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Psychiatric Nursing

Beliefs Feelings Behavior Therapeutic Communication Techniques What you see, you say What you hear, you say restating Sigmund Freud Father of Psychoanalysis Structure of Personality (Id, go, Superego) !ominant I! "ania #ntisocial Narcissistic S

! mpulsive want to want PL !S"#

eat drink urinate defecate

PL !S"#!BL P#$%&$PL Pain !voidance $t's all ($) !$"IN#NT S%P R &$ $*sessive + compulsive #nore,ia %ervosa I S

%P R &$ hould not mall voice of -od &.%S&$ %& P#$%&$PL

&$ /ecutive Secretary

Impaired Reality Schi0ophrenia

# !L$12 P#$%&$PL 'I(I!$ se,ual energy responsi*le for survival PS)C*$S +%#' T* $R) ,. $R#' ST#& 3 4 56 7onths old Survival $ want to eat, sleep, urinate, defecate

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Psychiatric Nursing

$9 formation &ry = Suck mouth &hild &ries Feed the $nfant Successful $gnore the $nfant "nsuccessful %arcissistic

Defense Mechanism: o FI+#TI$N when a person is stuck in a certain developmental stage o R &R SSI$N return to an earlier developmental stage EGO is develop in the 6th month

-. #N#' ST#& !teen 4 > years old (56 mos 4 > y:o:) 1oilet training Super go develop 1oilet 1raining -ood 7other Successful S 1oo #igid 1raining &lean .rgani0ed .*edient $(S SSI. / C$"P%'SSI. (!nal #etentive) 9irty 9isorgani0ed 9iso*edient #NTIS$CI#' (!nal ,pulsive) Bad 7other "nsuccessful

(I& S

Small S

0. P*#''IC > 4 ? y:o: Penis@ Aagina Parents is the significant person

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Psychiatric Nursing

&alled as Preschooler

$edipus Comple1 little *oy loves mommy lectra Comple1 little girl loves daddy Identi2ication *oy associates with daddy, girl assoc: with mommy Castration fear of the little *oy to daddy Penis nvy envy of little girl towards daddy

9r: Baren Corney opposition to penis envy Level of !wareness o Conscious highest level of awareness o Preconscious 1ip of the tongue o %nconscious deepest level of awareness Birth 1rauma First traumatic e,perience of child R PR SSI$N unconscious forgetting of an an,iety provoking concept S%PR SSI$N conscious forgetting of an an,iety provoking concept

3. '#T NC) ST#& ? 4 5; years old S&C..latency Se,ual energy is dormant #eading, #iting, #ithmetic S%('I"#TI$N placing se,ual energies toward a more productive endeavors

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Psychiatric Nursing

4. & NIT#' ST#& 5; y: o: 4 a*ove -ising -enital PHARMA MOMENTS

#NTI#N+I T)
AL!S1 7 A!$B .alium 4 ate A "iltown + 7eal 'i*reum + L Duanil 4 !Dua Bneel #tivan + !te -uy Seraks 4 Sera "lo Tran,ene + 1ransit .istaril + largavista #ttara, 4 7ga *ato (rocks) Inderal 4 hindi ralph (usfar 4 sasakay ng *us

RI5 RI5S$N PS)C*$S$CI#' T* $R) $F ! . '$P" NT 6 7 #ge 3+56 mos: 56 mos: 4 > y:o: 1rust !utonomy !" nal 1. ilet training %. favorite word 72 $nitiative $ndustry $dentity $ntimacy -enerativity go $ntegrity 7istrust Shame@ dou*t

#22ecting "a8or Factor Feeding 1oilet 1raining

> 4 ? y:o: ? 4 5; y:o: 5; 4 ;3 y:o: ;3 4 ;E y:o: ;E 4 FE y:o: FE y:o: and a*ove

-uilt $nferiority #ole confusion $solation Stagnation 9espair

$ndependence $n da+school Peer Love Parenting #eflection

"#S'$9:S * IR#RC*) $F N

!S

5: Physiologic %eeds o !ir, food, water, shelter, rest, sleep, activity and temperature maintenance that are crucial for survival ;: Safety and Security %eeds o Safe in physical and psychological aspects >: Love and Belonging %eeds o -iving and receiving affection, attaining a place in a group, maintaining the feeling of *elonging

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Psychiatric Nursing

F: Self 4 esteem %eeds o Self esteem 4 feelings of independence, competence and self respect o steem from others 4 recognition, respect, appreciation E: Self !ctuali0ation o .ne's ma,imum potential and reali0e one's a*ilities and Dualities ( *#.I$R#' "$! 'S 5: $van Pavlov &lassical &onditioning 7odel !ll *ehavior are learned Food dog Salivation Bell Food 9og Salivation Bell Salivation ;: B:F: Skinner .perant &onditioning !ll *ehaviors are unlearned #eward (G reinforcement) and Punishment (+ #einforcement) (R#IN '$( S #CTI$N Frontal Language, Learning, Personality, 8udgment 1emporal hearing, smelling Parietal 1aste, touch .ccipital Aision Sensory $ntegration 7otor $nvoluntary .$'%NT#R) N R.$%S S)ST " Somatic %ervous System !cetyl&holine Brain Spinal &ord 7otor %erve 7uscle Fi*er IN.$'%NT#R) N R.$%S S)ST " !utonomic %ervous System Sympathetic C# ## -$ &onstipation -"
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Aoluntary

Parasympathetic 9iarrhea
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Psychiatric Nursing

%euro

"rinary retention pi@ %or

"rinary FreDuency !cetyl &holine

PHARMA MOMENTS

"$N$#"IN $+I!#S IN*I(IT$RS

!#

7 % P

PL!% 9$L %!1

#NTIP#R5INS$N
&!P!BL S

Cogentin #rtane Parlodel #kineton (enadryl 'arodopa

ldepryl Symmetryl

T* R#P %TIC C$""%NIC#TI$N

1herapeutic .ffer your self $'ll stay with you Silence 7aking o*servations o 2ou seem sad !ctive listening o %odding o ye contact o Lean forward Who, what, when, where -eneral leads o -o on, $'m listening, what elseH Broad opening + *est .pening line %on+1herapeutic 9on't worry *e happy verything's gonna *e alright $gnoring the client &hanging the su*Iect %ice weather we're having o !dIectives 4 value *ased perception, should not *e use 2ou are the most *eautiful client Why !rguing Flattery 2ou should do this now $n my opinion
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Psychiatric Nursing

o Cow are you todayH o Cow are youH #estating &larrification #efocusing we are talking a*out the e,am Focusing tell me a*out ! F NS " C*#NIS"S Fight for stress 9$SPL!& 7 %1 1ransfer of feelings to a less threatening o*Iect rather than the one who provoke it 9 %$!L 9$SS.&$!1$.% # -# SS$.% # P# SS$.% #!1$.%!L$J!1$.% # !&1$.% F.#7!1$.% "%9.$% Failure to acknowledge an unaccepta*le trait or situation Psychological flight from self ! type of amnesia #eturn to an earlier developmental stage "nconscious forgetting of an an,iety provoking concept $llogical reasoning for a socially unaccepta*le trait (sayang ang *eer sa ref, kaya ko ininum) doing the opposite of your intention plastic

Boss shouts at you, you shout at your su*ordinate ($'m not an alcoholic) (Sino ka, Sino akoH) #eturn to thum*sucking Cindi ko maalala $ drink *ecause $ don't want to waste the *eer in the ref sasa*unutan kita: : : ay kuklulutin lang kita (ay pinatid kita, halika punta kita sa clinic) 1ulad niya

$9 %1$F$&!1$.% P#.8 &1$.%

$%1#.8 &1$.%

S"PP# SS$.% S"BL$7!1$.%

9oing the opposite of what you have done due to guilt orocan, plastic, 1upperware !ssume trait for personal, social, occupational role !ttri*uting to others one's (hindi ako accepta*le trait alcoholic, sila yon) Pasa load !ssume another person's trait as (ako din) your own %ot Iust you, me too &onscious forgetting of an Cindi ko alam an,iety provoking concept yan Placing se,ual energies toward !ngry at life, put a more productive endeavors anger in singing

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Psychiatric Nursing Biglang mangingig

&.%A #S$.%

&.7P %S!1$.%

#epressed angers put towards physical symptoms affecting nervous system leading to sensory num*ness and motor paralysis .verachievement in one area to cover a defective part #eplacing a difficult goal with a more accessi*le one

S"BS1$1"1$.%

Pilay pero magaling kumanta -usto ko 9isneyland: nchanted nalang:

S1.P -!B! $nhi*itory -amma !mino Butyric !cid

SNS
#N+I T)

-. pinephrine@ %orepinephrine ,itatory #nticholinergic side e22ect &onstipation "rinary #etention 9ry 7outh Blurred Aision

Within 5 week #e*ound phenomenon Sei0ure !*rupt 9ependence Withdrawal

!nti+!n,iety 9rowsy %o !lcohol %o &offee 9evelop .rthostatic Cypotension Prevetion of .:C: 5: Sit 9own ;: 9angle feet >: Stand "p -radually R '#+ !

-radually 1apered 9ose

#N+I T)
Aague sense of impending doom

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Psychiatric Nursing

"ild "oderate G5 G; Widened acing Perceptual Field #% 7eds #estless nhanced Learning &apacity (2ou Seem #estless (

Severe G> ont know what to say@do $# &1$A

Panic GF uicide afety 9on't touch client #espi !lkalosis Bown Bag

#ssess N1 !1

; Level of !n,iety ; $neffective $ndividual &oping Powerlessness $mpaired Skin $ntegrity Planning< Implementation; level of an,iety environmental Stimuli #ela,ation 1echniDue Showing pictures of flower, waterfalls Cearing sounds of chirping *irds valuation ; ffective individual coping

N R#'I= ! #N+I T) !IS$R! R

months e,cessive worrying 7ight *e mild, moderate and severe an,iety S<S1 #estless 9ifficulty of concentration Sleep 9isorders Palpitations dge of the seat asy fatiga*ility

P#NIC !IS$R! R
5E 4 >3 7inutes escalation of S%S #&$R#P*$(I# fear of open space@ pu*lic places
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Psychiatric Nursing

S$CI#' P*$(I# fear of pu*lic

P$ST TR#%"#TIC STR SS !IS$R! R

1rauma 9isaster !ccident War #ape arthDuake Soldier ? years old !ssignments@ Comeworks %o !ssignments@ Comeworks 2ou 1hink (1eacher may get angry)

Flash*acks .ICTI"S Survivors %ightmares

!n,iety ($ am sick) "#'IN& RIN& pretending to *e sick (&onscious) !*sent

S$"#T$F$R" K no pretension K no organic *asis K unconscious PS)C*$S$"#TIC K #eal pains@ illness K #eal symptoms K F maIor types L Cypertension L 7igraine L Stress "lcer L !sthma

scape from 1eacher PRI"#R) &#IN (Behavior an,iety)

7ama &are !ttention S C$N!#R) &#IN

S$"#T$F$R" !IS$R! RS S$"#T$F$R"

%ervous System $llusion of structural defect

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Psychiatric Nursing ($!) !)S"*$RPIC !IS$R! R

C$N. RSI$N !IS$R! R La Belle $ndifference emotional disattachment from disa*ility

7inor 9iscomfort $nterpreted as maIor illness *)P$C*$N!RI#SIS (7aliit na *utas, pinalalaki) Favorite Past 1imeM 9octor Copping %ursing FocusM Feelings

PS)C*$S$"#TIC !IS$R! RS
!n,iety S%S BP *ypertension P%S Aasoconstriction Bronchoconstriction &ere*ral !rtery Left -astric !rtery #sthma "igraine Stress %lcer

$(S SSI. / C$"P%'SI.

(elie2< thought 9oor .pen Burglar may go inside Feelings !n,iety

$>session an,iety (thought) #eturns to house (!ction) !n,iety Compulsion

P*$(I#
$rrational fears tiology o Bnowledge

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Psychiatric Nursing

o ,perience $mmediate %ursing $ntervention remove the stimuli S)ST "#TIC ! S NSITI=#TI$N o -radual e,posure to feared o*Iect

PHARMA MOMENTS

#NTIPS)C*$TIC #& NT
SSTTC"*P Stela0ine + se,y star Serentil 4 serena 1hora0ine 4 *a*aeng 1ora 1rilafon + tri+*and phone &lo0aril 4 closed reel 7ellaril 4 maraming reel Caldol 4 hahaha Proli,in 4 pero lick scene

#'C$*$'IS"
tiologyM Intergenerational Transmission From one generation to another generation

#lcohol

(lackout awake *ut unaware

Confa*ulation inventing stories to self+esteem

!enial ($ am not an alcoholic) !ependence ($ can't live without it)

na*ling significant other tolerates a*users !nother term C$ / ! P N! NC) T$' R#NC Su*stance to achieve a previous effect ! T$+IFIC#TI$N Withdrawal with 79 supervision &heck #lcohol, "outhwash, li1er void alcohol version therapy lcoholics !nonymous self help group

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Psychiatric Nursing

nta*use !IS%'FIR#" %ever drink alcohol 5; hour interval@ 5; h last alcohol intake

(5 Aitamin 9eficiency

or elseM nausea, vomiting and hypotension 9ernic?e:s ncephalopathy motor 5orsa?o22:s Psychosis memory

Complications !elirium 1remens ;F 4 N; h after last dose of alcohol

untreated withdrawal syndrome ormocation *ugs crawling under the skin amily 1herapy mother, father, *rother

#%TIS"
!utistic Savant autistic with a special talent #ssess #ppearance flat affect, consistent movement (ehavior repetitive, ritualistic Communication echolalia, incomprehensi*le N1 !1 $mpaired ver*al communication $mpaired social interaction Self mutilation #isk for inIury Planning< Implementation 7aslow's hierarchy of needs &onstancy, promote safety valuation ,pressive therapy drawing, muscic etc nhanced communication $mproved social interaction Safety

#TT NTI$N ! FICIT *)P R#CTI. !IS$R! R

.nset 9uration Settings $d 9ominant M N y:o: and *elow M ? months and a*ove M ; Couse and school M 7om or #% will act as superego

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Psychiatric Nursing

!9C9 -lucose Frontal Lo*e impaired Iudgement !9C9 S@S, #italin Frontal Lo*e 8udgement !9C9 S@S, (stimulant) #ssess #ppearance dirty (ehavior clumsy, impatient, easily distracted, hyperactive Communication talkative, *lurts out in class N1 !1 #isk for inIury $mpaired social interaction Planning< Implementation tructure separate room for eating, playing, sleeping and etc chedule time for everything et limits afety valuation 7inimi0e #isk for $nIury $mproved social interaction Safety #esidual !9C9 grows up not antisocial 7edsM #italin, de,edrin, pemoline, adderal Best time to giveM once a dayM !F1 # 7 !LSM prevent lost of appetite 9on't give at *edtime S1$7"L!%1 causes insomnia -ive ? hours prior *edtime if *id

#TIN& !IS$R! RS
56 mos: 4 > y:o: 1oilet 1raining &lean .*edient .rgani0ed 1hought $ !m Fat ? y:o: class valedictorian@ model student social inactive@ no BF weighing

Feeling Behavior Self steem 9iet, 9iet, 9iet

8omar !nthony 9: 7a,ion, BS%, #%

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Psychiatric Nursing (ulimia at, eat, vomit %ormal weight $rregular menstruation 9ao 7ing /i 9a 7ing Sugat@ suka Aomiting 9ental caries Wounded knuckles 7eta*olic alkalosis 7eta*olic acidosis

#nore1ia Nervosa 9iet, diet, diet O6EP of e,pected *ody > mos: ammenorhea Baren &arpenter

ating !isorders ating Pattern 9eight "enstruation

Aomiting Fluid Aolume 9eficit !##C21C7$! (fatal complication) 9iarrhea Interventions #estore fluid and electrolyte *alance &olla*orative regarding menu contract 1arget weight gain !fter mealsM stay >3 mins 4 5 hour

PHARMA MOMENT

'IT*I%"
' evel 3:? 4 5:; m D@L Increase urination Tremors, fine hand *ydration > L@day Increase %u diarhea "outh, dry ausea, vomiting, diarrhea Lithium 1o,icity aG

5idney

#NTIP#R5INS$N
#NTIC*$'IN R&IC #(C #rtane #kineton (enadryl Cogentin !$P#"IN R&IC P'S Parlodel 'arodopa Symmetyl ldepryl

8omar !nthony 9: 7a,ion, BS%, #%

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Psychiatric Nursing

SC*I=$P*R NI#
go disintegration $mpaired reality perception -enetic vulnera*ility Stress 4 9iathesis 7odel o 1oo much stress in the reality will lead client to escape it and go to the fantasy world Biological 1heory o 9opamine level is Cigh 1he e,act cause is unknown

ffect appropriate, inappropriate, flat, *lunt (incomplete emotion) m*ivalence torn *etween ; opposing forces utism ssociative Looseness Symptoms Negative Cypoactive Withdrawn !pathy #ssess ; &ontent of 1hought N1 !1 ; 9istur*ed thought process Planning< Implementation; Present reality Provide safety valuation ; $mprove thought process #ssess ; Callucination@ $llusions N1 !1 ; 9istur*ed sensory perception Planning< Implementation; Present reality Provide safety valuation ; $mprove sensory perception #ssess N1 !1 ; Suspicious ; #isk for other directive *ehavior Positive Cyperactive Socia*le Flight of $deas 1alkative

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Psychiatric Nursing

Planning< Implementation; Present reality Provide safety valuation ; liminate@ minimi0e risk for other+directed violence #ssess ; Suicidal N1 !1 ; #isk for self directive *ehavior Planning< Implementation; Present reality Provide safety valuation ; liminate@ minimi0e risk for self+directed violence Flight or 'ooseness $ am going to the mall: Where is the lightH -o here: 7ineral Water: $ am going to the mall: 1he mall is *ig: Big is the tree: 1he tree is tall:

"agical Thin?ing Believes to have a magical power $ can turn you into a frog cholalia $ repeat what you say Parrots chopra1ia $ repeat what you do 9ord Salad words, no rhyme Clang #ssociation words with rhyme M 9unk, plank, sunk Neologism creation of new words Plinking, hustash Clari2ication done in case of neologism !elusion; Persecutory %B$ is out to get me@ someone will harm the client Religious $ am 8esus &hrist &randeur $ am the Dueen of the world: Ideas o2 re2erence %urses are talking a*out me: Concrete #ssociation pilosopo (what will you wearH) (clothes) Thought (loc?ing

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Psychiatric Nursing

Stimulus Aisual !uditory 1actile

*alucination s !*sent / / /

Illusion Present

$n case of hallucinations doM

*allucinations #cknowledgment
$ know you the voices are real to you But $ don't hear them Lets go to the garden

Reality orientation !iversion

But if nothing in the preceeding intervention are seen Assess what the voices are saying SC*I=$PR NI#

!isorgani@ed
Sad *ut smiles o $nappropriate affect %o reaction o Flat affect Flight of ideas o HEBEPHRENIC -iggling Positive and

Catatonic
!m*ivalence Wa,y Fle,i*ility o $niwan na posture, ganun forever %o 4 favorite word

Paranoid
Suspicious 1endency to *e violent 7istrustScared Withdrawn %rsg: $ntM 9evelop trust 5 to 5 short interaction freDuent visit foods in sealed container meds wrapped for violent pt: 9oors open %ear the door 9on't touch the pt: ye contact 5 arms length away call reinforcement

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Psychiatric Nursing

Normally !cetylcholine Q .%

9opamine Q .FF

classi2ied di22erentiated
7i,ed classification &an't *e classified 5st paranoid, then %o more positive disorgani0ed then s@s,, Iust withdrawn catatonic, etc etc

Residual

2our always $N Schi0ophrenia With par?ins$N

Cigh 9opamineQ

#ntipsychotics Q makes 9opamine goes down 1trapyramidal Side 22ects #5#T*ISI# o #estless, ina*ility to sit o 7akati siya, ahh kati siya #5IN SI# o 7uscle rigidity o !hh kiniss siya !)ST$NI# o > features #nticholinergic 1.#1$&.LL$S Drugs that will make the Wry neck Ac down .&"L.-2#$& &#$S$S o !rtane Fi,ed stare o !kineton .P$S1C.1"%.S o Benadryl !rched *ack o &ogentin T#R!I. !)S5IN SI# o $rreversi*le side effects of !opaminergic antipsychotics Dopamine goes up o Parlodel o Larodopa 8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33< o Symmetryl o ldepryl .%

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Psychiatric Nursing

o Lip smacking o 1ongue protruding o &heeks puffing N %R$' PTIC "#'I&N#NT S)N!R$" o Cyperthermia among client taking antipsychotic o Cyperthermia with muscle rigidity

$ther Side 22ects Photosensitivity o Sunscreen o Wide *rimmed hat !granulocytosis o #eport immediately Sore throat 5st sign to appear

PHARMAMOMENTS

#NTI! PR SS#NTS
#NTS##. PP=

#sendin 4 ascending Norpramin 4 sa*aw ng knorr Tofranil 4 1ofu SineDuan 4 nood ng Sine Ruan ang title #nafranil 4 kina !na Praning #ventyl 4 kina !ven 1il 7idnight tayo .ivactil 4 Bye Back till ne,t week
lavil 4 h love mo *a ako Pro0ac 4 Pero saka na Pa,il + 1aksil =oloft 4 mag Solo ka (IP$'#R !IS$R! R / "ania more common Female ;3 years old and a*ove
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Psychiatric Nursing

Stressful life .*ese 1!SB &aregiver #ole Strain Self steem Safety $mpaired social interaction Safety
Cyperactive Se, !n,iety Self !ctuali0ation

#isk for inIury@ other directed violence ating finger food Sleep Private room

Lithium 4 ; 4 F weeks *efore effect

S &ompensation interfere !9Ls, harm others S &ompensation interfere !9Ls, harm others T#S5 increases client's self esteem -ross motor skills via su*limation scorted walk outdoors Punching *ag

%o group games compition will increase an,iety > or more signs confirms disorder & F S P randiose light of ideas leeplessness ressured speech ,agerated S ,traneous stimuli (easily distracted) ! istracti*ility
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Psychiatric Nursing

P RS$N#'IT) !IS$R! RS SC*I=$I! $ don't want people Believes he can stand on his own %ever had a *est friend !void groups and social activities no enIoyment &ares more a*out computers and pets #.$I!#NT $ avoid people, $ fear criticism Cave talent *ut no confidence #NTIS$CI#' $ *reak the law as motto !s a child,M steal, lie, always get reprimanded !dult 4 grand ro**ery, illegal activitist against the law, drug addiction, drives fast, unsafe se,, thrill seeker -ood talker, charmer, witty manipulator

($R! R'IN 4 my life is an emptyglass

!ependent $ can't live without you self esteem poor decision making skills *istrionic e,cited, dramatic *ut manipulative center of attention

8omar !nthony 9: 7a,ion, BS%, #%

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Psychiatric Nursing

Narcissistic $ love myself $nsensitive, arrogant $ am the *est $>sessive / Compulsive $ am organi0ed Perfectionist Provide time to do rituals Paranoid Suspicious Passive #ggressive !lways say yes *ut resistance is hidden

Serotonin
7!. kills Serotonin

7!. Serotonin 7!. Serotonin

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Psychiatric Nursing

Serotonin

!%1$9 P# SS!%1S wo 4 F weeks wo neurotransmitter RI C)C'IC

5st Line of 9rug Prescri*ed afest ' CTI. ide effects low R$T$NIN %PT#5 to F weeks N*I(IT$R
PP=

$N$ "IN

NTI! PR SS#NT Cigher incidence of Side effects Serotonin@ pi affected

+I!#S

N*I(IT$R
#NTS#. "NP

!ll neurotransmitter affected Cighest Side effects !void tyramine rich food may lead to C2P #1 %S$A &#$S S T)R#"IN RIC* F$$!S vocado ged &heese eer hocolate ermented Foods ickles reserved Foods oy Sauce !ntidepressant !nticholinergic Side ffects (Syphathetic) 7ale rectile 9ysfunction

SSRI "#$I

TC#

8omar !nthony 9: 7a,ion, BS%, #%

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Psychiatric Nursing

!ntidepressant no effect &1

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Psychiatric Nursing

' CR$C$N.%'SI. T* R#P) Pre o $nformed consent o %P. ? 4 6 hours prior 7eds o #tropine dry mouth o (ar*ituate Sedative o Succinylcholine muscle rela,ant, prevent sei0ure Post o Side+lying 4 lateral o S@ headache, di00iness, 1 7P.#!#2 7 7.#2 L.SS distinct sign N3 4 553 volts ;3 4 >3 seconds S hour asleep post

PHARMAMOMENTS

S%(ST#NC #(%S
!owners A#($N" IN B #lcohol (ar*ituates $piates Narcotics "ariIuana %ppers AC*#B Cocaine *allucinogen #mphetamines $. R!$S !lcohol C# ## BP L.& &ocaine 7orph &ode Cero %!#&!% antidote

&oma Bradycardia Bradypnea

Pupil constriction

Sei0ure

7oist mouth &onstipation Cypotension &oma !sleep 8omar !nthony 9: 7a,ion, Weight gain BS%, #%

&ollege of %ursing Batch ;33<

The Royal Pentagon Review Specialist, Inc.

Psychiatric Nursing

"PC.#$!

Psych well *eing %!#&!% %arcotic !ntagonist narcotic overdose

1achycardia 1achypnea Pupil 9ilation 9ry mouth Cypertension Sei0ure !wake Weight Loss

9 1./$F$&!1$.% withdrawal with 79 Supervision 7 1C!9.%

Withdrawal reverse of effect or opposite of overdose

! PR SSI$N Serotonin, if unresponsive to drugs, &1

The &rie2 Process !enial noT this can't *e true #nger why me, why me, why now (argaining if something happens, then $'ll give something *ack !epression $'m down ; weeks or more s@s, maIor depression #cceptance client acts according to situation
Self !ctuali0ation Self steem withdrawn

& 1!SB Stay

#isk for self directed violence ating Sleep Cypoactive Se,

Sensitivity to client needs

8omar !nthony 9: 7a,ion, BS%, #%

&ollege of %ursing Batch ;33<

The Royal Pentagon Review Specialist, Inc.

Psychiatric Nursing

S%ICI!
Aer*al $ wont *e a pro*lem anymore 1his is my last day on earth $'ll soon *e gone %on Aer*al 1ake this ring, its yours (giving of valua*le) Sudden change in mood

Who will commit SuicideH Se, 4 7ale (more successful)@ female (hesitant) #ge 4 5E 4;F y@o or a*ove FE !epression Patient with previous attempt 1.C 4 ethanol + alcoholics Rirrational Social support lacking $rgani0ed plan greater risk No family Sickness, terminal S%ICI! TRI#! Loss of spouse Loss of Io* !loneness $s Patient is S%ICI!#'U nurse shouldM 9$ !irect Duestion 4 (!re you going to commit suicideH) Irregular interval of visit to pt: room arly !7 and period of endorsement 4 the time pt's commit suicide (est approach 2or suicidal pt. ; 9irect approach Nursing "anagement; &lose surveillance *ospital area ma8ority sucide will happens at; weekends 5+ > am Sunday Weekend less staff personnel arly !7 every one is asleep -ive simple task: 9on't give comple, may cause depression e,: 8igsaw Water plants Wash the dishes e,cept sharps C*I'! #(%S !think B" Burns, *ruise, *one fractures, B"%-$T 9on't *athe the child, don't *rush teet: Body of evidence will *e lost
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<

The Royal Pentagon Review Specialist, Inc.

Psychiatric Nursing

Bantay Bata 5?> ' . 'S $F " NT#' R T#R!#TI$N Profound o O ;3 o thinks like an infants o can't *e trained ero 4 ; y@o o stay with the patient ensorimotor Severe evere o ;3 4 >E 7oderate 7odera e o >E 4 E3 hirtyfive 4 E3 raina*le o can *e train wo 4 N y@o o mental age is ; 4 N y@o o pre+operational stage 7ild o E3 4 N3 o meantal age is N 4 5; o educa*le o can go to school Borderline o N3 + <3 %ormal o <3 4 533 C$*N PI#& T:S C$&NITI. T* $R) 34; Sensorimotor Ba*y can sense, see, perceive and hear: .*Iect permanence ;4F Preconceptual Language F4N $ntuitive "nidimentional classification characteristic: &hild can fi, toys according to si0e, color, height Q one at a time N 4 5; &onservation 7ultidimensional &oncrete !ssociation Formal -ood a*stract thinking: &an interpret words 5; .peration #'=* I" R N$"I# don't know name of o*Iects &N$SI# pro*lem with senses P*#SI# can't say it PR#+I# can't do it &ocaine %asal Septum perforation 7ariIuana impaired Lung Structure eroine withdrawal ika*
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<

The Royal Pentagon Review Specialist, Inc.

Psychiatric Nursing

atsing u hu hu

CRITICAL REVIEW
T ST T#5IN& T C*NID% S 5: !ssess the answer, use circle 2. $nitial priority 1#"S1

!ir food, water !B& -ood Word@ Bad Word S 1echniDue eek support it tay upervised ee Q o*served eem Q notice assi t feeling ; same answer@ ; same mistake Words to watch out for $nappropriate 7ost %ot included ,cept !ll *ut one "m*rella !SS SS

>: F:

E: ?:

N:

R '#TI$NS*IP Preorientation Self awareness .rientation 1rust Setting &ontract #esistance Working 9iscussion 1ermination valuation

8omar !nthony 9: 7a,ion, BS%, #%

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The Royal Pentagon Review Specialist, Inc.

Psychiatric Nursing

PR#CTIC $F N%RSIN& Level of Prevention 5 ; > #elapse !!

Cealthy $ll &ommunity 9emog: &risis $ntervention S 'F * 'P &R$%PS niDue niversality r not alone R ST#T e,act words R F' CT use other words ! PR SSI$N ndogenous $nternal &hemical #eactive e,ternal

Bar*ituate withdrawal L$B#$"7 (&hloridia0epo,ide) 1.F#!%$L !ntidepressant@ !nticholinergic pupil dilation midriasis &atharsis Feelings Free !ssociation $deas #TTIT%! T* R#PI S !ctive friendliness ask permission assive Friendliness aranoid anipulative nic atter of Fact %o 9emand 9epressed Bind Firmness !nore,ic &risis F 4 ? weeks -oal #eturn the client to the pre+crisis level of functioning PS& Perception what do you think a*out itH &oping what will you do a*out itH Support who will *e there for youH
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<

The Royal Pentagon Review Specialist, Inc.

Psychiatric Nursing

Bulit kulit kulit kulit Perseveration stick to 5 topic "lit "lit "lit Aer*igeration !ISS$CI#TI$N 9issociative !mnesia don't know themselves Fugue Far 9issociative $dentity 9isorder 7ultiple Personality 9:.:

8omar !nthony 9: 7a,ion, BS%, #%

&ollege of %ursing Batch ;33<