Anger and At risk for other directed violence Unit 3 (1) Flashcards Preview

Semester Three - Half One - Nursing 211 > Anger and At risk for other directed violence Unit 3 (1) > Flashcards

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Risk Factors Violence

  1. Being cruel to animals
  2. Setting fires
  3. Witnessing family violence
  4. Past convictions
  5. Violent behavior
  6. Frequent psychiatric hospital admissions
  7. Aggressive behavior
  8. Emotional deprivation in childhood
  9. Substance abuse
  10. Impulsive behavior/poor impulse control
  11. Earlyage ofonset of psychiatric symptoms
  12. Unpredictable behavior
  13. Helplessness
  14. Inability to express anger to the person he/she is dependent upon for survival
  15. Poor frustration tolerance
  16. Ineffective coping skills
  17. Feelings of personal threat, rage, fear
  18. Intoxication
  19. Homicidal ideation
  20. Severe psychopathology
  21. Halluncination
  22. Delusions
  23. Suspicious agitation
  24. Escalating signs of anger
  25. Space and location problems
  26. Architectural design problems
  27. Activity level problems
  28. Staffing patterns
  29. Strong needs for attention
  30. Ruminates


Primary prevention Violence

Attempts to alleviate illnesses before they occur by removing possible causes and risk factors

  1. Conflict resolution programsin schools
  2. Stress management classes
  3. Parent training classes
  4. Lifestyle counseling programs
  5. Encourage zero-tolerance policies
  6. Educate that violence is not a normal aspectof healthy relationships


Secondary Prevention Violence

The early identification and treatment of violent behavior. Focus is on pro-active treatment because prognosis is affected by the duration of the mental disorder

  1. Inpatient units
  2. Outpatient groups (anger managment)


Tertiary Prevention Violence

The elimination or reduction of the aftermath of illness; rehabilitation (anger management)

  1. Case management
  2. Support services
  3. Probation
  4. Parole


Nursing Diagnosis Angry Client


  1. Risk for Other-Directed Violence
  2. Ineffective coping
  3. Impaired social interaction


Verbal Assessment

  1. Threats of harm
  2. Loud, demanding voice tone
  3. Abrupt silence
  4. Negative responses to staff requests
  5. Sarcastic remarks
  6. Pressured speech
  7. Illogical responses
  8. Yelling, screaming
  9. Statements of fear and/or suspicion


Behavior Assessment

  1. Clenched jaws
  2. Frowning, glaring
  3. Intense staring
  4. Flushing of face and neck
  5. Lip biting
  6. Smirkinggrin
  7. Dilated pupils
  8. Pacing
  9. Pounding fists
  10. Heightened vigilance
  11. Confrontational stance
  12. Aggession toward objects (slamming doors)
  13. Possession of a weapon


Specific times a client is likely to become aggressive

  1. On Admission
  2. Change of shift
  3. Meal times
  4. Evenings
  5. Visiting hours
  6. In elevators
  7. During periods of change


Safety Interventions

  1. Violence precautions
  2. Assign client to private room
  3. Do not touch client
  4. Be sure that you are between the client and the door
  5. Stand at a 45 degree angle to the client
  6. Maintain eye contact but do not stare
  7. Limit setting - be consistent and firm
  8. Establish the expectation that the client will remain in control
  9. Pharmacologic management 


Expressing Feelings Interventions

  1. Therapeutic Relationship
  2. Promote interaction that increase theclient's sense of trust
  3. Stateto the client what you see him doing and how you think he may be feeling
  4. Determine if you understand the client correctly
  5. Encourage the client to describe the experience to increase awareness
  6. Give positive verbal feedback when client uses words to express his feelings


Assist with Problem Solving Interventions

  1. Use show of force instead of approaching alone
  2. Allow for more personal space
  3. Talk down the client
  4. Make short, concise statements
  5. Make contact right away with an angry client
  6. Validate the client's feelings, help the client address the unmet need
  7. Avoid using "always" and "never"
  8. Helpful verbal wording
  9. Avoid threats
  10. When client has calmed down, offer choices and options for diversional activities