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Varcarolis' Foundations of Psychiatric-Mental Health Nursing - E-Book

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Varcarolis' Foundations of Psychiatric-Mental Health Nursing - E-Book

Margaret Jordan Halter

(2017)

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Additional Information

Book Details

ISBN
978-0-323-41731-0
Edition
8
Language
English
Pages
696
Subjects
Public health & preventive medicine
Nursing
Psychiatric nursing

Abstract

Varcarolis' Foundations of Psychiatric-Mental Health Nursing, 8th Edition is the most comprehensive RN psychiatric nursing text on the market! Awarded second place in the 2018 AJN Book of the Year Awards in Psychiatric Mental Health Nursing category. User-friendly by design, it simplifies the often-intimidating subject of psychiatric-mental health nursing with a practical, clinical perspective. This edition was revised in conjunction with a readability expert to support clarity and ease of understanding. Chapters follow the nursing process framework and progress from theory to application, preparing your students for clinical practice with real-world examples. New to this edition are full-page illustrated explanations about the neurobiology of disorders and associated medications, criteria from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) for major disorders, completely revised Evidence-Based Practice boxes, and a fully rewritten chapter on Dying, Death, and Grieving to provide students with essential information about difficult topics.

  • Mentor-like writing style reinforces important information and helps in applying textbook content to the clinical setting.
  • Coverage of key topics and emerging nursing trends keep you current with best practices in the field.
  • Considering Culture boxes discuss the importance of person-centered care in providing competent care to diverse populations in various clinical situations.
  • Vignettes with vivid mini-stories prepare you for real-world practice with personal, descriptive characterizations of patients with specific psychiatric disorders.
  • Health Policy Boxes introduce the role you can play in advocating for patients and the profession.
  • Clinical chapters follow the six-step nursing process, providing consistent guidelines for comprehensive assessment and intervention.
  • NEW! Full-page illustrated explanations about the neurobiology of disorders and associated medications.
  • NEW! DSM-5 guidelines from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders are fully incorporated in the text, and include updated NANDA content.
  • NEW! Completely revised Evidence-Based Practice boxes.
  • NEW! Revised chapter on Dying, Death and Grieving gives you all the vital information you need.
  • NEW! Ten NCLEX-style questions and answers at the end of each chapter.

Table of Contents

Section Title Page Action Price
Front Cover Cover
CONTENTS ES1
evolve page i
Varcarolis’FOUNDATIONS of PSYCHIATRIC-MENTAL HEALTH NURSING iii
Copyright iv
Dedication v
ACKNOWLEDGMENTS vi
CONTRIBUTOR LIST vii
ANCILLARY WRITERS viii
REVIEWERS ix
TO THE INSTRUCTOR x
CONTENT NEW TO THIS EDITION x
ORGANIZATION OF THE TEXT x
TEACHING AND LEARNING RESOURCES xi
For Instructors xi
For Students xi
TO THE STUDENT xii
READING AND REVIEW TOOLS xii
ADDITIONAL LEARNING RESOURCES xii
CHAPTER FEATURES xii
CONTENTS xiii
I - Foundations in Theory 2
1 - Mental Health and Mental Illness 1
MENTAL HEALTH AND MENTAL ILLNESS 2
MENTAL HEALTH CONTINUUM 3
RISK AND PROTECTIVE FACTORS 4
Individual Attributes and Behaviors 4
Social and Economic Circumstances 5
Environmental Factors 5
Perceptions of Mental Health and Mental Illness 6
Mental Illness Versus Physical Illness 6
Nature Versus Nurture 6
Social Influences on Mental Healthcare 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
Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative 9
Research Domain Criteria (RDoC) Initiative 9
LEGISLATION AND MENTAL HEALTH FUNDING 9
Mental Health Parity 9
Patient Protection and Affordable Care Act of 2010 9
EPIDEMIOLOGY OF MENTAL DISORDERS 10
Classification of Mental Disorders 11
The DSM-5 11
The ICD-10-CM 11
PSYCHIATRIC-MENTAL HEALTH NURSING 11
What Is Psychiatric-Mental Health Nursing? 11
Classification of Nursing Diagnoses, Outcomes, and Interventions 12
DSM-5 and NANDA-I–Approved Nursing Diagnoses 12
Nursing Outcomes Classification (NOC) 12
Nursing Interventions Classification (NIC) 12
Levels of Psychiatric-Mental Health Clinical Nursing Practice 12
Basic Level 13
Advanced Practice 13
FUTURE ISSUES FOR PSYCHIATRIC-MENTAL HEALTH NURSES 13
Educational Challenges 13
An Aging Population 14
Cultural Diversity 14
Science, Technology, and Electronic Healthcare 14
ADVOCACY AND LEGISLATIVE INVOLVEMENT 14
KEY POINTS TO REMEMBER 15
CRITICAL THINKING 15
REFERENCES 17
2 - Theories and Therapies 18
PSYCHOANALYTIC THEORIES AND THERAPIES 19
Psychoanalytic Theory 19
Levels of Awareness 19
Personality Structure 19
Defense Mechanisms and Anxiety 20
Psychosexual Stages of Development 20
Psychoanalytic Therapy 20
Psychodynamic Therapy 20
Implications of Psychoanalytic Theory for Nursing Practice 20
INTERPERSONAL THEORIES AND THERAPIES 21
Interpersonal Theory 21
Interpersonal Therapy 21
Implications of Interpersonal Theory to Nursing 22
Peplau’s Theory of Interpersonal Relationships 22
BEHAVIORAL THEORIES AND THERAPIES 22
Classical Conditioning Theory 22
Behavioral Theory 23
Operant Conditioning Theory 23
Behavioral Therapy 23
Modeling 24
Operant Conditioning 24
Aversion Therapy 24
Biofeedback 24
Implications of Behavioral Theory to Nursing 25
COGNITIVE THEORIES AND THERAPIES 25
Rational-Emotive Therapy 25
Cognitive-Behavioral Therapy 25
Implications of Cognitive Theories for Nursing 26
HUMANISTIC THEORIES 26
Theory of Human Motivation 26
Hierarchy of Needs 26
Implications of Motivation Theory for Nursing 27
BIOLOGICAL THEORIES AND THERAPIES 28
Biological Model 28
Biological Therapies 29
. In addition to psychotherapy and psychopharmacology as treatment for mental illness are the brain stimulation therapies. The o... 29
Implications of the Biological Model for Nursing 29
DEVELOPMENTAL THEORIES 29
Cognitive Development 29
Theory of Psychosocial Development 30
Theory of Object Relations 30
Theories of Moral Development 30
Stages of Moral Development 30
Preconventional level 30
Conventional level 30
Postconventional level 31
Ethics of Care Theory 31
CONCLUSION 32
REFERENCES 35
3 - Psychobiology and Psychopharmacology 36
STRUCTURE AND FUNCTION OF THE BRAIN 37
Functions and Activities of the Brain 37
Maintenance of Homeostasis 37
Regulation of the Autonomic Nervous System and Hormones 38
Control of Biological Drives and Behavior 39
Conscious Mental Activity 39
Memory 39
Social Skills 39
Cellular Composition of the Brain 40
Organization of the Brain 40
Brainstem 40
Hypothalamus 42
Cerebellum 42
Cerebrum 42
Visualizing the Brain 43
Disturbances of Mental Function 45
Genetics 45
Neurotransmitters 47
ACTION OF PSYCHOTROPIC DRUGS 48
Drug Agonism and Antagonism 49
Antianxiety and Hypnotic Drugs 49
Benzodiazepines 49
Short-Acting Sedative-Hypnotic Sleep Agents 49
Melatonin Receptor Agonists 50
Doxepin 50
Suvorexant 50
Buspirone 50
Treating Anxiety Disorders with Antidepressants 50
Antidepressant Drugs 51
Selective Serotonin Reuptake Inhibitors 52
Norepinephrine and Serotonin Specific Antidepressant 53
Norepinephrine Dopamine Reuptake Inhibitor 53
Serotonin Antagonist and Reuptake Inhibitors 53
Serotonin Modulator and Stimulator 53
Serotonin Norepinephrine Reuptake Inhibitors 53
Serotonin Partial Agonist and Reuptake Inhibitor 53
Tricyclic Antidepressants 53
Monoamine Oxidase Inhibitors 54
Mood Stabilizers 55
Lithium 55
Anticonvulsant Drugs 55
Valproate 55
Carbamazepine 56
Lamotrigine 56
Antipsychotic Drugs 56
First-Generation Antipsychotics 56
Second-Generation Antipsychotics 57
Clozapine 57
Risperidone 58
Quetiapine 58
Olanzapine 58
Ziprasidone 58
Aripiprazole 58
Paliperidone 58
Iloperidone 58
Lurasidone 58
Asenapine 58
Drug Treatment for Attention-Deficit/Hyperactivity Disorder 59
Drug Treatment for Alzheimer’s Disease 59
Herbal Treatments 59
REFERENCES 61
II - Foundations for Practice 62
4 - Treatment Settings 62
BACKGROUND 63
CONTINUUM OF CARE 64
OUTPATIENT CARE SETTINGS 64
Primary Care Providers 64
Specialized Psychiatric Care Providers 65
Patient-Centered Medical Homes 65
Community Mental Health Centers 66
Psychiatric Home Care 66
Assertive Community Treatment 66
Intensive Outpatient Programs and Partial Hospitalization Programs 67
Other Outpatient Venues for Psychiatric Care 67
Emergency Care 67
PREVENTION IN OUTPATIENT CARE 68
Primary Prevention 68
Secondary Prevention 68
Tertiary Prevention 68
OUTPATIENT PSYCHIATRIC NURSING CARE 68
Promoting Recovery and Continuation of Treatment 68
INPATIENT CARE SETTINGS 69
Crisis Stabilization/Observation Units 69
General Hospital and Private Hospital 69
State Hospital 69
CONSIDERATIONS FOR INPATIENT CARE 69
Entry to Acute Inpatient Care 69
Rights of the Hospitalized Patient 70
Teamwork and Collaboration 70
Therapeutic Milieu 71
Managing Behavioral Crises 71
Safety 71
Unit Design 72
INPATIENT PSYCHIATRIC NURSING CARE 72
SPECIALTY TREATMENT SETTINGS 73
Pediatric Psychiatric Care 73
Geriatric Psychiatric Care 73
Veterans Administration Centers 73
Forensic Psychiatric Care 74
Alcohol and Drug Use Disorder Treatment 74
Self-Help Options 74
REFERENCES 76
5 - Cultural Implications 77
MINORITY STATUS, RACE, ETHNICITY, AND CULTURE 78
Minority Status 78
Race 78
Ethnicity 78
Culture 78
Measuring Race and Ethnicity in the United States 78
DEMOGRAPHIC SHIFTS IN THE UNITED STATES 79
BASIC WORLDVIEWS 79
Western Tradition 79
Eastern Tradition 80
Indigenous Culture 80
IMPACT OF CULTURE 80
CULTURAL BARRIERS TO MENTAL HEALTH SERVICES 81
Communication Barriers 81
Stigma of Mental Illness 83
Misdiagnosis 83
Cultural Concepts of Distress 83
Genetic Variation in Pharmacodynamics 84
POPULATIONS AT RISK FOR MENTAL ILLNESS AND INADEQUATE CARE 85
Immigrants 85
Refugees 85
Cultural Minorities 85
CULTURALLY COMPETENT CARE 85
Cultural Awareness 86
Cultural Knowledge 86
Cultural Encounters 86
Cultural Skill 86
Cultural Desire 87
REFERENCES 89
6 - Legal and Ethical Considerations 91
ETHICAL CONCEPTS 92
MENTAL HEALTH LAWS 93
ADMISSION AND DISCHARGE PROCEDURES 93
Admission Procedures 93
Voluntary Admissions 93
Informal Admission 93
Involuntary Commitment 93
. Emergency commitment is also known as a temporary admission or emergency hospitalization. Emergency commitment is used (1) for... 94
. Assisted outpatient treatment is also known as court-ordered outpatient treatment and more than 20 other names throughout the ... 94
Discharge Procedures 94
Conditional Release 95
Unconditional Release 95
Release against Medical Advice (AMA) 95
PATIENTS’ RIGHTS UNDER THE LAW 95
Right to Treatment 95
Right to Refuse Treatment 95
Right to Informed Consent 96
Implied Consent 96
Capacity and Competency 96
Rights Regarding Psychiatric Advance Directives 97
Rights Regarding Restraint and Seclusion 97
Orders and Documentation with Restraint and Seclusion 97
Rights Regarding Confidentiality 98
Health Insurance Portability and Accountability Act 98
Confidentiality and Social Media 98
Confidentiality After Death 98
Confidentiality of Professional Communications 98
Exceptions to the Rule 98
. The California Supreme Court in its 1974 landmark decision Tarasoff v. Regents of University of California ruled that a therap... 98
. Staff nurses are obligated to report a patient’s threats of harm against specified victims or classes of victims to other memb... 99
. All 50 states and the District of Columbia have child abuse reporting statutes. Although these statutes differ from state to s... 99
Failure to Protect Patients 99
LAWS RELEVANT TO PSYCHIATRIC NURSING 99
Tort Law 99
Intentional Torts 99
Unintentional Torts 100
. When nurses represent themselves as being capable of caring for psychiatric patients and accept employment, a duty of care has... 100
. If you do not meet the standard of care that other nurses would be expected to supply under similar circumstances, you have br... 100
. Cause in fact may be evaluated by asking the question, “If it were not for what this nurse did (or failed to do), would this i... 100
. These include actual damages (e.g., loss of earnings, medical expenses, and property damage), as well as pain and suffering. T... 100
STANDARDS FOR NURSING CARE 101
State Boards of Nursing 101
Professional Associations 101
Institutional Policies and Procedures 101
Custom as a Standard of Care 102
ACTING ON QUESTIONABLE PRACTICE 102
Negligence, Irresponsibility, or Impairment 102
DOCUMENTATION OF CARE 103
Medical Records and Quality Improvement 103
Medical Records as Evidence 103
Guidelines for Electronic Documentation 103
FORENSIC NURSING 103
VIOLENCE IN THE PSYCHIATRIC SETTING 104
REFERENCES 107
III - Psychosocial Nursing Tools 107
7 - The Nursing Process and Standards of Care 108
Quality and Safety Education in Nursing 110
Standards of Practice in Psychiatric-Mental Health Nursing 110
STANDARDS OF PRACTICE FOR PSYCHIATRIC-MENTAL HEALTH NURSING: STANDARD 1: ASSESSMENT 110
Age Considerations 111
Assessment of Children 111
Assessment of Adolescents 111
Assessment of Older Adults 111
Language Barriers 111
Psychiatric-Mental Health Nursing Assessment 112
Gathering Data 112
Validating the Assessment 114
Using Rating Scales 115
STANDARDS OF PRACTICE FOR PSYCHIATRIC-MENTAL HEALTH NURSING: STANDARD 2: DIAGNOSIS 115
Diagnostic Statements 115
Types of Nursing Diagnoses 115
STANDARDS OF PRACTICE FOR PSYCHIATRIC-MENTAL HEALTH NURSING: STANDARD 3: OUTCOMES IDENTIFICATION 116
STANDARDS OF PRACTICE FOR PSYCHIATRIC-MENTAL HEALTH NURSING: STANDARD 4: PLANNING 116
STANDARDS OF PRACTICE FOR PSYCHIATRIC-MENTAL HEALTH NURSING: STANDARD 5: IMPLEMENTATION 118
Standard 5A. Coordination of Care 118
Standard 5B. Health Teaching and Health Promotion 118
Standard 5C. Consultation 118
Standard 5D. Prescriptive Authority and Treatment 118
Standard 5E. Pharmacological, Biological, and Integrative Therapies 118
Standard 5F. Milieu Therapy 118
Standard 5G. Therapeutic Relationship and Counseling 119
Standard 5H. Psychotherapy 119
STANDARDS OF PRACTICE FOR PSYCHIATRIC-MENTAL HEALTH NURSING: STANDARD 6: EVALUATION 119
DOCUMENTATION 119
Documentation of “Nonadherence” 119
REFERENCES 122
8 - Therapeutic Relationships 124
CONCEPTS OF THE NURSE-PATIENT RELATIONSHIP 125
Importance of Talk Therapy 125
Goals and Functions 125
Social Versus Therapeutic 125
Social Relationships 125
Therapeutic Relationships 126
Relationship Boundaries and Roles 126
Establishing Boundaries 126
Blurring of Boundaries 127
Blurring of Roles 127
Self-Check on Boundaries 128
A FOCUS ON SELF-AWARENESS 128
PEPLAU’S MODEL OF THE NURSE-PATIENT RELATIONSHIP 129
Preorientation Phase 130
Orientation Phase 130
Introductions 130
Working Phase 132
Termination Phase 132
FACTORS THAT PROMOTE PATIENTS’ GROWTH 133
Genuineness 133
Empathy 133
Empathy Versus Sympathy 133
Positive Regard 133
Attitudes 133
Actions 133
REFERENCES 136
9 - Therapeutic Communication 137
INTRODUCTION 138
Saying the Wrong Thing 138
Benefits of Therapeutic Communication 138
THE COMMUNICATION PROCESS 138
FACTORS THAT AFFECT COMMUNICATION 140
Personal Factors 140
Environmental Factors 140
Relationship Factors 140
VERBAL AND NONVERBAL COMMUNICATION 140
Verbal Communication 140
Nonverbal Communication 140
Interaction of Verbal and Nonverbal Communication 140
COMMUNICATION SKILLS FOR NURSES 141
Therapeutic Communication Techniques 141
Using Silence 141
Active Listening 142
Clarifying Techniques 142
Questions 143
Nontherapeutic Communication Techniques 145
Excessive Questioning 145
Giving Approval or Disapproval 145
Giving Advice 145
Asking “Why” Questions 146
Cultural Considerations 147
Communication Style 147
Eye Contact 147
Touch 148
Cultural Filters 148
Information Communication Technologies 148
Mobile Applications 149
Evaluation of Communication Skills 149
THE CLINICAL INTERVIEW 149
Preparing for the Interview 149
Pace 149
Setting 149
Seating 150
Introductions 150
Initiating the Interview 150
Tactics to Avoid 150
Helpful Guidelines 150
Attending Behaviors: The Foundation of Interviewing 150
Eye Contact 150
Body Language 151
Vocal Quality 151
Clinical Supervision and Debriefing 151
Process Recordings 151
REFERENCES 154
10 - Stress Responses and Stress Management 156
RESPONSES TO AND EFFECTS OF STRESS 157
Early Stress Response Theories 157
Fight-or-Flight Response 157
General Adaptation Syndrome 158
Bad Stress Versus Good Stress? 159
Critique of the GAS 159
Neurotransmitter Stress Responses 159
Immune System Stress Responses 159
MEDIATORS OF THE STRESS RESPONSE 160
Stressors 160
Perception 160
Individual Temperament 160
Social Support 161
Support Groups 161
Culture 161
Spirituality and Religion 162
NURSING MANAGEMENT OF STRESS RESPONSES 162
Measuring Stress 162
Assessing Coping Styles 164
Managing Stress through Relaxation Techniques 164
Biofeedback 164
Deep Breathing Exercises 165
Guided Imagery 166
Progressive Relaxation 166
Meditation 166
OTHER WAYS TO RELAX 167
Physical Exercise 167
Cognitive Reframing 167
Journaling 167
Humor 168
REFERENCES 170
IV - Psychobiological Disorders 171
11 - Childhood and Neurodevelopmental Disorders 171
RISK FACTORS 173
Biological Factors 173
Genetic 173
Neurobiological 173
Psychological Factors 173
Temperament 173
Resilience 173
Environmental Factors 173
HEALTH POLICY 174
Cultural 175
CHILD AND ADOLESCENT PSYCHIATRIC-MENTAL HEALTH NURSING 175
ASSESSMENT 175
Data Collection 175
Mental Status Examination 176
Developmental Assessment 176
General Interventions for Children and Adolescents 176
Behavioral Interventions 176
Play Therapy 177
Bibliotherapy 177
Expressive Arts Therapy 177
Journaling 177
Music Therapy 177
Family Interventions 177
Psychopharmacology 177
Teamwork and Safety 177
Disruptive Behavior Management 177
Advanced Practice Interventions 178
Group Therapy 178
Cognitive-Behavioral Therapy 178
NEURODEVELOPMENTAL DISORDERS: CLINICAL PICTURE 178
COMMUNICATION DISORDERS 179
MOTOR DISORDERS 179
Developmental Coordination Disorder 179
Stereotypic Movement Disorder 179
TIC DISORDERS 179
SPECIFIC LEARNING DISORDER 180
INTELLECTUAL DISABILITY 180
ASSESSMENT 180
DIAGNOSIS 181
OUTCOMES IDENTIFICATION 181
IMPLEMENTATION 181
Psychosocial Interventions 181
EVALUATION 181
AUTISM SPECTRUM DISORDER 181
ASSESSMENT 182
DIAGNOSIS 183
OUTCOMES IDENTIFICATION 183
IMPLEMENTATION 183
Psychosocial Interventions 183
Psychobiological Interventions 183
Pharmacological 183
EVALUATION 183
ATTENTION-DEFICIT/HYPERACTIVITY DISORDER 183
ASSESSMENT 184
DIAGNOSIS 185
OUTCOMES IDENTIFICATION 185
IMPLEMENTATION 185
Psychosocial Interventions 185
Psychobiological Interventions 185
Psychopharmacology 185
Medication for Aggressive Behaviors 186
EVALUATION 186
QUALITY IMPROVEMENT 187
REFERENCES 190
12 - Schizophrenia Spectrum Disorders 191
DELUSIONAL DISORDER 192
BRIEF PSYCHOTIC DISORDER 192
SCHIZOPHRENIFORM DISORDER 192
SCHIZOAFFECTIVE DISORDER 192
SUBSTANCE INDUCED PSYCHOTIC DISORDER AND PSYCHOTIC DISORDER DUE TO ANOTHER MEDICAL CONDITION 192
CLINICAL PICTURE 192
EPIDEMIOLOGY 193
COMORBIDITY 193
RISK FACTORS 194
Biological Factors 194
Genetic 194
Neurobiological 194
Brain Structure Abnormalities 194
Psychological and Environmental Factors 194
Prenatal Stressors 196
Psychological Stressors 196
Environmental Stressors 196
Prognostic Considerations 196
Phases of Schizophrenia 196
ASSESSMENT 196
Prodromal Phase 196
General Assessment 197
Positive Symptoms 197
NEGATIVE SYMPTOMS 199
Cognitive Symptoms 200
Affective Symptoms 200
Self-Assessment 200
DIAGNOSIS 201
OUTCOMES IDENTIFICATION 201
Phase I: Acute 201
Phase II: Stabilization 202
Phase III: Maintenance 202
PLANNING 202
V - Trauma Interventions 474
25 - Suicide and Nonsuicidal Self-Injury 474
EPIDEMIOLOGY 475
RISK FACTORS 476
Biological Factors 476
Psychological Factors 477
Environmental Factors 477
Cultural Factors 477
Societal Factors 477
Other Risk Factors 478
CLINICAL PICTURE 478
ASSESSMENT 478
Verbal and Nonverbal Clues 479
Lethality of Suicide Plan 479
Self-Assessment 479
DIAGNOSIS 480
OUTCOMES CRITERIA 480
PLANNING 480
INTERVENTION 480
PSYCHOSOCIAL INTERVENTIONS 482
PSYCHOBIOLOGICAL INTERVENTIONS 482
Pharmacological Interventions 482
Somatic Intervention 482
Health Teaching and Health Promotion 482
Case Management 483
Milieu Therapy 483
Documentation of Care 484
Postvention 484
Advanced Practice Interventions 485
EVALUATION 486
NONSUICIDAL SELF-INJURY 486
Epidemiology 486
Comorbidity 486
Risk Factors 486
Biological Factors 486
Environmental Factors 486
Societal Factors 486
CLINICAL PICTURE 487
ASSESSMENT 487
Self-Assessment 487
DIAGNOSIS 487
OUTCOMES CRITERIA 487
PLANNING 487
INTERVENTIONS 487
EVALUATION 487
REFERENCES 489
26 - Crisis and Disaster 490
CRISIS CHARACTERISTICS 491
Perception of the Event 491
Situational Support 491
Coping Mechanisms 491
CRISIS THEORY 491
TYPES OF CRISIS 492
Maturational Crisis 492
Situational Crisis 493
Adventitious Crisis 493
PHASES OF CRISIS 493
Phase 1 493
Phase 2 493
Phase 3 493
Phase 4 493
ASSESSMENT 493
General Assessment 493
Assessing Perception of Precipitating Event 494
Assessing Situational Supports 494
Assessing Coping Skills 494
Self-Assessment 495
DIAGNOSIS 495
OUTCOMES IDENTIFICATION 495
PLANNING 496
IMPLEMENTATION 496
Psychosocial Interventions 496
Levels of Care 496
Primary Care 496
Secondary Care 497
Tertiary Care 497
. Critical incident stress debriefing (CISD) is an example of a tertiary intervention directed toward a group that has experienc... 497
EVALUATION 498
Modalities of Crisis Intervention 498
Disaster Response 499
Disaster Management Context 499
REFERENCES 503
27 - Anger, Aggression, and Violence 504
CLINICAL PICTURE 505
EPIDEMIOLOGY 505
COMORBIDITY 505
ETIOLOGY 505
Biological Factors 505
Genetics 505
Neurobiological 505
Neurotransmitters 506
Psychological Factors 506
General Assessment 506
Self-Assessment 507
DIAGNOSIS 508
OUTCOMES IDENTIFICATION 508
PLANNING 508
IMPLEMENTATION 508
Psychosocial Interventions 508
Considerations for Staff Safety 509
Pharmacological Interventions 509
Health Teaching and Health Promotion 510
Teamwork and Safety 511
Use of Seclusion or Restraints 511
Caring for Patients in General Hospital Settings 513
Patients with Healthy Coping Who Are Overwhelmed 513
Patients with Marginal Coping Skills 514
Caring for Patients in Inpatient Psychiatric Settings 515
Caring for Patients with Cognitive Deficits 515
EVALUATION 516
REFERENCES 518
28 - Child, Older Adult, and Intimate Partner Violence 520
Types of Abuse 521
Crisis Situation 521
Perpetrator and the Vulnerable Person 521
CHILD ABUSE 521
Epidemiology 522
Risk Factors 522
Comorbidity 522
INTIMATE PARTNER VIOLENCE 522
Cycle of Violence 523
Risk Factors 523
OLDER ADULT ABUSE 524
Epidemiology 524
Risk Factors 524
General Assessment 525
Interview Process and Setting 525
Assessing Various Types of Abuse 525
Physical Abuse 525
Sexual Abuse 526
Emotional abuse 527
Neglect 527
Economic Abuse 527
Level of Anxiety and Coping Responses 527
Family Coping Patterns 527
Support Systems 528
Suicide Potential 528
Homicide Potential 528
Drug and Alcohol Use 528
Maintaining Accurate Records 528
Self-Assessment 529
DIAGNOSIS 529
OUTCOMES IDENTIFICATION 529
PLANNING 530
IMPLEMENTATION 530
Reporting Abuse 530
Culture 530
Counseling 531
Case Management 531
Promotion of Community Support 531
Health Teaching and Health Promotion 532
Prevention of Abuse 533
Primary Prevention 533
Secondary Prevention 533
Tertiary Prevention 533
Advanced Practice Interventions 533
Individual Psychotherapy 533
Family Psychotherapy 533
Group Psychotherapy 534
EVALUATION 534
REFERENCES 537
29 - Sexual Assault 538
SEXUAL ASSAULT AND SEXUAL VIOLENCE 539
Rape 539
Completed Rape 539
Attempted Rape 539
Laws and Sexual Assault 539
EPIDEMIOLOGY 540
Rape 540
Stalking 540
Sexual Violence 540
Sexual Offenders and Relationships with Victims 540
CLINICAL PICTURE 541
Psychological Effects of Sexual Assault 542
Specialized Sexual Assault Services 542
Guidelines for Medical Forensic Examinations 542
General Assessment 543
Level of Anxiety 543
Coping Mechanisms 543
Available Support Systems 543
Signs and Symptoms of Emotional Trauma 544
Signs and Symptoms of Physical Trauma 544
Best Practice Guidelines 544
Self-Assessment 544
DIAGNOSIS 545
OUTCOMES IDENTIFICATION 545
PLANNING 546
IMPLEMENTATION 546
Counseling 546
Promotion of Self-Care Activities 548
Case Management 548
Advanced Practice Interventions 548
Psychotherapy 548
. Most of those who have been raped are eventually able to resume their previous lifestyle and level of functioning after suppor... 548
. Psychotherapy is essential for perpetrators of sexual assault if behavioral change is to occur. Unfortunately, most perpetrato... 548
EVALUATION 549
CONCLUSION 549
REFERENCES 551
VI - Interventions for Special Populations 552
30 - Dying, Death, and Grieving 552
DEATH AND DYING 553
An Aging Population 553
Models for End-of-Life Care 554
Hospice 554
Palliative Care 554
Death and Dying Theory 554
FACILITATING DEATH 555
Artificial Nutrition and Hydration 555
Euthanasia 555
Physician-Assisted Suicide 556
Arguments Surrounding Physician-Assisted Suicide 556
ADVANCE CARE PLANNING 557
Advance Directive 557
Durable Power of Attorney for Healthcare 557
NURSING CARE AT THE END OF LIFE 557
Communication 557
Art of Presence 557
Symptom Management 557
Anticipatory Grief 558
Sustenance 558
Palliative Care for Patients with Dementia 558
Developmental Tasks in Dying 558
THE DYING PROCESS 559
GRIEVING 559
Grieving Theories 560
Grief and Technology 560
Grief Versus Major Depressive Disorder 560
Types of Grieving and Associated Nursing Care 561
Grieving 561
Complicated Grieving 561
Disenfranchised Grief 562
Grief Caused by Public Tragedy 562
SELF-CARE 563
REFERENCES 565
31 - Older Adults 566
MENTAL HEALTH ISSUES RELATED TO AGING 568
Late-Life Mental Illness 568
Depression 568
Aging and Suicide Risk 568
Anxiety Disorders 568
Delirium 569
Neurocognitive Disorders 569
Alcohol Use Disorder 569
Pain 570
Barriers to Accurate Pain Assessment 570
Assessment Tools 570
Pain Management 571
HEALTHCARE CONCERNS OF OLDER ADULTS 573
Financial Burden 573
Caregiver Burden 573
Ageism 574
Ageism and Public Policy 574
Ageism and Research 574
HEALTHCARE DECISION MAKING 574
Advance Directives 574
Living Will 575
Directive to Physician 575
Durable Power of Attorney for Healthcare 575
Guardianship 575
The Nurse’s Role in Decision Making 575
NURSING CARE OF OLDER ADULTS 575
Assessment 576
Assessment Strategies with Older Adults 576
Physical Assessment 576
Medication Reconciliation 576
Mental Status Exam 578
Driving and the Older Adult 578
Older Adult Abuse 579
Intervention 579
Psychosocial Interventions 579
Psychobiological Interventions 579
Advanced-Practice Interventions 580
Treatment Settings for Older Adults 580
Geropsychiatric Units 580
Skilled Nursing Facilities 580
Assisted Living 581
Respite Care 581
Residential Care 581
Partial Hospitalization 581
Day Care Programs 581
Home Healthcare 581
Community-Based Programs 581
REFERENCES 583
32 - Serious Mental Illness 584
SERIOUS MENTAL ILLNESS ACROSS THE LIFESPAN 586
Older Adults 586
Younger Adults 586
DEVELOPMENT OF SERIOUS MENTAL ILLNESS 586
REHABILITATION VERSUS RECOVERY: TWO MODELS OF CARE 586
ISSUES CONFRONTING THOSE WITH SERIOUS MENTAL ILLNESS 587
Establishing a Meaningful Life 587
Comorbid Conditions 587
Physical Disorders 587
Depression and Suicide 587
Substance Use 587
Social Problems 587
Stigma 587
Isolation and Loneliness 588
Victimization 588
Economic Challenges 588
Unemployment and Poverty 588
Housing Instability 588
Caregiver Burden 589
Treatment Issues 589
Anosognosia 589
Nonadherence 589
Medication Side Effects 589
Treatment Inadequacy 589
Residual Symptoms 590
Relapse, Chronicity, and Loss 590
SERIOUS MENTAL ILLNESS RESOURCES 590
Comprehensive Community Treatment 590
Community Services and Programs 590
Substance Use Treatment 591
EVIDENCE-BASED TREATMENT APPROACHES 592
Assertive Community Treatment 592
Cognitive-Behavioral Therapy 592
Cognitive Enhancement Therapy 592
Family Support and Partnerships 592
Social Skills Training 592
Vocational Rehabilitation and Related Services 593
OTHER TREATMENT APPROACHES 593
Court-Involved Intervention 593
Consumer-Run Programs 593
Peer Support 593
Wellness and Recovery Action Plans 594
Technology 594
Exercise 594
NURSING CARE OF PATIENTS WITH SERIOUS MENTAL ILLNESS 594
Assessment Strategies 594
Intervention Strategies 594
Evaluation 595
CURRENT ISSUES AFFECTING THOSE WITH SMI 595
Outpatient Commitment 595
Criminal Offenses and Incarceration 596
Deinstitutionalization and Transinstitutionalization 596
Inadequate Access to Care 596
REFERENCES 599
33 - Forensic Nursing 600
FORENSIC NURSING 601
Education 601
Forensic Nurse Generalist 601
Advanced Practice Forensic Nursing 602
Roles and Functions of Forensic Nurses 602
Sexual Assault Nurse Examiner 602
Nurse Coroner/Death Investigator 602
FORENSIC PSYCHIATRIC NURSING 603
Roles and Functions of Forensic Psychiatric Nurses 603
Nurse Psychotherapist 603
Forensic Psychiatric Nurse Examiner 603
Competency Evaluator 604
Fact and Expert Witnesses 604
Consultant 605
Hostage Negotiator 605
Criminal Profiler 605
CORRECTIONAL NURSING 605
REFERENCES 609
VII - Other Intervention Modalities 610
34 - Therapeutic Groups 610
FROM GROUP TO THERAPEUTIC GROUP 610
CONCEPTS COMMON TO ALL GROUPS 611
Therapeutic Factors 611
Group Content and Process 611
PHASES OF GROUP DEVELOPMENT 611
Planning Phase 611
Orientation Phase 613
Working Phase 613
Termination Phase 613
Post Group Issues: Evaluation and Follow-Up 613
GROUP PARTICIPANT ROLES 614
THERAPEUTIC FRAMEWORK FOR GROUPS 614
NURSE AS A GROUP LEADER 614
Styles of Leadership 615
Group Leader Supervision 615
NANDA-Approved Nursing Diagnoses 2015–2017 645
INDEX 648
A 648
B 650
C 651
D 652
E 653
F 654
G 655
H 655
I 655
J 656
K 656
L 656
M 657
N 657
O 658
P 659
Q 660
R 660
S 661
T 663
U 664
V 664
W 665
Y 665
Z 665

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