Basic Concepts of Psychiatric-Mental Health Nursing

by Shives, Louise Rebraca

• ISBN13: 9780397554577
• ISBN10: 0397554575
• Format: Paperback
• Copyright: 1997-08-01
• Publisher: Lippincott Williams & Wilkins

Summary

This updated Seventh Edition will equip psychiatric and mental health nurses with the essential clinical knowledge and skills needed to practice with confidence. Spanning the continuum of care, this text will help nurses excel in a range of settings, improve client and family education skills, and build the self-awareness a nurse needs as a member of the interdisciplinary care team. This edition includes a new chapter on forensic nursing, new content on spirituality, updated psychopharmacological information, current DSM-IV-TR diagnostic criteria, and Evidence-Based Practice Boxes throughout the text. A bound-in CD-ROM includes clinical simulations for major depression and schizophrenia, psychotropic drug monographs, over 300 NCLEX& -style questions, and movie viewing guides.

Table of Contents

Unit I Psychiatric-Mental Health Nursing	3	(64)
CHAPTER 1 Mental Health and Mental Illness	3	(18)
Learning Objectives	4	(1)
Introduction	4	(1)
Defining Mental Health	4	(1)
Factors Influencing Mental Health	5	(1)
Defining Mental Illness	5	(1)
Characteristics of Mental Health	6	(1)
Misconceptions About Mental Illness	6	(3)
Maintaining Mental Health	9	(7)
Significant Others or Support People	16	(1)
Summary	17	(1)
Learning Activities	17	(2)
Critical Thinking Questions	19	(1)
Self-Test	19	(1)
Selected References	20	(1)
CHAPTER 2 History and Trends in Psychiatric Nursing	21	(18)
Learning Objectives	22	(1)
Introduction	22	(1)
Early Civilization	23	(1)
Middle Ages	23	(1)
Eighteenth and Nineteenth Centuries	24	(1)
Twentieth Century	25	(1)
Standards of Psychiatric-Mental Health Clinical Nursing Practice	26	(6)
Psychiatric Nursing in the Twentieth Century	32	(2)
Summary	34	(1)
Critical Thinking Questions	35	(1)
Self-Test	36	(1)
Selected References	37	(2)
CHAPTER 3 Community Mental Health	39	(16)
Learning Objectives	40	(1)
Introduction	40	(1)
History of Community Mental Health	41	(1)
Concepts of Community Mental Health	42	(1)
Types of Community Mental Health Services	43	(4)
Role of Community Mental Health Center in Aftercare and Rehabilitation	47	(2)
Managed Care	49	(1)
Problems Related to Community Mental Health Care	49	(1)
Role of the Community Mental Health Nurse	49	(1)
Summary	50	(1)
Learning Activities	51	(1)
Critical Thinking Questions	51	(1)
Self-Test	52	(1)
Selected References	52	(3)
CHAPTER 4 Legal Issues	55	(12)
Learning Objectives	56	(1)
Introduction	56	(1)
Nursing Malpractice	56	(2)
Admission Criteria Based on Competency	58	(1)
Psychiatric Patients in Long-term Care Facilities	59	(1)
Bill of Rights for Mental Health Patients	60	(1)
Legal Rights of Minors	61	(1)
Forensic Psychiatry	61	(1)
Summary	61	(1)
Learning Activities	62	(1)
Critical Thinking Questions	62	(1)
Self-Test	63	(1)
Selected References	63	(4)
Unit II Components of Psychiatric-Mental Health Nursing	67	(154)
CHAPTER 5 The Nursing Process: Assessment of Psychiatric Patients	67	(20)
Learning Objectives	68	(1)
Introduction	68	(1)
Assessment	68	(1)
Transcultural Perspectives	69	(2)
Appearance	71	(1)
Behavior, Attitude, and Normal Coping Patterns	72	(1)
Personality Style and Communication Ability	72	(2)
Emotional State or Affect	74	(1)
Content of Thought	75	(2)
Orientation	77	(1)
Memory	78	(1)
Intellectual Ability	79	(1)
Insight Regarding Illness or Condition	79	(1)
Neurovegetative Changes	79	(1)
Recording of Assessments	79	(1)
Example of Nursing Progress Notes	80	(2)
Summary	82	(1)
Learning Activities	82	(1)
Critical Thinking Questions	83	(1)
Self-Test	84	(1)
Selected References	84	(3)
CHAPTER 6 The Nursing Process: Nursing Diagnosis and Intervention	87	(10)
Learning Objectives	88	(1)
Introduction	88	(1)
Nursing Diagnosis and Outcome Identification	88	(3)
Examples of Nursing Diagnoses	91	(1)
Formulation of Plan of Nursing Care	92	(1)
Implementation of Nursing Actions/Interventions	93	(1)
Evaluation	93	(1)
Summary	94	(1)
Learning Activities	94	(1)
Critical Thinking Questions	95	(1)
Self-Test	96	(1)
Selected References	96	(1)
CHAPTER 7 Therapeutic Interactions	97	(22)
Learning Objectives	98	(1)
Introduction	98	(1)
Communication	99	(1)
Nonverbal Communication	100	(2)
Communication Skills	102	(1)
Ineffective Communication	103	(2)
Interactions	105	(2)
Confidentiality	107	(1)
Therapeutic Relationships: Establishing Roles	107	(1)
The One-to-One Nurse-Patient Relationship	108	(2)
Interpersonal Techniques	110	(2)
Interaction or Process Recording	112	(1)
Example of Process Recording	112	(2)
Summary	114	(1)
Learning Activities	115	(1)
Critical Thinking Questions	116	(1)
Self-Test	116	(1)
Selected References	117	(2)
CHAPTER 8 The Therapeutic Milieu	119	(24)
Learning Objectives	120	(1)
Introduction	120	(1)
Developing the Therapeutic Milieu	120	(2)
Mental Health Team	122	(4)
Conceptual Models or Frameworks of Patient Care	126	(4)
Treatment Modalities in the Therapeutic Milieu	130	(7)
Spiritual Care of the Psychiatric Patient	137	(1)
Protective Care of the Psychiatric Patient	138	(1)
Summary	138	(1)
Learning Activities	139	(1)
Critical Thinking Questions	139	(1)
Self-Test	140	(1)
Selected References	141	(2)
CHAPTER 9 Crisis Intervention	143	(14)
Learning Objectives	144	(1)
Introduction	144	(1)
Characteristics of a Crisis	145	(1)
Phases of a Crisis	145	(2)
Classification of Crises According to Severity	147	(1)
Paradigm of Balancing Factors	148	(2)
Definition and Goals of Crisis Intervention	150	(1)
Steps in Crisis Intervention	150	(3)
Crisis Intervention Modes	153	(1)
Legal Aspects of Crisis Intervention	153	(1)
Summary	154	(1)
Learning Activities	154	(1)
Critical Thinking Questions	155	(1)
Self-Test	155	(1)
Selected References	156	(1)
CHAPTER 10 Group Therapy	157	(12)
Learning Objectives	158	(1)
Introduction	158	(1)
Definition of Group Therapy	158	(1)
Historical Overview	159	(1)
Characteristics of Group Therapy	160	(2)
Types of Therapy Groups	162	(1)
Establishing a Group	163	(1)
Stages of Group Development	163	(1)
Role of the Nurse	164	(2)
Summary	166	(1)
Learning Activities	166	(1)
Critical Thinking Questions	166	(1)
Self-Test	167	(1)
Selected References	167	(2)
CHAPTER 11 Family Therapy	169	(20)
Learning Objectives	170	(1)
Introduction	170	(1)
Duvall's Theory of the Family Life Cycle	170	(3)
Emerging Changes in Families	173	(1)
Healthy Functioning Families	174	(1)
Dysfunctional Families	175	(1)
Culturally Diverse Families	175	(1)
History of Family Therapy	175	(1)
Family Therapy	176	(1)
Different Therapies	177	(2)
Goals of Family Therapy	179	(1)
Stages of Family Therapy	180	(4)
Nurse's Role in Family Therapy	184	(1)
Common Nursing Diagnoses	185	(1)
Summary	186	(1)
Learning Activities	186	(1)
Critical Thinking Questions	187	(1)
Self-Test	187	(1)
Selected References	187	(2)
CHAPTER 12 Psychopharmacology	189	(32)
Learning Objectives	190	(1)
Introduction	190	(1)
Medicating the Psychiatric Patient	191	(1)
Antipsychotic Agents or Neuroleptics	191	(8)
Antianxiety Agents and Hypnotics	199	(4)
Antidepressants or Mood Elevators	203	(7)
Antimanic Agents (Lithium Salts)	210	(2)
Anticonvulsants	212	(2)
Anticholinergic/Antiparkinson Drugs	214	(2)
Summary	216	(1)
Learning Activities	216	(1)
Critical Thinking Questions	216	(1)
Self-Test	217	(1)
Selected References	218	(3)
UNIT III The Patient as a Person	221	(60)
CHAPTER 13 Theories of Personality Development	221	(14)
Learning Objectives	222	(1)
Introduction	222	(1)
Freud's Psychoanalytic Theory	223	(1)
Erikson's Psychosocial Theory	224	(1)
Piaget's Cognitive Developmental Theory	224	(3)
Cultural Considerations in Personality Development	227	(3)
Implications for Nursing Interventions	230	(1)
Summary	230	(1)
Learning Activities	231	(1)
Critical Thinking Questions	231	(1)
Self-Test	232	(1)
Selected References	232	(3)
CHAPTER 14 Emotional Responses to Illness and Hospitalization	235	(24)
Learning Objectives	236	(1)
Introduction	236	(2)
Hospitalization and the Sick Role	238	(1)
Psychological or Emotional Needs	239	(3)
Emotional Responses to Illness	242	(4)
Clinical Examples of Emotional Responses to Illness	246	(2)
Hospitalized Adolescents: Special Needs	248	(1)
Impact of Physical Illness	249	(3)
Nursing Interventions for Emotional Responses of Adults	252	(1)
Humor as a Nursing Intervention	252	(3)
Summary	255	(1)
Learning Activities	256	(1)
Critical Thinking Questions	257	(1)
Self-Test	257	(1)
Selected References	258	(1)
CHAPTER 15 Loss and Grief	259	(22)
Learning Objectives	260	(1)
Introduction	260	(2)
Grief and Bereavement	262	(3)
Pathologic or Dysfunctional Grief	265	(1)
Death and Dying	265	(2)
Needs of the Dying and Survivors	267	(1)
Living Wills	267	(3)
Spiritual Needs of the Person Suffering a Loss	270	(1)
Children and Death	270	(2)
Assessment and Nursing Care of the Dying Patient	272	(3)
Summary	275	(1)
Learning Activities	275	(1)
Critical Thinking Questions	276	(1)
Self-Test	276	(1)
Selected References	277	(4)
UNIT IV Nursing Interventions for Persons with Psychiatric Disorders	281	(164)
CHAPTER 16 Anxiety Disorders	281	(24)
Learning Objectives	282	(1)
Introduction	282	(1)
Types and Severity of Anxiety	283	(1)
Etiology	284	(2)
Research Regarding Anxiety	286	(1)
Clinical Symptoms of Anxiety	286	(2)
Classification of Anxiety Disorders	288	(8)
Treatment of Anxiety Disorders	296	(2)
Nursing Intervention	298	(2)
Summary	300	(2)
Learning Activities	302	(1)
Critical Thinking Questions	302	(1)
Self-Test	303	(1)
Selected References	303	(2)
CHAPTER 17 Anxiety-related Disorders	305	(30)
Learning Objectives	306	(1)
Introduction	306	(1)
Psychological Factors Affecting Medical Condition	306	(7)
Somatoform Disorders	313	(5)
Dissociative Disorders	318	(2)
Personality Disorders	320	(10)
Anxiety Disorder Due to a General Medical Condition	330	(1)
Culture-bound Syndromes	331	(1)
Summary	332	(1)
Learning Activities	332	(1)
Critical Thinking Questions	333	(1)
Self-Test	333	(1)
Selected References	334	(1)
CHAPTER 18 Human Sexuality and Sexual Disorders	335	(14)
Learning Objectives	336	(1)
Introduction	336	(1)
Classifications	337	(5)
Transcultural Considerations	342	(1)
Research Regarding Sexual Orientation	342	(1)
Treatment of Sexual Disorders	342	(1)
Nursing Intervention	343	(2)
Summary	345	(1)
Learning Activities	345	(2)
Critical Thinking Questions	347	(1)
Self-Test	347	(1)
Selected References	348	(1)
CHAPTER 19 Altered Mood: Depression and Mania	349	(24)
Learning Objectives	350	(1)
Introduction	350	(1)
Etiology	351	(2)
Risk Factors for Depression	353	(1)
Diagnostic Categories	353	(2)
Depressive Disorders	355	(1)
Bipolar Disorders	356	(3)
Mood Disorder Due to a General Medical Condition	359	(1)
Transcultural Considerations	360	(1)
Research	360	(1)
Treatment of Depression and Mania	361	(1)
Nursing Interventions	362	(4)
Nursing Diagnoses	366	(1)
Summary	366	(3)
Learning Activities	369	(1)
Critical Thinking Questions	370	(1)
Self-Test	371	(1)
Selected References	371	(2)
CHAPTER 20 Risk for Self-directed Violence: Suicide	373	(20)
Learning Objectives	374	(1)
Introduction	374	(1)
Etiology	375	(2)
Individuals at Risk for Self-destructive Behavior	377	(1)
Transcultural Considerations Regarding Suicide	378	(2)
Misconceptions About Suicide	380	(1)
Assessment	381	(1)
Nursing Intervention	382	(4)
Psychological Autopsy	386	(1)
Postvention	387	(1)
Nursing Diagnoses and Sample Care Plan	387	(2)
Summary	389	(1)
Learning Activities	389	(1)
Critical Thinking Questions	390	(1)
Self-Test	390	(1)
Selected References	391	(2)
CHAPTER 21 Altered Thought Processes: Delusional or Paranoid Behavior	393	(12)
Learning Objectives	394	(1)
Introduction	394	(1)
Etiology	394	(1)
Clinical Features	395	(1)
DSM-IV Criteria	395	(2)
Transcultural Considerations	397	(1)
Treatment	397	(1)
Nursing Diagnoses and Interventions	398	(3)
Summary	401	(1)
Learning Activities	401	(1)
Critical Thinking Questions	402	(1)
Self-Test	402	(1)
Selected References	402	(3)
CHAPTER 22 Altered Thought Processes: Schizophrenia and Other Psychotic Disorders	405	(20)
Learning Objectives	406	(1)
Introduction	406	(1)
Theories of Schizophrenia	406	(3)
Research Findings	409	(1)
Clinical Symptoms	409	(1)
Transcultural Considerations	410	(1)
Clinical Types of Schizophrenia	411	(4)
Schizophrenic-like Disorders	415	(1)
Treatment	416	(1)
Nursing Diagnoses and Interventions	417	(2)
Summary	419	(1)
Learning Activities	420	(2)
Critical Thinking Questions	422	(1)
Self-Test	423	(1)
Selected References	423	(2)
CHAPTER 23 Impaired Cognition: Delirium, Dementia, Amnestic, and Other Cognitive Disorders	425	(20)
Learning Objectives	426	(1)
Introduction	426	(1)
Clinical Types of Cognitive Disorders	427	(7)
Transcultural Considerations	434	(1)
Assessment	435	(1)
Nursing Diagnoses and Interventions	435	(5)
Summary	440	(1)
Learning Activities	440	(1)
Critical Thinking Questions	440	(1)
Self-Test	441	(1)
Selected References	441	(4)
UNIT V Special Populations in Psychiatric-Mental Health Nursing	445	(86)
CHAPTER 24 Disorders of Infancy, Childhood, and Adolescence	445	(30)
Learning Objectives	446	(1)
Introduction	446	(2)
Classification of Clinical Disorders	448	(13)
Transcultural Considerations	461	(1)
Research	461	(1)
Treatment	461	(4)
Assessment	465	(1)
Nursing Interventions	465	(5)
Summary	470	(1)
Learning Activities	471	(1)
Critical Thinking Questions	472	(1)
Self-Test	472	(1)
Selected References	473	(2)
CHAPTER 25 Eating Disorders	475	(16)
Learning Objectives	476	(1)
Introduction	476	(1)
Anorexia Nervosa	476	(2)
Bulimia Nervosa	478	(2)
Obesity	480	(2)
Transcultural Considerations	482	(1)
Medical Evaluation and Treatment of Anorexia and Bulimia	482	(2)
Nursing Assessment and Interventions	484	(3)
Summary	487	(1)
Learning Activities	487	(1)
Critical Thinking Questions	487	(1)
Self-Test	488	(1)
Selected References	488	(3)
CHAPTER 26 Ineffective Individual Coping: Alcoholism	491	(22)
Learning Objectives	492	(1)
Introduction	493	(1)
Etiology	493	(3)
Diagnostic Criteria for Alcohol Dependence and Abuse	496	(2)
Effects of Alcohol	498	(3)
Transcultural Considerations	501	(1)
Assessment	501	(3)
Treatment Including Nursing Interventions	504	(5)
Summary	509	(1)
Learning Activities	510	(1)
Critical Thinking Questions	510	(1)
Self-Test	510	(1)
Selected References	511	(2)
CHAPTER 27 Ineffective Individual Coping: Psychoactive Substance Abuse	513	(18)
Learning Objectives	514	(1)
Introduction	514	(1)
Etiology of Drug Abuse or Dependence	515	(1)
Classification of Substance Use Disorders	516	(5)
Medical Treatment of Psychoactive Substance Abuse	521	(2)
Assessment	523	(1)
Nursing Diagnoses and Interventions	524	(2)
Summary	526	(1)
Learning Activities	526	(1)
Critical Thinking Questions	527	(1)
Self-Test	527	(1)
Selected References	528	(3)
UNIT VI Relational Problems	531	(44)
CHAPTER 28 Child Abuse and Neglect	531	(16)
Learning Objectives	532	(1)
Introduction	532	(1)
Defining Child Abuse and Neglect	533	(1)
Causes of Abuse and Neglect: Risk Factors	533	(1)
Other Characteristics of Potentially Abusive or Neglectful Parents	534	(1)
Transcultural Considerations	534	(1)
Areas of Child Abuse or Neglect	535	(5)
Multidisciplinary Treatment	540	(1)
Nursing Care of Abused Children	541	(1)
Assessment	542	(1)
Nursing Diagnosis	542	(1)
Intervention	543	(1)
Prevention of Child Abuse and Neglect	543	(1)
Summary	544	(1)
Learning Activities	544	(1)
Critical Thinking Questions	544	(1)
Self-Test	545	(1)
Selected References	546	(1)
CHAPTER 29 The Abused Adult Within the Family Unit	547	(14)
Learning Objectives	548	(1)
Introduction	548	(1)
Theories Regarding Abusive Behavior	549	(1)
Abuse by Spouse or Significant Other	550	(1)
Dynamics of Physical Spouse Abuse	551	(1)
Abuse of the Elderly	552	(1)
Assessment of Abused or Assaulted Persons	552	(2)
Nursing Interventions	554	(2)
Summary	556	(3)
Learning Activities	559	(1)
Critical Thinking Questions	559	(1)
Self-Test	559	(1)
Selected References	560	(1)
CHAPTER 30 Rape and Sexual Assault	561	(14)
Learning Objectives	562	(1)
Introduction	562	(1)
Motives for Rape or Sexual Assault	563	(1)
Emotional Reactions to Rape and Sexual Assault	564	(1)
Assessment of Victims of Rape or Sexual Assault	564	(2)
Nursing Intervention	566	(2)
Summary	568	(2)
Learning Activities	570	(1)
Critical Thinking Questions	570	(1)
Self-Test	570	(1)
Selected References	571	(4)
UNIT VII Populations with Special Needs	575	(42)
CHAPTER 31 Coping with Acquired Immunodeficiency Syndrome (AIDS)	575	(12)
Learning Objectives	576	(1)
Overview of AIDS	576	(1)
Psychological Effects of AIDS	577	(2)
Transcultural Considerations	579	(2)
Treatment	581	(1)
Nursing Intervention	582	(1)
Summary	583	(2)
Learning Activities	585	(1)
Critical Thinking Questions	585	(1)
Self-Test	585	(1)
Selected References	586	(1)
CHAPTER 32 Psychosocial Aspects of Aging	587	(22)
Learning Objectives	588	(1)
Introduction	588	(1)
Theories About Aging	589	(1)
Factors Influencing the Aging Process	590	(1)
Myths About Aging	591	(1)
Developmental Tasks of Aging	591	(5)
Emotional Reactions or Behaviors	596	(4)
Transcultural Considerations	600	(1)
Assessment and Nursing Diagnosis	601	(1)
Nursing Interventions	602	(3)
Summary	605	(1)
Learning Activities	606	(1)
Critical Thinking Questions	606	(1)
Self-Test	607	(1)
Selected References	607	(2)
CHAPTER 33 Psychiatric Patients with Medical Problems/Syndromes	609	(8)
Learning Objectives	610	(1)
Admission Criteria	610	(1)
Neuroleptic Malignant Syndrome	611	(1)
Staff Development	612	(1)
Role of the Multidisciplinary Treatment Team	612	(1)
Summary	613	(1)
Learning Activities	613	(1)
Critical Thinking Questions	614	(1)
Self-Test	614	(1)
Selected References	614	(3)
APPENDIX A Nursing Assessment of the Adult/Adolescent	617	(8)
APPENDIX B DSM-IV Classification--Axis I and II Categories and Codes	625	(20)
APPENDIX C North American Nursing Diagnosis Association (NANDA) List of Approved Nursing Diagnoses	645	(4)
Glossary	649	(12)
Index	661