trauma, stressor-related and dissociative disorders

Question 1

posttraumatic stress disorder (PTSD) in preschool children s/s

Answer 1

• detaching from others
• blame themself for event
• not playing as much
• repetive play
• withdrawn
• sad/negative feelings/emotions

Question 2

reactive attachment disorder

Answer 2

consistent pattern of withdrawn behavior

• lacking good attachement
• lack of bonding before 8 months
• easier to treat

Question 3

disinhibited social engagement disorder

Answer 3

• extremely friendly/happy

- not afraid of strangers

Question 4

interventions for trauma- related disorders in children

Answer 4

• forceful hold

- more interaction with caregiver

Question 5

developmental assessment

Answer 5

see if there is a delay

• nightmares, hallucinating, self injury, flashbacks
• interview the child, screening, observe wile they play, interactions with others

Question 6

nursing diagnosis for kids

Answer 6

risk for impaired attachment

• caregiver form bond
• consistency

risk for impaired development
- special ed classes

Question 7

stage 1 interventions

Answer 7

Stage 1: Provide safety and stabilization

- environment they feel safe in, educating them

Question 8

stage 2 interventions

Answer 8

Stage 2: Reduce arousal and regulate emotion through symptom reduction
- emotion and memory, comfortable with others, not avoiding situation

Question 9

stage 3 interventions

Answer 9

Catch up on developmental and social skills; develop a value system

• help with social engagement
• problem solving skills
• effective coping skills
• health social supports

Question 10

interventions for children with ptsd

Answer 10

• Establish trust and safety
• Use developmentally appropriate language
• Teach relaxation techniques
• Use art and play to promote expression of feelings
• Involve caretakers in 1:1s, unless they are the cause of trauma
• Educate child and caretakers about grief process
• Assist caretakers in resolving personal distress
• Coordinate with social work for protections

Question 11

interventions therapies and meds

Answer 11

• CBT: cognitive behavioral therpay- reframing negative thoughts
• EMDR
• SSRI: first-line, improving social and school function, decrease level of avoidance; no numbing feelings

Question 12

post traumatic stress disorder adults

Answer 12

• Re-experiencing of the trauma: fearful, anxious, shame, guilt, nightmares, explosive
• Avoidance of stimuli associated with trauma
• Persistent symptoms of increased arousal
• Alterations in mood
  + want them in presence
  + identify what real vs not

Question 13

post-traumatic stress disorder diagnosis

Answer 13

Post trauma syndrome
- symptoms over a month impaired function, anxiety

Complicated grieving
- morning the situation

Question 14

post-traumatic stress disorder outcome identification

Answer 14

Manage anxiety.
Increase self-esteem.
Improve ability to cope.

Question 15

ptsd implementation

meds

Answer 15

• The same 3-stage model used for children
• Psychoeducation
• Psychopharmacology
  + persosin (key med): sleep disturbance
  + propanol: helps with anxiety - checking vitals

Question 16

acute stress disorder

Answer 16

• Immediately after a highly traumatic event
• Symptoms persist for 3 days
• Diagnosis made within month
• symptoms the same

After 1 month

• Resolution or
• Becomes PTSD

Question 17

ASD diagnosis s/s

Answer 17

Alterations in concentration
Anger
Dissociative amnesia
Headache
Irritability
Nightmares
Victimization

Question 18

asd implementation

Answer 18

• Establish therapeutic relationship
• Assist to problem solve
• Connect person to supports
  Collaborate for coordination of care
• Ensure and maintain safety
• Refer to a licensed mental health provider
• Monitor response and/or adherence to treatment
• Advanced practice: cognitive-behavioral therapy (CBT)

Question 19

adjustment disorder

Answer 19

• Precipitated by stressful event (not traumatic)
• Debilitating cognitive, emotional, and behavioral symptoms that negatively impact normal functioning
• Responses to stressful event may include combinations of depression, anxiety, and conduct disturbances
• struggle adls, bills, cognitive issues (memory)

Question 20

dissociative disorders

Answer 20

• Occur after significant adverse experiences/traumas
• Individuals respond to stress with severe interruption of consciousness
• Unconscious defense mechanism
• Protects individual against overwhelming anxiety through emotional separation

Question 21

dissociative disorder types

Answer 21

Depersonalization/derealization disorder
Dissociative amnesia
Dissociative identity disorder

Question 22

depersonalization

Answer 22

• cut off from self
• robot
• not intube
• outside observer
• out of body experience

Question 23

derealization

Answer 23

• cut off from world
• in dream
• objects feel bigger/smaller
• sounds overwhelming

Question 24

Dissociative Amnesia

Answer 24

• Inability to recall important personal information (driving home and zoning out)
• Often of traumatic or stressful nature

Dissociative fugue
- Subtype characterized by sudden, unexpected travel and inability to recall one’s identity

Question 25

Dissociative Identity Disorder

Answer 25

• Presence of two or more distinct personality states
• protect from traumatic event
• moral compas irratic

Each alternate personality (alter) has own pattern of

• Perceiving
• Relating to and
• Thinking about the self and environment

Question 26

Dissociative Disorders Assessment

Answer 26

• History: how long, short or long term memory, injuries (concussion, seizure)
• Moods
• Impact on patient and family
• Suicide risk
• Self-assessment

Question 27

Dissociative DisordersImplementation

Answer 27

Interventions

• Psychoeducation
• Pharmacological interventions: meds to treat others disorders no specific meds