Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Psychopharmacology and Other Biologic Treatments
Document related concepts
Transcript
Management of Aggression and Violence Chapter 34 Anger • Affective state experienced as the motivation to act in ways that warn, intimidate or attack those who are perceived as challenging or threatening • Targets – Others – Impersonal objects/life situations – Oneself Experience of Anger • Anger is a signal that something is wrong. • It is a normal human emotion. • It is inappropriate expression of anger that may be threatening to the self or others. • Difficulties expressing anger are associated with psychiatric problems. • Behavioral expressions of anger may vary. Aggression vs. Violence • Aggression – Verbal statements that are intended to threaten – Does not occur in a vacuum – Must consider the context • Violence – A physical act of force intended to cause harm to a person or an object – Conveys a message that the perpetrator’s point of view is correct, not the victim’s Models Biological – Cognitive neuroassociation – Neurostructural model - emotional circuit – Neurochemical model - serotonin Models Psychological – Psychoanalytic – Behavioral theories – Drive – Social learning – Cognitive Models Social – Western society’s values competitive, individualistic – Interactional theory - Morrison Nursing Management Psychosocial Assessment Biologic Assessment • Exposure to toxic chemicals • Thought processing • Missed doses of medications • Perception • Intoxication and withdrawal • Sensory impairment • Characteristics • Social factors, such as home, family or community problems – History or evidence of CNS lesion or dysfunction – Sudden onset and unprovoked – Outburst less controlled – Episode with clear beginning and end – Expression of remorse after episode – Financial – Legal Nursing Diagnosis • Risk for self-directed violence • Risk for other-directed violence Planning Interventions • Development of a partnership between nurse and patient, who work together to find solutions to prevent the recurrence of explosive episode • Guidelines for reducing risk: • Using non-threatening body language • Respecting patient’s personal space and boundaries • Positioning for immediate access to door • Leaving door open when talking to patient • Knowing where colleagues are, let colleagues know where you are • Removing clothing or accessories that could be harmful Biologic Interventions Administering and Monitoring Medications • Atypical antipsychotics • SSRIs • Beta-adrenergic receptor blockers • Lithium carbonate • Divalproex sodium and carbamazepine Psychological Interventions Affective Interventions – Validating – Listening to patient’s illness experience – Exploring beliefs Psychological Interventions Cognitive Interventions – Giving commendations – Offering information – Providing education – Contracting Psychological Interventions Behavioral Interventions – Using bibliotherapy – Interrupting patterns – Providing choices Social Interventions • Reducing stimulation • Anticipating needs • Interactional processes Nurses’ Responses to Assault • • Affective – Irritability – Depression – Anger – Anxiety – Apathy Cognitive – • Behavioral – • Suppressed or intrusive thoughts of assault Social withdrawal Physiologic – Disturbed sleep – Headaches – Stomach aches – Tension
