TY - BOOK AU - Townsend,Mary C. TI - Psychiatric mental health nursing: concepts of care in evidence-based practice SN - 9780803619173 U1 - WY 160 T749p 2009 PY - 2009/// CY - Philadelphia PB - F.A. Davis KW - Psychiatric nursing KW - Psychiatric Nursing KW - methods KW - Evidence-Based Medicine KW - Mental Disorders KW - nursing KW - Psychotherapy N1 - Includes bibliographical references and index; Contents UNIT ONE BASIC CONCEPTS IN PSYCHIATRIC/MENTAL HEALTH NURSING Chapter 1 The Concept of Stress Adaptation 2 STRESS AS A BIOLOGICAL RESPONSE 3 STRESS AS AN ENVIRONMENTAL EVENT 5 STRESS AS A TRANSACTION BETWEEN THE INDIVIDUAL AND THE ENVIRONMENT 5 Precipitating Event 5 The Individual's Perception of the Event 5 Predisposing Factors 6 STRESS MANAGEMENT 7 Adaptive Coping Strategies 7 SUMMARY AND KEY POINTS 8 REVIEW QUESTIONS 9 REFERENCES 10 CLASSICAL REFERENCES 10 Chapter 2 Mental Health/ Mental Illness: Historical and Theoretical Concepts 11 HISTORICAL OVERVIEW OF PSYCHIATRIC CARE 12 MENTAL HEALTH 13 MENTAL ILLNESS 14 PSYCHOLOGICAL ADAPTATION TO STRESS 15 Anxiety 15 Behavioral Adaptation Responses to Anxiety 17 Grief 20 MENTAL HEALTH/MENTAL ILLNESS CONTINUUM 22 THE DSM-IV-TR MULTIAXIAL EVALUATION SYSTEM 23 SUMMARY AND KEY POINTS 24 REVIEW QUESTIONS 25 REFERENCES 27 CLASSICAL REFERENCES 27 UNIT TWO FOUNDATIONS FOR PSYCHIATRIC/MENTAL HEALH NURSING Chapter 3 Theoretical Models of Personality Development 30 PSYCHOANALYTIC THEORY 31 Structure of the Personality 31 Topography of the Mind 31 Dynamics of the Personality 32 Freud's Stages of Personality Development 32 Relevance of Psychoanalytic Theory to Nursing Practice 34 INTERPERSONAL THEORY 34 Sullivan's Stages of Personality Development 34 Relevance of Interpersonal Theory to Nursing Practice 35 THEORY OF PSYCHOSOCIAL DEVELOPMENT 35 Erikson's Stages of Personality Development 35 Relevance of Psychosocial Development Theory to Nursing Practice 38 THEORY OF OBJECT RELATIONS 38 Phase I: The Autistic Phase (Birth to 1 Month) 38 Phase II: The Symbiotic Phase (1 to 5 Months) 38 Phase III: Separation-Individuation (5 to 36 months) 39 COGNITIVE DEVELOPMENT THEORY 39 Stage 1: Sensorimotor (Birth to 2 Years) 39 Stage 2: Preoperational (2 to 6 Years) 40 Stage 3: Concrete Operations (6 to 12 Years) 40 Stage 4: Formal Operations (12 to 15+ Years) 40 Relevance of Cognitive Development Theory to Nursing Practice 40 THEORY OF MORAL DEVELOPMENT 40 Level I: Preconventional Level (Prominent from Ages 4 to 10 Years) 41 Level II: Conventional Level (Prominent from Ages 10 to 13 Years and into Adulthood) 41 Level III: Postconventional Level (Can Occur from Adolescence Onward) 41 Relevance of Moral Development Theory to Nursing Practice 42 A NURSING MODEL-HILDEGARD E. PEPLAU 42 Peplau's Stages of Personality Development 42 Relevance of Peplau's Model to Nursing Practice 44 SUMMARY AND KEY POINTS 45 REVIEW QUESTIONS 46 REFERENCES 47 CLASSICAL REFERENCES 47 Chapter 4 Concepts of Psychobiology 48 THE NERVOUS SYSTEM: AN ANATOMICAL REVIEW 49 The Brain 49 Nerve Tissue 53 Autonomic Nervous System 53 Neurotransmitters 55 NEUROENDOCRINOLOGY 60 Pituitary Gland 60 Circadian Rhythms 63 Sleep 64 GENETICS 66 PSYCHOIMMUNOLOGY 66 Normal Immune Response 66 IMPLICATIONS FOR NURSING 68 SUMMARY AND KEY POINTS 69 REVIEW QUESTIONS 70 REFERENCES 71 Chapter 5 Ethical and Legal Issues in Psychiatric/ Mental Health Nursing 72 ETHICAL CONSIDERATIONS 73 Theoretical Perspectives 73 Ethical Dilemmas 74 Ethical Principles 74 A Model for Making Ethical Decisions 75 Ethical Issues in Psychiatric/Mental Health Nursing 76 LEGAL CONSIDERATIONS 76 Nurse Practice Acts 77 Types of Law 78 Classifications Within Statutory and Common Law 78 Legal Issues in Psychiatric/Mental Health Nursing 78 Commitment Issues 81 Nursing Liability 82 SUMMARY AND KEY POINTS 83 REVIEW QUESTIONS 85 REFERENCES 86 Chapter 6 Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing 87 CULTURAL CONCEPTS 88 HOW DO CULTURES DIFFER? 88 Communication 88 Space 89 Social Organization 89 Time 89 Environmental Control 89 Biological Variations 89 APPLICATION OF THE NURSING PROCESS 90 Background Assessment Data 90 Culture-Bound Syndromes 99 Diagnosis/Outcome Identification 99 Planning/Implementation 99 Evaluation 101 SPIRITUAL CONCEPTS 101 Spiritual Needs 101 Assessment of Spiritual and Religious Needs 103 Diagnoses/Outcome Identification/Evaluation 105 Planning/Implementation 105 Evaluation 105 SUMMARY AND KEY POINTS 107 REVIEW QUESTIONS 109 REFERENCES 110 CLASSICAL REFERENCES 111 UNIT THREE THERAPEUTIC APPROACHES IN PSYCHIATRIC NURSING CARE Chapter 7 Relationship Development 114 ROLE OF THE PSYCHIATRIC NURSE 115 DYNAMICS OF A THERAPEUTIC NURSE-CLIENT RELATIONSHIP 116 Therapeutic Use of Self 116 Gaining Self-Awareness 116 The Johari Window 117 CONDITIONS ESSENTIAL TO DEVELOPMENT OF A THERAPEUTIC RELATIONSHIP 119 Rapport 119 Trust 119 Respect 119 Genuineness 120 Empathy 120 PHASES OF A THERAPEUTIC NURSE-CLIENT RELATIONSHIP 121 The Preinteraction Phase 121 The Orientation (Introductory) Phase 121 The Working Phase 121 The Termination Phase 122 BOUNDARIES IN THE NURSE-CLIENT RELATIONSHIP 123 SUMMARY AND KEY POINTS 124 REVIEW QUESTIONS 125 REFERENCES 126 CLASSICAL REFERENCES 126 Chapter 8 Therapeutic Communication 127 WHAT IS COMMUNICATION? 128 THE IMPACT OF PREEXISTING CONDITIONS 128 Values, Attitudes, and Beliefs 128 Culture or Religion 128 Social Status 129 Gender 129 Age or Developmental Level 129 Environment in Which the Transaction Takes Place 129 NONVERBAL COMMUNICATION 130 Physical Appearance and Dress 130 Body Movement and Posture 130 Touch 130 Facial Expressions 131 Eye Behavior 131 Vocal Cues, or Paralanguage 131 THERAPEUTIC COMMUNICATION TECHNIQUES 132 NONTHERAPEUTIC COMMUNICATION TECHNIQUES 132 ACTIVE LISTENING 135 PROCESS RECORDINGS 135 FEEDBACK 135 SUMMARY AND KEY POINTS 137 REVIEW QUESTIONS 138 REFERENCES 139 CLASSICAL REFERENCES 139 Chapter 9 The Nursing Process in Psychiatric/Mental Health Nursing 140 THE NURSING PROCESS 141 Definition 141 Standards of Practice 141 WHY NURSING DIAGNOSIS? 149 NURSING CASE MANAGEMENT 149 Critical Pathways of Care 151 APPLYING THE NURSING PROCESS IN THE PSYCHIATRIC SETTING 151 CONCEPT MAPPING 153 DOCUMENTATION OF THE NURSING PROCESS 155 Problem-Oriented Recording 155 Focus Charting 156 The PIE Method 156 Electronic Documentation 157 SUMMARY AND KEY POINTS 158 REVIEW QUESTIONS 160 REFERENCES 160 Chapter 10 Therapeutic Groups 161 FUNCTIONS OF A GROUP 162 TYPES OF GROUPS 162 Task Groups 162 Teaching Groups 162 Supportive/Therapeutic Groups 162 Self-Help Groups 163 PHYSICAL CONDITIONS THAT INFLUENCE GROUP DYNAMICS 163 Seating 163 Size 163 Membership 163 CURATIVE FACTORS 164 PHASES OF GROUP DEVELOPMENT 164 Phase I. Initial or Orientation Phase 164 Phase II. Middle or Working Phase 164 Phase III. Final or Termination Phase 165 LEADERSHIP STYLES 165 Autocratic 165 Democratic 165 Laissez-Faire 165 MEMBER ROLES 166 PSYCHODRAMA 167 THE ROLE OF THE NURSE IN GROUP THERAPY 167 SUMMARY AND KEY POINTS 167 REVIEW QUESTIONS 169 REFERENCES 171 CLASSICAL REFERENCES 171 Chapter 11 Intervention with Families 172 STAGES OF FAMILY DEVELOPMENT 173 Stage I. The Single Young Adult 173 Stage II. The Newly Married Couple 173 Stage III. The Family with Young Children 173 Stage IV. The Family with Adolescents 173 Stage V. The Family Launching Grown Children 174 Stage VI. The Family in Later Life 175 MAJOR VARIATIONS 175 Divorce 175 Remarriage 175 Cultural Variations 175 FAMILY FUNCTIONING 176 Communication 177 Self-Concept Reinforcement 178 Family Members' Expectations 178 Handling Differences 179 Family Interactional Patterns 180 Family Climate 180 THERAPEUTIC MODALITIES WITH FAMILIES 181 The Family as a System 181 The Structural Model 183 The Strategic Model 184 The Evolution of Family Therapy 186 THE NURSING PROCESS-A CASE STUDY 187 Assessment 187 Diagnosis 190 Outcome Identification 190 Planning/Implementation 190 Evaluation 191 SUMMARY AND KEY POINTS 191 REVIEW QUESTIONS 193 REFERENCES 194 CLASSICAL REFERENCES 194 Chapter 12 Milieu Therapy-The Therapeutic Community 195 MILIEU, DEFINED 195 CURRENT STATUS OF THE THERAPEUTIC COMMUNITY 196 BASIC ASSUMPTIONS 196 CONDITIONS THAT PROMOTE A THERAPEUTIC COMMUNITY 197 THE PROGRAM OF THERAPEUTIC COMMUNITY 198 THE ROLE OF THE NURSE 199 SUMMARY AND KEY POINTS 201 REVIEW QUESTIONS 202 REFERENCES 203 CLASSICAL REFERENCES 203 Chapter 13 Crisis Intervention 204 CHARACTERISTICS OF A CRISIS 205 PHASES IN THE DEVELOPMENT OF A CRISIS 205 TYPES OF CRISES 206 Class 1: Dispositional Crises 206 Class 2: Crises of Anticipated Life Transitions 207 Class 3: Crises Resulting from Traumatic Stress 207 Class 4: Maturational/Developmental Crises 208 Class 5: Crises Reflecting Psychopathology 208 Class 6: Psychiatric Emergencies 208 CRISIS INTERVENTION 209 PHASES OF CRISIS INTERVENTION: THE ROLE OF THE NURSE 209 Phase 1. Assessment 209 Phase 2. Planning of Therapeutic Intervention 209 Phase 3. Intervention 210 Phase 4. Evaluation of Crisis Resolution and Anticipatory Planning 211 DISASTER NURSING 211 APPLICATION OF THE NURSING PROCESS TO DISASTER NURSING 211 Background Assessment Data 211 Nursing Diagnoses/Outcome Identification 211 Planning/Implementation 212 Evaluation 212 SUMMARY AND KEY POINTS 217 REVIEW QUESTIONS 218 REFERENCES 219 CLASSICAL REFERENCES 219 Chapter 14 Relaxation Therapy 220 THE STRESS EPIDEMIC 220 PHYSIOLOGICAL, COGNITIVE, AND BEHAVIORAL MANIFESTATIONS OF RELAXATION 221 METHODS OF ACHIEVING RELAXATION 223 Deep Breathing Exercises 223 Progressive Relaxation 223 Modified (or Passive) Progressive Relaxation 224 Meditation 225 Mental Imagery 225 Biofeedback 226 Physical Exercise 226 THE ROLE OF THE NURSE IN RELAXATION THERAPY 226 Assessment 227 Diagnosis 227 Outcome Identification/Implementation 227 Evaluation 228 SUMMARY AND KEY POINTS 228 REVIEW QUESTIONS 229 REFERENCES 229 Chapter 15 Assertiveness Training 230 ASSERTIVE COMMUNICATION 231 BASIC HUMAN RIGHTS 231 RESPONSE PATTERNS 231 Nonassertive Behavior 231 Assertive Behavior 232 Aggressive Behavior 232 Passive-Aggressive Behavior 232 BEHAVIORAL COMPONENTS OF ASSERTIVE BEHAVIOR 232 TECHNIQUES THAT PROMOTE ASSERTIVE BEHAVIOR 233 THOUGHT-STOPPING TECHNIQUES 234 Method 235 ROLE OF THE NURSE 235 Assessment 235 Diagnosis 236 Outcome Identification/Implementation 236 Evaluation 238 SUMMARY AND KEY POINTS 238 REVIEW QUESTIONS 239 REFERENCES 240 Chapter 16 Promoting Self-Esteem 241 COMPONENTS OF SELF-CONCEPT 242 Physical Self or Body Image 242 Personal Identity 242 Self -Esteem 242 DEVELOPMENT OF SELF-ESTEEM 242 Developmental Progression of Self-Esteem Through the Life Span 243 MANIFESTATIONS OF LOW SELF-ESTEEM 244 Focal Stimuli 244 Contextual Stimuli 244 Residual Stimuli 245 Symptoms of Low Self-Esteem 245 BOUNDARIES 245 Boundary Pliancy 246 Rigid Boundaries 246 Flexible Boundaries 246 Enmeshed Boundaries 247 Establishing Boundaries 247 THE NURSING PROCESS 247 Assessment 247 Diagnosis/Outcome Identification 247 Outcome Criteria 248 Planning/Implementation 248 Evaluation 250 SUMMARY AND KEY POINTS 250 REVIEW QUESTIONS 252 REFERENCES 253 CLASSICAL REFERENCES 253 Chapter 17 Anger/Aggression Management 254 ANGER AND AGGRESSION, DEFINED 255 PREDISPOSING FACTORS TO ANGER AND AGGRESSION 256 Modeling 256 Operant Conditioning 256 Neurophysiological Disorders 256 Biochemical Factors 256 Socioeconomic Factors 256 Environmental Factors 256 THE NURSING PROCESS 257 Assessment 257 Diagnosis/Outcome Identification 258 Planning/Implementation 258 Evaluation 261 SUMMARY AND KEY POINTS 261 REVIEW QUESTIONS 262 REFERENCES 263 Chapter 18 The Suicidal Client 264 HISTORICAL PERSPECTIVES 264 EPIDEMIOLOGICAL FACTORS 265 RISK FACTORS 265 Marital Status 265 Gender 265 Age 266 Religion 266 Socioeconomic Status 266 Ethnicity 266 Other Risk Factors 266 PREDISPOSING FACTORS: THEORIES OF SUICIDE 267 Psychological Theories 267 Sociological Theory 267 Biological Theories 268 APPLICATION OF THE NURSING PROCESS WITH THE SUICIDAL CLIENT 268 Assessment 268 Diagnosis/Outcome Identification 270 Planning/Implementation 270 Evaluation 275 SUMMARY AND KEY POINTS 275 REVIEW QUESTIONS 276 REFERENCES 277 CLASSICAL REFERENCES 278 Chapter 19 Behavior Therapy 279 CLASSICAL CONDITIONING 280 OPERANT CONDITIONING 281 TECHNIQUES FOR MODIFYING CLIENT BEHAVIOR 281 Shaping 281 Modeling 281 Premack Principle 282 Extinction 282 Contingency Contracting 282 Token Economy 282 Time Out 282 Reciprocal Inhibition 282 Overt Sensitization 283 Covert Sensitization 283 Systematic Desensitization 283 Flooding 283 ROLE OF THE NURSE IN BEHAVIOR THERAPY 283 SUMMARY AND KEY POINTS 285 REVIEW QUESTIONS 287 REFERENCES 288 CLASSICAL REFERENCES 288 Chapter 20 Cognitive Therapy 289 HISTORICAL BACKGROUND 290 INDICATIONS FOR COGNITIVE THERAPY 290 GOALS AND PRINCIPLES OF COGNITIVE THERAPY 290 BASIC CONCEPTS 291 Automatic Thoughts 291 Schemas (Core Beliefs) 292 TECHNIQUES OF COGNITIVE THERAPY 292 Didactic (Educational) Aspects 292 Cognitive Techniques 293 Behavioral Interventions 294 ROLE OF THE NURSE IN COGNITIVE THERAPY 295 SUMMARY AND KEY POINTS 298 REVIEW QUESTIONS 299 REFERENCES 300 CLASSICAL REFERENCES 300 Chapter 21 Psychopharmacology 301 HISTORICAL PERSPECTIVES 302 ROLE OF THE NURSE 302 Ethical and Legal Implications 302 Assessment 302 Medication Administration and Evaluation 302 Client Education 302 HOW DO PSYCHOTROPICS WORK? 304 APPLYING THE NURSING PROCESS IN PSYCHOPHARMACOLOGICAL THERAPY 306 Antianxiety Agents 306 Antidepressants 308 Mood-Stabilizing Agents 315 Antipsychotic Agents 321 Sedative-Hypnotics 327 Agents for Attention Deficit Hyperactivity Disorder (ADHD) 329 SUMMARY AND KEY POINTS 332 REVIEW QUESTIONS 334 REFERENCES 335 Chapter 22 Electroconvulsive Therapy 336 ELECTROCONVULSIVE THERAPY, DEFINED 337 HISTORICAL PERSPECTIVES 337 INDICATIONS 338 Major Depression 338 Mania 338 Schizophrenia 338 Other Conditions 338 CONTRAINDICATIONS 338 MECHANISM OF ACTION 338 SIDE EFFECTS 338 RISKS ASSOCIATED WITH ELECTROCONVULSIVE THERAPY 339 Mortality 339 Permanent Memory Loss 339 Brain Damage 339 THE ROLE OF THE NURSE IN ELECTROCONVULSIVE THERAPY 339 Assessment 339 Diagnosis/Outcome Identification 340 Planning/Implementation 340 Evaluation 341 SUMMARY AND KEY POINTS 341 REVIEW QUESTIONS 342 REFERENCES 343 Chapter 23 Complementary Therapies 344 COMMONALITIES AND CONTRASTS 347 TYPES OF COMPLEMENTARY THERAPIES 347 Herbal Medicine 347 Acupressure and Acupuncture 348 Diet and Nutrition 351 Chiropractic Medicine 355 Therapeutic Touch and Massage 356 Yoga 356 Pet Therapy 357 SUMMARY AND KEY POINTS 358 REVIEW QUESTIONS 359 REFERENCES 359 Chapter 24 Client Education 361 HISTORICAL PERSPECTIVES 362 THEORIES OF TEACHING AND LEARNING 363 Behaviorist Theory 363 Cognitive Theory 363 Humanistic Theory 363 DOMAINS OF LEARNING 364 Affective Domain 364 Cognitive Domain 364 Psychomotor Domain 364 AGE AND DEVELOPMENTAL CONSIDERATIONS 364 The Adult Learner 364 Teaching Children and Adolescents 365 Teaching the Elderly 365 THE NURSING PROCESS IN CLIENT EDUCATION 366 Assessment 366 Nursing Diagnosis 368 Outcome Identification 368 Planning/Implementation 368 Evaluation 370 DOCUMENTATION OF CLIENT EDUCATION 371 SUMMARY AND KEY POINTS 371 REVIEW QUESTIONS 373 REFERENCES 374 CLASSICAL REFERENCES 374 UNIT FOUR NURSING CARE OF CLIENTS WITH ALTERATIONS IN PSYCHOSOCIAL ADAPTATION Chapter 25 Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence 376 MENTAL RETARDATION 377 Predisposing Factors 377 Application of the Nursing Process to Mental Retardation 378 AUTISTIC DISORDER 380 Clinical Findings 380 Epidemiology and Course 380 Predisposing Factors 381 Application of the Nursing Process to Autistic Disorder 381 ATTENTION-DEFICIT/HYPERACTIVITY DISORDER 384 Clinical Findings, Epidemiology, and Course 384 Predisposing Factors 385 Application of the Nursing Process to ADHD 387 Psychopharmacological Intervention for ADHD 390 CONDUCT DISORDER 393 Predisposing Factors 394 Application of the Nursing Process to Conduct Disorder 394 OPPOSITIONAL DEFIANT DISORDER 397 Clinical Findings, Epidemiology, and Course 397 Predisposing Factors 397 Application of the Nursing Process to ODD 398 TOURETTE'S DISORDER 401 Clinical Findings, Epidemiology, and Course 401 Predisposing Factors 401 Application of the Nursing Process to Tourette's Disorder 401 Psychopharmacological Intervention for Tourette's Disorder 404 SEPARATION ANXIETY DISORDER 404 Clinical Findings, Epidemiology, and Course 404 Predisposing Factors 404 Application of the Nursing Process to Separation Anxiety Disorder 405 GENERAL THERAPEUTIC APPROACHES 407 Behavior Therapy 407 Family Therapy 408 Group Therapy 408 Psychopharmacology 408 SUMMARY AND KEY POINTS 408 REVIEW QUESTIONS 410 REFERENCES 411 INTERNET REFERENCES 412 Chapter 26 Delirium, Dementia, and Amnestic Disorders 413 DELIRIUM 414 Clinical Findings and Course 414 Predisposing Factors 414 DEMENTIA 415 Clinical Findings, Epidemiology, and Course 415 Predisposing Factors 417 AMNESTIC DISORDERS 422 Predisposing Factors 422 APPLICATION OF THE NURSING PROCESS 422 Assessment 422 Nursing Diagnosis/Outcome Identification 426 Planning/Implementation 427 Concept Care Mapping 430 Client/Family Education 430 Evaluation 432 MEDICAL TREATMENT MODALITIES 432 Delirium 432 Dementia 432 SUMMARY AND KEY POINTS 437 REVIEW QUESTIONS 438 REFERENCES 439 INTERNET REFERENCES 440 Chapter 27 Substance-Related Disorders 441 SUBSTANCE-USE DISORDERS 442 Substance Abuse 442 DSM-IV-TR Criteria for Substance Abuse 442 Substance Dependence 442 DSM-IV-TR Criteria for Substance Dependence 443 SUBSTANCE-INDUCED DISORDERS 443 Substance Intoxication 443 DSM-IV-TR Criteria for Substance Intoxication 443 Substance Withdrawal 443 DSM-IV-TR Criteria for Substance Withdrawal 443 CLASSES OF PSYCHOACTIVE SUBSTANCES 444 PREDISPOSING FACTORS TO SUBSTANCE-RELATED DISORDERS 444 Biological Factors 444 Psychological Factors 444 Sociocultural Factors 444 THE DYNAMICS OF SUBSTANCE-RELATED DISORDERS 445 Alcohol Abuse and Dependence 445 Alcohol Intoxication 449 Alcohol Withdrawal 450 Sedative, Hynotic, or Anxiolytic Abuse and Dependence 450 Sedative, Hypnotic, or Anxiolytic Intoxication 452 Sedative, Hypnotic, or Anxiolytic Withdrawal 452 CNS Stimulant Abuse and Dependence 452 CNS Stimulant Intoxication 455 CNS Stimulant Withdrawal 455 Inhalant Abuse and Dependence 456 Inhalant Intoxication 456 Opioid Abuse and Dependence 456 Opioid Intoxication 458 Opioid Withdrawal 458 Hallucinogen Abuse and Dependence 459 Hallucinogen Intoxication 461 Cannabis Abuse and Dependence 461 Cannabis Intoxication 463 APPLICATION OF THE NURSING PROCESS 463 Assessment 463 Diagnosis/Outcome Identification 470 Planning/Implementation 471 Concept Care Mapping 474 Client/Family Education 474 Evaluation 474 THE CHEMICALLY IMPAIRED NURSE 476 CODEPENDENCY 477 The Codependent Nurse 477 Treating Codependence 478 TREATMENT MODALITIES FOR SUBSTANCE-RELATED DISORDERS 478 Alcoholics Anonymous 478 Pharmacotherapy 478 Counseling 480 Group Therapy 481 Psychopharmacology for Substance Intoxication and Substance Withdrawal 481 SUMMARY AND KEY POINTS 484 REVIEW QUESTIONS 485 REFERENCES 487 CLASSICAL REFERENCES 488 INTERNET REFERENCES 488 Chapter 28 Schizophrenia and Other Psychotic Disorders 489 NATURE OF THE DISORDER 490 Phase I: The Premorbid Phase 490 Phase II: The Prodromal Phase 491 Phase III: Schizophrenia 491 Phase IV: Residual Phase 491 Prognosis 491 PREDISPOSING FACTORS 492 Biological Influences 492 Psychological Influences 494 Environmental Influences 494 Stressful Life Events 494 The Transactional Model 494 TYPES OF SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS 496 Disorganized Schizophrenia 496 Catatonic Schizophrenia 496 Paranoid Schizophrenia 496 Undifferentiated Schizophrenia 496 Residual Schizophrenia 496 Schizoaffective Disorder 496 Brief Psychotic Disorder 497 Schizophreniform Disorder 497 Delusional Disorder 497 Shared Psychotic Disorder 497 Psychotic Disorder Due to a General Medical Condition 498 Substance-Induced Psychotic Disorder 498 APPLICATION OF THE NURSING PROCESS 498 Background Assessment Data 498 Diagnosis/Outcome Identification 502 Planning/Implementation 503 Concept Care Mapping 506 Client/Family Education 506 Evaluation 506 TREATMENT MODALITIES FOR SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS 508 Psychological Treatments 508 Social Treatment 509 Organic Treatment 510 SUMMARY AND KEY POINTS 514 REVIEW QUESTIONS 516 REFERENCES 517 INTERNET REFERENCES 518 Chapter 29 Mood Disorders 519 HISTORICAL PERSPECTIVE 520 EPIDEMIOLOGY 520 Gender 521 Age 521 Social Class 521 Race and Culture 521 Marital Status 522 Seasonality 522 TYPES OF MOOD DISORDERS 522 Depressive Disorders 522 Bipolar Disorders 524 Other Mood Disorders 525 DEPRESSIVE DISORDERS 525 Predisposing Factors 525 Developmental Implications 529 APPLICATION OF THE NURSING PROCESS TO DEPRESSIVE DISORDERS 532 Background Assessment Data 532 Diagnosis/Outcome Identification 534 Planning/Implementation 535 Concept Care Mapping 538 Client/Family Education 538 Evaluation of Care for the Depressed Client 538 BIPOLAR DISORDER (MANIA) 540 Predisposing Factors 540 Developmental Implications 542 APPLICATION OF THE NURSING PROCESS TO BIPOLAR DISORDER (MANIA) 543 Background Assessment Data 543 Diagnosis/Outcome Identification 544 Planning/Implementation 545 Concept Care Mapping 547 Client/Family Education 547 Evaluation of Care for the Manic Client 547 TREATMENT MODALITIES FOR MOOD DISORDERS 549 Individual Psychotherapy 549 Group Therapy for Depression and Mania 550 Family Therapy for Depression and Mania 550 Cognitive Therapy for Depression and Mania 550 Electroconvulsive Therapy for Depression and Mania 551 Transcranial Magnetic Stimulation 551 Light Therapy for Depression 551 Psychopharmacology 551 SUMMARY AND KEY POINTS 556 REVIEW QUESTIONS 557 REFERENCES 559 CLASSICAL REFERENCES 560 INTERNET REFERENCES 560 Chapter 30 Anxiety Disorders 561 HISTORICAL ASPECTS 562 EPIDEMIOLOGICAL STATISTICS 562 HOW MUCH IS TOO MUCH? 564 APPLICATION OF THE NURSING PROCESS 564 Panic Disorder 564 Generalized Anxiety Disorder 565 Phobias 566 Obsessive-Compulsive Disorder 571 Posttraumatic Stress Disorder 574 Anxiety Disorder Due to a General Medical Condition 576 Substance-Induced Anxiety Disorder 576 Diagnosis/Outcome Identification 576 Planning/Implementation 578 Concept Care Mapping 580 Client/Family Education 583 Evaluation 583 TREATMENT MODALITIES 583 Individual Psychotherapy 583 Cognitive Therapy 584 Behavior Therapy 584 Group/Family Therapy 585 Psychopharmacology 585 SUMMARY AND KEY POINTS 588 REVIEW QUESTIONS 589 REFERENCES 590 CLASSICAL REFERENCES 591 INTERNET REFERENCES 591 Chapter 31 Somatoform and Dissociative Disorders 592 HISTORICAL ASPECTS 593 EPIDEMIOLOGICAL STATISTICS 593 APPLICATION OF THE NURSING PROCESS 595 Background Assessment Data: Types of Somatoform Disorders 595 Predisposing Factors Associated with Somatoform Disorders 598 Background Assessment Data: Types of Dissociative Disorders 600 Predisposing Factors Associated with Dissociative Disorders 602 Diagnosis/Outcome Identification 604 Planning/Implementation 605 Concept Care Mapping 609 Evaluation 609 TREATMENT MODALITIES 609 Somatoform Disorders 609 Dissociative Amnesia 612 Dissociative Fugue 612 Dissociative Identity Disorder 612 Depersonalization Disorder 613 SUMMARY AND KEY POINTS 614 REVIEW QUESTIONS 616 REFERENCES 617 CLASSICAL REFERENCES 618 INTERNET REFERENCES 618 Chapter 32 Issues Related to Human Sexuality 619 DEVELOPMENT OF HUMAN SEXUALITY 620 Birth Through Age 12 620 Adolescence 620 Adulthood 621 SEXUAL DISORDERS 622 Paraphilias 622 Sexual Dysfunctions 626 Application of the Nursing Process to Sexual Disorders 630 Treatment Modalities for Sexual Dysfunctions 636 VARIATIONS IN SEXUAL ORIENTATION 638 Homosexuality 638 Transsexualism 640 Bisexuality 640 SEXUALLY TRANSMITTED DISEASES 641 SUMMARY AND KEY POINTS 643 REVIEW QUESTIONS 645 REFERENCES 646 CLASSICAL REFERENCES 646 INTERNET REFERENCES 646 Chapter 33 Eating Disorders 647 EPIDEMIOLOGICAL FACTORS 648 APPLICATION OF THE NURSING PROCESS 648 Background Assessment Data (Anorexia Nervosa) 648 Background Assessment Data (Bulimia Nervosa) 649 Background Assessment Data (Obesity) 650 Diagnosis/Outcome Identification 652 Planning/Implementation 652 Concept Care Mapping 657 Client/Family Education 658 Evaluation 658 TREATMENT MODALITIES 659 Behavior Modification 659 Individual Therapy 659 Family Therapy 660 Psychopharmacology 660 SUMMARY AND KEY POINTS 662 REVIEW QUESTIONS 663 REFERENCES 664 INTERNET REFERENCES 665 Chapter 34 Personality Disorders 666 HISTORICAL ASPECTS 668 TYPES OF PERSONALITY DISORDERS 668 Paranoid Personality Disorder 668 Schizoid Personality Disorder 669 Schizotypal Personality Disorder 670 Antisocial Personality Disorder 671 Borderline Personality Disorder 671 Histrionic Personality Disorder 671 Narcissistic Personality Disorder 672 Avoidant Personality Disorder 673 Dependent Personality Disorder 674 Obsessive-Compulsive Personality Disorder 675 Passive-Aggressive Personality Disorder 676 APPLICATION OF THE NURSING PROCESS 676 Borderline Personality Disorder (Background Assessment Data) 676 Predisposing Factors to Borderline Personality Disorder 678 Diagnosis/Outcome Identification 679 Planning/Implementation 679 Concept Care Mapping 683 Evaluation 683 Antisocial Personality Disorder (Background Assessment Data) 683 Diagnosis/Outcome Identification 686 Planning/Implementation 687 Concept Care Mapping 689 Evaluation 689 TREATMENT MODALITIES 690 Interpersonal Psychotherapy 690 Psychoanalytical Psychotherapy 690 Milieu or Group Therapy 690 Cognitive/Behavioral Therapy 690 Psychopharmacology 690 SUMMARY AND KEY POINTS 692 REVIEW QUESTIONS 693 REFERENCES 695 CLASSICAL REFERENCES 695 INTERNET REFERENCES 695 UNIT FIVE PSYCHIATRIC/MENTAL HEALTH NURSING OF SPECIAL POPULATIONS Chapter 35 The Aging Individual 698 HOW OLD IS OLD? 699 EPIDEMIOLOGICAL STATISTICS 699 The Population 699 Marital Status 699 Living Arrangements 700 Economic Status 700 Employment 700 Health Status 700 THEORIES OF AGING 700 Biological Theories 700 Psychosocial Theories 701 THE NORMAL AGING PROCESS 702 Biological Aspects of Aging 702 Psychological Aspects of Aging 705 Sociocultural Aspects of Aging 707 Sexual Aspects of Aging 707 SPECIAL CONCERNS OF THE ELDERLY POPULATION 708 Retirement 708 Long-Term Care 710 Elder Abuse 711 APPLICATION OF THE NURSING PROCESS 713 Assessment 713 Diagnosis/Outcome Identification 714 Planning/Implementation 715 Evaluation 715 SUMMARY AND KEY POINTS 720 REVIEW QUESTIONS 723 REFERENCES 724 CLASSICAL REFERENCES 725 INTERNET REFERENCES 725 Chapter 36 Victims of Abuse or Neglect 726 HISTORICAL PERSPECTIVES 727 PREDISPOSING FACTORS 727 Biological Theories 728 Psychological Theories 728 Sociocultural Theories 728 APPLICATION OF THE NURSING PROCESS 730 Background Assessment Data 730 Diagnosis/Outcome Identification 736 Planning/Implementation 736 Concept Care Mapping 739 Evaluation 739 TREATMENT MODALITIES 739 Crisis Intervention 739 The Safe House or Shelter 741 Family Therapy 741 SUMMARY AND KEY POINTS 742 REVIEW QUESTIONS 743 REFERENCES 745 CLASSICAL REFERENCES 745 INTERNET REFERENCES 745 Chapter 37 Community Mental Health Nursing 746 THE CHANGING FOCUS OF CARE 747 THE PUBLIC HEALTH MODEL 748 THE ROLE OF THE NURSE 749 The Psychiatric-Mental Health Registered Nurse (RN-PMH) 749 The Psychiatric-Mental Health Advanced Practice Registered Nurse (APRN-PMH) 750 CASE MANAGEMENT 750 THE COMMUNITY AS CLIENT 751 Primary Prevention 751 Secondary Prevention 757 Tertiary Prevention 758 SUMMARY AND KEY POINTS 772 REVIEW QUESTIONS 774 REFERENCES 775 CLASSICAL REFERENCES 776 Chapter 38 Forensic Nursing 777 WHAT IS FORENSIC NURSING? 777 HISTORICAL PERSPECTIVES 778 THE CONTEXT OF FORENSIC NURSING PRACTICE 778 FORENSIC NURSING SPECIALTIES 778 Clinical Forensic Nursing Specialty 778 The Sexual Assault Nurse Examiner (SANE) 779 Forensic Psychiatric Nursing Specialty 779 Correctional/Institutional Nursing Specialty 779 Nurses in General Practice 779 APPLICATION OF THE NURSING PROCESS IN CLINICAL FORENSIC NURSING IN TRAUMA CARE 780 Assessment 780 Nursing Diagnosis 781 Planning/Implementation 781 Evaluation 783 APPLICATION OF THE NURSING PROCESS IN FORENSIC PSYCHIATRIC NURSING IN CORRECTIONAL FACILITIES 783 Assessment 783 Nursing Diagnosis 786 Planning/Implementation 786 Evaluation 789 SUMMARY AND KEY POINTS 789 REVIEW QUESTIONS 790 REFERENCES 790 CLASSICAL REFERENCE 791 INTERNET REFERENCES 791 Chapter 39 The Bereaved Individual 792 THEORETICAL PERSPECTIVES ON LOSS AND BEREAVEMENT 793 Stages of Grief 793 LENGTH OF THE GRIEF PROCESS 796 ANTICIPATORY GRIEF 797 MALADAPTIVE RESPONSES TO LOSS 797 Delayed or Inhibited Grief 797 Distorted (Exaggerated) Grief Response 797 Chronic or Prolonged Grieving 797 Normal versus Maladaptive Grieving 798 APPLICATION OF THE NURSING PROCESS 798 Background Assessment Data: Concepts of Death-Developmental Issues 798 Background Assessment Data: Concepts of Death-Cultural Issues 799 Nursing Diagnosis/Outcome Identification 801 Planning/Implementation 801 Evaluation 801 ADDITIONAL ASSISTANCE 804 Hospice 804 Advance Directives 806 SUMMARY AND KEY POINTS 807 REVIEW QUESTIONS 809 REFERENCES 810 CLASSICAL REFERENCES 810 INTERNET REFERENCES 810 UR - http://www.loc.gov/catdir/toc/ecip0827/2008039094.html ER -