BOOK
Varcarolis's Canadian Psychiatric Mental Health Nursing, Canadian Edition - E-Book
Margaret Jordan Halter | Cheryl L. Pollard | Sonya L. Jakubec
(2018)
Additional Information
Book Details
Abstract
Gain a clear understanding of the often-intimidating subject of psychiatric mental health nursing. Varcarolis's Canadian Psychiatric Mental Health Nursing, 2nd Edition uses a practical clinical perspective to prepare you for practice. This thoroughly updated, market-leading text features the latest Canadian research related to psychiatric mental health nursing, including DSM-5 guidelines from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Additionally, clinical chapters follow a practical framework and progress from theory to application, preparing you for practice with real-world examples presented within an historically Canadian legal, ethical, and cultural context.
- Research highlight boxes provide updated research in mental health.
- Canadian research and statistics provide a current perspective of mental health and mental health practice in Canada.
- Canadian focus throughout highlights key considerations such as our nation’s cultural diversity and federal/provincial/territorial distinctions.
- Student-friendly features reinforce important information and help in applying textbook content to the clinical setting, emphasizing key terms and concepts, learning objectives, key points to remember, critical thinking, and chapter reviews.
- Assessment Guidelines boxes provide specific instructions for diagnosis and treatment.
- Patient and Family Teaching boxes provide important details that should be discussed with patients and caregivers.
- Integrative Therapy boxes specifically focus on the mental health disorders covered in that chapter to help you communicate effectively when working with a variety of patients.
- Considering Culture boxes discuss the importance of cultural considerations in providing competent care to diverse populations within various clinical situations.
- Drug Treatment boxes feature generic and trade names for drugs used in Canada to ensure you have access to the latest information on medications used to treat psychiatric disorders.
- NEW! DSM-5 box features provide further evidence of disorders covered by the American Psychological Association.
- NEW! Added mental health content covers issues in the indigenous population and gender differences.
- NEW! Updated chapter that covers suicide and non-suicidal self-injury.
- NEW! Enhanced coverage of substance use disorders prepares you to treat this and related disorders.
- NEW! Enhanced coverage on the legislative changes related to medically assisted deaths.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Brief toc | IFC1 | ||
| Half title page | i | ||
| Evolve page | ii | ||
| Varcarolis's Canadian Psychiatric Mental Health Nursing, Canadian Edition | iii | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Table Of Contents | vi | ||
| Acknowledgements | xvi | ||
| Contributors | xvii | ||
| Contributors to Us Eighth Edition | xviii | ||
| Reviewers | xix | ||
| To The Instructor | xx | ||
| Content New to This Edition | xx | ||
| Organization of the Text | xx | ||
| Teaching and Learning Resources | xxi | ||
| For Instructors | xxi | ||
| For Students | xxi | ||
| To The Student | xxii | ||
| Reading and Review Tools | xxii | ||
| Additional Learning Resources | xxii | ||
| Chapter Features | xxii | ||
| Unit 1 Foundations in Theory | 1 | ||
| 1 Mental Health and Mental Illness | 2 | ||
| Objectives | 2 | ||
| Key Terms and Concepts | 2 | ||
| Website | 2 | ||
| Mental Health and Mental Illness | 3 | ||
| Two Conceptualizations of Mental Health and Mental Illness | 3 | ||
| Contributing Factors | 5 | ||
| Resilience | 5 | ||
| Mental health recovery. | 6 | ||
| Culture | 6 | ||
| Perceptions of Mental Health and Mental Illness | 7 | ||
| Mental Illness Versus Physical Illness | 7 | ||
| Nature Versus Nurture | 7 | ||
| Human Genome Project | 7 | ||
| Social Influences on Mental Health Care | 8 | ||
| Self-Help Movement | 8 | ||
| Decade of the Brain | 8 | ||
| Mental Health for Canadians: Striking a Balance | 8 | ||
| Changing Directions, Changing Lives: The Mental Health Strategy for Canada | 8 | ||
| Epidemiology of Mental Disorders | 9 | ||
| Classification of Mental Disorders | 10 | ||
| The Diagnostic and Statistical Manual | 10 | ||
| The DSM-5 Organizational Structure | 11 | ||
| The ICD-10-CA | 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 | ||
| Evidence-Informed Practice | 12 | ||
| Levels of Psychiatric Mental Health Clinical Nursing Practice | 12 | ||
| Future Challenges and Roles for Psychiatric Mental Health Nurses | 12 | ||
| Aging Population | 12 | ||
| Increasing Cultural Diversity | 12 | ||
| Expanding Technology | 13 | ||
| Twelve Key Social Determinants of Health | 14 | ||
| Key Points to Remember | 14 | ||
| Critical Thinking | 14 | ||
| Chapter Review | 15 | ||
| Website | 15 | ||
| References | 16 | ||
| 2 Historical Overview of Psychiatric Mental Health Nursing | 17 | ||
| Objectives | 17 | ||
| Key Terms and Concepts | 17 | ||
| Website | 17 | ||
| Early Mental Illness Care | 17 | ||
| Early Canadian Asylums | 18 | ||
| Early Psychiatric Treatments | 19 | ||
| The Introduction of Nurses to Asylum Care | 19 | ||
| Shifts in Control Over Nursing | 20 | ||
| Eastern and Atlantic Canada | 20 | ||
| Western Canada | 21 | ||
| Deinstitutionalization and the Nursing Role in Psychiatric Mental Health Care | 21 | ||
| University-Based Nursing Curriculum | 21 | ||
| National Organizations for Psychiatric Mental Health Nursing and Canadian Nurses Association Certification | 22 | ||
| Advanced-Practice Nursing in Psychiatric Mental Health Care | 22 | ||
| The Future of Psychiatric Mental Health Nursing | 23 | ||
| Key Points to Remember | 23 | ||
| Critical Thinking | 23 | ||
| Chapter Review | 24 | ||
| Website | 24 | ||
| References | 24 | ||
| 3 Overview of Psychiatric Mental Health Nursing Care Within Various Settings | 26 | ||
| Objectives | 26 | ||
| Key Terms and Concepts | 26 | ||
| Website | 26 | ||
| Funding Psychiatric Mental Health Care | 27 | ||
| The Continuum of Mental Health Care | 28 | ||
| Evolving Venues of Practice | 28 | ||
| Psychiatric Mental Health Care Settings | 28 | ||
| Community Mental Health Centres | 29 | ||
| Crisis Intervention Team | 31 | ||
| Disaster Response Teams | 32 | ||
| Partial Hospitalization Programs | 32 | ||
| Inpatient Psychiatric Mental Health Programs | 32 | ||
| Entry to Inpatient Care | 32 | ||
| Preparation for Discharge to the Community | 34 | ||
| Assertive Community Treatment | 34 | ||
| Ensuring Safety | 34 | ||
| Roles and Responsibilities | 36 | ||
| Community Psychiatric Mental Health Nursing | 36 | ||
| Biopsychosocial Assessment | 36 | ||
| Treatment Goals and Interventions | 37 | ||
| Interprofessional Team Member | 37 | ||
| Biopsychosocial Care Manager | 37 | ||
| Treatment Team | 38 | ||
| Nursing Care | 39 | ||
| Establishing a Therapeutic Relationship | 39 | ||
| Mental and Physical Health Assessment | 40 | ||
| Milieu Management | 40 | ||
| Structured Group Activities | 40 | ||
| Documentation | 40 | ||
| Medication Administration | 41 | ||
| Medication adherence. | 41 | ||
| Pain management. | 41 | ||
| Crisis Management | 41 | ||
| Medical crises. | 41 | ||
| Behavioural crises. | 41 | ||
| Future Issues | 41 | ||
| Barriers to Treatment | 41 | ||
| Meeting Changing Demands | 42 | ||
| Key Points to Remember | 42 | ||
| Critical Thinking | 42 | ||
| Chapter Review | 43 | ||
| Website | 43 | ||
| References | 44 | ||
| 4 Relevant Theories and Therapies for Nursing Practice | 45 | ||
| Objectives | 45 | ||
| Key Terms and Concepts | 45 | ||
| Website | 45 | ||
| Psychoanalytic Theories and Therapies | 46 | ||
| Sigmund Freud’s Psychoanalytic Theory | 46 | ||
| Levels of Awareness | 46 | ||
| Conscious. | 46 | ||
| Preconscious. | 46 | ||
| Unconscious. | 46 | ||
| Personality Structure | 46 | ||
| Id. | 46 | ||
| Ego. | 46 | ||
| Superego. | 46 | ||
| Defence Mechanisms and Anxiety | 47 | ||
| Psychosexual Stages of Development | 47 | ||
| Classical Psychoanalysis | 48 | ||
| Psychodynamic Therapy | 48 | ||
| Implications of Psychoanalytic Theory for Nursing Practice | 48 | ||
| Developmental Theories | 48 | ||
| Cognitive Development | 48 | ||
| Theory of Psychosocial Development | 49 | ||
| Stages of Moral Development | 49 | ||
| Preconventional level | 50 | ||
| Stage 1: Obedience and punishment. | 50 | ||
| Stage 2: Individualism and exchange. | 50 | ||
| Conventional level | 50 | ||
| Stage 3: Good interpersonal relationships. | 50 | ||
| Stage 4: Maintaining the social order. | 50 | ||
| Postconventional level | 50 | ||
| Stage 5: Social contract and individual rights. | 50 | ||
| Stage 6: Universal ethical principles. | 50 | ||
| Ethics of Care Theory | 50 | ||
| Implications of Developmental Theories for Nursing Practice | 50 | ||
| Interpersonal Theories and Therapies | 50 | ||
| Theory of Object Relations | 50 | ||
| Interpersonal Theory | 51 | ||
| Interpersonal Psychotherapy | 51 | ||
| Peplau’s Theory of Interpersonal Relations | 51 | ||
| Implications of Interpersonal Theories for Nursing Practice | 52 | ||
| Behavioural Theories and Therapies | 52 | ||
| Classical Conditioning Theory | 53 | ||
| Behaviourism Theory | 53 | ||
| Operant Conditioning Theory | 53 | ||
| Behavioural Therapy | 53 | ||
| Modelling | 53 | ||
| Operant Conditioning | 54 | ||
| Systematic Desensitization | 54 | ||
| Aversion Therapy | 54 | ||
| Biofeedback | 54 | ||
| Implications of Behavioural Theories for Nursing Practice | 54 | ||
| Cognitive Theories and Therapies | 55 | ||
| Rational Emotive Behaviour Therapy (REBT) | 55 | ||
| Cognitive Behavioural Therapy (CBT) | 55 | ||
| Dialectic Behavioural Therapy (DBT) | 56 | ||
| Implications of Cognitive Theories for Nursing Practice | 58 | ||
| Humanistic Theories | 58 | ||
| Abraham Maslow’s Humanistic Psychology Theory | 58 | ||
| Hierarchy of Needs | 58 | ||
| Implications of Motivation Theory for Nursing Practice | 60 | ||
| Biological Theories and Therapies | 60 | ||
| The Advent of Psychopharmacology | 60 | ||
| The Biological Model | 60 | ||
| Implications of the Biological Model for Nursing Practice | 60 | ||
| Additional Therapies | 60 | ||
| Milieu Therapy | 60 | ||
| Implications of Milieu Therapy for Nursing Practice | 60 | ||
| Key Points to Remember | 62 | ||
| Critical Thinking | 62 | ||
| Chapter Review | 63 | ||
| Website | 63 | ||
| References | 63 | ||
| 5 Understanding Responses to Stress | 65 | ||
| Objectives | 65 | ||
| Key Terms and Concepts | 65 | ||
| Website | 65 | ||
| Responses to and Effects of Stress | 66 | ||
| Early Stress Response Theories | 66 | ||
| Neurotransmitter Stress Responses | 66 | ||
| Immune Stress Responses | 67 | ||
| Mediators of the Stress Response | 68 | ||
| Stressors | 68 | ||
| Perception | 69 | ||
| Personality | 69 | ||
| Social Support | 69 | ||
| Self-Help Groups | 69 | ||
| Low- and High-Quality Support | 69 | ||
| Culture | 69 | ||
| Spirituality and Religious Beliefs | 69 | ||
| Nursing Management of Stress Responses | 70 | ||
| Measuring Stress | 70 | ||
| Assessing Coping Styles | 71 | ||
| Managing Stress through Relaxation Techniques | 71 | ||
| Relaxation Exercises | 72 | ||
| Meditation | 73 | ||
| Guided Imagery | 74 | ||
| Breathing Exercises | 74 | ||
| Physical Exercise | 75 | ||
| Biofeedback | 75 | ||
| Cognitive Reframing | 75 | ||
| Mindfulness | 76 | ||
| Journaling | 76 | ||
| Humour | 76 | ||
| Key Points to Remember | 76 | ||
| Critical Thinking | 77 | ||
| Chapter Review | 77 | ||
| Website | 77 | ||
| References | 78 | ||
| Unit 2 Foundations for Practice | 79 | ||
| 6 The Nursing Process and Standards of Care for Psychiatric Mental Health Nursing | 80 | ||
| Objectives | 80 | ||
| Key Terms and Concepts | 80 | ||
| Website | 80 | ||
| Assessment | 82 | ||
| Age Considerations | 83 | ||
| Assessment of Children | 83 | ||
| Assessment of Adolescents | 83 | ||
| Assessment of Older Adults | 84 | ||
| Language Barriers | 84 | ||
| Psychiatric Mental Health Nursing Assessment | 84 | ||
| Gathering Data | 84 | ||
| Review of systems. | 84 | ||
| Laboratory data. | 84 | ||
| Mental status examination. | 85 | ||
| Psychosocial assessment. | 87 | ||
| Spiritual or religious assessment. | 87 | ||
| Cultural and social assessment. | 88 | ||
| Validating the Assessment | 89 | ||
| Using Rating Scales | 89 | ||
| Nursing Diagnosis | 89 | ||
| Outcomes Identification | 90 | ||
| Planning | 90 | ||
| Implementation | 91 | ||
| Basic-Level Interventions | 92 | ||
| Coordination of Care | 92 | ||
| Health Teaching and Health Promotion | 92 | ||
| Milieu Therapy | 92 | ||
| Pharmacological, Biological, and Integrative Therapies | 92 | ||
| Advanced-Practice Interventions | 92 | ||
| Evaluation | 92 | ||
| Documentation | 92 | ||
| Key Points to Remember | 93 | ||
| Critical Thinking | 94 | ||
| Chapter Review | 94 | ||
| Website | 94 | ||
| References | 95 | ||
| 7 Ethical Responsibilities and Legal Obligations for Psychiatric Mental Health Nursing Practice | 96 | ||
| Objectives | 96 | ||
| Key Terms and Concepts | 96 | ||
| Website | 96 | ||
| Ethical Concepts | 97 | ||
| Mental Health Legislation | 100 | ||
| Establishing Best Practice | 102 | ||
| Standards of Practice | 102 | ||
| Standards of Care | 103 | ||
| Policies and Procedures | 103 | ||
| Traditional Practice Knowledge | 103 | ||
| Guidelines for Ensuring Adherence to Standards of Care | 103 | ||
| Patients’ Rights Under the Law | 104 | ||
| Authorization of Treatment | 104 | ||
| Autonomy | 104 | ||
| Consent | 104 | ||
| The Right to Refuse Treatment | 104 | ||
| Beneficence and Nonmaleficence | 105 | ||
| Involuntary Admission Criteria | 105 | ||
| Provision of the Least Restrictive Type of Mental Health Care | 105 | ||
| Advance Directives | 106 | ||
| Nursing responsibilities with advance directives. | 106 | ||
| Guardianship | 106 | ||
| Rights Regarding Confidentiality | 106 | ||
| Duty to Warn and Protect Third Parties | 107 | ||
| Collaboration of Treatment Team | 107 | ||
| Documentation of care. | 107 | ||
| Guidelines for electronic documentation. | 107 | ||
| Organizational use of medical records. | 108 | ||
| Medical records as evidence. | 108 | ||
| Reporting Suspected Child Abuse | 108 | ||
| Confidentiality and Communicable Diseases | 109 | ||
| Confidentiality After Death | 109 | ||
| Civil Obligations and Responsibilities | 109 | ||
| Tort Law | 109 | ||
| Intentional Torts | 109 | ||
| Unintentional Torts | 110 | ||
| Duty. | 110 | ||
| Breach of duty. | 110 | ||
| Cause in fact, proximate cause, damages, and foreseeability. | 111 | ||
| Key Points to Remember | 111 | ||
| Critical Thinking | 111 | ||
| Chapter Review | 112 | ||
| Website | 113 | ||
| References | 113 | ||
| 8 Cultural Considerations for Psychiatric Mental Health Nursing | 115 | ||
| Objectives | 115 | ||
| Key Terms and Concepts | 115 | ||
| Website | 115 | ||
| Understanding the Landscape of Culture in Mental Health | 116 | ||
| Culture, Race, Ethnicity, and the Social Determinants of Health | 116 | ||
| Cultural Views and Contexts Affecting Mental Health Care | 116 | ||
| Culture, Mental Health, and Mental Illness | 119 | ||
| The Cultural Landscape of Canada | 120 | ||
| Indigenous and Multicultural Contexts | 120 | ||
| Mental Health Concerns of Indigenous Peoples | 121 | ||
| Intergenerational Trauma | 121 | ||
| Hopelessness and Suicide | 122 | ||
| Family Violence and Separation and Community Violence | 122 | ||
| Substance Use | 122 | ||
| Need for Culturally Relevant and Appropriate Services | 122 | ||
| Mental Health Concerns of Immigrants | 123 | ||
| Mental Health Concerns of Refugees | 124 | ||
| Barriers and Facilitators to Mental Health Care in a Multicultural Context | 125 | ||
| Stigma and Discrimination | 125 | ||
| Communication Barriers | 125 | ||
| Misdiagnosis | 126 | ||
| Ethnic Variation in Pharmacodynamics | 127 | ||
| Cultural Competence in Psychiatric Mental Health Nursing | 127 | ||
| Culturally Competent Care | 127 | ||
| Cultural Awareness | 128 | ||
| Cultural Knowledge | 128 | ||
| Cultural Encounters | 128 | ||
| Cultural Skill | 128 | ||
| Cultural Desire | 130 | ||
| Key Points to Remember | 130 | ||
| Critical Thinking | 130 | ||
| Chapter Review | 131 | ||
| Website | 131 | ||
| References | 131 | ||
| Unit 3 Biopsychosocial Nursing Techniques | 134 | ||
| 9 Therapeutic Relationships | 135 | ||
| Objectives | 135 | ||
| Key Terms and Concepts | 135 | ||
| Website | 135 | ||
| Concepts of the Nurse–Patient Relationship | 136 | ||
| Goals and Functions | 137 | ||
| Social Versus Therapeutic | 137 | ||
| Social Relationships | 137 | ||
| Therapeutic Relationships | 137 | ||
| Relationship Boundaries | 139 | ||
| Establishing Boundaries | 139 | ||
| Blurring of Boundaries | 139 | ||
| Transference. | 139 | ||
| Counter-transference. | 140 | ||
| Self-Check on Boundaries | 140 | ||
| Values, Beliefs, and Self-Awareness | 140 | ||
| Peplau’s Model of the Nurse–Patient Relationship | 142 | ||
| Preorientation Phase | 143 | ||
| Orientation Phase | 143 | ||
| Establishing Rapport | 143 | ||
| Parameters of the Relationship | 143 | ||
| Formal or Informal Contract | 143 | ||
| Confidentiality | 143 | ||
| Planning for Terms of Termination | 146 | ||
| Working Phase | 146 | ||
| Termination Phase | 146 | ||
| What Hinders and What Helps the Nurse–Patient Relationship | 147 | ||
| Factors That Encourage and Promote Patients’ Growth | 147 | ||
| Genuineness | 148 | ||
| Empathy | 148 | ||
| Empathy Versus Sympathy | 148 | ||
| Positive Regard | 148 | ||
| Attitudes | 148 | ||
| Actions | 148 | ||
| Attending. | 148 | ||
| Suspending value judgements. | 148 | ||
| Helping patients develop resources. | 149 | ||
| Key Points To Remember | 149 | ||
| Critical Thinking | 149 | ||
| Chapter Review | 150 | ||
| Website | 150 | ||
| References | 151 | ||
| 10 Communication and the Clinical Interview | 152 | ||
| Objectives | 152 | ||
| Key Terms and Concepts | 152 | ||
| Website | 152 | ||
| The Communication Process | 153 | ||
| Factors That Affect Communication | 153 | ||
| Personal Factors | 153 | ||
| Environmental Factors | 154 | ||
| Relationship Factors | 154 | ||
| Verbal and Nonverbal Communication | 155 | ||
| Verbal Communication | 155 | ||
| Nonverbal Communication | 155 | ||
| Interaction of Verbal and Nonverbal Communication | 156 | ||
| Communication Skills for Nurses | 157 | ||
| Therapeutic Communication Strategies | 157 | ||
| Silence | 157 | ||
| Active Listening | 157 | ||
| Listening with empathy. | 158 | ||
| Clarifying Techniques | 158 | ||
| Paraphrasing. | 158 | ||
| Restating. | 158 | ||
| Reflecting. | 158 | ||
| Exploring. | 159 | ||
| Asking Questions and Eliciting Patient Responses | 159 | ||
| Open-ended questions. | 159 | ||
| Closed-ended questions. | 159 | ||
| Nontherapeutic Communication Techniques | 159 | ||
| Excessive Questioning | 159 | ||
| Giving Approval or Disapproval | 159 | ||
| Giving Advice | 161 | ||
| Asking “Why” Questions | 163 | ||
| Cultural Considerations | 163 | ||
| Communication Style | 163 | ||
| Eye Contact | 163 | ||
| Touch | 163 | ||
| Cultural Filters | 164 | ||
| Assertive Communication | 164 | ||
| Evaluation of Communication Skills | 164 | ||
| The Clinical Interview | 164 | ||
| Preparing for the Interview | 164 | ||
| Pace | 164 | ||
| Setting | 164 | ||
| Seating | 165 | ||
| Introductions | 165 | ||
| Initiating the Interview | 165 | ||
| Tactics to Avoid | 165 | ||
| Helpful Guidelines | 166 | ||
| Attending Behaviours: The Foundation of Interviewing | 166 | ||
| Eye Contact | 166 | ||
| Body Language | 166 | ||
| Vocal Quality | 166 | ||
| Verbal Tracking | 166 | ||
| Clinical Supervision | 167 | ||
| Process Recordings | 167 | ||
| Key Points to Remember | 169 | ||
| Critical Thinking | 169 | ||
| Chapter Review | 169 | ||
| Website | 170 | ||
| References | 170 | ||
| 11 Psychotropic Drugs | 171 | ||
| Objectives | 171 | ||
| Key Terms and Concepts | 171 | ||
| Website | 171 | ||
| Structure and Function of the Brain | 172 | ||
| Functions and Activities of the Brain | 172 | ||
| Maintenance of Homeostasis | 173 | ||
| Regulation of the Autonomic Nervous System and Endocrine System | 173 | ||
| Control of Biological Drives and Behaviour | 173 | ||
| Cycle of sleep and wakefulness. | 174 | ||
| Circadian rhythms. | 174 | ||
| Conscious Mental Activity | 174 | ||
| Memory | 175 | ||
| Social Skills | 175 | ||
| Cellular Composition of the Brain | 175 | ||
| Organization of the Brain | 177 | ||
| Brainstem | 177 | ||
| Cerebellum | 178 | ||
| Cerebrum | 178 | ||
| Visualizing the Brain | 179 | ||
| Disturbances of Mental Function | 183 | ||
| Use of Psychotropic Drugs | 184 | ||
| Drugs Used to Treat Anxiety and Insomnia | 185 | ||
| Benzodiazepines | 185 | ||
| Short-Acting Sedative–Hypnotic Sleep Drugs | 186 | ||
| Buspirone | 186 | ||
| Treating Anxiety Disorders With Antidepressant Drugs | 186 | ||
| Drug Treatment for Depression | 186 | ||
| Tricyclic Antidepressants | 187 | ||
| Selective Serotonin Reuptake Inhibitors | 188 | ||
| Serotonin–Norepinephrine Reuptake Inhibitors | 188 | ||
| Serotonin Modulator and Stimulator | 188 | ||
| Serotonin and Norepinephrine Disinhibitors | 188 | ||
| Monoamine Oxidase Inhibitors | 189 | ||
| Other Drugs Used to Treat Depression | 189 | ||
| Is the Monoamine Theory of Depression Still Valid? | 190 | ||
| Suicide Risk and Antidepressant Drugs | 190 | ||
| Drug Treatment for Bipolar Disorders | 190 | ||
| Lithium Carbonate | 190 | ||
| Other Drugs Used to Treat Bipolar Disorders | 191 | ||
| Carbamazepine | 191 | ||
| Valproate | 191 | ||
| Lamotrigine | 191 | ||
| Other Antiseizure Drugs | 191 | ||
| Drugs Used To Treat Psychosis | 192 | ||
| First-Generation (Conventional) Antipsychotic Drugs | 192 | ||
| Second-Generation Antipsychotic Drugs | 192 | ||
| Clozapine. | 193 | ||
| Risperidone. | 194 | ||
| Quetiapine. | 194 | ||
| Other second-generation antipsychotic drugs. | 194 | ||
| Drug Treatment for Attention-Deficit/ Hyperactivity Disorder | 194 | ||
| Drug Treatment for Alzheimer’s Disease | 195 | ||
| Natural Health Products | 195 | ||
| Key Points to Remember | 196 | ||
| Critical Thinking | 196 | ||
| Chapter Review | 196 | ||
| Website | 197 | ||
| References | 197 | ||
| Unit 4 Psychobiological Disorders | 199 | ||
| 12 Anxiety and Related Disorders | 200 | ||
| Objectives | 200 | ||
| Key Terms and Concepts | 200 | ||
| Website | 200 | ||
| Anxiety | 202 | ||
| Levels of Anxiety | 202 | ||
| Mild Anxiety | 202 | ||
| Moderate Anxiety | 202 | ||
| Severe Anxiety | 202 | ||
| Panic | 203 | ||
| Defences Against Anxiety | 203 | ||
| Clinical Picture | 204 | ||
| Anxiety Disorders | 204 | ||
| Panic Disorder | 204 | ||
| Agoraphobia | 206 | ||
| Phobias | 206 | ||
| Generalized Anxiety Disorder | 207 | ||
| Substance-Induced Anxiety Disorder | 209 | ||
| Anxiety Due to Nonpsychiatric Medical Conditions | 209 | ||
| Epidemiology | 209 | ||
| Comorbidity | 209 | ||
| Somatic Symptom and Related Disorders | 209 | ||
| Clinical Picture | 210 | ||
| Somatic Symptom Disorder | 210 | ||
| Illness Anxiety Disorder | 210 | ||
| Conversion Disorder | 210 | ||
| Epidemiology | 211 | ||
| Comorbidity | 211 | ||
| Obsessive-Compulsive Disorders | 211 | ||
| Epidemiology | 212 | ||
| Comorbidity | 212 | ||
| Trauma- and Stressor-Related Disorders | 214 | ||
| Acute Stress Disorder | 214 | ||
| Post-Traumatic Stress Disorder | 214 | ||
| Dissociative Disorders | 214 | ||
| Clinical Picture | 215 | ||
| Depersonalization/Derealization Disorder | 215 | ||
| Dissociative Amnesia | 215 | ||
| Dissociative Identity Disorder | 216 | ||
| Epidemiology | 216 | ||
| Comorbidity | 216 | ||
| Etiology of Anxiety-Related Disorders | 216 | ||
| Biological Factors | 216 | ||
| Genetic | 216 | ||
| Neurobiological | 216 | ||
| Psychological Factors | 216 | ||
| Psychodynamic Theories | 216 | ||
| Behavioural Theory | 217 | ||
| Cognitive Theory | 217 | ||
| Learning Theory | 217 | ||
| Environmental Factors | 217 | ||
| Sociocultural Factors | 217 | ||
| Culture-Bound Syndromes | 218 | ||
| Application of the Nursing Process | 218 | ||
| Assessment | 218 | ||
| General Assessment | 218 | ||
| Rating Scales | 218 | ||
| Psychosocial Factors | 221 | ||
| Coping Skills | 221 | ||
| Spirituality and Religion | 221 | ||
| Secondary Gains | 221 | ||
| Self-Assessment | 221 | ||
| Diagnosis | 222 | ||
| Outcomes Identification | 222 | ||
| Planning | 224 | ||
| Implementation | 225 | ||
| Determining Levels of Distress | 225 | ||
| Mild to Moderate Levels of Anxiety | 225 | ||
| Severe to Panic Levels of Anxiety | 225 | ||
| Psychosocial Interventions | 226 | ||
| Counselling | 227 | ||
| Health Teaching and Health Promotion | 227 | ||
| Milieu Therapy | 229 | ||
| Promotion of Self-Care Activities | 229 | ||
| Nutrition and Fluid Intake | 229 | ||
| Personal Hygiene and Grooming | 229 | ||
| Elimination | 229 | ||
| Sleep | 232 | ||
| Pharmacological Interventions | 232 | ||
| Antidepressants | 232 | ||
| Antianxiety Drugs | 232 | ||
| Other Classes of Medications | 233 | ||
| Integrative Therapy | 233 | ||
| Advanced Interventions | 233 | ||
| Behavioural Therapy | 233 | ||
| Cognitive Therapy | 234 | ||
| Cognitive Behavioural Therapy | 234 | ||
| Somatic Therapy | 234 | ||
| Evaluation | 234 | ||
| Key Points to Remember | 241 | ||
| Critical Thinking | 241 | ||
| Chapter Review | 241 | ||
| Website | 242 | ||
| References | 242 | ||
| 13 Depressive Disorders | 244 | ||
| Objectives | 244 | ||
| Key Terms and Concepts | 244 | ||
| Website | 244 | ||
| Clinical Picture | 245 | ||
| Disruptive Mood Dysregulation Disorder | 245 | ||
| Persistent Depressive Disorder | 246 | ||
| Premenstrual Dysphoric Disorder | 247 | ||
| Substance/Medication-Induced Depressive Disorder | 247 | ||
| Depressive Disorder Due to Another Medical Condition | 247 | ||
| Depression and Grieving | 247 | ||
| Epidemiology | 248 | ||
| Children and Adolescents | 248 | ||
| Older Adults | 248 | ||
| Comorbidity | 249 | ||
| Etiology | 249 | ||
| Biological Factors | 249 | ||
| Genetic | 249 | ||
| Biochemical | 250 | ||
| Hormonal | 250 | ||
| Inflammation | 251 | ||
| Diathesis–Stress Model | 251 | ||
| Psychological Factors | 251 | ||
| Cognitive Theory | 251 | ||
| Learned Helplessness | 251 | ||
| Application of the Nursing Process | 251 | ||
| Assessment | 251 | ||
| General Assessment | 251 | ||
| Assessment Tools | 251 | ||
| Assessment of Suicide Potential | 251 | ||
| Suicidal Ideation | 251 | ||
| Key Assessment Findings | 253 | ||
| Areas to Assess | 253 | ||
| Affect | 253 | ||
| Thought Processes | 253 | ||
| Mood | 253 | ||
| Feelings | 253 | ||
| Cognitive Changes | 253 | ||
| Physical Behaviour | 253 | ||
| Communication | 254 | ||
| Religious Beliefs and Spirituality | 254 | ||
| Age Considerations | 254 | ||
| Assessment of Children and Adolescents | 254 | ||
| Assessment of Older Adults | 254 | ||
| Self-Assessment | 254 | ||
| Unrealistic Expectations of Self | 254 | ||
| Feeling What the Patient Is Feeling | 254 | ||
| Diagnosis | 256 | ||
| Outcomes Identification | 256 | ||
| The Recovery Model | 256 | ||
| Planning | 256 | ||
| Implementation | 257 | ||
| Counselling and Communication Techniques | 257 | ||
| Health Teaching and Health Promotion | 257 | ||
| Promotion of Self-Care Activities | 258 | ||
| Milieu Management: Teamwork and Safety | 258 | ||
| Pharmacological Interventions | 258 | ||
| Antidepressant Drugs | 258 | ||
| Choosing an antidepressant. | 259 | ||
| Selective serotonin reuptake inhibitors. | 259 | ||
| Indications. | 262 | ||
| Common adverse reactions. | 262 | ||
| Potential toxic effects. | 262 | ||
| Serotonin–norepinephrine reuptake inhibitors. | 262 | ||
| Other newer antidepressants. | 262 | ||
| Tricyclic antidepressants. | 263 | ||
| Indications. | 263 | ||
| Common adverse reactions. | 263 | ||
| Potential toxic effects. | 263 | ||
| Adverse drug interactions. | 263 | ||
| Contraindications. | 263 | ||
| Patient and family teaching. | 263 | ||
| Monoamine oxidase inhibitors. | 263 | ||
| Indications. | 264 | ||
| Common adverse reactions. | 265 | ||
| Potential toxic effects. | 265 | ||
| Contraindications. | 265 | ||
| Use of antidepressants by pregnant women. | 265 | ||
| Use of antidepressants by children and adolescents. | 266 | ||
| Use of antidepressants by older adults. | 266 | ||
| Biological Interventions | 266 | ||
| Electroconvulsive Therapy | 266 | ||
| Indications | 266 | ||
| Risk Factors | 266 | ||
| Procedure | 266 | ||
| Adverse Reactions | 266 | ||
| Transcranial Magnetic Stimulation | 267 | ||
| Unit 5 Trauma Interventions | 476 | ||
| 21 Crisis and Disaster | 477 | ||
| Objectives | 477 | ||
| Key Terms and Concepts | 477 | ||
| Website | 477 | ||
| The Development of Crisis Theory | 478 | ||
| Types of Crisis | 479 | ||
| Maturational Crisis | 479 | ||
| Situational Crisis | 480 | ||
| Adventitious Crisis | 480 | ||
| Phases of Crisis | 480 | ||
| Phase 1 | 480 | ||
| Phase 2 | 480 | ||
| Phase 3 | 480 | ||
| Phase 4 | 480 | ||
| Application of the Nursing Process | 480 | ||
| Assessment | 480 | ||
| General Assessment | 480 | ||
| Self-Assessment | 482 | ||
| Diagnosis | 483 | ||
| Outcomes Identification | 484 | ||
| Planning | 485 | ||
| Implementation | 485 | ||
| Counselling | 485 | ||
| Primary Care | 485 | ||
| Secondary Care | 486 | ||
| Tertiary Care | 486 | ||
| Critical incident stress debriefing. | 486 | ||
| Evaluation | 487 | ||
| Key Points to Remember | 492 | ||
| Critical Thinking | 492 | ||
| Chapter Review | 493 | ||
| Website | 493 | ||
| References | 493 | ||
| 22 Suicide and Nonsuicidal Self-Injury | 495 | ||
| Objectives | 495 | ||
| Key Terms and Concepts | 495 | ||
| Website | 495 | ||
| Epidemiology | 496 | ||
| Racial and Ethnic Statistics | 496 | ||
| Risk Factors | 497 | ||
| Etiology | 498 | ||
| Biological Factors | 498 | ||
| Psychosocial Factors | 500 | ||
| Cultural Factors | 500 | ||
| Societal Factors | 500 | ||
| Application of the Nursing Process | 501 | ||
| Assessment | 502 | ||
| Verbal and Nonverbal Clues | 502 | ||
| Lethality of Suicide Plan | 503 | ||
| Assessment Tools | 503 | ||
| Self-Assessment | 503 | ||
| Implementation | 503 | ||
| Primary Intervention | 504 | ||
| Secondary Intervention | 505 | ||
| Tertiary Intervention | 505 | ||
| Milieu Management | 505 | ||
| Suicide Precautions | 505 | ||
| Counselling | 505 | ||
| Health Teaching and Health Promotion | 506 | ||
| Case Management | 506 | ||
| Pharmacological Interventions | 506 | ||
| Postvention for Survivors of Suicide | 506 | ||
| Evaluation | 507 | ||
| Nonsuicidal Self-Injury | 507 | ||
| Epidemiology | 507 | ||
| Comorbidity | 508 | ||
| Risk Factors | 508 | ||
| Biological Factors | 508 | ||
| Environmental Factors | 508 | ||
| Cultural | 508 | ||
| Societal | 508 | ||
| Clinical Picture | 508 | ||
| Assessment | 508 | ||
| Self-Assessment | 508 | ||
| Diagnosis | 508 | ||
| Outcomes Criteria | 508 | ||
| Planning | 508 | ||
| Interventions | 509 | ||
| Evaluation | 509 | ||
| Key Points to Remember | 509 | ||
| Critical Thinking | 509 | ||
| Chapter Review | 510 | ||
| Website | 510 | ||
| References | 510 | ||
| 23 Anger, Aggression, and Violence | 512 | ||
| Objectives | 512 | ||
| Key Terms and Concepts | 512 | ||
| Website | 512 | ||
| Clinical Picture | 512 | ||
| Epidemiology | 514 | ||
| Comorbidity | 514 | ||
| Etiology | 514 | ||
| Biological Factors | 514 | ||
| Neurological | 514 | ||
| Neurochemical | 515 | ||
| Psychological Factors | 515 | ||
| Sociological Factors | 516 | ||
| Application of the Nursing Process | 517 | ||
| Assessment | 517 | ||
| General Assessment | 517 | ||
| Self-Assessment | 517 | ||
| Diagnosis | 517 | ||
| Outcomes Identification | 517 | ||
| Planning | 517 | ||
| Implementation | 517 | ||
| Psychosocial Interventions | 518 | ||
| Staff Safety | 520 | ||
| Considerations for Engaging the Angry or Aggressive Patient | 520 | ||
| Pharmacological Interventions | 520 | ||
| Health Teaching and Health Promotion | 520 | ||
| Case Management | 521 | ||
| Milieu Management | 521 | ||
| Use of Restraints or Seclusion | 523 | ||
| Caring for Patients in General Hospital Settings | 524 | ||
| Patients With High Anxiety Related to Hospitalization | 524 | ||
| Patients With Healthy Coping Skills Who Are Overwhelmed | 524 | ||
| Patients With Marginal Coping Skills | 524 | ||
| Caring for Patients in Inpatient Psychiatric Settings | 525 | ||
| Patients Who Are Acutely Psychotic | 525 | ||
| Caring for Patients With Cognitive Deficits in Long-Term Residential Care Settings | 525 | ||
| Evaluation | 526 | ||
| Key Points to Remember | 527 | ||
| Critical Thinking | 527 | ||
| Chapter Review | 527 | ||
| Website | 528 | ||
| References | 528 | ||
| 24 Interpersonal Violence | 530 | ||
| Objectives | 530 | ||
| Key Terms and Concepts | 530 | ||
| Website | 530 | ||
| Clinical Picture | 531 | ||
| Violence | 532 | ||
| Types of Violence | 532 | ||
| Physical violence. | 532 | ||
| Sexual violence. | 533 | ||
| Emotional violence. | 533 | ||
| Psychological violence. | 534 | ||
| Spiritual violence. | 534 | ||
| Cultural violence. | 534 | ||
| Verbal abuse. | 534 | ||
| Financial abuse. | 534 | ||
| Neglect. | 534 | ||
| Cycle of Violence | 535 | ||
| Epidemiology | 535 | ||
| Child Abuse | 535 | ||
| Intimate Partner Violence | 535 | ||
| Older Adult Abuse | 536 | ||
| Comorbidity | 537 | ||
| Etiology | 537 | ||
| The Ecological Model of Violence | 537 | ||
| Environmental Factors | 537 | ||
| Perpetrator | 538 | ||
| Vulnerable Person | 538 | ||
| Women. | 538 | ||
| Children. | 538 | ||
| Older adults. | 538 | ||
| Crisis Situation | 539 | ||
| Application of the Nursing Process: Interpersonal Violence | 539 | ||
| Assessment | 539 | ||
| General Assessment | 539 | ||
| Interview Process and Setting | 541 | ||
| Maintaining Accurate Records | 542 | ||
| Self-Assessment | 544 | ||
| Level of Anxiety and Coping Responses | 544 | ||
| Family Coping Patterns | 544 | ||
| Support Systems | 545 | ||
| Suicide Potential | 545 | ||
| Homicide Potential | 545 | ||
| Drug and Alcohol Use | 545 | ||
| Diagnosis | 546 | ||
| Outcomes Identification | 546 | ||
| Planning | 546 | ||
| Implementation | 547 | ||
| Reporting Abuse | 547 | ||
| Counselling | 548 | ||
| Case Management | 548 | ||
| Milieu Management | 548 | ||
| Promotion of Self-Care Activities | 549 | ||
| Health Teaching and Health Promotion | 549 | ||
| Prevention of Abuse | 550 | ||
| Primary Prevention | 550 | ||
| Secondary Prevention | 550 | ||
| Tertiary Prevention | 550 | ||
| Advanced-Practice Interventions | 550 | ||
| Individual Psychotherapy | 550 | ||
| Family Psychotherapy | 551 | ||
| Group Psychotherapy | 551 | ||
| Evaluation | 552 | ||
| Key Points to Remember | 556 | ||
| Critical Thinking | 556 | ||
| Chapter Review | 557 | ||
| Website | 557 | ||
| References | 557 | ||
| 25 Sexual Assault | 560 | ||
| Objectives | 560 | ||
| Key Terms and Concepts | 560 | ||
| Website | 560 | ||
| Epidemiology | 561 | ||
| Profile of Sexual Perpetrators | 562 | ||
| Clinical Picture | 562 | ||
| Relationships Between Victims and Perpetrators | 562 | ||
| Psychological Effects of Sexual Assault | 562 | ||
| Rape-Trauma Syndrome | 562 | ||
| Acute Phase | 562 | ||
| Long-Term Reorganization Phase | 563 | ||
| Application of the Nursing Process | 564 | ||
| A Trauma-Informed Approach | 564 | ||
| Assessment | 564 | ||
| General Assessment | 565 | ||
| Level of Anxiety | 565 | ||
| Coping Mechanisms | 565 | ||
| Available Support Systems | 565 | ||
| Signs and Symptoms of Emotional Trauma | 565 | ||
| Signs and Symptoms of Physical Trauma | 566 | ||
| Self-Assessment | 566 | ||
| Diagnosis | 567 | ||
| Dissociative Disorders | 568 | ||
| Depersonalization/Derealization Disorder | 568 | ||
| Outcomes Identification | 568 | ||
| Planning | 568 | ||
| Implementation | 569 | ||
| Counselling | 569 | ||
| Promotion of Self-Care Activities | 570 | ||
| Follow-Up Care | 570 | ||
| Advanced-Practice Interventions | 570 | ||
| Sexual Assault Nurse Examiners | 570 | ||
| Survivors. | 570 | ||
| Perpetrators. | 570 | ||
| Evaluation | 571 | ||
| Key Points to Remember | 573 | ||
| Critical Thinking | 574 | ||
| Chapter Review | 574 | ||
| Website | 574 | ||
| References | 575 | ||
| Unit 6 Interventions for Distinct Populations | 576 | ||
| 26 Sexuality and Gender | 577 | ||
| Objectives | 577 | ||
| Key Terms and Concepts | 577 | ||
| Website | 577 | ||
| Sexuality | 577 | ||
| Gender | 578 | ||
| Gender Dysphoria | 579 | ||
| Clinical Picture | 579 | ||
| Epidemiology | 579 | ||
| Nursing Care for Gender Dysphoria | 579 | ||
| Advanced Interventions | 579 | ||
| Pharmacological | 579 | ||
| Surgical | 580 | ||
| Application of the Nursing Process | 580 | ||
| Assessment | 580 | ||
| Self-Assessment | 580 | ||
| General Assessment | 581 | ||
| Diagnosis | 581 | ||
| Outcomes Identification | 581 | ||
| Planning | 582 | ||
| Implementation | 582 | ||
| Mental Health Issues in the LGBTQ Population | 582 | ||
| Clinical Picture | 582 | ||
| Depression | 583 | ||
| Self-Harm and Suicide | 584 | ||
| Substance Abuse | 584 | ||
| Evaluation | 584 | ||
| Key Points to Remember | 585 | ||
| Critical Thinking | 585 | ||
| Chapter Review | 585 | ||
| Website | 586 | ||
| References | 586 | ||
| 27 Disorders of Children and Adolescents | 587 | ||
| Objectives | 587 | ||
| Key Terms and Concepts | 587 | ||
| Website | 587 | ||
| Epidemiology | 588 | ||
| Comorbidity | 589 | ||
| Risk Factors | 589 | ||
| Etiology | 590 | ||
| Biological Factors | 590 | ||
| Genetic | 590 | ||
| Brain Development and Biochemicals | 590 | ||
| Temperament | 590 | ||
| Resilience | 591 | ||
| Environmental Factors | 591 | ||
| Cultural Factors | 591 | ||
| Child and Adolescent Psychiatric Mental Health Nursing | 591 | ||
| Assessing Development and Functioning | 591 | ||
| Data Collection | 591 | ||
| Assessment Data | 592 | ||
| Developmental assessment. | 593 | ||
| Mental status examination. | 593 | ||
| Risk assessment. | 593 | ||
| Cultural factors. | 594 | ||
| General Interventions | 594 | ||
| Family Therapy | 594 | ||
| Group Therapy | 594 | ||
| Behavioural Therapy | 594 | ||
| Cognitive Behavioural Therapy | 595 | ||
| Milieu Management | 595 | ||
| Seclusion and restraint. | 595 | ||
| Quiet room. | 596 | ||
| Time out. | 596 | ||
| Mind–Body Therapies | 596 | ||
| Play Therapy | 596 | ||
| Mutual storytelling. | 596 | ||
| Therapeutic games. | 597 | ||
| Bibliotherapy. | 597 | ||
| Therapeutic drawing. | 597 | ||
| Psychopharmacology | 598 | ||
| Neurodevelopmental Disorders | 598 | ||
| Intellectual Disabilities | 599 | ||
| Communication Disorders | 599 | ||
| Autism Spectrum Disorder | 599 | ||
| Attention-Deficit/Hyperactivity Disorder | 599 | ||
| Specific Learning Disorder (SLD) | 600 | ||
| Motor Disorders | 600 | ||
| Application of the Nursing Process | 601 | ||
| Assessment | 601 | ||
| Diagnosis | 601 | ||
| Outcomes Identification | 601 | ||
| Implementation | 601 | ||
| Disruptive, Impulse Control, and Conduct Disorders | 603 | ||
| Oppositional Defiant Disorder | 603 | ||
| Conduct Disorder | 603 | ||
| Bullying | 604 | ||
| Application of the Nursing Process | 604 | ||
| Assessment | 604 | ||
| Diagnosis | 604 | ||
| Outcomes Identification | 604 | ||
| Implementation | 604 | ||
| Anxiety Disorders | 606 | ||
| Separation Anxiety Disorder | 606 | ||
| Generalized Anxiety Disorder (GAD) | 607 | ||
| Application of the Nursing Process | 607 | ||
| Assessment | 607 | ||
| Diagnosis | 608 | ||
| Outcomes Identification | 608 | ||
| Implementation | 608 | ||
| Other Disorders of Children and Adolescents | 608 | ||
| Depressive Disorders and Bipolar and Related Disorders | 608 | ||
| Post-Traumatic Stress Disorder (PTSD) | 609 | ||
| Feeding and Eating Disorders | 609 | ||
| Key Points to Remember | 609 | ||
| Critical Thinking | 609 | ||
| Chapter Review | 610 | ||
| Website | 610 | ||
| References | 610 | ||
| 28 Psychosocial Needs of the Older Adult | 614 | ||
| Objectives | 614 | ||
| Key Terms and Concepts | 614 | ||
| Website | 614 | ||
| Developmental Theories of Aging | 615 | ||
| Mental Health Issues Related to Aging | 616 | ||
| Late-Life Mental Illness | 616 | ||
| Depression | 616 | ||
| Depression and suicide risk. | 616 | ||
| Anxiety Disorders | 617 | ||
| Substance Use Disorders | 617 | ||
| Trauma | 618 | ||
| Caregiver Burden | 618 | ||
| Access to Care | 618 | ||
| Ageism | 619 | ||
| Ageism and Public Policy | 619 | ||
| Ageism and Drug Testing | 620 | ||
| Distinguishing Between Psychiatric and Physical Symptoms | 620 | ||
| Pain | 620 | ||
| Principles of Pain Management | 620 | ||
| Assessment tools. | 620 | ||
| Barriers to accurate pain assessment. | 620 | ||
| Pain treatment. | 620 | ||
| Pharmacological pain treatments. | 620 | ||
| Nonpharmacological pain treatments. | 623 | ||
| Nursing Care of Older Adults | 624 | ||
| Assessment Strategies | 624 | ||
| Intervention Strategies | 626 | ||
| Psychosocial Interventions | 626 | ||
| Pharmacological Interventions | 627 | ||
| Health Teaching and Health Promotion | 627 | ||
| Promotion of Self-Care Activities | 627 | ||
| Milieu Management | 627 | ||
| Care Settings | 629 | ||
| Long-Term Care Facilities | 629 | ||
| Partial Hospitalization | 629 | ||
| Day Treatment Programs | 630 | ||
| Behavioural Health Home Care | 630 | ||
| Respite Care | 630 | ||
| Community-Based Programs | 630 | ||
| Key Points to Remember | 630 | ||
| Critical Thinking | 631 | ||
| Chapter Review | 631 | ||
| Website | 631 | ||
| References | 631 | ||
| 29 Living With Recurrent and Persistent Mental Illness | 633 | ||
| Objectives | 633 | ||
| Key Terms and Concepts | 633 | ||
| Website | 633 | ||
| Serious Mental Illness Across the Lifespan | 634 | ||
| Older Adults | 634 | ||
| Younger Adults | 634 | ||
| Development of Serious Mental Illness | 635 | ||
| Rehabilitation Versus Recovery: Two Models of Care | 635 | ||
| Issues Confronting Those With Serious Mental Illness | 635 | ||
| Establishing a Meaningful Life | 635 | ||
| Comorbid Conditions | 636 | ||
| Physical Disorders | 636 | ||
| Depression and Suicide | 636 | ||
| Substance Abuse | 636 | ||
| Social Problems | 636 | ||
| Stigma | 636 | ||
| Isolation and Loneliness | 636 | ||
| Victimization | 636 | ||
| Economic Challenges | 637 | ||
| Unemployment and Poverty | 637 | ||
| Housing Instability | 637 | ||
| Caregiver Burden | 637 | ||
| Treatment Issues | 637 | ||
| Nonadherence | 637 | ||
| Anosognosia | 637 | ||
| Medication Adverse Effects | 638 | ||
| Treatment Inadequacy | 638 | ||
| Residual Symptoms | 638 | ||
| Relapse, Chronicity, and Loss | 639 | ||
| Resources for People With Serious Mental Illness | 639 | ||
| Comprehensive Community Treatment | 639 | ||
| Community Services and Programs | 639 | ||
| Substance Abuse Treatment | 639 | ||
| Evidence-Informed Treatment Approaches | 640 | ||
| Assertive Community Treatment | 640 | ||
| Cognitive Behavioural Therapy | 640 | ||
| Cognitive Enhancement Therapy | 640 | ||
| Family Support and Partnerships | 640 | ||
| Social Skills Training | 640 | ||
| Supportive Psychotherapy | 640 | ||
| Vocational Rehabilitation and Related Services | 641 | ||
| Other Potentially Beneficial Services or Treatment Approaches | 641 | ||
| Consumer-Run Programs | 641 | ||
| Wellness and Recovery Action Plans | 641 | ||
| Exercise | 641 | ||
| Nursing Care of Patients With Serious Mental Illness | 641 | ||
| Assessment Strategies | 641 | ||
| Intervention Strategies | 642 | ||
| Evaluation | 643 | ||
| Current Issues | 643 | ||
| Involuntary Treatment | 643 | ||
| Criminal Offences and Incarceration | 643 | ||
| Key Points to Remember | 643 | ||
| Critical Thinking | 644 | ||
| Chapter Review | 644 | ||
| Website | 645 | ||
| References | 645 | ||
| 30 Psychological Needs of Patients With Medical Conditions | 647 | ||
| Objectives | 647 | ||
| Key Terms and Concepts | 647 | ||
| Website | 647 | ||
| Psychological Factors Affecting Medical Conditions | 647 | ||
| Psychological Responses to Serious Medical Conditions | 649 | ||
| Depression | 649 | ||
| Anxiety | 649 | ||
| Substance Use | 650 | ||
| Grief and Loss | 650 | ||
| Denial | 650 | ||
| Fear of Dependency | 651 | ||
| Human Rights Abuses of Stigmatized Persons With Medical Conditions | 651 | ||
| Application of the Nursing Process | 651 | ||
| Assessment | 651 | ||
| Psychosocial Assessment | 651 | ||
| Quality of Life Assessment | 651 | ||
| Coping Skills | 652 | ||
| Social and Spiritual Support | 652 | ||
| Self-Assessment | 652 | ||
| Diagnosis | 653 | ||
| Outcomes Identification | 653 | ||
| Planning | 653 | ||
| Implementation | 653 | ||
| Health Teaching and Health Promotion | 653 | ||
| Coping Skills | 653 | ||
| Advanced-Practice Interventions | 654 | ||
| Evaluation | 654 | ||
| Key Points to Remember | 654 | ||
| Critical Thinking | 655 | ||
| Chapter Review | 655 | ||
| Website | 656 | ||
| References | 656 | ||
| 31 Care for the Dying and for Those Who Grieve | 657 | ||
| Objectives | 657 | ||
| Key Terms and Concepts | 657 | ||
| Website | 657 | ||
| Hospice Palliative Care | 658 | ||
| Nursing Care at the End of Life | 659 | ||
| Hospice Palliative Care Nursing | 659 | ||
| The Art, Presence, and Caring of Nursing | 659 | ||
| Assessment for Spiritual Issues | 659 | ||
| Awareness and Sensitivity of Cultural Contexts | 660 | ||
| Palliative Symptom Management | 660 | ||
| The Importance of Effective Communication | 661 | ||
| Anticipatory Grief | 663 | ||
| The Four Gifts of Resolving Relationships | 663 | ||
| Forgiveness. | 663 | ||
| Love. | 663 | ||
| Gratitude. | 663 | ||
| Farewell. | 663 | ||
| Self-Care | 664 | ||
| Nursing Care for Those Who Grieve | 664 | ||
| Grief Reactions, Bereavement, and Mourning | 665 | ||
| Types of Grief | 665 | ||
| Theories | 666 | ||
| Dual Process Model of Coping With Bereavement | 667 | ||
| Four Tasks of Mourning | 668 | ||
| Helping People Cope With Loss | 668 | ||
| Current Topics and Future Directions | 668 | ||
| Medically Assisted Death Legislation | 668 | ||
| Palliative Care for Patients With Dementia | 669 | ||
| Areas for Future Discovery | 670 | ||
| Key Points to Remember | 670 | ||
| Critical Thinking | 671 | ||
| Chapter Review | 671 | ||
| Website | 672 | ||
| References | 672 | ||
| 32 Forensic Psychiatric Nursing | 674 | ||
| Objectives | 674 | ||
| Key Terms and Concepts | 674 | ||
| Website | 674 | ||
| Forensic Nursing | 676 | ||
| Education | 676 | ||
| Roles and Functions | 676 | ||
| Nurse Examiner or Sexual Assault Nurse Examiner | 677 | ||
| Nurse Coroner or Death Investigator | 677 | ||
| The Forensic Mental Health System in Canada | 678 | ||
| Forensic Psychiatric Nursing | 678 | ||
| Roles and Functions | 678 | ||
| Correctional Nursing in Canada | 679 | ||
| Key Points to Remember | 681 | ||
| Critical Thinking | 681 | ||
| Chapter Review | 681 | ||
| Website | 682 | ||
| References | 682 | ||
| Unit 7 Advanced Intervention Modalities | 683 | ||
| 33 Therapeutic Groups | 684 | ||
| Objectives | 684 | ||
| Key Terms and Concepts | 684 | ||
| Website | 684 | ||
| Therapeutic Factors Common to All Groups | 685 | ||
| Planning a Group | 685 | ||
| Phases of Group Development | 685 | ||
| Group Member Roles | 686 | ||
| Group Leadership | 686 | ||
| Responsibilities | 686 | ||
| Styles of Leadership | 687 | ||
| Clinical Supervision | 687 | ||
| Group Observation | 688 | ||
| Nurse as Group Leader | 688 | ||
| Ethical Issues in Group Therapy | 688 | ||
| Basic Groups | 689 | ||
| Psychoeducational Groups | 689 | ||
| Medication education. | 689 | ||
| Health education. | 689 | ||
| Family education. | 689 | ||
| Concurrent disorders. | 690 | ||
| Symptom management. | 690 | ||
| Stress management. | 690 | ||
| Support and self-help groups. | 690 | ||
| Advanced-Practice Nurse or Nurse Therapist | 691 | ||
| Group Psychotherapy | 691 | ||
| Psychodrama groups. | 691 | ||
| Dialectical behaviour treatment. | 691 | ||
| Integrative groups. | 691 | ||
| Dealing With Challenging Member Behaviours | 691 | ||
| Monopolizing Member | 692 | ||
| Complaining Member Who Rejects Help | 692 | ||
| Demoralizing Member | 693 | ||
| Silent Member | 693 | ||
| Expected Outcomes | 693 | ||
| Key Points to Remember | 694 | ||
| Critical Thinking | 694 | ||
| Chapter Review | 694 | ||
| Website | 695 | ||
| References | 695 | ||
| 34 Family Interventions | 696 | ||
| Objectives | 696 | ||
| Key Terms and Concepts | 696 | ||
| Website | 696 | ||
| Family | 697 | ||
| Family Functions | 698 | ||
| Families and Mental Illness | 698 | ||
| Canadian Models of Family Nursing Care and Assessment | 698 | ||
| McGill Model of Nursing | 698 | ||
| Calgary Family Assessment Model (CFAM) and Calgary Family Intervention Model (CFIM) | 698 | ||
| Family Therapy | 699 | ||
| Issues Associated With Family Therapies | 699 | ||
| Communication | 699 | ||
| Emotional Support | 700 | ||
| Socialization | 700 | ||
| Family Life Cycle | 700 | ||
| Working With the Family | 700 | ||
| The Identified Patient | 700 | ||
| Family Triangles | 701 | ||
| The nurse’s response to triangulation. | 702 | ||
| The Nuclear Family Emotional System | 702 | ||
| Family Therapy Theory | 702 | ||
| The Family as a System | 703 | ||
| Application of the Nursing Process | 704 | ||
| Assessment | 704 | ||
| Sociocultural Context | 704 | ||
| Intergenerational Issues | 705 | ||
| Constructing a Genogram | 705 | ||
| Self-Awareness | 707 | ||
| Diagnosis | 708 | ||
| Outcomes Identification | 708 | ||
| Planning | 708 | ||
| Implementation | 708 | ||
| Counselling and Communication Techniques | 708 | ||
| Family Therapy | 709 | ||
| Traditional Family Therapy | 709 | ||
| Psychoeducational Family Therapy | 710 | ||
| Self-Help Groups | 710 | ||
| Case Management | 710 | ||
| Pharmacological Interventions | 710 | ||
| Evaluation | 711 | ||
| Key Points to Remember | 711 | ||
| Critical Thinking | 711 | ||
| Chapter Review | 712 | ||
| Website | 712 | ||
| References | 712 | ||
| 35 Integrative and Complementary Therapies | 714 | ||
| Objectives | 714 | ||
| Key Terms and Concepts | 714 | ||
| Website | 714 | ||
| Integrative Health Care in Canada | 715 | ||
| Research | 716 | ||
| Patients and Integrative Care | 716 | ||
| Safety | 716 | ||
| Efficacy | 717 | ||
| Integrative Nursing Care | 717 | ||
| Classification of Integrative Therapies | 717 | ||
| Whole Medical Systems | 717 | ||
| Traditional Indigenous Medicine | 717 | ||
| Ayurvedic Medicine | 718 | ||
| Traditional Chinese Medicine | 718 | ||
| Acupuncture. | 718 | ||
| Homeopathy and Naturopathy | 718 | ||
| Mind–Body–Spirit Approaches | 719 | ||
| Guided Imagery | 719 | ||
| Biofeedback | 719 | ||
| Hypnosis and Therapeutic Suggestion | 719 | ||
| Meditation | 719 | ||
| Rhythmic Breathing | 720 | ||
| Spirituality | 720 | ||
| Biologically Based Therapies | 721 | ||
| Diet and Nutrition | 721 | ||
| Herbal Therapy | 723 | ||
| Aromatherapy | 723 | ||
| Manipulative Practices | 724 | ||
| Chiropractic Medicine | 724 | ||
| Massage Therapy | 724 | ||
| Reflexology | 725 | ||
| Energy Therapies | 725 | ||
| Therapeutic Touch | 725 | ||
| Healing Touch | 725 | ||
| Reiki | 725 | ||
| Thought Field Therapy and Emotional Freedom Technique | 725 | ||
| Bioelectromagnetic-Based Therapies | 726 | ||
| Key Points to Remember | 726 | ||
| Critical Thinking | 726 | ||
| Chapter Review | 726 | ||
| Website | 727 | ||
| References | 727 | ||
| Appendix A Standards of Practice, Code of Ethics, Beliefs, and Values | 729 | ||
| Canadian Federation of Mental Health Nurses Standards of Practice | 729 | ||
| Standard I: | 729 | ||
| Standard II: | 729 | ||
| Standard III: | 729 | ||
| Standard IV: | 729 | ||
| Standard V: | 729 | ||
| Standard VI: | 729 | ||
| Standard VII: | 729 | ||
| Beliefs/Values | 729 | ||
| Registered Psychiatric Nurses of Canada | 730 | ||
| Standards of Psychiatric Nursing Practice | 730 | ||
| Standard 1: Therapeutic Interpersonal Relationships | 730 | ||
| Standard 2: Application and Integration of Theory-Based Knowledge | 730 | ||
| Standard 3: Professional Responsibility | 730 | ||
| Standard 4: Professional Ethics | 730 | ||
| The Code of Ethics | 730 | ||
| Canadian Nurses Association | 730 | ||
| Values and Ethical Responsibilities | 730 | ||
| Appendix B NANDA-International Nursing Diagnoses 2018–2020 | 733 | ||
| Domain 1: Health Promotion | 733 | ||
| Domain 2: Nutrition | 733 | ||
| Domain 3: Elimination and Exchange | 733 | ||
| Domain 4: Activity/Rest | 734 | ||
| Domain 5: Perception/Cognition | 734 | ||
| Domain 6: Self-Perception | 734 | ||
| Domain 7: Role Relationship | 734 | ||
| Domain 8: Sexuality | 734 | ||
| Domain 9: Coping/Stress Tolerance | 735 | ||
| Domain 10: Life Principles | 735 | ||
| Domain 11: Safety/Protection | 735 | ||
| Domain 12: Comfort | 736 | ||
| Domain 13: Growth/Development | 736 | ||
| Glossary | 737 | ||
| A | 737 | ||
| B | 738 | ||
| C | 738 | ||
| D | 739 | ||
| E | 740 | ||
| F | 740 | ||
| G | 741 | ||
| H | 741 | ||
| I | 741 | ||
| J | 742 | ||
| L | 742 | ||
| M | 742 | ||
| N | 743 | ||
| O | 743 | ||
| P | 744 | ||
| Q | 745 | ||
| R | 745 | ||
| S | 745 | ||
| T | 746 | ||
| U | 747 | ||
| V | 747 | ||
| W | 747 | ||
| Index | 748 | ||
| A | 748 | ||
| B | 750 | ||
| C | 751 | ||
| D | 754 | ||
| E | 756 | ||
| F | 757 | ||
| G | 757 | ||
| H | 758 | ||
| I | 759 | ||
| J | 760 | ||
| K | 760 | ||
| L | 760 | ||
| M | 760 | ||
| N | 762 | ||
| O | 763 | ||
| P | 763 | ||
| Q | 766 | ||
| R | 766 | ||
| S | 767 | ||
| T | 770 | ||
| U | 771 | ||
| V | 771 | ||
| W | 771 | ||
| Y | 771 | ||
| Z | 771 | ||
| Answers to Chapter Review Questions | IBC1 | ||
| Chapter 1 | IBC1 | ||
| Chapter 2 | IBC1 | ||
| Chapter 3 | IBC1 | ||
| Chapter 4 | IBC1 | ||
| Chapter 5 | IBC1 | ||
| Chapter 6 | IBC1 | ||
| Chapter 7 | IBC1 | ||
| Chapter 8 | IBC1 | ||
| Chapter 9 | IBC1 | ||
| Chapter 10 | IBC1 | ||
| Chapter 11 | IBC1 | ||
| Chapter 12 | IBC1 | ||
| Chapter 13 | IBC1 | ||
| Chapter 14 | IBC1 | ||
| Chapter 15 | IBC1 | ||
| Chapter 16 | IBC1 | ||
| Chapter 17 | IBC1 | ||
| Chapter 18 | IBC1 | ||
| Chapter 19 | IBC1 | ||
| Chapter 20 | IBC1 | ||
| Chapter 21 | IBC1 | ||
| Chapter 22 | IBC1 | ||
| Chapter 23 | IBC1 | ||
| Chapter 24 | IBC1 | ||
| Chapter 25 | IBC1 | ||
| Chapter 26 | IBC1 | ||
| Chapter 27 | IBC1 | ||
| Chapter 28 | IBC1 | ||
| Chapter 29 | IBC1 | ||
| Chapter 30 | IBC1 | ||
| Chapter 31 | IBC1 | ||
| Chapter 32 | IBC1 | ||
| Chapter 33 | IBC1 | ||
| Chapter 34 | IBC1 | ||
| Chapter 35 | IBC1 |