BOOK
Varcarolis' Foundations of Psychiatric Mental Health Nursing - E-Book
(2014)
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Book Details
Abstract
The 7th edition of this market-leading textbook offers a clear, straightforward way to understand the often intimidating subject of psychiatric mental health nursing. Its practical, clinical perspective and user-friendly writing style help you quickly master key concepts. Clinical chapters follow the nursing process framework and progress from theory to application with a wealth of real-world examples to prepare you for practice.
- UNIQUE! A conversational, user-friendly writing style helps you quickly grasp complex psychiatric mental health nursing concepts.
- Clinical chapters are logically and consistently organized with sections on the clinical picture, epidemiology, comorbidity, etiology, and application of the nursing process.
- Clinical chapters follow the nursing process, providing you with consistent guidelines for comprehensive assessment and intervention.
- Vignettes prepare you for real-world practice with personal, descriptive characterizations of patients with specific psychiatric disorders.
- Coverage of psychopharmacology in clinical chapters familiarizes you with specific drug treatment options, including the most commonly used drugs and important nursing considerations for their use.
- Assessment Guidelines boxes list essential guidelines for comprehensive patient assessment.
- Case Studies with Nursing Care Plans present individualized histories of patients with specific psychiatric disorders and include interventions with rationales and evaluation statements for each patient goal.
- A separate chapter on cultural implications, as well as Considering Culture boxes throughout the text, provides essential information on culture, worldviews, and techniques for providing culturally competent care.
- Coverage of treatment and recovery in the community addresses the need for successful ongoing psychiatric mental health nursing care in the community setting.
- A chapter on end-of-life care examines the psychological impact of terminal illness and death on patients, families, and nurses.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Varcarolis' Foundations of Psychiatric Mental Health Nursing A Clinical Approach Seventh Edition | iii | ||
| Copyright page | iv | ||
| Dedication | v | ||
| Acknowledgments | vii | ||
| Contributors | ix | ||
| Reviewers | xi | ||
| To The Instructor | xiii | ||
| To The Student | xv | ||
| Table of contents | xvii | ||
| I Foundations in theory | 18.e2 | ||
| 1 Mental health and mental illness | 1 | ||
| Objectives | 1 | ||
| Key terms and concepts | 1 | ||
| Continuum of mental health and mental illness | 2 | ||
| Contributing factors | 3 | ||
| Resilience | 3 | ||
| Culture | 4 | ||
| Perceptions of mental health and mental illness | 5 | ||
| Mental illness versus physical illness | 5 | ||
| Nature versus nurture | 6 | ||
| Social influences on mental health care | 6 | ||
| Consumer movement and mental health recovery | 6 | ||
| Decade of the brain | 7 | ||
| Surgeon general’s report on mental health | 7 | ||
| Human genome project | 7 | ||
| President’s new freedom commission on mental health | 8 | ||
| Institute of medicine | 8 | ||
| Legislation and funding mental health | 8 | ||
| Epidemiology of mental disorders | 9 | ||
| Classification of mental disorders | 10 | ||
| The DSM-5 | 10 | ||
| The DSM-5 organizational structure | 11 | ||
| The ICD-9-CM | 12 | ||
| Psychiatric mental health nursing | 12 | ||
| What is psychiatric mental health nursing? | 13 | ||
| Classification of nursing diagnoses, outcomes, and interventions | 13 | ||
| DSM-5 and NANDA-I–approved nursing diagnoses | 13 | ||
| Nursing outcomes classification (NOC) | 14 | ||
| Nursing interventions classification (NIC) | 14 | ||
| Levels of psychiatric mental health clinical nursing practice | 14 | ||
| Basic level | 14 | ||
| Advanced practice | 14 | ||
| Future challenges and roles for psychiatric mental health nurses | 15 | ||
| Educational challenges | 15 | ||
| An aging population | 15 | ||
| Cultural diversity | 15 | ||
| Science, technology, and electronic health care | 15 | ||
| Advocacy and legislative involvement | 16 | ||
| Key points to remember | 16 | ||
| Critical thinking | 17 | ||
| Chapter review | 17 | ||
| Answers to chapter review | 17 | ||
| References | 18 | ||
| 2 Relevant theories and therapies for nursing practice | 19 | ||
| Objectives | 19 | ||
| Key terms and concepts | 19 | ||
| Psychoanalytic theories and therapies | 20 | ||
| Sigmund freud’s psychoanalytic theory | 20 | ||
| Levels of awareness | 20 | ||
| Conscious. | 20 | ||
| Preconscious. | 20 | ||
| Unconscious. | 20 | ||
| Personality structure | 20 | ||
| Id. | 20 | ||
| Ego. | 20 | ||
| Superego. | 21 | ||
| Defense mechanisms and anxiety | 21 | ||
| Psychosexual stages of development | 21 | ||
| Implications for psychiatric mental health nursing | 21 | ||
| Classical psychoanalysis | 21 | ||
| Psychodynamic therapy | 21 | ||
| Erik erikson’s ego theory | 22 | ||
| Implications for psychiatric mental health nursing | 23 | ||
| Interpersonal theories and therapies | 24 | ||
| Harry stack sullivan’s interpersonal theory | 24 | ||
| Implications for psychiatric mental health nursing | 24 | ||
| Interpersonal psychotherapy | 24 | ||
| Hildegard peplau’s theory of interpersonal relationships in nursing | 24 | ||
| Implications for psychiatric mental health nursing | 25 | ||
| Behavior theories and therapies | 26 | ||
| Ivan pavlov’s classical conditioning theory | 26 | ||
| John B. watson’s behaviorism theory | 26 | ||
| B.F. Skinner’s operant conditioning theory | 27 | ||
| Implications for psychiatric mental health nursing | 27 | ||
| Behavior therapy | 27 | ||
| Modeling | 27 | ||
| Operant conditioning | 27 | ||
| Systematic desensitization | 28 | ||
| Aversion therapy | 28 | ||
| Biofeedback | 28 | ||
| Cognitive theories and therapies | 28 | ||
| Rational-emotive behavior therapy | 28 | ||
| Cognitive-behavioral therapy | 29 | ||
| Implications for psychiatric mental health nursing | 30 | ||
| Humanistic theories | 31 | ||
| Abraham maslow’s humanistic psychology theory | 31 | ||
| Hierarchy of needs | 31 | ||
| II Foundations for practice | 82.e1 | ||
| 4 Settings for psychiatric care | 65 | ||
| Objectives | 65 | ||
| Key terms and concepts | 65 | ||
| Continuum of psychiatric mental health care | 66 | ||
| Outpatient psychiatric mental health care | 66 | ||
| Primary care providers | 66 | ||
| Specialty psychiatric care providers | 67 | ||
| Patient-centered medical homes | 68 | ||
| Community mental health centers | 68 | ||
| Psychiatric home care | 69 | ||
| Assertive community treatment | 69 | ||
| Partial hospitalization programs | 70 | ||
| Other outpatient venues for psychiatric care | 70 | ||
| Prevention in community care | 70 | ||
| Outpatient and community psychiatric mental health care | 70 | ||
| Biopsychosocial assessment | 71 | ||
| Treatment goals and interventions | 71 | ||
| Case management | 72 | ||
| Promoting continuation of treatment | 72 | ||
| Nursing education | 72 | ||
| Teamwork and collaboration | 72 | ||
| Emergency care and crisis stabilization | 73 | ||
| Crisis stabilization/observation units | 73 | ||
| Inpatient psychiatric mental health care | 73 | ||
| Entry to acute inpatient care | 74 | ||
| Rights of the hospitalized patient | 74 | ||
| Working as a team in inpatient care | 75 | ||
| Therapeutic milieu | 75 | ||
| Managing behavioral crises | 76 | ||
| Safety | 77 | ||
| Unit design to promote safety | 77 | ||
| Inpatient psychiatric nursing care | 78 | ||
| Assessment | 78 | ||
| Treatment goals and interventions | 79 | ||
| Therapeutic groups | 79 | ||
| Documentation | 79 | ||
| Medication management | 79 | ||
| Medical emergencies | 79 | ||
| Preparation for discharge to the community | 79 | ||
| Key points to remember | 80 | ||
| Critical thinking | 80 | ||
| Chapter review | 80 | ||
| Answers to chapter review | 81 | ||
| References | 81 | ||
| 5 Cultural implications for psychiatric mental health nursing | 83 | ||
| Objectives | 83 | ||
| Key terms and concepts | 83 | ||
| Culture, race, ethnicity, and minority status | 84 | ||
| Demographic shifts in the united states | 85 | ||
| Worldviews and psychiatric mental health nursing | 85 | ||
| Culture and mental health | 86 | ||
| Barriers to quality mental health services | 88 | ||
| Communication barriers | 89 | ||
| Stigma of mental illness | 90 | ||
| Misdiagnosis | 90 | ||
| Genetic variation in pharmacodynamics | 91 | ||
| Populations at risk for mental illness and inadequate care | 92 | ||
| Immigrants | 92 | ||
| Refugees | 92 | ||
| Cultural minorities | 92 | ||
| Culturally competent care | 93 | ||
| Cultural awareness | 93 | ||
| Cultural knowledge | 93 | ||
| Cultural encounters | 93 | ||
| Cultural skill | 94 | ||
| Cultural desire | 95 | ||
| Key points to remember | 95 | ||
| Critical thinking | 95 | ||
| Chapter review | 96 | ||
| Answers to chapter review | 96 | ||
| References | 96 | ||
| 6 Legal and ethical guidelines for safe practice | 98 | ||
| Objectives | 98 | ||
| Key terms and concepts | 98 | ||
| Ethical concepts | 99 | ||
| Mental health laws | 99 | ||
| Civil rights of persons with mental illness | 99 | ||
| Admission and discharge procedures | 100 | ||
| Due process in involuntary admission | 100 | ||
| Admission procedures | 100 | ||
| Informal admission | 100 | ||
| Voluntary admission | 100 | ||
| Temporary admission | 100 | ||
| Involuntary admission | 100 | ||
| Long-term involuntary admission. | 101 | ||
| Involuntary outpatient commitment. | 101 | ||
| Discharge procedures | 101 | ||
| Conditional release | 101 | ||
| Unconditional release | 101 | ||
| Release against medical advice (ama) | 101 | ||
| Patients’ rights under the law | 101 | ||
| Right to treatment | 101 | ||
| Right to refuse treatment | 102 | ||
| Right to informed consent | 103 | ||
| Rights regarding involuntary admission and advance psychiatric directives | 103 | ||
| Rights regarding restraint and seclusion | 103 | ||
| Orders and documentation | 104 | ||
| Rights regarding confidentiality | 104 | ||
| Health insurance portability and accountability act (hipaa) | 105 | ||
| Confidentiality after death | 105 | ||
| Confidentiality of professional communications | 106 | ||
| Confidentiality and human immunodeficiency virus status | 106 | ||
| Exceptions to the rule | 106 | ||
| Duty to warn and protect third parties. | 106 | ||
| Implications for psychiatric mental health nursing. | 106 | ||
| Statutes for reporting child and elder abuse. | 106 | ||
| Failure to protect patients | 107 | ||
| Tort law | 108 | ||
| Intentional torts | 108 | ||
| Unintentional torts | 108 | ||
| Duty. | 108 | ||
| Breach of duty. | 108 | ||
| Cause in fact, proximate cause, and damages. | 108 | ||
| Standards for nursing care | 108 | ||
| Guidelines for ensuring adherence to standards of care | 109 | ||
| Negligence, irresponsibility, or impairment | 109 | ||
| Documentation of care | 110 | ||
| Medical records and quality improvement | 110 | ||
| Medical records as evidence | 110 | ||
| Guidelines for electronic documentation | 111 | ||
| Forensic nursing | 111 | ||
| Violence in the psychiatric setting | 111 | ||
| Key points to remember | 112 | ||
| Critical thinking | 112 | ||
| Chapter review | 113 | ||
| Answers to chapter review | 114 | ||
| References | 114 | ||
| III Psychosocial nursing tools | 130.e1 | ||
| 7 The nursing process and standards of care for psychiatric mental health nursing | 115 | ||
| Objectives | 115 | ||
| Key terms and concepts | 115 | ||
| Standard 1: Assessment | 117 | ||
| Age considerations | 118 | ||
| Assessment of children | 118 | ||
| Assessment of adolescents | 118 | ||
| Assessment of older adults | 118 | ||
| Language barriers | 118 | ||
| Psychiatric mental health nursing assessment | 119 | ||
| Gathering data | 119 | ||
| Review of systems. | 119 | ||
| Laboratory data. | 120 | ||
| Mental status examination. | 120 | ||
| Psychosocial assessment. | 120 | ||
| Spiritual/religious assessment. | 122 | ||
| Cultural and social assessment. | 122 | ||
| Validating the assessment | 122 | ||
| Using rating scales | 123 | ||
| Standard 2: Diagnosis | 123 | ||
| Diagnostic statements | 123 | ||
| Types of nursing diagnoses | 123 | ||
| Standard 3: Outcomes identification | 124 | ||
| Standard 4: Planning | 125 | ||
| Standard 5: Implementation | 126 | ||
| Basic level interventions | 126 | ||
| Standard 5A: Coordination of care | 126 | ||
| Standard 5B: Health teaching and health promotion | 126 | ||
| Standard 5C: Milieu therapy | 126 | ||
| Standard 5D: Pharmacological, biological, and integrative therapies | 127 | ||
| Advanced practice interventions | 127 | ||
| Standard 5E: Prescriptive authority and treatment | 127 | ||
| Standard 5F: Psychotherapy | 127 | ||
| Standard 5G: Consultation | 127 | ||
| Standard 6: Evaluation | 127 | ||
| Documentation | 127 | ||
| Key points to remember | 129 | ||
| Critical thinking | 129 | ||
| Chapter review | 129 | ||
| Answers to chapter review | 130 | ||
| References | 130 | ||
| 8 Therapeutic relationships | 131 | ||
| Objectives | 131 | ||
| Key terms and concepts | 131 | ||
| Concepts of the nurse-patient relationship | 132 | ||
| Goals and functions | 132 | ||
| Social versus therapeutic | 132 | ||
| Social relationships | 132 | ||
| Therapeutic relationships | 132 | ||
| Relationship boundaries and roles | 133 | ||
| Establishing boundaries | 133 | ||
| Blurring of boundaries | 134 | ||
| Blurring of roles | 134 | ||
| Transference. | 134 | ||
| Countertransference. | 134 | ||
| Self-check on boundaries | 135 | ||
| Values, beliefs, and self-awareness | 137 | ||
| Peplau’s model of the nurse-patient relationship | 137 | ||
| Preorientation phase | 137 | ||
| Orientation phase | 139 | ||
| Establishing rapport | 139 | ||
| Parameters of the relationship | 140 | ||
| Formal or informal contract | 140 | ||
| Confidentiality | 140 | ||
| Terms of termination | 141 | ||
| Working phase | 141 | ||
| Termination phase | 141 | ||
| What hinders and what helps the nurse-patient relationship | 142 | ||
| Factors that encourage and promote patients’ growth | 142 | ||
| Genuineness | 142 | ||
| Empathy | 143 | ||
| Empathy versus sympathy | 143 | ||
| Positive regard | 143 | ||
| Attitudes | 143 | ||
| Actions | 144 | ||
| Attending. | 144 | ||
| Suspending value judgments. | 144 | ||
| Helping patients develop resources. | 144 | ||
| Key points to remember | 144 | ||
| Critical thinking | 145 | ||
| Chapter review | 145 | ||
| Answers to chapter review | 145 | ||
| References | 146 | ||
| 9 Communication and the clinical interview | 147 | ||
| Objectives | 147 | ||
| Key terms and concepts | 147 | ||
| The communication process | 148 | ||
| Factors that affect communication | 148 | ||
| Personal factors | 148 | ||
| Environmental factors | 148 | ||
| Relationship factors | 148 | ||
| Verbal and nonverbal communication | 150 | ||
| Verbal communication | 150 | ||
| Nonverbal communication | 150 | ||
| Interaction of verbal and nonverbal communication | 150 | ||
| Communication skills for nurses | 151 | ||
| Therapeutic communication techniques | 151 | ||
| Using silence | 151 | ||
| Active listening | 152 | ||
| Clarifying techniques | 152 | ||
| Paraphrasing. | 152 | ||
| Restating. | 153 | ||
| Reflecting. | 153 | ||
| Exploring. | 153 | ||
| Questions | 153 | ||
| Open-ended questions. | 153 | ||
| Closed-ended questions. | 153 | ||
| Projective questions. | 153 | ||
| Presupposition questions. | 153 | ||
| Nontherapeutic communication techniques | 155 | ||
| Excessive questioning | 155 | ||
| Giving approval or disapproval | 157 | ||
| Giving advice | 157 | ||
| Asking “why” questions | 157 | ||
| Cultural considerations | 157 | ||
| Communication style | 158 | ||
| Eye contact | 158 | ||
| Touch | 158 | ||
| Cultural filters | 159 | ||
| Telehealth through information communication technologies | 159 | ||
| Evaluation of communication skills | 159 | ||
| The clinical interview | 159 | ||
| Preparing for the interview | 159 | ||
| Pace | 159 | ||
| Setting | 160 | ||
| Seating | 160 | ||
| Introductions | 160 | ||
| Initiating the interview | 160 | ||
| Tactics to avoid | 161 | ||
| Helpful guidelines | 161 | ||
| Attending behaviors: The foundation of interviewing | 161 | ||
| Eye contact | 161 | ||
| Body language | 161 | ||
| Vocal quality | 161 | ||
| Clinical supervision | 162 | ||
| Process recordings | 162 | ||
| Key points to remember | 163 | ||
| Critical thinking | 164 | ||
| Chapter review | 164 | ||
| Answers to chapter review | 164 | ||
| References | 165 | ||
| 10 Understanding and managing responses to stress | 166 | ||
| Objectives | 166 | ||
| Key terms and concepts | 166 | ||
| Responses to and effects of stress | 167 | ||
| Early stress response theories | 167 | ||
| Neurotransmitter stress responses | 169 | ||
| Immune stress responses | 169 | ||
| Mediators of the stress response | 170 | ||
| Stressors | 170 | ||
| Perception | 170 | ||
| Individual temperament | 170 | ||
| Social support | 170 | ||
| Support groups | 170 | ||
| Culture | 171 | ||
| Spirituality and religious beliefs | 171 | ||
| Nursing management of stress responses | 172 | ||
| Measuring stress | 172 | ||
| Assessing coping styles | 172 | ||
| Managing stress through relaxation techniques | 172 | ||
| Deep breathing exercises | 174 | ||
| Progressive muscle relaxation | 174 | ||
| Relaxation response | 175 | ||
| Meditation | 175 | ||
| Guided imagery | 176 | ||
| Biofeedback | 177 | ||
| Physical exercise | 177 | ||
| Cognitive reframing | 177 | ||
| Journaling | 177 | ||
| Humor | 177 | ||
| Key points to remember | 178 | ||
| Critical thinking | 178 | ||
| Chapter review | 179 | ||
| Answers to chapter review | 179 | ||
| References | 179 | ||
| IV Psychobiological disorders | 199.e1 | ||
| 11 Childhood and neurodevelopmental disorders | 181 | ||
| Objectives | 181 | ||
| Key terms and concepts | 181 | ||
| Etiology | 182 | ||
| Biological factors | 182 | ||
| Genetic | 182 | ||
| Neurobiological | 183 | ||
| Psychological factors | 183 | ||
| Temperament | 183 | ||
| Resilience | 183 | ||
| Environmental factors | 183 | ||
| Cultural | 184 | ||
| Child and adolescent psychiatric mental health nursing | 185 | ||
| Assessing development and functioning | 185 | ||
| Assessment data | 185 | ||
| Data collection | 185 | ||
| Mental status examination | 185 | ||
| Developmental assessment | 185 | ||
| General interventions for children and adolescents | 186 | ||
| Family therapy | 186 | ||
| Group therapy | 186 | ||
| Behavioral therapy | 186 | ||
| Cognitive-behavioral therapy | 187 | ||
| Disruptive behavior management | 187 | ||
| Time-out. | 187 | ||
| Quiet room. | 187 | ||
| Play therapy | 188 | ||
| Bibliotherapy | 188 | ||
| Therapeutic drawing | 188 | ||
| Journaling | 188 | ||
| Music therapy | 188 | ||
| Psychopharmacology | 188 | ||
| Teamwork and safety | 188 | ||
| Neurodevelopmental disorders: Clinical picture | 189 | ||
| Communication disorder | 189 | ||
| Specific learning disorder | 189 | ||
| Motor disorder | 189 | ||
| Intellectual development disorder | 190 | ||
| Application of the nursing process | 190 | ||
| Assessment | 190 | ||
| Diagnosis | 191 | ||
| Outcomes identification | 191 | ||
| Implementation | 191 | ||
| Psychosocial interventions | 191 | ||
| Evaluation | 191 | ||
| Autism spectrum disorders | 192 | ||
| Application of the nursing process | 192 | ||
| Assessment | 192 | ||
| Diagnosis | 192 | ||
| Outcomes identification | 192 | ||
| Implementation | 192 | ||
| Psychosocial interventions | 192 | ||
| Psychobiological interventions | 193 | ||
| Pharmacological | 193 | ||
| Evaluation | 193 | ||
| Attention deficit hyperactivity disorder | 193 | ||
| Application of the nursing process | 193 | ||
| Assessment | 193 | ||
| Diagnosis | 194 | ||
| Outcomes identification | 194 | ||
| Implementation | 194 | ||
| Psychosocial interventions | 194 | ||
| Psychobiological interventions | 194 | ||
| Psychopharmacology | 194 | ||
| Evaluation | 195 | ||
| Quality improvement | 196 | ||
| Key points | 197 | ||
| Critical thinking exercises | 197 | ||
| Chapter review | 197 | ||
| Answers to chapter review | 198 | ||
| References | 198 | ||
| 12 Schizophrenia and schizophrenia spectrum disorders | 200 | ||
| Objectives | 200 | ||
| Key terms and concepts | 200 | ||
| Clinical picture | 201 | ||
| Epidemiology | 202 | ||
| Comorbidity | 202 | ||
| Etiology | 202 | ||
| Biological factors | 202 | ||
| Genetic | 202 | ||
| Neurobiological | 203 | ||
| Dopamine theory. | 203 | ||
| Other neurochemical hypotheses. | 203 | ||
| Brain structure abnormalities | 203 | ||
| Psychological and environmental factors | 203 | ||
| Prenatal stressors | 203 | ||
| Psychological stressors | 203 | ||
| Environmental stressors | 203 | ||
| Course of the disorder | 203 | ||
| Prognostic considerations | 204 | ||
| Phases of schizophrenia | 204 | ||
| Application of the nursing process | 204 | ||
| Assessment | 204 | ||
| Prepsychotic phase | 204 | ||
| General assessment | 204 | ||
| Positive symptoms | 205 | ||
| Alterations in thought. | 205 | ||
| Alterations in speech. | 205 | ||
| Alterations in perception. | 206 | ||
| Alterations in behavior. | 207 | ||
| Negative Symptoms | 207 | ||
| Cognitive Symptoms | 208 | ||
| Affective Symptoms | 208 | ||
| Self-Assessment | 208 | ||
| Diagnosis | 209 | ||
| Outcomes identification | 209 | ||
| V Trauma interventions | 497.e1 | ||
| 25 Suicide and non-suicidal self-injury | 480 | ||
| Objectives | 480 | ||
| Key terms and concepts | 480 | ||
| Clinical picture | 481 | ||
| Epidemiology | 481 | ||
| Risk factors | 481 | ||
| Implications for nursing practice | 484 | ||
| Etiology | 484 | ||
| Biological factors | 484 | ||
| Psychosocial factors | 484 | ||
| Cultural factors | 484 | ||
| Societal factors | 485 | ||
| Application of the nursing process | 485 | ||
| Assessment | 485 | ||
| Verbal and nonverbal clues | 485 | ||
| Lethality of suicide plan | 486 | ||
| Assessment tools | 486 | ||
| Self-assessment | 487 | ||
| Diagnosis | 487 | ||
| Outcomes identification | 487 | ||
| Planning | 487 | ||
| Implementation | 487 | ||
| Primary intervention | 487 | ||
| Secondary intervention | 490 | ||
| Tertiary intervention | 491 | ||
| General interventions | 491 | ||
| Teamwork and safety | 491 | ||
| Suicide precautions | 491 | ||
| Counseling | 491 | ||
| Health teaching and health promotion | 492 | ||
| Case management | 492 | ||
| Pharmacological interventions | 492 | ||
| Postvention for survivors of completed suicide | 493 | ||
| Advanced practice interventions | 494 | ||
| Evaluation | 494 | ||
| Quality improvement | 494 | ||
| Non-suicidal self-injury | 494 | ||
| Prevalence | 494 | ||
| Comorbidity | 494 | ||
| Etiology | 495 | ||
| Biological factors | 495 | ||
| Cultural factors | 495 | ||
| Societal factors | 495 | ||
| Summary of nursing implications | 495 | ||
| Key points to remember | 495 | ||
| Critical thinking | 495 | ||
| Chapter review | 495 | ||
| Answers to chapter review | 496 | ||
| References | 496 | ||
| 26 Crisis and disaster | 498 | ||
| Objectives | 498 | ||
| Key terms and concepts | 498 | ||
| Crisis theory | 499 | ||
| Types of crisis | 500 | ||
| Maturational crisis | 500 | ||
| Situational crisis | 500 | ||
| Adventitious crisis | 501 | ||
| Phases of crisis | 501 | ||
| Phase 1 | 501 | ||
| Phase 2 | 501 | ||
| Phase 3 | 501 | ||
| Phase 4 | 501 | ||
| Application of the nursing process | 501 | ||
| Assessment | 501 | ||
| General assessment | 501 | ||
| Assessing perception of precipitating event | 502 | ||
| Assessing situational supports | 502 | ||
| Assessing personal coping skills | 502 | ||
| Self-assessment | 503 | ||
| Diagnosis | 504 | ||
| Outcomes identification | 505 | ||
| Planning | 505 | ||
| Implementation | 506 | ||
| Counseling | 506 | ||
| Primary care | 506 | ||
| Secondary care | 506 | ||
| Tertiary care | 507 | ||
| Critical incident stress debriefing. | 507 | ||
| Evaluation | 507 | ||
| Disasters in the context of psychiatric nursing | 508 | ||
| Disaster management context | 508 | ||
| Key points to remember | 512 | ||
| Critical thinking | 513 | ||
| Chapter review | 513 | ||
| Answers to chapter review | 513 | ||
| References | 513 | ||
| 27 Anger, aggression, and violence | 515 | ||
| Objectives | 515 | ||
| Key terms and concepts | 515 | ||
| Clinical picture | 515 | ||
| Epidemiology | 516 | ||
| Comorbidity | 516 | ||
| Etiology | 516 | ||
| Biological factors | 516 | ||
| Psychological factors | 516 | ||
| Application of the nursing process | 517 | ||
| Assessment | 517 | ||
| General assessment | 517 | ||
| Self-assessment | 518 | ||
| Diagnosis | 519 | ||
| Outcomes identification | 519 | ||
| Planning | 519 | ||
| Implementation | 519 | ||
| Psychosocial interventions | 520 | ||
| Considerations for staff safety | 520 | ||
| Pharmacological interventions | 520 | ||
| Health teaching and health promotion | 521 | ||
| Case management | 521 | ||
| Teamwork and safety | 521 | ||
| Use of restraints or seclusion | 521 | ||
| Caring for patients in general hospital settings | 524 | ||
| Patients with healthy coping who are overwhelmed | 524 | ||
| Patients with marginal coping skills | 525 | ||
| Caring for patients in inpatient psychiatric settings | 526 | ||
| Caring for patients with cognitive deficits | 527 | ||
| Evaluation | 528 | ||
| Key points to remember | 528 | ||
| Critical thinking | 528 | ||
| Chapter review | 529 | ||
| Answers to chapter review | 529 | ||
| References | 529 | ||
| 28 Child, older adult, and intimate partner violence | 531 | ||
| Objectives | 531 | ||
| Key terms and concepts | 531 | ||
| Clinical picture | 531 | ||
| Types of abuse | 531 | ||
| Epidemiology | 532 | ||
| Child abuse | 532 | ||
| Intimate partner abuse | 532 | ||
| Older adult abuse | 532 | ||
| Comorbidity | 533 | ||
| Etiology | 533 | ||
| Environmental factors | 533 | ||
| Perpetrator | 533 | ||
| Cycle of violence. | 534 | ||
| Vulnerable person | 534 | ||
| Women. | 534 | ||
| Children. | 535 | ||
| Older adults. | 535 | ||
| Crisis situation | 535 | ||
| Application of the nursing process | 535 | ||
| Assessment | 535 | ||
| General assessment | 535 | ||
| Interview process and setting | 536 | ||
| Types of abuse | 537 | ||
| Physical abuse | 537 | ||
| Sexual abuse | 538 | ||
| Emotional abuse | 538 | ||
| Neglect | 538 | ||
| Economic abuse | 538 | ||
| Level of anxiety and coping responses | 538 | ||
| Family coping patterns | 539 | ||
| Support systems | 539 | ||
| Suicide potential | 539 | ||
| Homicide potential | 540 | ||
| Drug and alcohol use | 540 | ||
| Maintaining accurate records | 540 | ||
| Self-assessment | 540 | ||
| Diagnosis | 541 | ||
| Outcomes identification | 541 | ||
| Planning | 542 | ||
| Implementation | 543 | ||
| Reporting abuse | 543 | ||
| Counseling | 543 | ||
| Case management | 544 | ||
| Therapeutic environment | 544 | ||
| Promotion of self-sare activities | 544 | ||
| Health teaching and health promotion | 545 | ||
| Prevention of abuse | 546 | ||
| Primary prevention | 546 | ||
| Secondary prevention | 546 | ||
| Tertiary prevention | 546 | ||
| Advanced practice interventions | 546 | ||
| Individual psychotherapy | 546 | ||
| Family psychotherapy | 547 | ||
| Group psychotherapy | 547 | ||
| Evaluation | 547 | ||
| Key points to remember | 550 | ||
| Critical thinking | 550 | ||
| Chapter review | 550 | ||
| Answers to chapter review | 550 | ||
| References | 551 | ||
| 29 Sexual assault | 552 | ||
| Objectives | 552 | ||
| Key terms and concepts | 552 | ||
| Epidemiology | 553 | ||
| Sexual offenders and relationships with victims | 553 | ||
| Clinical picture | 554 | ||
| Psychological effects of sexual assault | 555 | ||
| Specialized sexual assault services | 555 | ||
| Application of the nursing process | 555 | ||
| Assessment | 555 | ||
| General assessment | 556 | ||
| Level of anxiety | 556 | ||
| Coping mechanisms | 556 | ||
| Available support systems | 556 | ||
| Signs and symptoms of emotional trauma | 556 | ||
| Signs and symptoms of physical trauma | 557 | ||
| Best practice guidelines. | 557 | ||
| Self-assessment | 557 | ||
| Diagnosis | 557 | ||
| Outcomes identification | 558 | ||
| Planning | 558 | ||
| Implementation | 559 | ||
| Counseling | 559 | ||
| Promotion of self-care activities | 561 | ||
| Case management | 561 | ||
| Advanced practice interventions | 561 | ||
| Psychotherapy | 561 | ||
| Survivors. | 561 | ||
| Perpetrators. | 562 | ||
| Evaluation | 562 | ||
| Conclusion | 562 | ||
| Key points to remember | 562 | ||
| Critical thinking | 562 | ||
| Chapter review | 563 | ||
| Answers to chapter review | 563 | ||
| References | 563 | ||
| VI Interventions for special populations | 583.e1 | ||
| 30 Psychosocial needs of the older adult | 565 | ||
| Objectives | 565 | ||
| Key terms and concepts | 565 | ||
| Mental health issues related to aging | 566 | ||
| Late-life mental illness | 566 | ||
| Depression | 566 | ||
| Depression and suicide risk | 566 | ||
| Anxiety disorders | 567 | ||
| Delirium | 567 | ||
| Dementia | 567 | ||
| Alcohol abuse | 568 | ||
| Pain | 568 | ||
| Barriers to accurate pain assessment | 569 | ||
| Assessment tools | 569 | ||
| Pain management | 570 | ||
| Pharmacological pain treatments. | 570 | ||
| Nonpharmacological pain treatments. | 570 | ||
| Health care concerns of older adults | 572 | ||
| Financial burden | 572 | ||
| Caregiver burden | 572 | ||
| Ageism | 572 | ||
| Ageism and public policy | 573 | ||
| Ageism and research | 573 | ||
| Health care decision making | 573 | ||
| Advance directives | 573 | ||
| Living will | 573 | ||
| Directive to physician | 573 | ||
| Durable power of attorney for health care | 574 | ||
| Guardianship | 574 | ||
| The nurse’s role in decision making | 574 | ||
| Nursing care of older adults | 574 | ||
| Assessment strategies | 574 | ||
| Intervention strategies | 578 | ||
| Environmental interventions | 578 | ||
| Psychosocial interventions | 579 | ||
| Pharmacological interventions | 579 | ||
| Promotion of self-care activities | 579 | ||
| Teamwork and safety | 579 | ||
| Care settings | 580 | ||
| Skilled nursing facilities | 580 | ||
| Residential care settings | 581 | ||
| Partial hospitalization | 581 | ||
| Day treatment programs | 581 | ||
| Behavioral health home care | 581 | ||
| Community-based programs | 581 | ||
| Driving and the older adult. | 581 | ||
| Key points to remember | 582 | ||
| Critical thinking | 582 | ||
| Chapter review | 582 | ||
| Answers to chapter review | 582 | ||
| References | 583 | ||
| 31 Serious mental illness | 584 | ||
| Objectives | 584 | ||
| Key terms and concepts | 584 | ||
| Serious mental illness across the lifespan | 585 | ||
| Older adults | 585 | ||
| Younger adults | 585 | ||
| Development of serious mental illness | 585 | ||
| Rehabilitation versus recovery: Two models of care | 585 | ||
| Issues confronting those with serious mental illness | 586 | ||
| Establishing a meaningful life | 586 | ||
| Comorbid conditions | 586 | ||
| Physical disorders | 586 | ||
| Depression and suicide | 586 | ||
| Substance abuse | 586 | ||
| Social problems | 587 | ||
| Stigma | 587 | ||
| Isolation and loneliness | 587 | ||
| Victimization | 587 | ||
| Economic challenges | 587 | ||
| Unemployment and poverty | 587 | ||
| Housing instability | 587 | ||
| Caregiver burden | 587 | ||
| Treatment issues | 588 | ||
| Nonadherence | 588 | ||
| Anosognosia | 588 | ||
| Medication side effects | 588 | ||
| Treatment inadequacy | 588 | ||
| Residual symptoms | 588 | ||
| Relapse, chronicity, and loss | 588 | ||
| Resources for persons with serious mental illness | 589 | ||
| Comprehensive community treatment | 589 | ||
| Community services and programs | 589 | ||
| Substance abuse treatment | 590 | ||
| Evidence-based treatment approaches | 590 | ||
| Assertive community treatment | 590 | ||
| Cognitive and behavioral therapy | 590 | ||
| Cognitive enhancement therapy | 591 | ||
| Family support and partnerships | 591 | ||
| Social skills training | 591 | ||
| Supportive psychotherapy | 591 | ||
| Vocational rehabilitation and related services | 591 | ||
| Other potentially beneficial services or treatment approaches | 592 | ||
| Advance directives | 592 | ||
| Consumer-run programs | 592 | ||
| Wellness and recovery action plans | 592 | ||
| Technology | 592 | ||
| Exercise | 592 | ||
| Nursing care of patients with serious mental illness | 592 | ||
| Assessment strategies | 592 | ||
| Intervention strategies | 593 | ||
| Evaluation | 594 | ||
| Current issues | 594 | ||
| Mandatory outpatient treatment | 594 | ||
| Criminal offenses and incarceration | 594 | ||
| Transinstitutionalization | 595 | ||
| Key points to remember | 595 | ||
| Critical thinking | 596 | ||
| Chapter review | 596 | ||
| Answers to chapter review | 596 | ||
| References | 597 | ||
| 32 Forensic psychiatric nursing | 598 | ||
| Objectives | 598 | ||
| Key terms and concepts | 598 | ||
| Forensic nursing | 598 | ||
| Education | 599 | ||
| Forensic nurse generalist | 599 | ||
| Forensic nurse in advanced practice | 599 | ||
| Roles and functions | 600 | ||
| Sexual assault nurse examiner | 600 | ||
| Nurse coroner/death investigator | 600 | ||
| Forensic psychiatric nursing | 600 | ||
| Roles and functions of the forensic psychiatric nurse | 601 | ||
| Nurse psychotherapist | 601 | ||
| Forensic nurse examiner | 601 | ||
| Competency evaluator | 602 | ||
| Fact and expert witnesses | 602 | ||
| Consultant | 602 | ||
| Hostage negotiator | 603 | ||
| Criminal profiler | 603 | ||
| Correctional nursing | 603 | ||
| Key points to remember | 605 | ||
| Critical thinking | 605 | ||
| Chapter review | 605 | ||
| Answers to chapter review | 606 | ||
| References | 606 | ||
| VII Other intervention modalities | 618.e1 | ||
| 33 Therapeutic groups | 607 | ||
| Objectives | 607 | ||
| Key terms and concepts | 607 | ||
| Therapeutic factors common to all groups | 608 | ||
| Planning a group | 608 | ||
| Phases of group development | 609 | ||
| Group member roles | 609 | ||
| Group leadership | 610 | ||
| Responsibilities | 610 | ||
| Styles of leadership | 611 | ||
| Clinical supervision | 611 | ||
| Nurse as group leader | 612 | ||
| Basic-level registered nurse | 612 | ||
| Psychoeducational groups | 612 | ||
| Medication education. | 612 | ||
| Health education. | 613 | ||
| Dual-diagnosis. | 613 | ||
| Symptom management. | 613 | ||
| Stress management. | 614 | ||
| Therapeutic community meeting groups | 614 | ||
| Support and self-help groups | 614 | ||
| Advanced practice nurse | 615 | ||
| Group psychotherapy | 615 | ||
| Psychodrama groups. | 615 | ||
| Dialectical behavior treatment. | 615 | ||
| Dealing with challenging member behaviors | 615 | ||
| Monopolizing member | 615 | ||
| Complaining member who rejects help | 616 | ||
| Demoralizing member | 616 | ||
| Silent member | 616 | ||
| Expected outcomes | 617 | ||
| Key points to remember | 617 | ||
| Critical thinking | 617 | ||
| Chapter review | 617 | ||
| Answers to chapter review | 618 | ||
| References | 618 | ||
| 34 Family interventions | 619 | ||
| Objectives | 619 | ||
| Key terms and concepts | 619 | ||
| Overview of the family | 620 | ||
| Family functions | 621 | ||
| Management | 621 | ||
| Boundaries | 621 | ||
| Communication | 623 | ||
| Emotional support | 624 | ||
| Socialization | 624 | ||
| Overview of family therapy | 624 | ||
| Concepts central to family therapy | 626 | ||
| The “identified patient” | 626 | ||
| Family triangles | 627 | ||
| Application of the nursing process | 627 | ||
| Assessment | 627 | ||
| Assessment tools | 629 | ||
| Constructing a genogram | 629 | ||
| Other assessment tools | 629 | ||
| Self-assessment | 630 | ||
| Diagnosis | 631 | ||
| Outcomes identification | 631 | ||
| Planning | 631 | ||
| Implementation | 631 | ||
| Counseling and communication techniques | 631 | ||
| Pharmacological interventions | 632 | ||
| Advanced practice interventions | 633 | ||
| Evaluation | 633 | ||
| Case management | 633 | ||
| Key points to remember | 634 | ||
| Critical thinking | 634 | ||
| Chapter review | 634 | ||
| Answers to chapter review | 634 | ||
| References | 635 | ||
| 35 Integrative care | 636 | ||
| Objectives | 636 | ||
| Key terms and concepts | 636 | ||
| Integrative care in the united states | 637 | ||
| Research | 638 | ||
| Consumers and integrative care | 639 | ||
| Safety and efficacy | 639 | ||
| Cost | 640 | ||
| Reimbursement | 640 | ||
| Placebo effect | 640 | ||
| Integrative nursing care | 640 | ||
| Credentials in integrative care | 640 | ||
| Natural products | 641 | ||
| Diet and nutrition | 641 | ||
| Herbal therapy | 642 | ||
| Mind and body approaches | 643 | ||
| Meditation | 644 | ||
| Yoga | 644 | ||
| Acupuncture | 644 | ||
| Deep breathing exercises | 644 | ||
| Guided imagery | 644 | ||
| Hypnotherapy | 644 | ||
| Manipulative practices | 644 | ||
| Spinal manipulation | 644 | ||
| Massage therapy | 645 | ||
| Other complementary therapies | 645 | ||
| Homeopathy and naturopathy | 645 | ||
| Aromatherapy | 645 | ||
| Energy therapies | 646 | ||
| Therapeutic touch | 646 | ||
| Healing touch | 646 | ||
| Reiki | 646 | ||
| Thought field therapy and emotional freedom technique | 646 | ||
| Bioelectromagnetic-based therapies | 647 | ||
| Prayer and spirituality | 647 | ||
| Historical notes regarding cam | 647 | ||
| Key points to remember | 648 | ||
| Critical thinking | 648 | ||
| Chapter review | 648 | ||
| Answers to chapter review | 649 | ||
| References | 649 | ||
| APPENDIX A Classification | 651 | ||
| Neurodevelopmental disorders (31) | 651 | ||
| Intellectual disabilities (33) | 651 | ||
| Communication disorders (41) | 651 | ||
| Autism spectrum disorder (50) | 651 | ||
| Attention-deficit/hyperactivity disorder (59) | 651 | ||
| Specific learning disorder (66) | 651 | ||
| Motor disorders (74) | 652 | ||
| Tic disorders | 652 | ||
| Other neurodevelopment disorders (86) | 652 | ||
| Schizophrenia spectrum and other psychotic disorders (87) | 652 | ||
| Bipolar and related disorders (123) | 652 | ||
| Depressive disorders (155) | 653 | ||
| Anxiety disorders (189) | 653 | ||
| Obsessive-compulsive and related disorders (235) | 654 | ||
| Trauma- and stressor-related disorders (265) | 654 | ||
| Dissociative disorders (291) | 654 | ||
| Somatic symptom and related disorders (309) | 655 | ||
| Feeding and eating disorders (329) | 655 | ||
| Elimination disorders (355) | 655 | ||
| Sleep-wake disorders (361) | 655 | ||
| Breathing-related sleep disorders (378) | 655 | ||
| Parasomnias (399) | 656 | ||
| Sexual dysfunctions (423) | 656 | ||
| Gender dysphoria (451) | 656 | ||
| Disruptive, impulse-control, and conduct disorders (461) | 657 | ||
| Substance-related and addictive disorders (481) | 657 | ||
| Substance-related disorders (483) | 657 | ||
| Alcohol-related disorders (490) | 657 | ||
| Caffeine-related disorders (503) | 657 | ||
| Cannabis-related disorders (509) | 657 | ||
| Hallucinogen-related disorders (520) | 657 | ||
| Inhalant-related disorder (533) | 657 | ||
| Opioid-related disorders (540) | 658 | ||
| Sedative-, hynotic-, or anxiolytic-related disorders (550) | 658 | ||
| Stimulant-related disorders (561) | 658 | ||
| Tobacco-related disorders (571) | 658 | ||
| Other (or unknown) substance-related disorders (577) | 659 | ||
| Non-substance-related disorders (585) | 659 | ||
| Neurocognitive disorders (591) | 659 | ||
| Major and mild neurocognitive disorders (602) | 659 | ||
| Major or mild neurocognitive disorder due to alzheimer’s disease (611) | 659 | ||
| Major or mild frontotemporal neurocognitive disorder (614) | 659 | ||
| Major or mild neurocognitive disorder with lewy bodies (618) | 659 | ||
| Major or mild vascular neurocognitive disorder (621) | 659 | ||
| Major or mild neurocognitive disorder due to traumatic brain injury (624) | 660 | ||
| Substance/medication-induced major or mild neurocognitive disordera (627) | 660 | ||
| Major or mild neurocognitive disorder due to HIV infection (632) | 660 | ||
| Major or mild neurocognitive disorder due to prion disease (634) | 660 | ||
| Major or mild neurocognitive disorder due to parkinson’s disease (636) | 660 | ||
| Major or mild neurocognitive disorder due to huntington’s disease (638) | 660 | ||
| Major or mild neurocognitive disorder due to another medical conditiona (641) | 660 | ||
| Major or mild neurocognitive disorder due to multiple etiologies (642) | 660 | ||
| Unspecified neurocognitive disorder (643) | 660 | ||
| Personality disorders (645) | 660 | ||
| Cluster a personality disorders | 660 | ||
| Cluster b personality disorders | 660 | ||
| Cluster c personality disorders | 660 | ||
| Other personality disorders | 661 | ||
| Paraphilic disorders (685) | 661 | ||
| Other mental disorders (707) | 661 | ||
| Medication-induced movement disorders and other adverse effects of medication (709) | 661 | ||
| Other conditions that may be a focus of clinical attention (715) | 661 | ||
| Relational problems (715) | 661 | ||
| Problems related to family upbringing (715) | 661 | ||
| Other problems related to primary support group (716) | 661 | ||
| Abuse and neglect (717) | 661 | ||
| Child maltreatment and neglect problems (717) | 661 | ||
| Adult maltreatment and neglect problems (720) | 662 | ||
| Educational and occupational problems (723) | 663 | ||
| Educational problems (723) | 663 | ||
| Occupational problems (723) | 663 | ||
| Housing and economic problems (723) | 663 | ||
| Housing problems (723) | 663 | ||
| Economic problems (724) | 663 | ||
| Other problems related to the social environment (724) | 663 | ||
| Problems related to crime or interaction with the legal system (725) | 663 | ||
| Other health service encounters for counseling and medical advice (725) | 664 | ||
| Problems related to other psychosocial, personal, and environmental circumstances (725) | 664 | ||
| Other circumstances of personal history (726) | 664 | ||
| Problems related to access to medical and other health care (726) | 664 | ||
| Nonadherence to medical treatment (726) | 664 | ||
| APPENDIX B NANDA-I Nursing Diagnoses 2012 2014 | 665 | ||
| APPENDIX C Historical evolution of psychiatric mental health nursing | 668 | ||
| Glossary | 672 | ||
| Index | 683 | ||
| A | 683 | ||
| B | 685 | ||
| C | 686 | ||
| D | 689 | ||
| E | 690 | ||
| F | 691 | ||
| G | 692 | ||
| H | 693 | ||
| I | 693 | ||
| J | 695 | ||
| K | 695 | ||
| L | 695 | ||
| M | 695 | ||
| N | 697 | ||
| O | 698 | ||
| P | 698 | ||
| Q | 700 | ||
| R | 701 | ||
| S | 701 | ||
| T | 705 | ||
| U | 706 | ||
| V | 706 | ||
| W | 706 | ||
| Y | 706 | ||
| Z | 706 |