Essentials of Psychiatric Mental Health Nursing

by Townsend, Mary C.

• ISBN13: 9780803609204
• ISBN10: 0803609205
• Edition: 2nd
• Format: Paperback
• Copyright: 2002-01-01
• Publisher: F a Davis Co

Summary

Brandon/Hill Nursing List selection (#327). Textbook includes new chapters and features for this edition. Added features include diagnoses from the 2000 text revision of the DSM-IV, new content on anger/aggression management, Internet references for each DSM-IV-TR diagnosis, and the newest psychotropic medications. Previous edition: c1999. Softcover.

Table of Contents

Unit One Introduction to Psychiatric/Mental Health Concepts	1	(70)
Mental Health and Mental Illness	3	(14)
Introduction	4	(1)
Mental Health	4	(1)
Mental Illness	5	(1)
Physical and Psychological Responses to Stress	5	(7)
Physical Responses	5	(2)
Psychological Responses	7	(5)
The DSM-IV-TR Multiaxial Evaluation System	12	(1)
Summary	12	(2)
Review Questions	14	(1)
References	15	(2)
Concepts of Personality Development	17	(16)
Introduction	18	(1)
Psychoanalytic Theory	18	(3)
Structure of the Personality	18	(1)
Topography of the Mind	19	(1)
Dynamics of the Personality	19	(1)
Freud's Stages of Personality Development	19	(2)
Relevance to Nursing Practice	21	(1)
Interpersonal Theory	21	(1)
Sullivan's Stages of Personality Development	21	(1)
Relevance to Nursing Practice	22	(1)
Theory of Psychosocial Development	22	(3)
Erikson's Stages of Personality Development	23	(2)
Relevance to Nursing Practice	25	(1)
Theory of Object Relations	25	(2)
Phase I: The Autistic Phase (Birth to 1 Month)	26	(1)
Phase II: The Symbiotic Phase (1 to 5 Months)	26	(1)
Phase III: Separation-Individuation (5 to 36 Months)	26	(1)
Relevance to Nursing Practice	27	(1)
A Nursing Model-Hildegard E. Peplau	27	(3)
Peplau's Stages of Personality Development	28	(2)
Developing Skills in Participation	30	(1)
Relevance to Nursing Practice	30	(1)
Summary	30	(1)
Review Questions	31	(1)
References	32	(1)
Biological Implications	33	(20)
Introduction	34	(1)
Neurophysiological Influences	34	(12)
The Nervous System	34	(7)
The Neuroendocrine System	41	(5)
Implications for Psychiatric Illness	46	(2)
Schizophrenia	46	(1)
Mood Disorders	47	(1)
Anxiety Disorders	47	(1)
Anorexia Nervosa	48	(1)
Alzheimer's Disease	48	(1)
Diagnostic Procedures Used to Detect Altered Brain Function	48	(1)
Electroencephalography	48	(1)
Computerized EEG Mapping	49	(1)
Computed Tomographic Scan	49	(1)
Magnetic Resonance Imaging	49	(1)
Positron Emission Tomography	49	(1)
Single Photo Emission Computed Tomography	49	(1)
Implications for Nursing	49	(1)
Summary	50	(1)
Review Questions	51	(1)
References	52	(1)
Ethical and Legal Issues	53	(18)
Introduction	54	(1)
Definitions	54	(1)
Ethical Considerations	55	(5)
Theoretical Perspectives	55	(1)
Ethical Dilemmas	56	(1)
Ethical Principles	56	(1)
A Model for Making Ethical Decisions	57	(1)
Ethical Issues in Psychiatric/Mental Health Nursing	58	(2)
Legal Considerations	60	(7)
Nurse Practice Acts	60	(1)
Types of Law	61	(1)
Classifications Within Statutory and Common Law	61	(1)
Legal Issues in Psychiatric/Mental Health Nursing	62	(4)
Nursing Liability	66	(1)
Summary	67	(1)
Review Questions	68	(1)
References	69	(2)
Unit Two Psychiatric/Mental Health Nursing Interventions	71	(130)
Relationship Development and Therapeutic Communication	73	(20)
Introduction	74	(1)
The Therapeutic Nurse-Client Relationship
Therapeutic Use of Self	74	(1)
Conditions Essential to Development of a Therapeutic Relationship	75	(2)
Rapport	75	(1)
Trust	75	(1)
Respect	75	(1)
Genuineness	76	(1)
Empathy	76	(1)
Phases of a Therapeutic Nurse-Client Relationship	77	(1)
The Preinteraction Phase	77	(1)
The Orientation (Introductory) Phase	77	(1)
The Working Phase	78	(1)
The Termination Phase	78	(1)
Interpersonal Communication	78	(10)
The Impact of Preexisting Conditions	78	(2)
Nonverbal Communication	80	(2)
Therapeutic Communication Techniques	82	(2)
Nontherapeutic Communication Techniques	84	(1)
Process Recordings	84	(2)
Active Listening	86	(1)
Feedback	86	(2)
Summary	88	(2)
Review Questions	90	(1)
References	91	(2)
The Nursing Process in Psychiatric/Mental Health Nursing	93	(24)
Introduction	94	(1)
The Nursing Process	94	(1)
Definition	94	(1)
Standards of Care	94	(14)
Standard I. Assessment	94	(8)
How Do Cultures Differ?	102	(3)
Standard II. Diagnosis	105	(2)
Standard III. Outcome Identification	107	(1)
Standard IV Planning	107	(1)
Standard V. Implementation	107	(1)
Standard VI. Evaluation	108	(1)
Applying the Nursing Process in the Psychiatric Setting	108	(1)
Documentation to the Nursing Process	109	(4)
Problem-Oriented Recording	110	(1)
Focus Charting	111	(1)
The PIE Method	112	(1)
Summary	113	(1)
Review Questions	114	(1)
References	114	(3)
Milieu-The Therapeutic Environment	117	(10)
Introduction	118	(1)
Milieu Defined	118	(1)
Basic Assumptions	118	(1)
Conditions That Promote a Therapeutic Community	118	(2)
The Program of Therapeutic Community	120	(2)
Role of the Nurse	122	(1)
Summary	123	(2)
Review Questions	125	(1)
References	126	(1)
Intervention in Groups	127	(14)
Introduction	128	(1)
Group Defined	128	(1)
Functions of a Group	128	(1)
Types of Groups	128	(1)
Task Groups	128	(1)
Teaching Groups	128	(1)
Supportive/Therapeutic Groups	129	(1)
Self-Help Groups	129	(1)
Physical Conditions	129	(1)
Seating	129	(1)
Size	129	(1)
Membership	130	(1)
Curative Factors	130	(1)
Phases of Group Development	131	(1)
Phase I. Initial or Orientation Phase	131	(1)
Phase II. Middle or Working Phase	131	(1)
Phase III. Final or Termination Phase	131	(1)
Leadership Styles	132	(1)
Autocratic	132	(1)
Democratic	132	(1)
Laissez-Faire	132	(1)
Member Roles	133	(1)
Psychodrama	133	(1)
The Family as a Group	134	(1)
Role of the Nurse in Group Interventions	134	(1)
Summary	135	(2)
Review Questions	137	(2)
References	139	(2)
Intervening in Crises	141	(16)
Introduction	142	(1)
Crisis Defined	142	(1)
Phases in the Development of a Crisis	142	(1)
Types of Crisis	143	(3)
Class 1: Dispositional Crises	143	(1)
Class 2: Crises of Anticipated Life Transitions	144	(1)
Class 3: Crises Resulting from Traumatic Stress	144	(1)
Class 4: Maturational/Developmental Crises	144	(1)
Class 5: Crises Reflecting Psychopathology	145	(1)
Class 6: Psychiatric Emergencies	145	(1)
Crisis Intervention	146	(1)
Phases of Crisis Intervention: The Role of the Nurse	146	(1)
Phase 1. Assessment	146	(1)
Phase 2. Planning of Therapeutic Intervention	146	(1)
Phase 3. Intervention	147	(1)
Phase 4. Evaluation of Crisis Resolution and Anticipatory Planning	147	(1)
Crisis on the Inpatient Unit: Anger/Aggression Management	147	(5)
Assessment	147	(1)
Diagnosis/Outcome Identification	148	(1)
Planning/Implementation	149	(3)
Evaluation	152	(1)
Summary	152	(2)
Review Questions	154	(2)
References	156	(1)
Psychopharmacology	157	(28)
Introduction	158	(1)
Historical Perspectives	158	(1)
Applying the Nursing Process in Psychopharmacological Therapy	158	(22)
Antianxiety Agents	158	(3)
Antidepressants	161	(4)
Mood Stabilizing Agents	165	(5)
Antipsychotic Agents	170	(1)
Side Effects and Nursing Implications	171	(4)
Antiparkinsonian Agents	175	(2)
Sedative-Hypnotics	177	(1)
Central Nervous System Stimulants	178	(2)
Summary	180	(2)
Review Questions	182	(1)
References	183	(2)
Complementary Therapies	185	(16)
Introduction	186	(2)
Commonalities and Contrasts	188	(1)
Types of Complementary Therapies	188	(9)
Herbal Medicine	188	(3)
Acupressure and Acupuncture	191	(1)
Diet and Nutrition	191	(4)
Chiropractic Medicine	195	(1)
Therapeutic Touch and Massage	196	(1)
Yoga	196	(1)
Pet Therapy	197	(1)
Summary	197	(1)
Review Questions	198	(1)
References	199	(2)
Unit Three Care of Clients with Psychiatric Disorders	201	(278)
Delirium, Dementia, and Amnestic Disorders	203	(18)
Introduction	204	(1)
Delirium	204	(1)
Etiological Implications	204	(1)
Dementia	205	(5)
Etiological Implications	206	(4)
Amnestic Disorders	210	(1)
Etiological Implications	210	(1)
Application of the Nursing Process	211	(4)
Assessment	211	(1)
Diagnosis and Outcome Identification	212	(1)
Planning and Implementation	212	(3)
Client/Family Education	215	(1)
Evaluation	215	(1)
Medical Treatment Modalities	215	(2)
Delirium	215	(1)
Dementia	215	(2)
Summary	217	(1)
Review Questions	218	(2)
References	220	(1)
Substance-Related Disorders	221	(44)
Introduction	222	(1)
Substance-Use Disorders	222	(1)
Substance Abuse	222	(1)
DSM-IV-TR Criteria for Substance Abuse	222	(1)
Substance Dependence	222	(1)
DSM-IV-TR Criteria for Substance Dependence	223	(1)
Substance-Induced Disorders	223	(1)
Substance Intoxication	223	(1)
DSM-IV-TR Criteria for Substance Intoxication	223	(1)
Substance Withdrawal	223	(1)
DSM-IV-TR Criteria for Substance Withdrawal	223	(1)
Classes of Psychoactive Substances	224	(1)
Etiological Implications	224	(1)
Biological Factors	224	(1)
Psychological Factors	224	(1)
Sociocultural Factors	225	(1)
The Dynamics of Substance-Related Disorders	225	(20)
Alcohol Abuse and Dependence	225	(4)
Alcohol Intoxication	229	(1)
Alcohol Withdrawal	229	(1)
Sedative, Hypnotic, or Anxiolytic Abuse and Dependence	229	(4)
CNS Stimulant Abuse and Dependence	233	(3)
CNS Stimulant Intoxication	236	(1)
CNS Stimulant Withdrawal	236	(1)
Inhalant Abuse and Dependence	236	(1)
Inhalant Intoxication	237	(1)
Opioid Abuse and Dependence	237	(3)
Opioid Intoxication	240	(1)
Opioid Withdrawal	240	(1)
Hallucinogen Abuse and Dependence	240	(2)
Hallucinogen Intoxication	242	(1)
Cannabis Abuse and Dependence	242	(3)
Cannabis Intoxication	245	(1)
Application of the Nursing Process	245	(9)
Assessment	245	(9)
Treatment Modalities for Substance-Related Disorders	254	(5)
Alcoholics Anonymous	254	(2)
Pharmacotherapy	256	(2)
Psychopharmacology for Substance Intoxication and Substance Withdrawal	258	(1)
Summary	259	(1)
Review Questions	260	(2)
References	262	(3)
Schizophrenia and Other Psychotic Disorders	265	(28)
Introduction	266	(1)
Nature of the Disorder	266	(1)
Etiological Implications	267	(3)
Biological Influences	268	(1)
Psychological Influences	269	(1)
Environmental Influences	270	(1)
Theoretical Integration	270	(1)
Types of Schizophrenia and Other Psychotic Disorders	270	(3)
Disorganized Schizophrenia	270	(1)
Catatonic Schizophrenia	271	(1)
Paranoid Schizophrenia	271	(1)
Undifferentiated Schizophrenia	271	(1)
Residual Schizophrenia	271	(1)
Schizoaffective Disorder	271	(1)
Brief Psychotic Disorder	272	(1)
Schizophreniform Disorder	272	(1)
Delusional Disorder	272	(1)
Shared Psychotic Disorder	273	(1)
Psychotic Disorder Due to a General Medical Condition	273	(1)
Substance-Induced Psychotic Disorder	273	(1)
Application of the Nursing Process	273	(11)
Background Assessment Data	273	(5)
Diagnosis/Outcome Identification	278	(1)
Planning/Implementation	279	(4)
Client/Family Education	283	(1)
Evaluation	283	(1)
Treatment Modalities for Schizophrenia and Other Psychotic Disorders	284	(3)
Psychological Treatments	284	(1)
Social Treatment	285	(1)
Organic Treatment	286	(1)
Summary	287	(2)
Review Questions	289	(2)
References	291	(2)
Mood Disorders	293	(36)
Introduction	294	(1)
Historical Perspective	294	(1)
Epidemiology	294	(1)
Gender	294	(1)
Age	294	(1)
Social Class	295	(1)
Race	295	(1)
Marital Status	295	(1)
Seasonality	295	(1)
Types of Mood Disorders	295	(4)
Depressive Disorders	295	(4)
Other Mood Disorders	299	(1)
Depressive Disorders	299	(6)
Etiological Implications	299	(3)
Developmental Implications	302	(3)
Application of the Nursing Process to Depressive Disorders	305	(6)
Background Assessment Data	305	(2)
Diagnosis/Outcome Identification	307	(1)
Planning/Implementation	307	(2)
Client/Family Education	309	(1)
Evaluation of Care for the Depressed Client	309	(2)
Bipolar Disorder (Mania)	311	(1)
Predisposing Factors	311	(1)
Application of the Nursing Process to Bipolar Disorder (Mania)	312	(4)
Background Assessment Data	312	(1)
Diagnosis/Outcome Identification	313	(1)
Planning/Implementation	313	(3)
Client/Family Education	316	(1)
Evaluation of Care for the Manic Client	316	(1)
Treatment Modalities for Mood Disorders	316	(7)
Psychological Treatments	316	(2)
Organic Treatments	318	(3)
Suicide	321	(1)
Epidemiological Factors	321	(1)
Nursing Care of the Suicidal Client	321	(2)
Summary	323	(1)
Review Questions	324	(2)
References	326	(3)
Anxiety Disorders	329	(34)
Introduction	330	(1)
Historical Aspects	330	(1)
Epidemiological Statistics	330	(1)
How Much is too Much?	331	(1)
Application of the Nursing Process	331	(22)
Panic Disorder	331	(1)
Generalized Anxiety Disorder	332	(3)
Phobias	335	(7)
Obsessive-Compulsive Disorder	342	(2)
Posttraumatic Stress Disorder	344	(8)
Anxiety Disorder Due to a General Medical Condition	352	(1)
Substance-Induced Anxiety Disorder	352	(1)
Treatment Modalities	353	(4)
Individual Psychotherapy	353	(1)
Cognitive Therapy	353	(1)
Behavior Therapy	354	(1)
Group/Family Therapy	355	(1)
Psychopharmacology	356	(1)
Summary	357	(2)
Review Questions	359	(2)
References	361	(2)
Anxiety-Related Disorders	363	(38)
Introduction	364	(1)
Historical Aspects	364	(1)
Epidemiological Statistics	365	(1)
Application of the Nursing Process	366	(19)
Background Assessment Data-Types of Psychophysiological Disorders	366	(6)
Diagnosis/Outcome Identification	372	(1)
Planning/Implementation	373	(2)
Client/Family Education	375	(1)
Evaluation	375	(1)
Background Assessment Data-Types of Somatoform Disorders	375	(4)
Diagnosis/Outcome Identification	379	(1)
Planning/Implementation	379	(5)
Evaluation	384	(1)
Medical Treatment Modalities for Somatoform Disorders	385	(7)
Individual Psychotherapy	385	(1)
Group Psychotherapy	385	(1)
Behavior Therapy	385	(1)
Psychopharmacology	385	(1)
Background Assessment Data-Types of Dissociative Disorders	385	(3)
Diagnosis/Outcome Identification	388	(1)
Planning/Implementation	388	(4)
Evaluation
Medical Treatment Modalities for Dissociative Disorders	392	(1)
Dissociative Amnesia	392	(1)
Dissociative Fugue	392	(1)
Dissociative Identity Disorder	393	(1)
Depersonalization Disorder	393	(1)
Summary	393	(2)
Review Questions	395	(3)
References	398	(3)
Disorders of Human Sexuality	401	(32)
Introduction	402	(1)
Development of Human Sexuality	402	(2)
Birth Through Age 12	402	(1)
Adolescence	402	(1)
Adulthood	403	(1)
Sexual Disorders	404	(17)
Paraphilias	404	(4)
Sexual Dysfunctions	408	(4)
Application of the Nursing Process to Sexual Disorders	412	(6)
Treatment Modalities for Sexual Dysfunctions	418	(3)
Variations in Sexual Orientation	421	(3)
Homosexuality	421	(3)
Bisexuality	424	(1)
Sexually Transmitted Diseases	424	(3)
Summary	427	(1)
Review Questions	428	(2)
References	430	(3)
Eating Disorders	433	(18)
Introduction	434	(1)
Epidemiological Factors	434	(1)
Application of the Nursing Process	435	(9)
Background Assessment Data	435	(1)
Etiological Implications for Anorexia Nervosa and Bulimia Nervosa	436	(3)
Etiological Implications for Obesity	439	(1)
Diagnosis/Outcome Identification	439	(1)
Planning/Implementation	440	(1)
Client/Family Education	440	(1)
Evaluation	440	(4)
Treatment Modalities	444	(2)
Behavior Modification	444	(1)
Individual Therapy	445	(1)
Family Therapy	445	(1)
Psychopharmacology	445	(1)
Summary	446	(1)
Review Questions	447	(2)
References	449	(2)
Personality Disorders	451	(28)
Introduction	452	(1)
Historical Aspects	452	(1)
Types of Personality Disorders	453	(7)
Paranoid Personality Disorder	453	(1)
Schizoid Personality Disorder	454	(1)
Schizotypal Personality Disorder	455	(1)
Antisocial Personality Disorder	456	(1)
Borderline Personality Disorder	456	(1)
Histrionic Personality Disorder	456	(1)
Narcissistic Personality Disorder	457	(1)
Avoidant Personality Disorder	458	(1)
Dependent Personality Disorder	458	(1)
Obsessive-Compulsive Personality Disorder	459	(1)
Passive-Aggressive Personality Disorder	460	(1)
Application of the Nursing Process	460	(12)
Borderline Personality Disorder	460	(6)
Antisocial Personality Disorder	466	(6)
Treatment Modalities	472	(2)
Interpersonal Psychotherapy	473	(1)
Psychoanalytical Psychotherapy	473	(1)
Milieu or Group Therapy	473	(1)
Cognitive/Behavioral Therapy	473	(1)
Psychopharmacology	473	(1)
Summary	474	(1)
Review Questions	475	(1)
References	476	(3)
Unit Four Psychiatric/Mental Health Nursing of Special Populations	479	(122)
Children and Adolescents	481	(36)
Introduction	482	(1)
Mental Retardation	482	(4)
Etiological Implications	482	(1)
Application of the Nursing Process to Mental Retardation	483	(3)
Autistic Disorder	486	(3)
Etiological Implications	486	(1)
Application of the Nursing Process to Autistic Disorder	487	(2)
Attention-Deficit/Hyperactivity Disorder	489	(6)
Etiological Implications	490	(1)
Application of the Nursing Process to Attention-Deficit/Hyperactivity Disorder	491	(3)
Psychopharmacological Intervention	494	(1)
Conduct Disorder	495	(5)
Etiological Implications	496	(1)
Application of the Nursing Process to Conduct Disorder	497	(3)
Oppositional Defiant Disorder	500	(4)
Etiological Implications	500	(1)
Application of the Nursing Process to Oppositional Defiant Disorder	501	(3)
Tourette's Disorder	504	(3)
Etiological Implications	504	(1)
Application of the Nursing Process to Tourette's Disorder	504	(3)
Psychopharmacological Intervention	507	(1)
Separation Anxiety Disorder	507	(4)
Etiological Implications	507	(1)
Application of the Nursing Process to Separation Anxiety Disorder	508	(3)
Summary	511	(2)
Review Questions	513	(2)
References	515	(2)
Victims of Abuse or Neglect	517	(22)
Introduction	518	(1)
Historical Perspectives	518	(1)
Etiological Implications	519	(1)
Biological Theories	519	(1)
Psychological Theories	519	(1)
Sociocultural Theories	519	(1)
Application of the Nursing Process	520	(12)
Background Assessment Data	520	(7)
Diagnosis/Outcome Identification	527	(1)
Planning/Implementation	528	(3)
Evaluation	531	(1)
Treatment Modalities	532	(1)
Crisis Intervention	532	(1)
The Safe House or Shelter	532	(1)
Family Therapy	533	(1)
Summary	533	(2)
Review Questions	535	(2)
References	537	(2)
The Aging Individual	539	(30)
Introduction	540	(1)
How Old is Old?	540	(1)
Epidemiological Statistics	541	(1)
The Population	541	(1)
Marital Status	541	(1)
Living Arrangements	541	(1)
Economic Status	541	(1)
Employment	541	(1)
Health Status	541	(1)
Theories of Aging	542	(1)
Biological Theories	542	(1)
Psychosocial Theories	543	(1)
Personalitly Theories	543	(1)
The Normal Aging Process	543	(7)
Biological Aspects of Aging	543	(3)
Psychological Aspects of Aging	546	(2)
Sociocultural Aspects of Aging	548	(1)
Sexual Aspects of Aging	549	(1)
Special Concerns of the Elderly Population	550	(5)
Retirement	550	(2)
Long-Term Care	552	(1)
Elder Abuse	553	(2)
Suicide	555	(1)
Application of the Nursing Process	555	(8)
Assessment	555	(1)
Diagnosis/Outcome Identification	556	(1)
Planning/Implementation	557	(1)
Evaluation	557	(6)
Summary	563	(2)
Review Questions	565	(2)
References	567	(2)
Community Mental Health Nursing	569	(32)
Introduction	570	(1)
The Changing Focus of Care	570	(1)
The Public Health Model	571	(1)
The Community as Client	572	(25)
Primary Prevention	572	(1)
Populations at Risk	572	(8)
Secondary Prevention	580	(2)
Tertiary Prevention	582	(5)
The Homeless Mentally Ill	587	(10)
Summary	597	(1)
Review Questions	598	(2)
References	600	(1)
Appendix A: DSM-IV-TR Classification: Axes I and II Categories and Codes	601	(10)
Appendix B: Nanda Nursing Diagnoses Taxonomy II	611	(4)
Appendix C: Assigning Nursing Diagnoses to Client Behaviors	615	(2)
Appendix D: Mental Status Assessment	617	(4)
Appendix E: Critical Pathways of Care	621	(12)
Appendix F: Glossary	633	(12)
Appendix G: Answers To Review Questions	645	(6)
Index	651