unit 3 personality do Flashcards
1
Q
PD common char-4
A
- inflexible and maladaptive response to stress
- disability in working and loving
- ability to provoke interpersonal conflict in HCPs, fy, and friends
- capacity to have an intense effect on others-unconscious and undesireable
2
Q
paranoid PD sym-7
A
- vigilant and suspicious of others
- bears grudges/unforgiving of insults
- reads hidden threats into benign remarks
- diff w close relationships/works alone
- cold/impersonable, does not share thoughts, no sense of humor
- critical of others but can’t take criticism
- prone to file lawsuits
3
Q
Paranoid PD RN guidelines-6
A
- avoid too nice/friendly
- give clear explanations for tests and proceedures
- simple/clear language, avoid ambiguity
- project neutral but kind affect
- warn of any changes/side effects
- written plan of tx
4
Q
paranoid pd treatment -4
A
- initial mistrust
- cognitive and behavioral
- focus on counteracting fear and relieving stress
- severe paranoia-antipsychotic
5
Q
schizoid PD sym-5
A
- neither desires nor enjoys close rel, even w fy
- solitary/loner
- eccentric, flat affect
- occupation involves little interpersonal contact
- may also develop schizophrenia or delusional do
6
Q
schizoid pd rn guidelines-3
A
- avoid too nice/friendly
- don’t resocialize
- thourough assessment needed-reluctant to discuss
7
Q
schizoid pd tx-3
A
- only in crisis and to relieve symptoms
- group tx
- social skills training
8
Q
schizotypal pd sym-8
A
- high suicide and schizophrenia
- withdrawn/aloof
- ideas of reference, odd beliefs, magical thinking
- social anxiety ass w paranoid fears
- lack of close friends
- inappropriate or constricted affect
- behavior odd/eccentric/peculiar
- illogical speech/unkempt appearance
9
Q
schizotypal pd rn guidelines-3
A
- respect need for social isolation
- be aware of pt suspiciousness
- careful assessment needed (suicidal thoughts)
10
Q
schizotypal pd tx-2
A
- cognitive behavior tx
2. atypical (second gen) antipsychotics
11
Q
antisocial pd sym-10
A
- extended hx of antisocial behaviors begining before 15 and into adulthood
- deceitfulness
- blames others for problems
- consistent irresponsibility
- impassive/aggressive toward others
- lack of remorse/empathy
- can be charming
- manipulation/aggressive/ exploitive
- sub abuse common
- familial pattern/criminality
12
Q
antisocial pd rn guidelines-3
A
- prevent/reduce manipulation
- aware of instilling guilt when not getting their way
- sub abuse tx first
13
Q
antisocial pd tx-3
A
- little success
- treat specific behaviors that can be modified
- milieu programs-token/therapeutic
14
Q
boderline pd sym-7
A
- most have another do
- rel are intense, unstable and alternate between dependance and rejection
- impulsive and self-damaging behaviors (sex, spending)
- recurrent suicidal/self-mutilation
- intense anger/rage/hostility
- uses splitting
- rapid idealization-devaluation
15
Q
borderline pd rn guidelines-7
A
- set realistic goals w clear action words
- be aware of manipulation
- provide clear/consistent boundaries and limits
- use clear straightforward communication
- review therapeutic goals in response to behaviors
- avoid rejecting/rescuing
- assess for suicide and self-mutilation
16
Q
borderline pd tx-4
A
- dialectical behavioral therapy
- hospitalization common
- antidepressants/antipsychotics
- anticonvulsant- carbamzepine
17
Q
histrionic pd sym-7
A
- draw attention to self- attractive
- excessive emotionality and attention-getting behavior
- intense emotional expressions are shallow w rapid shifts
- describe rel as more intimate than reality
- suggestible
- smothering/destructive
- w/o instant gratification can become depressed/suicidal
18
Q
histrionic pd rn guide-4
A
- understand seductive behavior as response to stress
- stay professional
- encourage and model concrete and descriptive
- teach/role model assertiveness
19
Q
histrionic tx-2
A
- use indirect means to get others to take car of them
2. psychoanalytic and behavioral approach
20
Q
Narcissistic pd sym-6
A
- exploit others to meet own needs
- arrogant, entitled
- gradiosity, need for admiration, lack empathy
- will agree then sabatage others
- begrudge others for success
- rel are superficial/ argumentative/controlling
21
Q
narcissistic rn guide-2
A
- remain neutral to avoid power struggles/defensive
2. convey unassuming self-confidence
22
Q
narcissistic tx
A
- insight oriented psychotherapy
2. difficult to treat because can’t see anothers POV
23
Q
dependent pd sym-8
A
- unusual degree of agreeableness or friendliness
- use to attach to another as protector
- clingy- takes precedence over outside interests
- can’t make decisions
- will suffer self-sacrifice to obtain nurture and support from others
- need others to assume responibility
- difficulty expressing disagreements
- want everything done for them
24
Q
dependent pd rn guide-4
A
- id and help address current stressors
- satisfy needs w limits
- need supervision for countertranference
- teach/role model assertiveness
25
dependent tx-3
-supportive, cognitive-behavioral, and group
26
obsessive compulsive personality pd sym-9
1. inflexible, rigid, needs to be in control
2. perfectionist to point of incompletion
3. overemphasis on work to the exclusion of rel and pleasure leisure
4. preoccupied w details-can't make decision
5. intimacy rigidly controlled
6. financial stingyness, can't part w objects
7. highly critical
8. preoccupation w lists, rules, schedules
9. need to dominate people and situations
27
OCPD rn guide-2
1. guard against power struggles
| 2. intellectualization, rationalization, and reaction formation most common defense mech
28
avoidant pd sym-5
1. pervasive pattern of social inhibition/phobias
2. strong feelings of inadequacy
3. avoid interpersonal contact out of fear of critisim/rejection
4. view self as socially inept/unappealing/inferior
5. don't push into social situations
29
pd assessments-3
1. culture/social background
2. change in personality in middle adulthood signals need for medical workup
3. be cognizant of social stereotypes
30
RN diagnoses-8
1. risk for self-mutilation
2. chronic low self esteem
3. impaired social interaction
4. ineffective coping
5. manipulation
6. suicide
7. anger and hostility
8. nonadherance to meds or treatment