Beliefs Feelings Behavior

Therapeutic Communication Techniques

What you see, you say
What you hear, you say restating
Sigmund Freud
Father of Psychoanalysis
Structure of Personality (Id, Ego, Superego)
Dominant ID
Mania
D eat I Antisocial
mpulsive drink Narcissistic
want to urinate
want PLEASURE defecate

PLEASURABLE PRINCIPLE E
Pain Avoidance
Its all I

DOMINANT SUPER EGO

Obsessive - compulsive
UPER EGO Anorexia Nervosa
hould not
mall voice of God
I
CONSCIENCE PRINCIPLE
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
Child Cries

Feed the Infant Ignore the Infant

Successful 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 Bad Mother

Successful Unsuccessful

SE
Too Rigid Training Dirty
Disorganized
Clean Disobedient
Organized Small
Obedient ANTISOCIAL S
(Anal Expulsive) E
BIG OBSESSIVE COMPULSSIVE
SE (Anal Retentive)

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

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 Vistaril - largavista
Libreum - L Equanil Aqua Kneel Attarax Mga bato (rocks)
Ativan - Ate Guy Inderal hindi ralph
Seraks Sera Ulo Busfar sasakay ng bus
Tranxene - Transit

ERIK ERIKSON
PSYCHOSOCIAL THEORY OF DEVELOPMENT

Age + - Affecting Major Factor

0-18 mos. Trust Mistrust Feeding
18 mos. 3 y.o. Autonomy Shame/ doubt Toilet Training
AU nal
TO ilet training
NO favorite word
MY
3 6 y.o. Initiative Guilt Independence
6 12 y.o. Industry Inferiority In da-school
12 20 y.o. Identity Role confusion Peer
20 25 y.o. Intimacy Isolation Love
25 45 y.o. Generativity Stagnation Parenting
45 y.o. and above Ego Integrity Despair 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
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 Parasympathetic
 HR
RR
GI Constipation Diarrhea
GU Urinary retention Urinary Frequency
Neuro Epi/ Nor Acetyl Choline
PHARMA MOMENTS ANTIPARKINSON (CAPABLES)
MONOAMINE OXIDASE INHIBITORS Cogentin
AR Artane
M PLAN Parlodel
N DIL Akineton
P NATE Benadryl
Larodopa
Eldepryl
Symmetryl

THERAPEUTIC COMMUNICATION
Therapeutic Non-Therapeutic
Offer your self Ill stay with you Dont worry be happy
Silence Everythings gonna be alright
Making observations Ignoring the client
o You seem sad Changing the subject
Active listening Nice weather were having
o Nodding o Adjectives value based
o Eye contact perception, should not be use
o Lean forward You are the most beautiful client
Who, what, when, where Why
General leads Arguing
o Go on, Im listening, what else? Flattery
Broad opening - best Opening line You should do this now
o How are you today? In my opinion
o How are you?
Restating
Clarrification
Refocusing we are talking about the
exam
Focusing tell me about

DEFENSE MECHANISMS Fight for stress

DISPLACEMENT Transfer of feelings to a less threatening Boss shouts at you, you

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

STOP GABA Inhibitory

Gamma Amino Butyric Acid

GO Epinephrine/ Norepinephrine
SNS Exitatory

ANXIETY Anticholinergic side effect

Constipation
Urinary Retention Within 1 week
Dry Mouth Rebound
Blurred Vision 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 Gradually
3. Stand Up Gradually Tapered Dose

RELAXED

ANXIETY
Vague sense of impending doom

Mild Moderate Severe Panic

+1 +2 +3 +4
Widened acing ont know what uicide
Perceptual to say/do afety Dont touch client
Field RN Meds IRECTIVE Respi Alkalosis
Restless Bown Bag
Enhanced Learning
Capacity
You Seem Restless

Assess : Level of Anxiety

Nx Dx : Ineffective Individual Coping
Powerlessness
Impaired Skin Integrity
Planning/ Implementation:
level of anxiety
environmental Stimuli
Relaxation Technique
Showing pictures of flower, waterfalls
Hearing sounds of chirping birds
Evaluation : Effective individual coping

ENERALIZED ANXIETY DISORDER

months excessive worrying
Might be mild, moderate and severe 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 Flashbacks
War VICTIMS Survivors
Rape Nightmares
Earthquake
Soldier

6 years old Anxiety SOMATOFORM

> no pretension
Assignments/ I am sick > no organic
Homeworks basis

MALINGERING > unconscious

No Assignments/ pretending to be sick
Homeworks (Conscious) PSYCHOSOMATIC
> Real pains/ illness
You Think Absent > Real symptoms
Teacher may > 4 major types
get angry * Hypertension
* Migraine

Escape from Mama Care * Stress Ulcer

Teacher * Asthma
PRIMARY GAIN Attention
(Behavior anxiety) SECONDARY GAIN

SOMATOFORM DISORDERS

SOMATOFORM

Nervous System Illusion of structural defect

CONVERSION DISORDER BODY DYSMHORPIC DISORDER
La Belle Indifference
emotional disattachment
from disability

Minor Discomfort
Interpreted as major illness
HYPOCHONDRIASIS
Maliit na butas, pinalalaki

Favorite Past Time: Doctor Hopping

Nursing Focus: Feelings

PSYCHOSOMATIC DISORDERS

Anxiety
 SNS PNS

BP Vasoconstriction Bronchoconstriction

Hypertension Cerebral Artery Left Gastric Artery Asthma

Migraine Stress Ulcer

OBSESSIVE COMPULSIVE

Belief/ thought Feelings

Door Open Anxiety
Burglar may go inside

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 Clozaril closed reel

Serentil serena Mellaril maraming reel
Thorazine babaeng Tora Haldol hahaha
Trilafon - tri-band phone Prolixin pero lick scene

ALCOHOLISM
Etiology:
Intergenerational Transmission
From one generation to another generation

Alcohol

Blackout awake but unaware

Confabulation inventing stories to self-esteem

Denial I am not an alcoholic
Dependence I 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
Complications
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
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 : 7 y.o. and below
Duration : 6 months and above
Settings : 2 House and school
Id Dominant : Mom or RN will act as superego

ADHD Glucose Frontal Lobe impaired judgement ADHD S/Sx

Ritalin Frontal Lobe Judgement ADHD S/Sx
(stimulant)
Assess
Appearance dirty
Behavior clumsy, impatient, easily distracted, hyperactive
Communication talkative, blurts out in class
Nx Dx
Risk for injury
Impaired social interaction
Planning/ Implementation
tructure separate room for eating, playing, sleeping and etc
chedule time for everything
et limits
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
Anorexia Nervosa Eating Disorders Bulimia
Diet, diet, diet Eating Pattern Eat, eat, vomit
<85% of expected body Weight Normal weight
3 mos. ammenorhea Menstruation Irregular menstruation
Karen Carpenter Dao Ming Xi Da Ming Sugat/ suka
Vomiting; Dental caries; Wounded knuckles;
 Metabolic alkalosis; Metabolic acidosis

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

Toilet Training social inactive/ no BF

Clean weighing
Obedient
Organized

Thought Feeling Behavior

I Am Fat Self Esteem Diet, Diet, Diet

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 ausea, vomiting, diarrhea

Increase urination Lithium Toxicity
Tremors, fine hand a+
Hydration 3 L/day
Increase
Kidney Uu diarhea
Mouth, dry

ANTIPARKINSON
ANTICHOLINERGIC (ABC) DOPAMINERGIC (PLSE)
Artane Parlodel
Akineton Larodopa
Benadryl Symmetyl
Cogentin 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 Positive
Hypoactive Hyperactive
Withdrawn Sociable
Apathy 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. I am going to the mall.

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

Magical Thinking
Believes to have a magical power
I can turn you into a frog Halucinations Illusion
Echolalia I repeat what you say Parrots Stimulus Absent Present
Echopraxia I repeat what you do Visual X
Word Salad words, no rhyme Auditory X
Clang Association words with rhyme : Dunk, plank, sunk Tactile X
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

In case of hallucinations do: (HARD)

Hallucinations
Acknowledgment
I know you the voices are real to you
Reality orientation
But I dont hear them
Diversion
Paranoid
Lets go to the garden
Suspicious
But if nothing in the preceeding intervention are seen Tendency to be violent
Assess what the voices are saying MistrustScaredWithdrawn
SCHIZOPRENIA Nrsg. Int:
Develop trust
1 to 1
short interaction
Disorganized frequent visit
foods in sealed
Sad but smiles Catatonic container
Ambivalence meds wrapped
o Inappropriate affect
Waxy Flexibility for violent pt.
No reaction Doors open
o Flat affect o Iniwan na posture,
Near the door
ganun forever
Flight of ideas Dont touch the pt.
o HEBEPHRENIC No favorite word
Eye contact
Negativism
Giggling 1 arms length away
Positive and Negative call reinforcement
S/Sx
 Normally
Acetylcholine = ON Dopamine = OFF

Your always ON High Dopamine= Schizophrenia

With parkinsON

classified
differentiated

Residual Mixed classification

Cant be classified
No more positive s/sx,
1st paranoid, then ANTIPSYCHOTICS = makes Dopamine goes down
just withdrawn disorganized then
catatonic, etc etc
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 AcH Fixed stare
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 SYNDROME
o Larodopa o Hyperthermia among client taking
o Symmetryl antipsychotic
o Eldepryl 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
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
Impaired social interaction
Safety
Risk for injury/ other directed violence
Eating Sleep Hyperactive Sex
finger food Private room 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 (GF-SPEED)

G randiose
F light of ideas
S leeplessness
P ressured speech
E xagerated SE
E xtraneous stimuli (easily distracted)
D 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
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
afest ONO
ELECTIVE

ide effects low CYCLIC MINE

EROTONIN

EUPTAKE NTIDEPRESSANT XIDASE

Higher incidence of Side effects

Serotonin/ Epi affected
to 4 weeks
NHIBITOR NHIBITOR

PPZ ANTSAVE MNP

All neurotransmitter affected

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

TYRAMINE RICH FOODS

vocado
ged Cheese SSRI TCA MAOI
eer

hocolate
Antidepressant
ermented Foods
Anticholinergic Side Effects
ickles
reserved Foods
(Syphathetic)

oy Sauce
Male Erectile Dysfunction
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) UPPERS (CHA)

Alcohol Morph Cocaine
Barbituates Code NARCAN antidote Hallucinogen
Opiates Hero Amphetamines
Narcotics
Marijuana

OVERDOSE
Alcohol Cocaine
HR
RR
BP
Coma LOC Seizure

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 DETOXIFICATION withdrawal with MD Supervision
Hypertension METHADONE
Seizure
Awake
Weight Loss

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
Self Esteem
Stay
withdrawn
Risk for self directed violence

Eating Sleep Hypoactive Sex

Sensitivity to client needs
SUICIDE
Verbal Non Verbal
 I wont be a problem anymore Take this ring, its yours (giving of valuable)
This is my last day on earth Sudden change in mood
Ill soon be gone

WHO WILL COMMIT SUICIDE? (SAD PERSONS) SUICIDE TRIAD

Sex Male (more successful)/ female (hesitant) *Loss of spouse
Age 15 24 y/o or above 45 *Loss of Job
Depression *Aloneness
Patient with previous attempt
ETOH ethanol - alcoholics
Rirrational
Social support lacking
Organized plan greater risk
No family
Sickness, terminal

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
o stay with the patient ero 2 y/o
Severe ensorimotor
o 20 35 evere
Moderate
o 35 50 Modera e
o can be train hirtyfive 50
o mental age is 2 7 y/o rainable
o pre-operational stage
wo 7 y/o
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
12 Formal Good abstract thinking. Can interpret words
Operation
ALZHEIMER
COCAINE Nasal Septum perforation
NOMIA dont know name of objects MARIJUANA impaired Lung Structure
GNOSIA problem with senses eroine withdrawal
PHASIA cant say it ikab
PRAXIA cant do it atsing
u hu hu

CRITICAL REVIEW
TEST TAKING TECHNIQUES
1. Assess the answer, use circle
2. Initial priority TRUST
3. Good Word/ Bad Word Air food, water
4. S Technique

eek support
it
tay
upervised
ee = observed
eem = notice ABC ASSESS
assi t ABC ASSESSS ASSESS
feeling
air
5. 2 same answer/ 2 same mistake
6. Words to watch out for: (Inappropriate; Most; Not included; Except; All but one)
7. Umbrella

RELATIONSHIP

Preorientation Orientation Working Termination

Self awareness Trust Discussion Evaluation

Setting Contract
Resistance

PRACTICE OF NURSING
Level of Prevention

1 2 3

Healthy Ill Relapse

Community Demog. Crisis Intervention AA

SELF HELP GROUPS RESTATE exact words

Nique REFLECT use other words
niversality
r not alone

DEPRESSION

Endogenous Reactive
Internal external
Chemical
Barbituate withdrawal LIBRIUM (Chloridiazepoxide)
TOFRANIL Antidepressant/ Anticholinergic pupil dilation midriasis
Catharsis Feelings
Free Association Ideas

ATTITUDE THERAPIES assive Friendliness

Active friendliness ask permission aranoid
No Demand Depressed anipulative
Kind Firmness Anorexic anic
atter of fact
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
Ulit Ulit Ulit Verbigeration

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