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Essentials of Psychiatric Mental Health Nursing - E-Book

Essentials of Psychiatric Mental Health Nursing - E-Book

Elizabeth M. Varcarolis

(2016)

Additional Information

Book Details

Abstract

Awarded third place in the 2017 AJN Book of the Year Awards in the Psychiatric and Mental Health Nursing Category. Get a full understanding of today’s psychiatric nursing practice in less time! Essentials of Psychiatric Mental Health Nursing, 3rd Edition offers the perfect balance of essential nursing interventions and clinical content paired with current research and evidence-based practice to fully equip you for today’s field of mental health nursing. This new edition continues to retain the reader-friendly style, emphasis on therapeutic communication, and the nursing process organization that was successful in the previous edition. It also includes additional DSM-5 disorders, illustrations of various neurobiology disorders, a new neurobiology learning tool, and new NCLEX review questions to help you pass your course and thoroughly prepare for the psychiatric nursing section of the NCLEX.

  • REVISED! Examining the Evidence boxes explain the reasoning behind nursing interventions and how research affects everyday practice.
  • UNIQUE! Applying the Art sections in the clinical chapters provide examples of therapeutic and nontherapeutic communication techniques as well as realistic nurse-patient interaction scenarios.
  • Chapter review questions reinforce essential content from the chapter.
  • Critical thinking questions introduce clinical situations in psychiatric nursing.
  • Nursing Interventions tables familiarize readers with interventions for a disorder that they will encounter in clinical practice.
  • Key concepts and terms clarify essential terminology.
  • Vignettes offer succinct, real-life glimpses into clinical practice by describing patients and their psychiatric disorders.
  • Assessment Guidelines familiarize readers with methods of assessing patients.
  • Potential Nursing Diagnosis tables give several possible nursing diagnoses for a particular disorder along with the associated signs and symptoms.
  • DSM-5 diagnostic criteria identifies medical diagnostic criteria for psychiatric disorders for integration into the nursing plan of care.
  • Important contributions from psychiatric mental health nursing pioneers are featured in the opening unit pages.
  • Cultural Considerations sections reinforce the principles of culturally competent care.
  • Key Points to Remember outline the main concepts of each chapter in an easy to comprehend and concise bulleted list.
  • Appendices feature the DSM-5 Classifications and a list of the latest NANDA-I diagnoses for readers’ reference.

Table of Contents

Section Title Page Action Price
Front Cover Cover
IFC ES1
Essentials of Psychiatric Mental Health Nursing i
Essentials of Psychiatric Mental Health Nursing: A Communication Approach to Evidence-Based Care iii
Copyright iv
Dedication v
ACKNOWLEDGMENTS vi
CONTRIBUTORS vii
REVIEWERS viii
PREFACE ix
The Science ix
The Art ix
ORGANIZATION x
FEATURES x
LEARNING AND TEACHING AIDS x
For Students x
For Instructors x
CONTENTS xi
I - Essential Theoretical Concepts for Practice 1
1 - Practicing the Science and the Art of Psychiatric Nursing 2
INTRODUCTION 3
EVIDENCE-BASED PRACTICE 3
Resources for Clinical Practice 4
The Research-Practice Gap 4
Recovery Model 5
Trauma-Informed Care 5
Quality and Safety Education for Nurses (QSEN) 5
Caring 6
Attending 6
Patient Advocacy 6
Key Points to Remember 7
Applying Critical Judgment 7
Chapter Review Questions 7
REFERENCES 8
2 - Mental Health and Mental Illness 10
INTRODUCTION 10
CONCEPTS OF MENTAL HEALTH AND ILLNESS 12
MENTAL ILLNESS POLICY AND PARITY 13
Medical Diagnoses and the DSM-5 14
The DSM-5 in Culturally Diverse Populations 14
Nursing Diagnoses and NANDA International 15
PSYCHIATRY AND SPIRITUALITY/RELIGION 15
Stigma 16
Key Points to Remember 16
Applying Critical Judgment 17
Chapter Review Questions 17
REFERENCES 17
3 - Theories and Therapies 19
INTRODUCTION 19
PROMINENT THEORIES AND THERAPEUTIC MODELS 20
Psychoanalytic Theory 20
Therapeutic Model 20
Interpersonal Theory 20
Therapeutic Model 23
Behavioral Theories 23
Therapeutic Models 23
Humanistic Theory 23
II - Tools for Practice of the Art 74
7 - Nursing Process and QSEN: The Foundation for Safe and Effective Care 75
INTRODUCTION 75
STANDARDS OF PRACTICE FOR PSYCHIATRIC MENTAL HEALTH NURSING 77
Age Considerations 77
Assessment of Children 77
Assessment of Adolescents 78
Assessment of the Older Adult 78
Language Barriers 78
Psychiatric Nursing Assessment 78
Gathering Data 78
Validating the Assessment 82
Using Rating Scales 82
STANDARD 2: DIAGNOSIS 82
Formulating a Nursing Diagnosis 83
Standard Nursing Diagnosis 83
Risk Diagnoses 83
Health Promotion Diagnoses 83
STANDARD 3: OUTCOMES IDENTIFICATION 83
Determining Outcomes 83
STANDARD 4: PLANNING 85
STANDARD 5: IMPLEMENTATION 85
Basic Level and Advanced Practice Interventions 86
Basic Level: Psychiatric Mental Health Registered Nurse (PMH–RN) 86
Advanced Practice Interventions: Psychiatric Mental Health Advanced Practice Registered Nurse (PMH–APRN) 86
Prescriptive Authority and Treatment 86
Psychotherapy 86
Consultation 86
STANDARD 6: EVALUATION 86
DOCUMENTATION 87
Documentation of “Nonadherence” 87
Systems of Charting 87
Key Points to Remember 89
Applying Clinical Judgment 89
Chapter Review Questions 89
REFERENCES 90
8 - Communication Skills: Medium for All Nursing Practice 91
INTRODUCTION 91
COMMUNICATION 92
The Communication Process 92
Factors that Affect Communication 92
Personal Factors 92
Environmental Factors 92
Relationship Factors 92
Verbal Communication 93
Nonverbal Communication 93
Interaction of Verbal and Nonverbal Communication 94
EFFECTIVE COMMUNICATION SKILLS FOR NURSES 95
Use of Silence 95
Active Listening 95
Clarifying Techniques 96
Paraphrasing (Reflection of Content) 96
Restating 96
Reflecting of Feelings 96
Exploring 96
Projective Questions: The “What if” Question 96
Presupposition Questions: The “Miracle Question” 96
NONTHERAPEUTIC TECHNIQUES 98
Asking Excessive Questions 98
Giving Approval or Disapproval 98
Advising 99
Asking “Why” Questions 100
COMMUNICATING ACROSS CULTURES 100
Communication Styles 100
Eye Contact 100
Touch 101
Cultural Filters 101
COMMUNICATION THROUGH TECHNOLOGIES 101
Mobile Apps 101
EVALUATION OF CLINICAL SKILLS 102
Key Points to Remember 102
Applying Critical Judgment 103
Chapter Review Questions 103
REFERENCES 104
9 - Therapeutic Relationships and the Clinical Interview 105
INTRODUCTION 105
NURSE-PATIENT PARTNERSHIP/RELATIONSHIP 105
Therapeutic versus Other Types of Relationships 106
Social Relationships versus Therapeutic Relationships 106
Therapeutic Relationships 106
Establishing Relationship Boundaries 107
Transference 107
Countertransference 108
Values, Beliefs, and Self-Awareness 108
Self-Check on Boundary Issues 109
Phases of the Nurse-Patient Relationship 109
Preorientation Phase 110
Orientation Phase 111
Working Phase 112
Termination Phase 113
What Hinders and What Helps 113
Factors That Enhance Growth 114
Genuineness 114
Empathy 114
Positive Regard 114
THE CLINICAL INTERVIEW 115
Preparing for the Interview 115
Setting 115
Seating 115
Introductions 115
Initiating the Interview 116
Tactics to Avoid 116
Helpful Guidelines 116
Attending Behaviors: The Foundation of Interviewing 116
Eye Contact 116
Body Language 116
Vocal Qualities 116
Verbal Tracking 117
Clinical Supervision and Process Recordings 117
Key Points to Remember 117
Applying Critical Judgment 117
Chapter Review Questions 118
REFERENCES 118
III - Caring for Patients with Psychobiological Disorders 119
10 - Trauma and Stress-Related Disorders 120
INTRODUCTION 120
PHYSIOLOGICAL AND PSYCHOLOGICAL RESPONSES TO STRESS 121
STRESS REDUCTION TECHNIQUES 121
TRAUMA AND STRESS-RELATED DISORDERS 122
Posttraumatic Stress Disorder 122
GOALS OF TREATMENT 125
PSYCHOTHERAPEUTIC TREATMENT STRATEGIES 126
PSYCHOTHERAPY 126
Acute Stress Disorder 126
CRITICAL INCIDENT DEBRIEFING 127
SELF-CARE FOR NURSES 127
KEY POINTS TO REMEMBER 128
APPLYING CRITICAL JUDGMENT 128
CHAPTER REVIEW QUESTIONS 128
REFERENCES 129
11 - Anxiety, Anxiety Disorders, and Obsessive-Compulsive and Related Disorders 130
INTRODUCTION 131
ANXIETY 131
LEVELS OF ANXIETY 131
Mild Anxiety 131
Moderate Anxiety 131
Severe Anxiety 131
Panic Level of Anxiety 131
INTERVENTIONS 132
Mild to Moderate Levels of Anxiety 132
IV - Caring for Patients Experiencing Psychiatric Emergencies 323
20 - Crisis and Mass Disaster 324
INTRODUCTION 324
PREVALENCE AND COMORBIDITY 325
THEORY 325
CLINICAL PICTURE 325
Types of Crises 325
Maturational Crisis 326
Situational Crisis 326
Adventitious Crisis 326
Disaster Response 326
Self-Care for Nurses 327
Phases of Crisis 327
Assessing the Patient’s Perception of the Precipitating Crisis Event 327
Assessing the Patient’s Situational Supports 328
Assessing the Patient’s Personal Coping Skills 328
?Assessment Guidelines 329
Crisis 329
DIAGNOSIS 329
OUTCOMES IDENTIFICATION 329
PLANNING 329
IMPLEMENTATION 330
Levels of Nursing Care 330
Primary 330
Secondary 330
Tertiary 330
. Critical Incident Stress Debriefing (CISD) is an example of a tertiary intervention directed toward a group that has experienc... 330
EVALUATION 331
KEY POINTS TO REMEMBER 332
APPLYING CRITICAL JUDGMENT 332
CHAPTER REVIEW QUESTIONS 333
REFERENCES 333
21 - Child, Partner, and Elder Violence 334
INTRODUCTION 334
THEORY 335
Social Learning Theory 335
Societal and Cultural Factors 335
Psychological Factors 335
CHILD ABUSE 336
Child 337
Parent or Caregiver 337
DIAGNOSES AND OUTCOMES IDENTIFICATION 337
IMPLEMENTATION 338
INTIMATE PARTNER VIOLENCE 338
The Battered Partner 339
The Batterer 340
Cycle of Violence 340
Why Abused Partners Stay 340
DIAGNOSIS AND OUTCOMES IDENTIFICATION 342
IMPLEMENTATION 342
A Note on Programs for Batterers 342
ELDER ABUSE 343
The Abused Elder 344
The Abuser 344
DIAGNOSIS AND OUTCOMES IDENTIFICATION 345
IMPLEMENTATION 345
EVALUATION 346
KEY POINTS TO REMEMBER 346
APPLYING CRITICAL JUDGMENT 346
CHAPTER REVIEW QUESTIONS 347
REFERENCES 347
22 - Sexual Violence 349
INTRODUCTION 350
PREVALENCE AND COMORBIDITY 350
Children: Child Sexual Abuse and Incest 350
High School 351
Young Adults 351
Male and LGBTQ Victims of Sexual Assault 351
LGBTQ (Lesbian, Gay, Bisexual, Transgender, Questioning) Community 352
Cultural Considerations 352
THEORY 353
Vulnerable Individuals 353
The Perpetrator of Sexual Assault 353
Biological Factors 353
Psychosocial Factors 353
Hotlines and Other Sources 353
Emergency Departments 354
?Assessment Guidelines 354
Sexual Assault (Follow Unit Protocols) 354
DIAGNOSIS 355
Rape-Trauma Syndrome 355
The Acute Phase 355
The Long-Term Phase 355
OUTCOMES IDENTIFICATION 355
Short-Term Goals 355
Long-Term Goals 355
IMPLEMENTATION 355
Pharmacological, Biological, and Integrative Therapies 358
Emergency Department 358
Pharmacology 358
Psychotherapy 358
Therapy for Rapists 358
EVALUATION 358
KEY POINTS TO REMEMBER 359
APPLYING CRITICAL JUDGMENT 359
CHAPTER REVIEW QUESTIONS 360
REFERENCES 360
23 - Suicidal Thoughts and Behaviors 362
INTRODUCTION 362
PREVALENCE AND COMORBIDITY 363
THEORY 363
Contributing Risk Factors for Suicide 364
Neurobiological Aspects of Suicide 364
Genetic Factors 364
Societal Factors 364
Psychological Factors 364
Age 364
Adolescents and Young Adults 364
Older Adults 365
CULTURAL CONSIDERATIONS 365
Verbal Clues 366
Behavioral Clues 366
?Assessment Guidelines 367
Suicide Risk 367
DIAGNOSIS 367
OUTCOMES IDENTIFICATION AND PLANNING 367
IMPLEMENTATION 367
Communication Guidelines 367
Psychotherapy 370
Postvention 370
Self-Care for Nurses 371
KEY POINTS TO REMEMBER 372
APPLYING CRITICAL JUDGMENT 372
CHAPTER REVIEW QUESTIONS 372
REFERENCES 372
24 - Anger, Aggression, and Violence 374
INTRODUCTION 374
ANGER, AGGRESSION, AND VIOLENCE 374
BULLYING AND VIOLENCE 375
Bullying in Health Care Environments 375
PREVALENCE AND COMORBIDITY 375
THEORY 375
Environmental and Demographic Correlates of Violence 375
Neurobiological Factors 376
Brain Structure 376
Neurotransmitters 376
Genetic Factors 376
CULTURAL CONSIDERATIONS 376
Subjective Data 376
Objective Data 377
?Assessment Guidelines 377
Anger, Aggression, and Violent Acting-Out 377
DIAGNOSIS 377
OUTCOMES IDENTIFICATION 378
PLANNING 378
IMPLEMENTATION 379
Stages of the Violence Cycle 379
Pre-assaultive Stage: De-escalation Approaches 379
Assaultive Stage: Medication, Seclusion, and Restraint 380
. Sivak (2012) points out that there is no evidence to support the therapeutic value of seclusion and restraint and reports that... 382
Post-assaultive Stage 383
Critical Incident Debriefing 383
Documentation of a Violent Episode 383
Anticipating Increased Anxiety and Anger in Other Hospital Settings 383
Interventions for Patients with Neurocognitive Deficits 384
Psychotherapy 384
Pharmacological Therapies 385
Medications for Acute Aggression 385
Medications for Chronic Aggression 385
EVALUATION 385
KEY POINTS TO REMEMBER 386
APPLYING CRITICAL JUDGMENT 386
CHAPTER REVIEW QUESTIONS 386
REFERENCES 387
25 - Care for the Dying and Those Who Grieve 388
INTRODUCTION 388
Dying in America 388
LOSS, GRIEF, AND MOURNING 389
THEORY 390
PATIENT AND FAMILY-CENTERED GOALS OF CARE 391
Communication Skills 391
Assess and Address Spirituality 395
Advance Care Planning 395
Interdisciplinary Teamwork 395
CARING FOR THOSE WHO GRIEVE 395
Helping Bereaved Caregivers Make Sense of Their Feelings 396
Helping People Say Goodbye 396
Helping Families Maintain Hope 396
Therapeutic Presence 397
SELF-CARE FOR NURSES 397
?Assessment Guidelines 398
Grieving and Complicated Grieving 398
DIAGNOSIS 398
EXPECTED OUTCOMES 399
PLANNING 399
IMPLEMENTATION 399
Psychotherapy 399
EVALUATION 401
KEY POINTS TO REMEMBER 401
APPLYING CRITICAL JUDGMENT 402
CHAPTER REVIEW QUESTIONS 402
REFERENCES 402
V - Age-Related Mental Health Disorders 404
26 - Children and Adolescents 405
THEORY 406
Genetic Factors 406
Biochemical Factors 406
Environmental Factors 406
NEURODEVELOPMENTAL DISORDERS 407
Intellectual Disability (formerly called Mental Retardation) 407
Assessment 407
A - DSM-5 Classification\r 453
NEURODEVELOPMENTAL DISORDERS (31) 453
Intellectual Disabilities (33) 453
Motor Disorders (74) 453
A 453
Tic Disorders 454
BIPOLAR AND RELATED DISORDERS (123) 454
DEPRESSIVE DISORDERS (155) 455
ANXIETY DISORDERS (189) 455
DISSOCIATIVE DISORDERS (291) 456
SOMATIC SYMPTOM AND RELATED DISORDERS (309) 456
FEEDING AND EATING DISORDERS (329) 456
ELIMINATION DISORDERS (355) 457
SLEEP-WAKE DISORDERS (361) 457
SEXUAL DYSFUNCTIONS (423) 458
GENDER DYSPHORIA (451) 458
Substance-Related Disorders (483) 458
Alcohol-Related Disorders (490) 458
Caffeine-Related Disorders (503) 458
Cannabis-Related Disorders (509) 459
Hallucinogen-Related Disorders (520) 459
Inhalant-Related Disorder (533) 459
Opioid-Related Disorders (540) 459
Sedative-, Hynotic-, or Anxiolytic-Related Disorders (550) 459
Stimulant-Related Disorders (561) 459
Tobacco-Related Disorders (571) 460
Other (or Unknown) Substance-Related Disorders (577) 460
Non-Substance-Related Disorders (585) 460
NEUROCOGNITIVE DISORDERS (591) 460
Major and Mild Neurocognitive Disorders (602) 460
Major or Mild Neurocognitive Disorder Due to Alzheimer’s Disease (611) 460
Major or Mild Frontotemporal Neurocognitive Disorder (614) 461
Major or Mild Neurocognitive Disorder with Lewy Bodies (618) 461
Major or Mild Vascular Neurocognitive Disorder (621) 461
Major or Mild Neurocognitive Disorder Due to Traumatic Brain Injury (624) 461
Substance/Medication-Induced Major or Mild Neurocognitive Disordera (627) 461
Major or Mild Neurocognitive Disorder Due to HIV Infection (632) 461
Major or Mild Neurocognitive Disorder Due to Prion Disease (634) 461
Major or Mild Neurocognitive Disorder Due to Parkinson’s Disease (636) 461
Major or Mild Neurocognitive Disorder Due to Huntington’s Disease (638) 461
Major or Mild Neurocognitive Disorder Due to Another Medical Conditiona (641) 461
Major or Mild Neurocognitive Disorder Due to Multiple Etiologies (642) 461
Unspecified Neurocognitive Disorder (643) 462
PERSONALITY DISORDERS (645) 462
Cluster A Personality Disorders 462
Cluster B Personality Disorders 462
Cluster C Personality Disorders 462
Other Personality Disorders 462
PARAPHILIC DISORDERS (685) 462
OTHER MENTAL DISORDERS (707) 462
MEDICATION-INDUCED MOVEMENT DISORDERS AND OTHER ADVERSE EFFECTS OF MEDICATION (709) 462
OTHER CONDITIONS THAT MAY BE A FOCUS OF CLINICAL ATTENTION (715) 462
Relational Problems (715) 462
Problems Related to Family Upbringing (715) 462
Other Problems Related to Primary Support Group (716) 463
Abuse and Neglect (717) 463
Child Maltreatment and Neglect Problems (717) 463
Adult Maltreatment and Neglect Problems (720) 463
Educational and Occupational Problems (723) 464
Educational Problems (723) 464
Occupational Problems (723) 464
Housing and Economic Problems (723) 464
Housing Problems (723) 464
Economic Problems (724) 464
Other Problems Related to the Social Environment (724) 464
Problems Related to Crime or Interaction With the Legal System (725) 465
Other Health Service Encounters for Counseling and Medical Advice (725) 465
Problems Related to Other Psychosocial, Personal, and Environmental Circumstances (725) 465
Other Circumstances of Personal History (726) 465
Problems Related to Access to Medical and Other Health Care (726) 465
Nonadherence to Medical Treatment (726) 465
B - NANDA-Approved Nursing Diagnoses 2015–2017 466
C - Answers to Chapter Review Questions\r 469
Chapter 1 469
Chapter 2 469
Chapter 3 469
Chapter 4 469
Chapter 5 470
Chapter 6 470
Chapter 7 470
Chapter 8 470
Chapter 9 470
Chapter 10 470
Chapter 11 471
Chapter 12 471
Chapter 13 471
Chapter 14 471
Chapter 15 471
Chapter 16 472
Chapter 17 472
Chapter 18 472
Chapter 19 472
Chapter 20 472
Chapter 21 473
Chapter 22 473
Chapter 23 473
Chapter 24 473
Chapter 25 473
Chapter 26 474
Chapter 27 474
Chapter 28 474
A 475
B 476
C 477
D 479
E 480
F 480
G 480
H 481
I 481
J 481
K 481
L 481
M 482
N 483
O 483
P 484
Q 485
R 485
S 485
T 488
U 488
V 488
W 488
Y 488
Z 488
IBC ES2