Contemporary Psychiatric-Mental Health Nursing

by Kneisl, Carol Ren; Wilson, Holly Skodol; Trigoboff, Eileen

• ISBN13: 9780130415820
• ISBN10: 0130415820
• Edition: CD
• Format: Hardcover
• Copyright: 2004-01-01
• Publisher: Pearson

Summary

First published under the title Psychiatric Nursing, this book provides users with the most up-to-date, evidence-based, culturally competent, authoritative, comprehensive resource available; and presents the information in an accessible, clinically-relevant, and professional format. Comprehensive and easily accessible, this book covers all topics in the psychiatric-mental health nursing profession, including evidence-based practice, applying processes to practice, clients with mental disorders, vulnerable populations, and nursing intervention strategies and outcomes. For psychiatric-mental health nurses and practictioners.

Table of Contents

Preface	xix
Acknowledgments	xxiii
Reviewers	xxiv
About the Authors	xxvii
UNIT I. Theoretical Basis for Psychiatric--Mental Health Nursing	3	(126)
The Psychiatric--Mental Health Nurse's Personal Integration and Professional Role	4	(19)
Personal Integration	6	(5)
Creating a Common Ground	7	(1)
Feelings: The Affective Self	7	(1)
Self-Awareness of Feelings	7	(1)
Problems with Submerged Feelings	7	(1)
Dominant Emotional Themes	7	(2)
Acceptance of Disapproved Feelings	9	(1)
Beliefs and Values	10	(1)
Attitudes and Opinions	10	(1)
Arriving at Values	10	(1)
Taking Care of the Self	11	(2)
Assertiveness	11	(1)
Solitude	12	(1)
Personal Physical Health	12	(1)
Attending to Internal Stress Signals	12	(1)
Burnout	12	(1)
Cues to Burnout	13	(1)
Reducing Burnout	13	(1)
Qualities of Effective Psychiatric--Mental Health Nursing	13	(2)
Respect for the Client	14	(1)
Availability	14	(1)
Spontaneity	14	(1)
Hope	14	(1)
Acceptance	14	(1)
Sensitivity	14	(1)
Vision	14	(1)
Accountability	14	(1)
Advocacy	15	(1)
Spirituality	15	(1)
Empathy	15	(1)
Critical Thinking	15	(1)
Professional Role	15	(5)
Basic Level of Practice	16	(3)
Advanced Level of Practice	19	(1)
The Mental Health Team	20	(1)
Collaborating on the Mental Health Team	21	(2)
Cooperation Versus Competition	21	(1)
Engaging the Client in Collaboration	22	(1)
Philosophy and Theories for Interdisciplinary Psychiatric Care	23	(19)
Humanistic Interactionism and Psychobiology: The Mind--Body--Spirit Connection	25	(5)
Scope of Psychiatric--Mental Health Nursing Practice	25	(1)
Defining the Concept of Mental Disorder	26	(1)
Basic Premises of Interactionism	26	(1)
Implications for Psychiatric--Mental Health Nursing Practice	26	(1)
Basic Premises of Humanism	27	(1)
Implications for Psychiatric--Mental Health Nursing Practice	27	(3)
Basic Premises of Psychobiology	30	(1)
Implications for Psychiatric--Mental Health Nursing Practice	30	(1)
Theories for Interdisciplinary Psychiatric Care	30	(7)
Medical--Psychobiologic Theory	30	(1)
Assumptions and Key Ideas	30	(1)
Implications for Psychiatric--Mental Health Nursing Practice	31	(1)
Psychoanalytic Theory	31	(1)
Assumptions and Key Ideas	31	(1)
Implications for Psychiatric--Mental Health Nursing Practice	32	(1)
Behaviorist Theory	32	(1)
Assumptions and Key Ideas	32	(2)
Implications for Psychiatric--Mental Health Nursing Practice	34	(1)
Social--Interpersonal Theories	34	(1)
Assumptions and Key Ideas	35	(1)
Implications for Psychiatric--Mental Health Nursing Practice	36	(1)
Nursing's Theoretic Heritage	37	(2)
Peplau	37	(1)
Orem	38	(1)
Rogers	38	(1)
Roy	38	(1)
Orlando	38	(1)
Wiedenbach	38	(1)
Travelbee	38	(1)
Nursing Theory's Contemporary Directions	39	(3)
Paterson and Zderad	39	(1)
Watson	39	(1)
Benner	39	(1)
Implications for Psychiatric--Mental Health Nursing Practice	39	(3)
Evidence-Based Practice in Psychiatric--Mental Health Nursing	42	(15)
Contemporary Conditions Mandating Evidence-Based Practice	44	(1)
What Is Evidence-Based Practice?	45	(4)
Best Practices Based on Evidence	45	(1)
Critical Thinking and Evidence-Based Practice	45	(1)
Practice Guidelines, Clinical Pathways, and Clinical Algorithms	45	(1)
The Art of Nursing Embedded in the Science	46	(1)
The Sarah Cole Hirsh Institute for Best Practices Based on Evidence	46	(2)
Change to Evidence-Based Practice	48	(1)
Context for Evidence-Based Practice: The 4 A's	48	(1)
The Rosswurm and Larrabee Model for Change	49	(3)
Step 1. Assessing the Need for Change	49	(1)
Step 2. Linking the Problem with Interventions and Outcomes	50	(1)
Step 3. Synthesizing the Best Evidence	50	(1)
Step 4. Designing the Change in Practice	50	(1)
Step 5. Implementing and Evaluating the Change in Practice	50	(1)
Step 6. Integrating and Maintaining the Change in Practice	51	(1)
Building A Knowledge Base for Evidence-Based Psychiatric Nursing Practice	52	(3)
Discovering the Evidence	52	(1)
Synthesizing Research Data to Understand Sleep	52	(1)
A Clinical Trial of Wellness Training for Severely Mentally Ill Adults	52	(1)
Summarizing the Evidence	52	(1)
Evaluating the Evidence	53	(1)
Using the Evidence in Practice	53	(1)
The Wisconsin Aurora-Metro Health Care Project	53	(2)
Agenda for the Future	55	(2)
Psychobiology	57	(23)
Brain, Mind, and Behavior	59	(15)
Neuroanatomy	59	(1)
Cerebrum	59	(2)
Limbic System	61	(2)
Diencephalon	63	(1)
Pituitary Gland	63	(1)
Basal Ganglia	63	(1)
Cerebellum	63	(1)
Brain Stem	63	(2)
Genetics	65	(1)
Gene Structure	65	(1)
Gene Function	65	(1)
Genetic Research	66	(1)
Ethics in Genetic Research	67	(1)
The Genetic Basis of Psychiatric Illness	67	(1)
Neurons, Synapses, and Neurotransmission	68	(1)
Synaptic Transmission	69	(1)
Neurotransmitters	69	(2)
Psychoendocrinology and Psychoneuroimmunology	71	(1)
Endocrine System	72	(1)
Immune System	73	(1)
Kindling and Behavioral Sensitization	73	(1)
Circadian Rhythms	73	(1)
Psychobiology and Mental Disorders	74	(3)
Schizophrenia	74	(1)
Mood Disorders	75	(1)
Anxiety Disorders	76	(1)
Dementia of the Alzheimer's Type	77	(1)
Psychobiology and Nursing	77	(3)
Stress, Anxiety, and Coping	80	(28)
Stress	82	(1)
Conflict as a Stressor	82	(1)
Conflict with Approach--Avoidance Movements	83	(1)
Principles that Explain Vacillation	83	(1)
Avoidance--Avoidance Conflict	83	(1)
Biopsychosocial Theories of Stress	83	(4)
The Fight-or-Flight Response to Stress	83	(1)
Selye's Stress-Adaptation Theory	84	(1)
Life Changes as Stressful Events	84	(2)
Application to Clinical Practice	86	(1)
Stress as a Transaction	86	(1)
Psychoneuroimmunology Framework	87	(1)
Self-Healing Personalities	87	(1)
Hardiness and Health	87	(1)
Disease-Prone Personalities	87	(1)
Anxiety	87	(2)
Neurobiologic Basis of Anxiety	87	(1)
Sources of Anxiety	87	(1)
Anxiety as a Continuum	88	(1)
Mild Anxiety	88	(1)
Moderate Anxiety	88	(1)
Severe Anxiety	88	(1)
Panic	89	(1)
Assessing Anxiety	89	(1)
Physiologic Dimension	89	(1)
Cognitive Dimension	89	(1)
Emotional/Behavioral Dimension	89	(1)
Coping With Stress and Anxiety	89	(11)
Everyday Ways of Coping with Stress	89	(1)
Turning to a Comforting Person	90	(1)
Relying on Self-Discipline	91	(1)
Intense Expression of Feeling	91	(1)
Avoidance and Withdrawal	91	(1)
Talking It Out	91	(1)
Privately Thinking It Through	91	(1)
Working It Off	91	(1)
Engaging in Self-Healing Mind/Body Practices	91	(1)
Prayerfulness	92	(1)
Using Symbolic Substitutes	92	(1)
Somatizing	92	(1)
Coping Resources	92	(1)
Generalized Resistance	92	(1)
Defense-Oriented Ways of Coping: Defense Mechanisms	93	(1)
Repression	93	(1)
Suppression	94	(1)
Dissociation	95	(1)
Identification	96	(1)
Introjection	96	(1)
Projection	97	(1)
Denial	97	(1)
Fantasy	98	(1)
Rationalization	98	(1)
Reaction Formation	98	(1)
Displacement	99	(1)
Intellectualization	99	(1)
Psychological Factors Affecting Medical Conditions	100	(8)
Holistic Theory of Illness	101	(1)
Selected Conditions Affected by Psychological Factors	102	(1)
Gastrointestinal Disorders	102	(1)
Cardiovascular Disorders	103	(1)
Asthma	103	(1)
Arthritis	104	(1)
Headache	104	(1)
Endocrine Disorders	104	(1)
Skin Disorders	105	(1)
Resistance to Psychosocial Intervention	106	(2)
Cultural Competence and Psychiatric Epidemiology	108	(21)
Developing an Understanding of Cultural Competence	110	(4)
Cultural Competence	110	(1)
Worldview	111	(1)
Ethnicity and Ethnocentrism	111	(1)
Cultural Sensitivity	111	(1)
Global Burden of Disease	111	(1)
Cultural Values	112	(1)
Cross-Cultural Communication	112	(1)
Language and Dialect	112	(1)
Degree of Literacy	113	(1)
Other Cultural Phenomena Affecting Health	113	(1)
Environmental Control	113	(1)
Biologic Variations	113	(1)
Social Organization	113	(1)
Space	113	(1)
Time Orientation	113	(1)
Cultural Assessment	113	(1)
Degree of Acculturation	113	(1)
Heritage Assessment	113	(1)
Developing Cultural Competence in Nursing Practice	114	(4)
General Strategies for Developing Cultural Competence	115	(1)
Developing Cultural Competence with Specific Cultural Groups	115	(1)
Community-Based Health Care Promotion and Disease Prevention Programs	115	(2)
Advocating Issues of Cultural Diversity in Nursing	117	(1)
Nursing Practice	117	(1)
Nursing Research	117	(1)
Nursing Education	118	(1)
Psychiatric Epidemiology in a Culturally Diverse Society	118	(2)
Definition of Psychiatric Epidemiology	119	(1)
Uses of Psychiatric Epidemiology	119	(1)
Key Epidemiologic Concepts	120	(4)
Prevalence	120	(1)
Incidence	120	(1)
Risk Factors	120	(1)
Gender	120	(1)
Age	120	(1)
Social Class	120	(1)
Ethnicity	120	(1)
Marital Status	121	(1)
Physical Health Status	121	(1)
Positive Family History	121	(1)
Season of Birth	121	(1)
Social Environment	121	(1)
Physical Environment	121	(1)
Lifestyle Habits	121	(1)
The Natural History of Disorder	121	(1)
Levels of Prevention	122	(1)
Primary Prevention	122	(1)
Secondary Prevention	122	(1)
Tertiary Prevention	122	(1)
Epidemiologic/Cultural Studies	123	(1)
Descriptive Studies	123	(1)
Cross-Sectional Studies	124	(1)
Recent Developments Incorporating Cultural Diversity	124	(5)
Using DSM-IV-TR for Cultural Assessment	124	(1)
Key Findings from Recent Major Studies	124	(1)
Mortality	124	(1)
Morbidity and Comorbidity	125	(1)
Implications for Psychiatric--Mental Health Nursing Practice	126	(1)
Implications for Psychiatric--Mental Health Nursing Research	126	(3)
UNIT II. Applying Psychiatric--Mental Health Nursing Processes and Competencies	129	(104)
The Nursing Process with Psychiatric--Mental Health Clients	130	(11)
Standards of Psychiatric--Mental Health Nursing Practice	132	(2)
Standard I: Assessment	132	(1)
Rationale	132	(1)
Measurement Criteria	132	(1)
Subjective Data	133	(1)
Objective Data	133	(1)
The Nursing History	133	(1)
Standard II: Diagnosis	133	(1)
Rationale	133	(1)
Measurement Criteria	134	(1)
Nanda Diagnoses in Psychiatric Nursing	134	(1)
Relationship of Nanda Diagnoses to DSM-IV-TR Diagnoses	134	(5)
Standard III: Outcome Identification	134	(1)
Rationale	134	(2)
Measurement Criteria	136	(1)
Iowa Project Nursing Outcomes Classification	136	(1)
Standard IV: Planning	137	(1)
Rationale	137	(1)
Measurement Criteria	137	(1)
Hints for Negotiating a Plan of Care	137	(1)
Standard V: Implementation	137	(1)
Rationale	137	(1)
Measurement Criteria	138	(1)
Iowa Classification of Nursing Interventions	138	(1)
Measurement Criteria	139	(1)
Standard VI: Evaluation	139	(1)
Rationale	139	(1)
Measurement Criteria	139	(1)
Example of Using NOC Language to Evaluate	139	(1)
Putting Psychiatric--Mental Health Nursing Standards into Practice by Using the Nursing Process	139	(2)
Therapeutic Communication	141	(19)
The Process of Human Communication	143	(4)
Role of Perception	143	(1)
Role of Values	144	(1)
Role of Culture	144	(1)
The Spoken Word	145	(1)
Denotation and Connotation	145	(1)
Private and Shared Meanings	145	(1)
Nonverbal Messages	145	(1)
Body Movement	145	(1)
Voice Quality and Nonlanguage Sounds	146	(1)
Personal and Social Space	146	(1)
Touch	146	(1)
Cultural Artifacts	146	(1)
Verbal and Nonverbal Links	146	(1)
Biopsychosocial Theories and Models of Human Communication	147	(6)
Symbolic Interactionist Model	147	(1)
Neurobiologic Factors	148	(1)
Ruesch's Therapeutic Communication Theory	149	(1)
Basic Concepts	149	(1)
Successful Versus Disturbed Communication	150	(1)
Pragmatics of Human Communication Theory	151	(1)
Communication Levels	151	(1)
Communication Disturbances	151	(1)
Neurolinguistic Programming Theory	152	(1)
Determining the Representational System	152	(1)
Therapeutic Use of NLP	153	(1)
Facilitative Communication	153	(7)
Superficiality Versus Intimacy	153	(1)
Facilitating Intimacy	153	(1)
Responding with Empathy	153	(1)
Responding with Respect	153	(1)
Responding with Genuineness	154	(1)
Responding with Immediacy	154	(1)
Responding with Warmth	154	(1)
Facilitative Communication Skills	154	(1)
Empathizing	154	(1)
Actively Listening	154	(1)
Using Silence	155	(1)
Reflecting	155	(1)
Imparting Information	155	(1)
Clarifying	155	(1)
Paraphrasing	155	(1)
Checking Perceptions	156	(1)
Questioning	156	(1)
Structuring	156	(1)
Pinpointing	156	(1)
Linking	156	(1)
Giving Feedback	156	(1)
Confronting	156	(1)
Summarizing	157	(1)
Processing	157	(1)
Culturally Competent Communication Strategies	157	(1)
Understanding One's Own Sociocultural Heritage	158	(1)
Avoiding Misdiagnosis	158	(1)
Circumventing Potential Cultural Barriers to Communication	158	(2)
Assessment	160	(19)
Psychiatric Examination	162	(4)
Psychiatric History	162	(1)
Data Sources	162	(1)
Mental Status Examination	162	(3)
Mini-Mental State Exam	165	(1)
Nurses' Observation Scale for Inpatient Evaluations	165	(1)
Physiologic Assessment	166	(1)
Biologic History Taking	166	(1)
Observation	166	(1)
Neurologic Assessment	166	(1)
Brain Imaging Techniques	167	(1)
Psychological Testing	167	(3)
Intelligence Tests	167	(1)
Personality Tests	167	(2)
Examples of Objective Personality Tests	169	(1)
Examples of Projective Personality Tests	169	(1)
Cognitive Function Tests	170	(1)
Examples of Cognitive Function Tests	170	(1)
Psychiatric Diagnostic Practice According to the DSM-IV-TR	170	(4)
Basic Principles of the Multiaxial System	171	(1)
Description of the Axes	172	(1)
Psychiatric--Mental Health Nursing and DSM	173	(1)
Psychosocial Assessment	174	(2)
Individual Assessment	174	(2)
The Place of Assessment in Practice	176	(1)
Documentation	176	(1)
Nursing Care Plans	176	(1)
Critical Pathways	176	(1)
Algorithms	176	(1)
Quality Assurance	176	(3)
Clients' Rights, Ethics, and Advocacy	179	(27)
Ethics	181	(5)
Ethical Analysis	181	(1)
Principles of Bioethics	182	(1)
Autonomy	182	(1)
Beneficence	182	(1)
Fidelity	182	(1)
Justice	182	(1)
Nonmaleficence	182	(1)
Veracity	182	(1)
Ethical Guidelines for Psychiatric--Mental Health Nurses	182	(1)
Clinical Judgment and Ethical Reasoning	182	(2)
Ethical Dilemmas in Psychiatric--Mental Health Nursing	184	(1)
Stigma of Psychiatric Diagnoses	184	(1)
Controlling Individual Freedom	184	(2)
Client Privacy and Confidentiality	186	(1)
Legislation, Commitment, and Hospitalization Issues	186	(3)
Admission and Commitment Categories	186	(1)
Voluntary Admission to a Mental Hospital	186	(1)
Involuntary Commitment to a Mental Hospital	187	(1)
Involuntary Outpatient Commitment	188	(1)
Dilemmas Associated with Involuntary Commitment	188	(1)
Discharge or Separation Categories	188	(1)
Discharge	188	(1)
Transfer	189	(1)
Escape	189	(1)
Client Rights	189	(9)
Legislation and Client Rights	189	(1)
Psychiatric Advance Directives	189	(1)
Right to Informed Consent	190	(2)
Right to Treatment	192	(1)
Right to Refuse Treatment	193	(1)
Dilemmas Associated with the Right to Refuse Treatment	193	(1)
Right to Treatment in the Least Restrictive Setting	194	(1)
Treatment Setting	194	(1)
Institutional Policy	194	(1)
Enforcement	194	(1)
Treatment	195	(1)
Client Characteristics	195	(1)
Right to Communicate with Others	195	(1)
Right Not to Be Subjected to Unnecessary Mechanical Restraints	195	(1)
Right to Privacy	195	(1)
Privileged Communication	196	(1)
Disclosure to Safeguard Others	196	(1)
Right to Periodic Review	197	(1)
Right to Independent Psychiatric Examination	197	(1)
Right to Participate in Legal Matters	197	(1)
Contracts	197	(1)
Wills	197	(1)
Marriage and Divorce	197	(1)
Voting	198	(1)
Right to Drive	198	(1)
Right to Practice a Profession	198	(1)
Right to Habeas Corpus	198	(1)
Rights of Children or Minors	198	(1)
Liability and the Psychiatric--Mental Health Nurse	198	(2)
Negligence	198	(1)
Conditions for Establishing Negligence	199	(1)
Malpractice	200	(1)
Need to Document	200	(1)
Client Advocacy	200	(6)
Physical and Psychological Abuse of Clients	201	(1)
Advocacy Strategies	201	(1)
Duty to Intervene	202	(1)
Contract for Care	203	(1)
Assessment	204	(1)
Responsibility to Communicate and Collaborate	204	(1)
Formulating a Plan to Intervene	204	(1)
Illegal, Immoral, or Unethical Activities of Professionals	204	(2)
Creating a Therapeutic Environment	206	(27)
Deinstitutionalization and the Community Mental Health Movement	208	(1)
Types of Treatment Services and Programs	209	(3)
Hospital-Based Treatment	209	(1)
Community-Based Treatment	210	(1)
Community Mental Health Centers	210	(1)
Mobile Outreach Units	210	(1)
Assertive Community Treatment (ACT)	211	(1)
Psychiatric Home Care	211	(1)
Managed Mental Health Care	212	(5)
Managed Care Settings	213	(1)
Inpatient Settings	213	(1)
Primary Care Centers	213	(1)
Employer-Based Clinics	214	(1)
MCOs as a Practice Environment	214	(1)
Boundaries	214	(1)
Legal Issues	214	(1)
Treatment Adherence	214	(2)
Medication Adherence	216	(1)
Unrealistic Member Expectations	216	(1)
Continuity of Care and Treatment Breaks	216	(1)
Ethics in Managed Mental Health Care	216	(1)
Case Management	217	(1)
Case Manager Role	217	(1)
Process of Case Management	217	(1)
Gatekeeping and Facilitating	217	(1)
Client Advocacy	217	(1)
Assessment Phase Challenges	218	(1)
Planning Phase Challenges	218	(1)
Implementation Phase Challenges	218	(1)
Evaluation Phase Challenges	218	(1)
The Therapeutic Environment in Hospital-Based Care	218	(6)
A Unique Role for Nurses	218	(1)
External Factors Affecting Therapeutic Environments	219	(1)
Privacy	219	(1)
Autonomy	219	(1)
Safety	219	(1)
Group Well-Being	220	(1)
Applying Therapeutic Environment Principles	220	(1)
Restrictiveness	220	(1)
Orienting Client and Family	220	(1)
Safety and the Structural Environment	220	(2)
Program Structure	222	(1)
Supportive Social Climate	223	(1)
Spirituality	223	(1)
Client and Family Education	224	(1)
Treatment Settings and Programs for Severe and Persistent Mental Illness	224	(4)
Clinical Diversity	224	(1)
Defining Psychiatric Disability	224	(1)
Community Support Programs for SPMI	225	(1)
Case Management	225	(1)
Support for Basic Needs	225	(1)
Residential Services	225	(1)
Medication Management	225	(1)
Outpatient Treatment	226	(1)
Crisis Stabilization; Emergency and Acute Inpatient Care	226	(1)
General Health Care	226	(1)
Vocational Programs	227	(1)
Day Programs	227	(1)
Family and Network Support	227	(1)
Advocacy	227	(1)
Rehabilitation Approaches	228	(1)
Rehabilitation Philosophy	228	(1)
The Clubhouse Model	228	(1)
Vocational Rehabilitation	228	(1)
Social Skills Training	228	(1)
High-Risk SPMI Clients	228	(5)
Concurrent Substance-Related Disorders	228	(1)
Homeless and Mentally Ill	229	(1)
Frequent Readmissions and Relapse	229	(1)
Frequent Criminal Justice System Involvement	230	(3)
UNIT III. Clients with Mental Disorders	233	(292)
Cognitive Disorders	234	(26)
Delirium	236	(2)
Signs of Delirium	236	(1)
Cognition	236	(1)
Attention and Wakefulness	236	(1)
Psychomotor Behavior	237	(1)
Differentiating Delirium from Dementia	238	(1)
Pseudodelirium	238	(1)
Dementia	238	(6)
Dementia of the Alzheimer's Type	238	(2)
Signs of Dementia of the Alzheimer's Type	240	(1)
Progression of Dementia of the Alzheimer's Type	241	(1)
Dementia with Lewy Bodies	241	(1)
Vascular Dementia	242	(1)
Parkinson's Disease	242	(1)
Huntington's Disease	242	(1)
Pick's Disease	243	(1)
Creutzfeldt--Jakob Disease	243	(1)
New Variant Creutzfeldt--Jakob Disease	244	(1)
Pseudodementia	244	(1)
Amnestic Disorder	244	(1)
Biopsychosocial Theories	244	(1)
Nursing Process: Clients with Cognitive Disorders	245	(13)
Case Management	258	(1)
Community-Based Care	258	(1)
Home Care	258	(2)
Substance-Related Disorders	260	(44)
Substance-Related Disorders	262	(1)
Substance Dependence	262	(1)
Substance Abuse	263	(1)
Substance Intoxication	263	(1)
Substance Withdrawal	264	(1)
Biopsychosocial Theories	264	(2)
Biologic/Genetic Theories	264	(1)
Psychological Theories	265	(1)
Sociocultural Theories	265	(1)
Family Systems Theories	266	(1)
Dysfunctional Family Roles	266	(1)
Alcohol	266	(6)
The Effects of Alcohol	267	(1)
Patterns of Use	267	(1)
Alcohol Withdrawal Syndrome	268	(1)
Hangover	268	(1)
Alcoholic Hallucinosis	268	(1)
Generalized Seizures	268	(1)
Delirium Tremens	268	(1)
Medical Detoxification	268	(3)
Blackouts	271	(1)
Alcohol-Induced Persisting Amnestic Disorder	271	(1)
Fetal Alcohol Syndrome	271	(1)
Suicide and Alcoholism	272	(1)
Barbiturates or Similarly Acting Sedatives or Hypnotics	272	(1)
The Effects of Barbiturates, Sedatives, or Hypnotics	272	(1)
Patterns of Use	272	(1)
Action	272	(1)
Withdrawal	273	(1)
Opioids	273	(2)
The Effects of Opioids	273	(1)
Patterns of Use	274	(1)
Overdose	274	(1)
Withdrawal	274	(1)
Treatment	275	(1)
Amphetamines or Similarly Acting Sympathomimetics	275	(2)
The Effects of Amphetamines	275	(1)
Patterns of Use	275	(1)
Withdrawal	276	(1)
Cannabis	277	(2)
The Effects of Cannabis	277	(1)
Patterns of Use	278	(1)
Cocaine	279	(3)
The Effects of Cocaine	279	(1)
Cocaine Intoxication	279	(1)
The ``Post-Coke'' Blues	279	(1)
Patterns of Use	280	(1)
Treatment	280	(1)
Crack	281	(1)
Symptoms of Crack Use	281	(1)
Freebase	281	(1)
Phencyclidine (PCP)	282	(1)
The Effects of PCP	282	(1)
Treatment	283	(1)
Hallucinogens	283	(2)
The Effects of Hallucinogens	284	(1)
Treatment	284	(1)
Bad Trips	284	(1)
Flashbacks	284	(1)
Inhalants	285	(1)
The Effects of Inhalants	285	(1)
Patterns of Use	285	(1)
Treatment	285	(1)
Nicotine	285	(1)
The Effects of Nicotine	285	(1)
Patterns of Use	285	(1)
Treatment	286	(1)
Caffeine	286	(1)
The Effects of Caffeine	286	(1)
Patterns of Use	287	(1)
Treatment	287	(1)
Polydrug Use	287	(1)
Designer Drugs	287	(1)
Groups at Risk for Substance Abuse	288	(2)
Teenagers	288	(1)
Psychiatric Clients	288	(1)
Women	289	(1)
General Hospital Clients	289	(1)
The Elderly	289	(1)
Adult Children of Alcoholics	289	(1)
Health Care Providers	289	(1)
Nursing Process: Clients with Substance-Related Disorders	290	(10)
Case Management	300	(1)
Community-Based Care	301	(1)
Home Care	302	(2)
Schizophrenia and Other Psychotic Disorders	304	(30)
Symptoms of Schizophrenia	306	(6)
Positive Symptoms	306	(1)
Hallucinations	306	(1)
Delusions	307	(1)
Disordered Speech and Behavior	307	(1)
Negative Symptoms	307	(1)
Somatic Treatments	308	(2)
Relapse	310	(1)
Subtypes of Schizophrenia	311	(1)
Paranoid Type	311	(1)
Disorganized Type	312	(1)
Catatonic Type	312	(1)
Undifferentiated Type	312	(1)
Residual Type	312	(1)
Other Psychotic Disorders	312	(1)
Schizophreniform Disorder	312	(1)
Schizoaffective Disorder	312	(1)
Delusional Disorder	312	(1)
Brief Psychotic Disorder	313	(1)
Additional Psychotic Disorders	313	(1)
Biopsychosocial Theories	313	(4)
Biologic Theories	313	(1)
Genetic Theories	313	(1)
Brain Structure Abnormalities	314	(1)
Biochemical Theories	314	(1)
Psychological Theories	315	(1)
Information Processing	315	(1)
Attention and Arousal	315	(1)
Family Theories	316	(1)
Humanistic--Interactional Theories	316	(1)
Stress--Vulnerability Model	316	(1)
Resources That Moderate Stress	316	(1)
Nursing Process: Clients with Schizophrenia	317	(14)
Case Management	331	(1)
Community-Based Care	331	(1)
Home Care	331	(3)
Mood Disorders	334	(32)
Major Depressive Episode/Disorder	336	(2)
Dysthymic Disorder	338	(1)
Seasonal Affective Disorder	339	(1)
Bipolar Disorders	339	(3)
Manic and Hypomanic Episodes	339	(2)
Depressed Episodes	341	(1)
Mixed Episodes	341	(1)
Cyclothymic Disorder	342	(1)
Mood Disorders Due to Other Conditions	342	(1)
Postpartum Mood Episodes	342	(3)
Biopsychosocial Theories	345	(3)
Psychoanalytic Theory	345	(1)
Cognitive Theory	345	(1)
Object Loss Theory	346	(1)
Biologic Theories	346	(1)
Gender	346	(1)
Genetic Theories	346	(1)
Biochemical Theories	346	(1)
Biologic Rhythms	347	(1)
Psychological Factors	348	(1)
Sociocultural Factors	348	(1)
Nursing Process: Clients with Major Depressive Disorder	348	(7)
Case Management	355	(1)
Community-Based Care	355	(1)
Home Care	356	(1)
Nursing Process: Clients with Bipolar Disorders	356	(8)
Case Management, Community-Based Care, and Home Care	364	(2)
Anxiety, Somatoform, and Dissociative Disorders	366	(34)
Anxiety Disorders	368	(7)
Panic Disorder	369	(2)
Phobic Disorders	371	(1)
Agoraphobia	372	(1)
Social Phobia	372	(1)
Specific Phobia	373	(1)
Generalized Anxiety Disorder	373	(1)
Obsessive-Compulsive Disorder	373	(1)
Children with Obsessive-Compulsive Disorder	374	(1)
Posttraumatic Stress Disorder	374	(1)
Acute Stress Disorder	375	(1)
Biopsychosocial Theories	375	(2)
Biologic Factors	375	(1)
Genetic Theories	376	(1)
Psychosocial Theories	377	(1)
Behavioral Theories	377	(1)
Humanistic Theories	377	(1)
Nursing Process: Clients with Anxiety Disorders	377	(11)
Community-Based Care/Case Management	388	(1)
Home Care	388	(1)
Somatoform Disorders	389	(1)
Factitious Disorder	389	(1)
Somatization Disorder	389	(1)
Conversion Disorder	390	(1)
Pain Disorder	390	(1)
Hypochondriasis	390	(1)
Body Dysmorphic Disorder	390	(1)
Undifferentiated Somatoform Disorder	390	(1)
Biopsychosocial Theories	390	(1)
Biologic Factors	390	(1)
Genetic Theories	390	(1)
Psychosocial Theories	391	(1)
Nursing Process: Clients with Somatoform Disorders	391	(3)
Community-Based Care/Case Management/Home Care	394	(1)
Dissociative Disorders	394	(1)
Dissociative Identity Disorder	394	(1)
Dissociative Fugue	394	(1)
Dissociative Amnesia	394	(1)
Depersonalization Disorder	395	(1)
Dissociative Disorder, Not Otherwise Specified (NOS)	395	(1)
Biopsychosocial Theories	395	(1)
Biologic Factors	395	(1)
Genetic Theories	395	(1)
Psychosocial Theories	395	(1)
Nursing Process: Clients with Dissociative Disorders	395	(3)
Community-Based Care/Case Management/Home Care	398	(2)
Gender Identity and Sexual Disorders	400	(25)
Gender and Transgenderism	402	(2)
Gender Identity	402	(1)
Gender Roles	402	(1)
Androgyny	402	(1)
Transsexuals	403	(1)
Cross-dressers	403	(1)
Paraphilias	404	(2)
Noncoercive Paraphilias	404	(1)
Fetishism	404	(1)
Transvestic Fetishism	405	(1)
Sexual Sadism and Sexual Masochism	405	(1)
Autoerotic Asphyxia	405	(1)
Coercive Paraphilias	405	(1)
Exhibitionism, Voyeurism, and Frotteurism	406	(1)
Obscene Phone Calling	406	(1)
Pedophilia	406	(1)
Sexual Dysfunctions	406	(6)
Sexual Desire Disorders	407	(1)
Hypoactive Sexual Desire Disorder	407	(1)
Sexual Aversion Disorder	407	(1)
Sexual Arousal Disorders	408	(2)
Orgasmic Disorders	410	(1)
Female Orgasmic Disorder	410	(1)
Male Orgasmic Disorder	410	(1)
Premature Ejaculation	411	(1)
Sexual Pain Disorders	411	(1)
Dyspareunia	411	(1)
Vaginismus	412	(1)
Other Sexual Concerns and Problems	412	(2)
Problems with Satisfaction	412	(1)
Increased Sexual Interest	412	(1)
Sexual Addiction	412	(1)
Sexual Dysfunction Among Gay Men and Lesbians	413	(1)
Biopsychosocial Theories	414	(1)
Intrapersonal Theory	414	(1)
Behavioral Theory	414	(1)
Sociocultural Theory	414	(1)
Biologic Theory	415	(1)
Nursing Process: Clients with Gender Identity and Sexual Disorders	415	(8)
Case Management	423	(1)
Community-Based and Home Care	423	(2)
Eating Disorders	425	(26)
Anorexia Nervosa	427	(1)
Bulimia Nervosa	428	(1)
Binge-Eating Disorder	429	(1)
Biopsychosocial Theories	429	(2)
Psychoanalytic Theory	429	(1)
Family Systems Theory	430	(1)
Cognitive/Behavioral Theories	430	(1)
Sociocultural Theory	430	(1)
Biologic Theory	431	(1)
Nursing Process: Clients with Anorexia Nervosa	431	(7)
Case Management	438	(1)
Community-Based Care	438	(1)
Home Care	439	(1)
Nursing Process: Clients with Bulimia Nervosa	439	(4)
Case Management/Community-Based Care/Home Care	443	(1)
Nursing Process: Clients with Binge-Eating Disorder	443	(6)
Case Management/Community-Based Care/Home Care	449	(2)
Sleep Disorders	451	(27)
Normal Sleep	453	(3)
Optimal Sleep	453	(1)
Polysomnography	453	(1)
Sleep Pattern Variations	454	(1)
Healthy Sleep Behaviors	455	(1)
Dyssomnias	456	(7)
Primary Insomnia	457	(1)
Primary Hypersomnia	458	(1)
Breathing-Related Sleep Disorder	459	(1)
Narcolepsy	460	(1)
Diagnostic Sleep Tests	461	(1)
Circadian Rhythm Sleep Disorders	461	(1)
Jet Lag Type	461	(1)
Shift Work Type	461	(1)
Delayed Sleep Phase Type	462	(1)
Advanced Sleep Phase Type	462	(1)
Periodic Limb Movement Disorder	462	(1)
Nocturnal Eating (Drinking) Syndrome	463	(1)
Parasomnias	463	(1)
Sleep Disorder Related to Another Mental Disorder	463	(2)
Psychoses	465	(1)
Mood Disorders	465	(1)
Anxiety Disorders	465	(1)
Panic Disorder	465	(1)
Sleep Disorder Related to a General Medical Condition	465	(1)
Dementia and Other Cerebral Degenerative Conditions	465	(1)
Substance-Induced Sleep Disorder	466	(1)
Biopsychosocial Theories	466	(2)
Physiologic Factors	467	(1)
Psychosocial Factors	467	(1)
Environmental Conditioning	467	(1)
Nursing Process: Clients with Primary Insomnia	468	(3)
Case Management	471	(1)
Community-Based Care	471	(1)
Home Care	471	(1)
Nursing Process: Clients with Primary Hypersomnia	471	(1)
Case Management and Community-Based Care	472	(1)
Home Care	473	(1)
Nursing Process: Clients with Circadian Rhythm Sleep Disorder	473	(1)
Case Management	474	(1)
Community-Based Care	474	(1)
Home Care	475	(1)
Nursing Process: Clients with Parasomnias	475	(1)
Case Management and Community-Based Care	476	(1)
Home Care	477	(1)
Personality Disorders	478	(28)
Personality Disorders	480	(3)
Biopsychosocial Theories	483	(2)
Biologic Factors	483	(1)
Genetic Theories	484	(1)
Psychosocial Theories	484	(1)
Humanistic Theories	485	(1)
Nursing Process: Clients with Personality Disorders	485	(17)
Community-Based Care and Case Management	502	(1)
Home Care	503	(1)
Nurses' Self-Awareness	504	(2)
Coexisting Psychiatric and Substance Use Disorders	506	(19)
Prevalence of Coexisting Psychiatric and Substance Use Disorders	508	(1)
Characteristics of Clients with Coexisting Disorders	508	(2)
Racial and Ethnic Differences	509	(1)
Gender Differences	509	(1)
Problems Resulting from Coexisting Disorders	510	(1)
Biopsychosocial Theories	510	(1)
Mental Illness Leads to Substance Abuse	510	(1)
Self-Medication	510	(1)
Effects of Social Disadvantage Related to Mental Illness	511	(1)
Substance Abuse Leads to Mental Illness	511	(1)
Common Factor Causes Both Disorders	511	(1)
Disorders Develop Independently	511	(1)
Nursing Process: Emergency Settings	511	(4)
Nursing Process: Inpatient Settings	515	(3)
Case Management	518	(1)
Models of Treatment	518	(1)
Sequential Treatment	518	(1)
Parallel Treatment	518	(1)
Problems with Sequential and Parallel Treatment	518	(1)
Integrated Treatment	519	(1)
Community-Based Care	519	(2)
Group Treatment	519	(1)
Substance Abuse Treatment Settings	520	(1)
Home Care	521	(1)
Maintaining a Positive and Hopeful Attitude	522	(3)
UNIT IV. Vulnerable Populations	525	(134)
Clients at Risk for Suicide and Self-Destructive Behavior	526	(17)
Direct and Indirect Self-Destructive Behavior	529	(2)
Maladaptive Measures	529	(1)
Ethics and Suicide	530	(1)
Meaning and Motivation in Suicide	530	(1)
Cognitive Style	530	(1)
Ambivalence	530	(1)
Communication	531	(1)
Intended Effect on Significant Others	531	(1)
Nurses' Self-Awareness	531	(1)
Biopsychosocial Theories	531	(3)
Sociocultural Theories	532	(1)
Biologic Theories	533	(1)
Nursing Process: Suicide and Self-Destructive Behavior	534	(6)
Case Management, Community-Based Care and Home Care	540	(1)
Survivors of Suicide	540	(3)
Child Survivors	541	(1)
Adolescent Survivors	541	(1)
Cluster Suicide	541	(1)
Staff Survivors of Client Suicide	541	(2)
Persons at Risk for Abuse or Violence	543	(28)
Rape	545	(1)
Rape Trauma Syndrome	545	(1)
Biopsychosocial Theories	546	(1)
Intrapersonal Theory	547	(1)
Interpersonal Theory	547	(1)
Social Learning Theory	547	(1)
Feminist Theory	547	(1)
Nursing Process: The Client Who Has Been Raped	547	(4)
Community-Based Care and Home Care	551	(1)
Intrafamily Violence: Physical Abuse	551	(3)
Sibling Abuse	551	(1)
Child Abuse	551	(1)
Shaken Baby Syndrome	552	(1)
Child Neglect	552	(1)
Homicide of Child	552	(1)
Homicide of Parent	552	(1)
Partner Abuse---Heterosexual	552	(1)
Partner Abuse---Homosexual	552	(1)
Elder Abuse	553	(1)
Emotional Abuse	553	(1)
Abuse of Pregnant Women	553	(1)
Stalking	553	(1)
Cycle of Violence	554	(1)
Biopsychosocial Theories	554	(1)
Neurobiologic Theory	555	(1)
Intrapersonal Theory	555	(1)
Social Learning Theory	555	(1)
Feminist Theory	555	(1)
Nursing Process: Intrafamily Physical Abuse	555	(4)
Case Management	559	(1)
Community-Based Care	559	(1)
Home Care	560	(1)
Intrafamily Violence: Sexual Abuse	560	(2)
Types of Offenders	560	(1)
Juvenile Offenders	560	(1)
Male Offenders	560	(1)
Female Offenders	561	(1)
Abusive Behavior Patterns	561	(1)
Child Victims	561	(1)
Adult Survivors	561	(1)
Memory of Sexual Abuse	562	(1)
Biopsychosocial Theories	562	(1)
Intrapersonal Theory	562	(1)
Family Systems Theory	562	(1)
Nursing Process: Intrafamily Sexual Abuse	563	(5)
Case Management	568	(1)
Community-Based Care and Home Care	568	(3)
Psychiatric--Mental Health Clients with HIV/AIDS	571	(18)
The HIV Mental Health Spectrum	573	(2)
The General Worried Population	573	(1)
Health Care Providers	573	(1)
Significant Others and Family Members	573	(1)
Individuals at Risk	573	(1)
HIV Asymptomatic Individuals	574	(1)
Individuals with HIV-Related Conditions	574	(1)
People with AIDS	575	(1)
Long-Term Survivors	575	(1)
HIV Transmission Risks in Psychiatric Populations	575	(1)
Injection Drug Users	575	(1)
The Seriously Mentally III	576	(1)
The Homeless Mentally III	576	(1)
The Biopsychosocial Impact of HIV/AIDS	576	(4)
Neuropsychiatric Manifestations	576	(1)
Psychological	576	(1)
Neurologic/Neurocognitive	577	(1)
Psychoneuroimmunology	578	(1)
Developmental Effects	578	(1)
Sociocultural and Economic Effects	579	(1)
Stigma	579	(1)
Economic Factors	579	(1)
Homelessness	579	(1)
Ethical Concerns	580	(1)
Roles for Psychiatric--Mental Health Nurses	580	(9)
Providing a Therapeutic Milieu	580	(1)
Protecting Privacy	580	(1)
Modifying Agency Policies and Procedures	581	(1)
Implementing Infection Control Precautions	581	(1)
Giving Direct Care	581	(1)
Intervening in Impaired Communication	582	(1)
Intervening in Spiritual Distress	582	(1)
Enhancing Home Maintenance Management	582	(1)
Risk Reduction Education and Counseling	583	(1)
Sexual Behavior	583	(1)
Substance Use	584	(1)
Support for Caregivers	584	(1)
Bereavement Support	585	(1)
Self-Help	586	(1)
Research	587	(1)
Advocacy and Political Activism	587	(2)
Children	589	(26)
Developmental Disorders	591	(2)
Mental Retardation	591	(1)
Specific Developmental Disorders	591	(1)
Learning Disorders	592	(1)
Motor Skills Disorder	592	(1)
Communication Disorders	592	(1)
Pervasive Developmental Disorders	592	(1)
Autistic Disorder	592	(1)
Rett's Disorder	593	(1)
Childhood Disintegrative Disorder	593	(1)
Asperger's Disorder	593	(1)
Attention Deficit and Disruptive Behavior Disorders	593	(2)
Attention Deficit Hyperactivity Disorder	593	(1)
Conduct Disorder	594	(1)
Oppositional Defiant Disorder	595	(1)
Other Important Disorders of Infancy or Childhood	595	(3)
Feeding and Eating Disorders	595	(1)
Pica	595	(1)
Rumination Disorder	595	(1)
Feeding Disorder of Infancy or Early Childhood	595	(1)
Reactive Attachment Disorder of Infancy or Early Childhood	596	(1)
Separation Anxiety Disorder	596	(1)
Elimination Disorders	597	(1)
Encopresis	597	(1)
Enuresis	597	(1)
Selective Mutism	597	(1)
Stereotypic Movement Disorder	597	(1)
Tic Disorders	597	(1)
Tourette's Disorder	597	(1)
Chronic Versus Transient Tic Disorders	598	(1)
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)	598	(1)
Adult Disorders That May Begin in Childhood	598	(1)
Anxiety Disorders	598	(1)
Mood Disorders	598	(1)
Schizophrenia	599	(1)
Biopsychosocial Theories	599	(3)
Psychodynamic Theory	599	(1)
Object-Relations Theory	599	(1)
Attachment Theory	600	(1)
Cognitive-Behavioral Theory	600	(1)
Biologic Theory	601	(1)
Multicausal Model	601	(1)
Nursing Process: Children	602	(10)
Case Management, Community-Based Care, and Home Care	612	(3)
Adolescents	615	(23)
Biopsychosocial Theories	617	(1)
Biologic Theory	617	(1)
Findings of Neuroimaging	617	(1)
Effects of Chronic Illness	617	(1)
Effects of Psychotropic Medications	617	(1)
Developmental Theory	618	(1)
Humanistic Interactionist Theory	618	(1)
The Role of the Nurse	618	(5)
In the Outpatient Setting	618	(1)
As a Community Health Nurse	618	(2)
As a Nurse Counselor/Therapist	620	(1)
In the Inpatient Setting	621	(1)
As a Staff Nurse in a General Hospital Setting	622	(1)
As a Consultant in a General Hospital Setting	622	(1)
As a Staff Nurse or Clinical Specialist in a Psychiatric Setting	622	(1)
As a Milieu Therapist	623	(1)
Nursing Process: Adolescents	623	(13)
Case Management, Community-Based Care, and Home Care	636	(2)
Elders	638	(21)
Roadblocks to Mental Health Services for Elders	640	(2)
Ageism	641	(1)
Myths	641	(1)
Stigma	641	(1)
Health Care Financing	641	(1)
Biopsychosocial Theories of Aging	642	(1)
Biologic Theories	642	(1)
Genetic Theory	642	(1)
Wear-and-Tear Theory	642	(1)
Immunology Theory	642	(1)
Nutritional Theory	642	(1)
Environmental Theory	642	(1)
Psychosocial Theories	642	(1)
Disengagement Theory	642	(1)
Activity Theory	642	(1)
Psychiatric Disorders in the Elderly	643	(3)
Mood Disorders	643	(1)
Depression in the Elderly	643	(1)
Suicide Among Elders	644	(1)
Schizophrenia	644	(1)
Adjustment Disorders	644	(1)
Anxiety Disorders	644	(1)
Delusional Disorders	645	(1)
Substance-Related Disorders	645	(1)
Disorders of Arousal and Sleep	646	(1)
Palliative and End-of-Life Issues with Mentally Ill Elders	646	(1)
Precepts of Palliative Care	646	(1)
Spirituality and End-of Life Care	646	(1)
Nursing Process: Elders	647	(8)
Case Management, Community-Based Care, and Home Care	655	(4)
Restorative Care	655	(1)
Community-Based Programs	655	(1)
Resistance to Care	655	(4)
UNIT V. Nursing Intervention Strategies and Outcomes	659	(176)
Counseling the Individual	660	(23)
The One-to-One Relationship	662	(3)
Therapeutic Alliance	662	(1)
Cultural Context	662	(1)
Characteristics	663	(1)
Professional	663	(1)
Mutually Defined	663	(1)
Collaborative	663	(1)
Goal-Directed	664	(1)
Open	664	(1)
Negotiated	664	(1)
Committed	664	(1)
Responsible	665	(1)
Authentic	665	(1)
Meaningful	665	(1)
Phenomena Occurring in One-to-One Relationships	665	(5)
Resistance	665	(1)
Manifestations	666	(1)
Acting-Out	666	(1)
General Intervention Strategies	666	(1)
Transference	667	(1)
Positive Transference	667	(1)
Negative Transference	667	(1)
Countertransference	667	(1)
Conflict Between Caretaker and Therapist Roles	668	(1)
Critical Distance	668	(1)
Self-Disclosure	668	(1)
Gift Giving	669	(1)
During Orientation Phase	669	(1)
During Working Phase	669	(1)
During Termination Phase	670	(1)
Use of Touch	670	(1)
Values	670	(1)
Nursing Process: Orientation (Beginning) Phase	670	(4)
Nursing Process: Working (Middle) Phase	674	(4)
Nursing Process: Termination (End) Phase	678	(2)
Case Management, Community-Based Care, and Home Care	680	(3)
Group and Family Interventions	683	(24)
Small Group Dynamics	685	(2)
Trust	685	(1)
Cohesion	686	(1)
Group Roles	686	(1)
Power and Influence	686	(1)
Group Development Theory	687	(2)
Three Basic Interpersonal Needs	687	(1)
Inclusion	687	(1)
Control	687	(1)
Affection	687	(1)
Group Phases	687	(1)
Inclusion Phase	688	(1)
Control Phase	688	(1)
Affection Phase	689	(1)
Interweaving of Phases	689	(1)
Group Therapy Theory	689	(6)
Advantages of Group Therapy	689	(1)
Qualifications of Group Therapists	689	(1)
Curative Factors	689	(1)
Types of Group Leadership	689	(1)
Single Therapist Approach	690	(1)
Cotherapy Approach	690	(1)
Creating the Group	691	(1)
Selecting Members	691	(1)
Selection Interviews	692	(1)
Group Contract	692	(1)
Stages in Therapy Group Development	693	(1)
Here-and-Now Emphasis	693	(1)
Steering the Group into the Here-and-Now	694	(1)
Illuminating the Process	694	(1)
Therapeutic Groups	695	(2)
Self-Help Groups	695	(1)
Psychoeducation Groups	696	(1)
Medication Teaching Groups	696	(1)
Social Skills Training Groups	696	(1)
Groups of Medically Ill Clients and Their Families	696	(1)
Activity Therapy Groups	696	(1)
Poetry Therapy Groups	696	(1)
Art Therapy Groups	696	(1)
Music Therapy Groups	696	(1)
Dance Therapy Groups	697	(1)
Bibliotherapy Groups	697	(1)
Storytelling Groups	697	(1)
Community Client Groups	697	(1)
Groups with Nurse Colleagues	697	(1)
Family Dynamics	697	(3)
Family Structures	697	(1)
Family Characteristics and Dynamics	697	(1)
Family Roles	697	(1)
Boundaries	698	(1)
Power Structure	698	(1)
Relationship Strains or Conflicts	698	(1)
Relationship and Communication Intricacies in Families	698	(1)
Self-Fulfilling Prophecy and Life Scripts	698	(1)
Family Myths and Themes	698	(1)
Family Coalitions	699	(1)
Deviations in the Adult Partners' Coalition	699	(1)
Pseudomutuality and Pseudohostility	700	(1)
Family Assessment	700	(3)
Demographic Information	701	(1)
Medical and Mental Health History	701	(1)
Family Interactional Data	701	(1)
Family Burden	701	(1)
Family System Data	701	(1)
Needs, Goals, Values, and Aspirations	702	(1)
Family Genogram	702	(1)
Cultural Family Genogram	702	(1)
Spiritual Family Genogram	703	(1)
Forensic Family Genogram	703	(1)
Family Interventions	703	(4)
Family Psychoeducation	703	(1)
Referral to NAMI	704	(1)
Family Therapy	704	(1)
Forms of Family Therapy	704	(1)
Qualifications of Family Therapists	705	(1)
The Unit of Treatment	705	(1)
Contract or Goal Negotiation	705	(1)
Intervention	705	(1)
Terminating Family Therapy	705	(2)
Cognitive and Behavioral Interventions	707	(17)
Cognitive Therapy	709	(2)
Attributions	709	(1)
Modeling and Self-Efficacy	709	(1)
Cognitive Therapy Techniques	710	(1)
Positive Imagery	710	(1)
Mastery Imagery	710	(1)
Negative Imagery	711	(1)
Attribution Restructuring	711	(1)
Behavior Therapy	711	(3)
Classical Conditioning	711	(1)
Operant Conditioning	711	(1)
Rational Emotive Behavioral Therapy	712	(1)
Behavior Modification	713	(1)
Thought Stopping	714	(1)
Cognitive-Behavioral Therapy	714	(4)
Dialectical Behavioral Therapy	716	(1)
Cultural Aspects of Cognitive-Behavioral Interventions	717	(1)
Nursing Process: Behavioral Contracting	718	(4)
Case Management	722	(1)
Community-Based Care and Home Care	722	(2)
Psychopharmacology	724	(38)
Psychopharmacology and Nursing	726	(6)
The Client's Cultural Perspective	727	(1)
Biologic Impact on Ethnically Distinct Groups	728	(1)
Assessment of the Client Taking Psychiatric Medications	728	(1)
Drug Administration	729	(1)
Client/Family Education	729	(1)
Neuroleptics and Psychotropics	730	(2)
Antipsychotic Medications	732	(11)
Psychobiologic Considerations	732	(1)
Major Effects	732	(1)
The Choice of a Specific Drug	732	(1)
Newer Antipsychotics	733	(1)
Clozapine (Clozaril)	734	(1)
Risperidone (Risperdal)	734	(1)
Dosage	734	(1)
The Decision to Use a Drug	735	(1)
Special Considerations	735	(1)
A Unique Route of Administration	735	(1)
Medication Requirements of Certain Age Groups	735	(1)
Potential Side Effects of Antipsychotic Medications	736	(1)
Autonomic Nervous System Effects	736	(2)
Extrapyramidal Side Effects	738	(1)
Other Central Nervous System Effects	739	(1)
Allergic Effects	739	(2)
Blood, Skin, and Eye Effects	741	(1)
Endocrine Effects	742	(1)
Weight Gain	742	(1)
Neuroleptic Malignant Syndrome	742	(1)
Clinical Implications	742	(1)
Client/Family Education	743	(1)
Antidepressant Medications	743	(8)
Psychobiologic Considerations	743	(3)
Nursing Responsibilities When Clients Receive Uncommon Drug Combinations	746	(1)
Clinical Considerations	746	(1)
Tricyclic Antidepressants (TCAs)	746	(1)
Dosage	746	(1)
Side Effects	746	(1)
Overdose Effects	747	(1)
Monamine Oxidase Inhibitors (MAOIs)	747	(1)
Client/Family Education	747	(1)
Selective Seratonin Reuptake Inhibitors (SSRIs)	747	(1)
Side Effects	747	(1)
New Generation Antidepressants	748	(2)
Other Drugs Used for Depression	750	(1)
Mood Stabilizers	751	(4)
Dosage	752	(2)
Side Effects	754	(1)
Client/Family Education and Nursing Considerations	754	(1)
Psychobiology of Lithium	754	(1)
Anxiolytic Medications	755	(2)
Effects	755	(1)
Drug Classification	755	(1)
Meprobamate	755	(1)
Benzodiazepines and Nonbenzodiazepines	755	(1)
New Drugs	756	(1)
Uses for Anxiolytics	756	(1)
Client/Family Education and Nursing Considerations	757	(1)
Psychobiology of Anxiolytic Medications	757	(1)
Treatment for Insomnia	757	(1)
Client/Family Education and Nursing Considerations	757	(1)
Acetylcholinesterase Inhibitors	758	(1)
Herbal Medicines	759	(3)
Assessing Herb Taking	760	(2)
Complementary and Alternative Healing Practices	762	(20)
Move Toward Cam and Integrative Therapies	764	(1)
National Center for CAM	764	(1)
Consumers of CAM	764	(1)
Nursing Role in CAM	765	(3)
Helping Clients Become Informed Health Consumers	765	(1)
Safety and Effectiveness	765	(2)
Practitioner Expertise	767	(1)
Quality and Costs of Service Delivery	767	(1)
Integrating CAM into a Treatment Plan	767	(1)
Selecting Appropriate Clients	767	(1)
Monitoring Health Problems	768	(1)
Experimenting with What Works	768	(1)
Deep Breathing and Relaxation Exercises	768	(2)
Body Scanning to Assess Body Tension	768	(1)
Enhancing Relaxation with Music	768	(1)
Breathing Exercises	769	(1)
Awareness of Breathing	769	(1)
Deep Breathing	769	(1)
Ten-to-One Count	769	(1)
Alternate Nostril Breathing	769	(1)
Progressive Relaxation	770	(1)
Active Progressive Relaxation	770	(1)
Passive Progressive Relaxation	770	(1)
Visualization and Imagery	770	(1)
Visualization for Relaxation	771	(1)
Visualization for Guidance	771	(1)
Visualization for Symptom Control or Healing	771	(1)
Hypnotherapy and Self-Hypnosis	771	(1)
Meditation	772	(2)
Effects of Meditation	772	(1)
Steps in Meditating	772	(1)
Medical Meditation	773	(1)
Pressure Point Therapies	774	(1)
Acupuncture	774	(1)
Acupressure	774	(1)
Touch Therapies for Healing	774	(4)
Therapeutic Touch	776	(1)
Phases in Therapeutic Touch	776	(2)
Effectiveness of Therapeutic Touch	778	(1)
Herbal Therapy	778	(2)
Biofeedback	780	(1)
Repetitive Transcranial Magnetic Stimulation (RTMS)	780	(1)
Eye Movement Desensitization Reprocessing (EMDR)	780	(2)
Crisis Intervention	782	(20)
Crisis as Disequilibrium	785	(2)
Crisis as a Turning Point	785	(1)
Common Characteristics of Crisis	785	(1)
Risk Factors and Balancing Factors	786	(1)
Biopsychosocial Theories of Crisis	787	(1)
Caplan's Stages of a Crisis Reaction	788	(1)
Tyhurst's Stages of Disaster	788	(1)
Roberts' Model of Crisis Intervention	788	(1)
Types of Crises	788	(1)
Situational Crisis	788	(1)
Maturational Crisis	789	(1)
Nursing Process: Clients in Crisis	789	(9)
Case Management, Community-Based Care, and Home Care	798	(1)
Home Crisis Visits	798	(1)
Mobile Crisis Units	798	(1)
Vicarious Traumatization of Crisis Workers	798	(1)
Nursing Self-Awareness	799	(3)
Intervening in Violence in the Psychiatric Setting	802	(17)
Biopsychosocial Theories	804	(3)
Biologic Factors	804	(1)
Genetic Theories	805	(1)
Psychosocial Theories	806	(1)
Psychoanalytic Theory	806	(1)
Psychological Theory	806	(1)
Sociocultural Theory	806	(1)
Behavioral Theories	806	(1)
Humanistic Theories	806	(1)
Nursing Process: Clients Who Are Violent	807	(9)
Case Management, Community-Based Care, and Home Care	816	(1)
Nursing Self-Awareness	817	(2)
Forensic Psychiatric Nursing	819	(16)
Forensic Nursing as an Emerging Speciality Area	821	(2)
Nursing Role Functions	821	(1)
Understanding Both Victim and Perpetrator	821	(1)
Subspecialities in Forensic Nursing	822	(1)
Physiologic Forensic Nursing	822	(1)
Psychiatric Forensic Nursing	822	(1)
Roles within Psychiatric Forensic Nursing	823	(9)
Forensic Examiner	823	(1)
Differences Between Forensic and Therapeutic Relationships	824	(1)
Professional Qualities of a Forensic Examiner	825	(1)
Determining Legal Sanity	825	(1)
Legal Insanity Defense	826	(1)
Diminished Capacity	827	(1)
Competency Therapist	828	(1)
Competence to Proceed	829	(1)
Expert Witness	829	(1)
Consultant to Attorneys	830	(1)
Consultant to Law Enforcement	830	(1)
Hostage Negotiation	830	(1)
Criminal Profiling	831	(1)
Professionalism in the Role	832	(3)
Professional Credibility	832	(1)
Personal Safety	832	(1)
Victim-Witness Notification	832	(1)
Community Activism	832	(1)
Challenges of Forensic Psychiatric Nursing	833	(2)
Appendix A DSM-IV-TR Classification	835	(14)
Appendix B 2003--2004 NANDA-Approved Nursing Diagnoses	849	(2)
Index	851