disaster
Accident Flashbacks
War VICTIMS Survivors
Rape Nightmares
Earthquake
Soldier
SOMATOFORM DISORDERS
SOMATOFORM
PSYCHOSOMATIC DISORDERS
Anxiety
SNS PNS
BP Vasoconstriction Bronchoconstriction
Hypertension Cerebral Artery Left Gastric Artery Asthma
Migraine Stress Ulcer
OBSESSIVE – COMPULSIVE
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
PHARMA MOMENTS
ANTIPSYCHOTIC AGENT
SSTTCMHP
ALCOHOLISM
Etiology:
Intergenerational Transmission
From one generation to another generation
Alcohol
Blackout awake but unaware
Confabulation inventing stories to self-esteem
Denial “I am not an alcoholic”
Dependence “I can’t live without it”
Enabling significant other tolerates abusers
Another term CO – DEPENDENCY
DETOXIFICATION
Withdrawal with MD supervision
Check Alcohol, Mouthwash, Elixer
void alcohol
version therapy
lcoholics Anonymous self help group
ntabuse DISULFIRAM Never drink alcohol
12 hour interval/ 12 h last alcohol intake
B1 Vitamin Deficiency or else: nausea, vomiting and hypotension
Wernicke’s Encephalopathy motor
Complications
Korsakoff’s Psychosis memory
Delirium Tremens 24 – 72 h after last dose of alcohol
untreated withdrawal syndrome
ormocation bugs crawling under the skin
amily Therapy mother, father, brother
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
Maslow’s hierarchy of needs
Constancy, promote safety
Evaluation
Expressive therapy drawing, muscic etc
Enhanced communication
Improved social interaction
Safety
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
EATING DISORDERS
Vomiting
Diarrhea
Interventions
Restore fluid and electrolyte balance
Collaborative regarding menu contract
Target weight gain
After meals: stay 30 mins – 1 hour
PHARMA MOMENT
LITHIUM
ANTIPARKINSON
ANTICHOLINERGIC DOPAMINERGIC
ABC PLSE
Artane Parlodel
Akineton Larodopa
Benadryl Symmetyl
Cogentin Eldepryl
SCHIZOPHRENIA
Ego disintegration
Impaired reality perception
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
ssociative Looseness
Symptoms
Negative Positive
Hypoactive Hyperactive
Withdrawn Sociable
Apathy Flight of Ideas
Talkative
Assess : Suspicious
Nx Dx : Risk for other directive behavior
Planning/ Implementation:
Present reality
Provide safety
Evaluation : Eliminate/ minimize risk for other-directed violence
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
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
Halucinations Illusion
Stimulus Absent Present
Visual X
Auditory X
Tactile X
Hallucinations
Acknowledgment
I know you the voices are real to you
Reality orientation
But I don’t hear them
Diversion
Lets go to the garden
Normally
Acetylcholine = ON Dopamine = OFF
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
G randiose
F light of ideas
S leeplessness
P ressured speech
E xagerated SE
E xtraneous stimuli (easily distracted)
D istractibility
PERSONALITY DISORDERS
SCHIZOID
I don’t want people
Believes he can stand on his own
Never had a best friend
Avoid groups and social activities no enjoyment
Cares more about computers and pets
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 can’t 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
Obsessive – Compulsive
I am organized
Perfectionist
Provide time to do rituals
Paranoid
Suspicious
Passive Aggressive
Always say yes but resistance is hidden
Serotonin
MAO Serotonin
MAO Serotonin
Serotonin ANTIDEPRESSANTS
eer
Antidepressant
hocolate Anticholinergic Side Effects
(Syphathetic)
ermented Foods Male Erectile Dysfunction
ickles
reserved Foods
oy Sauce
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
½ hour asleep post
PHARMAMOMENTS
SUBSTANCE ABUSE
Downers (ABONM INE)
Alcohol Morph
Barbituates Code NARCAN antidote
Opiates Hero
Narcotics
Marijuana
Uppers (CHA)
Cocaine
Hallucinogen
Amphetamines
OVERDOSE
Alcohol Cocaine
HR
RR
BP
Coma LOC Seizure
Bradycardia
Bradypnea
Pupil constriction
Moist mouth
Constipation
Hypotension
Coma
Asleep
Weight gain
Tachycardia
Tachypnea
Pupil Dilation
Dry mouth
DETOXIFICATION withdrawal with MD Supervision
Hypertension
METHADONE
Seizure
Awake
Weight Loss
Self Actualization
Self Esteem C TASK
withdrawn Stay
Risk for self directed violence
SUICIDE TRIAD
Loss of spouse
Loss of job
Aloneness
Give simple task. Don’t give complex may cause depression ex. Jigsaw
Water plants
Wash the dishes except sharps
Don’t bathe the child, don’t brush teet. Body of evidence will be lost
Bantay Bata 163
LEVELS OF MENTAL RETARDATION
Profound
o < 20
o thinks like an infants
o can’t be trained
ero – 2 y/o
o stay with the patient ensorimotor
Severe evere
o 20 – 35
Moderate Modera e
o 35 – 50 hirtyfive – 50
o can be train rainable
o mental age is 2 – 7 y/o wo – 7 y/o
o pre-operational stage
Mild
o 50 – 70
o meantal age is 7 – 12
o educable
o can go to school
Borderline
o 70 - 90
Normal
o 90 – 100
JOHN PIAGET’S COGNITIVE THEORY
0–2 Sensorimotor Baby can sense, see, perceive and hear. Object
permanence
2–4 Preconceptual Language
4–7 Intuitive Unidimentional classification characteristic. Child can
fix toys according to size, color, height = one at a time
7 – 12 Conservation Multidimensional
Concrete
Association
12 Formal Good abstract thinking. Can interpret words
Operation
ALZHEIMER
NOMIA don’t know name of objects
GNOSIA problem with senses
PHASIA can’t say it
PRAXIA can’t do it
Cocaine Nasal Septum perforation
Marijuana impaired Lung Structure
eroine withdrawal
ikab
atsing
u hu hu
CRITICAL REVIEW
ABC ASSESS
3. Good Word/ Bad Word air
4. S Technique
eek support
it
tay
upervised
ee = observed
eem = notice
assi t
feeling
5. 2 same answer/ 2 same mistake
6. Words to watch out for
Inappropriate
Most
Not included
Except
All but one
7. Umbrella
RELATIONSHIP
PRACTICE OF NURSING
Level of Prevention
1 2 3
Endogenous Reactive
Internal external
Chemical
ATTITUDE THERAPIES
Active friendliness ask permission
assive Friendliness
aranoid
anipulative
nic
atter of Fact
No Demand Depressed
Kind Firmness Anorexic
Crisis 4 – 6 weeks
Goal Return the client to the pre-crisis level of functioning
PSC
Perception what do you think about it?
Coping what will you do about it?
Support who will be there for you?