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Psychiatric Mental Health Nursing - E-Book

Psychiatric Mental Health Nursing - E-Book

Katherine M. Fortinash | Patricia A. Holoday Worret

(2014)

Additional Information

Book Details

Abstract

Focusing on what psychiatric nurses actually do in everyday practice, Psychiatric Mental Health Nursing, 5th Edition, uses a balanced nursing-medical approach to cover all of the most common disorders and treatments. The text's full-color illustrations and straightforward style help you make sense of challenging material. And its strong emphasis on the nursing process, updated DSM-IV-TR diagnostic criteria, interdisciplinary interventions, and the latest mental health practices boost your confidence in managing clients and prepare you for success on the NCLEX¨ examination.

  • UNIQUE! Balanced nursing-medical approach offers strong baseline coverage of the nursing process and interdisciplinary interventions and focuses on what psychiatric nurses actually do.
  • Complete coverage of the nursing process features the six-step problem-solving method and how to put it into practice.
  • DSM-IV-TR Criteria boxes list categories of mental disorders and the criteria for diagnosing them.
  • Nursing care plans provide care guidelines for each plan and include a brief case study, followed by assessment, diagnosis, goal setting, interventions with rationales, and evaluation.
  • UNIQUE! Clinical Alert boxes address issues critical to the safety or well-being of the client.
  • Case studies depict effective nursing care strategies and promote critical thinking.
  • Research for Evidence-Based Practice boxes discuss the implications of current research studies.
  • Client and Family Teaching Guidelines boxes focus on the issues confronting families when a member suffers from mental illness.
  • UNIQUE! Medication Key Facts boxes highlight the most common psychopharmacologic interventions along with safe and effective use.
  • Nursing Assessment Questions boxes include questions that should be asked in the assessment of a particular disorder.
  • Clinical Symptoms boxes help you apply content to the real world.
  • Additional Treatment Modalities boxes summarize other modalities and interventions used in conjunction with nursing interventions in the treatment of a particular disorder.
  • Chapter summaries conclude each chapter with the most significant ideas to remember.
  • Review questions with answers in the appendix offer immediate reinforcement of chapter content and help you prepare for the NCLEX Examination.
  • Glossary provides concise definitions of key terms.
  • Objectives and key terms emphasize the most important concepts from each chapter.

Table of Contents

Section Title Page Action Price
Front cover cover
Inside front cover ifc_i
Half title page i
Evolve page ii
Psychiatric Mental Health Nursing iii
Copyright page iv
Dedication v
Acknowledgments v
Contributors vi
Reviewers vii
PREFACE viii
About This Book viii
Current Health Care viii
Research and Treatment viii
Integrated Nursing and Medical Models viii
PMH Nursing Focus viii
Interdisciplinary Care Planning Tools viii
Language and terminology viii
Features ix
Special Features ix
1. Disorder Chapter (Schizophrenia) ix
2. Concept Map ix
3. Research for Evidence-Based Practice Box ix
4. Patient and Family Teaching Guidelines x
5. Case Studies with Critical Thinking Skills x
6. Clinical Alert Boxes x
7. Chapter Summary, Review Questions, and References with Online Resources x
Teaching and Learning Package xi
Student Resources xi
Instructor Resources xi
Table of Contents xii
I Foundations for Psychiatric Mental Health Nursing 1
1 Psychiatric Nursing: 1
Objectives 1
Key Terms 1
Universal Agreement 1
Fundamental Objectives 2
Promotion and Protection 2
Sites for Health Promotion 2
Promotion Inhibitors 2
Expanded Involvement 2
Prevention 3
Primary Prevention 3
Secondary Prevention 3
Tertiary Prevention 3
Treatment 4
Background. 4
Treatment Plan. 4
Patients’ Rights in Treatment. 4
Evidence-Based Practice 5
Integrated Care: The Mind and the Body 5
Nursing Implications. 5
Recovery and Rehabilitation 6
Psychiatric Mental Health Nursing Today 7
Current Issues and Trends 7
The Recovery Initiative. 7
Nursing and Evidence-Based Practice. 7
Other Salient Issues 8
The Art and Science of PMHN 8
Mental Health and Mental Disorder 8
Mental Health 8
Factors and Indicators 8
Risk Factors and Protective Factors 10
Mental Disorder 10
The Etiology Argument 10
Statistics for Mental Disorders 11
Classification of Mental Disorders 11
Patient Diagnoses and Nursing 12
Social Stigma 12
Global Mental Health and Disorders 13
Mental Health Care Reform 13
Chapter Summary 14
Review Questions 14
References 15
Online Resources 15
2 Nursing Practice in the Clinical Setting 16
Objectives 16
Key Terms 16
Psychiatric Mental Health Nursing Leaders 17
Psychiatric Mental Health Nursing: A Practice-Oriented Profession 18
The Therapeutic Alliance: Definition and Description 18
Principles of the Nurse–Patient Relationship 19
Therapeutic Versus Social. 19
Patient Centered. 19
Goal Directed. 20
Objective Versus Subjective. 20
Time-Limited Interactions. 21
Stages of the Nurse–Patient Relationship 21
Preorientation Stage. 21
Orientation Stage. 21
The Contract. 21
Working Stage. 22
Termination Stage. 22
Clinical Concepts and Techniques 22
Helping: The Concept and the Activity 22
Altruism 23
II Biologic and Psychosocial Principles for Mental Health Nursing 87
5 Adaptation to Stress 87
Objectives 87
Key Terms 87
What is Stress? 87
Physical Responses to Stress 88
Hans Selye and the General Adaptation Syndrome 88
Personal Control and Stress 89
Life Events That Trigger Stress 90
Interventions to Promote Health in the Face of Stress 90
Stop, Divert, and Reframe 91
Chapter Summary 92
Review Questions 93
References 93
Online Resources 93
6 Neurobiology in Mental Health and Mental Disorder 95
Objectives 95
Key Terms 95
Neurobiology and Human Behavior 96
Neuroanatomy 96
The Brain 96
Brain Cells 96
Cerebrum 97
Basal Nuclei. 99
Limbic System. 100
Diencephalon 100
Cerebellum 101
Brainstem 101
Neurophysiology 101
Nerve Cell Electrical Function: Action Potential 101
Nerve Cell Chemical Function: Neurotransmitters 102
Specific Neurotransmitters. 103
Clinical Significance of Neurotransmitters. 104
Depression. 104
Anxiety. 104
Schizophrenia. 104
Parkinsonism. 105
Alzheimer’s Disease. 105
Interrelated Body Systems 105
Psychoneuroimmunology 105
Neuroendocrinology 105
Chronobiology 106
Genetics 106
Stem Cell Technology 106
Neuroplasticity 107
Neurotechnology: Psychobiologic Tools 107
Neuroimaging 107
Ultrasonography 107
Computed Tomography Scanning 109
Magnetic Resonance Imaging 109
Functional MRI. 109
Positron Emission Tomography and Single Photon Emission Computed Tomography 109
Psychiatric Nursing and Neurobiology 109
Chapter Summary 110
Review Questions 111
References 111
Online Resources 112
7 Human Development Across the Life Span 113
Objectives 113
Key Terms 113
Developmental Theories 114
Child and Adolescent Development 114
Psychosexual Theory 114
Psychosocial Theory 114
Interpersonal Theory 115
Cognitive Theory 116
Attachment Theory 117
Behavioral Theories 118
Classical and Operant Conditioning 118
Social Learning Theory 118
Moral Development 119
Adult Development 120
Life Stage Theories 120
Human Motivation and Development Theory 121
Contemporary Theorists 121
Midlife Transitions 123
Role of Stress in Adult Development 124
Gender Differences in Adult Development 124
Positive Psychology and Aging 124
Adult Development in Later Life 124
Overview of the Older Adult Population 124
Demographics 125
Health Status 125
A Life Span Perspective of Aging 125
Biologic Theories of Aging 126
Genetic Theory. 126
Immunologic Theory. 126
Cross-Linkage Theory. 126
Free Radical Theory. 127
Sociologic Theories of Aging 127
Disengagement Theory. 127
Continuity Theory. 127
Activity Theory. 127
Newer Theories and Emerging Models of Aging 128
Process of Aging 128
Physiologic Aging 128
Nervous System. 129
Functional Assessment. 129
Activities of Daily Living (ADL). 129
Instrumental Activities of Daily Living (IADL). 129
Psychosocial Aging 130
Cognition and Memory. 130
Intelligence and Aging. 130
Memory Processes and Aging. 130
Other Cognitive Functions. 131
Personality. 131
Social Support and Interactions. 131
Sexuality and Intimacy. 132
Role Transitions. 132
Retirement. 133
Loss of a Spouse. 133
Grandparent Role. 133
Role Reversal. 133
Mental Assessment. 133
Human Development During the Twenty-First Century 134
Images of Aging 134
Cultural Impact 135
Refocusing on Healthy Aging 135
Refocusing on Learning and Aging 136
Refocusing on Creativity and Aging 136
Chapter Summary 136
Review Questions 137
References 137
8 Culture, Ethnicity, and Spirituality 140
Objectives 140
Key Terms 140
The Many Faces of Culture 140
Cultural Heritage 141
Changing Trends 141
Subcultures 142
Cultural Diversity 143
Environmental Mixture of Cultures 144
Western Health Care System as Culture 144
Cultural Awareness 145
Culturally Competent Health Care 145
Transcultural Communication 145
High-Context and Low-Context Cultures. 145
Guidelines for Communicating with Non–English- Speaking Patients. 147
Personal Space. 147
Touch. 147
Time Orientation. 148
Biologic Characteristics. 148
Translation Services. 148
Spirituality 148
Spiritual Support 149
Intervention Tools 150
Spiritual Assessment 150
Vocation and Obligation 151
Experience 151
Courage and Growth 151
Ritual and Practice 151
Community 151
Authority and Guidance 151
Stages of Faith 151
Stages of Moral Development 151
Impartial Spirituality 152
Institutional Spirituality 152
Individual Spirituality 152
Integrated Spirituality 152
Selected Cases of Clinical Spiritual Interventions 153
Pain 153
Spiritual Torment 153
Punishment 153
Voices 153
Guilt 153
Hyperreligiosity 153
Selected Traditional and Cultural Mental Health Beliefs 154
Native American Communities 154
Asian and Pacific Islander Communities 154
Black American (African-American) Communities 154
Hispanic Communities 155
Arab-American Communities 155
Communities of European Origin 155
The Role of the Nurse 156
The Nursing Process 159
Assessment 159
Nursing Diagnosis 161
Outcome Identification 161
Planning 161
Implementation 162
Evaluation 162
Chapter Summary 162
Review Questions 164
References 164
Online Resources 165
9 Legal and Ethical Aspects in Clinical Practice 166
Objectives 166
Key Terms 166
Historic Review 166
Commitment 167
Voluntary Commitment 168
Emergency Commitment 168
Civil or Judicial Commitment 168
Psychiatric Advance Directives 168
Confidentiality 168
Nursing Implications 169
Privileged Communication 169
Duty to Warn and Protection: Tarasoff 170
III Psychiatric Disorders 184
10 Anxiety and Anxiety Disorders 184
Objectives 184
Key Terms 184
Historic and Theoretic Perspectives 186
Anxiety in the Context of Psychiatric Mental Health Nursing 187
Influence of Hildegard Peplau 188
Etiology 188
Biologic Model 188
Psychodynamic Model 189
Behavioral Model 189
Epidemiology and Age of Onset 189
Cultural Variance 190
Comorbidity (Co-occurrence) 190
Clinical Description 191
Panic 191
Panic Attack 191
Panic Disorder 191
Phobias 191
Agoraphobia 191
Specific Phobias 192
Social Phobia 192
Posttraumatic Stress Disorder 192
Acute Stress Disorder 193
Generalized Anxiety Disorder 193
Obsessive-Compulsive Disorder 193
Prognosis 194
Discharge Criteria 195
The Nursing Process 195
Assessment 195
Nursing Diagnosis 196
Outcome Identification 196
Generalized Anxiety Disorder 196
Obsessive-Compulsive Disorder 197
Posttraumatic Stress Disorder 197
Planning 197
Implementation 197
Nursing Interventions 197
Additional Treatment Modalities 198
Biologic Interventions 198
Pharmacologic Interventions. 198
Psychotherapy 198
Behavioral Therapy. 198
Cognitive Behavioral Therapy. 198
Psychologic First Aid. 199
Evaluation 199
Chapter Summary 202
Review Questions 202
References 203
Online Resources 203
11 Somatoform, Factitious, and Dissociative Disorders 204
Objectives 204
Key Terms 204
Historic and Theoretic Perspectives 204
Etiology 205
Biologic Theory 205
Behavioral Theory 205
Cognitive Theory 205
Epidemiology 205
Clinical Description 206
Somatoform Disorders 206
Somatization Disorder 206
Pain Disorder 207
Conversion Disorder 207
Hypochondriasis 207
Body Dysmorphic Disorder 208
Factitious Disorder 209
Dissociative Disorders 210
Dissociative Amnesia 210
Dissociative Fugue 210
Dissociative Identity Disorder 210
Depersonalization Disorder 210
Prognosis 210
Discharge Criteria 210
The Nursing Process 211
Assessment 211
Nursing Diagnosis 211
Outcome Identification 211
General Outcome Expectations 211
Somatization Disorder 212
Dissociative Identity Disorder 212
Planning 212
Implementation 212
Nursing Interventions 212
Additional Treatment Modalities 213
Biologic Interventions 213
Pharmacologic Interventions. 213
Psychotherapy 213
Cognitive Behavioral Therapy. 213
Evaluation 213
Chapter Summary 216
Review Questions 216
References 216
Online Resources 217
12 Mood Disorders: 218
Objectives 218
Key Terms 218
Mood Disorders 218
Etiology 219
Biologic Theories 219
Neurotransmission 219
Neuroendocrine Dysregulation 220
Genetic Transmission 220
Psychosocial Factors 222
Evolutionary Psychology and Biology 222
Psychodynamic Theory 223
Cognitive Theory 223
Learned Helplessness/Hopelessness Theory 223
Life Events and Stress Theory 224
Adjustment Disorders 224
Epidemiology 225
Children and Adolescents 226
Older Adults 226
Clinical Description 227
Types of Mood Disorders 227
Depressive Disorders 227
Major Depressive Episode, Single or Recurrent. 227
Emotional Symptoms. 227
Cognitive Symptoms. 227
Behavioral Symptoms. 227
Social Symptoms. 227
Dysthymic Disorder. 229
Emotional Symptoms. 229
Cognitive Symptoms. 229
Behavioral Symptoms. 229
Social Symptoms. 229
Depressive Disorders not Otherwise Specified. 229
Bipolar Disorders 230
Manic Episode. 230
Emotional Symptoms. 230
Cognitive Symptoms. 230
Behavioral Symptoms. 230
Social Symptoms. 232
Perceptual Symptoms. 232
Hypomanic Episode. 232
Cyclothymic Disorder. 232
Additional Types of Mood Disorders 232
Medical Conditions and Mood Disorders 232
Comorbidity 233
Additional Symptom Features of Mood Disorders 234
Adjustment Disorders 234
Prognosis for Mood Disorders 235
Discharge Criteria 236
Hospital Discharge Criteria 236
IV Crisis and Psychiatric Emergencies 481
21 Crisis: 481
Objectives 481
Key Terms 481
Crisis 481
Description of Crisis 481
Opportunities that Result from Crisis 482
Historic and Theoretic Perspectives 482
Definitions of Crisis 483
Crisis Components 483
Risk Factors for Crisis 484
Types of Crises 484
External (Situational) Crises 484
Internal (Subjective) Crises 484
Phase-of-Life (Maturational) Crises 484
Disasters (Adventitious Crises) 485
Human Responses to Crisis 485
Psychological Stages after a Disaster. 487
Crisis Intervention 487
An Overview 487
Global Intervention 487
Crises Caused by Psychiatric Emergencies 487
Nursing Assessment during Crisis and Disaster 488
Models and Methods of Crisis Intervention 489
Robert’s Seven-Stage Model of Crisis Intervention. 491
Acute Traumatic Stress Management. 491
Crisis Intervention with Children and Families. 491
Planning and Executing Therapeutic Intervention 492
Nursing Approaches to Crisis Intervention 492
Children in Crisis 492
Physical Safety. 492
Psychologic Safety. 492
Reassurance. 492
Adults in Crisis 492
Resolution of the Crisis 493
The Summary 493
Open Connection 493
Anticipatory Planning 493
Barriers to Effective Crisis Intervention or Resolution 494
Failure to Learn from Experience 494
Existing Mental Disorders 494
Secondary Gain 494
Therapist-Patient Boundary Problems 494
Sociocultural Considerations 494
Demands on the Psychiatric Nurse Working in Crisis 495
Prevention Strategies 496
Technology and Future Trends in Crisis Intervention 497
Resilience and Posttraumatic Growth 497
Chapter Summary 498
Review Questions 499
References 499
Online Resources 500
22 Suicide Prevention and Intervention 502
Objectives 502
Key Terms 502
Historic and Theoretic Perspectives 503
Sociologic Theory 503
Psychoanalytic Theory 503
Interpersonal Theory 503
Etiology 503
Biologic Factors 504
Psychologic Factors 505
Sociologic Factors 505
Epidemiology 505
Prevalence 505
Age 505
Older Adults. 505
Youth. 506
Gender and Ethnicity 507
Socioeconomic Status 507
Familial Influences 507
Co-occurrence with Related Health Issues 507
Psychiatric Disorders 507
Mood Disorders. 507
Schizophrenia. 508
Panic Disorder. 508
Borderline Personality Disorder. 508
Alcohol and Other Drugs 508
Medical Illnesses 508
Soldiers Returning From War in Iraq and Afghanistan 509
Erroneous Beliefs about Suicide 509
Clinical Description 509
Risk Factors for Suicide 510
Lethality Assessment Factors 510
Imminence versus Nonimminence 510
Ideation versus Intent 512
Chosen Method and Accessibility 512
Prognosis 513
Discharge Criteria 513
The Nursing Process 514
Assessment 514
Nursing Diagnosis 516
Outcome Identification 516
Planning 516
Implementation 517
Nursing Interventions 517
Additional Treatment Modalities 519
Evaluation 519
Chapter Summary 520
Review Questions 520
References 522
Online Resources 523
23 Violence: 524
Objectives 524
Key Terms 524
Violence Within Families 525
Bullying Behavior 525
Developmental Aspects of the Family and its Structure 526
Family 526
The Dynamic Nature of Family Violence 526
Phase 1: Assault During Courtship and Marriage 526
Stalking 527
Violence and Pregnancy 527
Phase 2: Assault of Women and Children 527
Phase 3: Assault of the Elderly 528
Explanations of Family Violence 528
The Social and Cultural Perspective 528
Social Isolation 529
Generational Transmission of Violence 529
Developmental Traumatology: A Neurobiologic Perspective 529
Assaultive and Homicidal Behavior 530
The Nursing Process 530
Assessment 530
Nursing Diagnosis 532
Outcome Identification 532
Planning 532
Implementation 533
Nursing Interventions 533
Evaluation 534
Child Maltreatment 534
Emotional Effects of Trauma on Children and Adolescents 534
Physical Abuse 535
Psychologic Abuse 535
Sexual Abuse 535
Gaining Access to the Child 536
Pressure Situations 536
Forced Situations 536
Acts of Sexual Assault 536
Incest 536
Offenders 536
Characteristics of the Nonoffending Parent 537
Long-Term Consequences: Trauma Learning 537
Integration of Trauma: No Posttraumatic Stress Disorder 537
Posttraumatic Stress Disorder 537
Delayed Posttraumatic Stress Disorder 537
The Nursing Process 537
Assessment 537
Nursing Diagnosis 540
Outcome Identification 540
Outcome Identification for Child Sexual Abuse 540
Planning 540
Implementation 540
Evaluation 541
Elder Abuse 542
Types of Elder Abuse 542
Theories Of Elder Abuse 542
Elder Sexual Abuse 542
Difficulties with Recognizing Elder Trauma 543
Elder Abuse Offenders 543
The Nursing Process 543
Assessment 543
Nursing Diagnosis 544
Outcome Identification 544
Outcome Identification for Elder Abuse 545
Planning 545
Implementation 545
Nursing Interventions 545
Evaluation 546
Rape and Sexual Assault 546
Cultural Components of Rape and Sexual Assault 546
Cultural Values and Sexual Assault 546
Research Related to Rape and Culture 546
Adolescent Populations 547
Statutory Rape 547
Risk Factors 547
Drug Use 548
Prior Victimization 548
Dynamics of Rape 548
Motivation During Rape 549
Effects of Rape on the Victim 549
Trauma and the Limbic System 549
Chapter Summary 550
Review Questions 550
References 551
Online Resources 552
Child Abuse and Neglect 552
Elder Abuse 552
Woman Abuse 552
24 Forensic Nursing 553
Objectives 553
Key Terms 553
The History of Forensic Nursing 554
Legislation 554
Violence Against Women Act 554
Education and Credentialing of the Forensic Nurse 555
Fact and Expert Witnesses 555
Specialty Areas and Practice within Forensic Nursing 555
Sexual Assault Nurse Examiners 555
Sexual Assault Statistics. 556
Initial Assessment. 556
Forensic Nurses and Clinical Nurse Specialists 557
Care of Weapon-Related Assault Victims 557
Weapon Assault Statistics. 557
Nursing Process for Weapon-Related Assault Victims 557
Assessment 557
Nursing Diagnosis 558
Intervention 558
Evidence Collection in the Emergency Department 558
Outcome Identification 558
Care of Trauma Victims’ Families 559
Nursing Process in Traumatic Victims’ Family Care 559
Assessment 559
Nursing Diagnosis 559
Intervention 559
Posttraumatic Stress Disorder and Homicide Survivors 559
Forensic Psychiatric Nurses 560
Death Investigators and Nurse Coroners 561
Forensic Correctional Nurse 561
Clinical Practice in Correctional Settings 561
Statistics. 561
Forensic Risk 562
Chapter Summary 563
Review Questions 563
References 563
V Therapeutic Interventions 565
25 Psychopharmacology 565
Objectives 565
Key Terms 565
Mode and Mechanism of Drug Action 566
Neurotransmitters 566
Acetylcholine 566
Dopamine 566
Serotonin 566
Glutamate 566
Psychotropic Pharmacotherapy Assessment 566
Variables That Affect Drug Therapy 567
Psychosis 567
Antipsychotic Medications 567
Indications 568
Goals of Therapy 568
Absorption, Distribution, Metabolism, and Excretion 568
Clinical Use and Efficacy 568
Drug Level Monitoring. 569
Treatment Therapy for Acute Episodes. 569
Adverse Effects of Antipsychotics: Nursing Management 569
Extrapyramidal Side Effects. 569
Dystonia. 569
Pseudoparkinsonism. 569
Akathisia. 570
Tardive Dyskinesia. 570
Neuroleptic Malignant Syndrome. 570
Drowsiness. 571
Anticholinergic Side Effects. 571
Cardiovascular Side Effects 571
Postural Hypotension. 571
Arrhythmias and Palpitations (Changes in Heart Rhythm). 571
Changes in QT Intervals. 571
Weight Gain. 571
Photosensitivity and Skin Changes. 572
Poikilothermia. 572
Galactorrhea and Gynecomastia. 572
Short-acting Typical (Conventional) Antipsychotics 572
Long-Acting Injectable Typical (Conventional) Antipsychotics 572
Fluphenazine Decanoate Injection. 572
Haloperidol Decanoate Injection. 572
Atypical Antipsychotics 572
Clozapine. 573
Mechanism of Action. 573
VI Nursing Interventions with Special Populations 640
28 Grief: 640
Objectives 640
Key Terms 640
Responses to Grief and Bereavement 642
Physical Manifestations 642
Cognitive Manifestations 642
Behavioral and Relating Manifestations 642
Affective Manifestations 643
Guilt 643
Anger 643
The Stages and Process of Grief 644
Stages 644
Process 644
Characteristics 644
Grief Work 644
Tasks of Grief 644
Complicating Factors 645
Types of Grief 646
Anticipatory Grief 646
Acute Grief 646
Complicated Grief 647
Chronic Sorrow 648
Children and Adolescents in Grief 648
Grief and Depression 648
Bereavement Care 648
Before Loss 648
When Loss Is Impending 649
After the Loss 649
Spirituality and Grief 649
The Nursing Process 650
Assessment 650
Physical Disturbances 650
Cognitive Disturbances 650
Behavioral and Relating Disturbances 650
Affective Disturbances 650
Nursing Diagnosis 650
Acute Grief 651
Complicated Grief 651
Chronic Sorrow 651
Other Nursing Diagnoses 651
Outcome Identification 651
Planning 652
Implementation 652
Nursing Interventions 652
Collaborative Interventions 653
Problem-Oriented Grief Therapy 653
Grief Intervention During Childhood and Adolescence 654
Medications During Grief 654
Interventions for Complicated Grief 654
Evaluation 656
Chapter Summary 657
Review Questions 658
References 658
29 Mental and Emotional Responses to Medical Illness 660
Objectives 660
Key Terms 660
Mental Aspects of Physiologic Illness 661
Theories of Illness or Disease: Biologic, Multicausal, and Psychosocial 661
General Adaptation Syndrome 661
Appraisal–Transaction Theory 662
Life Changes and Illness Theory 663
Stress, Organ Maladaptation, and Disease Theory 663
Psychoneuroimmunoendocrinology 663
Coping Mechanisms 663
Acute Illness or Disease Responses 664
Chronic Illness or Disease Responses 664
Hiv and Aids 665
Cultural Considerations 666
Etiology of Psychologic Distress in Patients with Hiv/Aids 666
Biologic/Neuropsychiatric Factors 667
Psychosocial Factors 668
Clinical Description 669
Prognosis 669
The Nursing Process 669
Assessment 669
Nursing Diagnosis 670
Outcome Identification 670
Planning 671
Implementation 671
Nursing Interventions 671
Additional Treatment Modalities 672
Pharmacologic Intervention 673
Medical 673
Psychopharmacology 673
Integrative Therapies 673
Evaluation 674
Chapter Summary 674
Review Questions 675
References 675
VII Nursing Interventions in the Home and Community 677
30 Community Mental Health Nursing for Patients with Severe and Persistent Mental Illness 677
Objectives 677
Key Terms 677
Role of the Nurse 678
Historic Perspectives 678
Deinstitutionalization 678
Persons with Severe and Persistent Mental Illness 679
Psychotropic Medications 679
Legal Influences 680
Current Community Mental Health Treatment Systems 680
Community Mental Health Centers 680
Funding 680
Philosophy 680
Freedom of Choice 681
Continuity of Care 681
Cultural Considerations in Community Mental Health Nursing 681
Components of Community Mental Health Care 682
Community Mental Health Programs 682
Partial Hospitalization Programs 682
Psychosocial Rehabilitation and Skills Training Programs 682
Programs for Assertive Community Treatment 683
Clubhouse Model 683
Case Management 684
Levels of Assisted Living 684
Home Visits 686
Safety 686
The Homeless Mentally Ill Population 688
Violence and the Mentally Ill Population 689
Mentally Ill Persons in the Criminal Justice System 690
Mentally Ill Persons with Human Immunodeficiency Virus 691
Other Components of Community Psychiatric Mental Health Nursing 691
Chapter Summary 696
Review Questions 696
References 697
APPENDIX DSM-IV-TR Classification e1
Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence e1
Mental Retardation e1
Learning Disorders e1
Motor Skills Disorder e1
Communication Disorders e1
Pervasive Developmental Disorders e1
Attention-Deficit and Disruptive Behavior Disorders e1
Feeding and Eating Disorders of Infancy or Early Childhood e1
Tic Disorders e1
Elimination Disorders e1
Other Disorders of Infancy, Childhood, or Adolescence e2
Delirium, Dementia, and Amnestic and Other Cognitive Disorders e2
Delirium e2
Dementia e2
Amnestic Disorders e2
Other Cognitive Disorders e2
Mental Disorders Due to A General Medical Condition Not Elsewhere Classified e2
Substance-Related Disorders e2
Alcohol-Related Disorders e3
Alcohol Use Disorders e3
Alcohol-Induced Disorders e3
Amphetamine (or Amphetamine-Like)–Related Disorders e3
Amphetamine Use Disorders e3
Amphetamine-Induced Disorders e3
Caffeine-Related Disorders e3
Caffeine-Induced Disorders e3
Cannabis-Related Disorders e3
Cannabis Use Disorders e3
Cannabis-Induced Disorders e3
Cocaine-Related Disorders e3
Cocaine Use Disorders e3
Cocaine-Induced Disorders e3
Hallucinogen-Related Disorders e3
Hallucinogen Use Disorders e3
Hallucinogen-Induced Disorders e3
Inhalant-Related Disorders e3
Inhalant Use Disorders e3
Inhalant-Induced Disorders e3
Nicotine-Related Disorders e4
Nicotine Use Disorder e4
Nicotine-Induced Disorder e4
Opioid-Related Disorders e4
Opioid Use Disorders e4
Opioid-Induced Disorders e4
Phencyclidine (or Phencyclidine-Like)– Related Disorders e4
Phencyclidine Use Disorders e4
Phencyclidine-Induced Disorders e4
Sedative-, Hypnotic-, or Anxiolytic-Related Disorders e4
Sedative, Hypnotic, or Anxiolytic Use Disorders e4
Sedative-, Hypnotic-, or Anxiolytic-Induced Disorders e4
Polysubstance-Related Disorder e4
Other (or Unknown) Substance-Related Disorders e4
Other (or Unknown) Substance Use Disorders e4
Other (or Unknown) Substance-Induced Disorders e4
Schizophrenia and Other Psychotic Disorders e5
Mood Disorders e5
Depressive Disorders e5
Bipolar Disorders e5
Anxiety Disorders e5
Somatoform Disorders e6
Factitious Disorders e6
Dissociative Disorders e6
Sexual and Gender Identity Disorders e6
Sexual Dysfunctions e6
Sexual Desire Disorders e6
Sexual Arousal Disorders e6
Orgasmic Disorders e6
Sexual Pain Disorders e6
Sexual Dysfunction Due to a General Medical Condition e6
Paraphilias e7
Gender Identity Disorders e7
Eating Disorders e7
Sleep Disorders e7
Primary Sleep Disorders e7
Dyssomnias e7
Parasomnias e7
Sleep Disorders Related to Another Mental Disorder e7
Other Sleep Disorders e7
Impulse-Control Disorders Not Elsewhere Classified e7
Adjustment Disorders e7
Personality Disorders e7
Other Conditions That May be A Focus of Clinical Attention e8
Psychologic Factors Affecting Medical Condition e8
Medication-Induced Movement Disorders e8
Other Medication-Induced Disorder e8
Relational Problems e8
Problems Related to Abuse or Neglect e8
Additional Conditions That May Be a Focus of Clinical Attention e8
Additional Codes e8
Multiaxial System e8
APPENDIX A Answers to Review Questions 699
Glossary 701
A 701
B 701
C 702
D 703
E 703
F 704
G 704
H 704
I 704
J 705
K 705
L 705
M 705
N 705
O 706
P 706
R 707
S 707
T 709
U 709
V 709
W 709
X 709
Index 710
A 710
B 712
C 713
D 715
E 717
F 718
G 718
H 719
I 719
J 720
K 720
L 720
M 721
N 722
O 723
P 724
Q 726
R 726
S 726
T 730
U 730
V 730
W 731
X 731
Y 731
Z 731
NANDA International-Approved Nursing Diagnoses 732
Inside back cover ibc_i