Mental Health and Nursing Diagnosis Overview

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Questions and Answers

Which of the following is a physical need for individuals requiring long-term care?

  • Emotional support
  • Reassurance
  • Shelter (correct)
  • Connection with community resources

Emotional needs do not include reassurance.

False (B)

Name one sign of crisis.

Increased agitation

The last resort for managing violent behavior is the use of __________.

<p>restraint</p> Signup and view all the answers

What is the purpose of verbal de-escalation techniques?

<p>To promote a resolution (B)</p> Signup and view all the answers

Match the phases of the Cycle of Violence with their descriptions:

<p>Tension Building Phase = Stress and conflict escalate. Acute Battering Phase = Physical violence occurs. Honeymoon Phase = Perpetrator apologizes and promises change.</p> Signup and view all the answers

Older adults have a lower risk of depression compared to younger adults.

<p>False (B)</p> Signup and view all the answers

What should a nurse do if they suspect abuse?

<p>Report it to the appropriate authorities.</p> Signup and view all the answers

What scale is recommended for assessing pain in older adults?

<p>PAINAD Scale (B)</p> Signup and view all the answers

Older adults are likely to report pain accurately without any concerns.

<p>False (B)</p> Signup and view all the answers

Name one herbal remedy that is commonly used for mild depression.

<p>St. John's Wort</p> Signup and view all the answers

Complementary and Alternative Medicine (CAM) includes __________, chiropractic, herbal medicine, and mind-body techniques.

<p>acupuncture</p> Signup and view all the answers

Match the herbal product with its intended use:

<p>St. John's Wort = Mild depression Valerian root = Anxiety Ginseng = Energy Kava = Sleep aid</p> Signup and view all the answers

Which of the following is a primary focus of Western Medicine?

<p>Pharmacology (C)</p> Signup and view all the answers

Non-adherence to treatment is uncommon in serious mental illness.

<p>False (B)</p> Signup and view all the answers

What is the aim of massage therapy?

<p>To relieve muscle tension and improve circulation.</p> Signup and view all the answers

Which of the following is NOT a psychological factor that can disrupt sleep hygiene?

<p>Temperature fluctuations (B)</p> Signup and view all the answers

Gender dysphoria only affects individuals who are transgender.

<p>False (B)</p> Signup and view all the answers

What is dysthymia?

<p>A chronic, low-grade form of depression lasting at least 2 years (D)</p> Signup and view all the answers

Anhedonia refers to the increase in pleasure one experiences from enjoyable activities.

<p>False (B)</p> Signup and view all the answers

Name one medical condition that can disturb normal sleep hygiene.

<p>Insomnia</p> Signup and view all the answers

LGBTQ+ individuals may face significant __________ that affects their mental health and self-esteem.

<p>stigma</p> Signup and view all the answers

What type of therapy involves electrical stimulation of the brain while the patient is under general anesthesia?

<p>ECT (Electroconvulsive Therapy)</p> Signup and view all the answers

Match the psychological challenges faced by transgender individuals with their descriptions:

<p>Depression = Mood disorder often caused by discrimination Anxiety = Mental health condition characterized by excessive worry Social Isolation = Feeling disconnected from community or support Trauma-related disorders = Mental health conditions stemming from past trauma</p> Signup and view all the answers

Patients experiencing __________ anxiety may need medications and a quiet, safe environment.

<p>severe</p> Signup and view all the answers

Which of the following practice is recommended for gathering a history from LGBTQ+ individuals?

<p>Use open-ended questions (C)</p> Signup and view all the answers

Match the following anxiety levels with their appropriate nursing interventions:

<p>Mild Anxiety = Encourage problem-solving techniques Moderate Anxiety = Use grounding techniques and reassurance Severe Anxiety = Provide a quiet, safe environment Panic Anxiety = Stay with the patient and offer clear instructions</p> Signup and view all the answers

Creating a safe environment for LGBTQ+ individuals includes ensuring privacy and a nonjudgmental attitude.

<p>True (A)</p> Signup and view all the answers

Which of the following is a common side effect of Transcranial Magnetic Stimulation (TMS)?

<p>Headache (D)</p> Signup and view all the answers

What is one approach to reduce stigma in healthcare organizations?

<p>Providing training to healthcare providers about LGBTQ+ issues.</p> Signup and view all the answers

Agoraphobia is an intense and irrational fear of open spaces.

<p>True (A)</p> Signup and view all the answers

Which theory focuses on the individual's ability to meet their own care needs?

<p>Orem's Self-Care Deficit Theory (B)</p> Signup and view all the answers

Benzodiazepines are long-term medications for managing severe anxiety and do not have any risk of dependence.

<p>False (B)</p> Signup and view all the answers

List one example of a vegetative sign associated with depression.

<p>Changes in appetite</p> Signup and view all the answers

What is the primary action of antipsychotic medications like Haloperidol?

<p>They block dopamine receptors in the brain.</p> Signup and view all the answers

Cholinesterase inhibitors, such as ______, aim to increase acetylcholine levels in the brain.

<p>Donepezil</p> Signup and view all the answers

What is a common side effect associated with antipsychotic medications?

<p>Sedation (A)</p> Signup and view all the answers

Match the following psychiatric medications with their primary use:

<p>Benzodiazepines = Immediate relief of severe anxiety or agitation Antipsychotics = Manage acute psychotic episodes or severe agitation Antidepressants = Long-term treatment of depression Cholinesterase inhibitors = Improve memory and cognitive function in Alzheimer's</p> Signup and view all the answers

SSRIs are typically used for the immediate treatment of acute anxiety.

<p>False (B)</p> Signup and view all the answers

Name one class of medication used in treating Alzheimer's Disease.

<p>Cholinesterase inhibitors</p> Signup and view all the answers

Which of the following is NOT a side effect of NMDA receptor antagonists like Memantine?

<p>Hair loss (B)</p> Signup and view all the answers

Lithium is safe to use without monitoring blood levels.

<p>False (B)</p> Signup and view all the answers

What is the therapeutic range for lithium?

<p>0.6--1.2 mEq/L</p> Signup and view all the answers

The early symptoms of lithium toxicity (1.5--2.0 mEq/L) include nausea, vomiting, and ______.

<p>diarrhea</p> Signup and view all the answers

Match the medications with their usage:

<p>Valproate = Treats mixed episodes in bipolar disorder Lamotrigine = Maintenance therapy for depressive episodes Olanzapine = Mood stabilization in bipolar disorder Quetiapine = Atypical antipsychotic for mood stabilization</p> Signup and view all the answers

What is a serious side effect of lithium that requires immediate medical intervention?

<p>Seizures (A)</p> Signup and view all the answers

Elevated blood pressure is a common side effect of lithium.

<p>False (B)</p> Signup and view all the answers

What types of medications are often used as alternatives to lithium?

<p>Anticonvulsants and atypical antipsychotics</p> Signup and view all the answers

Flashcards

Peplau's Interpersonal Relations Theory

A nursing theory that emphasizes the importance of interpersonal relationships in mental health and guides nurses in building therapeutic relationships.

Orem's Self-Care Deficit Theory

This theory focuses on the individual's ability to meet their own self-care needs. It emphasizes that individuals need to be self-sufficient in caring for their own needs.

Roy's Adaptation Model

This theory focuses on how individuals adapt to stressors in their environment. It addresses the process of adapting to challenges and maintaining well-being.

Psychopharmacology

The study of medications used to treat mental health disorders. It covers how these medications work, their side effects, and the nursing care involved.

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Benzodiazepines

A class of medications often used in psychiatric emergencies for immediate relief of anxiety and agitation. They work by calming the brain.

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Antipsychotics

Medications used to manage acute psychotic episodes or severe agitation. They help to stabilize mood and thought processes.

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Cholinesterase inhibitors

These medications increase acetylcholine levels in the brain, which can improve memory and cognitive function in patients with Alzheimer's Disease.

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Antidepressants (SSRIs)

A class of antidepressants often used in emergency situations if depression is a factor. They increase serotonin levels in the brain, which can alleviate depressive symptoms.

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Dysthymia

A chronic, low-grade form of depression that lasts for at least 2 years in adults or 1 year in children. It often presents with symptoms of hopelessness and low self-esteem.

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Anhedonia

Loss of interest or pleasure in activities that were once enjoyable.

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Anergia

Lack of energy, often leading to fatigue and difficulty performing daily activities.

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Vegetative Signs

Physical symptoms associated with depression, including changes in appetite, sleep disturbances, and decreased libido.

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Electroconvulsive Therapy (ECT)

A treatment for severe depression involving electrical stimulation of the brain while the patient is under general anesthesia.

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Transcranial Magnetic Stimulation (TMS)

A non-invasive procedure using magnetic fields to stimulate nerve cells in the brain. Used for depression that doesn't respond to medication.

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Mild Anxiety

Anxiety experienced in everyday situations. Intervention: Encourage problem-solving or relaxation techniques.

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Moderate Anxiety

Anxiety that disrupts thinking clearly. Intervention: Use grounding techniques, provide reassurance, and reduce stressors.

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NMDA receptor antagonists

A group of medications that block the NMDA receptor. This receptor is involved in learning and memory, and these medications can help regulate the activity of glutamate, a neurotransmitter involved in these processes.

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Lithium

A medication commonly used to treat bipolar disorder, particularly during manic episodes. It has a narrow therapeutic range, meaning that the difference between a therapeutic dose and a toxic dose is small.

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Therapeutic Range for Lithium

The range of lithium blood levels that is effective in treating bipolar disorder without causing significant side effects. It typically ranges from 0.6 to 1.2 mEq/L.

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Signs of Lithium Toxicity

Signs of lithium toxicity can range from mild symptoms like nausea and tremors to severe symptoms like seizures and coma. It is crucial to monitor lithium levels closely and seek immediate medical attention if toxicity is suspected.

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Medication Alternatives for Lithium

Anticonvulsants (e.g., valproate, lamotrigine) and atypical antipsychotics (e.g., olanzapine, quetiapine, aripiprazole) are alternative medications used to treat bipolar disorder when lithium is not tolerated or ineffective.

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Long-Acting Antipsychotic Medications

These are specialized antipsychotic medications administered through injections that provide a consistent therapeutic level for an extended period (usually 2-4 weeks). This less frequent administration can improve medication adherence.

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Lamotrigine (Lamictal)

A medication that can be used to prevent the onset of manic episodes and, in some cases, depressive episodes in bipolar disorder.

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Lithium Toxicity

A common side effect of lithium that can be managed by ensuring adequate hydration and monitoring sodium levels.

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What are Environmental Factors that affect Sleep?

Any factors that make it hard to fall asleep or stay asleep. These include noise, light, uncomfortable bedding, temperature changes, and more.

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What are Psychological Factors affecting Sleep?

Mental health conditions like anxiety, stress, depression, and mood disorders can disrupt sleep patterns.

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What are Poor Sleep Habits?

Bad sleep habits can interfere with sleep quality. This includes irregular sleep schedules, excessive naps during the day, stimulating activities before bed (like screen time), and consuming caffeine or alcohol late in the day.

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What are Medical Conditions affecting Sleep?

Conditions that directly impact sleep, such as insomnia, obstructive sleep apnea, restless leg syndrome, and more.

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What is Gender Dysphoria?

The distress a person feels when their gender identity doesn't match the sex they were assigned at birth.

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What are the Mental Health Needs of Transgender individuals?

Mental health challenges faced by transgender individuals, including depression, anxiety, social isolation, and trauma-related disorders. These can be caused by discrimination, lack of acceptance, and overall societal stigma.

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What is Transgender-Specific Care?

Care specifically for transgender individuals, focusing on affirming their gender identity through hormone therapy, surgeries, supporting their self-expression, and reducing social and healthcare stigma.

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What is Stigma and how does it affect LGBTQ+ individuals?

Prejudice and negative attitudes towards LGBTQ+ individuals, especially affecting their self-esteem, mental health, and ability to seek care.

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Verbal De-escalation

A process that involves using calm communication to acknowledge feelings and help an individual find a solution, especially in a situation where they are experiencing anger or aggression.

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Crisis

A state of heightened emotional and physical arousal often accompanied by behaviors like increased agitation, restlessness, yelling, clenching fists, glaring, pacing, or hostile body language.

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Cycle of Violence

A pattern of behavior in abusive relationships that includes a period of tension building, followed by an act of violence, and a period of reconciliation or honeymoon.

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Mandated Reporter

The legal responsibility of certain professionals, including nurses, to report suspected abuse of children or vulnerable adults to appropriate authorities.

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Trauma-Informed Care

An approach to care that recognizes the impact of trauma on an individual's health and behavior.

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Restraint

Physical restraints are used as a last resort to prevent harm when there is a risk of danger to the patient, staff, or others.

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Risk Factors for Abuse

Factors that are linked to an increased likelihood of experiencing abuse. In child abuse, these factors may include parental substance abuse, mental illness, history of being abused, poverty, and social isolation.

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Depression in Older Adults

A common mental health concern among older adults, often linked to factors like chronic illness, loss of loved ones, social isolation, and significant life changes.

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Pain Underreporting in Older Adults

Older adults may underreport pain due to fear of becoming a burden or cognitive decline.

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PAINAD Scale

A specialized pain scale designed for older adults who may have difficulty expressing their pain verbally.

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Stigma in Older Adults

Negative stereotypes or attitudes towards older adults, often related to their mental health and seeking help.

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Therapeutic Communication with Older Adults

Using active listening, respect, and empathy when communicating with older adults.

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Non-adherence in Mental Illness

The act of not following prescribed medication or treatment plans.

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Psychosocial Support for Mental Illness

Support that addresses the emotional, social, and practical needs of individuals with mental health challenges.

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Complementary and Alternative Medicine (CAM)

Practices that complement or replace conventional Western medical treatments, including acupuncture, herbal remedies, chiropractic care, and mind-body techniques.

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Acupuncture

A CAM technique involving inserting fine needles to stimulate energy flow and promote healing.

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Study Notes

Chapter 1: Mental Health and Mental Illness (DSM-5)

  • The DSM-5 is a comprehensive classification system for mental health disorders
  • It standardizes definitions and diagnostic criteria
  • It's crucial for professionals to diagnose and categorize mental health conditions based on observable symptoms, etiology, and outcomes
  • The DSM-5 guides treatment planning and prognosis

Nursing Diagnoses

  • Psychiatric-mental health nursing diagnoses focus on holistic patient care, addressing physiological and psychological aspects
  • These diagnoses guide nursing interventions and improve outcomes
  • Examples in psychiatric settings include Ineffective Coping, Risk for Self-Harm, Disturbed Thought Processes, and Anxiety

Chapter 2: Theories and Therapies (Cognitive Behavioral Therapy)

  • CBT is a structured, time-limited psychotherapy focused on changing unhelpful cognitive patterns
  • It aims to manage emotional distress and maladaptive behaviors
  • It's an effective therapy for various mental health conditions, including anxiety, depression, and PTSD

Chapter 3: Psychopharmacology

  • Psychopharmacology studies medications used to treat mental health disorders
  • It examines the role of medications in managing symptoms, side effects, risks, and nursing responsibilities
  • Medications in psychiatric emergencies are used to stabilize patients quickly, such as benzodiazepines (e.g., Lorazepam, Diazepam)

Chapter 4: Treatment Settings (Environmental Safety)

  • Psychiatric inpatient units prioritize safety to protect patients and staff
  • Features like locked units, restricted items, continuous observation, and seclusion/restraint are used when necessary

Chapter 5: Cultural Implications (Barriers to Care)

  • Cultural barriers to mental health care include language differences, stigma surrounding mental illness, and a lack of culturally competent providers
  • Structural barriers include limited access to services, especially in rural areas, long wait times, and inadequate insurance coverage
  • Economic barriers include the high cost of mental health services and medications
  • Patient rights include confidentiality, the right to treatment, refusal of treatment (except in involuntary commitment), and informed consent
  • Involuntary admission criteria vary by state but typically include danger to self or others, and/or inability to meet basic needs

Chapter 7: The Nursing Process and Standards of Care

  • Nursing diagnoses focus on the patient's response to their mental health condition (e.g., "Ineffective Coping," "Risk for Self-Harm")
  • DSM-5 diagnoses focus on the medical classification (e.g., Major Depressive Disorder)

Chapter 8: Therapeutic Relationships

  • Therapeutic relationships in psychiatric nursing develop in structured phases that facilitate patient trust and healing
  • The phases include orientation, working, and termination
  • Therapeutic responses involve active listening, reflection, restating, open-ended questions, and validation

Chapter 9: Therapeutic Communication

  • Therapeutic communication is essential to build trust and promote healing
  • Techniques include silence, focusing, clarifying, offering information, and summarizing

Chapter 10: Stress Responses and Stress Management

  • Stress manifests in physiological, emotional, and behavioral symptoms
  • Coping mechanisms include problem-focused and emotion-focused coping, and avoidance coping
  • The Life Changes Questionnaire assesses the impact of life events on stress levels

Chapter 11: Childhood and Neurodevelopmental Disorders

  • Temperament refers to inherent personality traits influencing how children respond to their environment
  • Types include easy, difficult, and slow-to-warm-up
  • Therapeutic approaches based on developmental level are crucial for children and adolescents

Chapter 12: Schizophrenia Spectrum Disorders

  • Positive symptoms include hallucinations, delusions, disorganized thinking
  • Negative symptoms include affective flattening, avolition, anhedonia, and social withdrawal
  • Key components of the Mental Status Exam (MSE) include appearance, behavior, speech, mood and affect, thought process, cognition, and insight

Chapter 13: Bipolar Disorder

  • Manic episodes are characterized by abnormally elevated or irritable mood, increased energy, euphoria, grandiosity, and pressured speech

Chapter 14: Depressive Disorders

  • Depression is common in older adults, impacting chronic illness, loss of loved ones, social isolation, and life changes
  • Suicide risk increases due to these factors
  • Assessment includes pain, suicidal ideation, risk factors, and protective factors

Chapter 15: Anxiety and Obsessive-Compulsive Disorder

  • Anxiety levels range from mild to panic
  • Interventions vary depending on the severity of anxiety
  • Treatment for OCD includes cognitive-behavioral therapy with exposure and response prevention, and medication such as SSRIs
  • The ACES Study links early childhood trauma to higher risks of mental health disorders, substance abuse, and physical health issues
  • PTSD is a disorder that results from traumatic events with flashbacks, nightmares, hypervigilance, and avoidance behaviours

Chapter 17: Somatic Symptom Disorders

  • Somatic symptom disorder involves an excessive focus on physical symptoms with no medical explanation
  • Illness anxiety disorder is marked by excessive preoccupation with illness, despite lack of symptoms and conversion disorders involve neurological symptoms without a medical cause

Chapter 18: Eating and Feeding Disorders

  • Anorexia Nervosa is characterized by severe restriction of food intake, fear of gaining weight
  • Bulimia Nervosa involves episodes of binge eating followed by compensatory behaviors like purging

Chapter 19: Sleep-Wake Disorders

  • Normal sleep cycles include 4 stages of NREM and REM sleep
  • Factors affecting sleep hygiene include environmental factors, and psychological and medical conditions

Chapter 20: Sexual Dysfunction, Gender Dysphoria, and Paraphilic Disorders

  • Gender dysphoria involves distress caused by a mismatch between gender identity and assigned sex
  • Mental health needs for LGBTQ+ populations, especially transgender individuals, often include depression, anxiety, social isolation, and trauma

Chapter 21: Impulse Control Disorders

  • Impulse control disorders are characterized by impulsive behaviors, like intermittent explosive disorder, kleptomania, pyromania, and trichotillomania
  • Cognitive behavioral therapy (CBT) is often used to treat these disorders
  • Delirium tremens (DTs) is a severe alcohol withdrawal syndrome with confusion, agitation, hallucinations, seizures, and autonomic instability
  • Substance use can lead to various medical problems like liver disease and respiratory diseases
  • Interventions like providing a safe and calm environment, and administering benzodiazepines are necessary

Chapter 23: Neurocognitive Disorders

  • Risk factors for overdose include polypharmacy, tolerance, and mental health disorders
  • Signs of intoxication and withdrawal vary depending on the substance

Chapter 24: Personality Disorders

  • Cluster A personality disorders include paranoid, schizoid, and schizotypal personality disorders
  • Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality disorders
  • Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality disorders

Chapter 25: Suicide and Non-Suicidal Self-Injury

  • Assessment of risk factors for suicide includes mental health disorders, history of previous attempts, substance abuse, and chronic illness
  • Warning signs for suicide include verbal and behavioral cues

Chapter 26: Crisis and Disaster Interventions

  • Psychological first aid is provided to reduce distress and emotional responses

Chapter 27: Anger and Aggression

  • Assessment for potential danger to patients, staff, and others is essential, and includes evaluating for physical aggression and verbal threats
  • De-escalation techniques are crucial to acknowledge feelings and to promote resolution
  • Sensory approaches may also aid with de-escalation techniques

Chapter 28: Child and Intimate Partner Abuse

  • Risk factors for abuse include child abuse (parental substance abuse, mental illness, poverty), and intimate partner abuse (prior abuse, substance abuse, financial dependence)

Chapter 31: Older Adults

  • Risk of depression increases in older adults due to chronic illness, loss of loved ones, social isolation, and life changes
  • Pain assessment and management are crucial, and older adults often underreport pain
  • Stigma surrounding mental health can hinder help-seeking behaviours

Chapter 32: Serious Mental Illness (Non-Adherence)

  • Non-adherence is common in serious mental illness and includes a collaborative approach to treatment
  • Include family members, and address concerns regarding medications

Chapter 36: Integrative Care

  • Integrative care refers to complementary and alternative medicine (CAM) practices, including acupuncture, chiropractic care, massage therapy, and mindfulness practices

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