Mental Health Disorders PDF

Cluster A personality disorders identify with ODD, BIZARRE, and ECCENTRIC BEHAVIORS. MANIPULATIVE and a DISREGARD for social norms is consistent with antisocial personality disorders. SUBMISSIVE and CLINGING behavior and FEAR OF SEPERATION is consistent with Cluster C: dependent disorder. A clien...

Cluster A personality disorders identify with ODD, BIZARRE, and ECCENTRIC BEHAVIORS. MANIPULATIVE and a DISREGARD for social norms is consistent with antisocial personality disorders. SUBMISSIVE and CLINGING behavior and FEAR OF SEPERATION is consistent with Cluster C: dependent disorder. A client DISPLAYING SELF-INJURY and VIOLENCE would be a priority action for a nurse caring for a client with a personality disorder. When a nurse is caring for a patient with a personality disorder, it would be most appropriate for the nurse to EXPLAIN THAT THERE IS NO MEDICATION THAT CAN CURE THE DISORDER. The client who verbalizes UNDERSTANDING OF TREATMENT SETTING RULES and REGULATIONS and the CONSEQUENCES FOR VIOLATION is an eUective evaluation of a short-term goal for a client with personality disorder. The nurse is to maintain a culture of safety. A client who reports any form of harm or violence to self or other is a SAFETY PRIORITY and needs immediate follow-up. The nurse knows that with a paranoid personality, a client is very suspicious and takes everything as a threat. The nurse will need to APPEAR NON-THREATENING WHEN SPEAKING TO THE CLIENT. The nurse knows that a client with the OCD has a need to control their environment and keep their items in a neat stack or organized way.  HAVING BELONGINGS STRUNG ABOUT HAPHAZARDLY is a sign of distress and needs follow-up. Part of the plan of care for a client with antisocial personality disorder is to help them gradually VERBALIZE HOSTILE FEELINGS SO THAT THEY CAN LEARN HOW TO HANDLE THEIR ISSUES in a productive way. THE CLIENT REQUESTING A SECOND TRAY LESS THAN AN HOUR AFTER EATING would be a concern for the nurse caring for a client with bulimia. A NORMAL WEIGHT is a characteristic of a client diagnosed with bulimia. When a nurse develops a plan of care for a client with bulimia, it would be appropriate for them to INVOLVE THE CLIENT TO HELP SET THE GOALS. Clients with bulimia need to be educated on ADDITOTIONAL WAYS TO MANAGE THEIR LIFE CONTROL aside from food intake. It takes up to 2 MONTHS FOR FLUOXETINE(PROZAC) to have maximal response. Clients with anorexia nervosa have an EXTREME FEAR OF BECOMING OBESE. A client with anorexia nervosa who would require immediate follow-up by the nurse would be AN IRREGULAR HEART RATE. A short-term goal for a client with anorexia would include SETTING AN OBTAINABLE WEIGHT GAIN GOAL. SSRIs are used to treat symptoms of anorexia. A nurse needs to educate the client and report any SUICIDAL IDEATIONS immediately. Clients with anorexia have a BMI OF 17 or less. RUSSELL’S SIGN is indicative of self-induced vomiting with scars being found on the hands. People with binge eating disorder frequently report FEELINGS OF GUILT. The interprofessional team is important in providing care to clients with eating disorders. The DIETICIAN is trained to help with the physiological needs of the client and would be a priority. It is important for SOMEONE TO ACCOMPANY A CLIENT WITH AN EATING DISORDER to the bathroom AFTER they eat to know if the client is vomiting. Disruptive mood dysregulation disorder (DMDD) is characteristic of having outbursts in MORE than ONE location. It may not be a true diagnosis if the symptoms are ONLY OCCURRING AT ONE LOCATION. When preparing to teach the client's family with a child with Disruptive mood dysregulation disorder, the nurse needs to know the CLIENT’S LEVEL OF DEVELOPMENT to prepare appropriate teaching material. When a nurse is caring for a 3-year-old client with autism, it's appropriate for the nurse to INVOLVE THE PARENT IN THE ASSESSMENT, as children this age are not comfortable speaking to the nurse without a parent in the room. CONSISTENCY is a priority for managing care at home with a child that has autism spectrum disorder. child's routine and special toys should not be changed. child with autism spectrum disorder has the characteristics of INABILITY TO MAINTAIN EYE CONTAACT, REPETITIVE ACTIONS, AND VERY STRICT ROUTINES. A nurse should question the use of ELECTROCONVULSIVE THERAPY with a child who has autism spectrum disorder. When a nurse is caring for a client with ADD, the symptom of DIFFICULTY CONCENTRATING would indicate a need for a prn medication. The nurse knows adolescents with ADHD will try risky behavior and is looking for signs that the client understands the risks. When the client states "I KNOW HOW IMPORTANT IT IS TO NOT TEXT AND DRIVE” the nurse knows their teaching was eUective. The nurse should understand one goal for children with ADHD is to learn to be less intrusive and more mature. RECOGNIZING PERSONAL SPACE is an important step for a child with ADHD. The nurse recognizes that a client with Oppositional Defiant disorder (ODD) and POSES A THREAT TO THEMSELVES OR OTHERS needs additional follow-up. Splitting and manipulative behaviors are characteristic of personality disorders; it is important to SET THERAPUTIC BOUNDARIES OR LIMITS WITH THE CLIENT. Narcissistic personality disorder is a part of Cluster B and is characterized by ARROGANCE, GRANDIOSE VIEWS of self-importance, the need for consistent admiration, and a lack of empathy for others that strains most relationships, often sensitive to criticism. A client diagnosed with Conduct Disorder who is verbally abusing or arguing with a mental health technician in the milieu creates RISK FOR INJURY TO OTHERS. The nurse should remain with clients diagnosed with either Anorexia Nervosa or Bulimia Nervosa for AT LEAST 1 HOUR AFTER MEALS as the client may use this time to discard food that has been stashed from the food tray or to engage in self-induced vomiting. An adolescent female who has an eating disorder has a distorted body image. A client who has anorexia nervosa sees themselves as overweight and often have fear of gaining weight. These clients will have ALTERED HORMONES and a VERY LOW BMI. When completing an intake, the nurse MUST address the client's psychosocial and family environment and the specific needs for the client. Adolescents are prone to impulsive and occasionally dangerous behavior and this needs to be addressed. These clients are NOT AT A DIAGNOSABLE AGE FOR PERSONALITY DISORDER per the DSM, however they may exhibit signs that will help the healthcare team determine if they may be diagnosed in the future. Individuals diagnosed with HISTRIONIC PERSONALITY DISORDER tend to be self- dramatizing, attention seeking, overly gregarious, and seductive. They often use manipulation and exhibitionism as a means of gaining attention. When a client LOSES TOTAL CONTROL then it becomes a safety concern for all involved and the nurse knows to intervene. The nurse knows that a client with a paranoid personality is on constant guard ready for any real or perceived threat, they may be tense and irritable and extremely over sensitive. They learn to defend themselves by attacking first. The MOST appropriate nursing intervention when caring for a client with Paranoid Personality Disorder is to USE A CLEAR, CALM STATEMENTS AND TO ASSUME A CONFIDENT PHYSICAL STANCE. A calm attitude provides the client with a feeling of safety and security and avoids escalating the aggressive behavior. The BEST nursing approach when working with a client diagnosed with borderline personality disorder is to BE FIRM, CONSISTENT, and EMPATHETIC while addressing specific client behaviors. Antisocial Personality Disorder is characterized by: deceitful, manipulative, rage toward others often involving other harm, entitled behaviors and an inability to take responsibility for their own actions. LONG-TERM GOALS for this individual would include accepting ACCOUNTABILITY for not breaking rules and laws. The nurse should educate the family on the importance of family dynamics, involvement, and SUPPORT OF THE TREATMENT of anorexia nervosa. Families engaging in conflict avoidance and struggling with issues of power and control may CONTRIBUTE to the DEVELOPMENT of this disorder or IMPEDE the progress of recovery. When caring for a client with anorexia nervosa, ENCOURAGE THE CLIENT TO VERBALIZE FEELINGS regarding his or her role within the family and issues related to dependence/independence. Behavior modification therapy is used to treat a client with anorexia nervosa because it provides the client with CONTROL OVER BEHAVIORAL CHOICES. Implementing 1:1 OBSERVATION DURING and AFTER mealtimes for the client who has anorexia nervosa with binge-eating behavior is an action the nurse should include in the client's plan of care. A systolic blood pressure (BP) of 62 mm Hg would meet the criteria for hospitalization for a client diagnosed with an eating disorder. Children with depression may show signs of DOING POORLY IN SCHOOL. Stimulant medications are the FIRST LINE TREATMENT for ATTENTION DEFICIT DISORDER (ADD) and can be used for all symptoms of the disorder, not just inattentiveness. Children diagnosed with ADHD have limited attention span and shift from one uncompleted activity to another DIVIDING HOMEWORK TASKS INTO SMALLER STEPS HELPS ACHIEVE COMPLETION. The pharmacological action of Ritalin causes a DECREASE IN APPETITE that can often lead to WEIGHT LOSS. Ritalin is a central nervous symptom stimulant that serves to increase attention span, control hyperactive behaviors, and improve learning ability for clients diagnosed with ADHD. Childhood-onset conduct disorder is MORE SEVERE than adolescent-onset type. These individuals are LIKELY TO DEVELOP antisocial personality disorder in adulthood. A BEHAVIOR CONTRACT is appropriate to identify the expected behavior and consequences of a client who has conduct disorder. What a client tells a nurse about their fs is PRIVATE WHILE CONDUCTING AN ASSESSMENT INTERVIEW; however, some things like SUICIDAL THINKING MUST be reported to the treatment team. ELECTROCONVULSIVE THERAPY is indicated for those who have NOT responded to meds or therapy. Up to 50% of children with Tourette's have ADHD and up to 40% have OCD. ANTIPSYCHOTICS and alpha-adrenergic agonists are prescribed for Tourette's disorder. Children and adolescents with Tourette's disorder may choose to suppress their tics while in the presence of others to the degree to which they are able. However, they may need "TIC TIME" AFTERWARDS to let out an INCREASE in tic behavior. Tics tend to worsen under stress. the nurse knows the importance of developing a therapeutic relationship with the client. ASSISTING THE CLIENT WITH PROBLEM SOLVING, practice with utilizing coping skills is important when developing a therapeutic relationship. The nurse knows that a client with the characteristics of dependent personality disorder would exhibit an overall lack of self-confidence BE PASSIVE AND DEFAULTS DECISIONS TO OTHERS be generous and thoughtful, may feel pessimistic about themselves and are EASILY hurt by criticism. Clients with anorexia nervosa are concerned with BODY IMAGE, FEAR OF GAINING WEIGHT, and generally have a HISTORY OF DIETING and LACK OF FAMILY SUPPORT. A client with anorexia nervosa may experience AMENORRHEA and MENSTRUAL ABNORMALITIES. When providing care to a client with ADD, the nurse knows that it's important to OBTAIN THE CHILD’S ATTENTION BEFORE SPEAKING, ENCOURAGE the child to participate in therapy, and SET CLEAR LIMITS on unacceptable behaviors.. Clients with personality disorders exhibit INFLEXABILITY, COMPULSIVENESS and INABILITY TO CONNECT EMOTIONALLY in social or professional relationships. Consult a DIETICIAN to develop a CONTROLLED RATE of nutritional support, monitor blood electrolytes CLOSELY and place the client on telemetry or continuous cardiac monitoring are appropriate nursing interventions for a client at risk for refeeding syndrome.