Bachelor of Science in Nursing 4YA-1A

WK 8

o Urination = bed pan

Structures of Personality  Verbal (LRE)
Id o Least Restrictive Environment
 Pleasure seeking principle, satisfaction  Contract setting
 Instinctual drive (kung ano naisip, yun ung gagawin)  Reward and punishment
 “what I want is what I get”  Restrain
 Infant stage (oral, trust vs. mistrust) – iiyak ng iiyak pag  Seclude patient, solidary
increased ang Id SUPEREGO DISORDERS (BAO)
 At birth – in order to SURVIVE  Bulimia – pinipilit isuka ung kinain nya
 Self preservation  Anorexia – super payat ng pt, low self esteem, can’t
Superego decide
 Morality principle  Obsessive compulsive – caused by anxiety
 Conscience Similarities
 Angel/ voice of the heart  Perfectionist
 “I should not do that”  Achiever
 Toddler stage – nadedevelop  Low self-esteem
 Parental/Social norm Treatment
Ego  Nutrition
 Reality principle  Tx of anxiety
 Balance or intermediary 
 Focuses “HERE & NOW” EGO DISORDERS
ID DISORDERS (MANAH)  Schizophrenia
 Mania - hyper o ↑ dopamine
 Anti social - kriminal o S/Sx: Hallucination (w/o stimuli), Delusion,
 Narcissistic – pabida, positive lahat sa kanila Illusion (with stimuli)
 ADHD Management
 Histrionic – attention seeker; kahit negative and sabihin  Present reality
okay lang as long as napansin mo sya  Antipsychotic drugs
Similarities o 2 types
 Demanding  Typical
 Manipulative  Atypical
 Aggressive BIPOLAR DISORDER
Mania (Type 1)
Management
 Hyper (same sa ADHD - child), always of the go
 Set limits
 Sleep deprivation
 Verbal = verbal (Pt, what is the reason why u said it
to me?)  Red color and favorite
 Physical = physical (restrain)
 Give warm milk to induce sleep
 2 types of restrain  Avoid afternoon nap
o Chemical – 1st, need doctor’s order, PRN, IM for  Provide relaxation technique
fast absorption o Deep breathing exercise – most affordable and
o Physical – 2nd accessible
 4 point restrain, narorotate o Music therapy – relaxing, classical music
 5 point (waist) o Guided imagery – adjunct to music therapy
 2 point restrain (kamay)  Give finger foods (French fries, pizza, cheese burger)
o Priority  High in calories, CHO, CHON ang foods nila
 Circulation = 30 mins check  Risk for injury
o Compartment syndrome – bluish discoloration in o Priority: SAFETY
casting  Others directed ang harm
o Things to check in physical restrain  “AKO LANG PALAGI”
 Temperature  Flight of ideas – unconnected ideas
 Movement o Clarifyyyy
 Color  AVOID
o 2 hrs – evaluation after removal of restraint o Combative
o Document = still verbally abusive; do not remove o Competitive
the restrain o Contact sports

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 Bawal ang fine motor na play  SSRI

o GROSS MOTOR dapat para marelease ang excess  Panic
energy nila  1st drug to be given
 Bawal and DETAILED  Safest & latest line of drug
 What to do: SOLITARY/PRODUCTIVE PLAY  Physician’s choice because it has the
Treatment lowest side effects
 APCD  DOC for elders
o Anti Anxiety  No suicide contract/ No harm to self
o Anti Psychotic SONG HITS
o Anti Cholinergic Constipation….retention….
o Anti Depressant Hypotension at dry mouth saka blurring of vision
o Lithium (DRUG OF CHOICE)
 Major Tranquilizer Asendin, Aventyl, Norpramin, tofranil
o Anti psychotic Anafranil, Sinequan, TCA iyan!
o Anti depressant
 LITHIUM Therapeutic effects ay 2-4 weeks pa
o Level of Therapeutic Effect Initially pasyente ay depressed at aantukin
 0.5 – 1.5 / 0.6 – 1.2 (safest range of Lithium)
 <0.5 = manic Isama mo pa LUVOX, PAXIL, PROZAC, ZOLOFT
 >1.5 = toxicity For panic attack, Safest SSRI iyan
o Indicated for MANIA
o Toxic s/sx PANAMA naman ang mga MAOI
 N/v – indicator of toxicity Ang tyramine foods causes HTN crisis
 Diarrhea
 Tremors (PA-parnite, NA-nardil, MA-marplan)
o Hydrate 2-3 L/day
o Increased UO/ dry mouth – Side effects  1-2 weeks – initial effects
 Antidote = mannitol, Diamox (osmotics)  2-4 – desired effects; suicidal = ↑ energy
o U o Hypertensive crisis
o Maintain normal salt 2-3 g/day  ↑ BP
Depression  Occipital headache
 Self-care deficit  Blurring of vision
 Hypoactive (walang energy)  Palpitations
 Evasive, isolate themselves  Seizure
 Treatment I. NURSE PATIENT RELATIONSHIP
o Create STRUCTURED ACTIVITIES (mutually  A series of interaction between the patient and the nurse
done by the nurse)  GOAL: positive behavioral change
o Gradual exposure to activities  When does therapeutic relationship begin?
 Disorganized thoughts – allow independent decision o When pt interact with the nurse
making o Once they meet each other during orientation
 Risk for injury – self phase
 DEPRESSION = SUICIDAL  What is the only tool available for the nurse?
 “WHY” becomes therapeutic o Him/her self (communication skills)
 4 B na Suicidal Elements of Therapeutic Relationship
o Bulimia  Trust
o Borderline o Very important for sharing
o B(D)epression  Rapport
o B(A)utism o Needed to establish trust
 History increase risk, lalo pag may ENERGY. o Connection
Nagiincrease and risk na mag SUICIDE o Make pt feel more comfortable
 DRUG OF CHOICE (suicidal)  Unconditional Positive Regard
o Anti-depressant o Acceptance of pt whatever he or she is
 MAOI  Set limits
 Most effective o Put on a limitation on bad pt. behavior
 But has the highest Side Effects  Therapeutic use of self
 TCA o Utilization of your nursing knowledge, skills, and
 Most sedating attitudes
 Secondary drug II. Therapeutic Behaviors of the Nurse

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 Characteristics that a nurse should have: 4. Silence

o Respectful  Encourages the patient to express
 Should be freely given  Let them know that you are there
o Genuine  PRESENT
 Sincere and honest 5. Paralanguage
o Concreteness
 Voice quality (tone, inflection)
 Ability of the nurse to know what the pt
 How the message is delivered
feels
VI. Therapeutic Communication
III. Phases of Therapeutic Relationship
 Offering self
1. Pre-Interaction Phase = Pre-orientation Phase o It has to be SMART in order to be therapeutic
 Contact: not yet o “Let me sit here with you for 5 minutes”
 Activities: (1) self-awareness  Active Listening
(2) secondary sources of data o Indicates that you are paying full attention to
2. Interaction Phase = Orientation phase your patient
 Contact: 1st contact with the nurse o “Ah huh”, “Okay”, nodding
 Activities:  Exploring
o This is when trust is established + rapport o Will provide further information about the
o Inform the client about termination subject
o Mutual agreement o “You said he is the best partner ever. Can you,
3. Working phase further describe him?”
 Activities:  Broad openings
o Implementation of intervention o Giving the client a chance to open up a topic
o Longest phase he/she wants to talk about
o Preparing the patient for termination o “Where would you like to begin?”
o Highly individualized  Making observations
4. Termination phase o Boost self-esteem of patient; letting them know
that you care
 Activities:
o “I noticed you have combed your hair today.”
o Moving towards independence
 Summarizing
o Explore client’s feelings about independence
o Gives the patient time to reflect; time to validate
 Pag nagrelapse
I patient’s information is correct
IV. Therapeutic Communication
o “in the past 15 mins, we have talked about…”
 Elements
 Sender – source of message, encoder
 Making clarifications
 Message – actual information being transmitted
o Important because you have to document the
 Receiver – recipient of the message, decoder
exact same words in the patient’s chart
 Feedback – reply or response to the message being
o “Do you mean…”
sent  Reflecting
V. Non-Verbal Communication o Allows the patient to have an independent
decision
1. Proxemics
o Pt: “Do you think I need to leave my husband?”
 Physical space or distance between the sender and o N: “do you think it will be better if you leave
receiver your husband”
 Intimate – 0-1 ft
 Restating
 Personal Space – 1-4 ft
o A type of clarifying metaphoric message
 Social Space – 4-12 ft
o Pt; “I am down”
 Public space – 12 ft and above
o N: “Are you depressed?”
 3-6 ft or about an arm’s length is okay for psychiatric
 General ideas
patients
o Encourages pt to continue
2. Kinetics o “Go on..”
 Body movement, gestures, facial expression, and  Focusing
mannerism o “Let us look at it more closely”
3. Touch  Presenting reality
 Pat on the back or shoulder o Pt: “I am hearing voices”
 Be cautious o N: “I do not hear voices”, “What are the voices
 Obtain consent first telling you?”
 Assault – imminent threat  Encouraging description of perception
 Battery – touch, physical contact o P: “I am hearing voices”
o N: “What are the voices telling you?”

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VII. Non-Verbal Communication » responsible for thinking, schizophrenia

 Giving advise » mataas ang level ng dopamine
o fosters independence » ntianxiety/antipsychotic, neuroleptics
 Talking about self  Self esteem
o nag open up ka ng problem, pero mas pinapalala  Dysfunctional family relationship
ang problem. Make them feel invalidated and it  decision is always sa parents
has to be patient -centered  anorexia & bulimia suffer from low self esteem
 Telling the client is wrong  Potentials realize
o bawal sabihin na Tama or Mali ang patient; It  hopelessness
lowers the patient self esteem  Firearm, gunshot, weapon (common suicide method)
 False reassurance  common sa male, middle adult (25-65 years old)
 Asking "why" questions  atypical depression - undiagnosed
o naninisi ka at pinaparamdam mo na mali ang  Happy with self and can laugh at mistakes
patient. Except duting SUICIDAL PATIENT.  Maslow's hierarchy of needs
You need to be directive. It will make them feel  money - Safety & Security
defensive  coitus - physiological needs
PSYCHIATRY  recognition - Love & belongingness
 “Psyche” – mind/soul  alcohol - ethanol, causes euphoria (extreme happiness),
 Coined by Johann Christian Reil – 1808 CNS depressant
 Fusion between clinical care in law and order  Emotionally flexible
 No cure in psyche  Borderline - clingy, magccr need may kasama, pabida, tas
 But there are variety of treatment pag di sinamahan, magbabanta
Mental Health  Make use of splitting (all good - all bad)
 A state of mental well-being that enables people to:  Reality testing
 Cope with the stresses of life  Paranoid, delusion – SCHIZOPHRENIA
 Realize their abilities  loss of ego boundary
 Learn well and work well  Illusion, delusion, hallucination
 Contribute to their community  Alzheimer's - no contact to reality
- WHO (longterm)  Evolving self
 A state of mind characterized by:  Personally na di pwede macorrect, perfect
 Emotional well-being (feelings)  Paranoid - distrustful, suspicious
 Behavioural adjustment (reaction to stress)  Histrionic - KSP, Bida Bida
 Freedom from illness & symptoms  Antisocial - mang-aagaw, as early as childhood, gusto lagi
 Establish relationships may away, stealing, risk taking behavior, chismosa,
 Cope with the demands and stresses of life  Personality disorder
- APA: short term  Internal/ endogenous depression - Sa loob ang serotonin
Criteria of Mental Health (ATMOSPHERE) Mental Disorders
 Autonomy  a medically/clinically diagnosable illness which results in
 (autonomy vs shame & mistrust - Erik Erikson, 2nd stage) significant impairment of one's
 they try to be independent *Cognitive
 Tolerance of life complexity *Affect - feelings, blunt flat
 if unable to develop coping mechanism *Relational Ability
3 types of crisis *Lead MENTAL ILLNESS
Accidental/situational - death of husband  Disorder - short term,
Social/adventitious - war Mental Illness
 Mastery of the environment  a state of imbalance characterized by a disturbance in a
 awareness of physical surroundings person's
 IQ *behavior
 Outlook that is positive *Emotion & feelings
 Depression - laging sinisisi ang sarili *Thinking or thought process
 1-2 weeks ang normal na depression  Resulting to deficit in functioning and is unable to
 more than 2 weeks - diagnosed as major depression maintain personal relationship
 dysphoria - extreme sadness, negative view of self
 ACTH - learning, loss of memory (Alzheimer's)
o Serotonin Psychiatric Nursing
» in depression, major neurotransmitter  is an interpersonal process the professional nurse of
» Mababa ang level ng serotonin & dopamine practitioner through the therapeutic use of self
 Assist an individual, family, or group or community
o Dopamine  it is both an ART and SCIENCE

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 science because we use theoretical frameworks o Management of complication

 Jean Piaget - Cognitive theory o Active program of rehabilitation - examples:
 Erik Erikson - Psychosocial theory occupational therapy, alcoholics anonymous
 Sigmund Freud - Psychosexual theory (tertiary prevention)
 create a positive change in patients behavior TREATMENT MODALITY/THERAPY
 BF Skinner - Behavioral theory, through positive Attitude or aversion therapy
reinforcement (rewards and punishment)  Match the behavior of our patient to our own behavior
 GOAL: to maintain mental hygiene Approach Client Behavior Important points
Mental Hygiene matter of fact manipulate direct patient to his room
 A science that deals with measures to; -tatay role and bed
o Promote mental health passive paranoid maintain distance at
o Prevent mental Illness and suffering friendliness least 4 ft., (safety), avoid
o Facilitative rehabilitation touching the patient
LEVELS OF INTERVENTION Active withdrawn nurse takes initiative to
 Primary - Prevention friendliness bring patient to activity
 Secondary - Screening no "demand" assaultive restraint chemical or
 Tertiary - tertiary furious or in mechanical - pag may
Primary rage panic
kind firmness depressed offer self use
 Prevention, eliminate risk factors
mother role
 aims to promote mental health
sit with the patient
 lower the rate of cases "I will sit with you for a
 altering the stressors while" - sasamahan kita
 eg: health education, health teachings, information mamaya
dissemination, counseling (potential foreseeable crisis),
youth groups, parenting classes, education about  Can touch a diagnosed patient
substance abuse  catatonic client - can be touched, bec. May Waxy
Secondary flexibility
 screening  bipolar - during manic (No touch), during depression
 early detection and prompt treatment (can be touched)
 limit the severity of disorder  ADHD - can be touched
 diagnosis (physical exam, lab test & psych exam)  autistic - depends
 case findinggggg  Schizoid - inferiority complex
 EG. Depression  Panic is an entry point from neurosis to psychosis
o Brain biopsy - confirmatory test pero pag
patay na ang pt Behavioral Therapy
o CBC - to confirm any underlying cause  modify and change behavior
o Neurocognitive test - to determine any cognitive  it changes positive to negative, adaptive to maladaptive
deficit
o Ritalin - DOC for ADHD Crisis intervention
 check CBC, Liver function test  any event of situation that causes disequilibrium
 cylert- Liver fct test  priority is safety
o Psychological evaluation  Goal: patient returns to pre-crisis state of higher level of
o NO CONFIRMATORY TEST functioning
o CAGE assessment A. Directive
o Hamilton Anxiety scale (SAD PERSON) - assess health status - conduct vs
Tertiary - offering alternatives - failed
 Treatment B. Supportive
- emotional support - perception of problem
 Reduce disability after the disorder
- verbalization of feelings
 EPS (life threatening)
 Neuroleptic malignant syndrome Desensitization
- fatal, muscle rigidity, hyperrexia,  indication: phobia disorder, demobilizing
- withhold meds  approach: gradual exposure of client to a dreaded object
 Pseudoparkinsonism  resolution: client seen with the feared object
 Goal: overcome fear
 Congentin
 relaxation techniques like deep breathing exercises
 Substance abuse - narcotic toxicity
 Antidote: Narcan (Naloxone) Electroconvulsive therapy
 Components  no direct explanation on the effect of ECT
 a medical procedure that uses electrical currents to induce

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controlled seizures in the brain (self-care deficit)

 Used to treat » structure activities of ADL
 major depressive disorder » years of lifespan if diagnosed with having
 bipolar disorder Alzheimer's - 10 years average, 20 years maximum
 schizophrenia  Socializing agent
 catatonia - (-) residual phase, more severe sx » assists the patient to feel comfortable with others
 severe anxiety disorders » Schizoid lack interpersonal skills,
 Parkinson's disease  Counselor
Family Therapy » listens to the patient's verbalizations
 Purposes of family therapy » Parent surrogate - assists the patient in the
 Promote family function - establish roles and performance of activities of daily living
responsibilities, boundaries. Lack of boundaries causes  Dressing
enmeshment  Eating
 Improve relationships among family members - cohesion  Ambulating (walking)
(understanding of the same beliefs, values, and attitudes)  Toileting
& communication  Hygiene
 Resolve family problems  -for Alzheimer's, depression,
 ambivalence - schizophrenia  Patient advocate
 Assist family ,find ways to cope with problems » enables the patient and his relatives to know their
Group Therapy rights and responsibilities
Herbal Therapy » battered wife - physical safety
» rape - acquaintance rape; preserve body of
HERBS INDICATION
evidence
Gingko biloba Enhance memory
 Teacher
Amnesia
» assists the patient more adaptive ways of coping.
Alzheimer's
» Health teachings
Ginseng stamina and immune system
 Technician
increases libido
» facilitate performance of nursing procedures
premature ejaculation
» ECT - need consent
dyspareunia (sexual aversion disorder)
» avoid sa pregnant, cardiac problems (MI),
Gotu kola (Lola) Alzheimer's disease
congestive heart failure, fracture
65 and above presenile dementia
» complications: respiratory arrest
- familial onset
» give pre ECT meds:
- sporadic onset
» Atropine sulfate - prevent mouth secretions
most important factor for Alzheimer's -
» Brevital (Metohexital) - to sedate patient
lack of sleep
» Anectine - muscle relaxant
Kava kava Anxiety
 Therapist
St. John's Wort Depression
» explores the patient's needs, problems and
Valeria Insomnia concerns through varied therapeutic means
 keep nerves calm and sensation of  Reality base
tranquility » enables patient to distinguish objective and
 Tryptophan – given for depression, appetite subjective reality
 Narcolepsy – bigla nalang nakakatulog  Healthy role model
Characteristics of a Psychiatric Nurse » acts as a symbol of health by serving as an
 Empathy example of healthy living
» the ability to see beyond outward behavior and » Professional relationship
sense accurately another person's inner » Addiction
experiencing. Need to let them understand that
they are responsible for their own NURSING PATIENT RELATIONSHIP
 Genuineness/congruence  Hildegard Peplau
» ability to use therapeutic tools appropriately. Dapat o initiated this theory (interpersonal skills)
magmamatch ang diagnosis sa behavior o based on theory of Harry Stack Sullivan
 Unconditional positive regard o According to Sullivan, anxiety is interpersonal in
» regardless of the patient type (abuser, rapist, origin.
molester - pedophile) - respect lang  Dynamic and continuous - capable of change,
Roles of a Psychiatric Nurse in a Psychiatric Setting o orientation phase, identify goals
 Ward manager o Working phase - redefine the goals
» create a therapeutic environment,  client-centered
» mileu therapy – when u structure the environment  Goal-oriented - what needs to be prioritized
» leading cause of death Alzheimer's - pneumonia  Attain positive behavioral change

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 Acknowledge client's angry feelings

PROFESSIONAL AND NOT SOCIAL RELATIONSHIP  Referral/endorsement
 Random notes:
Pre-Interaction o Lithium therapy - check blood lithium regularly.
 Patient is excluded as an active participant o Lithium toxicity, pag dehydrated because susunod
 things that u need to do first before meeting the patient ang Na sa water
 read chart/background of the patient o *Magiging manic, risk directed to others
 Nurse is assigned to a patient - review what was done to o Low lithium efficacy, mababa lithium, mataas Na
the patient o Technician - ADMINISTRATION OF
 Nurse does self assessment MEDICATIONS
 Nurse feels certain degree of anxiety  Major task of the nurse:
 what is the major task of a nurse in pre-interaction phase? o To assist the patient to review what he has learned
Most difficult part is to accept who you are. and transfer his learning to his relationship with
 major task of the nurse: to develop self awareness others.
 Johari's Window o Understand and promote (+) self concept
1. PUBLIC - I know, u know o I learned all by myself
2. BLIND - They know, but u don't know Theoretical Foundationd of Psychiatric Nursing
3. PRIVATE/HIDDEN - Things that I know, but 1. Sigmund Freud - Psychoanalytical theory
they don't know (secret)  All human behavior is caused and can be explained
4. UNKNOWN - Things that u don't know now, but  Repression - individual should articulate feelings
might happen later - lesbian
 Expressive therapy - play therapy
 Reminiscing therapy
Orientation Phase
 psychoanalysis:
 Contract setting
o Discovering the causes of the client's unconscious
 Assess client's problem and repressed thoughts, feelings and conflicts
 Listen to non-verbal cues believed to cause anxiety and on helping the client
 Maintain a professional relationship to gain insight into and resolves these conflicts and
 Establish rapport, develop trust, assessment anxieties
 Define goals with the client  dream analysis:
 Major task of the Nurse: o discussing a client's dream discover their true
o To develop a mutually acceptable contract meaning and significance
o Include NO SUICIDE contract  free association:
o uncover the client's true thoughts and feelings by
Working (PRIDE) saying a word and asking the client to respond
 Promote positive self-concept - u know how to build ur quickly with the first thing that comes to
strengths and areas of opportunities Personality Components
 Redefine goals as appropriate  ID
 Increase client's independence o bipolar
 Develop positive coping skills o anti-social personality - con artist, pokpok,
 Encourage verbalization of feelings criminal, pasaway.
 longest phase o narcissistic personality - Siya na pinakamagaling
 Major task of the nurse:  SUPEREGO
o Identification and resolution of the patient's o Anorexia Nervosa
problems o Bulimia
 Problems affecting NPI o Major Depression - commit suicide bec they are
o Transference : the development of an emotional hearing voices
attitude of the patient either positive or negative o Obsessive compulsive personality disorder - ayaw
towards the patient sa microbe, perfect
o Counter transference - transference as  EGO
experienced by the nurse; nurse develops o Schizophrenia
emotional attachment to the client Defense Mechanism
o Resistance - development of ambivalent feelings  these are automatic and usually u conscios processes or
towards self-exploration act by the individuals to:
o Cross transference - the patient & the nurse live o Reduce or relieve anxiety or fear
happily ever after hahaha o Resolve emotional or mental conflict
Termination o Protects one's self esteem
 Feeling of impending loss - exogenous loss of depression o Protects one's sense of security
(pag iniwan ka ng jowa mo)  becomes pathologic when overused
 Evaluate progress - adequacy, efficiency, effectiveness  Used by both mentally healthy and mentally ill

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individuals LEVEL OF AWARENESS

 Denial - Failure to acknowledge an intolerable thought, 1. Conscious - perceptions, thought, emotions exist on the
feelings or reality person's awareness
 Compensation - Lacks one thing but excels on other 2. Preconscious - subconscious - thoughts and emotions are
thing not currently in the person's awareness but cab be recalled
 Conversion - emotional problems are converted to 3. Unconscious - related thoughts and feelings that motivate
physical symptoms - paraplegia (di makatayo), blindness, a person even though he is totally unaware of them most
aphonia (motor - di makasalita), deafness (di makarinig), defense mechanisms
 Displacement - the redirection of feelings to less
threatening object Nursing Intervention
 Fantasy - conscious distortion of unconscious feelings or
wishes  Administer HRT as ordered.
 Substitution - replacing desired gratification with one  Glucocorticoids (Cortisone, Hydrocortisone)
that is more available o simulate diurnal rhythm of cortisol release,
 Sublimation - channeling unacceptable drives into give 2/3 of dose in early morning and 1/3 of
acceptable activities dose in afternoon
 Projection - blaming someone else for one's difficulties  Mineralocorticoids (Fludrocortisone acetate)
or placing ones unethical desires on someone else  Monitor VS
 Introjection - blaming oneself symbolic assimilation or  Decrease stress in the environment
taking into oneself a love/hatred object.  Provide rest periods; prevent fatigue
 Internal imitation - good traits  Prevent exposure to infection
 External imitation - ginagaya ang outfits (identification)  Monitor I&O, weigh daily
 Rationalization - justification without reference.  Provide proper nutrition in small, frequent feedings of diet
Attempts to make prove that one's feelings or behaviors high in Sugar (carbohydrate), Salt (sodium) and Protein
are justifiable  Provide client teaching and D/C planning concerning:
 Intellectualization - Justification with reference. Using  Use of prescribed medications for lifelong
only logical explanations replacement therapy; never omit medications
 Repression - the involuntary forgetting of unpleasant  Need to avoid stress, trauma, and infections, and to
ideas or impulses. Nangutang pero hindi na maalala notify physician if these occur as medication
(unconscious forgetting) dosage may need to be adjusted
 Suppression - conscious forgetting  Stress management techniques
 Regression - the turning back to earlier patterns of  Diet modification
behavior in solving personal conflict  Use of salt tablets (if prescribed) or ingestion of
 Dissociation - detachment of ego, "flight of self", salty foods (potato chips) if experiencing increased
multiple personality disorder sweating
 Undoing- an attempt to erase an act, thought, feeling,  Importance of alternating regular exercise with rest
guilt or desire (tolerate ung maling gawa sayo) periods, avoidance of strenuous exercise especially
 Symbolization- a less threatening object is used to in hot weather
represent another Sigmund Freud Psychosexual Development
 Fixation - unsuccessful completion of task in the OAPhalAGe
developmental stages, walang contentment (body Age Stages Focus Developme Adult Fixation
dysmorphic disorder) group of nt
 Splitting - "all good all bad" Libido
 Reaction Formation - expression of feeling that is the 0-18 Infant Oral Mouth  overly
direct opposite of one's real feeling (plastic), sense of Feeding breastfed -
superiority
social decency (plastic)
2 types: complex
Disorders with their Defense Mechanism  Breastf (Narcissistic)
 Paranoid - Projection eeding Narcissistic
 Depression - Identification – Fixation
 Phobia - Displacement narcissi  unmet needs -
 Bipolar Disorder - Reaction Formation stic Alcoholism
 Amnesia - Repression  Bottle
feeding
 Alcoholism - Denial, Rationalization 18-3 Toddler Anal Anus Toilet  Obsessive
 OCD - Undoing Training Compulsive
 Borderline - Splitting Disorder -
 Schizophrenia - Paranoid, 2 types Rigid or
 Catatonic - Regression 1.Bowel meticulous
training - 1st toilet training
 Anorexia Nervosa – Suppression
to be trained  Anti-social
2. Bladder personality -

8
 CA1 WK8– BSN 4th YEAR 1st SEMESTER 2023

training lack of toilet

training
3-6 Prescho Phallic Genital  Oedipal
oler Penis/Ph aware complex -
allus Oedipus/Ele boy develop
ktra complex emotional
attachment to
their mother
 Elektra - girl
develop
emotional
attachment to
their father
 Gender
identification:
homosexual ,
lesbian ,
heterosexual
6-12 Schoole Latent dormant/  Socialism
r school Skills
bullying
 Moral -
disintegrative
behavior
conduct
disorder -
biglang
binuhusan ng
tubig ung
nananahimik
na tao
 Anti-social
Personality
12-18 Adolesc Genital Genital Sexual Maturity
ence sexual Coitus
expression

2. Erik Erikson - Psychosocial

3. jean Piaget - Cognitive Theory
4. Harry Stack Sullivan - Interpersonal Theory
5. Abraham Maslow - Humanistic Theory
6. Ivan Pavlov and BF Skinner: Behavioral Theory
7. Lawrence Kohlberg - Moral Theory

 Alcoholic: Dopamine - euphoria

 Withdrawal leads to depression, depression if left
untreated causes suicide
 DOC to lessen withdrawal symptoms: parlodel -
Dopamine agonist