Transcript Mental Health Unit 30-2

Mental Health Unit 30
Adonis K. Lomibao, R.N.
11/22/11
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Objectives
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Identify different types of anxiety, affective,
eating, and substance abuse disorders.
Understand patient behaviors including the
topics of defense mechanisms, coping,
demanding, and maladaptive behaviors.
Understand professional boundaries
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Mental Health
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Means exhibiting behaviors that reflect a
person's adaptation or adjustment to the
multiple stresses of life.
Stressors-situations, feelings, or conditions that
cause a person to be anxious about his or her
physical or emotional well-being.
Coping-handling stressful situations
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Anxiety Disorders
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Anxiety-fear, apprehension, or a sense of
impending danger.
Anxiety disorder- recognized mental illness
involving anxiety reactions in response to
stress.
Includes: Generalized anxiety, Panic disorder,
OCD, PTSD, & Phobias
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Agitation
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Agitation- inappropriate verbal, vocal, or motor
activity due to other causes other than
disorientation or real need.
Includes behavior such as: pacing, cursing,
biting, demanding attention,etc. (p.498)
Contributing factors include: Noise, loneliness,
depression, etc. (p.499)
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Panic Disorder
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Panic Disorder-characterized by unexpected,
chronic panic attacks (bouts of overwhelming
fear)
Person feels he is in danger, but has no specific
cause or basis of the fear.
May be so fearful that he is unable to function
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Obsessive-Compulsive Disorder
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OCD- patient has recurrent obsessions, frequent
thoughts, ideas,impulses or compulsions
Person has no control & derives no pleasure from the
ritualistic behavior
Obsession- a frequent idea, impulse, or thought that is
usually unrelated to current conditions and does not
make sense.
Compulsion-purposeful, repetitive behavior that is
done many times each day
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Posttraumatic Stress Disorder
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PTSD-the development of unusual symptoms
after a psychologically traumatic event.
Person may relive the event,have nightmares
or flashbacks.
May have trouble with normal emotional
responses, feel detached from others, feel
anxious, have difficulty sleeping, remembering,
or concentrating.
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Phobias
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Phobia-an unfounded, recurring fear that
causes the person to feel panic.
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Expressed as an unreasonable fear.
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Usually an object, insect,activity, or situation.
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Reaction to phobia may range from a feeling of
dread to terror.
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Affective Disorders
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A group of mental disorders characterized by a disturbance in
mood.
Also called mood disorders & are marked by a profound and
persistent sadness.
Include:
-Bipolar affective disorder
-Schizoaffective disorder
-Seasonal affective disorder
-Borderline personality disorder
-Depression
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Bipolar Affective Disorder
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Also called manic or bipolar depression
Person has marked mood swings from elation
(mania) to severe depression.
Most have many cycles of depression or mania.
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Schizoaffective Disorder
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Combination of schizophrenia and a mood
disorder.
Person will have symptoms of schizophrenia
(delusions, hallucinations, etc.) & symptoms of
major depression or manic episode.
Must have delusions and hallucinations to be
diagnosed.
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Seasonal Affective Disorder
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A depression that recurs each year at the same time
Usually starts in fall or winter and ends in the spring or
summer.
Believed to be related to the lack of sunlight exposure
or abnormal melatonin levels.
Symptoms include sleepiness, carb-cravings, weight
gain, etc. (p 501).
May be treated with light therapy
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Borderline Personality Disorder
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Controversial diagnosis and speculation about
the cause.
People with BPD feel unstable, impulsive, fear
abandonment, are manipulative, and are prone
to self-injurious behavior.
Mutilation, suicide attempts, difficulty
maintaining stable relationships
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Depression
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Most common in elderly, but also in the young.
Signs may include: crying spells,feeling of
dejection, feeling of worthlessness, etc. (p.502)
Risk factors: sudden loss of support system,
sudden decision to donate body parts, changes
in behavior,the very old, persons with
unrelieved chronic pain, etc. (p.503)
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Depression- Nursing Care
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Implement suicide precautions per protocol
Be observant for clues to suicide intent or
attempts
Work to restore the patient's self-esteem, selfworth, & self-respect.
Never ignore the person's statements or threats
about suicide
(p.504)
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Hypochondriasis
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Imagines or magnifies each physical ailment.
May be an expression of depression and is the
individual's way to reduce stress.
Reassure understand person, but do not
encourage focus or belief of the person's
supposed ill-ness.
Report all complaints and never judge the
person as a hypochondriac.
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Paranoia
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An extreme maladaptive response to stress.
Characterized by a heightene, false sense of
self-importance and delusions of being
persecuted.
Delusions- false beliefs about oneself, other
people, and events.
They believe everyone is against them
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Eating Disorders
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Characterized by disturbances in appetite or food
intake.
Anorexia nervosa- disturbed body image, limit intake
through diet, exercise, purging, & using laxatives and
diuretics. 15% below average weight.
Bulimia nervosa- binge-eat then purge to undo the
binge. Feelings of guilt, depression, and selfcondemnation. Also attempts to lose weight.
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Anorexia
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Substance Abuse
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Substance Abuse- characterized by the use of
one or more substances that alter mood or
behavior, resulting in impairment.
Results in maladaptive pattern that strains
finances, causes irresponsibility, makes user
unable to fulfill obligations.
Can be swallowed,inhaled, injected, or smoked
substances.
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Alcoholism
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A dependency on alcohol. Regarded as a disease.
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Is a drug and mixes unfavorably with other drugs.
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Can mask symptoms of other conditions
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Delirium tremens- serious withdrawal syndrome
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S&S include severe confusion, tremors,hallucinations,
seizures, & overactive nervous system.
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Defense Mechanisms
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Psychological reaction or technique for
protection against a stressful environmental
situation or anxiety.
Harmful when it is the major means of coping
with stress. (does not recognize reality or use
problem-solving methods.
Common defense mechanisms on (p.506)
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The Demanding Patient
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The demanding patient is frustrated by loss of
control.
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Behavior is a coping mechanism.
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Nursing care:
-Show that you care while controlling emotions
-Maintain open communications..listen!
-Allow pt. To regain control by making choices.
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(p.507)
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Maladaptive Behavior
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Occur when behaviors and responses disrupt
the person's ability to function smoothly within
the family, environment, or community.
May include: physical responses, emotional
responses, and patient behavior.
May result in: Depression, disorientation,
agitation, or paranoia.
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Disorientation
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A condition in which a person shows a lack of
reality awareness with regard to time, person,
or place.
Reality Orientation- making the disoriented
patient aware of person, place, and time by
visual reminders,activities, and verbal cues.
Protection of the patient is the most important
nursing responsibility.
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Professional Boundaries
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Unspoken limits on the physical and emotional
relationship with patients.
Limit how healthcare workers act with patients.
Involve using your best behavior, ethical
practices, and good judgement in patient care.
Relationship danger zones: (p.510)
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