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Psychiatric Nursing Review

Psychiatric Nursing Review

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Published by JanMiguel

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Published by: JanMiguel on Sep 18, 2009
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12/22/2012

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PSYCHIATRIC NURSINGRoyal PentagonRvw Ctr
Beliefs—Feelings—Behavior Sigmund Freud – Father of Psychoanalysis-structure of personalityId-impulsive part, pleasure principle-eat, urinate, have sex-it’s all “I”Superego – small voice of God-conscience-should not eat yet, should not eat yetEgo- arbiter, decision maker -in touch with realityId___________________SuperegoEGOID DOMINANT – needs a superego-needs a conscienceM- manicA- antisocial – serial killer  N- narcissisticSUPEREGO DOMINANT –needs an IdO- Obsessive CompulsiveA- Anorexia nervosaEGO – impaired reality perception (RN will present reality)S- schizophrenia- cant distinguish fact from realityLibido- sexual energyFREUD - PSYCHOSEXUAL THEORYORAL – 0-18 monthsCry, suck – mouth- survivalId dominantMaternal deprivation if not feed, not given milk/water, not kept warm. Narcissistic – seeks the Id – I love myself Regression – return to an earlier stage or earlier levelFixation – stopped in a stageANAL- 18 mos-3yrsToilet trainingMom is superego.Superego is being formedChild is caught in ambivalence – pulled in 2 opposing factorsToo much toilet training with punishment will result to a child who is:Obedient, organized, cleanRebel, dirty, disobedient
1
 
= OC=Anti-social=anal retentive=anal expulsive PHALLIC – 3-6 yrs old-penis & vagina-love of parent of opposite sexOedipal-boy loves momElectra-girl loves dadIdentification- boy imitates dadCastration fears- fear that dad is angry at him and will cut off penisPenis envy- girls envy little boysDr. Karen Horney- detractor of Freud, didn’t believe in penis envy. Freud said that it is maybe in her unconsciousmind.Or repressed.Conscious- highest level of awarenessPre-conscious- at tip of tongueUnconscious – forgottenRepression-kept in unconscious. Unconscious forgotten.Suppression – conscious forgettingLATENT- 6-12 years oldLatent- Logtu = sexual energy asleepSchool age – School phobia- 1
st
time to go to school – Separation anxietyChild is busy with Reading, writing, arithmetic.Sublimation –putting anger into something more productive putting all energies into schoolingEx. Angry at life, pour anger in singing.GENITAL –12 years old Genital-Gising sexual energySexual intercourse most important in this stage!!PHARMA MOMENTSAnti-anxiety Drugs (used also for alcohol withdrawal)ValiumLibriumAtivanSeraxTranxeneMiltownEquanilVistarilAtaraxInderalBuspaERIK ERIKSONSTAGE (+)(-)FACTO0-18 months (Oral)Trust vsMistrustFeeding18 mos- 3yrs old (Anal)Autonomy vsAu-(anal)To-ilet training No-No! Favorite word.MyShame/doubtToilet training3-6 yrs old (Phallic)Initiative vs(Initiate 1
st
steps)Phallic-oedipal,electraGuilt –anger turned inwardIndependence6-12 yrs old (Latent)Industry vsInferiorityIndustryInduskul12-20 (Genital)Identity vsRole confusionPeers20-25Intimacy vsIsolationLove25-45Generativity vsStagnationParenting45 upEgo Integrity vsDespairReflection Newly admitted pt- develop trust 1
st
2
 
-pts are dependent=self care deficit-develop/teach autonomy-then pt will develop initiative-etcFrontal lobe- personality, learning, judgment, languageOccipital- visionTemporal- hearing, smellParietal -taste,touch Sensory Integration Motor Somatic nervous system- voluntary movementsAcetylcholine- responsible for voluntary movements- on switch of movementAutonomic nervous system- involuntary movements-Sympathetic(Anti cholinergic) and parasympathetic (cholinergic)SYMPATHETIC (alert)PARASYMPATHETIC (relax)HearttachycardiabradycardiaRespiratorytachypneabradypneaGI (opposite effect)Slow, constipationdiarrheaGU (opposite effect)Slow, oliguria, retentionPolyuria, frequencyDry mouthMoist mouth NeurotransmitterEpinephrine, NorepinephrineAcetylcholine (AcH)PupilsDilated (dilat when alert) (Midriasis)Constricted (Myotic)Blood vesselsvasoconstrictionvasodilatedBPincreaseddecreasedAnti-cholinergic / anti-parasympathetic =effect is sympathetic!Sympathetic drug classifications:
 
A- anxietyP- psychotic
Anti
C- cholinergicD- depressantsMONO AMINE OXIDASE INHIBITORS:
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