Posttraumatic stress disorder (PTSD) is a 

psychiatric disorder that may occur in people who have

experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a
terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or
serious injury.

B.HISTORY COLLECTION

HISTORY COLLECTION

I. IDENTIFICATION

Name: I. N

Sex: Female

Age:

Marital status: Single

Place of birth: Western Province

Nyabihu District

Bigger Sector

Arusha Cell

Ngamba village

Sibling’s position: 3th

Profession: Accountant

Religion: ADVENTIST

Nationality: Rwandese

Admission date:
II. CHIEF COMPLAINT

The patient has been brought by her brother because of having physical and verbal aggressively,
total insomnia, and logorrhea.

III. ANTECEDENT/PEVIOUS MENTAL HISTORY

It is the 3rd crisis and all were trigged by stopping medications.

IV. FAMILY HISTORY: The client was born in a family of six children, three boys and three
girls, and she occupies the 5th place her both parents and her 2 brothers with 1 sister have been
killed in 1994 Genocide and remained five children who are all married except the client who
lives with her brother who is married having two children.

Her Uncle was mentally ill but died in 2008 with other medical condition not mental problem.

V. MEDICAL AND SURGICAL: None

VI. GYNECOLOGICAL HISTORY: She is still single with no gynecological problems.

VII. JUDICIAL HISTORY: None

iii) Respiratory system: no any problem in respiration presented or observed to the client.

iv) Cardiovascular system: no problem indicated to the heart with normal heart sounds.

v) Nervous system: normal sensations, shaking due to side effects of drugs, pupils are reacting
to light, with GCS of 15/15.

vi) GI: No abdominal tenderness or distended

vii) Urinary system: no complaints of urination with normal urine output.

viii) Integumentary system: she has scars on the legs and left arm due to wounding during 2nd
crisis.
ix. Vital signs: Blood pressure: 118/75mmhg

Pulse: 88 bpm

Temperature: 36.70c

Respiration rate: 18 bpm

X. PSYCHIATRIC CONDITIONS

General appearance: she is a middle size girl who is well dress compared to the time of
admission. She appears her stated age, with no agitation or hyperactivity compared to before.

Affect and mood: Appropriate affect, and labile mood.

Perception: she no longer has hallucinations and no illusion as before.

Thought and speech: Has a normal flow of speech compared to before where she had logorrhea.
Her thoughts full of hopelessness and low self-esteem but no delusions.

Orientation: she is oriented to time, place and to person.

Memory and concentration: she has the ability to recall past and recent history of her life.

Judgment and impulse control: she has ability to plan for his future

Insight: negative

Vegetative symptoms: normal level of energy

Maintains normal sleep cycle

MULTIAXIAL DIAGNOSIS

Axis I: Bipolar disorder

Axis II: neither mental retardation nor personality disorder

Axis III: NONE

AXIS IV: Job stress and excessive losses

XI. COMPLEMENTARY EXAMS

-Full blood count (FBC): NORMAL RESULTS

-HIV Test: Neg.

Symptoms of PTSD often are grouped into four main categories, including:

 Reliving: People with PTSD repeatedly relive the ordeal through thoughts and memories of
the trauma. These may include flashbacks, hallucinations, and nightmares. They also may
feel great distress when certain things remind them of the trauma, such as the anniversary
date of the event.
 Avoiding: The person may avoid people, places, thoughts, or situations that may remind
them of the trauma. This can lead to feelings of detachment and isolation from family and
friends, as well as a loss of interest in activities that the person once enjoyed.
 Increased arousal: These include excessive emotions; problems relating to others, including
feeling or showing affection; difficulty falling or staying asleep; irritability; outbursts of
anger; difficulty concentrating; and being "jumpy" or easily startled. The person may also
suffer physical symptoms, such as increased blood pressure and heart rate, rapid breathing,
muscle tension, nausea, and diarrhea.
 Negative cognitions and mood: This refers to thoughts and feelings related to blame,
estrangement, and memories of the traumatic event.

RISK FACTORS

Everyone reacts to traumatic events differently. Each person is unique in their ability to manage
fear, stress and the threat posed by a traumatic event or situation. For that reason, not everyone
who has a trauma will develop PTSD. Also, the type of help and support a person receives from
friends, family members, and professionals following the trauma may impact the development of
PTSD or the severity of symptoms.

PTSD was first brought to the attention of the medical community by war veterans; hence the
names shell shock and battle fatigue syndrome. However, anyone who has had a traumatic event
can develop PTSD. People who were abused as children or who have been repeatedly exposed to
life-threatening situations are at risk for developing PTSD. Victims of trauma related to physical
and sexual assault face the greatest risk for PTSD.

You may be more likely to develop PTSD after a traumatic event if you have a history of other
mental health problems, have blood relatives with mental health problems, or have a history of
alcohol or drug abuse

PTSD Diagnosis
PTSD isn’t diagnosed until at least 1 month has passed since the traumatic event happened. If
symptoms of PTSD are present, the doctor will begin an evaluation by performing a complete
medical history and physical exam. Although there are no lab tests to specifically diagnose PTSD,
the doctor may use various tests to rule out physical illness as the cause of the symptoms.
If no physical illness is found, you may be referred to a psychiatrist, psychologist, or other mental
health professional who is specially trained to diagnose and treat mental illnesses. Psychiatrists and
psychologists use specially designed interview and assessment tools to evaluate a person for the
presence of PTSD or other psychiatric conditions. The doctor bases their diagnosis of PTSD on
reported symptoms, including any problems with functioning caused by the symptoms. The doctor
then determines if the symptoms and degree of dysfunction indicate PTSD. PTSD is diagnosed if the
person has symptoms of PTSD that last for more than one month.

PTSD Treatment
The goal of PTSD treatment is to reduce the emotional and physical symptoms, to improve daily
functioning, and to help the person better manage with the event that triggered the
disorder. Treatment for PTSD may involve psychotherapy (a type of counseling), medication, or
both.
Medication

 Selective serotonin reuptake inhibitors (SSRIs) such

as citalopram (Celexa), fluvoxamine (Luvox), fluoxetine (Prozac), paroxetine (Paxil),
and sertraline (Zoloft)
 Tricyclic antidepressants such as amitriptyline (Elavil) and isocarboxazid (Doxepin)
 Mood stabilizers such as divalproex (Depakote) and lamotrigine (Lamictal)
 Atypical antipsychotics such as aripiprazole (Abilify)  and quetiapine (Seroquel 

COMPLICATIONS

PTSD can cause problems in every aspect of your life, including your job, your relationships, your
health, and your everyday activities. It may also make you more likely to develop other mental health
problems, such as:
  Depression and anxiety
 Drug or alcohol abuse
 Eating disorders
 Suicidal thoughts and actions

PREVENTION
Some studies suggest that early intervention with people who had a trauma may reduce some of
the symptoms of PTSD or prevent it all together.

g Objectives Planning/interv Rationale Implement Evaluation

is ention ation
em After 2 weeks of 1. Introduce self 1. This will help client All planed After 2 weeks of
ce nursing and intention build his trust with the intervention nursing interaction,
to interaction, during the first nurse; ensuring that it is were done. the client can
n client will be phase of a professional type of verbalize positive
able to view self interaction. interaction and that will concept of self,
ments positively 2. Interact with ensure the confidentiality know his strengths
tiona through the client in a of interaction. and limits as a
realization of slow pace, using 2. This will promote a person. At the end of
strengths and a low firm tone. positive and trusting nursing interaction,
e limits as a 3. Do not hurry environment with the the client is
person. client into an client considering that participative in daily
interaction, depressed clients activities, shows
instead maintain sometimes communicate eagerness to
a therapeutic and with some gaps or may socialize with other
reassuring be unresponsive for people, copes well
atmosphere that some reasons. with problems
you are available through omission of
if he is already 3. Sometimes clients negative thinking,
ready to talk or who are depressed may acceptance of honest
share his have some emotional appraisal, and
thoughts with outbursts, crying spells express emotions
you. or hesitancy in sharing productively.
their thoughts. Be wary
of these nonverbal cues
and provide some
comforting gestures or
allow client cry as it
would lessen his
exaggerated emotions.
Health education

Health Education of Post Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a mental health disorder that can occur after a traumatic
event. Treatment for PTSD may include medicines, counseling, eye movement desensitization
and reprocessing therapy (EMDR), or a combination of therapies
REFERENCES

 Body dysmorphic disorder, Mayo Clinic, Mayo Foundation for Medical Education and
Research, USA.2018

 Schramme T,(2008), ‘Should we prevent non-therapeutic mutilation and extreme body
modification?’, Bioethics, vol. 22, no. 1, pp. 8-15