exam 2 Flashcards
cluster A eccentric group psychotics: paranoid personality disorder
S: Spouse fidelity suspected
U: Unforgiving (bears grudges)
S: Suspicious of others
P: Perceives attacks (and reacts
quickly)
E: “Enemy or friend” (suspects
associates, friends)
C: Confiding in others feared
T: Threats p
cluster A eccentric group psychotics: schizoid personality disorder: DISTANT
D: Detached (or flattened) affect
I: Indifferent to criticism and praise
S: Sexual experiences of little
interest
T: Tasks (activities) done solitarily
A: Absence of close friends
N: Neither desires nor enjoys close
relations
T: Takes pleasure in few activities
cluster A eccentric group psychotics schizotypal personality disorder: MEPECULIAR
M: Magical thinking or odd beliefs
E: Experiences unusual perceptions
P: Paranoid ideation
E: Eccentric behavior or appearance
C: Constricted (or inappropriate)
affect
U: Unusual (odd) thinking and
speech
L: Lacks close friends
I: Ideas of reference
A: Anxiety in social situations
R: Rule out psychotic disorders and
pervasive developmental disorder
cluster B dramatic, erratic group extraverts antisocial personality disorder: corrupt
C: Conformity to law lacking
O: Obligations ignored
R: Reckless disregard for safety of self or
others
R: Remorse lacking
U: Underhanded (deceitful, lies, cons
others)
P: Planning insufficient (impulsive)
T: Temper (irritable and aggressive)
cluster B dramatic erratic group extraverts borderline personality disorder AMSUICIDE
A: Abandonment
M: Mood instability (marked reactivity of
mood)
S: Suicidal (or self-mutilating) behavior
U: Unstable and intense relationships
I: Impulsivity (in two potentially selfdamaging areas)
C: Control of anger
I: Identity disturbance
D: Dissociative (or paranoid) symptoms
that are transient and stress-related
E: Emptiness (chronic feelings of)
cluster B: Dramatic, erratic group extraverts histrionic personality disorder: PRAISEME
P: Provocative (or sexually seductive)
behaviorR: Relationships (considered
more intimate than they are)
A: Attention (uncomfortable when not the
center of attention)
I: Influenced easily
S: Style of speech (impressionistic, lacks
detail)
E: Emotions (rapidly shifting and shallow)
M: Made up (physical appearance used to
draw attention to self)
E: Emotions exaggerated (theatrical)
cluster B dramatic erratic group extraverts narcissistic personality disorder: special 5
S: Special (believes he or she is special and
unique)
P: Preoccupied with fantasies (of unlimited
success, power, brilliance, beauty, or ideal
love)
E: Entitlement
C: Conceited (grandiose sense of selfimportance)
I: Interpersonal exploitation
A: Arrogant (haughty)
L: Lacks empathy
cluster C: Anxious, fearful group neurotics avoidant personality disorder CRINGES
C: Certainty (of being liked required before
willing to get involved with others)
R: Rejection (or criticism) preoccupies one’s
thoughts in social situations
I: Intimate relationships (restraint in intimate
relationships due to fear of being shamed)
N: New interpersonal relationships (is inhibited
in)
G: Gets around occupational activity (involving
significant interpersonal contact)
E: Embarrassment (potential) prevents new
activity or taking personal risks
S: Self viewed as unappealing, inept, or inferior
cluster C: anxious, fearful group neurotics dependent personality disorder: RELIANCE
R: Reassurance required for decisions
E: Expressing disagreement difficult (due to fear
of loss of support or approval)
L: Life responsibilites (needs to have these
assumed by others)
I: Initiating projects difficult (due to lack of selfconfidence)
A: Alone (feels helpless and discomfort when
alone)
N: Nurturance (goes to excessive lengths to
obtain nurturance and support)
C: Companionship (another relationship) sought
urgently when close relationship ends
E: Exaggerated fears of being left to care for self
cluster C: anxious, fearful group neurotics obsessive-compulsive personality disorder LAW FIRMS?
L: Loses point of activity (due to preoccupation
with detail)
A: Ability to complete tasks (compromised by
perfectionism)
W: Worthless objects (unable to discard)
F: Friendships (and leisure activities) excluded
(due to a preoccupation with work)
I: Inflexible, scrupulous, overconscientious (on
ethics, values, or morality, not accounted for by
religion or culture)
R: Reluctant to delegate (unless others submit to
exact guidelines)
M: Miserly (toward self and others)
S: Stubbornness (and rigidity)
nursing interventions for lack of trust in feeling of safety and security
- Keep interactions brief, especially orientation
- Structure environment
- Be consistent and reliable; notify patient of anticipated schedule changes
- Decrease physical contact
- Eye contact during greeting
- Maintain attentiveness with head slightly leaning toward patient and nonintrusive attitude
- Allow physical distance
- Accept patient’s behavior (with silence), maintain matter-of-fact attitude toward behavior
nursing interventions for hallucinations
- Maintain accepting attitude
- Do not argue with patient about reality of hallucinations
- Comment on feeling, tone of hallucinations, “that must be frightening to you”
- Encourage diversional activities (playing cards), especially activities in which patient can gain a sense of mastery (artwork)
- Encourage discussions of reality-based interests
nursing intervention for lack of attention to personal needs (nutrition, hygiene, etc)
- Assess adequacy of hydration, nutrition
- Structure routine for bathing, mealtime
- Offer encouragement of assistance if necessary (sit with patient or feed patient if appropriate)
- Decrease environmental stimuli at mealtime (suggest early dinner before dining room crowds)
- Positioning and skin care for catatonic patient
nursing intervention for mistrust and feeling of rejection
- Keep appointments with patients
- Clear, consistent communication
- Allow patient physical distance and keep door open when interviewing
- Genuineness and honesty in interactions
- Recognize testing behavior and show persistence in interest in client
nursing intervention for delusions?
- Allow patient to verbalize the delusion in a limited manner
- Do not argue with patient or try to convince that delusions are not real
- Point out feeling tone of delusion
- Provide activities to divert attention from delusions
- Solitary activities best at first and then may progress to noncompetitive games or activities
- Do not reinforce delusions by validating them
- Focus on potential real concerns of patient
nursing intervention for increased agitation and anxiety
- Recognize signs of impending violence (increased motor activity, pacing, or sudden stop – “calm before the storm”)
- Identify yourself, speak calmly but firmly in normal tone of voice
- Help verbalize feelings
- Use nonthreatening body language (arms to side, palms outward, keep distance, avoid blocking exit, avoid body contact)
- Avoid disagreeing with or threatening patient
- Decrease stimuli, remove threatening objects or people
nursing intervention for violence
- Intercede early
- Continue nonthreatening behavior
- If patient needs to be restrained to protect self or others, get help (at least 4 people)
- Move in organized, calm manner, stating that you want to help and that you will not permit patient to harm self or others
- Use restraints correctly (never tie to bedside rail, check circulation frequently)
defense mechanism: acting out
You engage in extreme, disruptive, and/or unacceptable behaviors and actions. Example: a child throws a temper tantrum because they cannot deal with frustration at school or home.
defense mechanism: compensation
Your self-worth and self-esteem are protected by overachieving in a new area after failing in another area. Example: a young college student hoping to become an engineer fails his math class, so he decides to leave college and instead get and excel in a sales career.
defense mechanism denial
You completely reject the thought or feeling to avoid damage to the ego caused by the anxiety or guilt of accepting them. Example: A married woman might deny to herself that she holds affections for her husband’s friend, rather than accepting her true feelings.
defense mechanism displacement
You direct your feelings of anger and hostility to another target (person or object). Displacement allows the person to ventilate and act out their anger in a less harmful and more socially acceptable manner. Example: a man who is fired by their boss comes home and kicks the dog.
defense mechanism dissociation
You lose track of time and/or person, and instead find another representation of yourself in order to continue in the moment. You can “disconnect” from the real world for a time and live in a world that is not cluttered with thoughts, feelings, or memories that are unbearable. In extreme cases, this can lead to a person believing they have multiple selves (dissociative identity disorder). Example: a friend enters a state of daydreaming, staring in to space and letting their mind wander until you nudge them, prompting them to acknowledge reality once more.
defense mechanism: identification
In order to pacify a person whom we perceive to be a threat, we may emulate aspects of their behavior (adopting their mannerisms, repeating phrases or language patterns, and mirroring character traits). Example: A teenager moves to a new school and adopts the attitudes of classmates from whom they seek acceptance, in order to not be rejected by their new peers.
defense mechanism intellectualization
A type of rationalization, only more intellectualized. You use conscious, intellectual, and rational thinking to explain some stressful event. This often involves standing back from the situation and attempting to take a cold, neutral view of it. Example: A person was laid off after twenty years of service may intellectualize it by acknowledging the management’s view that redundancies need to be made in order for the company to survive.
