Essentials of Psychiatric Mental Health Nursing

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ISBN: 9780803609204 | 0803609205
Cover: Paperback
Copyright: 1/1/2002

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Brandon/Hill Nursing List selection (#327). Textbook includes new chapters and features for this edition. Added features include diagnoses from the 2000 text revision of the DSM-IV, new content on anger/aggression management, Internet references for each DSM-IV-TR diagnosis, and the newest psychotropic medications. Previous edition: c1999. Softcover.

Unit One Introduction to Psychiatric/Mental Health Concepts

(70)

Mental Health and Mental Illness

(14)

Introduction

(1)

Mental Health

(1)

Mental Illness

(1)

Physical and Psychological Responses to Stress

(7)

Physical Responses

(2)

Psychological Responses

(5)

The DSM-IV-TR Multiaxial Evaluation System

(1)

Summary

(2)

Review Questions

(1)

References

(2)

Concepts of Personality Development

(16)

Introduction

(1)

Psychoanalytic Theory

(3)

Structure of the Personality

(1)

Topography of the Mind

(1)

Dynamics of the Personality

(1)

Freud's Stages of Personality Development

(2)

Relevance to Nursing Practice

(1)

Interpersonal Theory

(1)

Sullivan's Stages of Personality Development

(1)

Relevance to Nursing Practice

(1)

Theory of Psychosocial Development

(3)

Erikson's Stages of Personality Development

(2)

Relevance to Nursing Practice

(1)

Theory of Object Relations

(2)

Phase I: The Autistic Phase (Birth to 1 Month)

(1)

Phase II: The Symbiotic Phase (1 to 5 Months)

(1)

Phase III: Separation-Individuation (5 to 36 Months)

(1)

Relevance to Nursing Practice

(1)

A Nursing Model-Hildegard E. Peplau

(3)

Peplau's Stages of Personality Development

(2)

Developing Skills in Participation

(1)

Relevance to Nursing Practice

(1)

Summary

(1)

Review Questions

(1)

References

(1)

Biological Implications

(20)

Introduction

(1)

Neurophysiological Influences

(12)

The Nervous System

(7)

The Neuroendocrine System

(5)

Implications for Psychiatric Illness

(2)

Schizophrenia

(1)

Mood Disorders

(1)

Anxiety Disorders

(1)

Anorexia Nervosa

(1)

Alzheimer's Disease

(1)

Diagnostic Procedures Used to Detect Altered Brain Function

(1)

Electroencephalography

(1)

Computerized EEG Mapping

(1)

Computed Tomographic Scan

(1)

Magnetic Resonance Imaging

(1)

Positron Emission Tomography

(1)

Single Photo Emission Computed Tomography

(1)

Implications for Nursing

(1)

Summary

(1)

Review Questions

(1)

References

(1)

Ethical and Legal Issues

(18)

Introduction

(1)

Definitions

(1)

Ethical Considerations

(5)

Theoretical Perspectives

(1)

Ethical Dilemmas

(1)

Ethical Principles

(1)

A Model for Making Ethical Decisions

(1)

Ethical Issues in Psychiatric/Mental Health Nursing

(2)

Legal Considerations

(7)

Nurse Practice Acts

(1)

Types of Law

(1)

Classifications Within Statutory and Common Law

(1)

Legal Issues in Psychiatric/Mental Health Nursing

(4)

Nursing Liability

(1)

Summary

(1)

Review Questions

(1)

References

(2)

Unit Two Psychiatric/Mental Health Nursing Interventions

(130)

Relationship Development and Therapeutic Communication

(20)

Introduction

(1)

The Therapeutic Nurse-Client Relationship

Therapeutic Use of Self

(1)

Conditions Essential to Development of a Therapeutic Relationship

(2)

Rapport

(1)

Trust

(1)

Respect

(1)

Genuineness

(1)

Empathy

(1)

Phases of a Therapeutic Nurse-Client Relationship

(1)

The Preinteraction Phase

(1)

The Orientation (Introductory) Phase

(1)

The Working Phase

(1)

The Termination Phase

(1)

Interpersonal Communication

(10)

The Impact of Preexisting Conditions

(2)

Nonverbal Communication

(2)

Therapeutic Communication Techniques

(2)

Nontherapeutic Communication Techniques

(1)

Process Recordings

(2)

Active Listening

(1)

Feedback

(2)

Summary

(2)

Review Questions

(1)

References

(2)

The Nursing Process in Psychiatric/Mental Health Nursing

(24)

Introduction

(1)

The Nursing Process

(1)

Definition

(1)

Standards of Care

(14)

Standard I. Assessment

(8)

How Do Cultures Differ?

102

(3)

Standard II. Diagnosis

105

(2)

Standard III. Outcome Identification

107

(1)

Standard IV Planning

107

(1)

Standard V. Implementation

107

(1)

Standard VI. Evaluation

108

(1)

Applying the Nursing Process in the Psychiatric Setting

108

(1)

Documentation to the Nursing Process

109

(4)

Problem-Oriented Recording

110

(1)

Focus Charting

111

(1)

The PIE Method

112

(1)

Summary

113

(1)

Review Questions

114

(1)

References

114

(3)

Milieu-The Therapeutic Environment

117

(10)

Introduction

118

(1)

Milieu Defined

118

(1)

Basic Assumptions

118

(1)

Conditions That Promote a Therapeutic Community

118

(2)

The Program of Therapeutic Community

120

(2)

Role of the Nurse

122

(1)

Summary

123

(2)

Review Questions

125

(1)

References

126

(1)

Intervention in Groups

127

(14)

Introduction

128

(1)

Group Defined

128

(1)

Functions of a Group

128

(1)

Types of Groups

128

(1)

Task Groups

128

(1)

Teaching Groups

128

(1)

Supportive/Therapeutic Groups

129

(1)

Self-Help Groups

129

(1)

Physical Conditions

129

(1)

Seating

129

(1)

Size

129

(1)

Membership

130

(1)

Curative Factors

130

(1)

Phases of Group Development

131

(1)

Phase I. Initial or Orientation Phase

131

(1)

Phase II. Middle or Working Phase

131

(1)

Phase III. Final or Termination Phase

131

(1)

Leadership Styles

132

(1)

Autocratic

132

(1)

Democratic

132

(1)

Laissez-Faire

132

(1)

Member Roles

133

(1)

Psychodrama

133

(1)

The Family as a Group

134

(1)

Role of the Nurse in Group Interventions

134

(1)

Summary

135

(2)

Review Questions

137

(2)

References

139

(2)

Intervening in Crises

141

(16)

Introduction

142

(1)

Crisis Defined

142

(1)

Phases in the Development of a Crisis

142

(1)

Types of Crisis

143

(3)

Class 1: Dispositional Crises

143

(1)

Class 2: Crises of Anticipated Life Transitions

144

(1)

Class 3: Crises Resulting from Traumatic Stress

144

(1)

Class 4: Maturational/Developmental Crises

144

(1)

Class 5: Crises Reflecting Psychopathology

145

(1)

Class 6: Psychiatric Emergencies

145

(1)

Crisis Intervention

146

(1)

Phases of Crisis Intervention: The Role of the Nurse

146

(1)

Phase 1. Assessment

146

(1)

Phase 2. Planning of Therapeutic Intervention

146

(1)

Phase 3. Intervention

147

(1)

Phase 4. Evaluation of Crisis Resolution and Anticipatory Planning

147

(1)

Crisis on the Inpatient Unit: Anger/Aggression Management

147

(5)

Assessment

147

(1)

Diagnosis/Outcome Identification

148

(1)

Planning/Implementation

149

(3)

Evaluation

152

(1)

Summary

152

(2)

Review Questions

154

(2)

References

156

(1)

Psychopharmacology

157

(28)

Introduction

158

(1)

Historical Perspectives

158

(1)

Applying the Nursing Process in Psychopharmacological Therapy

158

(22)

Antianxiety Agents

158

(3)

Antidepressants

161

(4)

Mood Stabilizing Agents

165

(5)

Antipsychotic Agents

170

(1)

Side Effects and Nursing Implications

171

(4)

Antiparkinsonian Agents

175

(2)

Sedative-Hypnotics

177

(1)

Central Nervous System Stimulants

178

(2)

Summary

180

(2)

Review Questions

182

(1)

References

183

(2)

Complementary Therapies

185

(16)

Introduction

186

(2)

Commonalities and Contrasts

188

(1)

Types of Complementary Therapies

188

(9)

Herbal Medicine

188

(3)

Acupressure and Acupuncture

191

(1)

Diet and Nutrition

191

(4)

Chiropractic Medicine

195

(1)

Therapeutic Touch and Massage

196

(1)

Yoga

196

(1)

Pet Therapy

197

(1)

Summary

197

(1)

Review Questions

198

(1)

References

199

(2)

Unit Three Care of Clients with Psychiatric Disorders

201

(278)

Delirium, Dementia, and Amnestic Disorders

203

(18)

Introduction

204

(1)

Delirium

204

(1)

Etiological Implications

204

(1)

Dementia

205

(5)

Etiological Implications

206

(4)

Amnestic Disorders

210

(1)

Etiological Implications

210

(1)

Application of the Nursing Process

211

(4)

Assessment

211

(1)

Diagnosis and Outcome Identification

212

(1)

Planning and Implementation

212

(3)

Client/Family Education

215

(1)

Evaluation

215

(1)

Medical Treatment Modalities

215

(2)

Delirium

215

(1)

Dementia

215

(2)

Summary

217

(1)

Review Questions

218

(2)

References

220

(1)

Substance-Related Disorders

221

(44)

Introduction

222

(1)

Substance-Use Disorders

222

(1)

Substance Abuse

222

(1)

DSM-IV-TR Criteria for Substance Abuse

222

(1)

Substance Dependence

222

(1)

DSM-IV-TR Criteria for Substance Dependence

223

(1)

Substance-Induced Disorders

223

(1)

Substance Intoxication

223

(1)

DSM-IV-TR Criteria for Substance Intoxication

223

(1)

Substance Withdrawal

223

(1)

DSM-IV-TR Criteria for Substance Withdrawal

223

(1)

Classes of Psychoactive Substances

224

(1)

Etiological Implications

224

(1)

Biological Factors

224

(1)

Psychological Factors

224

(1)

Sociocultural Factors

225

(1)

The Dynamics of Substance-Related Disorders

225

(20)

Alcohol Abuse and Dependence

225

(4)

Alcohol Intoxication

229

(1)

Alcohol Withdrawal

229

(1)

Sedative, Hypnotic, or Anxiolytic Abuse and Dependence

229

(4)

CNS Stimulant Abuse and Dependence

233

(3)

CNS Stimulant Intoxication

236

(1)

CNS Stimulant Withdrawal

236

(1)

Inhalant Abuse and Dependence

236

(1)

Inhalant Intoxication

237

(1)

Opioid Abuse and Dependence

237

(3)

Opioid Intoxication

240

(1)

Opioid Withdrawal

240

(1)

Hallucinogen Abuse and Dependence

240

(2)

Hallucinogen Intoxication

242

(1)

Cannabis Abuse and Dependence

242

(3)

Cannabis Intoxication

245

(1)

Application of the Nursing Process

245

(9)

Assessment

245

(9)

Treatment Modalities for Substance-Related Disorders

254

(5)

Alcoholics Anonymous

254

(2)

Pharmacotherapy

256

(2)

Psychopharmacology for Substance Intoxication and Substance Withdrawal

258

(1)

Summary

259

(1)

Review Questions

260

(2)

References

262

(3)

Schizophrenia and Other Psychotic Disorders

265

(28)

Introduction

266

(1)

Nature of the Disorder

266

(1)

Etiological Implications

267

(3)

Biological Influences

268

(1)

Psychological Influences

269

(1)

Environmental Influences

270

(1)

Theoretical Integration

270

(1)

Types of Schizophrenia and Other Psychotic Disorders

270

(3)

Disorganized Schizophrenia

270

(1)

Catatonic Schizophrenia

271

(1)

Paranoid Schizophrenia

271

(1)

Undifferentiated Schizophrenia

271

(1)

Residual Schizophrenia

271

(1)

Schizoaffective Disorder

271

(1)

Brief Psychotic Disorder

272

(1)

Schizophreniform Disorder

272

(1)

Delusional Disorder

272

(1)

Shared Psychotic Disorder

273

(1)

Psychotic Disorder Due to a General Medical Condition

273

(1)

Substance-Induced Psychotic Disorder

273

(1)

Application of the Nursing Process

273

(11)

Background Assessment Data

273

(5)

Diagnosis/Outcome Identification

278

(1)

Planning/Implementation

279

(4)

Client/Family Education

283

(1)

Evaluation

283

(1)

Treatment Modalities for Schizophrenia and Other Psychotic Disorders

284

(3)

Psychological Treatments

284

(1)

Social Treatment

285

(1)

Organic Treatment

286

(1)

Summary

287

(2)

Review Questions

289

(2)

References

291

(2)

Mood Disorders

293

(36)

Introduction

294

(1)

Historical Perspective

294

(1)

Epidemiology

294

(1)

Gender

294

(1)

Age

294

(1)

Social Class

295

(1)

Race

295

(1)

Marital Status

295

(1)

Seasonality

295

(1)

Types of Mood Disorders

295

(4)

Depressive Disorders

295

(4)

Other Mood Disorders

299

(1)

Depressive Disorders

299

(6)

Etiological Implications

299

(3)

Developmental Implications

302

(3)

Application of the Nursing Process to Depressive Disorders

305

(6)

Background Assessment Data

305

(2)

Diagnosis/Outcome Identification

307

(1)

Planning/Implementation

307

(2)

Client/Family Education

309

(1)

Evaluation of Care for the Depressed Client

309

(2)

Bipolar Disorder (Mania)

311

(1)

Predisposing Factors

311

(1)

Application of the Nursing Process to Bipolar Disorder (Mania)

312

(4)

Background Assessment Data

312

(1)

Diagnosis/Outcome Identification

313

(1)

Planning/Implementation

313

(3)

Client/Family Education

316

(1)

Evaluation of Care for the Manic Client

316

(1)

Treatment Modalities for Mood Disorders

316

(7)

Psychological Treatments

316

(2)

Organic Treatments

318

(3)

Suicide

321

(1)

Epidemiological Factors

321

(1)

Nursing Care of the Suicidal Client

321

(2)

Summary

323

(1)

Review Questions

324

(2)

References

326

(3)

Anxiety Disorders

329

(34)

Introduction

330

(1)

Historical Aspects

330

(1)

Epidemiological Statistics

330

(1)

How Much is too Much?

331

(1)

Application of the Nursing Process

331

(22)

Panic Disorder

331

(1)

Generalized Anxiety Disorder

332

(3)

Phobias

335

(7)

Obsessive-Compulsive Disorder

342

(2)

Posttraumatic Stress Disorder

344

(8)

Anxiety Disorder Due to a General Medical Condition

352

(1)

Substance-Induced Anxiety Disorder

352

(1)

Treatment Modalities

353

(4)

Individual Psychotherapy

353

(1)

Cognitive Therapy

353

(1)

Behavior Therapy

354

(1)

Group/Family Therapy

355

(1)

Psychopharmacology

356

(1)

Summary

357

(2)

Review Questions

359

(2)

References

361

(2)

Anxiety-Related Disorders

363

(38)

Introduction

364

(1)

Historical Aspects

364

(1)

Epidemiological Statistics

365

(1)

Application of the Nursing Process

366

(19)

Background Assessment Data-Types of Psychophysiological Disorders

366

(6)

Diagnosis/Outcome Identification

372

(1)

Planning/Implementation

373

(2)

Client/Family Education

375

(1)

Evaluation

375

(1)

Background Assessment Data-Types of Somatoform Disorders

375

(4)

Diagnosis/Outcome Identification

379

(1)

Planning/Implementation

379

(5)

Evaluation

384

(1)

Medical Treatment Modalities for Somatoform Disorders

385

(7)

Individual Psychotherapy

385

(1)

Group Psychotherapy

385

(1)

Behavior Therapy

385

(1)

Psychopharmacology

385

(1)

Background Assessment Data-Types of Dissociative Disorders

385

(3)

Diagnosis/Outcome Identification

388

(1)

Planning/Implementation

388

(4)

Evaluation

Medical Treatment Modalities for Dissociative Disorders

392

(1)

Dissociative Amnesia

392

(1)

Dissociative Fugue

392

(1)

Dissociative Identity Disorder

393

(1)

Depersonalization Disorder

393

(1)

Summary

393

(2)

Review Questions

395

(3)

References

398

(3)

Disorders of Human Sexuality

401

(32)

Introduction

402

(1)

Development of Human Sexuality

402

(2)

Birth Through Age 12

402

(1)

Adolescence

402

(1)

Adulthood

403

(1)

Sexual Disorders

404

(17)

Paraphilias

404

(4)

Sexual Dysfunctions

408

(4)

Application of the Nursing Process to Sexual Disorders

412

(6)

Treatment Modalities for Sexual Dysfunctions

418

(3)

Variations in Sexual Orientation

421

(3)

Homosexuality

421

(3)

Bisexuality

424

(1)

Sexually Transmitted Diseases

424

(3)

Summary

427

(1)

Review Questions

428

(2)

References

430

(3)

Eating Disorders

433

(18)

Introduction

434

(1)

Epidemiological Factors

434

(1)

Application of the Nursing Process

435

(9)

Background Assessment Data

435

(1)

Etiological Implications for Anorexia Nervosa and Bulimia Nervosa

436

(3)

Etiological Implications for Obesity

439

(1)

Diagnosis/Outcome Identification

439

(1)

Planning/Implementation

440

(1)

Client/Family Education

440

(1)

Evaluation

440

(4)

Treatment Modalities

444

(2)

Behavior Modification

444

(1)

Individual Therapy

445

(1)

Family Therapy

445

(1)

Psychopharmacology

445

(1)

Summary

446

(1)

Review Questions

447

(2)

References

449

(2)

Personality Disorders

451

(28)

Introduction

452

(1)

Historical Aspects

452

(1)

Types of Personality Disorders

453

(7)

Paranoid Personality Disorder

453

(1)

Schizoid Personality Disorder

454

(1)

Schizotypal Personality Disorder

455

(1)

Antisocial Personality Disorder

456

(1)

Borderline Personality Disorder

456

(1)

Histrionic Personality Disorder

456

(1)

Narcissistic Personality Disorder

457

(1)

Avoidant Personality Disorder

458

(1)

Dependent Personality Disorder

458

(1)

Obsessive-Compulsive Personality Disorder

459

(1)

Passive-Aggressive Personality Disorder

460

(1)

Application of the Nursing Process

460

(12)

Borderline Personality Disorder

460

(6)

Antisocial Personality Disorder

466

(6)

Treatment Modalities

472

(2)

Interpersonal Psychotherapy

473

(1)

Psychoanalytical Psychotherapy

473

(1)

Milieu or Group Therapy

473

(1)

Cognitive/Behavioral Therapy

473

(1)

Psychopharmacology

473

(1)

Summary

474

(1)

Review Questions

475

(1)

References

476

(3)

Unit Four Psychiatric/Mental Health Nursing of Special Populations

479

(122)

Children and Adolescents

481

(36)

Introduction

482

(1)

Mental Retardation

482

(4)

Etiological Implications

482

(1)

Application of the Nursing Process to Mental Retardation

483

(3)

Autistic Disorder

486

(3)

Etiological Implications

486

(1)

Application of the Nursing Process to Autistic Disorder

487

(2)

Attention-Deficit/Hyperactivity Disorder

489

(6)

Etiological Implications

490

(1)

Application of the Nursing Process to Attention-Deficit/Hyperactivity Disorder

491

(3)

Psychopharmacological Intervention

494

(1)

Conduct Disorder

495

(5)

Etiological Implications

496

(1)

Application of the Nursing Process to Conduct Disorder

497

(3)

Oppositional Defiant Disorder

500

(4)

Etiological Implications

500

(1)

Application of the Nursing Process to Oppositional Defiant Disorder

501

(3)

Tourette's Disorder

504

(3)

Etiological Implications

504

(1)

Application of the Nursing Process to Tourette's Disorder

504

(3)

Psychopharmacological Intervention

507

(1)

Separation Anxiety Disorder

507

(4)

Etiological Implications

507

(1)

Application of the Nursing Process to Separation Anxiety Disorder

508

(3)

Summary

511

(2)

Review Questions

513

(2)

References

515

(2)

Victims of Abuse or Neglect

517

(22)

Introduction

518

(1)

Historical Perspectives

518

(1)

Etiological Implications

519

(1)

Biological Theories

519

(1)

Psychological Theories

519

(1)

Sociocultural Theories

519

(1)

Application of the Nursing Process

520

(12)

Background Assessment Data

520

(7)

Diagnosis/Outcome Identification

527

(1)

Planning/Implementation

528

(3)

Evaluation

531

(1)

Treatment Modalities

532

(1)

Crisis Intervention

532

(1)

The Safe House or Shelter

532

(1)

Family Therapy

533

(1)

Summary

533

(2)

Review Questions

535

(2)

References

537

(2)

The Aging Individual

539

(30)

Introduction

540

(1)

How Old is Old?

540

(1)

Epidemiological Statistics

541

(1)

The Population

541

(1)

Marital Status

541

(1)

Living Arrangements

541

(1)

Economic Status

541

(1)

Employment

541

(1)

Health Status

541

(1)

Theories of Aging

542

(1)

Biological Theories

542

(1)

Psychosocial Theories

543

(1)

Personalitly Theories

543

(1)

The Normal Aging Process

543

(7)

Biological Aspects of Aging

543

(3)

Psychological Aspects of Aging

546

(2)

Sociocultural Aspects of Aging

548

(1)

Sexual Aspects of Aging

549

(1)

Special Concerns of the Elderly Population

550

(5)

Retirement

550

(2)

Long-Term Care

552

(1)

Elder Abuse

553

(2)

Suicide

555

(1)

Application of the Nursing Process

555

(8)

Assessment

555

(1)

Diagnosis/Outcome Identification

556

(1)

Planning/Implementation

557

(1)

Evaluation

557

(6)

Summary

563

(2)

Review Questions

565

(2)

References

567

(2)

Community Mental Health Nursing

569

(32)

Introduction

570

(1)

The Changing Focus of Care

570

(1)

The Public Health Model

571

(1)

The Community as Client

572

(25)

Primary Prevention

572

(1)

Populations at Risk

572

(8)

Secondary Prevention

580

(2)

Tertiary Prevention

582

(5)

The Homeless Mentally Ill

587

(10)

Summary

597

(1)

Review Questions

598

(2)

References

600

(1)

Appendix A: DSM-IV-TR Classification: Axes I and II Categories and Codes

601

(10)

Appendix B: Nanda Nursing Diagnoses Taxonomy II

611

(4)

Appendix C: Assigning Nursing Diagnoses to Client Behaviors

615

(2)

Appendix D: Mental Status Assessment

617

(4)

Appendix E: Critical Pathways of Care

621

(12)

Appendix F: Glossary

633

(12)

Appendix G: Answers To Review Questions

645

(6)

Index

651

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Essentials of Psychiatric Mental Health Nursing

Summary

Table of Contents

Supplemental Materials