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- What is the primary goal of the nurse-patient relationship in psychiatric nursing?
The primary goal of the nurse-patient relationship in psychiatric nursing is to facilitate communication of distressing thoughts and feelings, aid the patient with problem-solving, help examine self-defeating behaviors and test alternatives, and promote self-care and independence.
- What is transference in the nurse-patient relationship?
Transference is when the patient unconsciously and inappropriately displaces onto the nurse feelings and behaviors related to significant figures in the patient's past. The patient is expressing their feelings about someone of importance from their past to the nurse, which is intensified in relationships of authority.
- What is the Diathesis-Stress Model in mental health?
The Diathesis-Stress Model proposes that mental health disorders develop due to the interaction between genetic vulnerability (diathesis) and environmental stressors (stress). It helps explain why some people with a genetic risk develop mental health issues and others do not, highlighting the importance of early intervention and stress management in preventing vulnerable individuals.
- What are the five principles of bioethics?
The five principles of bioethics are: 1) Beneficence - the duty to promote good, 2) Autonomy - respecting the rights of others to make their own decisions, 3) Justice - distributing resources or care equally, 4) Fidelity (nonmaleficence) - maintaining loyalty and commitment; doing no wrong to a patient, and 5) Veracity - one's duty to always communicate truthfully.
- What is the Tarasoff rule?
The Tarasoff rule is an exception to patient confidentiality. It states that there is a duty to warn and protect third parties, and HIPAA can be broken for the Tarasoff rule. Healthcare providers, including nurses, are required to report abuse or neglect to protect at-risk populations such as children, the disabled, the vulnerable, and the elderly.
- What are the criteria for involuntary commitment in California?
The criteria for involuntary commitment in California include: 5150 - 72- hour hold (danger to self, danger to others, gravely disabled), 5250 - 14-day hold (same criteria as 5150), 5260 - extends hospitalization for another 14
days (only for patients who remain a danger to themselves), and 5300 - 180- day hold (danger to others).
- What is a Riese Petition, and what does it determine?
A Riese Petition is a medication capacity hearing that determines whether a psychiatric patient has the capacity to refuse medication. The judge or hearing officer will evaluate the patient's ability to understand their condition, comprehend the risks and benefits of medication, and make a rational decision.
- What is the Lanterman-Petris-Short (LPS) Conservatorship in California?
The Lanterman-Petris-Short (LPS) Conservatorship is a legal process in California that allows for the court-appointed management of a person with a severe mental illness who is unable to care for themselves due to their condition. It can be temporary (30 days) or permanent (1-year, renewable), and the conservator has the power to place the individual in a locked psychiatric facility, approve or refuse psychiatric medications, and make financial and personal decisions related to the individual's care and treatment.
- What are the patient's rights regarding seclusion and restraints?
All least restrictive measures must be exhausted before seclusion and restraints are used. For adults 18 and older, seclusion and restraints are limited to 4 hours, for ages 9-17 it's 2 hours, and for ages 8 and below it's 1 hour. Chemical restraints, such as sedatives and antipsychotics, are also regulated.
- What is the difference between derealization and depersonalization?
Derealization (DR) is the perception of the external world being distorted or strange, where objects may seem distorted in size or people may appear distant or unrecognizable. Depersonalization (DP) is the feeling of being disconnected from one's own body, such as feeling like a robot or that one's body isn't their own.
- What is the average onset age for schizophrenia?
The average onset of schizophrenia is in the late teens to early twenties, but it can occur as late as the mid-fifties.
- What are some of the medical issues that need to be ruled out before schizophrenia can be diagnosed?
Medical issues that need to be ruled out before schizophrenia can be diagnosed include meth use, traumatic brain injury, urinary tract infection, and hypoglycemia.
- What is the relapse rate for schizophrenia in the first year?
- What are the common anticholinergic side effects of first- generation antipsychotics?
The common anticholinergic side effects of first-generation antipsychotics include dry mouth, constipation and urinary retention, blurred vision, and cognitive impairment.
- Describe the key features of tardive dyskinesia.
Tardive dyskinesia involves involuntary, repetitive movements, often affecting the mouth, tongue, face, and limbs. It is a potential long-term side effect of first-generation antipsychotics.
- Explain the differences between high-potency and low-potency first-generation antipsychotics.
High-potency first-generation antipsychotics (e.g., haloperidol, fluphenazine) have a higher risk of extrapyramidal symptoms (EPS) but lower sedation and anticholinergic effects. Low-potency first-generation antipsychotics (e.g., chlorpromazine) have lower EPS risk but higher sedation and anticholinergic effects.
- What are the common extrapyramidal side effects (EPS) associated with first-generation antipsychotics, and how are they managed?
The common EPS associated with first-generation antipsychotics include acute dystonia (bizarre muscle contractions), akathisia (inability to sit still), pseudoparkinsonism (tremors, pill rolling), and tardive dyskinesia (abnormal involuntary movements). These EPS are managed by administering anticholinergic medications like Artane, Benadryl, and Cogentin alongside the first-generation antipsychotics.
- Describe the key features and uses of second-generation (atypical) antipsychotics.
Second-generation antipsychotics treat both positive and negative symptoms of psychosis, with fewer extrapyramidal side effects and tardive dyskinesia compared to first-generation antipsychotics. They have reduced affinity for dopamine (D2) receptors and increased affinity for serotonin receptors. Second-generation antipsychotics are used to treat schizophrenia, bipolar disorder, behavioral disruptions in dementia, and other psychiatric conditions.
- Explain the unique features and considerations for using clozapine, a second-generation antipsychotic.
Clozapine is a highly sedating second-generation antipsychotic with an increased risk of seizures and weight gain. It is considered a last-resort option due to the risk of agranulocytosis, a severe reduction in white blood cells. Patients taking clozapine require regular blood tests to monitor their absolute neutrophil count, and a national registry tracks all individuals prescribed this medication.
- What are the key differences between first-generation, second- generation, and third-generation antipsychotics?
First-generation antipsychotics work the fastest and are best for emergency situations, but have a higher risk of extrapyramidal side effects. Second- generation antipsychotics are more expensive but better for long-term use, with fewer side effects. Third-generation antipsychotics, like aripiprazole, have the pros of second-generation antipsychotics with even lower risk of metabolic side effects.
- Describe the key features and management of neuroleptic malignant syndrome (NMS).
Neuroleptic malignant syndrome (NMS) is a rare, life-threatening reaction to antipsychotic medications, particularly first-generation antipsychotics. It is characterized by fever, autonomic instability, muscle rigidity, and renal impairment. NMS is managed by immediately discontinuing the antipsychotic, providing supportive care, and administering medications to control the symptoms.
- What are the key features of anticholinergic toxicity, and how does it differ from neuroleptic malignant syndrome?
Anticholinergic toxicity is characterized by hyperthermia, hot and dry skin, reduced bowel sounds, agitation, delirium, tachycardia, and potentially coma and death. It differs from neuroleptic malignant syndrome in that it is caused by the anticholinergic effects of certain medications, rather than being a reaction to the dopamine-blocking effects of antipsychotics.
- Explain the key diagnostic criteria and subtypes of major depressive disorder (MDD) according to the DSM-5.
The DSM-5 criteria for MDD include the presence of at least 5 of the following symptoms for a 2-week period, with at least one being depressed mood or loss of interest/pleasure: depressed mood, diminished interest/ pleasure, significant weight loss, insomnia/hypersomnia, psychomotor agitation/retardation, fatigue, feelings of worthlessness/guilt, difficulty concentrating, and suicidal thoughts. Subtypes of MDD include psychotic features, catatonic features, melancholic features, and seasonal features.
- What is the primary neurotransmitter effect of tricyclic antidepressants (TCAs)?
Tricyclic antidepressants (TCAs) prevent the reuptake of serotonin and norepinephrine, thereby increasing the availability of these neurotransmitters in the brain.
- What are the key assessment findings that a nurse should consider when evaluating a patient with depression?
Key assessment findings for a patient with depression include urinalysis, complete blood count, screening for infection, urine toxicology, and thyroid function (to rule out hypothyroidism).
Serotonin syndrome is a potentially life-threatening condition caused by taking too much of an SSRI or combining an SSRI with another medication that increases serotonin levels in the central nervous system. Symptoms include mental status changes, agitation, myoclonus, shivering, hyperreflexia, labile blood pressure, ataxia, diaphoresis, and hyperpyrexia. Management involves supportive measures, discontinuation of the offending medication, and the use of benzodiazepines and anti-serotonergic agents. Prevention involves careful monitoring and avoidance of serotonin- increasing drug combinations.
- Describe the role of electroconvulsive therapy (ECT) in the treatment of depression.
Electroconvulsive therapy (ECT) is a treatment procedure in which an electric current is passed through the brain, inducing a generalized seizure. ECT is typically considered a last resort for the treatment of severe depression, acute mania, psychotic symptoms, and acute suicidality, when other treatments have been ineffective. The treatment is usually administered three times per week until a course of 12 treatments is completed. While ECT can be effective, it is an invasive and expensive procedure with the potential for transient short-term memory loss as a side effect.
- Discuss the risk factors and protective factors associated with suicidal ideation and non-suicidal self-injury.
Risk factors for suicidal ideation and self-injury include psychiatric disorders (especially those associated with low serotonin levels), alcohol or substance abuse, male gender, increasing age, and a family history of suicidal behavior. Protective factors include religion, culture, marriage, problem-solving skills, coping mechanisms, a strong support system, access to mental health care, and resilience. Cultural factors, such as the role of religion and extended family, can also serve as protective factors for certain ethnic groups.
- What are the three central desires that Menninger believed underlie suicide?
According to Menninger, the three central desires that underlie suicide are:
- the wish to kill, which is the urge to harm someone else, 2) the wish to be killed, which is the desire for death coming from a place of victimhood or self-punishment, and 3) the wish to die, which is the desire for self- destruction.
- What is the central emotional factor in suicide risk according to Aaron Beck?
According to Aaron Beck, the central emotional factor in suicide risk is hopelessness - the feeling that things will never improve and that there is no possibility of relief from emotional pain.
- Describe the concept of suicidal fantasies and how they can contribute to suicide risk.
Suicidal fantasies refer to individuals experiencing repeated thoughts or fantasies about death, dying, or suicide. These can become more pervasive and difficult to control over time. When these suicidal fantasies are combined with real or perceived loss, individuals may feel more isolated, hopeless, and desperate, which can lead them to consider suicide as a solution to their pain.
- What are the key components of a patient safety plan for individuals at risk of suicide?
A patient safety plan is a unique, patient-centered approach aimed at heightening the patient's commitment to safety and mental health treatment, developing coping strategies, and adherence to personal safety plan before acting on suicidal thoughts. The key components include identifying warning signs, coping strategies, social contacts, and professional support to be accessed during a crisis.
- Explain the different classifications of self-injurious behavior (SIB) and how they differ.
The different classifications of self-injurious behavior (SIB) include:
- Stereotypic SIB: Repeated self-injurious behaviors such as cutting or scratching to the same severity and area.
- Major SIB: Self-injurious behavior that results in a severe injury such as deep cutting.
- Compulsive SIB: Feeling that they "need" to harm themselves or "deserve" to be harmed.
- Impulsive SIB: Act of hurting themselves in the "heat of the moment".
- Describe the key differences between Bipolar I and Bipolar II disorders.
The key differences between Bipolar I and Bipolar II disorders are: Bipolar I: Mania occurs during high mood swings, with extreme energy, impulsive behavior, racing thoughts, and potential psychosis. Depression occurs during low mood swings, with sadness, loss of energy, and difficulty concentrating. The highs and lows are more drastic. Bipolar II: Hypomania occurs during high mood swings, which is a less extreme form of mania without psychosis. Depression also occurs during low mood swings. The highs and lows are not as drastic as in Bipolar I.
- What are the key symptoms of mania in bipolar disorder?
The key symptoms of mania in bipolar disorder include:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- Pressured speech
- Flight of ideas
- Distractibility
- Psychomotor agitation
- Involvement in pleasurable activities with a high potential for painful consequences (e.g., hypersexuality, gambling, reckless spending)
Benzodiazepines are used in the short-term to provide relief from mania or hypomania symptoms while waiting for the effects of longer-acting bipolar medications like lithium or valproic acid to take effect.
- Describe the key differences between fear and anxiety.
Fear is a reaction to a specific, identifiable danger, while anxiety is a more general apprehension, uneasiness, or uncertainty about a perceived threat. Fear is a necessary survival response, while anxiety can become maladaptive if it is disproportionate to the situation.
- What are the four levels of anxiety, and how do they impact a person's perceptual field and problem-solving ability?
The four levels of anxiety are: 1) Mild - perceptual field slightly narrowed but sharpened, effective problem-solving; 2) Moderate - perceptual field somewhat narrowed, problem-solving more difficult; 3) Severe - perceptual field greatly narrowed, problem-solving significantly impaired; 4) Panic - perceptual field severely distorted, problem-solving impossible. As anxiety increases, the person's ability to perceive their surroundings and think clearly becomes increasingly compromised.
- Which defense mechanism involves unconsciously suppressing distressing memories, thoughts, or feelings?
Repression is the defense mechanism that involves the unconscious suppression of distressing memories, thoughts, or feelings in order to protect the individual from anxiety or other uncomfortable emotions.
- Describe the key features and potential consequences of separation anxiety disorder.
Separation anxiety disorder involves developmentally inappropriate levels of concern over being away from a significant other. In children, it typically lasts 4-6 weeks, while in adults it can persist for 6 months or more. Potential consequences include loss of independence, lack of a social circle, and increased isolation if the individual is unable to tolerate being away from their attachment figure.
- How do the cognitive and behavioral theories explain the development of anxiety disorders?
Cognitive theories, such as Cognitive Behavioral Therapy (CBT), posit that anxiety disorders arise from irrational thoughts and beliefs that lead to maladaptive behaviors. Behavioral theories, on the other hand, suggest that anxiety disorders develop through classical conditioning (associating neutral stimuli with fear) and operant conditioning (using avoidance behaviors to reduce anxiety).
- What is the primary characteristic of obsessive-compulsive disorder (OCD)?
The primary characteristic of OCD is the presence of obsessions, which are persistent, intrusive thoughts, impulses, or images that the individual feels driven to act upon through compulsions, which are repetitive behaviors or mental acts performed to reduce the anxiety caused by the obsessions.
- Describe the key features and potential consequences of social anxiety disorder.
Social anxiety disorder is characterized by a persistent fear of social or performance situations where the individual may be negatively evaluated by others. This can lead to significant impairment in social, occupational, and other areas of functioning, as the individual may avoid these situations or endure them with intense distress, which can further isolate them and limit their opportunities for personal and professional growth.
- What are the key factors that contribute to the development of anxiety disorders according to the diathesis-stress model?
The diathesis-stress model of anxiety disorders suggests that the development of these disorders is influenced by both a predisposition or vulnerability (diathesis) and the presence of stressful life events or environmental factors. The diathesis may be biological, psychological, or a combination of the two, while the stress can come from a variety of sources, such as traumatic experiences, interpersonal conflicts, or major life changes.
- Which defense mechanism involves acting in a way that is the opposite of one's true feelings?
Reaction formation is the defense mechanism where an individual acts in a way that is the opposite of their true feelings in order to protect themselves from anxiety or guilt.
- Which anxiety problem is characterized by an impulse to use tissues to touch or grab everything around the patient, due to a feeling of needing to be clean and safe?
The patient appears to have obsessive-compulsive disorder (OCD). The described behavior of feeling compelled to use tissues to touch objects in order to feel clean and safe is indicative of OCD.
- A patient has been isolating herself in her room due to social embarrassment and has Inderal (propranolol) ordered. Which is an appropriate short-term outcome for this client?
The appropriate short-term outcome is for the patient to communicate with staff and peers for at least 10 minutes within 5 days. This helps address the patient's social isolation and embarrassment by gradually increasing her social interaction.
- Which television character appears to have obsessive-compulsive disorder (OCD)?
- What are the key characteristics of dissociative identity disorder (DID)?
Dissociative identity disorder (DID) is characterized by the presence of two or more distinct personality states, each with its own pattern of perceiving, relating to, and thinking about the self and the environment. This is often the result of repeated trauma that the individual has had to formulate new personalities to escape.
- What are the key signs and symptoms of Wernicke-Korsakoff syndrome, a result of thiamine deficiency in alcohol dependence?
Wernicke-Korsakoff syndrome is characterized by ataxia (loss of coordination due to cerebellar dysfunction), somnolence and stupor (signs of progressing neurological decline that can lead to coma and death if untreated), as well as peripheral neuropathy, confabulation, and myopathies.
- What are the key signs of alcohol intoxication and withdrawal?
Signs of alcohol intoxication include slurred speech, lack of coordination, unsteady gait, blackouts, nystagmus, flushed face, and impaired judgment. Withdrawal symptoms develop within 4-12 hours after cessation and peak at 24-48 hours, including anxiety, agitation, tremors, tachycardia, hypertension, diaphoresis, hallucinations, nausea/vomiting, and delirium tremens (a medical emergency with severe autonomic instability).
- What is the CAGE questionnaire and how is it used to screen for alcohol use disorder?
The CAGE questionnaire consists of 4 questions: 1) Have you ever felt you should Cut down on your drinking? 2) Have people Annoyed you by criticizing your drinking? 3) Have you ever felt Guilty about your drinking?
- Have you ever needed an Eye-opener drink in the morning to steady your nerves or get rid of a hangover? A positive response to 2 or more questions indicates a likely alcohol use disorder.
- How is the Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA-Ar) used to manage alcohol withdrawal?
The CIWA-Ar is used to recognize the process of alcohol withdrawal before it progresses to more advanced stages, in order to prevent over- or under- treatment. It assesses 10 signs and symptoms of withdrawal, including nausea/vomiting, tremors, sweating, anxiety, agitation, and sensory disturbances. Scores below 8-10 indicate mild withdrawal, while scores of 15 or more indicate severe withdrawal requiring aggressive pharmacological management.
- What are the key pharmacological interventions for alcohol use disorder?
Key pharmacological treatments for alcohol use disorder include:
- Benzodiazepines (e.g. Valium, Ativan, Librium) for managing withdrawal symptoms
- Disulfiram (Antabuse) which causes unpleasant physical effects when combined with alcohol, serving as a deterrent
- Naltrexone (ReVia, Vivitrol) which blocks the euphoric effects of alcohol and reduces cravings
- Acamprosate (Campral) which stabilizes the glutamatergic system to decrease alcohol cravings
- SSRIs which may decrease drinking in late-onset alcoholism
- What are the key signs and symptoms of central nervous system stimulant abuse?
Common signs of central nervous system stimulant abuse include dilated pupils, dryness of the oronasal cavity, excessive motor activity, elevated vital signs, insomnia, and psychosis. Examples of stimulants include cocaine, crack, caffeine, nicotine, and ADHD medications. Withdrawal symptoms can include depression, paranoia, lethargy, anxiety, insomnia, nausea, vomiting, and suicidal thoughts.
- How does nicotine act on the brain and what are the key effects of nicotine addiction?
Nicotine is a psychoactive stimulating substance found in tobacco. It occupies the receptors for acetylcholine in both dopamine and serotonin neural pathways, acting on the brain's reward mechanisms. Nicotine addiction is associated with cancer, heart disease, emphysema, hypertension, and death. Withdrawal symptoms include irritability and headaches.
- What are the key factors to consider in a successful substance abuse treatment plan?
For a substance abuse treatment plan to be successful, key factors to consider include:
- Establishing a strong support system for the patient
- Incorporating group therapy such as AA or NA
- Helping the patient find a sponsor
- Identifying the patient's coping mechanisms and triggers
- Addressing any co-occurring psychiatric or medical conditions
- What are the key principles of smoking cessation pharmacotherapy?
Key principles of smoking cessation pharmacotherapy include:
- Varenicline (Chantix) - a partial nicotine receptor agonist that reduces cravings and withdrawal symptoms
- Bupropion (Zyban) - an antidepressant that increases dopamine to help decrease nicotine cravings
- Nicotine replacement therapy (patches, gum, lozenges) - provides steady levels of nicotine to desensitize receptors and relieve cravings
- What are the key signs and symptoms of alcohol poisoning and delirium tremens (DTs)?
Flunitrazepam (Rohypnol) and Gamma hydroxybutyric acid (GHB) rapidly produce disinhibition, relaxation of voluntary muscles, and anterograde amnesia, making them dangerous "date rape" drugs.
- Explain the similarities between pathological gambling and substance use disorders.
Pathological gamblers show tolerance, dependence, and withdrawal, similar to substance use disorders. The brain's reward system and neural circuits react in similar ways, and pathological gamblers have a 17% rate of attempted suicide, as well as frontal lobe dysfunction, impulsive control dysregulation, and genetic factors.
- What is the CAGE-AID screening tool, and how is it used to assess for potential substance use disorders?
The CAGE-AID is a screening tool that asks four questions: 1) Have you ever felt you should Cut down on your drinking or drug use? 2) Have people Annoyed you by criticizing your drinking or drug use? 3) Have you ever had a drink or used drugs first thing in the morning (Eye-opener) to steady your nerves or get rid of a hangover? 4) Scoring: 1 point for each 'Yes' answer. A score of 2 or more indicates a potential substance use disorder and suggests the need for further assessment or referral for treatment.
- Describe the key aspects of the nursing process in caring for individuals with substance use disorders.
The nursing process for individuals with substance use disorders includes comprehensive assessment (screening, drug use history, family assessment, self-assessment), identifying potential nursing diagnoses (e.g., imbalanced nutrition, disturbed thought processes, risk for suicide), setting appropriate outcomes (e.g., withdrawal management, fluid balance, neurological status), and implementing interventions (e.g., referrals to support groups, addressing underlying causes, providing a safe environment).
- What is the stage of Alzheimer's disease where the patient has no obvious symptoms, but changes in the brain have already started?
The stage where the patient has no obvious symptoms, but changes in the brain have already started is the preclinical stage. This stage can last for years before symptoms appear.
- What are the key characteristics of mild cognitive impairment (MCI)?
The key characteristics of mild cognitive impairment (MCI) are mild memory problems, a slight struggle with activities of daily living (ADLs) but still able to complete them, and an increased risk of developing Alzheimer's disease, although not everyone with MCI will develop Alzheimer's.
- Describe the symptoms and care needs associated with the severe cognitive decline stage (stage 7) of Alzheimer's disease.
In the severe cognitive decline stage (stage 7) of Alzheimer's disease, the patient experiences severe memory loss, apraxia (difficulty performing learned movements), agnosia (inability to recognize objects, sounds, or people), and aphasia (difficulty with language). The patient requires full- time care and assistance with all activities of daily living.
- What are some important things to assess when caring for a patient with Alzheimer's disease?
When caring for a patient with Alzheimer's disease, it is important to assess the following: cognitive function (memory, decision-making, and orientation), safety concerns (wandering, falls, and ability to find direction), mood and behavior changes (agitation, aggression, or depression), caregiver ability and strain, and availability of resources such as adult day care services, home health services, Alzheimer's Association, and senior transportation.
- What are the nursing diagnoses commonly associated with Alzheimer's disease?
The common nursing diagnoses for patients with Alzheimer's disease include risk for injury, impaired verbal communication, impaired environmental interpretation syndrome, impaired memory, confusion, and caregiver role strain.
- Describe the pharmacological interventions used to manage the various symptoms and complications of Alzheimer's disease.
The pharmacological interventions for Alzheimer's disease include:
- Cholinesterase inhibitors (e.g., donepezil, rivastigmine, galantamine) to improve memory and cognition
- NMDA receptor antagonist (memantine) to regulate glutamate
- Melatonin for sleep disturbances
- SSRIs and cholinesterase inhibitors for depression
- Dopamine-related medications for Parkinsonian symptoms
- Low-dose antipsychotics (e.g., quetiapine) for agitation and psychosis
- What are some effective non-pharmacological strategies for managing Alzheimer's disease symptoms?
Effective non-pharmacological strategies for managing Alzheimer's disease symptoms include the use of live and animated stimuli (e.g., aquarium, music), bright lights, and physical contact (e.g., foot washing). These strategies can help address issues such as agitation, hallucinations, and disorientation.
- Which of the following is the most associated with the acute onset of disordered thinking?
C. Depression. Delirium, which is characterized by a sudden onset and fluctuating severity of disordered thinking, is often reversible if the underlying cause (e.g., infection, medications, metabolic imbalance) is
- Describe the schema or core beliefs associated with schizotypal personality disorder.
The schema or core beliefs associated with schizotypal personality disorder include: 1) Ideas of reference (belief that casual incidents or events are of particular significance), 2) Odd beliefs or magical thinking, 3) Suspiciousness or paranoid ideation, and 4) Lack of close friends or confidants.
- What are the key characteristics of antisocial personality disorder?
The key characteristics of antisocial personality disorder include: failure to conform to social norms, deceitfulness, impulsivity, irritability and aggressiveness, reckless disregard for safety of self or others, irresponsibility, and lack of remorse. Individuals with this disorder are often charming and able to easily gain the trust of others.
- Describe the schema or core beliefs associated with borderline personality disorder.
The schema or core beliefs associated with borderline personality disorder include: 1) I am not sure who I am, 2) I will eventually be abandoned, 3) There is no place where I fit in, and my pain is so intense that I can't bear it,
- My anger controls me, and I can't modulate my feelings, and 5) When I am overwhelmed I must escape (through running away or suicide).
- What are the key nursing guidelines for working with clients with Cluster B personality disorders?
Key nursing guidelines for working with clients with Cluster B personality disorders include: 1) Implement safety precautions, 2) Be alert to manipulation, 3) Set clear and realistic limits on behavior, 4) Do not seek approval or coax, 5) Confront inappropriate behaviors and consequences, 6) Avoid rejecting or rescuing, 7) Use a calm tone of voice and positive, friendly attitude, and 8) Express concern for the patient's wellbeing.
- What are the three main types of Cluster C personality disorders?
The three main types of Cluster C personality disorders are: 1) Avoidant personality disorder, 2) Dependent personality disorder, and 3) Obsessive- compulsive personality disorder.
- What are the key features of Avoidant Personality Disorder?
The key features of Avoidant Personality Disorder include a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Individuals with this disorder tend to avoid occupational activities, are unwilling to get involved with people, avoid intimate relationships, and are afraid of being criticized or rejected in social situations. They view themselves as socially inept, personally unappealing,
or inferior to others, and are reluctant to take personal risks or engage in new activities.
- What are the core schemas associated with Dependent Personality Disorder?
The core schemas associated with Dependent Personality Disorder include:
- I can't function without the support of others, 2) Without the advice and reassurance of others I can't exist, 3) In any situation, I am probably wrong,
- If I express anger, people will abandon me, 5) If I am abandoned, I will be destroyed, 6) I must keep people near me, and 7) If I am alone, I may be hurt.
- What are the key features of Obsessive-Compulsive Personality Disorder?
The key features of Obsessive-Compulsive Personality Disorder include a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. Individuals with this disorder are preoccupied with details, rules, lists, order, organization, or schedules, show perfectionism that interferes with task completion, are excessively devoted to work and productivity, and are overconscientious, scrupulous, and inflexible.
- Which assessment finding would the nurse anticipate in a client diagnosed with Narcissistic Personality Disorder?
The nurse would anticipate finding grandiosity, a sense of self-importance, and a sense of entitlement in a client diagnosed with Narcissistic Personality Disorder. Individuals with this disorder often display a grandiose sense of self-importance and entitlement, along with a preoccupation with fantasies of success, power, beauty, or ideal love.
- What is the appropriate initial nursing intervention for a patient with Antisocial Personality Disorder who is observed using a cell phone (contraband) in the bathroom on a psychiatric unit?
The appropriate initial nursing intervention for a patient with Antisocial Personality Disorder who is observed using a cell phone (contraband) in the bathroom is to confront the client about the behavior. Directly addressing the inappropriate behavior and setting clear boundaries is important, as individuals with Antisocial Personality Disorder often lack empathy and disregard social norms and rules.
- What is the priority nursing intervention for a patient with Borderline Personality Disorder who is admitted to the psychiatric unit after being treated in the ED for superficial cuts on both wrists and suicidal statements?
The priority nursing intervention for a patient with Borderline Personality Disorder who is admitted to the psychiatric unit after self-harm and suicidal statements is to assess the client frequently for self-injurious behaviors. Individuals with Borderline Personality Disorder are at high risk for self-
