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, go, Superego)
!ominant I!
"ania
! eat #ntisocial
mpulsive drink Narcissistic
want to urinate
want PL!S"# defecate
PL!S"#!BL P#$%&$PL
Pain !voidance
$t's all ($)
!$"IN#NT S%PR &$
$*sessive + compulsive
%PR &$ #nore,ia %ervosa
hould not
mall voice of -od
&.%S&$%& P#$%&$PL
&$
/ecutive Secretary Impaired Reality
Schi0ophrenia
#!L$12 P#$%&$PL

'I(I!$ se,ual energy responsi*le for survival
PS)C*$S+%#' T*$R)
,. $R#' ST#&
3 4 56 7onths old
Survival
$ want to eat, sleep, urinate, defecate
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I

The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing

$9 formation
&ry = Suck mouth
&hild &ries
Feed the $nfant $gnore the $nfant

Successful "nsuccessful

%arcissistic
Defense Mechanism:
o FI+#TI$N when a person is stuck in a certain developmental
stage
o R&RSSI$N return to an earlier developmental stage
EGO is develop in the 6
th
month
-. #N#' ST#&
!teen 4 > years old (56 mos 4 > y:o:)
1oilet training
Super go develop
1oilet 1raining
-ood 7other Bad 7other

Successful "nsuccessful
1oo #igid 1raining 9irty
9isorgani0ed
&lean 9iso*edient
.rgani0ed
.*edient #NTIS$CI#'
(!nal ,pulsive)
$(SSSI. / C$"P%'SSI.
(!nal #etentive)
0. P*#''IC
> 4 ? y:o:
Penis@ Aagina
Parents is the significant person
&alled as Preschooler
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S
(I&
S
Small
S

The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing

$edipus Comple1 little *oy loves mommy
lectra Comple1 little girl loves daddy
Identi2ication *oy associates with daddy, girl assoc: with
mommy
Castration fear of the little *oy to daddy
Penis nvy envy of little girl towards daddy
9r: Baren Corney opposition to penis envy
Level of !wareness
o Conscious highest level of awareness
o Preconscious 1ip of the tongue
o %nconscious deepest level of awareness
Birth 1rauma First traumatic e,perience of child
RPRSSI$N unconscious forgetting of an an,iety provoking
concept
S%PRSSI$N conscious forgetting of an an,iety provoking
concept
3. '#TNC) ST#&
? 4 5; years old
S&C..latency
Se,ual energy is dormant
#eading, #iting, #ithmetic
S%('I"#TI$N placing se,ual energies toward a more
productive endeavors
4. &NIT#' ST#&
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The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
5; y: o: 4 a*ove
-ising
-enital
PHARMA MOMENTS
#NTI#N+IT)
AL!S1 7 A!$B
.alium 4 ate A "iltown + 7eal .istaril + largavista
'i*reum + L Duanil 4 !Dua Bneel #ttara, 4 7ga *ato (rocks)
#tivan + !te -uy Inderal 4 hindi ralph
Seraks 4 Sera "lo (usfar 4 sasakay ng *us
Tran,ene + 1ransit
RI5 RI5S$N
PS)C*$S$CI#' T*$R) $F !.'$P"NT
#ge
6 7 #22ecting "a8or
Factor
3+56 mos: 1rust 7istrust Feeding
56 mos: 4 > y:o: !utonomy
!" nal
1. ilet training
%. favorite word
72
Shame@ dou*t 1oilet 1raining
> 4 ? y:o: $nitiative -uilt $ndependence
? 4 5; y:o: $ndustry $nferiority $n da+school
5; 4 ;3 y:o: $dentity #ole confusion Peer
;3 4 ;E y:o: $ntimacy $solation Love
;E 4 FE y:o: -enerativity Stagnation Parenting
FE y:o: and a*ove go $ntegrity 9espair #eflection
"#S'$9:S *IR#RC*) $F N!S
5: Physiologic %eeds
o !ir, food, water, shelter, rest, sleep, activity and temperature
maintenance that are crucial for survival
;: Safety and Security %eeds
o Safe in physical and psychological aspects
>: Love and Belonging %eeds
o -iving and receiving affection, attaining a place in a group,
maintaining the feeling of *elonging
F: Self 4 esteem %eeds
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The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
o Self esteem 4 feelings of independence, competence and self
respect
o steem from others 4 recognition, respect, appreciation
E: Self !ctuali0ation
o .ne's ma,imum potential and reali0e one's a*ilities and Dualities
(*#.I$R#' "$!'S
5: $van Pavlov
&lassical &onditioning 7odel
!ll *ehavior are learned
Food dog Salivation
Bell Food 9og Salivation
Bell Salivation
;: B:F: Skinner
.perant &onditioning
!ll *ehaviors are unlearned
#eward (G reinforcement) and Punishment (+
#einforcement)
(R#IN '$(S #CTI$N
Frontal Language, Learning, Personality, 8udgment
1emporal hearing, smelling
Parietal 1aste, touch
.ccipital Aision
Sensory
$ntegration Aoluntary
7otor
$nvoluntary
.$'%NT#R) NR.$%S S)ST"
Somatic %ervous System
!cetyl&holine

Brain Spinal &ord 7otor %erve 7uscle Fi*er
IN.$'%NT#R) NR.$%S S)ST"
!utonomic %ervous System
Sympathetic Parasympathetic
C#
##
-$
&onstipation

9iarrhea
-"
"rinary

"rinary
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
retention FreDuency
%euro pi@ %or !cetyl &holine
PHARMA MOMENTS
"$N$#"IN $+I!#S IN*I(IT$RS
!#
7 PL!%
% 9$L
P %!1
#NTIP#R5INS$N
&!P!BLS
Cogentin
#rtane
Parlodel
#kineton
(enadryl
'arodopa
ldepryl
Symmetryl
T*R#P%TIC C$""%NIC#TI$N
1herapeutic %on+1herapeutic
.ffer your self $'ll stay with
you
Silence
7aking o*servations
o 2ou seem sad
!ctive listening
o %odding
o ye contact
o Lean forward
Who, what, when, where
-eneral leads
o -o on, $'m listening,
what elseH
Broad opening + *est .pening
line
o Cow are you todayH
9on't worry *e happy
verything's gonna *e alright
$gnoring the client
&hanging the su*Iect
%ice weather we're having
o !dIectives 4 value
*ased perception,
should not *e use
2ou are the most *eautiful
client
Why
!rguing
Flattery
2ou should do this now
$n my opinion
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
o Cow are youH
#estating
&larrification
#efocusing we are talking
a*out the e,am
Focusing tell me a*out
!FNS "C*#NIS"S Fight for stress
9$SPL!&7%1 1ransfer of feelings to a less
threatening o*Iect rather than the
one who provoke it
Boss shouts at
you, you shout at
your su*ordinate
9%$!L Failure to acknowledge an
unaccepta*le trait or situation
($'m not an
alcoholic)
9$SS.&$!1$.% Psychological flight from self
! type of amnesia
(Sino ka, Sino
akoH)
#-#SS$.% #eturn to an earlier developmental
stage
#eturn to
thum*sucking
#P#SS$.% "nconscious forgetting of an
an,iety provoking concept
Cindi ko maalala
#!1$.%!L$J!1$.% $llogical reasoning for a socially
unaccepta*le trait
(sayang ang *eer sa ref, kaya ko
ininum)
$ drink *ecause $
don't want to
waste the *eer in
the ref
#!&1$.%
F.#7!1$.%
doing the opposite of your
intention
plastic
sasa*unutan
kita: : : ay
kuklulutin lang kita
"%9.$%- 9oing the opposite of what you
have done due to guilt
orocan, plastic, 1upperware
(ay pinatid kita,
halika punta kita
sa clinic)
$9%1$F$&!1$.% !ssume trait for personal, social,
occupational role
1ulad niya
P#.8&1$.% !ttri*uting to others one's
accepta*le trait
Pasa load
(hindi ako
alcoholic, sila yon)
$%1#.8&1$.% !ssume another person's trait as
your own

(ako din)
%ot Iust you, me
too
S"PP#SS$.% &onscious forgetting of an an,iety
provoking concept
Cindi ko alam yan
S"BL$7!1$.% Placing se,ual energies toward a
more productive endeavors
!ngry at life, put
anger in singing
&.%A#S$.% #epressed angers put towards
physical symptoms affecting
Biglang mangingig
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
nervous system leading to sensory
num*ness and motor paralysis
&.7P%S!1$.% .verachievement in one area to
cover a defective part
Pilay pero
magaling kumanta
S"BS1$1"1$.% #eplacing a difficult goal with a
more accessi*le one
-usto ko
9isneyland:
nchanted
nalang:
S1.P -!B! $nhi*itory
-amma !mino Butyric !cid

-. pinephrine@ %orepinephrine
SNS ,itatory
#N+IT) #nticholinergic side e22ect
&onstipation
"rinary #etention Within 5 week
9ry 7outh #e*ound
Blurred Aision phenomenon
Sei0ure
!*rupt
!nti+!n,iety 9ependence
Withdrawal
9rowsy
%o !lcohol
%o &offee
9evelop .rthostatic
Cypotension
Prevetion of .:C:
5: Sit 9own
;: 9angle feet -radually
>: Stand "p -radually 1apered 9ose
R'#+!
#N+IT)
Aague sense of impending doom
"ild "oderate Severe Panic
G5 G; G> GF
Widened acing ont know what uicide
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The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
Perceptual to say@do afety 9on't touch client
Field #% 7eds $#&1$A #espi !lkalosis
#estless Bown Bag
nhanced Learning
&apacity
(2ou Seem #estless (
#ssess ; Level of !n,iety
N1 !1 ; $neffective $ndividual &oping
Powerlessness
$mpaired Skin $ntegrity
Planning< Implementation;
level of an,iety
environmental Stimuli
#ela,ation 1echniDue
Showing pictures of flower, waterfalls
Cearing sounds of chirping *irds
valuation ; ffective individual coping
NR#'I=! #N+IT) !IS$R!R
months e,cessive worrying
7ight *e mild, moderate and severe an,iety
S<S1
#estless
9ifficulty of concentration
Sleep 9isorders
Palpitations
dge of the seat
asy fatiga*ility
P#NIC !IS$R!R
5E 4 >3 7inutes escalation of S%S
#&$R#P*$(I# fear of open space@ pu*lic places
S$CI#' P*$(I# fear of pu*lic
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The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
P$ST TR#%"#TIC STRSS !IS$R!R
1rauma
9isaster
!ccident Flash*acks
War .ICTI"S Survivors
#ape %ightmares
arthDuake
Soldier
? years old !n,iety S$"#T$F$R"
K no pretension
!ssignments@ ($ am sick) K no organic
Comeworks *asis

"#'IN&RIN& K unconscious
%o !ssignments@ pretending to *e sick
Comeworks (&onscious) PS)C*$S$"#TIC
K #eal pains@ illness
2ou 1hink !*sent K #eal symptoms
(1eacher may K F maIor types
get angry) L Cypertension
L 7igraine
scape from 7ama &are L Stress "lcer
1eacher L !sthma
PRI"#R) &#IN !ttention
(Behavior an,iety) SC$N!#R) &#IN
S$"#T$F$R" !IS$R!RS
S$"#T$F$R"
%ervous System $llusion of structural defect
C$N.RSI$N !IS$R!R ($!) !)S"*$RPIC !IS$R!R
La Belle $ndifference
emotional disattachment
from disa*ility
7inor 9iscomfort
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
$nterpreted as maIor illness
*)P$C*$N!RI#SIS
(7aliit na *utas, pinalalaki)
Favorite Past 1imeM 9octor Copping
%ursing FocusM Feelings
PS)C*$S$"#TIC !IS$R!RS
!n,iety
S%S P%S

BP Aasoconstriction Bronchoconstriction

*ypertension &ere*ral !rtery Left -astric !rtery #sthma

"igraine Stress %lcer
$(SSSI. / C$"P%'SI.
(elie2< thought Feelings
9oor .pen !n,iety
Burglar may go inside
$>session an,iety
(thought)
#eturns to house
(!ction)
!n,iety Compulsion
P*$(I#
$rrational fears
tiology
o Bnowledge
o ,perience
$mmediate %ursing $ntervention remove the stimuli
S)ST"#TIC !SNSITI=#TI$N
o -radual e,posure to feared o*Iect
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
PHARMA MOMENTS
#NTIPS)C*$TIC #&NT
SSTTC"*P
Stela0ine + se,y star &lo0aril 4 closed reel
Serentil 4 serena 7ellaril 4 maraming reel
1hora0ine 4 *a*aeng 1ora Caldol 4 hahaha
1rilafon + tri+*and phone Proli,in 4 pero lick scene
#'C$*$'IS"
tiologyM
Intergenerational Transmission
From one generation to another generation
#lcohol

(lackout awake *ut unaware

Confa*ulation inventing stories to self+esteem

!enial ($ am not an alcoholic)
!ependence ($ can't live without it)

na*ling significant other tolerates a*users
!nother term C$ / !PN!NC)
T$'R#NC Su*stance to achieve a previous effect
!T$+IFIC#TI$N
Withdrawal with 79 supervision
&heck #lcohol, "outhwash, li1er
void alcohol
version therapy
lcoholics !nonymous self help group
nta*use !IS%'FIR#" %ever drink alcohol
5; hour interval@ 5; h last alcohol intake
(5 Aitamin 9eficiency or elseM nausea, vomiting and hypotension
9ernic?e:s ncephalopathy motor
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The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
Complications
5orsa?o22:s Psychosis memory
!elirium 1remens ;F 4 N; h after last dose of alcohol
untreated withdrawal syndrome
ormocation *ugs crawling under the skin
amily 1herapy mother, father, *rother
#%TIS"
!utistic Savant autistic with a special talent
#ssess
#ppearance flat affect, consistent movement
(ehavior repetitive, ritualistic
Communication echolalia, incomprehensi*le
N1 !1
$mpaired ver*al communication
$mpaired social interaction
Self mutilation
#isk for inIury
Planning< Implementation
7aslow's hierarchy of needs
&onstancy, promote safety
valuation
,pressive therapy drawing, muscic etc
nhanced communication
$mproved social interaction
Safety
#TTNTI$N !FICIT *)PR#CTI. !IS$R!R
.nset M N y:o: and *elow
9uration M ? months and a*ove
Settings M ; Couse and school
$d 9ominant M 7om or #% will act as superego
!9C9 -lucose Frontal Lo*e impaired Iudgement !9C9 S@S,
#italin Frontal Lo*e 8udgement !9C9 S@S,
(stimulant)
#ssess
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
#ppearance dirty
(ehavior clumsy, impatient, easily distracted, hyperactive
Communication talkative, *lurts out in class
N1 !1
#isk for inIury
$mpaired social interaction
Planning< Implementation
tructure separate room for eating, playing, sleeping and etc
chedule time for everything
et limits
afety
valuation
7inimi0e #isk for $nIury
$mproved social interaction
Safety
#esidual !9C9 grows up not antisocial
7edsM #italin, de,edrin, pemoline, adderal
Best time to giveM once a dayM !F1# 7!LSM prevent lost of appetite
9on't give at *edtime S1$7"L!%1 causes insomnia
-ive ? hours prior *edtime if *id
#TIN& !IS$R!RS
56 mos: 4 > y:o: ? y:o: class valedictorian@ model student

1oilet 1raining social inactive@ no BF

&lean weighing
.*edient
.rgani0ed
1hought Feeling Behavior
$ !m Fat Self steem 9iet, 9iet, 9iet
#nore1ia Nervosa ating !isorders (ulimia
9iet, diet, diet ating Pattern at, eat, vomit
O6EP of e,pected *ody 9eight %ormal weight
> mos: ammenorhea "enstruation $rregular menstruation
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
Baren &arpenter 9ao 7ing /i
9a 7ing Sugat@ suka
Aomiting
9ental caries
Wounded knuckles
7eta*olic alkalosis
7eta*olic acidosis
Aomiting
Fluid Aolume 9eficit !##C21C7$! (fatal complication)
9iarrhea
Interventions
#estore fluid and electrolyte *alance
&olla*orative regarding menu contract
1arget weight gain
!fter mealsM stay >3 mins 4 5 hour
PHARMA MOMENT
'IT*I%"
' evel 3:? 4 5:; mD@L ausea, vomiting, diarrhea
Increase urination Lithium 1o,icity
Tremors, fine hand aG
*ydration > L@day
Increase
5idney %u diarhea
"outh, dry
#NTIP#R5INS$N
#NTIC*$'INR&IC
#(C
!$P#"INR&IC
P'S
#rtane Parlodel
#kineton 'arodopa
(enadryl Symmetyl
Cogentin ldepryl
SC*I=$P*RNI#
go disintegration
$mpaired reality perception
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
-enetic vulnera*ility
Stress 4 9iathesis 7odel
o 1oo much stress in the reality will lead client to escape it and go to
the fantasy world
Biological 1heory
o 9opamine level is Cigh
1he e,act cause is unknown
ffect appropriate, inappropriate, flat, *lunt (incomplete emotion)
m*ivalence torn *etween ; opposing forces
utism
ssociative Looseness
Symptoms
Negative Positive
Cypoactive Cyperactive
Withdrawn Socia*le
!pathy Flight of $deas
1alkative
#ssess ; &ontent of 1hought
N1 !1 ; 9istur*ed thought process
Planning< Implementation;
Present reality
Provide safety
valuation ; $mprove thought process
#ssess ; Callucination@ $llusions
N1 !1 ; 9istur*ed sensory perception
Planning< Implementation;
Present reality
Provide safety
valuation ; $mprove sensory perception
#ssess ; Suspicious
N1 !1 ; #isk for other directive *ehavior
Planning< Implementation;
Present reality
Provide safety
valuation ; liminate@ minimi0e risk for other+directed violence
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
#ssess ; Suicidal
N1 !1 ; #isk for self directive *ehavior
Planning< Implementation;
Present reality
Provide safety
valuation ; liminate@ minimi0e risk for self+directed violence
Flight or 'ooseness
$ am going to the mall: $ am going to the mall:
Where is the lightH 1he mall is *ig:
-o here: Big is the tree:
7ineral Water: 1he tree is tall:
"agical Thin?ing
Believes to have a magical power
$ can turn you into a frog
cholalia $ repeat what you say Parrots
chopra1ia $ repeat what you do
9ord Salad words, no rhyme
Clang #ssociation words with rhyme M 9unk, plank, sunk
Neologism creation of new words Plinking, hustash
Clari2ication done in case of neologism
!elusion;
Persecutory %B$ is out to get me@ someone will harm the client
Religious $ am 8esus &hrist
&randeur $ am the Dueen of the world:
Ideas o2 re2erence %urses are talking a*out me:
Concrete #ssociation pilosopo (what will you wearH) (clothes)
Thought (loc?ing
*alucinations Illusion
Stimulus !*sent Present
Aisual /
!uditory /
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The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
1actile /
$n case of hallucinations doM
*allucinations
#cknowledgment
$ know you the voices are real to you
Reality orientation
But $ don't hear them
!iversion
Lets go to the garden
But if nothing in the preceeding intervention are seen
Assess what the voices are saying
SC*I=$PRNI#

8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
!isorgani@ed
Sad *ut smiles
o $nappropriate affect
%o reaction
o Flat affect
Flight of ideas
o HEBEPHRENIC
-iggling
Positive and %egative
S@S,
Catatonic
!m*ivalence
Wa,y Fle,i*ility
o $niwan na posture,
ganun forever
%o 4 favorite word
%egativism
Paranoid
Suspicious
1endency to *e violent
7istrustScaredWithdraw
n
%rsg: $ntM
9evelop trust
5 to 5
short interaction
freDuent visit
foods in sealed
container
meds wrapped
for violent pt:
9oors open
%ear the door
9on't touch the pt:
ye contact
5 arms length away
call reinforcement
Residual
%o more positive s@s,,
Iust withdrawn
classi2ied
di22erentiated
7i,ed classification
&an't *e classified
5
st
paranoid, then
disorgani0ed then
catatonic, etc etc
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
Normally
!cetylcholine Q .% 9opamine Q .FF
2our always $N Cigh 9opamineQ Schi0ophrenia
With par?ins$N
#ntipsychotics Q makes 9opamine goes down
.% 1trapyramidal Side 22ects
#5#T*ISI#
o #estless, ina*ility to sit
o 7akati siya, ahh kati siya
#5INSI#
o 7uscle rigidity
o !hh kiniss siya
!)ST$NI#
o > features
1.#1$&.LL$S
Wry neck
.&"L.-2#$& &#$S$S
Fi,ed stare
.P$S1C.1"%.S
!rched *ack
T#R!I. !)S5INSI#
o $rreversi*le side effects of
antipsychotics
o Lip smacking
o 1ongue protruding
o &heeks puffing
N%R$'PTIC "#'I&N#NT
S)N!R$"
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<






#nticholinergic
Drugs that will make the
Ac down
o !rtane
o !kineton
o Benadryl
o &ogentin
!opaminergic
Dopamine goes up
o Parlodel
o Larodopa
o Symmetryl
o ldepryl
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
o Cyperthermia among client
taking antipsychotic
o Cyperthermia with muscle
rigidity
$ther Side 22ects
Photosensitivity
o Sunscreen
o Wide *rimmed hat
!granulocytosis
o #eport immediately Sore throat
5
st
sign to appear
PHARMAMOMENTS
#NTI!PRSS#NTS
#NTS##. PP=
#sendin 4 ascending
Norpramin 4 sa*aw ng knorr
Tofranil 4 1ofu
SineDuan 4 nood ng Sine Ruan ang title
#nafranil 4 kina !na Praning
#ventyl 4 kina !ven 1il 7idnight tayo
.ivactil 4 Bye Back till ne,t week
lavil 4 h love mo *a ako
Pro0ac 4 Pero saka na
Pa,il + 1aksil
=oloft 4 mag Solo ka
(IP$'#R !IS$R!R / "ania more common
Female
;3 years old and a*ove
Stressful life
.*ese
1!SB
&aregiver #ole Strain
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
Self !ctuali0ation
Self steem
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
Safety
Safety
Lithium 4 ; 4 F weeks *efore effect
S &ompensation interfere !9Ls, harm others
S &ompensation interfere !9Ls, harm others
T#S5 increases client's self esteem

-ross motor skills via su*limation
scorted walk outdoors
Punching *ag
%o group games compition will increase an,iety
> or more signs confirms disorder
&
F
S
P

!
randiose
light of ideas
leeplessness
ressured speech
,agerated S
,traneous stimuli (easily distracted)
istracti*ility
PRS$N#'IT) !IS$R!RS
SC*I=$I!
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
$mpaired social interaction
#isk for inIury@ other directed violence
ating Sleep Cyperactive Se,
finger food Private room !n,iety
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
$ don't want people
Believes he can stand on his own
%ever had a *est friend
!void groups and social activities no enIoyment
&ares more a*out computers and pets
#.$I!#NT
$ avoid people, $ fear criticism
Cave talent *ut no confidence
#NTIS$CI#'
$ *reak the law as motto
!s a child,M steal, lie, always get reprimanded
!dult 4 grand ro**ery, illegal activitist against the law, drug addiction,
drives fast, unsafe se,, thrill seeker
-ood talker, charmer, witty manipulator
($R!R'IN 4 my life is an emptyglass
!ependent
$ can't live without you
self esteem
poor decision making skills
*istrionic
e,cited, dramatic *ut manipulative
center of attention
Narcissistic
$ love myself
$nsensitive, arrogant
$ am the *est
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
$>sessive / Compulsive
$ am organi0ed
Perfectionist
Provide time to do rituals
Paranoid
Suspicious
Passive #ggressive
!lways say yes *ut resistance is hidden
Serotonin
7!. kills Serotonin
7!. Serotonin
7!. Serotonin
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
T)R#"IN RIC* F$$!S
vocado
ged &heese
eer
hocolate
ermented Foods
ickles
reserved Foods
oy Sauce
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
SSRI TC# "#$I
!ntidepressant

!nticholinergic Side ffects

(Syphathetic)

7ale rectile 9ysfunction

Serotonin !%1$9P#SS!%1S
5
st
Line of 9rug Prescri*ed wo 4 F weeks
wo neurotransmitter
afest RI $N$
'CTI.
ide effects low C)C'IC "IN
R$T$NIN
%PT#5 NTI!PRSS#NT +I!#S
Cigher incidence of Side effects
to F weeks Serotonin@ pi affected
N*I(IT$R N*I(IT$R

PP= #NTS#. "NP

!ll neurotransmitter affected
Cighest Side effects
!void tyramine rich food
may lead to
C2P#1%S$A &#$SS
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
!ntidepressant no effect &1
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
'CR$C$N.%'SI. T*R#P)
Pre
o $nformed consent
o %P. ? 4 6 hours prior
7eds
o #tropine dry mouth
o (ar*ituate Sedative
o Succinylcholine muscle rela,ant, prevent sei0ure
Post
o Side+lying 4 lateral
o S@
headache, di00iness,
17P.#!#2 77.#2 L.SS distinct sign
N3 4 553 volts
;3 4 >3 seconds
S hour asleep post
PHARMAMOMENTS
S%(ST#NC #(%S
!owners A#($N" INB
#lcohol 7orph
(ar*ituates &ode %!#&!% antidote
$piates Cero
Narcotics
"ariIuana
%ppers AC*#B
Cocaine
*allucinogen
#mphetamines
$.R!$S
!lcohol &ocaine
C#
##
BP
&oma L.& Sei0ure
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
Bradycardia
Bradypnea
Pupil constriction
7oist mouth
&onstipation
Cypotension
&oma
!sleep
Weight gain
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
Psych well *eing
%!#&!% %arcotic !ntagonist narcotic overdose
91./$F$&!1$.% withdrawal with 79 Supervision
71C!9.%
Withdrawal reverse of effect or opposite of overdose
!PRSSI$N Serotonin, if unresponsive to drugs, &1
The &rie2 Process
!enial noT this can't *e true
#nger why me, why me, why now
(argaining if something happens, then $'ll give something *ack
!epression $'m down ; weeks or more s@s, maIor depression
#cceptance client acts according to situation
& 1!SB
Stay

Sensitivity to client needs
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
1achycardia
1achypnea
Pupil 9ilation
9ry mouth
Cypertension
Sei0ure
!wake
Weight Loss
"PC.#$!
Self !ctuali0ation
Self steem
withdrawn
#isk for self directed violence
ating Sleep Cypoactive Se,
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
S%ICI!
Aer*al %on Aer*al
$ wont *e a pro*lem anymore
1his is my last day on earth
$'ll soon *e gone
1ake this ring, its yours (giving of
valua*le)
Sudden change in mood
Who will commit SuicideH
Se, 4 7ale (more successful)@ female (hesitant)
#ge 4 5E 4;F y@o or a*ove FE
!epression
Patient with previous attempt
1.C 4 ethanol + alcoholics
Rirrational
Social support lacking
$rgani0ed plan greater risk
No family
Sickness, terminal
S%ICI! TRI#!
Loss of spouse
Loss of Io*
!loneness
$s Patient is S%ICI!#'U nurse shouldM 9$
!irect Duestion 4 (!re you going to commit suicideH)
Irregular interval of visit to pt: room
arly !7 and period of endorsement 4 the time pt's commit suicide
(est approach 2or suicidal pt. ; 9irect approach
Nursing "anagement; &lose surveillance
*ospital area ma8ority sucide will happens at;
weekends 5+ > am Sunday
Weekend less staff personnel
arly !7 every one is asleep
-ive simple task: 9on't give comple, may cause depression e,: 8igsaw
Water plants
Wash the dishes e,cept sharps
C*I'! #(%S !think B"
Burns, *ruise, *one fractures, B"%-$T
9on't *athe the child, don't *rush teet: Body of evidence will *e lost
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
Bantay Bata 5?>
'.'S $F "NT#' RT#R!#TI$N
Profound
o O ;3
o thinks like an infants
o can't *e trained
o stay with the patient
Severe
o ;3 4 >E
7oderate
o >E 4 E3
o can *e train
o mental age is ; 4 N y@o
o pre+operational stage
7ild
o E3 4 N3
o meantal age is N 4 5;
o educa*le
o can go to school
Borderline
o N3 + <3
%ormal
o <3 4 533
C$*N PI#&T:S C$&NITI. T*$R)
3 4 ; Sensorimotor Ba*y can sense, see, perceive and hear: .*Iect
permanence
; 4 F Preconceptual Language
F 4 N $ntuitive "nidimentional classification characteristic: &hild can
fi, toys according to si0e, color, height Q one at a time
N 4 5; &onservation
&oncrete
!ssociation
7ultidimensional
5; Formal
.peration
-ood a*stract thinking: &an interpret words
#'=*I"R
N$"I# don't know name of o*Iects
&N$SI# pro*lem with senses
P*#SI# can't say it
PR#+I# can't do it
&ocaine %asal Septum perforation
7ariIuana impaired Lung Structure
eroine withdrawal
ika*
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
ero 4 ; y@o
ensorimotor
evere
7odera e
hirtyfive 4 E3
raina*le
wo 4 N y@o
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
atsing
u hu hu
CRITICAL REVIEW
TST T#5IN& TC*NID%S
5: !ssess the answer, use circle
;: $nitial priority 1#"S1
!B& !SSSS
>: -ood Word@ Bad Word
F: S 1echniDue
eek support
it
tay
upervised
ee Q o*served
eem Q notice
assi t
feeling
E: ; same answer@ ; same mistake
?: Words to watch out for
$nappropriate
7ost
%ot included
,cept
!ll *ut one
N: "m*rella
R'#TI$NS*IP

Preorientation .rientation Working 1ermination
Self awareness 1rust 9iscussion valuation
Setting &ontract
#esistance
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
!ir food, water
air
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
PR#CTIC $F N%RSIN&
Level of Prevention
5 ; >
Cealthy $ll #elapse
&ommunity 9emog: &risis $ntervention !!
S'F *'P &R$%PS
niDue
niversality
r not alone
RST#T e,act words
RF'CT use other words
!PRSSI$N
ndogenous #eactive
$nternal e,ternal
&hemical
Bar*ituate withdrawal L$B#$"7 (&hloridia0epo,ide)
1.F#!%$L !ntidepressant@ !nticholinergic pupil dilation midriasis
&atharsis Feelings
Free !ssociation $deas
#TTIT%! T*R#PIS
!ctive friendliness ask permission
assive Friendliness
aranoid
anipulative
nic
atter of Fact
%o 9emand 9epressed
Bind Firmness !nore,ic
&risis F 4 ? weeks
-oal #eturn the client to the pre+crisis level of functioning
PS&
Perception what do you think a*out itH
&oping what will you do a*out itH
Support who will *e there for youH
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<
The Royal Pentagon Review Specialist, Inc. Psychiatric Nursing
Bulit kulit kulit kulit Perseveration stick to 5 topic
"lit "lit "lit Aer*igeration
!ISS$CI#TI$N

9issociative !mnesia don't know themselves
Fugue Far
9issociative $dentity 9isorder 7ultiple Personality 9:.:
8omar !nthony 9: 7a,ion, BS%, #% &ollege of %ursing Batch ;33<