Johnson's Psychiatric-Mental Health Nursing

by Mohr, Wanda K.

• ISBN13: 9780781719841
• ISBN10: 0781719844
• Edition: 5th
• Format: Hardcover
• Copyright: 2002-09-30
• Publisher: LWW

Summary

This comprehensive, revised text discusses psychiatric nursing through an adaptation and growth framework integrating the nursing process. This edition emphasizes psychiatric mental health nursing more from in-patient care to community-based care. Major disorders are addressed, as well as treatments and psychiatric topics throughout the lifespan. Other features include its visual and readable presentation and numerous pedagogical tools,such as learning objectives and therapeutic dialogues. New to this edition are: clinical examples at the beginning of every disorder; reflection and critical thinking questions; nursing care plans; historical capsule; nursing practice implications; key terms and more. A Study Guide accompanies the text. For more information, visit http://connection.lww.com/go/mohr.

Author Biography

Wanda K. Mohr, PhD, RN, FAAN: Rutgers University College of Nursing Newark, New Jersey

Table of Contents

UNIT I Foundations of Psychiatric-Mental Health Nursing	1	(132)
Introduction to Psychiatric-Mental Health Nursing	3	(18)
Barbara Schoen Johnson
Wanda K. Mohr
Mental Health and Mental Illness	3	(9)
The Mental Health-Illness Continuum	4	(1)
Mental Health: A Report of the Surgeon General	4	(1)
Elements of Mental Health	5	(1)
Influences on Mental Health	5	(1)
Incidence and Prevalence of Mental Illness	5	(1)
Etiology of Mental Illness	6	(1)
Diagnosis of Mental Illness	6	(2)
Prevention and Treatment of Mental Illness	8	(1)
Problems in Treating Mental Illness	8	(1)
Cost-Related Issues	8	(1)
Stigma	9	(1)
Revolving Door Treatment	9	(1)
Lack of Parity	9	(1)
Limited Access to Services	9	(1)
Goals of Care and Methods of Achievement	9	(1)
Beyond Response to Recovery	10	(1)
Reintegration into Society	10	(1)
Mental Health Parity	10	(1)
Culturally Competent Care	10	(1)
Medication Adherence	10	(1)
Self-Help Movements and Advocacy	11	(1)
National Alliance for the Mentally III	11	(1)
Family Advocacy Movement	11	(1)
Psychiatric Advanced Directives	11	(1)
Psychiatric-Mental Health Nursing	12	(9)
Nursing Process and Standards of Care	12	(1)
Levels of Practice	12	(1)
Guiding Principles	13	(1)
The Role of the Psychiatric Nurse as a Team Member	13	(3)
Learning to Provide Appropriate Care	16	(1)
Understanding the Client's View of Mental Healthcare	17	(1)
Managing Stress and Burnout	17	(4)
Neuroscience: Biology and Behavior	21	(56)
Wanda K. Mohr
Neuroanatomy and Neurophysiology	22	(10)
Neurons	22	(1)
Neurotransmission	22	(2)
Plasticity	24	(1)
Central Nervous System	24	(1)
Spinal Cord	25	(1)
The Brain	25	(1)
Organization and Structure	25	(3)
Brain Development	28	(1)
Neuroplasticity	29	(1)
The Role of Genetics	30	(1)
Genetics and Psychiatric Disorders	31	(1)
Interactions Between Genes and Environment	32	(1)
Other Topics in Neuroscience	32	(6)
Memory, Repetition, and Learning	32	(1)
Circadian Rhythm	32	(1)
Psychoneuroimmunology	33	(1)
Neuroimaging Techniques	33	(5)
Conceptual Frameworks and Theories
Wanda K. Mohr
Theories: Who Cares and so What?	38	(1)
Theories of Human Behavior	39	(8)
Psychoanalytic Perspective	39	(1)
General Principles	40	(1)
Critiques of Psychoanalytic Theory	40	(1)
Behavior Theory	41	(1)
General Principles	42	(1)
Conditioning	43	(1)
Reinforcement	43	(1)
Punishment	43	(1)
Generalization and Discrimination	43	(1)
Modeling and Shaping	44	(1)
Applied Behavior Analysis	44	(1)
Cognitive-Behavior Theory	44	(1)
The Humanistic Perspective	45	(1)
The Interpersonal Perspective	46	(1)
The Biophysiological Perspective	46	(1)
The Sociocultural Viewpoint	47	(1)
Toward a Comprehensive, Multidisciplinary Understanding of Psychopathology	47	(7)
The Emergence of Mental Illness	49	(1)
Multidimensionality of Assessment (Assessing Multiple Systems)	49	(1)
Family Characteristics (Microsystem)	49	(1)
Community Characteristics (Exosystem)	49	(5)
Therapeutic Relationships and Communication
Catherine Deering
Jane Frederick
Therapeutic Relationships	54	(9)
Essential Elements	55	(1)
Trust	55	(1)
Professionalism	55	(1)
Mutual Respect	55	(1)
Caring	56	(1)
Partnership	57	(1)
Obstacles to Establishing a Therapeutic Relationship	57	(1)
Judgmental Analysis	57	(1)
Excessive Probing	58	(1)
Lack of Self-Awareness	59	(1)
Phases of the Therapeutic Relationship	60	(1)
Introductory Phase	60	(2)
Middle or Working Phase	62	(1)
Termination Phase	63	(1)
Therapeutic Communication	63	(14)
Theoretical Framework and Communication Model	64	(1)
Listening	64	(6)
Assertiveness	70	(1)
Confrontation and Limit Setting	70	(1)
Self-Disclosure	71	(1)
Therapeutic Communication in Special Situations	72	(1)
Clients With Anxiety	72	(1)
Clients With Psychoses	72	(1)
Families	72	(5)
Culture	77	(18)
Mary Huggins
Culture	79	(5)
Changing Demographics and Cultural Awareness	79	(1)
Assimilation	80	(1)
Implications for Healthcare	80	(1)
Culturally Competent Healthcare	81	(1)
Cultural Congruence	82	(2)
Cultural Care Theory	84	(1)
Disparities in Mental Health and Barriers to Effective Treatment	84	(3)
Variability and Vulnerability	84	(1)
Accessibility	85	(1)
Racial Bias	85	(1)
Religious and Spiritual Influences	86	(1)
Sociocultural Variations in Response to Mental Healthcare	87	(1)
African-American Clients	87	(1)
Native-American Clients	87	(1)
Hispanic and Latino Clients	88	(1)
Asian and Pacific Islander Clients	88	(1)
Culturally Competent and Congruent Nursing Care	88	(7)
Essential Skills	88	(2)
Phases of Transcultural Nursing Knowledge	90	(1)
Transcultural Assessment	90	(1)
Building Cultural Awareness	90	(1)
Cultural Self-Awareness	91	(4)
The Nursing Process in Psychiatric-Mental Healthcare	95	(18)
Suzanne Perraud
Steps of the Nursing Process	96	(17)
Assessment	97	(1)
Components of the Psychosocial Assessment	97	(1)
Interview	97	(1)
Health History	97	(2)
Mental Status Examination	99	(3)
Nursing Diagnosis	102	(1)
The NANDA Taxonomy	102	(1)
Choosing and Formulating the Nursing Diagnosis	102	(1)
Nursing Diagnosis and Psychiatric Diagnosis	103	(1)
Planning	104	(1)
Identifying Outcomes	104	(3)
Selecting Interventions	107	(1)
Standardized Care Plans	108	(1)
Clinical or Critical Pathways	108	(1)
Implementation	108	(1)
Intervention Strategies for Beginning Practitioners	109	(1)
Supervision	109	(1)
Evaluation	109	(4)
Legal and Ethical Aspects of Psychiatric-Mental Health Nursing	113	(20)
Robin S. Diamond
Gwen Larsen
Legal Issues in Psychiatric-Mental Health Nursing Care	114	(11)
Nurse Practice Acts and the Expanding Role of Nursing	116	(1)
Malpractice	116	(1)
Obtaining Legal Counsel	117	(1)
Basic Rights of Clients Receiving Psychiatric Care	117	(1)
Informed Consent	118	(2)
Special Considerations in Psychiatric Settings	120	(1)
Substituted Consent	120	(1)
Confidentiality	121	(1)
Responsible Record Keeping	121	(1)
Privileged Communication	121	(1)
Evolving Legal Rights	122	(1)
Right to Treatment	122	(1)
Right to Treatment in the Least Restrictive Environment	122	(1)
Right to Refuse Treatment	122	(1)
Right to Aftercare	122	(1)
Client Status and Specific Legal Issues	122	(1)
Voluntary Admissions	122	(1)
Emergency Admissions	123	(1)
Involuntary Admissions	123	(1)
Legal Issues and Special Client Populations	124	(1)
Forensic Clients	124	(1)
Competency to Stand Trial	124	(1)
Pleas of Insanity or Mental Illness	124	(1)
Minors	124	(1)
Ethical Issues in Psychiatric-Mental Health Nursing Care	125	(8)
Bioethical Principles in Psychiatric Nursing Practice	126	(1)
Autonomy	126	(1)
Beneficence and Paternalism	126	(1)
Veracity and Fidelity	126	(1)
Justice	127	(1)
Nursing Ethics in Community Mental Health	127	(1)
Boundaries in Ethical Nursing Care	127	(6)
UNIT II Conceptual Bases of Treatment	133	(158)
Working with Individuals	135	(16)
Jeanneane L. Cline
Collaborative Goals of Individual Therapy	136	(1)
Types of Individual Psychotherapy	136	(9)
Classic Psychoanalysis	138	(1)
Cognitive Therapy	138	(1)
Issues Identified by Cognitive Therapy	139	(1)
Cognitive Therapy Treatment Approach	139	(1)
Behavioral Therapy	139	(2)
Behavioral Theory	141	(1)
The Process of Behavioral Therapy	142	(1)
Cognitive-Behavioral Therapy	143	(1)
Rational Emotive Behavior Therapy	143	(1)
Choice Therapy	144	(1)
Brief, Solution-Focused Therapy	144	(1)
The Nurse's Role	145	(6)
Levels of Clinical Nursing Practice	145	(1)
Therapeutic Interventions in Nursing	146	(5)
Working with Groups	151	(18)
Barbara G. Tunley Crenshaw
Group Process	152	(6)
What Is a Group?	152	(1)
Characteristics of Groups	152	(1)
Types of Groups	152	(1)
Group Norms	152	(1)
Group Leadership	152	(1)
Styles of Group Leadership	153	(1)
Decision Making	153	(1)
Structuring the Group	153	(1)
Group Roles	154	(1)
Group Task Roles	154	(1)
Group Building and Maintenance Roles	154	(1)
Individual Roles	154	(1)
Group Communication	154	(1)
Latent and Manifest Communication	154	(1)
Content and Process Communication	154	(2)
Transference and Countertransference	156	(1)
Communication Themes	157	(1)
Stages of Group Development	157	(1)
Initial Stage	157	(1)
Working Stage	157	(1)
Mature Stage	157	(1)
Termination Stage	157	(1)
Group Therapy	158	(4)
Purposes	158	(1)
Advantages and Disadvantages	158	(2)
Therapeutic Factors of Group Therapy	160	(1)
Instillation of Hope	161	(1)
Universality	161	(1)
Imparting of Information	161	(1)
Group Cohesiveness	161	(1)
Catharsis	161	(1)
Existential Factors	161	(1)
Types of Therapy Groups	161	(1)
Psychotherapeutic Groups	161	(1)
Growth Groups	162	(1)
Nurses and Group Process and Therapy	162	(7)
Group Process and Therapy in Nursing Education	162	(2)
Group Process and Therapy in Nursing Practice	164	(1)
Historical Perspective	164	(1)
Contemporary Nursing Groups	164	(5)
Working with Families	169	(22)
Victoria Conn
Family Caregiving from 1850 to 2000	170	(1)
Family Burden	170	(8)
Objective Burden	171	(2)
Subjective Burden	173	(2)
Iatrogenic Burden	175	(1)
Confidentiality Issues	175	(1)
Involuntary Treatment Statutes	175	(1)
Discrimination	175	(1)
Burden Attributable to Professionals	175	(3)
Family Resilience	178	(1)
Needs of Families for Secondary Prevention	178	(13)
Families as a Population at Risk	178	(1)
Family Consultation	179	(1)
Family Consultation Versus Family Therapy	180	(1)
Components of Family Consultation	180	(1)
The Nurse as Family Consultant	180	(3)
Family Empowerment	183	(1)
Family Education	183	(1)
Family Education Versus Family Psychoeducation	183	(1)
Components of Family Education	183	(1)
The Nurse as Family Educator	184	(1)
Peer-Taught Family Education	184	(1)
Psychotherapy and Medication	185	(6)
Working with Special Environments: Forensic Clients, Crisis Intervention, and the Homeless	191	(32)
Cindy A. Peternelji-Taylor
Anita G. Hufft
Phyllis M. Connolly
Kay Peterson
Forensic Nursing	191	(6)
Forensic Settings	192	(1)
Factors Contributing to Incarceration	192	(1)
Characteristics of the Forensic Population	193	(3)
Effects of Incarceration on Mental Health	196	(1)
Characteristics of Forensic Psychiatric Nurses	196	(1)
Application of the Nursing Process to the Forensic Client	197	(4)
Assessment	198	(1)
Nursing Diagnosis	198	(1)
Planning	198	(1)
Implementation	199	(2)
Evaluation	201	(1)
Nursing Care for the Client in Crisis	201	(5)
Crisis Theory	202	(2)
Crisis Prevention	204	(1)
Crisis Intervention and Stabilization	204	(2)
Application of the Nursing Process to the Client in Crisis	206	(4)
Assessment	206	(1)
Nursing Diagnosis	207	(1)
Planning	208	(1)
Implementation	209	(1)
Evaluation	210	(1)
Nursing Care of Homeless Clients	210	(5)
Demographics	210	(1)
Homeless Mentally III People	210	(5)
Application of the Nursing Process to the Homeless Client	215	(8)
Assessment	215	(1)
Nursing Diagnosis	215	(1)
Planning	216	(1)
Implementation	217	(1)
Evaluation	217	(6)
Psychopharmacology	223	(40)
Geraldine Pearson
Important Principles of Psychopharmacotherapeutics	224	(2)
Agonists	224	(1)
Antagonists	224	(1)
Affinity	224	(1)
Efficacy	225	(1)
Potency	225	(1)
Target Symptoms	225	(1)
Refractoriness	225	(1)
Polypharmacy	225	(1)
Important Psychotherapeutic Drugs	226	(20)
Medications for Mood Disorders	227	(1)
Antidepressants	227	(1)
Tricyclic Antidepressants	227	(5)
Atypical Antidepressants	232	(1)
Monoamine Oxidase Inhibitors	232	(1)
Selective Serotonin Reuptake Inhibitors, Selective Reuptake Inhibitors, and Selective Norepineprine Reuptake Inhibitors	233	(1)
Mood Stabilizers	234	(1)
Lithium Carbonate	234	(1)
Anticonvulsants	234	(2)
Medications for Refractory Mania	236	(1)
Anxiolytics	237	(1)
Buspirone	237	(1)
Benzodiazepines	237	(2)
Antipsychotic (Neuroleptic) Agents	239	(1)
Typical or Traditional Antipsychotics	240	(1)
Low-Potency Typical Antipsychotics	240	(4)
High-Potency Typical Antipsychotics	244	(1)
Atypical Antipsychotics	244	(1)
Clozapine	244	(1)
Risperidone	245	(1)
Olanzapine	245	(1)
Quetiapine	245	(1)
Stimulants	245	(1)
Application of the Nursing Process to Clients Receiving Psychopharmacologic Agents	246	(9)
Assessment	247	(1)
Nursing Diagnosis	248	(1)
Planning	248	(1)
Prescribed and Maximum Dose	248	(1)
Method of Administration	248	(1)
Expected Drug Action	249	(1)
Side Effects	249	(1)
Adverse Effects	249	(3)
Implementation	252	(1)
Promoting Adherence to the Medication Regimen	253	(1)
Factors Contributing to Nonadherence	253	(1)
Implications for Practice	253	(1)
Working With the Family	254	(1)
Performing Self-Clarification	254	(1)
Evaluation	255	(1)
Important Issues Related to Psychopharmacology and Nursing Management	255	(8)
Lifespan Considerations	255	(1)
Pregnant and Lactating Women	255	(1)
Children and Adolescents	256	(1)
Older Adults	256	(1)
Use of Alternative Agents to Treat Psychiatric Illness	257	(1)
Nursing Research	257	(6)
Spirituality in Psychiatric Care	263	(12)
Wanda K. Mohr
Spirituality and Religion	264	(1)
Spirituality, Religion, and Mental Health and Illness	264	(2)
Illness Prevention	264	(1)
Spirituality, Religion, and Mental Illness	265	(1)
Religious and Spiritual Interventions in Mental Health Care	266	(3)
Changing Attitudes and Philosophies	266	(1)
Clarifying Values	266	(1)
The Role of Clergy in Mental Healthcare	266	(1)
The Role of the Nurse in Mental Healthcare	267	(1)
Spiritual Assessment	267	(1)
Spiritual Coping Practices and Interventions	268	(1)
Prayer	268	(1)
Bibliotherapy With Scared Writings	268	(1)
Contemplation and Meditation	268	(1)
Repentance and Forgiveness	268	(1)
Worship and Rituals	269	(1)
Fellowship and Altruistic Service	269	(1)
Journal Writing	269	(1)
Ethical Concerns	269	(6)
Complementary and Alternative Medicine	275	(16)
Jeanneane Cline
Overview of Complementary and Alternative Medicine	275	(2)
National Center for Complementary and Alternative Medicine and CAM Expansion	276	(1)
Prevalence of Complementary and Alternative Medicine	276	(1)
Research Studies	276	(1)
Ethical and Legal Considerations	276	(1)
Classification of Complementary and Alternative Medicine	277	(8)
Alternative Systems of Medical Practice	277	(1)
Traditional Chinese Medicine	277	(1)
Acupuncture	277	(1)
Ayurvedic Medicine	278	(1)
Naturopathy	278	(1)
Homeopathy	278	(1)
Mind-Body Interventions	279	(1)
Meditation	279	(1)
Imagery	279	(1)
Music Therapy	279	(1)
Spiritual Healing and Prayer	279	(1)
Biological-Based Therapies	280	(1)
Herbal Therapies	280	(1)
Aromatherapy	280	(3)
Manipulative and Body-Based Methods	283	(1)
T'ai Chi	283	(1)
Yoga	284	(1)
Massage	284	(1)
Energy Therapies	284	(1)
Biofield Therapies	284	(1)
Healing Touch and Therapeutic Touch	284	(1)
Reiki	284	(1)
Bioelectromagnetic-Based Therapies	285	(1)
The Nurse's Role	285	(6)
UNIT III Continuum of Care	291	(56)
Community Mental Health, Support, and Rehabilitation	293	(18)
Mary Huggings
Jeffrey A. Anderson
Sue Ellen Odom
Community Mental Health	294	(3)
Historical Perspective	294	(1)
Levels of Prevention	295	(1)
Primary Prevention	295	(2)
Secondary Prevention	297	(1)
Tertiary Prevention	297	(1)
Community Support Systems	297	(7)
Components of a Community Support System	297	(1)
Guiding Principles	298	(1)
Program Models	298	(1)
Psychosocial Rehabilitation Model	299	(1)
Fairweather Lodge Model	299	(1)
Training in Community Living Model	299	(1)
Consumer-Run Alternative Models	299	(1)
Community Worker Models	299	(1)
Community Support Programs	300	(1)
Child and Adolescent Service System Program	300	(1)
Public Policy and Trends	301	(1)
Chronicity of Severe Mental Illness	301	(1)
Stalled Resources	302	(1)
Poverty	302	(1)
Reinstitutionalization	302	(1)
Education	302	(1)
Stigma	302	(1)
Reforms	303	(1)
Safety Net Services	303	(1)
Legislation	303	(1)
Public Policy	303	(1)
Application of the Nursing Process to Community Settings	304	(7)
Assessment	304	(1)
Nursing Diagnosis	305	(1)
Planning	305	(1)
Implementation	306	(1)
Evaluation	306	(5)
Behavioral Health Home Care	311	(12)
Nina A. Klebanoff
Foundations of Behavioral Health Home Care	312	(1)
History of Behavioral Health Home Care	312	(1)
Principles of Behavioral Health Home Care	312	(1)
Home Care Services	312	(1)
Home Care Providers	313	(1)
Goals of Behavioral Health Home Care	313	(1)
Behavioral Health Home Care Nursing	313	(10)
Behavioral Health Clinical Nurse Specialists	314	(1)
Attitudes and Feelings	315	(1)
The Nursing Process and Behavioral Health Home Care	315	(1)
Assessment	315	(1)
Indicators and Standards of Care	315	(1)
Data to Collect	315	(1)
Data Gathering Methods	315	(1)
Nursing Diagnosis	315	(1)
Planning	315	(4)
Implementation	319	(1)
Evaluation	319	(1)
Trends in Behavioral Health Home Care Nursing	320	(3)
Violence and Abuse Within the Community	323	(24)
Kathleen R. Delaney
Delia Esparza
Diane Hinderliter
Karen Van Dyke Lamb
Wanda K. Mohr
The Ecological Model of Violence	324	(1)
Macrosystem	324	(1)
Microsystem	324	(1)
Exosystem	325	(1)
Ontogenic Development	325	(1)
Public Health Approach to Violence Prevention	325	(1)
Youth Violence	325	(3)
Risk and Protective Factors for Youth Violence	326	(1)
Individual Risk Factors	326	(1)
Family Risk Factors	326	(1)
Peer Risk Factors	326	(1)
Neighborhood Risk Factors	327	(1)
Protective Factors	327	(1)
Public Health Approach to Youth Violence	327	(1)
Nurses' Role in Youth Violence Prevention Efforts	328	(1)
Family Violence	328	(7)
Intimate Partner Violence	328	(1)
Defining the Scope of Intimate Partner Violence	328	(1)
Cost to Children	328	(1)
Addressing Intimate Partner Violence	329	(1)
Problems With Detection and Screening	329	(1)
Importance of Screening	330	(1)
Nurses' Role in Identification and Treatment of Intimate Partner Violence	330	(1)
Child Maltreatment	331	(1)
Effects of Maltreatment on Child Function	331	(1)
Social Functioning	331	(1)
Behavioral Functioning	331	(1)
Emotional and Intellectual Functioning	332	(1)
Health and Physical Functioning	332	(1)
Family Functioning and Parenting Practices	333	(1)
Nurses' Role in the Identification of Maltreatment	333	(1)
Elder Abuse	333	(1)
Types of Elder Abuse	333	(1)
Causes of Elder Abuse	334	(1)
Nurses' Role in the Identification and Treatment of Elder Abuse	334	(1)
Rape and Sexual Assault	335	(12)
Types of Rape	335	(1)
Rape by a Stranger	335	(1)
Date Rape and Acquaintance Rape	335	(1)
Marital Rape	335	(1)
Rape Trauma Syndrome	336	(1)
Additional Ramifications of Rape	336	(1)
Treatment for Survivors of Rape of Sexual Assault	337	(1)
Psychopharmacologic Interventions	337	(1)
Psychological Interventions	337	(1)
Rape Prevention	337	(1)
Nurses' Role in the Assessment and Treatment of Survivors of Rape Trauma	338	(1)
Assessment	338	(1)
Treatment	339	(8)
UNIT IV Nursing Care for Clients With Psychiatric Disorders	347	(294)
The Client With an Anxiety Disorder	349	(24)
Judith A. Greene
Anxiety	350	(1)
The Continuum of Anxiety	350	(1)
Effects on Sensation	350	(1)
Effects on Cognition	350	(1)
Effects on Verbal Ability	351	(1)
Normal Versus Abnormal Anxiety	351	(1)
Anxiety Disorders	351	(15)
Etiology	352	(1)
Neurological Theories	352	(1)
Psychological Theories	352	(1)
Signs and Symptoms/Diagnostic Criteria	353	(1)
Generalized Anxiety Disorder	353	(4)
Phobic Disorders	357	(1)
Agoraphobia	357	(1)
Social Phobia	357	(1)
Specific Phobia	358	(1)
Panic Attacks	358	(1)
Panic Disorder	358	(1)
Obsessive-Compulsive Disorder	358	(1)
Post-Traumatic Stress Disorder	359	(2)
Acute Stress Disorder	361	(1)
Comorbidities and Dual Diagnoses	361	(1)
Implications and Prognoses	361	(1)
Interdisciplinary Goals and Treatment	362	(1)
Psychodynamic Therapies	362	(1)
Basic Cognitive Therapy Techniques for Anxiety	362	(1)
Systematic Desensitization and Exposure Treatment	363	(1)
Relaxation Techniques and Breathing Retraining	363	(1)
Pharmacologic Treatment	364	(1)
Selective Serotonin Reuptake Inhibitors	364	(1)
Benzodiazepines	365	(1)
Buspirone	365	(1)
Beta Blockers	365	(1)
Tricyclic Antidepressants	365	(1)
Application of the Nursing Process to the Client With an Anxiety Disorder	366	(7)
Assessment	366	(1)
Nursing Diagnosis	366	(1)
Planning	366	(1)
Implementation	366	(1)
Alleviating Anxiety	367	(1)
Initiating a Therapeutic Dialogue	367	(1)
Countering Faulty Thinking	368	(1)
Managing Hyperventilation	368	(1)
Suggesting Lifestyle Changes	368	(1)
Teaching Adaptive Coping Strategies	368	(1)
Teaching Relaxation	368	(1)
Teaching Problem-Solving Skills	369	(1)
Evaluation	369	(4)
The Client with a Samatoform Disorder	373	(24)
Carol J. Cornwell
Somatoform Disorders	374	(9)
Epidemiology	375	(1)
Cultural Considerations	375	(1)
Etiology	375	(2)
Signs and Symptoms/Diagnostic Criteria	377	(1)
Primary and Secondary Gain	377	(1)
Somatization Disorder	377	(3)
Undifferentiated Somatoform Disorder	380	(1)
Conversion Disorder	380	(1)
Pain Disorder	381	(1)
Hypochondriasis	381	(1)
Body Dysmorphic Disorder	381	(1)
Somatoform Disorder Not Otherwise Specified	381	(1)
Comorbidities and Dual Diagnoses	381	(1)
Implications and Prognosis	381	(1)
Interdisciplinary Goals and Treatment	382	(1)
Individual and Group Psychotherapies	383	(1)
Somatic Therapies	383	(1)
Application of the Nursing Process to the Client With a Somatoform Disorder	383	(14)
Assessment	383	(1)
Pshychological Assessment	383	(1)
Behavior	384	(1)
Mood and Affect	385	(1)
Thought Process and Content	385	(1)
Intellectual and Cognitive Processing	385	(1)
Insight and Judgment	385	(1)
Suicidal Ideation	385	(1)
Physical Examination	385	(1)
Vegetative Signs	385	(1)
Energy and Psychomotor Functioning	385	(1)
Social Assessment	385	(1)
Nursing Diagnoses	386	(1)
Planning	386	(1)
Implementation	386	(1)
Establising a Trusting Relationship	386	(2)
Managing Ineffective Coping	388	(3)
Addressing Powerlessness and Dependency Issues	391	(1)
Enhancing Self-Esteem	391	(1)
Reducing Anxiety	391	(1)
Reestablishing Social Activities	391	(1)
Reestablishing Functional Family Processes	391	(1)
Evaluation	392	(5)
The Client with a Sexual or Gender Disorder	397	(24)
Delia Esparza
Normal Human Sexuality	398	(4)
Sexual Expression	398	(1)
Effects of Sexual Orientation on Sexual Expression	399	(1)
Sexual Preference	399	(1)
Gender Role	400	(1)
Sexual Identity	400	(1)
Effects of Culture on Sexual Expression	400	(1)
Effects of Ill Health on Sexual Expression	400	(1)
Sexual Response	401	(1)
Human Sexual Response Phases	401	(1)
Desire	402	(1)
Excitement	402	(1)
Orgasm	402	(1)
Normal Age-Related Sexual Changes	402	(1)
Sexual and Gender Disorders	402	(1)
Sexual Dysfunction Disorders	403	(6)
Etiology	403	(1)
Signs and Symptoms/Diagnostic Criteria	403	(1)
Desire Disorders	403	(1)
Arousal Disorders	403	(2)
Orgasmic Disorders	405	(1)
Pain Disorders	405	(1)
Interdisciplinary Goals and Treatments	405	(4)
Pharmacologic Therapy	409	(1)
Sex Therapy	409	(1)
Application of the Nursing Process to the Client With Sexual Dysfunction	409	(7)
Assessment	409	(3)
Nursing Diagnosis	412	(1)
Planning	413	(1)
Implementation	414	(1)
Counseling the Client With a Sexual Dysfunction Disorder	414	(1)
Enhancing Self-Esteem	414	(2)
Evaluation	416	(1)
Paraphilias	416	(1)
Signs and Symptoms/Diagnostic Criteria	416	(1)
Interdisciplinary Goals and Treatment	416	(1)
Gender Identity Disorders	417	(4)
Signs and Symptoms/Diagnostic Criteria	417	(1)
Interdisciplinary Goals and Treatment	417	(1)
Sex Reassignment Surgery	417	(1)
Hormone Treatment	417	(1)
Psychotherapy	417	(4)
The Client With a Dissociative Disorder	421	(16)
Jan Dalsheimer
Janet Stagg
Dissociative Disorders	422	(6)
Epidemiology	422	(1)
Cultural Considerations	423	(1)
Etiology	423	(1)
Biologic Factors	423	(1)
Psychological and Social Factors	423	(1)
Role of Family Dynamics	424	(1)
Signs and Symptoms/Diagnostic Criteria	424	(1)
Comorbidities and Dual Diagnoses	424	(1)
Interdisciplinary Goals and Treatment	424	(2)
Treatment Approach	426	(1)
Individual Therapy	427	(1)
Group Therapy	427	(1)
Pharmacotherapy	427	(1)
Art Therapy	427	(1)
Milieu Management	428	(1)
Family Education	428	(1)
Application of the Nursing Process to the Client With a Dissociative Disorder	428	(9)
Assessment in Adults	428	(1)
Assessment in Children	429	(1)
Nursing Diagnosis	429	(1)
Planning	429	(1)
Implementation	429	(2)
Evaluation	431	(6)
The Client With a Personality Disorder	437	(18)
Judith Greene
Personality Disorders	437	(9)
Etiology	438	(1)
Signs and Symptoms/Diagnostic Criteria	438	(1)
Cluster A Personality Disorders	438	(4)
Paranoid Personality Disorder	442	(1)
Schizoid Personality Disorder	442	(1)
Schizotypal Personality Disorder	442	(1)
Cluster B Personality Disorders	442	(1)
Antisocial Personality Disorder	442	(1)
Borderline Personality Disorder	442	(1)
Histrionic Personality Disorder	442	(1)
Narcissistic Personality Disorder	443	(1)
Cluster C Personality Disorders	443	(1)
Avoidant Personality Disorder	443	(1)
Dependent Personality Disorder	443	(1)
Obsessive-Compulsive Personality Disorder	443	(1)
Comorbidities and Dual Diagnoses	444	(1)
Implications and Prognosis	444	(1)
Interdisciplinary Goals and Treatment	444	(1)
Individual Psychotherapy	444	(1)
Group Therapy	445	(1)
Family Education and Therapy	445	(1)
Application of the Nursing Process to a Client With a Personality Disorder	446	(5)
Assessment	446	(1)
Nursing Diagnoses	447	(1)
Planning	447	(1)
Implementation	447	(1)
Promoting Participation in Treatment	447	(1)
Enlisting the Family in the Treatment Plan	447	(1)
Improving Coping Skills	447	(1)
Reducing Inappropriate Behaviors	447	(1)
Confronting the Client	448	(1)
Setting Limits	449	(1)
Providing for Physical Safety	449	(2)
Evaluation	451	(1)
Nurse's Self Care	451	(4)
The Client With an Eating Disorder	455	(24)
Susan D. Decker
Eating Disorders	456	(8)
Etiology	456	(1)
Biologic Theories	456	(2)
Behavioral Theories	458	(1)
Sociocultural Theories	458	(1)
Family-Based Theories	458	(1)
Signs and Symptoms/Diagnostic Criteria	459	(1)
Anorexia Nervosa	459	(1)
Bulimia Nervosa	459	(1)
Comorbidities and Dual Diagnoses	459	(3)
Implications and Prognosis	462	(1)
Interdisciplinary Goals and Treatment	462	(1)
Behavioral Therapy	462	(1)
Cognitive Therapy	462	(1)
Cognitive-Behavioral Therapy	462	(1)
Interpersonal Therapy	462	(1)
Solution-Focused Brief Therapy	463	(1)
Family Therapy	463	(1)
Group Therapy	463	(1)
Pharmacologic Interventions	463	(1)
Application of the Nursing Process to Clients With Eating Disorders	464	(15)
Assessment	464	(1)
History and Physical Examination	464	(1)
Psychosocial Assessment	464	(3)
Nursing Diagnosis	467	(1)
Planning	468	(1)
Implementation	468	(1)
Restoring Nutritional Balance	469	(1)
Encouraging Realistic Thinking Processes	469	(3)
Improving Body Image	472	(1)
Building Self-Esteem	472	(1)
Exploring Feelings of Powerlessness	473	(1)
Encouraging Effective Coping	473	(1)
Restoring Family Processes	473	(1)
Enmeshments and Overprotectiveness	473	(1)
Conflict Avoidance and Rigidity	473	(1)
Evaluation	473	(6)
The Client With a Mood Disorder	479	(42)
Carol J. Cornwell
Mood Disorders	480	(21)
Epidemiology	480	(1)
Etiology	481	(1)
Genetic Factors	481	(1)
Physiologic Factors	482	(1)
Biogenic Amines	482	(1)
Psychoneuroendocrine and Immune Relationships	483	(1)
Psychological Factors	484	(1)
Psychodynamic Factors	485	(1)
Learned Helplessness	485	(1)
Cognitive Factors	485	(1)
Feminist Factors	486	(1)
Signs and Symptoms/Diagnostic Criteria	486	(1)
Major Depressive Disorders	486	(1)
Dysthymic Disorder	487	(3)
Bipolar Disorders	490	(1)
Bipolar I Disorder	490	(1)
Bipolar II Disorder	491	(1)
Cyclothymic Disorder	492	(1)
Implications and Prognosis	492	(1)
Interdisciplinary Goals and Treatment	492	(1)
Psychotherapy	492	(1)
Cognitive-Behavioral Therapy	492	(2)
Pharmacologic Therapy	494	(1)
Antidepressants	494	(3)
Mood Stabilizers	497	(2)
Medications for Refractory Mania	499	(1)
Somatic Nonpharmacologic Interventions	500	(1)
Electroconvulsive Therapy	500	(1)
Phototherapy	500	(1)
Sleep Deprivation	501	(1)
Transcranial Magnetic Stimulation	501	(1)
Vagus Nerve Stimulation	501	(1)
Application of the Nursing Process to the Client With a Mood Disorder	501	(20)
Assessment	501	(1)
Safety Assessment	501	(1)
Suicide Risk Assessment	501	(1)
Violence Assessment	502	(1)
Mental Status Examination	502	(1)
Appearance and General Behavior	503	(1)
Mood and Affect	503	(1)
Thought Process and Content	503	(1)
Perceptual Disturbances	503	(1)
Judgment and Insight	503	(1)
Physiological Stability Assessment	503	(1)
Family Issues Assessment	504	(1)
Nursing Diagnoses	504	(1)
Planning	504	(1)
Implementation	504	(1)
Protecting the Client from Suicide	504	(5)
Managing the Potential for Violence	509	(1)
Maintaining Physical Health and Personal Hygiene	509	(3)
Enhancing Thought Processes	512	(1)
Self-Esteem Issues	512	(1)
Anxiety and Agitation	512	(1)
Encouraging Treatment and Medication Adherence	513	(1)
Evaluation	513	(8)
The Client With a Thought Disorder	521	(34)
Barbara Schoen Johnson
Geraldine S. Pearson
Schizophrenia and Other Thought Disorders	522	(20)
The Stigma of Schizophrenia	523	(1)
Etiology	523	(3)
Biologic Theories	526	(1)
Genetic Influences	526	(2)
Neurochemical and Neuroanatomic Changes	528	(1)
Psychosocial Theories	529	(1)
Signs and Symptoms/Diagnostic Criteria	530	(1)
The Disorganization Dimension	530	(1)
Disorganized Speech	530	(2)
Disorganized Behavior	532	(1)
Incongruous Affect	532	(1)
The Psychotic Dimension	533	(1)
Delusions	533	(1)
Hallucinations	533	(1)
The Negative Dimension	533	(1)
Other Symptoms	534	(1)
Subtypes of Schizophrenia	534	(1)
Water Intoxication in Schizophrenia	534	(1)
Comorbidities and Dual Diagnoses	535	(1)
Implications and Prognosis	535	(1)
Interdisciplinary Goals and Treatment	535	(2)
Pharmacological Interventions	537	(1)
Traditional (Conventional) Antipsychotics	537	(2)
Atypical (Novel) Antipsychotics	539	(1)
Psychosocial Interventions	540	(1)
Milieu Management	540	(1)
Individual and Group Therapy	540	(1)
Cognitive-behavioral Therapy	540	(1)
Vocational Rehabilitation	540	(1)
Continuum of Care	541	(1)
Discharge Planning	541	(1)
Care in the Community	541	(1)
Application of the Nursing Process to the Client With a Thought Disorder	542	(13)
Assessment	542	(1)
Assessing Mood and Cognitive State	542	(1)
Assessing Potential for Violence	542	(1)
Assessing Social Support	543	(1)
Assessing Knowledge	543	(1)
Nursing Diagnosis	543	(1)
Planning	543	(1)
Implementation	543	(3)
Intervening in Disturbed Thought Processes and Sensory Perceptions	546	(1)
Reinforcing Reality	546	(1)
Understanding Language Content	546	(1)
Intervening in Hallucinations	546	(1)
Managing Violent Behavior	547	(1)
Lessening Social Isolation	547	(1)
Developing Trust	547	(1)
Initiating Interaction	547	(1)
Modeling Affect	547	(1)
Promoting Adherence to Medication Regimens	547	(2)
Promoting Improved Individual Coping Skills	549	(1)
Strengthening Family Processes	549	(1)
Providing Client and Family Education	550	(1)
Teaching Symptom Management	550	(1)
Evaluation	550	(5)
The Client Who Displays Angry, Aggressive, or Violent Behavior	555	(20)
Bonnie Louise Rickelman
Aggressive Behavior, Hostility-Related Variables, and Violence	556	(19)
Profiles of Aggressive and Violent Behaviors in Persons With Psychiatric Diagnoses	556	(1)
Sociodemographic Factors	556	(1)
Inpatient Factors	557	(1)
Outpatient Factors	557	(1)
Family Factors	557	(1)
Determinants of Aggression	557	(1)
Neurobiologic Factors	558	(1)
Psychological Factors	558	(1)
Temperament Theory	558	(1)
Cognitive Theory	558	(1)
Social-Environmental Factors	559	(1)
Legal Issues	559	(1)
Interdisciplinary Goals and Treatment	560	(1)
Verbal Interventions	560	(1)
Limit Setting	560	(1)
Cognitive Interventions	560	(1)
Guided Discovery	560	(1)
Anger Management	560	(1)
Behavior Therapy: Token Economy	560	(1)
Group and Family Therapy	561	(1)
Pharmacological Intervention	561	(1)
Seclusion and Restraint	561	(3)
Outpatient Management	564	(1)
Application of the Nursing Process to the Client Displaying Angry, Aggressive, or Violent Behavior	565	(1)
Assessment	565	(1)
Nursing Diagnosis	565	(1)
Planning	565	(1)
Implementation	565	(1)
Maintaining the Safety of Clients and Staff	566	(1)
Defusing Anger and Aggression through Verbal Interventions	566	(2)
Setting Limits to Prevent Violent Behavior	568	(1)
Teaching Anger Management and Coping Skills	568	(1)
Evaluation	569	(6)
The Client Who Abuses Drugs and Alcohol	575	(32)
Carol J. Cornwell
Substance Abuse and Dependency	576	(17)
Historical Context	576	(1)
Epidemiology	576	(2)
Prenatal Alcohol and Drug Abuse	578	(3)
Cultural Considerations	581	(1)
Etiology	581	(1)
Psychosocial and Behavioral Factors	581	(1)
Biological Factors	581	(1)
Theoretical Concepts	582	(1)
Comorbidities and Dual Diagnoses	582	(1)
Implications and Prognosis	582	(1)
Signs and Symptoms/Diagnostic Criteria	583	(1)
Alcohol Abuse and Dependency	583	(1)
Chemical Properties of Alcohol	583	(1)
Alcohol Concentration in the Body	584	(1)
Tolerance	585	(1)
Blackout	585	(1)
Alcohol-Induced Disorders	585	(1)
Medical Consequences of Alcohol Abuse and Dependency	586	(1)
Controlled Substances	586	(3)
Interdisciplinary Treatment	589	(1)
Medical Detoxification from Alcohol	589	(2)
The Rehabilitation Process	591	(1)
Medications Used to Treat Drug Dependency	591	(1)
Self-Help Groups	591	(2)
Application of the Nursing Process to the Client With a Substance-Related Disorder	593	(14)
Assessment	593	(2)
Physical Examination	595	(1)
Psychosocial Assessment	595	(1)
Nursing Diagnoses	595	(1)
Planning	595	(1)
Implementation	595	(1)
Maintaining Safety	595	(4)
Breaking Through Denial	599	(1)
Managing Anxiety	600	(1)
Teaching Effective Coping Strategies	600	(1)
Improving Family Processes	600	(1)
Enhancing Self-Esteem	600	(3)
Promoting Healthy Activities	603	(1)
Evaluation	603	(4)
The Client with a Cognitive Disorder	607	(34)
Cheryl Detwiler
Cognitive Disorders	608	(1)
Delirium	609	(4)
Etiology	609	(1)
Signs and Symptoms/Diagnostic Criteria	610	(1)
Implications and Prognosis	611	(1)
Interdisciplinary Goals and Treatment	611	(1)
Medical Interventions	611	(1)
Environmental Interventions	611	(1)
Cognitive Interventions	611	(2)
Psychological Interventions	613	(1)
Application of the Nursing Process to the Client With Delirium	613	(5)
Assessment	613	(1)
Nursing Diagnosis	614	(1)
Planning	614	(1)
Implementation	614	(1)
Managing Confusion	614	(3)
Providing a Safe Environment	617	(1)
Helping the Client With Personal Care	617	(1)
Providing Client and Family Education	617	(1)
Evaluation	617	(1)
Dementia	618	(8)
Signs and Symptoms/Diagnostic Criteria	618	(1)
Learning and Retaining New Information	618	(1)
Handling Complex Tasks	618	(1)
Reasoning Ability	618	(1)
Spatial Ability and Orientation	618	(1)
Language	618	(1)
Behaviour	618	(3)
Types of Dementia	621	(1)
Alzheimer's Disease	621	(3)
Vascular Dementia	624	(1)
Parkinson's Disease	624	(1)
Huntington's Chorea	624	(1)
Human Immunodeficiency Virus	624	(1)
Pick's Disease	624	(1)
Creutzfeldt-Jakob Disease	625	(1)
Implications and Prognosis	625	(1)
Interdisciplinary Goals and Treatment	625	(1)
Medical and Supportive Interventions	625	(1)
Psychosocial Interventions	626	(1)
Application of the Nursing Process to the Client with Dementia	626	(10)
Assessment	626	(1)
Behavior	626	(1)
Mental Status	626	(1)
Perceptual Problems	626	(1)
Orientation	626	(1)
Memory	626	(1)
Family	626	(3)
Education	629	(1)
Nursing Diagnoses	630	(1)
Planning	630	(1)
Implementation	630	(1)
Managing the Client's Health	630	(3)
Enhancing Sensory Capabilities	633	(1)
Meeting the Client's Physical Needs	633	(1)
Encouraging Appropriate Behaviors	634	(1)
Modifying the Environment	634	(1)
Performing Pharmacologic Interventions	634	(2)
Preventing Injury	636	(1)
Preserving the Family Unit	636	(1)
Evaluation	636	(1)
Amnestic Disorders	636	(5)
UNIT V Nursing Care for Special Populations	641	(60)
Working With Pediatric Clients	643	(42)
Barbara Schoen Johnson
Wanda K. Mohr
Sherill Nones Cronin
Overview of Mental Health and Psychiatric Disorders in Children and Adolescents	644	(9)
Theories of Child Development	644	(1)
Psychoanalytic Perspectives	645	(1)
Sigmund Freud's Psychosexual Theory	645	(1)
Erik Erikson's Psychosocial Theory	645	(1)
Piaget's Cognitive-Developmental Theory	645	(1)
Contemporary Approaches to Child Development	646	(1)
Risk Factors for Child and Adolescent Mental Disorders	647	(1)
Biological Influences	647	(1)
Psychosocial Influences	647	(1)
Stressors	647	(1)
Divorce	648	(1)
Child Abuse	648	(1)
Protective and Resilient Infleunces for Mental Health in Children and Adolescents	648	(1)
General Interventions for Child and Adolescent Mental Disorders	649	(1)
The Interdisciplinary Team and Coordination of Care	649	(1)
Treatment Settings and Continuum of Care	649	(1)
Wrap-Around Services and Systems-of-Care Approaches	649	(1)
Prevention and Early Identification	649	(1)
Types of Therapies	650	(1)
Special Education	651	(1)
Community-Based Services	651	(1)
Pharmacologic Therapy	651	(1)
Nursing Care	651	(1)
Assessment	651	(1)
Interventions	652	(1)
Common Psychiatric Disorders of Children and Adolescents	653	(5)
Disruptive Behavior Disorders	658	(1)
Attention-Deficit Hyperactivity Disorder and Attention-Deficit Disorder	658	(1)
Etiology	658	(1)
Signs and Symptoms/Diagnostic Criteria	658	(1)
Comorbidities	658	(1)
Interdisciplinary Goals and Treatment	659	(1)
Pharmacologic Therapy	659	(1)
Psychosocial Interventions	659	(1)
Application of the Nursing Process to a Client With ADHD	659	(4)
Assessment	659	(1)
Nursing Diagnosis	660	(1)
Planning	660	(1)
Implementation	660	(1)
Educating the Family About Treatment and Behavioral Strategies	660	(2)
Helping Families Cope	662	(1)
Managing Developmental and Academic Issues	662	(1)
Teaching Social Skills	663	(1)
Improving Self-Esteem	663	(1)
Evaluation	663	(1)
Oppositional Defiant Disorder	663	(1)
Conduct Disorder	664	(1)
Adjustment Disorders	664	(1)
Anxiety Disorders	664	(1)
Obsessive-Compulsive Disorder	664	(1)
Phobias	665	(1)
Social Anxiety Disorder (Social Phobia)	665	(1)
Generalized Anxiety Disorder	665	(1)
Separation Anxiety Disorder	665	(1)
Post-Traumatic Stress Disorder	666	(1)
Mood Disorders	666	(1)
Depression	666	(2)
Etiology	667	(1)
Signs and Symptoms	667	(1)
Comorbidities	668	(1)
Prevention	668	(1)
Interdisciplinary Goals and Treatment	668	(1)
Cognitive-Behavioral and Family Consultation	668	(1)
Pharmacologic Therapy	668	(1)
Bipolar Disorder	668	(2)
Etiology	668	(1)
Signs and Symptoms	669	(1)
Interdisciplinary Goals and Treatment	669	(1)
Importance of Early Identification and Treatment	669	(1)
Pharmacologic Therapy	669	(1)
Autism Spectrum Disorders	670	(1)
Autism	670	(1)
Asperger Syndrome	670	(1)
Interdisciplinary Goals and Treatment	670	(1)
Eating Disorders	671	(1)
Substance Abuse	671	(1)
Etiology	671	(1)
Prevention of Drug and Alcohol Abuse	671	(1)
Interdisciplinary Goals and Treatment	672	(1)
TIC Disorders	672	(1)
Trichotillomania	673	(1)
Suicide	673	(1)
Signs	673	(1)
Prevention	673	(1)
Interdisciplinary Goals and Treatment	674	(1)
Children with Medical Illness or Disability	674	(1)
Application of the Nursing Process to the Child or Adolescent With Medical Illness or a Disability	674	(5)
Assessment	674	(1)
Characteristics of the Disease	674	(1)
Family Assessment	675	(1)
Nursing Diagnosis	676	(1)
Planning	676	(1)
Implementation	676	(2)
Evaluation	678	(1)
Nurses' Self-Care	679	(6)
Working With Older Adults	685	(16)
Mildred O. Hogstel
Susan E. Margolis
Demographics of Aging and Future Trends	686	(1)
Psychosocial Issues and Influences	686	(1)
Retirement	686	(1)
Relocation	686	(1)
Bereavement	687	(1)
Spirituality	687	(1)
Issues Related to Ethnicity and Language Barriers	687	(1)
Communicating Effectively With Older Adults	687	(1)
Techniques	688	(1)
Terminology	688	(1)
Issues Related to Older Clients with Psychiatric Disorders	688	(8)
Ageism, Myths, and Prejudices	690	(1)
Settings for Care	690	(1)
Specific Mental Health Disorders	690	(1)
Treatment	690	(3)
Assessment	693	(1)
Psychotropic Medications	693	(1)
Methods of Administration	693	(1)
Polypharmacy	694	(1)
Pharmacokinetics and Pharmacodynamics	694	(1)
Adverse and Side Effects	695	(1)
Role of the Nurse	695	(1)
Promoting Mental Health and Wellness in Older Adults	696	(5)
Nutrition and Fluids	696	(1)
Mental and Physical Activities	696	(1)
Support Systems	696	(5)
Appendix A Review Question Answers with Rationales	701	(34)
Appendix B DSM-IV-TR Classification: Axes I and II Categories and Codes	735	(8)
Appendix C NANDA-Approved Nursing Diagnoses	743	(2)
Appendix D Canadian Standards of Psychiatric and Mental Health Nursing Practice	745	(4)
Appendix E Additional Resources	749	(6)
Appendix F Nursing Interventions and Outcomes Related to Psychiatric Disorders	755	(4)
Appendix G Commonly Used Assessment Tools	759	(4)
Glossary	763	(10)
Index	773