crisis intervention Flashcards
(31 cards)
1
Q
goal when a person is in crisis
A
- maintain system stability
- mobilize resources required to assist the person
- restore the person to adaptive function (cog. ability is diminished, they cannot function)
2
Q
stress
A
state of disequilibrium in response to environmental stressors
- if overwhelming and cannot cope = disequilibrium occurs = crisis
- can be positive or negative
3
Q
adaptive response to stress
A
- healthy
- maintains individual integrity
- person is able to cope
4
Q
maladaptive response to stress
A
- unhealthy
- disrupts individual integrity and homeostasis
- unable to cope
5
Q
general adaptation syndrome
A
- stress as a biological response
1. alarm reaction stage
2. stage of resistance
3. stage of exhaustion
6
Q
alarm reaction stage
A
- stage 1
- “fight or flight”
- emergency systems activate, glands enlarge
- increased catecholamines cortisol leads to increased glycogenolysis
7
Q
stage of resistance
A
- 2nd stage
- physiological response of first stage are used as a defense in an attempt to adapt
- successful adaptation = delayed 3rd stage
8
Q
stage of exhaustion
A
- 3rd stage
- prolonged exposure to the stressor
- adaptive energy is depleted
- ind. can no longer draw from resources for adaptation in first 2 stages
- diseases of adaptation can ensue: decreased immune response, hyperglycemia, ulcers, HA, mental disorders)
9
Q
anxiety
A
- most common emotional response to stressors
- vague feeling of dread which is not reality bases and a major component of crisis
10
Q
crisis
A
- acute and time limited state of disequilibrium r/t perceived threat
- usual coping skills cannot resolve the problem
- threat doesn’t have to be real
11
Q
crisis characteristics
A
- occurs in everyone, does not mean you have a mental illness
- personal, a crisis is a crisis to the person who is in it
- acute and will be resolved in one way or another within a brief period
- contains potential for psychological growth or deterioration
12
Q
phase I of crisis development
A
- impact phase
- ind is exposed to a precipitating stressor = increased anxiety
- person starts using the usual problem solving skills
13
Q
phase 2 of crisis development
A
- event is perceived as a threat
- usual problem solving skills are unsuccessful, leading to helplessness, confusion, and disorganization
14
Q
phase 3 of crisis development
A
- all resources and new problem solving skills are used but fail
- total disorganization, severe anxiety, depression, and withdrawal
15
Q
phase 4 of crisis development
A
- if problem remains unresolved, anxiety increased to panic
- cognitive functions are disordered
- emotions are labile
- behavior may reflect the presence of psychotic thinking and violent behavior
- crisis ensues
16
Q
emotional responses during crisis
A
- high anxiety
- denial
- anger
- remorse
- grief
17
Q
active s/s of crisis
A
- agitated
- screaming
- crying
- rapid speech
- emotional out of control
- n/v
- wringing hands
- hyperactive
- flushed face
18
Q
passive s/s of crisis
A
- fainting
- inactivity
- weak pulse
- diaphoresis
- pale face
- emotionally subdued
19
Q
variables in crisis development
A
- individual’s perception of the event
- availability of situational support
- adequacy of coping mechanisms
- *whether or not an ind. experiences a crisis in response to a stressful situation depends on these variables
20
Q
realistic/accurate perception of event
A
- greater success at problem solving efforts
- individual more likely to draw upon adequate resources to restore equilibrium
21
Q
distorted/inaccurate perception of event
A
- problem solving fails, leading to disequilibrium
- ineffective attempts to problem solve
- restoration of equilibrium goes unresolved
22
Q
risk factors for crisis development
A
- intense & multiple concurrent threats
- pre-existing psychological & psychiatric problems increase vulnerability to crisis development
- family hx of psychiatric problems
- lack of nurturing and childhood guidance
23
Q
availability of situational support
A
- provide assistance in coping
- parents, siblings, friends, clergy, counselor
- without anyone, a person becomes vulnerable and overwhelmed
24
Q
developmental crisis
A
- transitional changes in predictable life events that occur gradually in the course of a life cycle
- when the pattern of predictable life events break, a dev. crisis can occur
25
maturational crisis
-failure to meet expectations of development can lead to crisis (Erikson's)
26
situational crisis
- external situations mostly unpredictable and threatens one's well being
- material: natural disasters, environmental
- personal: physical, disfigurement
- interpersonal/social: divorce, death
27
crisis intervention
- short term therapeutic process that focuses on immediate crisis using support system, professional help, and environmental resources
- primary goal: re-establish a level of functioning equal or higher to pre-crisis state and regain emotional balance
- immediate attention to problems = healthy adaptation
28
role of nurse in crisis
- talk in a reassuring tone
- use person's name
- talk directly and keep language simple
- warn client when something is going to be done
29
assessment in crisis
- assess situation first
- observe first, listen carefully, don't talk, obtain as much background and hx as possible
- as if the pt knows what he or she needs at this moment
- ask individual to describe event that precipitated the crisis
- asses the individual's physical and mental status
- determine if individual has experienced this stressor before
- assess for SI and homicide
30
planning/implementation in crisis
- offer assistance: "what can I do to help?"
- touch gently
- provide concrete directions
- cut down on stimuli around the ind.
- do not rush
- talk calmly and slowly
- be prepared to repeat information
- they take things literally
- offer reasonable alternatives
- don't argue
- don't leave pt alone
31
evaluation in crisis
- is the client able to maintain system stability
- is the client able to recognize events that lead to the crisis
- are the client's problem solving skills improved as a result of the crisis
