Psych HESI Hint

Crisis Intervention: Focus on the problem, not the cause The goal is to return individual to pre-crisis level of functioning. The purpose of therapeutic interaction with clients is to allow then the autonomy to make choices when appropriate. Keep statements value-free, advise-free, and reassurance-free. Remember, just the facts! No opinions! (Review the useful & forbidden phrases) What action should the nurse take in a psychiatric situation when the client describes a physical problem? Assess, assess, assess!!! If a psych patient complains of chest pain, FIRST, take his BP. (Just because the focus of the clients situation is on his or her psychological needs, it does not mean that the nurse can ignore physiologic needs.) Basic communication principals can be applied to all clients: • Establish trust • Demonstrate a nonjudgmental attitude • Offer self; ne empathetic, NOT sympathetic • Use active listening • Accept and support client’s feelings • Clarify and validate client’s statements • Use matter of fact approach ECT Nausea is a common complaint after ECT. Vomiting by an unconscious client can lead to aspiration; Maintain patent airway. Anxiety: Common physiologic responses to anxiety include increased heart rate and blood pressure; rapid, shallow respirations; dry mouth; tight feelings in throat; tremors and muscle tension; anorexia; urinary frequency; and palmar sweating. Anxiety is very contagious and is easily transferred from client to nurse and from nurse to client. First, the nurse must assess his/her own level of anxiety and remain calm. A calm nurse helps the client to gain control, decrease anxiety, and increase feelings of security. The nurse should place an anxious client where there are reduced environmental stimuli (a quiet area of the unit, away from the nurses’ station) OCD The best time for interaction with a client is at the completion of the performed ritual. The client’s anxiety is lowest at this time; therefore, it is an optimal time for learning. Compulsive acts are used in response to anxiety, which may or may not be related to the obsession. It is the nurse’s responsibility to help alleviate anxiety. Interfering with increase anxiety. These acts should be allowed as long as the client’s acts are free of violence. The nurse should: • actively listen to the client’s obsessive themes • acknowledge the effects that ritualistic acts have on the client • demonstrate empathy • avoid being judgmental PTSD For clients with PTSD, the nurse should: • Actively listen to clients stories of experiences surrounding the traumatic event • Assess suicide risk • Assist client to develop objectivity about the even and problem-solve regarding possible means of controlling anxiety related to the event • Encourage group therapy with other clients who have experienced the same or related traumatic events Dissociative Disorder Avoid giving clients with dissociative disorders too much information about past event at one time. The various types of amnesia that accompany dissociative disorders provide protection from pain. Too much, too soon may cause decompensation. ............................................CONTINUED.........................................