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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 Antisocial Narcissistic S E

D mpulsive want to want PLEASURE

eat drink urinate defecate

PLEASURABLE PRINCIPLE Pain Avoidance Its all I

UPER EGO hould not mall voice of God CONSCIENCE PRINCIPLE

DOMINANT SUPER EGO Obsessive - compulsive Anorexia Nervosa I E

GO Xecutive Secretary

Impaired Reality Schizophrenia

REALITY PRINCIPLE LIBIDO sexual energy responsible for survival PSYCHOSEXUAL THEORY 1. ORAL STAGE 0 18 Months old Survival I want to eat, sleep, urinate, defecate ID formation Cry & Suck mouth teruel

Psychiatric Nursing Child Cries Feed the Infant Successful Ignore the Infant Unsuccessful Narcissistic

Defense Mechanism: o FIXATION when a person is stuck in a certain developmental stage o REGRESSION return to an earlier developmental stage EGO is develop in the 6th month

2. ANAL STAGE Ateen 3 years old (18 mos 3 y.o.) Toilet training Super Ego develop Toilet Training Good Mother Successful SE Too Rigid Training Clean Organized Obedient OBSESSIVE COMPULSSIVE (Anal Retentive) Dirty Disorganized Disobedient ANTISOCIAL (Anal Expulsive) Bad Mother Unsuccessful

BIG SE

Small SE

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

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Psychiatric Nursing

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 Awareness o Conscious highest level of awareness o Preconscious Tip of the tongue o Unconscious deepest level of awareness Birth Trauma First traumatic experience of child REPRESSION unconscious forgetting of an anxiety provoking concept SUPPRESSION 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 teruel

Psychiatric Nursing

PHARMA MOMENTS

ANTIANXIETY
VLAST ME VAIB Valium ate V Miltown - Meal Libreum - L Equanil Aqua Kneel Ativan - Ate Guy Seraks Sera Ulo Tranxene - Transit Vistaril - largavista Attarax Mga bato (rocks) Inderal hindi ralph Busfar sasakay ng bus

ERIK ERIKSON PSYCHOSOCIAL THEORY OF DEVELOPMENT + Age 0-18 mos. 18 mos. 3 y.o. Trust Autonomy AU nal TO ilet training NO favorite word MY Initiative Industry Identity Intimacy Generativity Ego Integrity Mistrust Shame/ doubt

Affecting Major Factor Feeding Toilet Training

3 6 y.o. 6 12 y.o. 12 20 y.o. 20 25 y.o. 25 45 y.o. 45 y.o. and above

Guilt Inferiority Role confusion Isolation Stagnation Despair

Independence In da-school Peer Love Parenting Reflection

MASLOWS HEIRARCHY OF NEEDS

1. Physiologic Needs o Air, food, water, shelter, rest, sleep, activity and temperature maintenance that are crucial for survival 2. Safety and Security Needs o Safe in physical and psychological aspects 3. Love and Belonging Needs o Giving and receiving affection, attaining a place in a group, maintaining the feeling of belonging 4. Self esteem Needs o Self esteem feelings of independence, competence and self respect o Esteem from others recognition, respect, appreciation teruel

Psychiatric Nursing

5. Self Actualization o Ones maximum potential and realize ones abilities and qualities BEHAVIORAL 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 ACTION Frontal Language, Learning, Personality, Judgment Temporal hearing, smelling Parietal Taste, touch Occipital Vision Sensory Integration Motor Involuntary VOLUNTARY NERVOUS SYSTEM Somatic Nervous System AcetylCholine Brain Spinal Cord Motor Nerve Muscle Fiber INVOLUNTARY NERVOUS SYSTEM Autonomic Nervous System Sympathetic HR RR GI Constipation GU Urinary retention Neuro Epi/ Nor Voluntary

Parasympathetic Diarrhea Urinary Frequency Acetyl Choline

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Psychiatric Nursing

PHARMA MOMENTS

MONOAMINE OXIDASE INHIBITORS

AR

M N P

PLAN DIL NATE

ANTIPARKINSON
CAPABLES

Cogentin Artane Parlodel Akineton Benadryl Larodopa Eldepryl Symmetryl THERAPEUTIC COMMUNICATION
Therapeutic Offer your self Ill stay with you Silence Making observations o You seem sad Active listening o Nodding o Eye contact o Lean forward Who, what, when, where General leads o Go on, Im 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 Non-Therapeutic Dont worry be happy Everythings gonna be alright Ignoring the client Changing the subject Nice weather were 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

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Psychiatric Nursing

Focusing tell me about DEFENSE MECHANISMS Fight for stress DISPLACEMENT Transfer of feelings to a less Boss shouts at threatening object rather than the you, you shout at one who provoke it your subordinate DENIAL Failure to acknowledge an Im not an unacceptable trait or situation alcoholic DISSOCIATION Psychological flight from self Sino ka, Sino ako? A type of amnesia REGRESSION Return to an earlier developmental Return to stage thumbsucking REPRESSION Unconscious forgetting of an Hindi ko maalala anxiety provoking concept RATIONALIZATION Illogical reasoning for a socially I drink because I unacceptable trait dont want to waste the beer in sayang ang beer sa ref, kaya ko the ref ininum REACTION doing the opposite of your sasabunutan kita. FORMATION intention . . ay kuklulutin lang kita plastic UNDOING Doing the opposite of what you ay pinatid kita, have done due to guilt halika punta kita sa clinic orocan, plastic, Tupperware IDENTIFICATION Assume trait for personal, social, Tulad niya occupational role PROJECTION Attributing to others ones hindi ako acceptable trait alcoholic, sila yon Pasa load INTROJECTION Assume another persons trait as ako din your own Not just you, me too SUPPRESSION Conscious forgetting of an anxiety Hindi ko alam yan provoking concept SUBLIMATION Placing sexual energies toward a Angry at life, put more productive endeavors anger in singing CONVERSION Repressed angers put towards Biglang physical symptoms affecting manginginig nervous system leading to sensory numbness and motor paralysis COMPENSATION Overachievement in one area to Pilay pero cover a defective part magaling kumanta SUBSTITUTION Replacing a difficult goal with a Gusto ko more accessible one Disneyland. Enchanted teruel

Psychiatric Nursing nalang.

STOP GABA Inhibitory Gamma Amino Butyric Acid GO Epinephrine/ Norepinephrine Exitatory

SNS
ANXIETY

Anticholinergic side effect Constipation Urinary Retention Dry Mouth Blurred Vision

Within 1 week Rebound phenomenon Seizure Abrupt Dependence Withdrawal

Anti-Anxiety Drowsy No Alcohol No Coffee Develop Orthostatic Hypotension Prevetion of O.H. 1. Sit Down 2. Dangle feet 3. Stand Up Gradually RELAXED

Gradually Tapered Dose

ANXIETY
Vague sense of impending doom

Mild Moderate +1 +2 Widened acing Perceptual Field RN Meds Restless Enhanced Learning Capacity You Seem Restless

Severe +3 ont know what to say/do IRECTIVE

Panic +4 uicide afety Dont touch client Respi Alkalosis Brown Bag

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Psychiatric Nursing

Assess Nx Dx

: Level of Anxiety : 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 anxiety S/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

Trauma Disaster Accident War Rape Earthquake teruel

Flashbacks VICTIMS Survivors Nightmares

. Soldier 6 years old Assignments/ Homeworks No Assignments/ Homeworks You Think Teacher may get angry

Psychiatric Nursing

Anxiety I am sick MALINGERING pretending to be sick (Conscious) Absent

SOMATOFORM > no pretension > no organic basis > unconscious PSYCHOSOMATIC > Real pains/ illness > Real symptoms > 4 major types * Hypertension * Migraine * Stress Ulcer * Asthma

Escape from Teacher PRIMARY GAIN (Behavior anxiety)

Mama Care Attention SECONDARY GAIN

SOMATOFORM DISORDERS SOMATOFORM

Nervous System CONVERSION DISORDER La Belle Indifference emotional disattachment from disability Illusion of structural defect BODY DYSMHORPIC DISORDER

Minor Discomfort Interpreted as major illness HYPOCHONDRIASIS Maliit na butas, pinalalaki Favorite Past Time: Doctor Hopping Nursing Focus: Feelings

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Psychiatric Nursing

PSYCHOSOMATIC DISORDERS
Anxiety SNS BP Hypertension PNS Vasoconstriction Bronchoconstriction Cerebral Artery Left Gastric Artery Asthma Migraine Stress Ulcer

OBSESSIVE COMPULSIVE
Belief/ thought Door Open Burglar may go inside Feelings Anxiety

Obsession anxiety (thought) Returns to house (Action) Anxiety Compulsion

PHOBIA
Irrational fears Etiology o Knowledge o Experience Immediate Nursing Intervention remove the stimuli SYSTEMATIC DESENSITIZATION o Gradual exposure to feared object

PHARMA MOMENTS

ANTIPSYCHOTIC AGENT
SSTTCMHP Stelazine - sexy star Serentil serena Thorazine babaeng Tora Trilafon - tri-band phone teruel Clozaril closed reel Mellaril maraming reel Haldol hahaha Prolixin pero lick scene

Psychiatric Nursing

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 cant 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 Wernickes Encephalopathy motor Korsakoffs Psychosis memory

Complications

Delirium Tremens 24 72 h after last dose of alcohol

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

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Psychiatric Nursing

AUTISM
Autistic 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 Maslows hierarchy of needs Constancy, promote safety Evaluation Expressive therapy drawing, muscic etc Enhanced communication Improved social interaction Safety

ATTENTION DEFICIT HYPERACTIVE DISORDER

Onset Duration Settings Id Dominant : 7 y.o. and below : 6 months and above : 2 House and school : 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 everything et limits teruel

Psychiatric Nursing

afety Evaluation Minimize Risk for Injury Improved social interaction Safety Residual ADHD grows up not antisocial Meds: Ritalin, dexedrin, pemoline, adderal Best time to give: once a day: AFTER MEALS: prevent lost of appetite Dont give at bedtime STIMULANT causes insomnia Give 6 hours prior bedtime if bid

EATING DISORDERS
18 mos. 3 y.o. Toilet Training Clean Obedient Organized Thought I Am Fat 6 y.o. class valedictorian/ model student social inactive/ no BF weighing

Feeling Behavior Self Esteem Diet, Diet, Diet

Anorexia Nervosa Diet, diet, diet <85% of expected body 3 mos. ammenorhea Karen Carpenter

Eating Disorders Eating Pattern Weight Menstruation

Bulimia Eat, eat, vomit Normal weight Irregular menstruation Dao Ming Xi Da Ming Sugat/ suka Vomiting Dental caries Wounded knuckles Metabolic alkalosis Metabolic acidosis

Vomiting Fluid Volume Deficit ARRHYTHMIA (fatal complication) Diarrhea teruel

Psychiatric Nursing

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

PHARMA MOMENT

LITHIUM
L evel 0.6 1.2 mEq/L Increase urination Tremors, fine hand Hydration 3 L/day Increase Uu diarhea Mouth, dry ausea, vomiting, diarrhea Lithium Toxicity a+

Kidney

ANTIPARKINSON
ANTICHOLINERGIC ABC Artane Akineton Benadryl Cogentin DOPAMINERGIC PLSE Parlodel Larodopa Symmetyl 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 Theory o Dopamine level is High The exact cause is unknown ffect appropriate, inappropriate, flat, blunt (incomplete emotion) mbivalence torn between 2 opposing forces utism ssociative Looseness teruel

Psychiatric Nursing

Symptoms Negative Hypoactive Withdrawn Apathy Positive Hyperactive Sociable Flight of Ideas Talkative

Assess : Content of Thought Nx Dx : Disturbed thought process Planning/ Implementation: Present reality Provide safety Evaluation : Improve thought process

Assess : Hallucination/ Illusions Nx Dx : Disturbed sensory perception Planning/ Implementation: Present reality Provide safety Evaluation : Improve sensory perception

Assess : Suspicious Nx Dx : Risk for other directive behavior Planning/ Implementation: Present reality Provide safety Evaluation : Eliminate/ minimize risk for other-directed violence

Assess : Suicidal Nx Dx : Risk for self directive behavior Planning/ Implementation: Present reality Provide safety Evaluation : Eliminate/ minimize risk for self-directed violence

Flight or Looseness I am going to the mall. Where is the light? Go here. Mineral Water. teruel I am going to the mall. The mall is big. Big is the tree. The tree is tall.

Psychiatric Nursing

Magical Thinking Believes to have a magical power I can turn you into a frog Echolalia I repeat what you say Parrots Echopraxia I repeat what you do Word Salad words, no rhyme Clang 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 client Religious I am Jesus Christ Grandeur 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

Stimulus Visual Auditory Tactile

Halucinations Absent X X X

Illusion Present

In case of hallucinations do:

Hallucinations Acknowledgment
I know you the voices are real to you Reality orientation But I dont hear them Diversion Lets go to the garden But if nothing in the preceeding intervention are seen teruel

Psychiatric Nursing

Assess what the voices are saying SCHIZOPRENIA

Disorganized
Sad but smiles o Inappropriate affect No reaction o Flat affect Flight of ideas o 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 violent MistrustScaredWithdrawn Nrsg. Int: Develop trust 1 to 1 short interaction frequent visit foods in sealed container meds wrapped for violent pt. Doors open Near the door Dont touch the pt. Eye contact 1 arms length away call reinforcement

classified differentiated
Mixed classification Cant be classified 1st paranoid, then disorganized then catatonic, etc etc

Residual
No more positive s/sx, just withdrawn

Normally Acetylcholine = ON

Dopamine = OFF

Your always ON With parkinsON

High Dopamine= Schizophrenia

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Psychiatric Nursing

Antipsychotics = makes Dopamine goes down

Extrapyramidal Side Effects AKATHISIA o Restless, inability to sit o Makati siya, ahh kati siya AKINESIA o Muscle rigidity o Ahh kiniss siya DYSTONIA o 3 features TORTICOLLIS Wry neck Anticholinergic OCULOGYRIC CRISIS Drugs that will make the Fixed stare AcH down OPISTHOTUNOS o Artane Arched back o Akineton TARDIVE DYSKINESIA o Benadryl o Irreversible side effects of o Cogentin antipsychotics o Lip smacking Dopaminergic o Tongue protruding Dopamine goes up o Cheeks puffing o Parlodel NEUROLEPTIC MALIGNANT o Larodopa SYNDROME o Symmetryl o Hyperthermia among client o Eldepryl taking antipsychotic o Hyperthermia with muscle rigidity Other Side Effects Photosensitivity o Sunscreen o Wide brimmed hat Agranulocytosis o Report immediately Sore throat 1st sign to appear

ON

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Psychiatric Nursing

PHARMAMOMENTS

ANTIDEPRESSANTS
ANTSAAVE PPZ

Asendin ascending Norpramin sabaw ng knorr Tofranil Tofu Sinequan nood ng Sine Quan ang title Anafranil kina Ana Praning Aventyl kina Aven Til Midnight tayo Vivactil Bye Back till next week Elavil Eh love mo ba ako Prozac Pero saka na Paxil - Taksil Zoloft mag Solo ka
BIPOLAR DISORDER Mania more common Female 20 years old and above Stressful life Obese TASK Caregiver Role Strain Self Esteem Safety Impaired social interaction Safety
Hyperactive Sex Anxiety Self Actualization

Risk for injury/ other directed violence Eating finger food Sleep Private room

Lithium 2 4 weeks before effect

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Psychiatric Nursing

SE Compensation interfere ADLs, harm others SE Compensation interfere ADLs, harm others TASK increases clients self esteem Gross motor skills via sublimation Escorted walk outdoors Punching bag

No group games compition will increase anxiety 3 or more signs confirms disorder G F S P E E D randiose light of ideas leeplessness ressured speech xagerated SE xtraneous stimuli (easily distracted) istractibility

PERSONALITY DISORDERS SCHIZOID I dont 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 teruel

Psychiatric Nursing

BORDERLINE my life is an emptyglass

Dependent I cant 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
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Psychiatric Nursing

MAO Serotonin
Serotonin

ANTIDEPRESSANTS wo 4 weeks wo neurotransmitter RI

1st Line of Drug Prescribed afest ELECTIVE ide effects low EROTONIN

ONO

CYCLIC

MINE

EUPTAKE

NTIDEPRESSANT Higher incidence of Side effects Serotonin/ Epi affected

XIDASE

to 4 weeks NHIBITOR
PPZ

NHIBITOR
ANTSAVE MNP

All neurotransmitter affected Highest Side effects Avoid tyramine rich food may lead to HYPERTENSIVE CRISES

TYRAMINE RICH FOODS vocado ged Cheese eer

SSRI

TCA
Antidepressant Anticholinergic Side Effects (Syphathetic) Male Erectile Dysfunction

MAOI

hocolate

ermented Foods ickles reserved Foods teruel

Psychiatric Nursing

oy Sauce

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Psychiatric Nursing

Antidepressant no effect ECT ELECROCONVULSIVE THERAPY Pre o Informed consent o NPO 6 8 hours prior Meds o Atropine dry mouth o Barbituate Sedative o Succinylcholine muscle relaxant, prevent seizure Post o Side-lying lateral o S/E headache, dizziness, TEMPORARY MEMORY LOSS distinct sign 70 110 volts 20 30 seconds hour asleep post

PHARMAMOMENTS

SUBSTANCE ABUSE
Downers (ABONM INE) Alcohol Barbituates Opiates Narcotics Marijuana Uppers (CHA) Cocaine Hallucinogen Amphetamines OVERDOSE Alcohol HR RR BP LOC Cocaine Morph Code Hero NARCAN antidote

Coma teruel

Seizure

Psychiatric Nursing

Bradycardia Bradypnea
Pupil constriction

Moist mouth Constipation Hypotension Coma Asleep Weight gain

EUPHORIA

Psych well being NARCAN Narcotic Antagonist narcotic overdose

Tachycardia Tachypnea Pupil Dilation Dry mouth Hypertension Seizure Awake Weight Loss

DETOXIFICATION withdrawal with MD Supervision METHADONE

Withdrawal reverse of effect or opposite of overdose

DEPRESSION Serotonin, if unresponsive to drugs, ECT

The Grief Process Denial no! this cant be true Anger why me, why me, why now Bargaining if something happens, then Ill give something back Depression Im down 2 weeks or more s/sx major depression Acceptance client acts according to situation
Self Actualization Self Esteem withdrawn

C TASK Stay

Risk for self directed violence

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Eating

Sleep

Hypoactive

Sex

Psychiatric Nursing

Sensitivity to client needs

SUICIDE
Verbal I wont be a problem anymore This is my last day on earth Ill soon be gone Non Verbal 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 45 Depression Patient with previous attempt ETOH ethanol - alcoholics Rirrational Social support lacking Organized plan greater risk No family Sickness, 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 pts commit suicide Best approach for suicidal pt. : Direct approach Nursing 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. Dont give complex may cause depression ex. Jigsaw Water plants Wash the dishes except sharps teruel

Psychiatric Nursing

CHILD ABUSE (think B) Burns, bruise, bone fractures, BUNGI! Dont bathe the child, dont brush teet. Body of evidence will be lost Bantay Bata 163 LEVELS OF MENTAL RETARDATION Profound o < 20 o thinks like an infants o cant be trained ero 2 y/o o stay with the patient ensorimotor Severe evere o 20 35 Moderate Modera e o 35 50 hirtyfive 50 o can be train rainable o mental age is 2 7 y/o wo 7 y/o o pre-operational stage Mild o 50 70 o meantal age is 7 12 o educable o can go to school Borderline o 70 - 90 Normal o 90 100 JOHN PIAGETS COGNITIVE THEORY 02 Sensorimotor Baby can sense, see, perceive and hear. Object permanence 24 Preconceptual Language 47 Intuitive Unidimentional classification characteristic. Child can fix toys according to size, color, height = one at a time 7 12 Conservation Multidimensional Concrete Association Formal Good abstract thinking. Can interpret words 12 Operation ALZHEIMER NOMIA dont know name of objects GNOSIA problem with senses PHASIA cant say it PRAXIA cant do it Cocaine Nasal Septum perforation Marijuana impaired Lung Structure teruel

. eroine withdrawal ikab atsing u hu hu

Psychiatric Nursing

CRITICAL REVIEW
TEST TAKING TECHNIQUES 1. Assess the answer, use circle 2. Initial priority TRUST

Air food, water

ABC air 3. Good Word/ Bad Word 4. S Technique eek support it tay upervised ee = observed eem = notice assi t feeling 5. 2 same answer/ 2 same mistake 6. Words to watch out for Inappropriate Most Not included Except All but one 7. Umbrella

ASSESS

RELATIONSHIP Preorientation Self awareness teruel Orientation Trust Setting Contract Working Discussion Termination Evaluation

Psychiatric Nursing Resistance

PRACTICE OF NURSING Level of Prevention 1 2 3 Relapse AA

Healthy Ill Community Demog. Crisis Intervention

SELF HELP GROUPS nique niversality r not alone RESTATE exact words REFLECT use other words DEPRESSION Endogenous Internal Chemical Reactive external

Barbituate withdrawal LIBRIUM (Chloridiazepoxide) TOFRANIL Antidepressant/ Anticholinergic pupil dilation midriasis Catharsis Feelings Free Association Ideas ATTITUDE THERAPIES Active friendliness ask permission assive Friendliness aranoid anipulative nic atter of Fact No Demand Depressed Kind Firmness Anorexic Crisis 4 6 weeks Goal Return the client to the pre-crisis level of functioning PSC Perception what do you think about it? teruel

Psychiatric Nursing

Coping what will you do about it? Support who will be there for you? Kulit kulit kulit kulit Perseveration stick to 1 topic Ulit Ulit Ulit Verbigeration DISSOCIATION Dissociative Amnesia dont know themselves Fugue Far Dissociative Identity Disorder Multiple Personality D.O.

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