psych nursing complete

ReD Mapalo – BSN Psychiatric Nursing

Beliefs Feelings Behavior

Therapeutic Communication Techniques What you see, you say What you hear, you say restating

Sigmund Freud Father of Psychoanalysis Structure of Personality (Id, Ego, Superego)

Dominant ID Mania

D eat Antisocialmpulsive drink Narcissistic want to urinate want PLEASURE defecate

PLEASURABLE PRINCIPLEPain AvoidanceIt’s all “I”

DOMINANT SUPER EGOObsessive - compulsive

UPER EGO Anorexia Nervosahould notmall voice of God

CONSCIENCE PRINCIPLE

GOXecutive Secretary Impaired Reality

Schizophrenia

REALITY PRINCIPLE

LIBIDO sexual energy responsible for survival

PSYCHOSEXUAL THEORY1. ORAL STAGE

0 – 18 Months old Survival I want to eat, sleep, urinate, defecate ID formation Cry & Suck mouth

I

S

E

I

S

E


Child Cries

Feed the Infant Ignore the Infant

Successful Unsuccessful

Narcissistic

Defense Mechanism:o FIXATION when a person is stuck in a certain developmental

stageo REGRESSION return to an earlier developmental stage

EGO is develop in the 6th month

2. ANAL STAGE A teen – 3 years old (18 mos – 3 y.o.) Toilet training Super Ego develop

Toilet Training

Good Mother Bad Mother

Successful Unsuccessful

Too Rigid Training Dirty DisorganizedClean DisobedientOrganized Obedient ANTISOCIAL (Anal Expulsive)

OBSESSIVE – COMPULSSIVE(Anal Retentive)

3. PHALLIC 3 – 6 y.o. Penis/ Vagina Parents is the significant person Called as Preschooler

SE

BIG SE

Small SE


Oedipus Complex little boy loves mommy Electra Complex little girl loves daddy Identification boy associates with daddy, girl assoc. with mommy Castration fear of the little boy to daddy Penis Envy envy of little girl towards daddy

Dr. Karen Horney opposition to penis envy

Level of Awarenesso Conscious highest level of awarenesso Preconscious Tip of the tongueo Unconscious deepest level of awareness

Birth Trauma First traumatic experience of child REPRESSION unconscious forgetting of an anxiety provoking

concept SUPRESSION conscious forgetting of an anxiety provoking

concept

4. LATENCY STAGE 6 – 12 years old SCHOOlatency Sexual energy is dormant Reading, Riting, Rithmetic

SUBLIMATION placing sexual energies toward a more productive endeavors

5. GENITAL STAGE 12 y. o. – above Gising Genital


PHARMA MOMENTS

ANTIANXIETY VLAST ME VAIBValium – ate V Miltown - Meal Vistaril - largavistaLibreum - L Equanil – Aqua Kneel Attarax – Mga bato (rocks)Ativan - Ate Guy Inderal – hindi ralphSeraks – Sera Ulo Busfar – sasakay ng busTranxene - Transit

ERIK ERIKSON PSYCHOSOCIAL THEORY OF DEVELOPMENT

Age + - Affecting Major Factor

0-18 mos. Trust Mistrust Feeding18 mos. – 3 y.o. Autonomy

AU nalTO ilet trainingNO favorite wordMY

Shame/ doubt Toilet Training

3 – 6 y.o. Initiative Guilt Independence6 – 12 y.o. Industry Inferiority In da-school

12 – 18 y.o. Identity Role confusion Peer18- 35 y.o. Intimacy Isolation Love35 – 65 y.o. Generativity Stagnation Parenting

65 y.o. and above Ego Integrity Despair Reflection

MASLOW’S HEIRARCHY OF NEEDS

1. Physiologic Needso Air, food, water, shelter, rest, sleep, activity and temperature

maintenance that are crucial for survival2. Safety and Security Needs

o Safe in physical and psychological aspects3. Love and Belonging Needs

o Giving and receiving affection, attaining a place in a group, maintaining the feeling of belonging

4. Self – esteem Needso Self esteem – feelings of independence, competence and self

respecto Esteem from others – recognition, respect, appreciation

5. Self Actualization


o One’s maximum potential and realize one’s abilities and qualitiesBEHAVIORAL MODELS

1. Ivan Pavlov Classical Conditioning Model All behavior are learned

Food dog Salivation Bell Food Dog Salivation Bell Salivation

2. B.F. Skinner Operant Conditioning All behaviors are unlearned Reward (+ reinforcement) and Punishment (-

Reinforcement)

BRAIN LOBES ACTIONFrontal Language, Learning, Personality, JudgmentTemporal hearing, smellingParietal Taste, touchOccipital Vision

SensoryIntegration Voluntary

MotorInvoluntary

VOLUNTARY NERVOUS SYSTEM Somatic Nervous System

AcetylCholine

Brain Spinal Cord Motor Nerve Muscle Fiber

INVOLUNTARY NERVOUS SYSTEM Autonomic Nervous System

Sympathetic ParasympatheticHR RR GI

Constipation

DiarrheaGU

Urinary retention

Urinary

FrequencyNeuro Epi/ Nor Acetyl Choline


PHARMA MOMENTS MONOAMINE OXIDASE INHIBITORS (PANAMA) AR

M PLANN DILP NATE

ANTIPARKINSON CAPABLES

CogentinArtaneParlodelAkinetonBenadrylLarodopaEldeprylSymmetryl

THERAPEUTIC COMMUNICATIONTherapeutic Non-Therapeutic

Offer your self I’ll stay with you

Silence Making observations

o You seem sad Active listening

o Noddingo Eye contacto Lean forward

Who, what, when, where General leads

o Go on, I’m listening, what else?

Broad opening - best Opening line

o How are you today?o How are you?

Restating Clarrification Refocusing we are talking

about the exam Focusing tell me about

Don’t worry be happy Everything’s gonna be alright Ignoring the client Changing the subject Nice weather we’re having

o Adjectives – value based perception, should not be use

You are the most beautiful client

Why Arguing Flattery You should do this now In my opinion


DEFENSE MECHANISMS Fight for stressDISPLACEMENT Transfer of feelings to a less

threatening object rather than the one who provoke it

Boss shouts at you, you shout at your subordinate

DENIAL Failure to acknowledge an unacceptable trait or situation

“I’m not an alcoholic”

DISSOCIATION Psychological flight from self A type of amnesia

“Sino ka, Sino ako?”

REGRESSION Return to an earlier developmental stage

Return to thumbsucking

REPRESSION Unconscious forgetting of an anxiety provoking concept

Hindi ko maalala

RATIONALIZATION Illogical reasoning for a socially unacceptable trait

“sayang ang beer sa ref, kaya ko ininum”

I drink because I don’t want to waste the beer in the ref

REACTION FORMATION

doing the opposite of your intention

plastic

sasabunutan kita. . . ay kuklulutin lang kita

UNDOING Doing the opposite of what you have done due to guilt

orocan, plastic, Tupperware

“ay pinatid kita, halika punta kita sa clinic”

IDENTIFICATION Assume trait for personal, social, occupational role

Tulad niya

PROJECTION Attributing to others one’s acceptable trait

Pasa load

“hindi ako alcoholic, sila yon”

INTROJECTION Assume another person’s trait as your own

“ako din” Not just you, me

tooSUPPRESSION Conscious forgetting of an anxiety

provoking concept Hindi ko alam yan

SUBLIMATION Placing sexual energies toward a more productive endeavors

Angry at life, put anger in singing

CONVERSION Repressed angers put towards physical symptoms affecting nervous system leading to sensory numbness and motor paralysis

Biglang mangingig

COMPENSATION Overachievement in one area to cover a defective part

Pilay pero magaling kumanta

SUBSTITUTION Replacing a difficult goal with a more accessible one

Gusto ko Disneyland. Enchanted nalang.


STOP GABA Inhibitory Gamma Amino Butyric Acid

GO Epinephrine/ Norepinephrine

SNS Exitatory

ANXIETY Anticholinergic side effectConstipationUrinary Retention Within 1 weekDry Mouth Rebound Blurred Vision phenomenon

SeizureAbrupt

Anti-Anxiety DependenceWithdrawal

DrowsyNo AlcoholNo CoffeeDevelop OrthostaticHypotension

Prevetion of O.H.1. Sit Down2. Dangle feet Gradually3. Stand Up Gradually Tapered Dose

RELAXED

ANXIETY Vague sense of impending doom

Mild Moderate Severe Panic +1 +2 +3 +4Widened acing ont know what uicidePerceptual to say/do afety Don’t touch clientField RN Meds IRECTIVE Respi AlkalosisRestless Bown BagEnhanced LearningCapacity“You Seem Restless “

Assess : Level of Anxiety


Nx Dx : Ineffective Individual Coping Powerlessness Impaired Skin Integrity

Planning/ Implementation: level of anxiety environmental Stimuli Relaxation Technique

Showing pictures of flower, waterfalls Hearing sounds of chirping birds

Evaluation : Effective individual coping

ENERALIZED ANXIETY DISORDER months excessive worrying

Might be mild, moderate and severe anxietyS/Sx

Restless Difficulty of concentration Sleep Disorders Palpitations Edge of the seat Easy fatigability

PANIC DISORDER 15 – 30 Minutes escalation of SNS AGORAPHOBIA fear of open space/ public places SOCIAL PHOBIA fear of public

POST TRAUMATIC STRESS DISORDER

TraumaDisasterAccident FlashbacksWar VICTIMS Survivors Rape NightmaresEarthquakeSoldier

6 years old Anxiety SOMATOFORM > no pretension


Assignments/ “I am sick” > no organic Homeworks basis

MALINGERING > unconsciousNo Assignments/ pretending to be sickHomeworks (Conscious) PSYCHOSOMATIC > Real pains/ illnessYou Think Absent > Real symptoms“Teacher may > 4 major typesget angry” * Hypertension

* MigraineEscape from Mama Care * Stress UlcerTeacher * Asthma

PRIMARY GAIN Attention (Behavior anxiety) SECONDARY GAIN

SOMATOFORM DISORDERS

SOMATOFORM

Nervous System Illusion of structural defectCONVERSION DISORDER BODY DYSMHORPIC DISORDERLa Belle Indifference emotional disattachment from disability

Minor DiscomfortInterpreted as major illness

HYPOCHONDRIASIS“Maliit na butas, pinalalaki”

Favorite Past Time: Doctor Hopping Nursing Focus: Feelings

PSYCHOSOMATIC DISORDERS

Anxiety


SNS PNS

BP Vasoconstriction Bronchoconstriction Hypertension Cerebral Artery Left Gastric Artery Asthma

Migraine Stress Ulcer

OBSESSIVE – COMPULSIVE

Belief/ thought FeelingsDoor Open AnxietyBurglar may go inside

Obsession anxiety(thought)

Returns to house (Action)

Anxiety Compulsion

PHOBIA Irrational fears Etiology

o Knowledgeo Experience

Immediate Nursing Intervention remove the stimuli SYSTEMATIC DESENSITIZATION

o Gradual exposure to feared object

PHARMA MOMENTS ANTIPSYCHOTIC AGENT

SSTTCMHP

Stelazine - sexy star Clozaril – closed reelSerentil – serena Mellaril – maraming reelThorazine – babaeng Tora Haldol – hahaha Trilafon - tri-band phone Prolixin – pero lick scene

ALCOHOLISM

Etiology:Intergenerational Transmission

From one generation to another generation


Alcohol Blackout awake but unaware Confabulation inventing stories to self-esteem Denial “I am not an alcoholic”

Dependence “I can’t live without it” Enabling significant other tolerates abusers

Another term CO – DEPENDENCY

TOLERANCE Substance to achieve a previous effect

DETOXIFICATION Withdrawal with MD supervision Check Alcohol, Mouthwash, Elixer

void alcohol version therapy lcoholics Anonymous self help group ntabuse DISULFIRAM Never drink alcohol

12 hour interval/ 12 h last alcohol intake

B1 Vitamin Deficiency or else: nausea, vomiting and hypotension Wernicke’s Encephalopathy motor

Complications Korsakoff’s Psychosis memory

Delirium Tremens 24 – 72 h after last dose of alcohol untreated withdrawal syndrome

ormocation bugs crawling under the skin amily Therapy mother, father, brother

AUTISMAutistic Savant autistic with a special talent

Assess Appearance flat affect, consistent movement Behavior repetitive, ritualistic Communication echolalia, incomprehensible


Nx Dx Impaired verbal communication Impaired social interaction Self mutilation Risk for injury

Planning/ Implementation Maslow’s hierarchy of needs Constancy, promote safety

Evaluation Expressive therapy drawing, muscic etc Enhanced communication Improved social interaction Safety

ATTENTION DEFICIT HYPERACTIVE DISORDER Onset : 7 y.o. and below Duration : 6 months and above Settings : 2 House and school Id Dominant : Mom or RN will act as superego

ADHD Glucose Frontal Lobe impaired judgement ADHD S/Sx Ritalin Frontal Lobe Judgement ADHD S/Sx (stimulant)

Assess Appearance dirty Behavior clumsy, impatient, easily distracted, hyperactive Communication talkative, blurts out in class

Nx Dx Risk for injury Impaired social interaction

Planning/ Implementation tructure separate room for eating, playing, sleeping and etc

chedule time for everythinget limits afety

Evaluation Minimize Risk for Injury Improved social interaction Safety

Residual ADHD grows up not antisocial

Meds: Ritalin, dexedrin, pemoline, adderalBest time to give: once a day: AFTER MEALS: prevent lost of appetite

Don’t give at bedtime STIMULANT causes insomnia


Give 6 hours prior bedtime if bid

EATING DISORDERS

18 mos. – 3 y.o. 6 y.o. class valedictorian/ model student

Toilet Training social inactive/ no BF

Clean weighing Obedient Organized

Thought Feeling BehaviorI Am Fat Self Esteem Diet, Diet, Diet

Anorexia Nervosa Eating Disorders BulimiaDiet, diet, diet Eating Pattern Eat, eat, vomit

<85% of expected body Weight Normal weight3 mos. ammenorhea Menstruation Irregular menstruation

Karen Carpenter Dao Ming XiDa Ming Sugat/ suka

VomitingDental caries

Wounded knucklesMetabolic alkalosisMetabolic acidosis

Vomiting

Fluid Volume Deficit ARRHYTHMIA (fatal complication)

Diarrhea

Interventions Restore fluid and electrolyte balance Collaborative regarding menu contract Target weight gain After meals: stay 30 mins – 1 hour

PHARMA MOMENTLITHIUM

L evel 0.6 – 1.2 mEq/L ausea, vomiting, diarrhea


Increase urination Lithium Toxicity Tremors, fine hand a+

Hydration 3 L/day IncreaseKidney Uu diarhea Mouth, dry

ANTIPARKINSONANTICHOLINERGIC

ABCDOPAMINERGIC

PLSEArtane ParlodelAkineton LarodopaBenadryl SymmetylCogentin Eldepryl

SCHIZOPHRENIA Ego disintegration Impaired reality perception Genetic vulnerability Stress – Diathesis Model

o Too much stress in the reality will lead client to escape it and go to the fantasy world

Biological Theoryo Dopamine level is High

The exact cause is unknown

ffect appropriate, inappropriate, flat, blunt (incomplete emotion)mbivalence torn between 2 opposing forcesutismssociative Looseness

SymptomsNegative Positive

Hypoactive HyperactiveWithdrawn SociableApathy Flight of Ideas

Talkative

Assess : Content of ThoughtNx Dx : Disturbed thought processPlanning/ Implementation:

Present reality Provide safety

Evaluation : Improve thought process


Assess : Hallucination/ IllusionsNx Dx : Disturbed sensory perceptionPlanning/ Implementation:


Evaluation : Improve sensory perception

Assess : SuspiciousNx Dx : Risk for other directive behaviorPlanning/ Implementation:


Evaluation : Eliminate/ minimize risk for other-directed violence

Assess : SuicidalNx Dx : Risk for self directive behaviorPlanning/ Implementation:


Evaluation : Eliminate/ minimize risk for self-directed violence

Flight or Looseness

I am going to the mall. I am going to the mall.

Where is the light? The mall is big.Go here. Big is the tree.Mineral Water. The tree is tall.

Magical Thinking Believes to have a magical power I can turn you into a frog

Echolalia I repeat what you say ParrotsEchopraxia I repeat what you doWord Salad words, no rhymeClang Association words with rhyme : Dunk, plank, sunk


Neologism creation of new words Plinking, hustash Clarification done in case of neologism

Delusion:Persecutory NBI is out to get me/ someone will harm the clientReligious I am Jesus ChristGrandeur I am the queen of the world.Ideas of reference Nurses are talking about me.

Concrete Association pilosopo “what will you wear?” “clothes”Thought Blocking

Halucinations IllusionStimulus Absent PresentVisual X Auditory X Tactile X

In case of hallucinations do:

Hallucinations

Acknowledgment I know you the voices are real to you

Reality orientation But I don’t hear them

Diversion Lets go to the garden

But if nothing in the preceeding intervention are seenAssess what the voices are sayingSCHIZOPRENIA

Disorganized

Sad but smileso Inappropriate affect

No reactiono Flat affect

Flight of ideaso HEBEPHRENIC

Giggling Positive and Negative

S/Sx

Catatonic Ambivalence Waxy Flexibility

o Iniwan na posture, ganun forever

No – favorite word Negativism

Paranoid Suspicious Tendency to be violentMistrustScaredWithdrawnNrsg. Int:Develop trust

1 to 1 short interaction frequent visit foods in sealed

container meds wrapped

for violent pt. Doors open Near the door Don’t touch the pt. Eye contact 1 arms length away call reinforcement


Normally Acetylcholine = ON Dopamine = OFF

Your always ON High Dopamine= Schizophrenia

With parkinsON

Antipsychotics = makes Dopamine goes down

ON Extrapyramidal Side Effects AKATHISIA

o Restless, inability to sito Makati siya, ahh kati siya

AKINESIAo Muscle rigidityo Ahh kiniss siya

DYSTONIAo 3 features

TORTICOLLIS Wry neck

OCULOGYRIC CRISIS Fixed stare

OPISTHOTUNOS Arched back

TARDIVE DYSKINESIAo Irreversible side effects of

antipsychoticso Lip smacking

Residual

No more positive s/sx, just withdrawn

classifieddifferentiated

Mixed classification Can’t be classified 1st paranoid, then

disorganized then catatonic, etc etc

Anticholinergic Drugs that will make the

AcH downo Artaneo Akinetono Benadrylo Cogentin

Dopaminergic Dopamine goes up

o Parlodelo Larodopao Symmetrylo Eldepryl


o Tongue protrudingo Cheeks puffing

NEUROLEPTIC MALIGNANT SYNDROME

o Hyperthermia among client taking antipsychotic

o Hyperthermia with muscle rigidity

Other Side Effects Photosensitivity

o Sunscreeno Wide brimmed hat

Agranulocytosiso Report immediately Sore throat

1st sign to appear

PHARMAMOMENTS

ANTIDEPRESSANTSANTSAAVE PPZ

Asendin – ascending Norpramin – sabaw ng knorrTofranil – Tofu Sinequan – nood ng Sine Quan ang titleAnafranil – kina Ana PraningAventyl – kina Aven Til Midnight tayoVivactil – Bye Back till next weekElavil – Eh love mo ba akoProzac – Pero saka naPaxil - TaksilZoloft – mag Solo ka

BIPOLAR DISORDER – Mania more common Female 20 years old and above Stressful life


Obese

TASK Caregiver Role Strain

Safety Safety

Lithium – 2 – 4 weeks before effect

SE Compensation interfere ADLs, harm othersSE Compensation interfere ADLs, harm others

TASK increases client’s self esteem

Gross motor skills via sublimation Escorted walk outdoors Punching bag

No group games compition will increae anxiety

3 or more signs confirms disorder

GFSPEED

randioselight of ideasleeplessnessressured speechxagerated SExtraneous stimuli (easily distracted)istractibility

Self Actualization

Self Esteem

Impaired social interaction

Risk for injury/ other directed violence

Eating Sleep Hyperactive Sexfinger food Private room Anxiety


PERSONALITY DISORDERS

SCHIZOID I don’t want people Believes he can stand on his own Never had a best friend Avoid groups and social activities no enjoyment Cares more about computers and pets

AVOIDANT I avoid people, I fear criticism Have talent but no confidence

ANTISOCIAL I break the law as motto As a child,: steal, lie, always get reprimanded Adult – grand robbery, illegal activitist against the law, drug addiction,

drives fast, unsafe sex, thrill seeker Good talker, charmer, witty manipulator

BORDERLINE – my life is an emptyglass

Dependent I can’t live without you self esteem poor decision making skills

Histrionic excited, dramatic but manipulative center of attention

Narcissistic I love myself Insensitive, arrogant I am the best


Obsessive – Compulsive I am organized Perfectionist Provide time to do rituals

Paranoid Suspicious

Passive Aggressive Always say yes but resistance is hidden

Serotonin

MAO kills Serotonin

MAO Serotonin MAO Serotonin


TYRAMINE RICH FOODSvocadoged Cheese

eer

hocolate

ermented Foods

icklesreserved Foods

oy Sauce

SSRI TCAMAOI

Antidepressant

Anticholinergic Side Effects(Syphathetic)

Male Erectile Dysfunction

Serotonin ANTIDEPRESSANTS

1st Line of Drug Prescribed wo – 4 weekswo neurotransmitter

afest RI ONO ELECTIVE

ide effects low CYCLIC MINE EROTONIN

EUPTAKE NTIDEPRESSANT XIDASE

Higher incidence of Side effects to 4 weeks Serotonin/ Epi affected NHIBITOR NHIBITOR

PPZ ANTSAVE MNP

All neurotransmitter affectedHighest Side effectsAvoid tyramine rich food may lead to HYPERTENSIVE CRISES


Antidepressant no effect ECT


ELECROCONVULSIVE THERAPY Pre

o Informed consento NPO 6 – 8 hours prior

Medso Atropine dry mouth

o Barbituate Sedative

o Succinylcholine muscle relaxant, prevent seizure Post

o Side-lying – lateralo S/E

headache, dizziness, TEMPORARY MEMORY LOSS distinct sign

70 – 110 volts 20 – 30 seconds ½ hour asleep post

PHARMAMOMENTS

SUBSTANCE ABUSE

Downers (ABONM INE)Alcohol MorphBarbituates Code NARCAN antidoteOpiates HeroNarcoticsMarijuana

Uppers (CHA)CocaineHallucinogenAmphetamines

OVERDOSEAlcohol Cocaine

HRRRBP

Coma LOC SeizureBradycardiaBradypnea

Pupil constrictionMoist mouthConstipationHypotension

ComaAsleep

Weight gain


Psych well being NARCAN Narcotic Antagonist narcotic overdose

DETOXIFICATION withdrawal with MD SupervisionMETHADONE

Withdrawal reverse of effect or opposite of overdose

DEPRESSION Serotonin, if unresponsive to drugs, ECTThe Grief Process

Denial no! this can’t be true Anger why me, why me, why now Bargaining if something happens, then I’ll give something back Depression I’m down 2 weeks or more s/sx major depression Acceptance client acts according to situation

C TASK Stay

Sensitivity to client needsSUICIDE

Verbal Non Verbal

TachycardiaTachypnea

Pupil DilationDry mouth

HypertensionSeizureAwake

Weight Loss

EUPHORIA

Self Actualization

Self Esteem

withdrawn

Risk for self directed violence

Eating Sleep Hypoactive Sex


I wont be a problem anymore This is my last day on earth I’ll soon be gone

Take this ring, its yours (giving of valuable)

Sudden change in mood

Who will commit Suicide?Sex – Male (more successful)/ female (hesitant)Age – 15 –24 y/o or above 45DepressionPatient with previous attemptETOH – ethanol - alcoholicsRirrationalSocial support lackingOrganized plan greater riskNo familySickness, terminal

SUICIDE TRIAD Loss of spouse Loss of job Aloneness

Is Patient is SUICIDAL; nurse should: DIE Direct question – “Are you going to commit suicide?” Irregular interval of visit to pt. room Early AM and period of endorsement – the time pt’s commit suicide

Best approach for suicidal pt. : Direct approachNursing Management: Close surveillance

Hospital area majority sucide will happens at: weekends 1- 3 am Sunday Weekend less staff personnel Early AM every one is asleep

Give simple task. Don’t give complex may cause depression ex. Jigsaw Water plants Wash the dishes except sharps

CHILD ABUSE (think B) Burns, bruise, bone fractures, BUNGI! Don’t bathe the child, don’t brush teet. Body of evidence will be lost Bantay Bata 163

LEVELS OF MENTAL RETARDATION Profound

o < 20o thinks like an infants


o can’t be trainedo stay with the patient

Severeo 20 – 35

Moderateo 35 – 50o can be traino mental age is 2 – 7 y/oo pre-operational stage

Mildo 50 – 70o meantal age is 7 – 12o educableo can go to school

Borderlineo 70 - 90

Normalo 90 – 100

JOHN PIAGET’S COGNITIVE THEORY0 – 2 Sensorimotor Baby can sense, see, perceive and hear. Object

permanence2 – 4 Preconceptual Language4 – 7 Intuitive Unidimentional classification characteristic. Child can

fix toys according to size, color, height = one at a time7 – 12 Conservation

Concrete Association

Multidimensional

12 Formal Operation

Good abstract thinking. Can interpret words

ALZHEIMERNOMIA don’t know name of objectsGNOSIA problem with sensesPHASIA can’t say itPRAXIA can’t do it

Cocaine Nasal Septum perforationMarijuana impaired Lung Structure

eroine withdrawalikabatsingu hu hu

CRITICAL REVIEW

ero – 2 y/o ensorimotor evere

Modera e hirtyfive – 50

rainable wo – 7 y/o


TEST TAKING TECHNIQUES1. Assess the answer, use circle2. Initial priority TRUST

ABC ASSESS3. Good Word/ Bad Word4. S Technique

eek supportittayupervisedee = observedeem = notice

assi t feeling

5. 2 same answer/ 2 same mistake6. Words to watch out for

InappropriateMostNot includedExceptAll but one

7. Umbrella

RELATIONSHIP Preorientation Orientation Working Termination

Self awareness Trust Discussion Evaluation Setting Contract Resistance

PRACTICE OF NURSINGLevel of Prevention

1 2 3

Air food, water

air


Healthy Ill RelapseCommunity Demog. Crisis Intervention AA

SELF HELP GROUPS nique

niversality r not alone

RESTATE exact wordsREFLECT use other words

DEPRESSION

Endogenous ReactiveInternal externalChemical

Barbituate withdrawal LIBRIUM (Chloridiazepoxide)TOFRANIL Antidepressant/ Anticholinergic pupil dilation midriasis Catharsis FeelingsFree Association Ideas

ATTITUDE THERAPIESActive friendliness ask permission

assive Friendlinessaranoid anipulative anic atter of Fact

No Demand DepressedKind Firmness Anorexic

Crisis 4 – 6 weeksGoal Return the client to the pre-crisis level of functioningPSCPerception what do you think about it?Coping what will you do about it?Support who will be there for you?

Kulit kulit kulit kulit Perseveration stick to 1 topicUlit Ulit Ulit VerbigerationDISSOCIATION Dissociative Amnesia don’t know themselvesFugue FarDissociative Identity Disorder Multiple Personality D.O.

psych nursing complete

Documents

observations o

o fixation

self respect o esteem

general leads o

security needs o safe

physiologic needs o

anal stage

toilet training super