This is completed downloadable of Psychiatric-Mental Health Nursing: Evidence-Based Concepts, Skills, and Practices Mohr 8th Edition Test Bank
Product Details:
- ISBN-10 ‏ : ‎ 1609137086
- ISBN-13 ‏ : ‎ 978-1609137083
- Author:Â R.N. Mohr, Wanda K., Ph.D.
This edition focuses on evidence-based practice and rational practice with more case-oriented content that helps students better understand how to apply key concepts to practice. Plus, new illustrations, photographs, and special features actively engage students in learning and appeal to a variety of different types of learners. Wanda Mohr aims to empower students by the down-to-earth discussion of theory and theoretical frame-work.
Table of Content:
- 1: Introduction to Psychiatric–Mental Health Nursing
- LEARNING OBJECTIVES
- KEY TERMS
- MENTAL HEALTH
- FIGURE 1.1
- Elements of and Influences on Mental Health
- FIGURE 1.2
- Mental Health as a National Priority
- Checkpoint Questions
- MENTAL ILLNESS
- The Mental Health–Illness Continuum
- Incidence and Prevalence
- TABLE 1.1: Mental Disorders in the United States
- Etiology
- Checkpoint Questions
- Diagnosis
- Five Axes of the DSM
- DSM-IV-TR BOX 1.1: Examples of Axis IV (Psychosocial and Environmental) Problems
- Case Vignette 1.1
- Reflection and Critical Thinking
- Limitations and Criticisms of the DSM
- Prevention and Treatment
- FIGURE 1.3
- Problems in Treating Mental Illness
- COST-RELATED ISSUES.
- STIGMA.
- REVOLVING DOOR TREATMENT.
- FIGURE 1.4
- Checkpoint Questions
- Challenges Remaining
- THE NEW FREEDOM COMMISSION REPORT.
- LIMITED ACCESS TO SERVICES.
- Goals of Care and Methods of Achievement
- FIGURE 1.5
- BEYOND RESPONSE TO RECOVERY.
- Think About It 1.1
- REINTEGRATION INTO SOCIETY.
- MENTAL HEALTH PARITY.
- CULTURALLY COMPETENT CARE.
- FIGURE 1.6
- MEDICATION ADHERENCE.
- Self-Help Movements and Advocacy
- NATIONAL ALLIANCE FOR THE MENTALLY ILL.
- Client-Centered Education 1.1: Managing Drug Therapy
- FAMILY ADVOCACY MOVEMENT.
- TABLE 1.2: Family Adaptation Model
- TABLE 1.3: Client Adaptation Model
- PSYCHIATRIC ADVANCED DIRECTIVES.
- Checkpoint Questions
- PSYCHIATRIC-MENTAL HEALTH NURSING
- Nursing Process and Standards of Care
- Levels of Practice
- FIGURE 1.7
- NURSING SPOTLIGHT 1.1: Psychiatric–Mental Health Nursing’s Phenomena of Concern
- Think About It 1.2
- Guiding Principles
- The Role of the Psychiatric Nurse as a Team Member
- Development of Appropriate Client Care Skills
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- References
- Web Resources
- 2: Neuroscience: Biology and Behavior
- LEARNING OBJECTIVES
- KEY TERMS
- NEUROANATOMY AND NEUROPHYSIOLOGY
- Neurons
- FIGURE 2.1
- Neurotransmitters
- Checkpoint Questions
- TYPES OF NEUROTRANSMITTERS.
- TABLE 2.1: Some Neurotransmitters and Their Functions
- BOX 2.1: Neurotransmitters in the Brain
- PROCESS OF NEUROTRANSMISSION.
- FIRST AND SECOND MESSENGERS.
- PSYCHIATRIC NURSING IMPLICATIONS.
- UNDERSTANDING BIOLOGIC FOUNDATIONS 2.1: Neurotransmission
- Think About It 2.1
- Plasticity
- UNDERSTANDING BIOLOGIC FOUNDATIONS 2.2: Major Neurotransmitter Pathways in Mental Health
- Neurogenesis
- Apoptosis
- Central Nervous System
- Spinal Cord
- Brain
- FIGURE 2.2
- ORGANIZATION AND STRUCTURE.
- TABLE 2.2: Organization of the Brain
- Cerebrum.
- FIGURE 2.3
- Diencephalon.
- Cerebellum.
- Brainstem.
- Limbic System.
- FIGURE 2.4
- Basal Ganglia.
- Checkpoint Questions
- BRAIN DEVELOPMENT.
- FIGURE 2.5
- Client-Centered Education 2.1: Encouraging Optimal Learning in Children
- Checkpoint Questions
- NEUROPLASTICITY.
- PSYCHIATRIC NURSING IMPLICATIONS.
- Think About It 2.2
- The Role of Genetics
- Genetics and Psychiatric Disorders
- Interaction Between Genes and Environment
- FIGURE 2.6
- Stress–Diathesis Model
- Checkpoint Questions
- OTHER TOPICS IN NEUROSCIENCE
- Memory, Repetition, and Learning
- FIGURE 2.7
- Circadian Rhythm
- FIGURE 2.8
- Neuroimaging Techniques
- TABLE 2.3: Neuroimaging Techniques
- FIGURE 2.9
- Psychoneuroimmunology
- Checkpoint Questions
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- References
- 3: Conceptual Frameworks and Theories
- LEARNING OBJECTIVES
- KEY TERMS
- THEORIES: WHO CARES AND SO WHAT?
- FIGURE 3.1
- Checkpoint Questions
- THEORIES OF HUMAN BEHAVIOR
- Psychoanalytic or Psychodynamic Theory
- General Principles
- TABLE 3.1: Defense Mechanisms
- TABLE 3.2: Freud’s Model of Psychosexual Development
- Critiques
- Nursing Applications
- Behavioral Theory
- Checkpoint Questions
- General Principles
- CONDITIONING.
- FIGURE 3.2
- REINFORCEMENT.
- FIGURE 3.3
- PUNISHMENT.
- GENERALIZATION AND DISCRIMINATION.
- MODELING AND SHAPING.
- Applied Behavior Analysis
- TABLE 3.3: Behavior Modification Techniques
- Nursing Applications
- Think About It 3.1
- Cognitive Theory
- Rational Emotive Theory
- BOX 3.1: Examples of Distorted Beliefs
- Beck’s Cognitive Theory
- TABLE 3.4: Types of Cognitions in Cognitive Therapy
- Cognitive–Behavioral Theory
- TABLE 3.5: Cognitive–Behavioral Techniques
- A Brief Note on Dialectic Behavior Therapy
- Nursing Applications
- Humanistic Theory
- Checkpoint Questions
- Interpersonal Theory
- General Principles
- Hildegard Peplau
- Biophysiologic Theory
- General Principles
- The Stress–Diathesis Model
- FIGURE 3.4
- Checkpoint Questions
- Sociocultural Theory
- FIGURE 3.5
- Cultural Spotlight 3.1: Koro
- Think About It 3.2
- TOWARD A COMPREHENSIVE, MULTIDISCIPLINARY UNDERSTANDING OF PSYCHOPATHOLOGY
- TABLE 3.6: Examples of Risk and Protective Factors
- FIGURE 3.6
- The Emergence of Mental Illness
- Nursing Applications: Assessing Multiple Systems
- Family Characteristics (Microsystem)
- Community Characteristics (Exosystem)
- FIGURE 3.7
- Implications and Criticisms
- Checkpoint Questions
- EVIDENCE-BASED PRACTICE SPOTLIGHT 3.1: Family Functioning and Juvenile Violence
- Reference
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- References
- 4: Evidence-Based Practice
- LEARNING OBJECTIVES
- KEY TERMS
- FIGURE 4.1
- SCIENCE
- TABLE 4.1: Scientific Processes
- Principles of the Scientific Method
- Systematic Empiricism
- FIGURE 4.2
- Publicly Verifiable Knowledge
- Empirically Solvable Problems and Testable Theories
- Types of Scientific Evidence
- EVIDENCE-BASED PRACTICE SPOTLIGHT 4.1: Typology of Studies
- Checkpoint Questions
- PSEUDOSCIENCE
- FIGURE 4.3
- EVIDENCE-BASED PRACTICE SPOTLIGHT 4.2: Exemplars of Levels of Study
- Pseudoscience Versus Science
- Myths
- Quackery
- Patterning
- Facilitated Communication
- The Dangers of “Junk Science”
- Multiple Personality Disorder
- Aspartame
- Checkpoint Questions
- The Dangers of Pseudoscience: Attachment Therapy
- Think About It 4.1
- IMPLICATIONS FOR PROFESSIONAL NURSES
- Client-Centered Education 4.1: Combating Quackery and Fraudulent Claims
- THE FUTURE OF MENTAL HEALTH AND PSYCHIATRIC NURSING
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 5: Legal and Ethical Aspects
- LEARNING OBJECTIVES
- KEY TERMS
- LEGAL ISSUES IN PSYCHIATRIC-MENTAL HEALTH NURSING
- Nurse Practice Acts and the Expanding Role of Nursing
- Case Vignette 5.1
- Reflection and Critical Thinking
- Malpractice
- BOX 5.1: Malpractice Suits Against Nurses
- Think About It 5.1
- Legal Counsel
- Checkpoint Questions
- Basic Rights of Clients Receiving Psychiatric Nursing Care
- BOX 5.2: Federal Bill of Rights for Mental Health Clients
- Informed Consent
- NURSING SPOTLIGHT 5.1: Nursing Care Guidelines to Maintain Legal Rights of Clients
- SPECIAL CONSIDERATIONS IN PSYCHIATRIC SETTINGS.
- FIGURE 5.1
- SUBSTITUTED CONSENT.
- Confidentiality
- HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT.
- RESPONSIBLE RECORD KEEPING.
- FIGURE 5.2
- PRIVILEGED COMMUNICATION.
- Think About It 5.2
- Evolving Legal Rights
- Right to Treatment
- Right to Treatment in the Least Restrictive Environment
- Right to Refuse Treatment
- FIGURE 5.3
- Right to Aftercare
- Checkpoint Questions
- Client Status and Specific Legal Issues
- Voluntary Admissions
- FIGURE 5.4
- Emergency Admissions
- Involuntary Admissions
- Legal Issues and Special Client Populations
- Forensic Clients
- Case Vignette 5.2
- Reflection and Critical Thinking
- COMPETENCY TO STAND TRIAL.
- PLEAS OF INSANITY OR MENTAL ILLNESS.
- Minors
- Checkpoint Questions
- ETHICAL ISSUES IN PSYCHIATRIC-MENTAL HEALTH NURSING
- FIGURE 5.5
- NURSING SPOTLIGHT 5.2: American Nurses Association Code of Ethics for Nurses
- Bioethical Principles in Psychiatric Nursing Practice
- Autonomy
- Beneficence and Paternalism
- Veracity and Fidelity
- Case Vignette 5.3
- Reflection and Critical Thinking
- Justice
- Checkpoint Questions
- Nursing Ethics in Community Mental Health
- FIGURE 5.6
- Boundaries in Ethical Nursing Care
- Case Vignette 5.4
- Reflection and Critical Thinking
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- TWO: Client Care Considerations
- 6: Culture
- LEARNING OBJECTIVES
- KEY TERMS
- CULTURE
- Changing Demographics and Cultural Awareness
- TABLE 6.1: Trends in U.S. Demographics
- Assimilation
- Implications for Health Care
- Checkpoint Questions
- Culturally Competent Health Care
- BOX 6.1: National Standards for Culturally and Linguistically Appropriate Services (CLAS)
- Cultural Congruence
- Health Literacy
- Models of Transcultural Nursing
- SUNRISE MODEL.
- CULTURAL COMPETENCE IN HEALTH CARE DELIVERY.
- FIGURE 6.1
- CULTURAL COMPETENCE.
- ASSESSMENT TOOL 6.1: Fostering Cultural Self-Awareness
- TRANSCULTURAL ASSESSMENT MODEL.
- Think About It 6.1
- Disparities in Mental Health and Barriers to Effective Treatment
- Variability and Vulnerability
- Ethnopharmacology
- FIGURE 6.2
- Traditional Medicine
- Accessibility
- FIGURE 6.3
- Racial Bias
- BOX 6.2: Diagnosis and Race: The Case of Junius Wilson
- Religious and Spiritual Influences
- Checkpoint Questions
- SOCIOCULTURAL VARIATIONS IN RESPONSE TO MENTAL HEALTH CARE
- Hispanic and Latino(a) Clients
- FIGURE 6.4
- Black Americans
- Case Vignette 6.1
- Reflection and Critical Thinking
- FIGURE 6.5
- Native Americans
- FIGURE 6.6
- Asian and Pacific Islanders
- Cultural Spotlight 6.1: Post-Traumatic Stress Disorder and Culture-Bound Syndromes Among Asian Groups
- FIGURE 6.7
- Middle Eastern Clients
- FIGURE 6.8
- Eastern Europeans
- FIGURE 6.9
- Checkpoint Questions
- CULTURALLY COMPETENT AND CONGRUENT NURSING CARE
- BOX 6.3: Treatment Strategies for Cultural Competence in Mental Health care Delivery
- Essential Skills
- FIGURE 6.10
- Think About It 6.2
- Phases of Transcultural Nursing Knowledge
- Transcultural Assessment
- Building Cultural Awareness
- Cultural Self-Awareness
- Checkpoint Questions
- EVIDENCE-BASED PRACTICE
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 7: Spirituality in Psychiatric Care
- LEARNING OBJECTIVES
- KEY TERMS
- SPIRITUALITY, RELIGION, AND MENTAL HEALTH
- Definitions
- FIGURE 7.1
- Importance of Spirituality and Religion in North America
- Health-Related Attitudes and Philosophies
- Positive Effects of Spirituality and Religion
- Mental Health
- FIGURE 7.2
- Case Vignette 7.1
- Reflection and Critical Thinking
- Critiques and Criticisms of Available Research
- Negative Effects of Religion and Spirituality
- Mental Illness
- FIGURE 7.3
- Checkpoint Questions
- RELIGIOUS AND SPIRITUAL INTERVENTIONS IN MENTAL HEALTH CARE
- Clarifying Values
- FIGURE 7.4
- The Role of Clergy in Mental Health Care
- FIGURE 7.5
- The Role of the Nurse in Mental Health Care
- Think About It 7.1
- Spiritual Assessment
- Spiritual Coping Practices and Interventions
- Therapeutic Communication 7.1: Spiritual Dialogue
- Reflection and Critical Thinking
- NURSING SPOTLIGHT 7.1: NANDA, NOC, and NIC Related to Spirituality
- PRAYER.
- FIGURE 7.6
- BIBLIOTHERAPY WITH SACRED WRITINGS.
- CONTEMPLATION AND MEDITATION.
- FIGURE 7.7
- REPENTANCE AND FORGIVENESS.
- WORSHIP AND RITUALS.
- FIGURE 7.8
- FELLOWSHIP AND ALTRUISTIC SERVICE.
- JOURNAL WRITING.
- Checkpoint Questions
- ETHICAL CONCERNS
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- THREE: The Nurse–Client Relationship
- 8: Nursing Values, Attitudes, and Self-Awareness
- LEARNING OBJECTIVES
- KEY TERMS
- FIGURE 8.1
- FEAR OF MENTAL ILLNESS: STIGMA AT WORK
- BOX 8.1: Visual Hallucinations in Charles Bonnet Syndrome
- MYTHS AND MENTAL ILLNESS
- UNDERSTANDING MENTAL ILLNESS: CLIENTS IN THEIR OWN WORDS
- Checkpoint Questions
- HURTFUL LANGUAGE
- FIGURE 8.2
- Think About It 8.1
- SITUATIONAL AND DISPOSITIONAL FACTORS IN CLINICAL SETTINGS
- Checkpoint Questions
- LABELING AND SOCIAL PERCEPTION
- Checkpoint Questions
- REALITY AND MENTAL HEALTH CARE: CHALLENGES FOR NURSING
- Recommendations for Working with Clients
- FIGURE 8.3
- Managing Stress and Burnout
- FIGURE 8.4
- BOX 8.2: Managing Work-Related Stress
- Checkpoint Questions
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 9: The Nursing Process in Psychiatric–Mental Health Care
- LEARNING OBJECTIVES
- KEY TERMS
- STEPS OF THE NURSING PROCESS
- FIGURE 9.1
- Assessment
- Interview
- FIGURE 9.2
- Health History
- Mental Status Examination
- NURSING SPOTLIGHT 9.1: Standards of Practice for Psychiatric–Mental Health Nursing
- Psychosocial Assessment
- Physical Examination and Laboratory and Diagnostic Testing
- Checkpoint Questions
- Nursing Diagnosis
- The NANDA Taxonomy
- FIGURE 9.3
- Choosing and Formulating the Nursing Diagnosis
- TABLE 9.1: Writing the Diagnostic Statement: Examples of Incorrect and Correct Diagnoses
- Nursing Diagnosis and Psychiatric Diagnosis
- Checkpoint Questions
- Planning
- Identifying Outcomes
- TABLE 9.2: Examples of SMART Outcome Indicators
- Selecting Interventions
- FIGURE 9.4
- NANDA and the NOC and NIC Taxonomies
- STANDARDIZED CARE PLANS.
- CLINICAL OR CRITICAL PATHWAYS.
- Think About It 9.1
- Implementation
- FIGURE 9.5
- Intervention Strategies for Beginning Practitioners
- Supervision
- FIGURE 9.6
- Checkpoint Questions
- Evaluation
- FIGURE 9.7
- DOCUMENTATION
- TABLE 9.3: Documentation of the Nursing Process
- TABLE 9.4: Comparing Documentation Notes
- FIGURE 9.8
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 10: The Interview and Assessment Process
- LEARNING OBJECTIVES
- KEY TERMS
- PREPARATION
- Self-Awareness
- FIGURE 10.1
- BOX 10.1: Process Recording Format
- Review of the Client’s History
- Think About It 10.1
- Setting Preparation
- FIGURE 10.2
- Checkpoint Questions
- CONTENT OF THE ASSESSMENT
- FIGURE 10.3
- ASSESSMENT TOOL 10.1: PERSONS Acronym for Identifying Major Aspects of Psychiatric–Mental Health Nursing Assessment
- Health History
- Initial Information
- BOX 10.2: Tips for Interviewing Clients With Psychiatric Disorders
- Reason for Seeking Health Care
- Present Illness
- Medications
- FIGURE 10.4
- Drug Allergies
- Substance Use
- Checkpoint Questions
- Past Illnesses
- Family History
- Personal and Social History
- Review of Systems
- Checkpoint Questions
- ASSESSMENT TOOL 10.2: Brief Review of Sleep Patterns
- Physical Examination
- TABLE 10.1: Physical Assessment Findings That May Be Psychiatric or Medical in Origin
- FIGURE 10.5
- Mental Status Examination
- Appearance and Behavior
- FIGURE 10.6
- LEVEL OF CONSCIOUSNESS.
- POSTURE AND MOTOR MOVEMENTS.
- FIGURE 10.7
- DRESS, GROOMING, AND HYGIENE.
- Mood and Affect
- FIGURE 10.8
- Speech and Language
- Thought and Perception
- THOUGHT CONTENT.
- TABLE 10.2: Thought Content Disturbances
- THOUGHT PROCESSES.
- PERCEPTIONS.
- INSIGHT.
- JUDGMENT.
- Cognitive Functions
- ORIENTATION.
- MEMORY.
- ATTENTION/CONCENTRATION.
- INTELLIGENCE.
- ABSTRACT REASONING.
- Think About It 10.2
- Safety Assessments
- Checkpoint Questions
- Suicide Assessment
- Dangerousness to Others and Homicide Assessment
- Victimization Through Abuse or Neglect
- Individualized Needs
- Wellness
- Strengths and Weaknesses
- Cultural Needs
- ASSESSMENT TOOL 10.3: Wellness Evaluation
- Spiritual Assessment
- Coping and Stress Management
- Checkpoint Questions
- RATING SCALES
- SPECIAL CHALLENGES
- Age Group
- FIGURE 10.9
- Communication Challenges
- NURSE’S FOLLOW-UP
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 11: Therapeutic Relationships and Communication
- LEARNING OBJECTIVES
- KEY TERMS
- THERAPEUTIC RELATIONSHIPS
- EVIDENCE-BASED PRACTICE SPOTLIGHT 11.1: The Primacy of the Therapeutic Relationship in Psychiatric Treatment
- Essential Elements
- Trust
- FIGURE 11.1
- Professionalism
- TABLE 11.1: Social Versus Therapeutic Relationships
- Mutual Respect
- FIGURE 11.2
- Think About It 11.1
- Caring
- FIGURE 11.3
- Partnership
- Checkpoint Questions
- Obstacles to Therapeutic Relationships
- Confronting Judgmental Attitudes
- Case Vignette 11.1
- Reflection and Critical Thinking
- Think About It 11.2
- Enhancing Self-Awareness
- Excessive Probing
- FIGURE 11.4
- Phases of the Therapeutic Relationship
- Introductory Phase
- FIGURE 11.5
- Challenging Behaviors 11.1: The Withdrawn Client
- Working (Middle) Phase
- FIGURE 11.6
- Termination Phase
- FIGURE 11.7
- Checkpoint Questions
- THERAPEUTIC COMMUNICATION
- TABLE 11.2: Therapeutic Communication Techniques
- TABLE 11.3: Nontherapeutic Communication Techniques
- Theoretical Framework and Communication Model
- FIGURE 11.8
- Listening
- Therapeutic Communication 11.1: Encouraging Formulation of a Plan
- Reflection and Critical Thinking
- Assertiveness
- Confrontation and Limit Setting
- TABLE 11.4: Examples of Positive Reframing
- Checkpoint Questions
- Self-Disclosure
- Therapeutic Communication in Special Situations
- Clients With Anxiety
- FIGURE 11.9
- Clients With Psychoses
- Challenging Behaviors 11.2: The Angry Client
- Families
- Checkpoint Questions
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 12: Working With the Multidisciplinary Team
- LEARNING OBJECTIVES
- KEY TERMS
- PSYCHOLOGISTS
- Educational Background and Training
- Checkpoint Questions
- The Role of School Psychologists
- FIGURE 12.1
- Individualized Education Programs
- Multidisciplinary Service Coordination Plans in Communities
- FIGURE 12.2
- TEAM COMPOSITION.
- TEAM FUNCTIONING.
- Case Vignette 12.1
- Psychologists, Nurses, and Multidisciplinary Teams
- Checkpoint Questions
- OCCUPATIONAL THERAPISTS
- FIGURE 12.3
- Educational Background and Training
- The Role of Occupational Therapists
- TABLE 12.1: Systems in Sensory Integration
- BOX 12.1: Client Groups That Benefit from Occupational Therapy
- Occupational Therapists, Nurses, and Multidisciplinary Teams
- PROFESSIONAL SOCIAL WORKERS
- Educational Background and Training
- Case Vignette 12.2
- The Role of Social Workers
- FIGURE 12.4
- FIGURE 12.5
- Case Vignette 12.3
- Social Workers, Nurses, and Multidisciplinary Teams
- Checkpoint Questions
- PSYCHIATRISTS
- Educational Background and Training
- FIGURE 12.6
- The Role of Psychiatrists
- Psychiatrists, Nurses, and Multidisciplinary Teams
- Checkpoint Questions
- REGISTERED DIETITIANS
- FIGURE 12.7
- Case Vignette 12.4
- Educational Background and Training
- The Role of Registered Dietitians
- BOX 12.2: Role of the Registered Dietitian in Treatment Plans
- Registered Dietitians, Nurses, and Multidisciplinary Teams
- Case Vignette 12.5
- ART THERAPISTS
- Educational Background and Training
- Role of the Art Therapist
- Art Therapists, Nurses, and Multidisciplinary Teams
- PROFESSIONAL CERTIFIED THERAPEUTIC RECREATION SPECIALISTS
- Educational Background and Training
- The Role of Recreational Therapists
- Recreational Therapists, Nurses, and Multidisciplinary Teams
- BENEFITS OF THE MULTIDISCIPLINARY APPROACH
- FIGURE 12.8
- Think About It 12.1
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- References
- FOUR: Conceptual Bases of Treatment
- 13: Individual Therapies and Nursing Interventions
- LEARNING OBJECTIVES
- KEY TERMS
- THERAPIES FOR INDIVIDUAL CLIENTS
- FIGURE 13.1
- Goals of Individual Therapy
- Practitioners of Psychotherapy
- Current Trends
- Common Modalities
- TABLE 13.1: Selected Approaches to Psychotherapy
- Psychoanalysis/Psychodynamic Therapies
- Checkpoint Questions
- Cognitive–Behavioral Therapies
- EVIDENCE-BASED PRACTICE SPOTLIGHT 13.1: Cognitive Behavioral Therapy
- References
- Think About It 13.1
- COGNITIVE THERAPY.
- Core Issues.
- TABLE 13.2: Cognitive Distortions
- Treatment Approach.
- TABLE 13.3: Therapeutic Techniques of Cognitive Therapy
- RATIONAL EMOTIVE BEHAVIOR THERAPY.
- DIALECTICAL BEHAVIOR THERAPY.
- FIGURE 13.2
- Checkpoint Questions
- Behavioral Theory
- Client-Centered Therapy
- FIGURE 13.3
- Solution-Focused Therapy
- BOX 13.1: Process of Solution-Focused Therapy
- Checkpoint Questions
- Integrative Approaches to Psychotherapy
- Cultural Considerations in Psychotherapy
- FIGURE 13.4
- PSYCHIATRIC NURSING ROLES AND STRATEGIES FOR INDIVIDUAL CLIENTS
- Basic-Level Psychiatric Nursing Care
- Health Promotion and Health Maintenance
- FIGURE 13.5
- Intake Screening and Evaluation
- FIGURE 13.6
- Case Management
- FIGURE 13.7
- Milieu Therapy
- Promoting Self-Care Activities
- FIGURE 13.8
- Implementing Psychobiologic Interventions
- Health Teaching
- Counseling and Crisis Intervention
- Psychiatric Rehabilitation
- Advanced-Level Therapeutic Nursing Interventions
- FIGURE 13.9
- Think About It 13.2
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 14: Groups and Group Interventions
- LEARNING OBJECTIVES
- KEY TERMS
- GROUP PROCESS
- Characteristics of Groups
- Types of Groups
- FIGURE 14.1
- Group Norms
- Group Leadership
- FIGURE 14.2
- Styles of Group Leadership
- TABLE 14.1: Leadership Styles
- Leadership Qualities for Effective Groups
- BOX 14.1: Role Function Areas for Evaluation of a Group Leader
- Ethical Principles in Group Counseling
- AUTONOMY.
- FIGURE 14.3
- NONMALEFICENCE.
- BENEFICENCE.
- CONFIDENTIALITY.
- INFORMED CONSENT.
- Documentation
- FIGURE 14.4
- Decision Making
- Structuring the Group
- Checkpoint Questions
- Group Roles
- Task Roles
- FIGURE 14.5
- Building and Maintenance Roles
- Individual Roles
- Think About It 14.1
- Group Communication
- TABLE 14.2: Group Communication Techniques
- Latent and Manifest Communication
- Content and Process Communication
- Transference and Countertransference
- Communication Themes
- Stages of Group Development
- Initial Stage
- BOX 14.2: Stages of Group Development
- Working Stage
- Mature Stage
- TABLE 14.3: Common Problems Affecting Group Therapy and Process
- Termination Stage
- Checkpoint Questions
- GROUP THERAPY
- Advantages and Disadvantages
- Therapeutic Factors of Group Therapy
- BOX 14.3: Yalom’s Curative (Therapeutic) Factors
- Instillation of Hope
- Universality
- Imparting of Information
- FIGURE 14.6
- Group Cohesiveness
- Catharsis
- Existential Factors
- Checkpoint Questions
- Types of Therapy Groups
- Psychotherapeutic Groups
- INPATIENT PSYCHOTHERAPEUTIC GROUPS.
- EVIDENCE-BASED PRACTICE SPOTLIGHT 14.1: Reminiscence Therapy for Dementia
- References
- OUTPATIENT PSYCHOTHERAPEUTIC GROUPS.
- Growth Groups
- ENCOUNTER GROUPS.
- FIGURE 14.7
- TRAINING GROUPS.
- COMMUNITY SUPPORT GROUPS.
- TABLE 14.4: Community Support Groups
- Think About It 14.2
- NURSES AND GROUP PROCESS AND THERAPY
- Group Process and Therapy in Nursing Education
- Group Process and Therapy in Nursing Practice
- Historical Perspective
- Contemporary Nursing Groups
- FIGURE 14.8
- EVIDENCE-BASED PRACTICE SPOTLIGHT 14.2: Group Behavior Therapy for Smoking Cessation
- References
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 15: Families and Family Interventions
- LEARNING OBJECTIVES
- KEY TERMS
- FAMILY THEORIES AND MODELS
- FIGURE 15.1
- Family as a System
- FIGURE 15.2
- Checkpoint Questions
- Family Development
- BOX 15.1: Family Development Stages and Tasks
- Role of the Family
- Family and Stress
- FIGURE 15.3
- Strengths Perspective With Families
- Checkpoint Questions
- NURSING ASSESSMENT WITH FAMILIES
- Structural Assessment
- FIGURE 15.4
- ASSESSMENT TOOL 15.1: Components of the Calgary Family Assessment Model
- FIGURE 15.5
- Developmental Assessment
- Functional Assessment
- Cultural Considerations
- NURSING INTERVENTIONS
- Cognitive Interventions
- Affective Interventions
- Behavioral Interventions
- NURSING SPOTLIGHT 15.1: NANDA, NOC, and NIC Labels in Psychiatric Family Care
- FAMILIES OF CLIENTS WITH MENTAL ILLNESS
- Family Burden
- Objective Burden
- FIGURE 15.6
- Case Vignette 15.1
- Reflection and Critical Thinking
- Checkpoint Questions
- Subjective Burden
- Case Vignette 15.2
- Reflection and Critical Thinking
- Iatrogenic Burden
- Confidentiality Issues
- Involuntary Treatment Statutes
- Discrimination
- Burden Attributable to Professionals
- Checkpoint Questions
- Families as a Population at Risk
- Family Consultation
- Components
- FIGURE 15.7
- Nurses as Family Consultants
- Checkpoint Questions
- Family Empowerment
- Therapeutic Communications 15.1: Family Consultation
- Reflection and Critical Thinking
- Family Education
- Components
- Nurses as Family Educators
- Peer-Taught Family Education
- Psychotherapy and Medication
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resource
- 16: Psychopharmacology
- LEARNING OBJECTIVES
- KEY TERMS
- THE FOOD AND DRUG ADMINISTRATION DRUG-APPROVAL PROCESS
- TABLE 16.1: The FDA Drug Testing Protocol for Humans
- Clinical Trials
- Special Considerations with Psychotropic Agents
- PHARMACODYNAMICS
- Neurons and Neurotransmission
- FIGURE 16.1
- Affinity
- Receptor–Pharmacology Spectrum
- Refractoriness
- Efficacy and Potency
- Rule of 5s
- Effect of Medications on Neurons
- TABLE 16.2: Effects of Receptor Antagonism
- Effects of Medications on Synapses
- Checkpoint Questions
- PHARMACOKINETICS
- FIGURE 16.2
- Absorption
- TABLE 16.3: Effects of Psychotropic Medications on Appetite, Gastrointestinal Function, Nutrient Absorption, and Metabolism
- Distribution
- FIGURE 16.3
- Metabolism
- Elimination
- TABLE 16.4: Foods That Contribute to Acid or Alkaline Urine
- TABLE 16.5: Effects of Food and Drug pH on Elimination
- BOX 16.1: Effects of Dietary Substances on Psychotropic Medications
- Checkpoint Questions
- MAJOR CLASSES OF PSYCHOTROPIC DRUGS
- Antidepressants
- FIGURE 16.4
- UNDERSTANDING PSYCHOPHARMACOLOGY 16.1: Antidepressants
- Tricyclic Antidepressants (TCAs)
- Think About It 16.1
- Monoamine Oxidase Inhibitors (MAOIs)
- FIGURE 16.5
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Other Selective Antidepressants
- SELECTIVE SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIS).
- SEROTONIN ANTAGONIST/REUPTAKE INHIBITORS (SARIS).
- SELECTIVE DOPAMINE REUPTAKE INHIBITOR (SDRI).
- ALPHA-2 REUPTAKE INHIBITOR (ARI).
- Drugs for Refractory Depression
- Checkpoint Questions
- Mood Stabilizers
- Lithium Carbonate
- FIGURE 16.6
- UNDERSTANDING PSYCHOPHARMACOLOGY 16.2: Mood Stabilizers
- Anticonvulsants
- Client-Centered Education 16.1: Teaching Points for Clients Taking Lithium
- Medications for Refractory Mania
- Anxiolytics
- Buspirone
- Benzodiazepines
- FIGURE 16.7
- UNDERSTANDING PSYCHOPHARMACOLOGY 16.3: Anxiolytics
- Other Anxiolytics
- Checkpoint Questions
- Antipsychotic (Neuroleptic) Agents
- Typical or Traditional Antipsychotics
- UNDERSTANDING PSYCHOPHARMACOLOGY 16.4: Antipsychotics/Neuroleptics
- TABLE 16.6: Extrapyramidal Motor Side Effects of Antipsychotic Medications
- LOW-POTENCY TYPICAL ANTIPSYCHOTICS.
- HIGH-POTENCY TYPICAL ANTIPSYCHOTICS.
- Atypical Antipsychotics
- TABLE 16.7: Comparisons of Antipsychotic Side Effects Based on Receptor Blockade
- TABLE 16.8: Actions of Atypical Antipsychotic Medications by Receptor Blockade
- FIGURE 16.8
- Checkpoint Questions
- Stimulant and Nonstimulant Cognitive Enhancers
- UNDERSTANDING PSYCHOPHARMACOLOGY 16.5: Stimulants and Cognitive Enhancers
- Memory and Cognition Enhancers
- UNDERSTANDING PSYCHOPHARMACOLOGY 16.6: Cognitive and Memory Enhancers
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Clients Using Psychopharmacologic Agents
- ASSESSMENT
- Target Symptoms
- ASSESSMENT TOOL 16.1: Brief Psychiatric Rating Scale
- Caffeine Use
- BOX 16.2: Assessing Caffeine Intake
- Nicotine Use
- Polypharmacy
- FIGURE 16.9
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- NURSING SPOTLIGHT 16.1: Selected Nursing Diagnoses Pertaining to Drug Effects
- Prescribed and Maximum Dose
- Method of Administration
- BOX 16.3: Decanoate Injections
- Expected Drug Action
- Side Effects
- IMPLEMENTATION
- Promoting Medication Adherence
- ASSESSMENT TOOL 16.2: Abnormal Involuntary Movement Scale
- Factors Contributing to Nonadherence
- Client-Centered Education 16.2: Psychopharmacology Teaching Plan
- Case Vignette 16.1
- Reflection and Critical Thinking
- Nursing Responses
- FIGURE 16.10
- Working With the Family
- Lifespan Considerations
- Pregnancy
- Case Vignette 16.2
- Reflection and Critical Thinking
- Lactation
- Children and Adolescents
- Older Adults
- Pharmacogenetics
- Complementary and Alternative Modalities (CAM)
- Performing Self-Clarification
- Checkpoint Questions
- EVALUATION
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 17: Integrative Therapies
- LEARNING OBJECTIVES
- KEY TERMS
- NCCAM’S CATEGORIES OF PRACTICE
- BOX 17.1: Whole Systems of Medical Practice
- TABLE 17.1: Illustrated Review of Common Integrative Modalities
- Checkpoint Questions
- PSYCHIATRIC CONDITIONS AND INTEGRATIVE THERAPIES
- Anxiety Disorders
- TABLE 17.2: Selected Herbs, Minerals, and Vitamins for Mental Health Use
- Mood Disorders
- EVIDENCE-BASED PRACTICE SPOTLIGHT 17.1: Preferred Music Listening Intervention to Lower Anxiety in Older Adults With Dementia
- Reference
- Light Therapy
- Meditation
- Cultural Spotlight 17.1: Drumming and Chanting
- Herbal and Dietary Supplements
- FIGURE 17.1
- Client-Centered Education 17.1: Mindfulness Meditation
- Other Modalities for Depression
- Schizophrenia and Other Thought Disorders
- Addictive Disorders
- FIGURE 17.2
- FIGURE 17.3
- Cognitive Disorders
- Think About It 17.1
- INTEGRATIVE CARE: INCORPORATING CAM INTO EVIDENCE-BASED NURSING PRACTICE
- Checkpoint Questions
- Importance of Assessment
- Ethical, Legal, and Research-Oriented Obligations
- Case Vignette 17.1
- Reflection and Critical Thinking
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 18: Somatic Therapies
- LEARNING OBJECTIVES
- KEY TERMS
- ELECTROCONVULSIVE THERAPY
- Pretreatment Evaluation
- Procedure
- FIGURE 18.1
- Indications
- Mechanism of Action
- Side Effects
- Nursing Role and Care
- Checkpoint Questions
- MAGNETIC SEIZURE THERAPY
- PHOTOTHERAPY
- Think About It 18.1
- TRANSCRANIAL MAGNETIC STIMULATION
- UNDERSTANDING BIOLOGIC FOUNDATIONS 18.1: Light Therapy for Seasonal Affective Disorder
- Client-Centered Education 18.1: Seasonal Affective Disorder
- FIGURE 18.2
- VAGUS NERVE STIMULATION
- TRANSCRANIAL DIRECT CURRENT STIMULATION
- Checkpoint Questions
- DEEP BRAIN STIMULATION AND OTHER PSYCHOSURGERIES
- FIGURE 18.3
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- FIVE: Settings for Care
- 19: Inpatient Care Settings
- LEARNING OBJECTIVES
- KEY TERMS
- INPATIENT CARE CRITERIA AND VARIATIONS
- Levels of Care
- FIGURE 19.1
- Types of Settings
- Psychiatric Units
- Psychiatric Specialty Units
- Nonpsychiatric Units
- Scatter Beds
- Checkpoint Questions
- NURSING ROLES IN INPATIENT CARE MANAGEMENT
- Admission
- FIGURE 19.2
- Types
- BOX 19.1: Types of Involuntary Commitment
- Assessment
- Therapeutic Strategies
- BOX 19.2: Criteria for Establishing a Therapeutic Milieu
- Professional Relationships
- Nurse–Client Contracts
- Checkpoint Questions
- Milieu Management
- Think About It 19.1
- INTERDISCIPLINARY MANAGEMENT.
- FOSTERING SELF-CARE.
- FIGURE 19.3
- CLIENT EDUCATION.
- LIVING SKILLS GROUPS.
- MEDICATION ADMINISTRATION.
- FIGURE 19.4
- WORKING WITH SUPPORT SYSTEMS/FAMILIES.
- Checkpoint Questions
- Documentation and Reporting
- Transfers
- Discharge
- FIGURE 19.5
- Checkpoint Questions
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- References
- 20: Community and Home Psychiatric Care
- KEY TERMS
- LEARNING OBJECTIVES
- COMMUNITY MENTAL HEALTH
- Evolution
- Levels of Prevention
- TABLE 20.1: Interventions According to Levels of Prevention
- Primary Prevention
- BOX 20.1: Mental Health Promotion Interventions
- Secondary Prevention
- Tertiary Prevention
- Checkpoint Questions
- COMMUNITY SUPPORT SYSTEMS
- Components of a Community Support System
- BOX 20.2: Essential Components of a Community Support System
- Community Support Programs
- Guiding Principles
- Models of Community Support Programs
- Assertive Community Treatment
- Examples of Programs
- CLUBHOUSE MODEL.
- EVIDENCE-BASED PRACTICE SPOTLIGHT 20.1: Psychiatric Rehabilitation
- FAIRWEATHER LODGE.
- CONSUMER-RUN ALTERNATIVES.
- COMMUNITY WORKER PROGRAMS.
- Checkpoint Questions
- Systems of Care
- Public Policy and Trends
- Chronicity of SPMI
- FIGURE 20.1
- Stalled Resources
- Poverty
- Reinstitutionalization
- BOX 20.3: Community Alternatives to Rehospitalization for Clients With SPMI
- Education
- Psychopharmacology
- Stigma
- Checkpoint Questions
- COMMUNITY PSYCHIATRIC NURSING
- FIGURE 20.2
- Think About It 20.1
- PSYCHIATRIC HOME CARE
- Services
- Principles
- Case Vignette 20.1
- Reflection and Critical Thinking
- Goals
- FIGURE 20.3
- Funding and Eligibility
- BOX 20.4: Common Indications for and Sources of Referral in Psychiatric Home Care
- Checkpoint Questions
- Psychiatric Home Care Nurses
- Think About It 20.2
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 21: Forensic Psychiatric Nursing
- KEY TERMS
- LEARNING OBJECTIVES
- NURSING SPOTLIGHT 21.1: IAFN Subspecialties of Forensic Nursing
- FORENSIC SETTINGS
- FACTORS CONTRIBUTING TO INCARCERATION
- FIGURE 21.1
- ALTERNATIVES TO INCARCERATION
- Checkpoint Questions
- CHARACTERISTICS OF THE FORENSIC POPULATION
- Offenders With Mental Illness
- Cultural Spotlight 21.1: Minority Offenders
- Violent Offenders
- Special Populations
- Juvenile Offenders
- Case Vignette 21.1
- Reflection and Critical Thinking
- Female Offenders
- FIGURE 21.2
- Older Adult Offenders
- Offenders With HIV/AIDS or Hepatitis
- Offenders With Terminal Illness
- Checkpoint Questions
- EFFECTS OF INCARCERATION ON MENTAL HEALTH
- BOX 21.1: Common Stressors to Mental Health in Secure Environments
- CHARACTERISTICS OF FORENSIC PSYCHIATRIC NURSES
- Attitudes
- Skills
- BOX 21.2: Levels of Prevention in Forensic Settings
- NURSING SPOTLIGHT 21.2: ANA Standards for Forensic Nursing
- Standards of Practice for Corrections Nursing
- Standards of Corrections Nursing Professional Performance
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Forensic Clients
- ASSESSMENT
- FIGURE 21.3
- Content
- Risk of Suicide
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- Think About It 21.1
- EVIDENCE-BASED PRACTICE SPOTLIGHT 21.1: Interventions for Suicide Prevention in Incarcerated Populations
- References
- IMPLEMENTATION
- BOX 21.3: Boundary Maintenance Strategies
- Challenging Behaviors 21.1: The Client Who Requests Personal Information
- Promoting Health
- Challenging Behaviors 21.2: The Client Who Gives Compliments and Makes Sexually Explicit Remarks
- Maintaining an Interdisciplinary Approach
- Focusing on the Family
- FIGURE 21.4
- Ensuring Continuity of Care
- FIGURE 21.5
- Acting as Advocate
- FIGURE 21.6
- EVALUATION
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- SIX: Psychiatric Disorders
- 22: Sleep Disorders
- KEY TERMS
- LEARNING OBJECTIVES
- SLEEP
- Physiology of Sleep
- Sleep Stages
- TABLE 22.1: Characteristics of the Sleep Stages
- NREM SLEEP.
- FIGURE 22.1
- REM SLEEP.
- Sleep-Regulating Processes
- CIRCADIAN RHYTHM.
- HOMEOSTASIS.
- Purposes of Sleep
- UNDERSTANDING BIOLOGIC FOUNDATIONS 22.1: The Suprachiasmatic Nuclei
- Influences on Sleep
- Developmental Changes
- NEWBORNS AND INFANTS.
- FIGURE 22.2
- CHILDREN AND ADOLESCENTS.
- FIGURE 22.3
- Sleep Disorders in Children.
- YOUNG AND MIDDLE ADULTS.
- OLDER ADULTS.
- Sex and Gender
- Race and Ethnicity
- Medical Disorders and Treatments
- Drugs and Chemical Substances
- BOX 22.1: Drugs That Contribute to Disturbed Sleep
- SLEEP DISORDERS
- Signs and Symptoms/Diagnostic Criteria
- Insomnia
- FIGURE 22.4
- TABLE 22.2: Components of Coanitive-Behavioral Theraov for Insomnia
- Therapeutic Communication 22.1: Assessing Sleep Patterns
- Reflection and Critical Thinking
- Sleep-Related Breathing Disorders
- FIGURE 22.5
- DSM-IV-TR BOX 22.1: Sleep Disorders
- Insomnia
- Sleep-Related Breathing Disorder
- Hypersomnia
- Circadian Rhythm Sleep Disorder
- Other Sleep Disorders
- HYPERSOMNIAS.
- CIRCADIAN RHYTHM SLEEP DISORDERS.
- PARASOMNIAS.
- SLEEP-RELATED MOVEMENT DISORDERS.
- NARCOLEPSY.
- Think About It 22.1
- Psychiatric Comorbidity and Sleep
- Mood Disorders
- TABLE 22.3: Antidepressants and Sleep
- Anxiety Disorders
- Attention Deficit/Hyperactivity Disorder
- Schizophrenia
- TABLE 22.4: Antipsychotics and Sleep
- Cognitive Disorders
- Treatment of Sleep Disorders in Clients with Comorbid Psychiatric Disorders
- Interdisciplinary Goals and Treatment
- FIGURE 22.6
- Checkpoint Questions
- Sleep Hygiene
- Hypnotic Drugs
- UNDERSTANDING PSYCHOPHARMACOLOGY BOX 22.1: Drugs Used to Treat Insomnia
- Complementary and Alternative Modalities
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Sleep Disorders
- ASSESSMENT
- ASSESSMENT TOOL 22.1: Sleep Inventory
- FIGURE 22.7
- ASSESSMENT TOOL 22.2: The Epworth Sleepiness Scale
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- UNDERSTANDING NURSING CARE 22.1
- Case in Point 22.1: Agatha’s Story
- Key Assessment Findings
- FIGURE A
- FIGURE B
- FIGURE C.
- EPILOGUE
- FIGURE 22.8
- Client-Centered Education 22.1: Recommended Sleep Hygiene Strategies
- EVALUATION
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Review Questions
- Critical Thinking Questions
- References
- Web Resources
- 23: Anxiety Disorders
- KEY TERMS
- LEARNING OBJECTIVES
- ANXIETY
- FIGURE 23.1
- The Continuum of Anxiety
- Effects on Sensation
- Effects on Cognition
- Effects on Verbal Ability
- FIGURE 23.2
- Normal Versus Abnormal Anxiety
- BOX 23.1: Adaptive and Maladaptive Coping Mechanisms for Anxiety
- Checkpoint Questions
- ANXIETY DISORDERS
- Incidence and Prevalence
- Etiology
- Neurobiologic Theories
- FIGURE 23.3
- Psychological Theories
- Checkpoint Questions
- Signs and Symptoms/Diagnostic Criteria
- Generalized Anxiety Disorder
- Phobic Disorders
- Case Vignette 23.1
- Reflection and Critical Thinking
- AGORAPHOBIA.
- SPECIFIC PHOBIA.
- SOCIAL PHOBIA.
- Panic Attacks
- DSM-IV-TR BOX 23.1: Phobic Disorders
- Agoraphobia
- Specific Phobia
- Social Phobia
- Panic Disorder
- Obsessive-Compulsive Disorder
- DSM-IV-TR BOX 23.2: Panic Disorders
- Panic Attack
- Panic Disorder
- FIGURE 23.4
- Case Vignette 23.2
- Reflection and Critical Thinking
- Stress Disorders
- ACUTE STRESS DISORDER.
- POST-TRAUMATIC STRESS DISORDER.
- Checkpoint Questions
- DSM-IV-TR BOX 23.3: Stress Disorders
- Acute Stress Disorder
- Post-Traumatic Stress Disorder
- Comorbidities and Dual Diagnoses
- Differential Diagnosis
- BOX 23.2: Differential Diagnoses for Anxiety Disorders
- Implications and Prognoses
- Think About It 23.1
- Interdisciplinary Goals and Treatment
- Cognitive-Behavioral Therapy
- TABLE 23.1: Selected Cognitive-Behavioral Treatment Strategies for Clients With Anxiety Disorders
- EVIDENCE-BASED PRACTICE SPOTLIGHT 21.1: Interventions for Anxiety Disorders
- References
- BASIC COGNITIVE THERAPY FOR ANXIETY.
- FIGURE 23.5
- Client-Centered Education 23.1: Progressive Relaxation
- SYSTEMATIC DESENSITIZATION AND EXPOSURE TREATMENT.
- RELAXATION TECHNIQUES AND BREATHING RETRAINING.
- Psychopharmacology
- SELECTIVE SEROTONIN REUPTAKE INHIBITORS.
- BENZODIAZEPINES.
- BUSPIRONE.
- BETA BLOCKERS.
- UNDERSTANDING PSYCHOPHARMACOLOGY BOX 23.1: Guidelines for Use of Benzodiazepines
- TRICYCLIC ANTIDEPRESSANTS.
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Clients With Anxiety Disorders
- ASSESSMENT
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- ASSESSMENT TOOL 23.1: Common Findings Associated With Anxiety Disorders
- Cognitive
- Affective
- Physiologic
- Behavioral
- Alleviating Anxiety
- Initiating a Therapeutic Dialogue
- Countering Faulty Thinking
- Managing Hyperventilation
- FIGURE 23.6
- Case in Point 23.1: Ruth’s Story
- Key Assessment Findings
- FIGURE A.
- FIGURE B.
- FIGURE C.
- EPILOGUE
- Therapeutic Communication 23.1: The Client With Generalized Anxiety Disorder
- Reflection and Critical Thinking
- Suggesting Lifestyle Changes
- Teaching Adaptive Coping Strategies
- Teaching Relaxation
- Teaching Problem-Solving Skills
- EVALUATION
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 24: Somatoform, Dissociative, and Sexual Disorders
- LEARNING OBJECTIVES
- KEY TERMS
- SOMATOFORM DISORDERS
- Incidence and Prevalence
- Etiology
- Signs and Symptoms/Diagnostic Criteria
- DSM-IV-TR BOX 24.1: Somatoform Disorders
- Somatization Disorder
- Undifferentiated Somatoform Disorder
- Conversion Disorder
- Hypochondriasis
- Body Dysmorphic Disorder
- Checkpoint Questions
- Somatization Disorder
- Undifferentiated Somatoform Disorder
- Conversion Disorder
- Hypochondriasis
- Pain Disorder
- Body Dysmorphic Disorder
- FIGURE 24.1
- Comorbidities and Dual Diagnoses
- Implications and Prognosis
- Interdisciplinary Goals and Treatment
- BOX 24.1: Selected Multidiscipfinary Interventions for Clients With Somatoform Disorders
- Individual and Group Psychotherapies
- Psychopharmacology and Somatic Therapies
- EVIDENCE-BASED PRACTICE SPOTLIGHT 24.1: Interventions for Hypochondriasis
- References
- APPLYING THE NURSING PROCESS: Somatoform Disorders
- FIGURE 24.2
- ASSESSMENT
- Mental Status
- Physical Examination
- Social Assessment
- ASSESSMENT TOOL 24.1: Common Mental Status Findings in Somatoform Disorders
- Behavior
- Mood and Affect
- Thought Process and Content
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- Case in Point 24.1: Rose and Andrew’s Story
- Key Assessment findings
- EPILOGUE
- Establishing a Trusting Relationship
- EVIDENCE-BASED PRACTICE SPOTLIGHT 24.2: Interventions for Body Dysmorphic Disorder
- References
- Managing Ineffective Coping
- Therapeutic Communication 24.1: Addressing Somatization Disorder
- Reflection and Critical Thinking
- Addressing Powerlessness and Dependency
- Enhancing Self-Esteem
- Reducing Anxiety
- FIGURE 24.3
- Reestablishing Social Activities
- Reestablishing Functional Family Processes
- Think About It 24.1
- EVALUATION
- DISSOCIATIVE DISORDERS
- Cultural Spotlight 24.1: Dissociative Cultural Phenomena
- FIGURE 24.4
- Incidence and Prevalence
- Etiology
- Signs and Symptoms/Diagnostic Criteria
- DSM-IV-TR BOX 24.2: Dissociative Disorders
- Dissociative Fugue
- Dissociative Amnesia
- Depersonalization Disorder
- Dissociative Identity Disorder
- Comorbidities and Dual Diagnoses
- Case Vignette 24.1
- Reflection and Critical Thinking
- Interdisciplinary Goals and Treatment
- Checkpoint Questions
- Individual Therapy
- Group Therapy
- Psychopharmacology
- Art Therapy
- APPLYING THE NURSING PROCESS: Dissociative Disorders
- ASSESSMENT
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- ASSESSMENT TOOL 24.2: Inventory for Symptoms of Dissociation
- IMPLEMENTATION
- Therapeutic Communication 24.2: The Client With a Dissociative Disorder
- Reflection and Critical Thinking
- Milieu Management
- Family Education
- EVALUATION
- SEXUAL DISORDERS
- Sexual Dysfunction
- Etiology
- Signs and Symptoms/Diagnostic Criteria
- BOX 24.2: Phases of Sexual Response
- Desire Disorders
- Arousal Disorders
- Orgasmic Disorders
- Case Vignette 24.2
- Reflection and Critical Thinking
- Pain Disorders
- Checkpoint Questions
- Interdisciplinary Goals and Treatments
- TABLE 24.1: Psychological, Physical, and Pharmacologic Causes of Sexual Dysfunction*
- Pharmacologic Therapy
- Think About It 24.2
- Sex Therapy
- Nursing Assessment
- ASSESSMENT TOOL 24.3: Sexual Health History
- FIGURE 24.5
- Nursing Interventions
- Checkpoint Questions
- Paraphilias
- Therapeutic Communication 24.3: Respecting a Client’s Wishes Regarding Sexual Issues
- Reflection and Critical Thinking
- Client-Centered Education 24.1: Fostering Self-Esteem Related to Sexuality
- Checkpoint Questions
- Gender Identity Disorders
- DSM-IV-TR BOX 24.3: Paraphilias
- Exhibitionism
- Fetishism
- Frotteurism
- Pedophilia
- Sexual Masochism
- Sexual Sadism
- Transvestic Fetishism
- Voyeurism
- Paraphilia Not Otherwise Specified
- Compulsive Sexual Behavior
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 25: Personality Disorders
- LEARNING OBJECTIVES
- KEY TERMS
- PERSONALITY
- OVERVIEW OF PERSONALITY DISORDERS
- Incidence and Prevalence
- Cultural Spotlight 25.1: Care in Diagnosis of Personality Disorders
- Etiology
- Signs and Symptoms/Diagnostic Criteria
- Checkpoint Questions
- Cluster A
- DSM-IV-TR BOX 25.1: Cluster A Personality Disorders
- Paranoid Personality Disorder
- Schizoid Personality Disorder
- Schizotypal Personality Disorder
- PARANOID PERSONALITY DISORDER.
- FIGURE 25.1
- SCHIZOID PERSONALITY DISORDER.
- SCHIZOTYPAL PERSONALITY DISORDER.
- Case in Point 25.1: Margaret’s Story
- Key Assessment Findings
- EPILOGUE
- Cluster B
- ANTISOCIAL PERSONALITY DISORDER.
- FIGURE 25.2
- DSM-IV-TR BOX 25.2: Cluster B Personality Disorders
- Antisocial Personality Disorder
- Borderline Personality Disorder
- Histrionic Personality Disorder
- Narcissistic Personality Disorder
- BORDERLINE PERSONALITY DISORDER.
- HISTRIONIC PERSONALITY DISORDER.
- FIGURE 25.3
- NARCISSISTIC PERSONALITY DISORDER.
- Cluster C
- AVOIDANT PERSONALITY DISORDER.
- DEPENDENT PERSONALITY DISORDER.
- FIGURE 25.4
- OBSESSIVE-COMPULSIVE PERSONALITY DISORDER.
- Checkpoint Questions
- Comorbidities and Dual Diagnoses
- DSM-IV-TR BOX 25.3: Cluster C Personality Disorders
- Avoidant Personality Disorder
- Dependent Personality Disorder
- Obsessive-Compulsive Personality Disorder
- Implications and Prognosis
- Interdisciplinary Goals and Treatment
- FIGURE 25.5
- TABLE 25.1: Goals of Treatment for Specific Personality Disorders
- Psychopharmacology
- Individual Psychotherapy
- Dialectical Behavioral Therapy
- Group Therapy
- Family Education and Therapy
- EVIDENCE-BASED PRACTICE SPOTLIGHT 25.1: Evidence-Based Interventions for Borderline Personality Disorder
- Reference
- EVIDENCE-BASED PRACTICE SPOTLIGHT 25.2: Evidence-Based Interventions for Antisocial Personality Disorder
- Reference
- Case Vignette 25.1
- Reflection and Critical Thinking
- Think About It 25.1
- APPLYING THE NURSING PROCESS: Personality Disorders
- ASSESSMENT
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- TABLE 25.2: Recommended Approaches to Personality Types
- Promoting Participation in Treatment
- FIGURE 25.6
- Case in Point 25.2: Gail’s Story
- Key Assessment Findings
- FIGURE A.
- FIGURE B.
- FIGURE C.
- EPILOGUE
- Enlisting the Family in the Treatment Plan
- Improving Coping Skills
- Reducing Inappropriate Behaviors
- Confronting the Client
- Client-Centered Education 25.1: Helping Families When Clients Have Personality Disorders
- Setting Limits
- Therapeutic Communication 25.1: Antisocial Personality Disorder
- Reflection and Critical Thinking
- Providing for Physical Safety
- EVALUATION
- Checkpoint Questions
- NURSE’S SELF-CARE
- FIGURE 25.7
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 26: Eating Disorders
- LEARNING OBJECTIVES
- KEY TERMS
- EATING DISORDERS: DEFINITION AND TYPES
- FIGURE 26.1
- Incidence and Prevalence
- Etiology
- FIGURE 26.2
- Biologic Theories
- Psychosocial Theories
- Sociocultural Theories
- FIGURE 26.3
- Family-Based Theories
- Checkpoint Questions
- Signs and Symptoms/Diagnostic Criteria
- Anorexia Nervosa
- FIGURE 26.4
- DSM-IV-TR BOX 26.1: Eating Disorders
- Anorexia Nervosa
- Bulimia Nervosa
- Bulimia Nervosa
- FIGURE 26.5
- Other Eating Disorders
- Comorbidities and Dual Diagnoses
- Case Vignette 26.1
- Reflection and Critical Thinking
- Checkpoint Questions
- Implications and Prognosis
- Interdisciplinary Goals and Treatment
- EVIDENCE-BASED PRACTICE SPOTLIGHT 26.1: Interventions for Eating Disorders
- Settings for Care
- Clinical and Dialectical-Pharmacologic Behavioral Therapies
- Family Therapy
- Psychopharmacology
- EVIDENCE-BASED PRACTICE SPOTLIGHT 26.2: Interventions for Anorexia Nervosa
- References
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Eating Disorders
- ASSESSMENT
- Health History
- Case in Point 26.1: Jody’s Story
- Key Assessment findings
- FIGURE A.
- FIGURE B.
- FIGURE C.
- FIGURE D.
- FIGURE E.
- EPILOGUE
- ASSESSMENT TOOL 26.1: Inventory for Clients With Eating Problems
- Health Perception-Health Management
- Nutrition-Metabolism
- Elimination
- Activity-Exercise
- Sleep-Rest
- Self-Perception-Self-Concept
- Roles Relationships
- Sexuality-Reproduction
- Coping-Stress Tolerance
- Values-Beliefs
- Nutrition
- Elimination
- Reproduction and Hormones
- Activity and Rest
- Psychosocial
- TABLE 26.1: Manifestations of Cognitive Distortions in Clients With Eating Disorders
- Therapeutic Communication 26.1: Moving with Resistance
- Reflection and Critical Thinking
- Physical Examination
- FIGURE 26.6
- Laboratory Testing
- Electrocardiogram Studies
- FIGURE 26.7
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- UNDERSTANDING NURSING CARE 26.1
- Checkpoint Questions
- BOX 26.1: Preventing Eating Disorders
- Restoring Nutritional Balance
- FIGURE 26.8
- Think About It 26.1
- Encouraging Realistic Thinking Processes
- Client-Centered Education 26.1: Teaching Points for Clients With Eating Disorders
- Improving Body Image
- Fostering Self-Esteem
- Exploring Feelings of Powerlessness
- Encouraging Effective Coping
- Challenging Behaviors 26.1: The Client With a Distorted Body Image
- Restoring Family Processes
- Enmeshment and Overprotectiveness
- Conflict Avoidance and Rigidity
- Think About It 26.2
- EVALUATION
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 27: Depressive Disorders
- LEARNING OBJECTIVES
- KEY TERMS
- OVERVIEW OF DEPRESSIVE ILLNESS
- Incidence and Prevalence
- Etiology
- BOX 27.1: Risk Factors for Depression
- Genetic Factors
- Physiologic Factors
- FIGURE 27.1
- BIOGENIC AMINES.
- PSYCHONEUROENDOCRINE AND IMMUNE RELATIONSHIPS.
- Psychological Factors
- LEARNED HELPLESSNESS.
- COGNITIVE FACTORS.
- Checkpoint Questions
- Signs and Symptoms/Diagnostic Criteria
- Major Depressive Disorder
- FIGURE 27.2
- Dysthymic Disorder
- FIGURE 27.3
- DSM-IV-TR BOX 27.1: Depressive Disorders
- Major Depressive Episode
- Dysthymic Disorder
- Postpartum Depression
- Implications and Prognosis
- Case Vignette 27.1
- Reflection and Critical Thinking
- Interdisciplinary Goals and Treatment
- FIGURE 27.4
- Cognitive-Behavioral Therapy
- EVIDENCE-BASED PRACTICE SPOTLIGHT 27.1: Findings From the Sequenced Treatment Alternatives to Relieve Depression (STAR*D)
- FIGURE 27.5
- Psychopharmacology
- UNDERSTANDING BIOLOGIC FOUNDATIONS 27.1: Effects of Antidepressants on Neurotransmitters
- SELECTIVE SEROTONIN REUPTAKE INHIBITORS AND RELATED DRUGS.
- NOVEL (ATYPICAL) ANTIDEPRESSANTS.
- CYCLIC ANTIDEPRESSANTS.
- UNDERSTANDING PSYCHOPHARMACOLOGY BOX 27.1: Symptoms of and Treatment for Serotonin Syndrome
- MONOAMINE OXIDASE INHIBITORS.
- Checkpoint Questions
- Somatic and Integrative Interventions
- UNDERSTANDING PSYCHOPHARMACOLOGY BOX 27.2: Hypertensive Crisis Alert
- APPLYING THE NURSING PROCESS: Depressive Disorders
- ASSESSMENT
- Safety
- Suicide Risk
- Case in Point 27.1: Richard’s Story
- Key Assessment Findings
- EPILOGUE
- ASSESSMENT TOOL 27.1: Scales and Screening Instruments for Depression
- Violence Risk
- Mental Status Examination
- Physiologic Stability
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- FIGURE 27.6
- Protecting the Client From Suicide
- Managing the Potential for Violence
- Maintaining Physical Health and Personal Hygiene
- FIGURE 27.7
- Enhancing Thought Processes
- Encouraging Treatment and Medication Adherence
- EVALUATION
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 28: Bipolar Disorders
- LEARNING OBJECTIVES
- KEY TERMS
- OVERVIEW OF BIPOLAR DISORDERS
- Incidence and Prevalence
- Etiology
- Biologic Foundations
- GENETIC FACTORS.
- NEUROANATOMIC FACTORS.
- UNDERSTANDING BIOLOGIC FOUNDATIONS 28.1: Brain Region Alterations in Bipolar Disorder
- NEUROTRANSMITTERS.
- Psychological Factors
- FIGURE 28.1
- COGNITIVE FACTORS.
- INTERPERSONAL AND SOCIAL RHYTHM MODEL.
- Cognitive Functioning and Bipolar Disorder
- Checkpoint Questions
- Signs and Symptoms/Diagnostic Criteria
- Bipolar I Disorder
- FIGURE 28.2
- Bipolar II Disorder
- DSM-IV-TR BOX 28.1: Bipolar I Disorder
- Manic Episode
- Mixed Episode
- FIGURE 28.3
- Cyclothymic Disorder
- Rapid Cycling
- Implications and Prognosis
- Interdisciplinary Goals and Treatment
- DSM-IV-TR BOX 28.2: Bipolar II Disorder
- Hypomanic Episode
- Psychotherapy
- DSM-IV-TR BOX 28.3: Cyclothymic Disorder
- EVIDENCE-BASED PRACTICE SPOTLIGHT 28.1: Intensive Psychotherapy for Bipolar Depression
- References
- Checkpoint Questions
- Psychopharmacologic Therapy
- MOOD STABILIZERS.
- BOX 28.1: Antidepressants and Bipolar Disorders
- UNDERSTANDING PSYCHOPHARMACOLOGY BOX 28.1: Lithium
- UNDERSTANDING PSYCHOPHARMACOLOGY BOX 28.2: Lithium Toxicity and Associated Serum Levels*
- UNDERSTANDING PSYCHOPHARMACOLOGY BOX 28.3: Divalproex Sodium
- MEDICATIONS FOR REFRACTORY MANIA.
- FIGURE 28.4
- Checkpoint Questions
- Somatic Nonpharmacologic Interventions
- BOX 28.2: Somatic Therapies for Bipolar Illnesses
- Sleep Deprivation
- Transcranial Magnetic Stimulation
- Vagal Nerve Stimulation
- APPLYING THE NURSING PROCESS: Bipolar Mania
- ASSESSMENT
- Safety
- Mental Status Examination
- Physiologic Stability
- Family Issues
- FIGURE 28.5
- EVIDENCE-BASED PRACTICE SPOTLIGHT 28.2: Client Education in Lithium Therapy
- References
- UNDERSTANDING NURSING CARE 28.1
- ASSESSMENT TOOL 28.1: Components and Findings of the MSE in Mania
- Appearance and General Behavior
- Mood and Affect
- Thought Content and Process
- Perceptual Disturbances
- Judgment and Insight
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- Managing the Potential for Violence
- Case in Point 28.1: Danielle’s Story
- Key Assessment Findings
- FIGURE A
- FIGURE B
- FIGURE C
- EPILOGUE
- Maintaining Physical Health and Personal Hygiene
- FIGURE 28.6
- Enhancing Thought Processes
- Self-Esteem Issues
- Anxiety and Agitation
- Encouraging Treatment and Medication Adherence
- Think About It 28.1
- EVALUATION
- Client-Centered Education 28.1: Helping a Loved One Who Has Bipolar Disorder
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 29: Thought Disorders
- LEARNING OBJECTIVES
- KEY TERMS
- SCHIZOPHRENIA AND OTHER THOUGHT DISORDERS
- FIGURE 29.1
- Incidence and Prevalence
- Etiology
- Biologic Theories
- GENETIC INFLUENCES.
- NEUROCHEMICAL AND NEUROANATOMIC CHANGES.
- FIGURE 29.2
- UNDERSTANDING BIOLOGIC FOUNDATIONS 29.1: The Dopamine Hypothesis of Schizophrenia
- Psychosocial Theories
- Checkpoint Questions
- Signs and Symptoms/Diagnostic Criteria
- DSM-IV-TR BOX 29.1: Thought Disorders
- Schizophrenia
- Schizophreniform Disorder
- Schizoaffective Disorder
- Delusional Disorder
- Brief Psychotic Disorder
- Shared Psychotic Disorder (Formerly Called Folie Ă Deux)
- BOX 29.1: Positive and Negative Symptoms of Schizophrenia
- Positive Symptoms
- Negative Symptoms
- The Disorganization Dimension
- DISORGANIZED SPEECH.
- BOX 29.2: Illustrations of Bizarre and Disorganized Speech
- Loose Associations
- Clanging
- Neologisms
- Word Salad
- DISORGANIZED BEHAVIOR.
- FIGURE 29.3
- INCONGRUOUS AFFECT.
- The Psychotic Dimension
- DELUSIONS.
- Cultural Spotlight 29.1: Delusions, Hallucinations, and Contextual Experience
- HALLUCINATIONS.
- Challenging Behaviors 29.1: Hallucinations
- The Negative Dimension
- FIGURE 29.4
- Other Symptoms
- Subtypes of Schizophrenia
- Water Intoxication
- Checkpoint Questions
- Comorbidities and Dual Diagnoses
- Differential Diagnosis
- BOX 29.3: Differential Diagnoses of Thought Disorders
- Implications and Prognosis
- Interdisciplinary Goals and Treatment
- TABLE 29.1: Clinical Pathway: Schizophrenic Disorder (295.1x, catatonic 295.2x, delusional 297.10, brief reactive psychosis 298.80)
- EVIDENCE-BASED PRACTICE SPOTLIGHT 29.1: Interventions for Schizophrenia
- References
- Checkpoint Questions
- Psychopharmacologic Interventions
- TRADITIONAL (CONVENTIONAL) ANTIPSYCHOTICS.
- UNDERSTANDING PSYCHOPHARMACOLOGY BOX 29.1: Traditional and Atypical Antipsychotic Medications
- FIGURE 29.5
- UNDERSTANDING PSYCHOPHARMACOLOGY BOX 29.2: Medications Used for Side Effects of Antipsychotics
- ATYPICAL (NOVEL) ANTIPSYCHOTICS.
- EVIDENCE-BASED PRACTICE SPOTLIGHT 29.2: Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)
- References
- Psychosocial Interventions
- MILIEU MANAGEMENT.
- INDIVIDUAL AND GROUP THERAPY.
- COGNITIVE–BEHAVIORAL THERAPY.
- SOCIAL SKILLS TRAINING.
- VOCATIONAL REHABILITATION.
- FIGURE 29.6
- Checkpoint Questions
- Continuum of Care
- DISCHARGE PLANNING.
- CARE IN THE COMMUNITY.
- Think About It 29.1
- APPLYING THE NURSING PROCESS: Schizophrenia and Thought Disorders
- ASSESSMENT
- Mood and Cognitive State
- FIGURE 29.7
- Potential for Violence
- Assessing Social Support
- Challenging Behaviors 29.2: Threatened Aggression
- Knowledge of Illness
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- Case in Point 29.1: James’s Story
- Key Assessment Findings
- FIGURE A
- FIGURE B
- FIGURE C
- FIGURE D
- FIGURE E
- EPILOGUE
- IMPLEMENTATION
- UNDERSTANDING NURSING CARE 29.1
- Addressing Disturbed Thought Processes and Sensory Perceptions
- Reinforcing Reality
- Challenging Behaviors 29.3: The Client Who Is Hostile
- Understanding Language Content
- Intervening in Hallucinations
- Managing Violent Behavior
- Enhancing Social Interaction
- Developing Trust
- Initiating Interaction
- FIGURE 29.8
- Modeling Affect
- Promoting Medication Adherence
- Therapeutic Communication 29.1: Disorganized Speech in Schizophrenia
- Reflection and Critical Thinking Questions
- Promoting Improved Coping
- Checkpoint Questions
- Strengthening Family Processes
- FIGURE 29.9
- Educating Clients and Families
- Teaching Symptom Management
- EVALUATION
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 30: Substance Use Disorders
- KEY TERMS
- LEARNING OBJECTIVES
- SUBSTANCE ABUSE AND DEPENDENCE
- Incidence and Prevalence
- FIGURE 30.1
- BOX 30.1: Key Facts from the 2009 National Household Survey on Drug Abuse
- Alcohol-Related Statistics
- Drug-Related Statistics
- Cultural and Ethnic Variations
- Checkpoint Questions
- Etiology
- Biologic Foundations
- Psychosocial and Behavioral Factors
- Signs and Symptoms/Diagnostic Criteria
- Alcohol-Related Disorders
- FIGURE 30.2
- UNDERSTANDING BIOLOGIC FOUNDATIONS 30.1: Effects of Cocaine on Neurotransmission
- DSM-IV-TR BOX 30.1: Substance-Related Disorders
- Categories
- Criteria
- FIGURE 30.3
- ALCOHOL CONCENTRATION IN THE BODY.
- INTOXICATION.
- BLACKOUTS.
- TOLERANCE.
- WITHDRAWAL.
- COMPLICATIONS.
- FIGURE 30.4
- FIGURE 30.5
- FIGURE 30.6
- Think About It 30.1
- Controlled Substance Disorders
- TABLE 30.1: Commonly Abused Controlled Substances
- STIMULANTS.
- FIGURE 30.7
- CANNABIS.
- HALLUCINOGENS AND PHENCYCLIDINE.
- OPIOIDS.
- FIGURE 30.8
- SEDATIVES, HYPNOTICS, AND ANXIOLYTICS.
- Checkpoint Questions
- Comorbidities and Co-occurring Disorders
- FIGURE 30.9
- Implications and Prognosis
- Perinatal Statistics and Risks
- FIGURE 30.10
- Preventive and Public Health Strategies
- BOX 30.2: Consequences of Cocaine Use During Pregnancy
- Increased Risks to Pregnancy
- Maternal Risks
- Effects on Fetus
- Effects on the Newborn
- Checkpoint Questions
- Interdisciplinary Goals and Treatment
- Detoxification
- BOX 30.3: Principles of Addiction Treatment
- EVIDENCE-BASED PRACTICE SPOTLIGHT 30.1: Evidence-Based Practice Guideline for Detoxification and Substance Abuse Treatment: An Overview of the Psychosocial and Biomedical Issues During Detoxification
- References
- UNDERSTANDING PSYCHOPHARMACOLOGY 30.1: Medications Used for Detoxification
- ALCOHOL.
- ASSESSMENT TOOL 30.1: Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)
- OPIOIDS AND OTHER DRUGS.
- Checkpoint Questions
- Rehabilitation
- TABLE 30.2: Selected Interdisciplinary Interventions in Rehabilitation
- SELF-HELP GROUPS.
- BOX 30.4: The 12 Steps of Alcoholics Anonymous
- BRIEF INTERVENTION.
- Client-Centered, Culturally Competent Care
- APPLYING THE NURSING PROCESS: Substance Use Disorders
- ASSESSMENT
- UNDERSTANDING NURSING CARE 30.1
- Screening
- Case in Point 30.1: Erica and Paul’s Story
- Key Assessment Findings
- FIGURE A
- FIGURE B
- FIGURE C
- FIGURE D
- EPILOGUE
- Physical Examination
- Psychosocial Assessment
- ASSESSMENT TOOL 30.2: Substance Use Inventory
- Health History Questions
- Physical Examination
- NURSING DIAGNOSIS
- ASSESSMENT TOOL 30.3: The CAGE Questionnaire for Substance Abuse Screening
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- Managing Withdrawal
- FIGURE 30.11
- Breaking Through Denial
- TABLE 30.3: Forms of Denial
- Managing Anxiety
- Teaching Effective Coping Strategies
- Therapeutic Communication 30.1: A Cocaine Abuser in Denial
- Reflection and Critical Thinking
- Improving Relationships
- Improving Self-Image
- Case Vignette 30.1
- Reflection and Critical Thinking
- Promoting Healthy Activities
- EVALUATION
- Checkpoint Questions
- IMPAIRED NURSES
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 31: Cognitive Disorders
- KEY TERMS
- LEARNING OBJECTIVES
- ETIOLOGIC AND DIAGNOSTIC CHALLENGES OF COGNITIVE DISORDERS
- TABLE 31.1: Delirium Versus Dementia
- DELIRIUM
- Incidence and Prevalence
- Etiology
- BOX 31.1: Specific Causes of Delirium
- FIGURE 31.1
- Checkpoint Questions
- Signs and Symptoms/Diagnostic Criteria
- DSM-IV-TR BOX 31.1: Delirium
- Delirium Due to a General Medical Condition
- Substance-Withdrawal Delirium
- Substance-Intoxication Delirium
- Delirium Due to Multiple Etiologies
- Delirium Not Otherwise Specified
- Case Vignette 31.1
- Reflection and Critical Thinking
- Implications and Prognosis
- Interdisciplinary Goals and Treatment
- Medical Interventions
- Environmental Interventions
- FIGURE 31.2
- Cognitive and Psychosocial Interventions
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Delirium
- ASSESSMENT
- ASSESSMENT TOOL 31.1: Sample Mini-Mental Status Examination Questions
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- Think About It 31.1
- IMPLEMENTATION
- Managing Symptoms of Delirium
- FIGURE 31.3
- Challenging Behaviors 31.1: The Client Who Has Acute Confusion
- Providing a Safe Environment
- Assisting With Personal Care
- FIGURE 31.4
- Providing Client and Family Education
- EVALUATION
- Checkpoint Questions
- DEMENTIA
- Incidence and Prevalence
- Signs and Symptoms/Diagnostic Criteria
- DSM-IV-TR BOX 31.2: Dementia
- Dementia of the Alzheimer’s Type
- Vascular Dementia
- Dementia Due to Other General Medical Conditions
- Impaired Learning
- Compromised Ability for Complex Tasks
- Impaired Reasoning
- Compromised Spatial Ability and Orientation
- Language Deficits
- FIGURE 31.5
- Behavioral Problems
- Checkpoint Questions
- Types of Dementia
- TABLE 31.2: Comparative Assessment for Cognitive Disorders
- Alzheimer’s Disease
- ETIOLOGIC FACTORS.
- UNDERSTANDING BIOLOGIC FOUNDATIONS 31.1: Neurologic Alterations in Alzheimer’s Disease
- BOX 31.2: Stages of Alzheimer’s Disease
- Genetics.
- Oxidative Stress.
- Immunology.
- Hormones.
- Inflammation.
- Diet.
- PREVENTIVE FACTORS.
- FIGURE 31.6
- Vascular Dementia
- Lewy Body Disease
- Parkinson’s Disease
- UNDERSTANDING BIOLOGIC FOUNDATIONS 31.2: The Pathophysiology of Parkinson’s Disease
- Huntington’s Disease
- Human Immunodeficiency Virus Dementia
- Frontotemporal Lobar Degeneration
- Creutzfeldt-Jakob Disease
- Implications and Prognosis
- Interdisciplinary Goals and Management
- EVIDENCE-BASED PRACTICE SPOTLIGHT 31.1: Nonpharmacologic Treatment of Dementia-Related Agitation
- References
- Medical and Supportive Interventions
- Psychopharmacologic Interventions
- Think About It 31.2
- Psychosocial Interventions
- EVIDENCE-BASED PRACTICE SPOTLIGHT 31.2: Interventions for Cognitive Disorders
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Dementia
- ASSESSMENT
- BOX 31.3: Differential Diagnosis for Dementia
- ASSESSMENT TOOL 31.2: Screening Tests for Dementia
- Behavior
- ASSESSMENT TOOL 31.3: Questionnaire for Dementia
- Subjective Data
- Behavioral Changes (Often Asked of the Family)
- Emotional Changes
- Social Changes
- Intellectual Behavior
- Functional Capacity
- Objective Data
- Level of Consciousness
- Appearance
- Attention
- Language
- Memory
- Constructional Ability
- Cortical Function
- Mental Status
- ASSESSMENT TOOL 31.4: Testing for Cognitive Deficits
- FIGURE 31.7
- Perceptual Problems
- Orientation
- Memory
- Family
- Education
- NURSING DIAGNOSES
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- Case in Point 31.1: Betty’s Story
- Key Assessment Findings
- FIGURE A.
- FIGURE B.
- FIGURE C.
- FIGURE D.
- FIGURES E AND F.
- FIGURE G.
- Epilogue
- Managing the Client’s Health
- Enhancing Sensory Capabilities
- Meeting the Client’s Physical Needs
- Encouraging Appropriate Behaviors
- Modifying the Environment
- FIGURE 31.8
- Challenging Behaviors 31.2: The Client Who Is Disruptive
- FIGURE 31.9
- Therapeutic Communication 31.1
- A Client with Dementia
- Reflection and Critical Thinking
- Performing Pharmacologic Interventions
- Preserving the Family Unit
- FIGURE 31.10
- EVALUATION
- AMNESTIC DISORDERS
- DSM-IV-TR BOX 31.3: Amnestic Disorders
- Amnestic Disorder Due to a General Medical Condition
- Substance-Induced Persisting Amnestic Disorder
- Checkpoint Questions
- NURSE’S SELF-CARE
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- SEVEN: Psychiatric Emergencies
- 32: Anger and Aggression
- LEARNING OBJECTIVES
- KEY TERMS
- DEFINITIONS
- POTENTIAL CONTRIBUTORS TO ANGRY, AGGRESSIVE, OR VIOLENT BEHAVIORS
- Psychiatric Illness
- BOX 32.1: Psychiatric Diagnoses and Patterns of Aggression or Violence
- Medical Conditions
- BOX 32.2: Selected Medical Conditions Associated With Aggression and Violence
- Traumatic Life Events
- Biologic Factors and Temperament
- FIGURE 32.1
- Social–Environmental Factors
- Checkpoint Questions
- HEALTH CARE ENVIRONMENTS AND ANGRY AND AGGRESSIVE CLIENT BEHAVIOR
- Challenging Behaviors 32.1: The Client Who Is Hostile and Profane
- Considerations for Inpatient Settings
- FIGURE 32.2
- Outpatient Factors
- LEGAL ISSUES RELATED TO DANGEROUSNESS AND INTENT
- Checkpoint Questions
- INTERDISCIPLINARY MANAGEMENT OF AGGRESSION AND VIOLENCE
- Verbal Interventions
- FIGURE 32.3
- Limit Setting
- FIGURE 32.4
- Cognitive–Behavioral Interventions
- Guided Discovery
- Anger Management
- Behavior Therapy: Token Economy
- Case Vignette 32.1
- Reflection and Critical Thinking
- Group and Family Therapy
- Prevention of Vapor Lock and Meltdown
- Pharmacologic Intervention
- UNDERSTANDING PSYCHOPHARMACOLOGY 32.1: Typical Medications Used to Treat Aggressive Behavior
- Checkpoint Questions
- Restraint and Seclusion
- Related Controversies
- Think About It 32.1
- Standards in Behavioral Health Care
- BOX 32.3: Summary of Standards for Restraint and Seclusion (R/S)
- Outpatient Management
- A Note on Other Settings
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Angry, Aggressive, or Violent Behavior
- ASSESSMENT
- BOX 32.4: Risk Factor Profiles for Violent Behavior
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- ASSESSMENT TOOL 32.1: Assessment of Violence and Homicidal Ideation
- Violence Assessment
- Assessment of Homicidal Ideation
- Maintaining the Safety of Clients and Staff
- Defusing Anger and Aggression Through Verbal Interventions
- BOX 32.5: Situation-Specific Interventions to Prevent Escalation of Client Aggression
- Setting Limits to Prevent Violent Behavior
- Teaching Anger Management and Coping Skills
- FIGURE 32.5
- Checkpoint Questions
- EVALUATION
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 33: Violence and Abuse
- KEY TERMS
- LEARNING OBJECTIVES
- THE ECOLOGICAL MODEL OF VIOLENCE
- Societal Influences and Macrosystem
- FIGURE 33.1
- Microsystem
- Individual Factors
- PUBLIC HEALTH APPROACH TO VIOLENCE PREVENTION
- Checkpoint Questions
- YOUTH VIOLENCE
- FIGURE 33.2
- Risk and Protective Factors for Youth Violence
- Individual Risk Factors
- Family Risk Factors
- Peer Risk Factors
- Neighborhood Risk Factors
- Protective Factors
- FIGURE 33.3
- Public Health Approach to Youth Violence
- Nurses’ Role in Youth Violence Prevention Efforts
- Checkpoint Questions
- FAMILY VIOLENCE
- Intimate Partner Violence
- Defining the Scope of Intimate Partner Violence
- FIGURE 33.4
- Cost to Children
- Addressing Intimate Partner Violence
- PROBLEMS WITH DETECTION AND SCREENING.
- IMPORTANCE OF SCREENING.
- Nurses’ Role
- ASSESSMENT TOOL 33.1: Intimate Partner Violence Documentation Form
- Checkpoint Questions
- Child Maltreatment
- Effects on Child Functioning
- SOCIAL FUNCTIONING.
- BEHAVIORAL FUNCTIONING.
- EMOTIONAL AND INTELLECTUAL FUNCTIONING.
- BOX 33.1: Child Maltreatment and Post-Traumatic Stress Disorder
- Case Vignette 33.1
- HEALTH AND PHYSICAL FUNCTIONING.
- Nurses’ Role
- FIGURE 33.5
- Checkpoint Questions
- Elder Abuse
- TABLE 33.1: Types of Elder Abuse
- Causes
- Nurses’ Role
- Checkpoint Questions
- RAPE AND SEXUAL ASSAULT
- ASSESSMENT TOOL 33.2: Elder Assessment Instrument (EAI)
- Types of Rape
- Rape by a Stranger
- Date Rape and Acquaintance Rape
- Marital Rape
- Rape Trauma Syndrome
- FIGURE 33.6
- Additional Ramifications of Rape
- Treatment for Survivors of Rape or Sexual Assault
- Case Vignette 33.2
- Reflection and Critical Thinking
- Psychopharmacologic Interventions
- Psychological Interventions
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Survivors of Rape Trauma
- ASSESSMENT
- Case Vignette 33.3
- Reflection and Critical Thinking
- NURSING DIAGNOSIS, OUTCOME IDENTIFICATION, AND PLANNING
- Think About It 33.1
- IMPLEMENTATION
- EVALUATION
- Case in Point 33.1: Alicia’s Story
- Key Assessment Findings
- EPILOGUE
- Client-Centered Education 33.1: Coping with Rape Trauma Syndrome
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 34: Suicide and Suicidal Behavior
- KEY TERMS
- LEARNING OBJECTIVES
- SUICIDE
- Incidence and Prevalence
- Suicide Prevention Efforts
- Checkpoint Questions
- Etiology
- Genetic Factors
- Psychological Factors
- Physical Factors
- Case Vignette 34.1
- Reflection and Critical Thinking
- Other Factors
- Checkpoint Questions
- Protective Factors
- APPLYING THE NURSING PROCESS: Suicidal Clients
- ASSESSMENT
- BOX 34.1: Warning Signs of Suicide
- ASSESSMENT TOOL 34.1: Questions to Review Stressors for Suicidal Clients
- Eating
- Sleeping
- Mood
- Health
- Activities
- Coping
- Prior Suicidal Behavior
- BOX 34.2: Is Path Warm?
- Current Suicide Plan
- Lethality Assessment
- Current Resources
- TABLE 34.1: Lethality of Suicide Attempts by Method
- Checkpoint Questions
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- Think About It 34.1
- General Overall Guidelines
- Therapeutic Communication 34.1
- The Suicidal Client
- Reflection and Critical Thinking
- Additional Guidelines for Hospitalized Clients
- EVALUATION
- SUICIDE AS A PUBLIC HEALTH PROBLEM
- THOSE LEFT BEHIND
- BOX 34.3: Blueprint for a National Suicide Prevention Strategy
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 35: Crisis Intervention
- KEY TERMS
- LEARNING OBJECTIVES
- CRISIS
- FIGURE 35.1
- Phases of a Crisis
- FIGURE 35.2
- Types of Crises
- Maturational Crisis
- FIGURE 35.3
- Situational Crisis
- FIGURE 35.4
- Adventitious Crisis
- CRISIS RESPONSES TO TERRORISM.
- FIGURE 35.5
- EVIDENCE-BASED PRACTICE SPOTLIGHT 35.1: Crisis Intervention for People With Severe Mental Illnesses Living in the Community
- Reference
- CRITICAL INCIDENT STRESS DEBRIEFING.
- SELF-CARE FOR PROVIDERS RESPONDING TO ADVENTITIOUS CRISES.
- CRISIS PREVENTION
- FIGURE 35.6
- Checkpoint Questions
- CRISIS INTERVENTION AND STABILIZATION
- Crisis Intervention Versus Traditional Therapies
- Crisis Intervention Across Contexts
- Characteristics and Skills of the Crisis Intervener
- Case Vignette 35.1
- Reflection and Critical Thinking
- Checkpoint Questions
- Team Approach
- Challenging Behaviors 35.1: The Client Who Pits Staff Members Against One Another
- Crisis Groups
- Families in Crisis
- FIGURE 35.7
- Telephone Counseling
- FIGURE 35.8
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Clients in Crisis
- ASSESSMENT
- FIGURE 35.9
- Evaluating Feelings
- NURSING SPOTLIGHT 35.1: Ten Tips for Crisis Prevention
- Determining Perception of the Event
- Assessing Support Systems
- Assessing Coping Skills
- Determining Potential for Self-Harm
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- FIGURE 35.10
- IMPLEMENTATION
- Realizing the Potential for Growth
- Think About It 35.1
- Learning to Ask for Help
- Using Adaptive Coping
- Focusing on Problem Resolution
- Using Information Technology
- EVALUATION
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- EIGHT: Special Populations
- 36: Pediatric Clients
- KEY TERMS
- LEARNING OBJECTIVES
- THEORIES OF CHILD DEVELOPMENT
- TABLE 36.1: Overview of Traditional Developmental Theories
- Temperament Theory
- BOX 36.1: Temperaments
- Moral Development Theory
- Cognitive Development Theory
- TABLE 36.2: Piaget’s Theory of Cognitive Development
- Attachment Theory
- FIGURE 36.1
- Contemporary Views of Child Development
- FIGURE 36.2
- MENTAL HEALTH: PROTECTIVE INFLUENCES FOR RESILIENCE
- OVERVIEW OF PEDIATRIC MENTAL ILLNESS
- FIGURE 36.3
- Infrastructure and Availability of Care to Pediatric Populations
- Cultural Barriers to Mental Health Care for Children
- Risk Factors and Etiology
- Biologic Influences
- FIGURE 36.4
- Familial and Societal Influences
- Stressors
- DIVORCE.
- FIGURE 36.5
- CHILD ABUSE.
- Checkpoint Questions
- Evidence-Based Interventions
- EVIDENCE-BASED PRACTICE SPOTLIGHT 36.1: Interventions for Child and Adolescent Disorders
- Prevention and Early Identification
- FIGURE 36.6
- Psychosocial Modalities
- INDIVIDUAL THERAPY.
- Cultural Spotlight 36.1: Considerations for Mental Health Services
- BRIEF PSYCHOTHERAPY.
- PLAY THERAPY.
- FAMILY THERAPY.
- TRAUMA-INFORMED CARE.
- TABLE 36.3: Behaviors and Cognitions Associated With Traumatized Children
- PARENT MANAGEMENT TRAINING AND MULTISYSTEMIC THERAPY.
- GROUP THERAPY.
- FIGURE 36.7
- MILIEU THERAPY.
- Pharmacologic Therapy
- Interdisciplinary Coordination
- TREATMENT SETTINGS AND CONTINUUM OF CARE.
- WRAP-AROUND SERVICES AND SYSTEMS OF CARE.
- Client-Centered Education 36.1: Warnings for Families Considering a Child’s Residential Placement
- COMMUNITY-RELATED FOCI.
- SPECIAL EDUCATION.
- FIGURE 36.8
- General Nursing Care for Pediatric Clients With Psychiatric Disorders
- Assessment
- FAMILY FUNCTIONING.
- FIGURE 36.9
- CURRENT PROBLEM.
- HISTORY.
- MENTAL STATUS EXAMINATION.
- FIGURE 36.10
- PHYSICAL EXAMINATION.
- Interventions
- PROVIDING MEDICATION EDUCATION.
- MEETING FAMILIES’ NEEDS.
- PROMOTING THE RIGHTS OF CHILDREN IN TREATMENT SETTINGS.
- NURSING SPOTLIGHT 36.1: Rights of Pediatric Clients in Health Care Settings
- AVOIDING SECLUSION AND RESTRAINT.
- PROVIDING ADVOCACY.
- Checkpoint Questions
- COMMON PSYCHIATRIC DISORDERS OF CHILDREN AND ADOLESCENTS
- DISRUPTIVE BEHAVIOR DISORDERS
- Attention Deficit/Hyperactivity Disorder
- Etiology
- Signs and Symptoms/Diagnostic Criteria
- DSM-IV-TR BOX 36.1: Attention Deficit/Hyperactivity Disorder
- Comorbidities
- Interdisciplinary Goals and Treatment
- Behavioral Treatment and Other Psychosocial Interventions
- Pharmacologic Therapy
- UNDERSTANDING PSYCHOPHARMACOLOGY 36.1: Methylphenidate (Ritalin, Concerta)
- APPLYING THE NURSING PROCESS: ADHD
- ASSESSMENT
- Case in Point 36.1: Michael’s Story
- Key Assessment Findings
- FIGURE A
- FIGURE B AND C.
- FIGURE D.
- FIGURE E.
- FIGURE F.
- FIGURE G.
- FIGURE H.
- EPILOGUE
- FIGURE I.
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- Teaching Social Skills
- FIGURE 36.11
- Educating the Family
- FIGURE 36.12
- Helping Families Cope
- Managing Developmental and Academic Issues
- Improving Self-Esteem
- FIGURE 36.13
- EVALUATION
- Checkpoint Questions
- Oppositional-Defiant Disorder
- DSM-IV-TR BOX 36.2: Oppositional-Defiant Disorder
- Conduct Disorder
- DSM-IV-TR BOX 36.3: Conduct Disorder
- EVIDENCE-BASED PRACTICE SPOTLIGHT 36.2: Parent Management Training and Conduct Disorder
- References
- ADJUSTMENT DISORDERS
- FIGURE 36.14
- ANXIETY DISORDERS
- Obsessive–Compulsive Disorder
- Separation Anxiety Disorder
- FIGURE 36.15
- Phobias
- Social Anxiety Disorder (Social Phobia)
- Generalized Anxiety Disorder
- Post-Traumatic Stress Disorder
- Checkpoint Questions
- MOOD DISORDERS
- Case Vignette 36.1
- Reflection and Critical Thinking
- Depression
- Signs and Symptoms
- BOX 36.2: What Does a Child Have to Be Depressed About?
- Think About It 36.1
- Comorbidities
- Prevention
- Interdisciplinary Goals and Treatment
- Cognitive–Behavioral Therapy and Family Consultation
- FIGURE 36.16
- Pharmacologic Therapy
- Bipolar Disorder
- Signs and Symptoms
- Interdisciplinary Goals and Treatment
- Importance of Early Identification and Treatment
- Pharmacologic Therapy
- AUTISM SPECTRUM DISORDERS
- Signs and Symptoms/Diagnostic Criteria
- DSM-IV-TR BOX 36.4: Autism Spectrum Disorders
- Autistic Disorder
- Asperger’s Disorder
- Autism
- Asperger’s Syndrome
- Interdisciplinary Goals and Treatment
- Checkpoint Questions
- EATING DISORDERS
- SUBSTANCE ABUSE
- BOX 36.3: Signs and Symptoms of Substance Abuse in Adolescents
- Prevention of Drug and Alcohol Abuse
- Interdisciplinary Goals and Treatment
- Therapeutic Communication 36.1: Discussing Peer Pressure and Substance Use With Adolescents
- Reflection and Critical Thinking
- TIC DISORDERS
- TRICHOTILLOMANIA
- FIGURE 36.17
- Checkpoint Questions
- SUICIDE
- Signs
- Prevention
- Interdisciplinary Goals and Treatment
- CHILDREN WITH MEDICAL ILLNESS OR DISABILITY
- FIGURE 36.18
- MENTAL RETARDATION
- FIGURE 36.19
- Checkpoint Questions
- NURSES’ SELF-CARE
- FIGURE 36.20
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 37: Older Adult Clients
- LEARNING OBJECTIVES
- KEY TERMS
- DEMOGRAPHICS OF AGING AND FUTURE TRENDS
- FIGURE 37.1
- BIOPSYCHOSOCIAL COMPONENTS OF AGING
- FIGURE 37.2
- Biologic Changes
- BOX 37.1: Ten Tips for Healthy Aging
- Risk Factors Affecting Health and Functional Status
- Chronic Illness
- Medications
- UNDERSTANDING BIOLOGIC FOUNDATIONS 37.1: Acetylcholine and Aging
- Checkpoint Questions
- Psychosocial Issues and Influences of Aging
- Retirement
- Client-Centered Education 37.1: Preretirement Planning
- Relocation
- FIGURE 37.3
- Bereavement
- Case Vignette 37.1
- Reflection and Critical Thinking
- Responses to Life Transitions
- Sociopolitical Issues and Influences
- Ageism, Myths, and Prejudices
- Fragmentation of Health Care
- Checkpoint Questions
- OLDER ADULTS WITH PSYCHIATRIC DISORDERS
- TABLE 37.1: Common Psychiatric Conditions in Older Adults
- Sleep Disorders
- Anxiety Disorders
- Somatoform Disorders
- Mood Disorders
- FIGURE 37.4
- Major Depression
- Suicide
- Nursing and Health Care Responses
- Thought Disorders
- Substance Use Disorders
- FIGURE 37.5
- Cognitive Disorders
- Checkpoint Questions
- COMMUNICATING EFFECTIVELY WITH OLDER ADULTS
- BOX 37.2: Useful Communication Skills With Older Adults
- TABLE 37.2: Age-Sensitive Terminology
- CARE OF OLDER ADULTS
- Comprehensive Geriatric Mental Health Assessment
- Think About It 37.1
- Case Vignette 37.2
- Intervention and Treatment
- General Medication Management
- Psychotropic Medication Management
- Electroconvulsive Therapy
- Psychosocial Interventions
- FIGURE 37.6
- Role of Nurses
- Checkpoint Questions
- PROMOTING MENTAL HEALTH AND WELLNESS IN OLDER ADULTS
- Nutrition and Fluids
- Client-Centered Education 37.2: Suggestions About Mental Wellness
- EVIDENCE-BASED PRACTICE SPOTLIGHT 37.1: Interventions to Increase Health Promotion Activities in Older Adults
- References
- Mental and Physical Activities
- FIGURE 37.7
- Support Systems
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- 38: Homeless Clients
- LEARNING OBJECTIVES
- KEY TERMS
- DEMOGRAPHICS
- FIGURE 38.1
- HOMELESSNESS AND MENTAL ILLNESS
- Checkpoint Questions
- Contributing Factors
- Deficient Mental Health Care System
- DSM-IV-TR BOX 38.1: Common Diagnoses in Homeless People with Mental Illness
- Functional Abilities and Deficits
- Substance Abuse
- FIGURE 38.2
- Poverty
- FIGURE 38.3
- Inadequate Housing
- High Mobility
- FIGURE 38.4
- Critical Issues Affecting the Homeless Population with Mental Illness
- A Changing Mental Health System
- Barriers to Care
- BOX 38.1: Barriers to Health Care for the Homeless Population
- FIGURE 38.5
- The Shelter System
- FIGURE 38.6
- Health Concerns
- Case Vignette 38.1
- Reflection and Critical Thinking
- FIGURE 38.7
- Criminal Justice System
- Checkpoint Questions
- APPLYING THE NURSING PROCESS: Homelessness
- ASSESSMENT
- BOX 38.2: Stressors of Homelessness That Influence Mental Health
- Think About It 38.1
- BOX 38.3: Communication Suggestions With Homeless Clients Who Have a Mental Illness
- NURSING DIAGNOSIS
- OUTCOME IDENTIFICATION AND PLANNING
- IMPLEMENTATION
- EVIDENCE-BASED PRACTICE SPOTLIGHT 38.1: Meeting the Needs of Homeless People
- Reference
- Forming a Therapeutic Alliance
- Challenging Behaviors 38.1: The Client Lost in the System
- Managing Medications
- Teaching Clients
- Providing Case Management
- Becoming Politically Involved
- EVALUATION
- UNDERSTANDING PSYCHOPHARMACOLOGY 38.1: Medication Management Suggestions for the Homeless Person
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- 39: Clients With Medical Illnesses
- LEARNING OBJECTIVES
- KEY TERMS
- FIGURE 39.1
- MENTAL DISORDER DUE TO A GENERAL MEDICAL CONDITION
- BOX 39.1: Common Medical Disorders Associated With Psychiatric Symptoms
- General Features
- Example: Seizure Disorder (Epilepsy)
- DSM-IV-TR BOX 39.1: Mental Disorders Due to a Medical Condition
- Diagnostic Criteria
- Categories
- Treatment
- Nursing Implications
- Checkpoint Questions
- ADJUSTMENT DISORDERS
- General Features
- DSM-IV-TR BOX 39.2
- Adjustment Disorder
- Reactions to Physical Illness
- BOX 39.2: Factors That Influence Reactions to Illness
- Treatment
- Nursing Implications
- Checkpoint Questions
- MENTAL DISORDER NOT OTHERWISE SPECIFIED DUE TO A GENERAL MEDICAL CONDITION
- FIGURE 39.2
- Cardiovascular Illness
- FIGURE 39.3
- Client Reactions
- Treatment and Nursing Implications
- Pulmonary Illness
- Client Reactions
- Treatment and Nursing Implications
- FIGURE 39.4
- Think About It 38.1
- Reproductive Challenges
- Client Reactions
- FIGURE 39.5
- Treatment and Nursing Implications
- Checkpoint Questions
- Neoplastic Diseases (Cancer)
- Client Reactions
- Treatment and Nursing Implications
- FIGURE 39.6
- NURSING STRATEGIES FOR PSYCHOSOCIAL CARE IN MEDICAL ILLNESS
- Reviewing and Applying Your Knowledge
- Chapter Summary
- Study Questions
- Critical Thinking Questions
- References
- Web Resources
- Back Matter
- APPENDIX A: Global Assessment of Functioning (GAF) Scale
- APPENDIX B: DSM-IV-TR Classification: Axes I and II Categories and Codes
- DISORDERS USUALLY FIRST DIAGNOSED IN INFANCY, CHILDHOOD, OR ADOLESCENCE
- Mental Retardation
- Learning Disorders
- Motor Skills Disorder
- Communication Disorders
- Pervasive Developmental Disorders
- Attention-Deficit and Disruptive Behavior Disorders
- Feeding and Eating Disorders of Infancy or Early Childhood
- Tic Disorders
- Elimination Disorders
- Other Disorders of Infancy, Childhood, or Adolescence
- DELIRIUM, DEMENTIA, AND AMNESTIC AND OTHER COGNITIVE DISORDERS
- Delirium
- Dementia
- Amnestic Disorders
- Other Cognitive Disorders
- MENTAL DISORDERS DUE TO A GENERAL MEDICAL CONDITION NOT ELSEWHERE CLASSIFIED
- SUBSTANCE-RELATED DISORDERS
- Alcohol-Related Disorders
- Alcohol Use Disorders
- Alcohol-Induced Disorders
- Amphetamine (or Amphetamine-Like)-Related Disorders
- Amphetamine Use Disorders
- Amphetamine-Induced Disorders
- Caffeine-Related Disorders
- Caffeine-Induced Disorders
- Cannabis-Related Disorders
- Cannabis Use Disorders
- Cannabis-Induced Disorders
- Cocaine-Related Disorders
- Cocaine Use Disorders
- Cocaine-Induced Disorders
- Hallucinogen-Related Disorders
- Hallucinogen-Use Disorders
- Hallucinogen-Induced Disorders
- Inhalant-Related Disorders
- Inhalant Use Disorders
- Inhalant-Induced Disorders
- Nicotine-Related Disorders
- Nicotine Use Disorder
- Nicotine-Induced Disorder
- Opioid-Related Disorders
- Opioid Use Disorders
- Opioid-Induced Disorders
- Phencyclidine (or Phencyclidine-Like)-Related Disorders
- Phencyclidine Use Disorders
- Phencyclidine-Induced Disorders
- Sedative-Hypnotic- or Anxiolytic-Related Disorders
- Sedative-Hypnotic- or Anxiolytic Use Disorders
- Sedative, Hypnotic, or Anxiolytic-Induced Disorders
- Polysubstance-Related Disorder
- Other (or Unknown) Substance-Related Disorders
- Other (or Unknown) Substance Use Disorders
- Other (or Unknown) Substance-Induced Disorders
- SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS
- MOOD DISORDERS
- Depressive Disorders
- Bipolar Disorders
- ANXIETY DISORDERS
- SOMATOFORM DISORDERS
- FACTITIOUS DISORDERS
- DISSOCIATIVE DISORDERS
- SEXUAL AND GENDER IDENTITY DISORDERS
- Sexual Dysfunctions
- Sexual Desire Disorders
- Sexual Arousal Disorders
- Orgasmic Disorders
- Sexual Pain Disorders
- Sexual Dysfunction Due to a General Medical Condition
- Paraphilias
- Gender Identity Disorders
- EATING DISORDERS
- SLEEP DISORDERS
- Primary Sleep Disorders
- Dyssomnias
- Parasomnias
- Sleep Disorders Related to Another Mental Disorder
- Other Sleep Disorders
- IMPULSE-CONTROL DISORDERS NOT ELSEWHERE CLASSIFIED
- ADJUSTMENT DISORDERS
- PERSONALITY DISORDERS
- OTHER CONDITIONS THAT MAY BE A FOCUS OF CLINICAL ATTENTION
- Psychological Factors Affecting Medical Condition
- Medication-Induced Movement Disorders
- Other Medical-Induced Disorder
- Relational Problems
- Problems Related to Abuse or Neglect
- Additional Conditions That May be Focus of Clinical Attention
- ADDITIONAL CODES
- Glossary
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