PSYCHE

The Royal Pentagon Review Specialist, Inc.
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)
D
mpulsive
want to
want PLEASURE
eat
drink
urinate
defecate
Dominant ID
Mania
Antisocial
Narcissistic
PLEASURABLE PRINCIPLE
Pain Avoidance
Its all I
UPER EGO
hould not
mall voice of God
DOMINANT SUPER EGO

Obsessive - compulsive
Anorexia Nervosa
I
CONSCIENCE PRINCIPLE
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
Child Cries
Feed the Infant
Successful
Ignore the Infant
Unsuccessful
Narcissistic
Defense Mechanism:
Jomar Anthony D. Maxion, BSN, RN
College of Nursing Batch 2009
Psychiatric Nursing
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
Bad Mother
Unsuccessful
SE
BIG
SE
Too Rigid Training
Clean
Organized
Obedient
OBSESSIVE COMPULSSIVE
(Anal Retentive)
Dirty
Disorganized
Disobedient
ANTISOCIAL
(Anal Expulsive)
Small
S
E
3. PHALLIC
3 6 y.o.
Penis/ Vagina
Parents is the significant person
Called as Preschooler
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
Psychiatric Nursing
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
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 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.
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
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
Guilt
Inferiority
Role confusion
Isolation
Stagnation
Despair
Independence
In da-school
Peer
Love
Parenting
Reflection
Psychiatric Nursing
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
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
Voluntary
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
Parasympathetic
Constipation
Urinary
retention
Epi/ Nor
GI
GU
Neuro
Psychiatric Nursing
Diarrhea
Urinary
Frequency
Acetyl Choline
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
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
FORMATION
intention
kita. . . 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 mangingig
physical symptoms affecting
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
nalang.
STOP GABA Inhibitory
Gamma Amino Butyric Acid
SNS
GO Epinephrine/ Norepinephrine
Exitatory
ANXIETY
Psychiatric Nursing
Anticholinergic side effect

Constipation
Urinary Retention
Dry Mouth
Blurred Vision
Within 1 week
Rebound
phenomenon
Seizure
Abrupt
Anti-Anxiety
Dependence
Withdrawal
Drowsy
No Alcohol
No Coffee
Develop Orthostatic
Hypotension
Prevetion of O.H.
1. Sit Down
2. Dangle feet
3. Stand Up Gradually
Gradually
Tapered Dose
RELAXED
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
Bown Bag
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
Psychiatric Nursing
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
Soldier
Flashbacks
VICTIMS Survivors
Nightmares
Anxiety
I am sick
6 years old
Assignments/
Homeworks
No Assignments/
Homeworks
You Think
Teacher may
get angry
SOMATOFORM
> no pretension
> no organic
basis
MALINGERING
pretending to be sick
(Conscious)
Absent
Escape from
Teacher
PRIMARY GAIN
(Behavior anxiety)
> unconscious
PSYCHOSOMATIC
> Real pains/ illness
> Real symptoms
> 4 major types
* Hypertension
* Migraine
* Stress Ulcer
* Asthma
Mama Care
Attention
SECONDARY GAIN
Psychiatric Nursing
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
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
Psychiatric Nursing
o Gradual exposure to feared object
PHARMA MOMENTS
ANTIPSYCHOTIC AGENT
SSTTCMHP
Stelazine - sexy star
Serentil serena
Thorazine babaeng Tora
Trilafon - tri-band phone
Clozaril closed reel

Mellaril maraming reel
Haldol hahaha
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 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
Complications
or else: nausea, vomiting and hypotension

Wernickes Encephalopathy motor
Korsakoffs 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
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
Planning/ Implementation
tructure separate room for eating, playing, sleeping and etc
chedule time for everything
et limits
afety
Evaluation
Minimize Risk for Injury
Improved social interaction
Safety
Residual ADHD grows up not antisocial
Psychiatric Nursing
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
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
ausea, vomiting, diarrhea

Lithium Toxicity
a+
Kidney
Psychiatric Nursing
Uu diarhea
Mouth, dry
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
Symptoms
Negative
Hypoactive
Withdrawn
Apathy
Positive
Hyperactive
Sociable
Flight of Ideas
Talkative
Assess
: Content of Thought
Nx Dx
: Disturbed thought process
Present reality
Provide safety
Evaluation : Improve thought process
Assess
: Hallucination/ Illusions
Nx Dx
: Disturbed sensory perception
Present reality
Provide safety
Evaluation : Improve sensory perception
Assess
Nx Dx
: Suspicious
: Risk for other directive behavior
Psychiatric Nursing
Present reality
Provide safety
Evaluation : Eliminate/ minimize risk for other-directed violence
Assess
: Suicidal
Nx Dx
: Risk for self directive behavior
Present reality
Provide safety
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?

Go here.
Mineral Water.
The mall is big.

Big is the tree.
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 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:

Psychiatric Nursing
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

Assess what the voices are saying
SCHIZOPRENIA
Disorganized
Catatonic
Sad but smiles

o Inappropriate affect
No reaction
o Flat affect
Flight of ideas
o HEBEPHRENIC
Giggling
Positive
and Negative
classified
S/Sx differentiated
Residual Mixed classification
Cant be classified
1st paranoid, then
No more positive s/sx,
disorganized then
just withdrawn
catatonic, etc etc
Normally
Acetylcholine = ON
Paranoid
Ambivalence
Waxy Flexibility
o Iniwan na posture,
ganun forever
No favorite word
Negativism
Suspicious
Tendency to be violent
MistrustScaredWithdraw
n
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
Dopamine = OFF
Your always ON
With parkinsON
High Dopamine= Schizophrenia
Psychiatric Nursing
Antipsychotics = makes Dopamine goes down

ON
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
PHARMAMOMENTS
ANTIDEPRESSANTS
ANTSAAVE PPZ
Asendin ascending
Psychiatric Nursing
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
Self Actualization
TASK
Caregiver Role Strain
Self Esteem
Safety
Safety
Risk for injury/ other directed violence

Eating
finger food
Sleep
Private room
Hyperactive
Sex
Anxiety
Lithium 2 4 weeks before effect
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 randiose
F
S
P
E
E
D
Psychiatric Nursing
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
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
Psychiatric Nursing
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
Serotonin
ANTIDEPRESSANTS
1st Line of Drug Prescribed
wo 4 weeks
wo neurotransmitter
RI
ONO
ide effects low

EROTONIN
CYCLIC
MINE
EUPTAKE
NTIDEPRESSANT
XIDASE
afest
ELECTIVE
to 4 weeks
NHIBITOR
PPZ
Higher incidence of Side effects

Serotonin/ Epi affected
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
MAOI
Antidepressant
Anticholinergic Side Effects

(Syphathetic)
College of Nursing
Batch 2009
Male Erectile Dysfunction
Psychiatric Nursing
hocolate
ermented Foods
ickles
reserved Foods
oy Sauce
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
Morph
Code
Hero
NARCAN antidote
Uppers (CHA)
Cocaine
Hallucinogen
Amphetamines
OVERDOSE
Alcohol
Coma
Cocaine
HR
RR
BP
LOC
Seizure
Bradycardia
Bradypnea
Pupil constriction
Moist mouth
Constipation
Hypotension
Coma
Asleep
Weight gain
EUPHORIA
Tachycardia
Tachypnea
Pupil Dilation
Dry mouth
Hypertension
Seizure
Awake
Weight Loss
Psychiatric Nursing
Psych well being

NARCAN Narcotic Antagonist narcotic overdose
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
C TASK
Stay
Self Esteem
withdrawn
Risk for self directed violence

Eating
Sleep
Hypoactive
Sex
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
Psychiatric Nursing
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
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
rainable
o can be train
wo 7 y/o
o mental age is 2 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
7 12
Conservation
Concrete
Association
Formal
Operation
12
Psychiatric Nursing
Unidimentional classification characteristic. Child can

fix toys according to size, color, height = one at a time
Multidimensional
Good abstract thinking. Can interpret words
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
eroine withdrawal
ikab
atsing
u hu hu
CRITICAL REVIEW
TEST TAKING TECHNIQUES
1. Assess the answer, use circle
2. Initial priority
TRUST
Air food, water
3.
4.
5.
6.
7.
ABC
Good Word/ Bad Word
air
S Technique
eek support
it
tay
upervised
ee = observed
eem = notice
assi
t
feeling
2 same answer/ 2 same mistake
Words to watch out for
Inappropriate
Most
Not included
Except
All but one
Umbrella
ASSESS
Psychiatric Nursing
RELATIONSHIP
Preorientation
Self awareness
Orientation
Trust
Setting Contract
Resistance
Working
Termination
Discussion
Evaluation
PRACTICE OF NURSING
Level of Prevention
1
Healthy
Ill
Community Demog. Crisis Intervention
Relapse
AA
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?
Coping what will you do about it?
Support who will be there for you?
Kulit kulit kulit kulit Perseveration stick to 1 topic
Psychiatric Nursing
Ulit Ulit Ulit Verbigeration

DISSOCIATION
Dissociative Amnesia dont know themselves
Fugue Far
Dissociative Identity Disorder Multiple Personality D.O.

PSYCHE

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The Royal Pentagon Review Specialist, Inc.

Beliefs Feelings Behavior

DOMINANT SUPER EGO

Ignore the Infant

College of Nursing Batch 2009

The Royal Pentagon Review Specialist, Inc.

o FIXATION when a person is stuck in a certain developmental

EGO is develop in the 6th month

Too Rigid Training

Oedipus Complex little boy loves mommy

Jomar Anthony D. Maxion, BSN, RN

College of Nursing Batch 2009

The Royal Pentagon Review Specialist, Inc.

Dr. Karen Horney opposition to penis envy

Birth Trauma First traumatic experience of child

Sexual energy is dormant

Reading, Riting, Rithmetic

SUBLIMATION placing sexual energies toward a more

Jomar Anthony D. Maxion, BSN, RN

College of Nursing Batch 2009

The Royal Pentagon Review Specialist, Inc.

MASLOWS HEIRARCHY OF NEEDS

VOLUNTARY NERVOUS SYSTEM

Brain Spinal Cord Motor Nerve Muscle Fiber

Jomar Anthony D. Maxion, BSN, RN

College of Nursing Batch 2009

The Royal Pentagon Review Specialist, Inc.

MONOAMINE OXIDASE INHIBITORS

Jomar Anthony D. Maxion, BSN, RN

College of Nursing Batch 2009

The Royal Pentagon Review Specialist, Inc.

Focusing tell me about

Jomar Anthony D. Maxion, BSN, RN

College of Nursing Batch 2009

The Royal Pentagon Review Specialist, Inc.

Anticholinergic side effect

Vague sense of impending doom

Jomar Anthony D. Maxion, BSN, RN

College of Nursing Batch 2009

The Royal Pentagon Review Specialist, Inc.

ENERALIZED ANXIETY DISORDER

15 30 Minutes escalation of SNS

POST TRAUMATIC STRESS DISORDER

Jomar Anthony D. Maxion, BSN, RN

College of Nursing Batch 2009

The Royal Pentagon Review Specialist, Inc.

Illusion of structural defect

Jomar Anthony D. Maxion, BSN, RN

College of Nursing Batch 2009

The Royal Pentagon Review Specialist, Inc.

o Gradual exposure to feared object

Clozaril closed reel

Blackout awake but unaware

Confabulation inventing stories to self-esteem

Denial I am not an alcoholic

Enabling significant other tolerates abusers

12 hour interval/ 12 h last alcohol intake

or else: nausea, vomiting and hypotension

Delirium Tremens 24 72 h after last dose of alcohol

untreated withdrawal syndrome

Jomar Anthony D. Maxion, BSN, RN

College of Nursing Batch 2009

The Royal Pentagon Review Specialist, Inc.

ATTENTION DEFICIT HYPERACTIVE DISORDER