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Psychiatric Mental Health Nursing, An Issue of Nursing Clinics of North America, E-Book

Psychiatric Mental Health Nursing, An Issue of Nursing Clinics of North America, E-Book

Deborah Antai-Otong

(2016)

Additional Information

Abstract

Nurses are challenged to understand the scientific bases of psychiatric disorders and treatment implications that modify behavior and improve functional status and quality of life for clients and their significant others. This challenge extends to integration of scientific knowledge into the biological, functional, and psychosocial distress experienced by persons with mental disorders. The primary strength of this issue is its broad focus and synthesis of scientific knowledge into psychiatric mental health practice. The initial section centers on technological advances and the art of psychiatric mental health nursing and legal considerations when caring for persons with mental disorders. The following section provides discussions of various psychiatric disorders, including anxiety and mood disorders, acute psychosis, attention deficit disorders, substance-related disorders, eating disorders, and borderline personality disorder. The remaining section focuses on special populations and treatment concerning children and adolescents and families in crisis, geriatric emergencies, adverse drug reactions, and suicide. Each article integrates innovative treatment modalities, including pharmacotherapy and psychotherapeutic interventions such as psychoeducation, family involvement, and psychosocial rehabilitation. This issue will provide timely updates in these areas and be a go-to source for mental health and psychiatric nurses.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Psychiatric Mental HealthNursing: An Update\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents v
Foreword: Patients with Mental Health Issues Transcend Centralized Care Settings\r v
Preface: Psychiatric Mental Health Nursing: Update\r v
Technological Advances in Psychiatric Nursing: An update\r v
Legal Considerations of Psychiatric Nursing Practice\r v
Caring for the Patient with an Anxiety Disorder\r v
Assessing and Treating the Patient with Acute Psychotic Disorders\r vi
Treatment Approaches to Attention Deficit Hyperactivity Disorder\r vi
Nursing Care Considerations for the Hospitalized Patient with an Eating Disorder\r vi
Dual Diagnosis: Coexisting Substance Use Disorders and Psychiatric Disorders\r vi
Evidenced-Based Care of Adolescents and Families in Crisis\r vii
Managing the Care of the Older Patient with Delirium and Dementia\r vii
Suicide: Across the Life Span\r vii
Psychosocial Recovery and Rehabilitation\r vii
Evidence-Based Care of the Patient with Borderline Personality Disorder\r viii
Adverse Drug Reactions Associated with Antipsychotics, Antidepressants, Mood Stabilizers, and Stimulants\r viii
Caring for Trauma Survivors\r viii
Contemporary Treatment Approaches to Major Depression and Bipolar Disorders\r ix
Foreword:\rPatients with Mental Health Issues Transcend Centralized Care Settings xi
REFERENCES xii
Preface:\rPsychiatric Mental Health Nursing: An Update xiii
Technological Advances in Psychiatric Nursing 151
Key points 151
INTRODUCTION 151
UPDATE ON TECHNOLOGIES DESCRIBED IN THE ORIGINAL ARTICLE 152
Brain Scans/Imaging Technologies 152
Alternative Treatments/Biofeedback 153
Genetics and Medications 153
APPLICATIONS FOR COMPUTER TECHNOLOGIES 154
Internet-Based Treatment 155
Telecommunications in Psychiatry 156
Health Information Technology 156
RELATIONSHIP BETWEEN NURSING AND TECHNOLOGY IN MENTAL HEALTH CARE AND TREATMENT 157
SUMMARY 159
REFERENCES 159
Legal Considerations of Psychiatric Nursing Practice 161
Key points 161
INTRODUCTION 161
STANDARDS FOR LEGAL PSYCHIATRIC NURSING PRACTICE 162
PATIENT RIGHTS AND NURSING RESPONSIBILITIES 162
Least Restrictive Alternative: Seclusion and Restraint 162
Right to Refuse Treatment 163
Confidentiality 163
Duty to Protect 164
Mandated Reporting 164
Informed Consent 165
Treatment of Minors 165
Documentation 165
Supervision and Safety 165
Suicide Risk Assessment 166
FORENSIC PSYCHIATRIC ISSUES (PERTAINING TO THE COURT SYSTEM) 166
Civil Commitment Process 166
Competency 167
Insanity Defense 167
LEGAL TRENDS 167
Legal Issues in Advanced Practice 167
Liability Risks 168
Gun Laws and Mental Illness 168
Criminal Justice System and Mental Illness 169
Mental Health Courts 169
Disaster Nursing 169
SUMMARY 169
REFERENCES 170
Caring for the Patient with an Anxiety Disorder 173
Key points 173
ECONOMIC AND PERSONAL COSTS OF ANXIETY DISORDERS 174
CAUSES OF ANXIETY DISORDERS 174
SPECIFIC ANXIETY DISORDERS 175
Panic Disorder 175
Agoraphobia 176
Treatment Considerations 176
Provide health education 177
Minimize avoidant behaviors 177
Challenge distorted cognitions (same as suppressing avoidant behaviors) 177
Provide long-term monitoring 177
Assess for coexisting disorders, such as depression and substance use disorders 177
Use technologies to increase access 178
Generalized Anxiety Disorder 178
Treatment Considerations 178
Social Anxiety Disorder (Social Phobia) 179
Assessing and Treating the Patient with Acute Psychotic Disorders 185
Key points 185
INTRODUCTION 185
DEFINITIONS 186
BEHAVIOR DISTURBANCES 187
Case Example 187
ASSESSMENT AND DIAGNOSIS 187
Brief Psychotic Episode 188
Schizophrenia 188
Bipolar Disorder, Manic Phase 188
Schizoaffective Disorder 188
Psychotic Disorder Caused by Another Medical Condition 188
Acute Intoxication 189
Differential Diagnosis 189
TREATMENT AND INTERVENTIONS 190
Safety 191
Therapeutic Alliance 191
Case Example 191
Provision of a Calm Environment 192
Use of Medications 192
Verbal De-Escalation 194
Seclusion and Restraint 194
Debriefing Staff Members 195
SUMMARY 195
REFERENCES 196
Treatment Approaches to Attention Deficit Hyperactivity Disorder 199
Key points 199
INTRODUCTION 199
CORE FEATURES 200
CAUSATIVE FACTORS 201
Neurochemical and Neuroanatomical 201
Genetics 201
Environmental 201
DIAGNOSIS, ASSESSMENT, AND EVALUATION 202
COURSE OF ATTENTION DEFICIT HYPERACTIVITY DISORDER 203
TREATMENT CONSIDERATIONS 204
PHARMACOTHERAPY 205
Psychostimulants 205
Nonstimulants 206
PSYCHOTHERAPEUTIC INTERVENTIONS 206
PSYCHOSOCIAL INTERVENTIONS 206
BEHAVIORAL INTERVENTIONS AND PSYCHOEDUCATION 207
Group-Based and Parenting Classes 208
CLASS-BASED BEHAVIORAL INTERVENTIONS 208
SUMMARY 208
REFERENCES 209
Nursing Care Considerations for the Hospitalized Patient with an Eating Disorder 213
Key points 213
EPIDEMIOLOGY 213
CAUSES 214
DIAGNOSTIC CRITERIA 214
Anorexia Nervosa 214
Bulimia Nervosa 214
Other Eating and Feeding Disorders 214
COMORBID DISORDERS 215
PROGNOSIS 215
INPATIENT NURSING CARE 215
Therapeutic Relationship 215
Nurse 215
Patient 216
NURSING PLAN OF CARE 216
Key Areas of Assessment 216
Chief Complaint 216
Mental Status 216
Developmental and Social History 217
Family History and Functioning 217
Medical History and Current Medical Problems 217
Psychiatric Treatment History 217
Eating Patterns and Compensatory Behaviors 217
Other Core Eating Disorder Symptoms 219
Self-esteem, body image, and cognitive disturbances 219
Body weight 219
Menstrual cycle 220
Nursing Diagnoses, Desired Outcomes, Goals, and Interventions 220
Aims of Hospitalization 220
Targeted Interventions 220
Cognitive disturbances 220
Nutritional requirements, meal patterns, and body weight 220
Exercise 230
Medications 230
Milieu 230
Discharge Planning 230
SUMMARY 231
REFERENCES 231
Dual Diagnosis 237
Key points 237
INTRODUCTION 237
PREVALENCE 238
INTEGRATED SCREENING AND ASSESSMENT OF SUBSTANCE USE DISORDER AND PSYCHIATRIC DISORDERS 239
Integrated Screening and Assessment 239
Making a Diagnosis 240
TREATMENT CONSIDERATIONS 241
Dual Diagnosis Treatment Modalities 241
Pharmacologic Interventions 243
Psychotherapeutic Interventions 243
SUMMARY 245
REFERENCES 245
Evidenced-Based Care of Adolescents and Families in Crisis 249
Key points 249
INTRODUCTION 249
CRISES 250
RISKS AND PROTECTIVE FACTORS 250
HIGH RISK FACTORS 251
Mental Illness 251
Sexuality 252
Substance Use 252
Technology and Media 253
Violence 254
Family 254
CRISIS INTERVENTION 255
CRISIS INTERVENTION, THE NURSING PROCESS, AND ROBERT’S SEVEN-STAGE MODEL 255
Assessment 257
Stage 1: assessing lethality 257
Stage 2: establishing rapport and communication 257
Stage 3: identifying major problems 257
Stage 4: dealing with feelings and emotions 257
Planning 258
Stage 5: explore and generate alternatives 258
Implementation 258
Stage 6: formulating an action plan 258
Evaluation 258
Stage 7: termination and follow-up 258
SUMMARY 259
REFERENCES 259
Managing the Care of the Older Patient with Delirium and Dementia 261
Key points 261
PREVALENCE AND COST OF COGNITIVE DISORDERS 262
DELIRIUM 262
Definition and Clinical Features 262
Causative Factors 264
Acute Management 265
Assessment and Diagnosis 265
Interventions 265
Evaluation 266
DEMENTIA 267
Definition and Clinical Features 267
Causative Factors 268
Acute Management of Behavioral and Psychiatric Symptoms 268
Assessment and Diagnosis 268
Interventions 269
Evaluation 270
SUMMARY 270
REFERENCES 270
Suicide 275
Key points 275
INTRODUCTION 275
NEUROBIOLOGICAL AND PSYCHOLOGICAL THEORIES OF SUICIDE 276
NEUROBIOLOGY OF SUICIDE 276
CHANGES IN THE BRAIN AND NEUROTRANSMITTER SYSTEMS 276
PSYCHOLOGICAL THEORIES OF SUICIDE 276
PSYCHOLOGICAL INFLUENCES 277
PSYCHOSOCIAL INFLUENCES 277
ASSESSING PROTECTIVE FACTORS 277
HIGH-RISK POPULATIONS 277
Older Adults 277
Psychosocial factors 278
TREATMENT CONSIDERATIONS 278
Older Adults 278
Youth 279
Psychological considerations 279
Psychosocial considerations 280
Sexual Minorities 280
TREATMENT CONSIDERATIONS 280
NURSING IMPLICATIONS AND TREATMENT 280
Nurse Patient Relationship 280
Therapeutic Communication Techniques 281
Assessment of Suicidal Patients 282
Assessing Suicide Risk 282
Suicide Contracts 283
SUMMARY 284
REFERENCES 284
Psychosocial Recovery and Rehabilitation 287
Key points 287
MAJOR COMPONENTS OF PSYCHOSOCIAL REHABILITATION AND MENTAL HEALTH RECOVERY 289
SYMPTOMATIC REMISSION 289
SELF-EFFICACY AND MANAGEMENT OF ILLNESS 290
PSYCHOTHERAPEUTIC INTERVENTIONS 291
Intensive Case Management 291
Social Cognition Training, Rehabilitation, and Recovery 292
Psychoeducation and Family Therapy 293
Supported Employment 294
SUMMARY 295
REFERENCES 295
Evidence-Based Care of the Patient with Borderline Personality Disorder 299
Key points 299
INTRODUCTION 299
CAUSATIVE FACTORS 300
ASSESSMENT AND DIAGNOSTIC CONSIDERATIONS 300
PHARMACOLOGIC AND PSYCHOTHERAPEUTIC CONSIDERATIONS 304
Pharmacologic Interventions 304
Social Cognitive Disturbances 305
Psychotherapeutic Interventions 305
SUMMARY 306
REFERENCES 306
Adverse Drug Reactions Associated with Antipsychotics, Antidepressants, Mood Stabilizers, and Stimulants 309
Key points 309
PSYCHOTROPIC MEDICATIONS 310
ANTIPSYCHOTIC OR NEUROLEPTIC AGENTS 310
First-generation (or Conventional) Antipsychotics 311
Movement disorders 311
Hyperprolactinemia 312
Second-generation (or Atypical) Antipsychotics 312
Adverse Drug Reactions and Side Effects that May Occur with First-generation Antipsychotics and Second-generation Antipsych ... 313
Neuroleptic malignant syndrome 313
Corrected QT prolongation 313
LONG-ACTING INJECTABLE ANTIPSYCHOTICS 314
ANTIDEPRESSANTS 314
Selective Serotonin Reuptake Inhibitors 315
Other Antidepressants 315
Serotonin Syndrome 316
Suicide Risk and Mania 317
Withdrawal 317
MOOD STABILIZERS 317
Lithium 318
Divalproex Sodium or Valproic Acid 318
Carbamazepine 318
Lamotrigine 319
STIMULANTS 319
SUMMARY 320
REFERENCES 320
Caring for Trauma Survivors 323
Key points 323
INTRODUCTION 323
PREVALENCE 323
CAUSES OF TRAUMA AND STRESS-RELATED DISORDERS 324
CORE FEATURES OF TRAUMA AND STRESS-RELATED DISORDERS 325
TRAUMA-INFORMED CARE 325
TRAUMA SCREENING AND ASSESSMENT 326
Trauma Awareness 327
Emphasize Safety 328
Strength-Based Care: Respect the Survivor’s Input and Concerns in All Aspects of Care 328
Offer Opportunities to Reclaim Control 329
TREATMENT CONSIDERATIONS FOR TRAUMA AND STRESS-RELATED DISORDERS 330
SUMMARY 331
REFERENCES 331
Contemporary Treatment Approaches to Major Depression and Bipolar Disorders 335
Key points 335
INTRODUCTION 335
Prevalence 336
CAUSES OF MOOD DISORDERS 337
Unipolar Depression 337
Bipolar Disorders 338
Medical Assessment 338
Biopsychosocial Assessment 338
Mental Status Examination 339
Suicide Risk Assessment 340
Documentation 340
DIAGNOSIS 341
Major Depressive Disorder (Unipolar Depression) 341
Persistent Depressive Disorder 342
Postpartum Depression 342
Seasonal Affective Disorder 342
TREATMENT CONSIDERATIONS FOR UNIPOLAR DEPRESSION (MAJOR DEPRESSIVE DISORDER) 343
Psychotherapeutic Interventions 345
Other Somatic Therapies 345
Complementary and Alternative Therapies 346
Bipolar Disorders 346
Bipolar I Disorder 346
Bipolar II Disorder 347
Pharmacologic Interventions 347
Psychotherapeutic Interventions 348
SUMMARY 349
REFERENCES 349
Index 353