Varcarolis Ch. 16 Quiz on Trauma Disorders

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Questions and Answers

Which symptom is associated with posttraumatic stress disorder (PTSD)?

Reexperiencing

Avoidance (correct)

Psychosis

Hyperarousal

What is the best response from the nurse regarding the spouse’s concerns about the soldier's behavior?

I encourage you to continue to participate in social activities where children are present.

Posttraumatic stress disorder often strains relationships. Here are some community resources for help and support. (correct)

Have you talked with your spouse about these reactions? Sometimes we just need to confront behavior.

Posttraumatic stress disorder often changes a person's sexual functioning.

Which assessment finding best supports dissociative fugue?

I feel like different parts of my body are at war.

I feel as if I'm living in a fuzzy dream state.

I feel very anxious and worried about my problems.

I cannot recall why I'm living in this town. (correct)

Which pathophysiology would be expected for a patient whose wounds dehisced after major reconstructive surgery?

hippocampus Signup and view all the answers

Relaxation techniques help patients who have experienced major traumas because they:

engage the parasympathetic nervous system. Signup and view all the answers

Select the correct etiology to complete the nursing diagnosis for a patient with dissociative identity disorder.

cognitive distortions associated with unresolved childhood abuse issues. Signup and view all the answers

Based on the patient's history of abuse, which disorders should the nurse suspect? (Select all that apply)

Depersonalization disorder Signup and view all the answers

What helpful measures should the nurse suggest to foster parents of a traumatized child? (Select all that apply)

Staying with the child until the anxiety decreases. Signup and view all the answers

What findings indicate a patient may have posttraumatic stress disorder? (Select all that apply)

Experiences flashbacks or reexperiences the trauma. Signup and view all the answers

Which experiences are most likely to precipitate posttraumatic stress disorder (PTSD)? (Select all that apply)

An adolescent was kidnapped and held for 2 years in the home of a sexual predator. Signup and view all the answers

Which intervention should be included in the plan of care for a patient diagnosed with posttraumatic stress disorder who has frequent flashbacks?

Explain that the physical symptoms are related to the psychological state. Signup and view all the answers

Which behavior by the parents of the teenagers who died in an automobile accident most clearly demonstrates resilience?

Create a scholarship fund at their child's high school. Signup and view all the answers

What is the most therapeutic reply a nurse can give to a man who lost his wife and says, 'I can't live without her, she was my whole life'?

Her death is a terrible loss for you. Signup and view all the answers

How should the nurse analyze a woman's statement, 'If you had given him your undivided attention, he would still be alive'?

Anger is an expected emotion in an adjustment disorder. Signup and view all the answers

What behavior indicates that a child's parents have adapted to their loss after the child drowned 2 years ago?

Throw flowers on the lake on each anniversary of the accident. Signup and view all the answers

What is the most therapeutic response from a nurse to a widow who cries spontaneously after her husband's recent death?

The unexpected death of your husband is very painful. I'm glad you are able to talk about your feelings. Signup and view all the answers

Which scenario demonstrates a dissociative fugue?

A man disappears after an affair and reappears months later with no memory of what happened. Signup and view all the answers

What is the assessment of highest priority for a patient with dissociative identity disorder?

Risk for self-harm. Signup and view all the answers

Which health problem does a patient refer to when saying, 'I feel detached and weird all the time, like I'm looking at life through a cloudy window'?

Depersonalization disorder Signup and view all the answers

What should the nurse reply to the unlicensed assistive personnel who says a patient with amnesia seems vague?

Use short, simple sentences and keep the environment calm and protective. Signup and view all the answers

What intervention is most appropriate for a patient experiencing the sensation of 'floating away' in depersonalization disorder?

Engage the patient in a physical activity such as exercise. Signup and view all the answers

Which division of the autonomic nervous system is stimulated when a person runs from a fire?

Sympathetic nervous system Signup and view all the answers

What assessment finding would be expected with the dysregulation of cortisol after a traumatic event?

Flashbacks Signup and view all the answers

What should the nurse immediately screen for in a soldier diagnosed with PTSD?

Depression Signup and view all the answers

Which comment by a soldier diagnosed with PTSD requires immediate attention?

I saw my best friend get killed by a roadside bomb. I don't understand why it wasn't me. Signup and view all the answers

What type of experience has a soldier described when saying, 'If there's a loud noise at night, I get under my bed because I think we're getting bombed'?

Flashback Signup and view all the answers

Which social event would be most disturbing for a soldier diagnosed with PTSD?

Fireworks display on July 4th Signup and view all the answers

When is it most important for the nurse to screen for signs of PTSD in a soldier?

Screening should be on-going Signup and view all the answers

What phenomenon is a soldier describing when stating, 'I saw a child get blown up over a year ago, and I still keep seeing bits of flesh everywhere'?

Reexperiencing Signup and view all the answers

What issue does a soldier's spouse raise about changing family plans after his return from combat?

The soldier won't talk about starting a family or even look at children. Signup and view all the answers

Study Notes

Posttraumatic Stress Disorder (PTSD)

Treatment involves explaining physical symptoms as responses to psychological trauma, fostering understanding and hope.
Common symptoms include flashbacks, persistent arousal, and somatic complaints.
Survivors may experience survivor's guilt and suicidal ideation, needing immediate attention and assessment.
Comorbidities include depression and anxiety disorders, making screening ongoing and critical.

Resilience and Grieving

Resilience is characterized by positive adaptation despite adversity, like creating memorials to honor lost loved ones.
Parents dealing with the loss of a child demonstrate resilience by expressing their feelings openly rather than isolating.
Validation of loss through compassionate communication is essential for those in grief.

Adjustment Disorders and Anger

Anger is a natural response in adjustment disorders; it signifies expected emotional experiences during bereavement.
Supportive responses from healthcare professionals can aid in acceptance and processing of loss.

Dissociative Disorders

Dissociative fugue involves loss of identity and memory about personal history, often triggered by trauma.
Patients may experience feelings of detachment or disconnection from reality, which can severely impact daily functioning.
Grounding techniques, such as physical activity, can help interrupt dissociative episodes.

Autonomic Nervous System

The sympathetic nervous system is activated during stressful events (fight or flight response).
Responses to traumatic stimuli, such as loud noises, may provoke exaggerated reactions in individuals with PTSD.

Flashbacks and Reexperiencing

Flashbacks are common in PTSD, where individuals relive traumatic events, often triggered by environmental cues.
Reexperiencing memories can manifest as intrusive thoughts and vivid memories, disrupting daily life.

Avoidance Symptoms

Individuals with PTSD may avoid reminders of trauma, leading to relational strain and emotional distance from loved ones.
Expressing behavioral changes to supportive staff helps facilitate coping and understanding demeanor shifts post-trauma.

Assessment and Prioritization

Risk for self-harm is the highest priority in patients with dissociative identity disorder.
Short, simple communication and a calm environment are essential in supporting individuals with memory impairments.

Community resources are vital for helping both veterans and their families navigate the complexities introduced by PTSD.
Long-term screening and supportive conversations are crucial in the adjustment period post-deployment.### Dissociative Disorders
Fugue state involves relocation and assuming a new identity, with no recall of previous identity or places.
Common distracters include depersonalization disorder, generalized anxiety disorder, and dissociative identity disorder.

Pathophysiology of Chronic Stress

Chronic stress after surgery can lead to extensive wound care needs, impacting social life and work.
Ongoing stress may cause neuronal changes in the prefrontal cortex and reduce hippocampal size, impairing memory function.

Relaxation Techniques and Trauma

Relaxation techniques engage the parasympathetic nervous system, helping to mitigate trauma effects.
They counteract sympathetic nervous system's "fight or flight" response, promoting heart rate and respiration normalization.

Nursing Diagnosis for Dissociative Identity Disorder

Disturbed personal identity in dissociative identity disorder is often linked to cognitive distortions from unresolved childhood abuse.
Many individuals with this disorder have a history of trauma or abuse.

Symptoms of Trauma in Adolescents

Indicators of trauma in children include feeling numb, experiencing dissociative episodes, and avoiding relationships.
Commonly suspected disorders include acute stress disorder, depersonalization disorder, and posttraumatic stress disorder (PTSD).

Support for Foster Parents

Empathy and acknowledgment of the child’s distress are crucial in treatment for PTSD.
Using a calm demeanor, reinforcing reality, and remaining with the child can help reduce anxiety and provide stability.

PTSD Assessment Findings

Key symptoms of PTSD include avoidance of reminders, flashbacks, hypervigilance, and feelings of detachment or emptiness.
Engagement in ritualistic behaviors is more characteristic of obsessive-compulsive disorder, not PTSD.

Precipitating Experiences for PTSD

Traumatic events likely to lead to PTSD include long-term captivity, serious accidents, or being trapped in dangerous situations.
Experiences should involve a sense of extreme helplessness or powerlessness to qualify as PTSD triggers.

Non-Traumatic Experiences

Activities like bungee jumping or watching R-rated movies with parents are unlikely to precipitate PTSD due to their inherent dynamics of safety or thrill seeking.

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Description

This quiz focuses on Chapter 16 of Varcarolis, covering trauma, stressor-related, and dissociative disorders. It includes flashcards that test your knowledge of nursing interventions and patient care strategies. Enhance your understanding of PTSD and related symptoms through this engaging quiz.