Quiz 2 Blueprint:

 PTSD
o Re-experiencing
 Flashbacks, nightmares, unwanted distressing memories of the event, feelings
of unreality
o Flashback
 Individual feels or acts as if a traumatic event was recurring
 Anxiety
o How to teach patients during different stages of anxiety? Which anxiety stages can the
patient not learn anything new at? Which stages are going to require you to lower
patient anxiety before attempting to teach?
 Mild
 Ability to perceive reality is brought into sharp focus
 sees, hears, and grasps more information and problem-solving becomes
More effective
 Moderate
 Perceptual field is somewhat narrowed
 Sees, hears, and grasp less information than someone who is not in that
state
 “Selective in attention” which only certain things in the environment are
seen or heard
 Ability to think clearly is hampered, but learning and problem solving
can still take place, just not at optimal level
 Problem-solving ability is enhanced by having another person present
 Severe
 Perceptual field is greatly reduced
 Focus on one particular detail or many scattered details
 Will have difficulty noticing events occurring in the environment, even
when they are pointed out by others
 Learning and problem solving are not possible at this level, patient may
be dazed and confused
 Panic
 not able to process events in the environment and may lose touch with
reality
 Severe to panic levels: nurse must be concerned with patients safety and safety
of others. Physical needs (fluids and rest) must be met to prevent exhaustion.
Firm, short Statements are useful when communicating with these patients
o How will you know when the patient has reduced the level of anxiety?
o Nursing interventions for patients with High motor activity anxiety.
 Dissociative Amnesia with fugue
o Dissociative Amnesia: related to traumatic incident. The patient is unable to recall
specific information about the self, and may include a specific period of time, or
 generalized for the entire life history. NOT related to drugs or medical condition.
Consider head injury, PTSD, or neurological disorder.
o Fugue is where the patient flees their current life and start a new
 Dissociative Amnesia without fugue
o Patient is unable to recall specific information about the self, and may include a specific
period of time, or generalized for the entire life history
 Somatic Symptom Disorder
o Secondary gains
 Benefits derived from symptoms
o Nursing outcomes that would show that the patient is improving in level of functioning.

 Antisocial Personality disorder
o Persistent disregard for others
o Persistent violation of others’ rights
o Absence of remorse for hurting others (callousness)
o Sense of entitlement
o Deceitfulness
o Impulsiveness; risky behaviors to “feel alive”
 Dependent personality
o Belief in inability to survive if left alone
o Excess need to be taken care of
o Solicit caretaking through clinging and submission
o Perversely, excessively submissive
o Intense fear of separation and being alone
o Tolerant of poor, even abusive relationships
o If relationship does end, the individual has an urgent need to get into another
o Inability to make decisions without excessive reassurance
 Narcissistic Personality
o Grandiose sense of personal achievement
o Haughty sense of entitlement
o Lack of empathy; exploiting others to meet own needs
o Increasing attention seeking over time
o Envious of others
o Use of splitting, tantrums
o Can be sadistic, with paranoid tendencies
 Borderline Personality
o Unstable, intense relationships
o Instability of affect; unstable, frequent mood changes
o Emotional lability (shifting from anxiety, to irritability, etc.)
o Poor impulse control; self-destructive; suicide-prone
o Chronic depression
o Projected identification
o Emotional dysregulation
o Splitting