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1. An emotional response to frus- Anger
tration of desires, threat to one's
needs (emotional or physical), or
a challenge
2. Action or behavior that results in Aggression
verbal or physical attack
3. In the hospital, violence is most Psychiatric units
frequent in Emergency departments
Geriatric units
4. Comorbidities for anger and ag- PTSD
gression substance abuse
depression, anxiety, PD's and psychosis
5. The limbic system is responsible aggression
for
6. The amygdala is responsible for emotion
7. Serotonin responsible for emotions and anger
Dopamine
Gaba
8. Nursing diagnosis for patients Ineffective coping
with anger Risk for violence
9. Nursing implementations for Psychological interventions
anger Consideration for staff safety
Pharmacological interventions
10. Get the other patients out
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If a patient is escalating and
is around other patients, what
should you do?
11. De-escalation Listen to the patient
Offer the things they want or need
Don't demand
Give respectable answers
12. Consideration for staff safety Avoid wearing dangling ear rings, necklaces, and scarves
Ensure there is enough staff for back up
Always know the layout of the area '
Do not stand directly in front of the patient or in front of
the doorway
If the patient's behavior begins to escalate, provide feed-
back
Avoid confrontation
13. B-52 Benadryl 50mg
5 mg Haldol
2 mg Ativan
Beware in elderly and those with prolonged QT
14. antianxiety agents and antipsy- Haldol
chotics are used in the treatment Ativan
of acute symptoms of anger and B-52
aggression
15. Acute anger patient nursing im- Health teaching and promotion
plementation Case management
, NSG-3450 EXAM 4
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Team work and safety
- Restraints or seclusions might be necessary
16. Involuntary confinement alone in Seclusion
a room that the patient is physi-
cally prevented from leaving
17. Any manual method, physical or Restraints
mechanical device, material, or
equipment that immobilizes or
reduces the ability of a patient to
move his or her arms, legs, body,
or head freely
18. Guidelines for use of mechanical 1. Indications for use
restraints 2. Legal Requirements
3. Documentation
4. Clinical Assessments
5. Observation
6. Release procedure
7. Restraint tips
19. Types of abuse Physical
Visa
Psychological
Sexual
Controlling
Financial
Digital
Emotional
20. Examples of physical abuse -Shaking, biting, hitting, burning, throwing, kicking, gag-
ging, twisting, binding, starving, poking, choking, scald-
, NSG-3450 EXAM 4
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ing, cutting.
Damaging property
Taking prescriptions
Leaving in places
Driving recklessly
forcing drug or alcohol use
21. Examples of emotional abuse Ignores partner's feelings, Ridicules or insults women /
men as a group, Ridicules partner's beliefs, Withholds
approval, Criticizes, Insults and/or drives away partner's
family friends, Humilities partner in public / private, Re-
fuses to socialize with partner, Takes away car keys /
money / personal property, Threatens to leave, Threatens
partner's family / friends, Punishes children when an-
gry with partner, Threatens to kidnap children if partner
leaves, Abuses pets to hurt partner, Tells partner about
affairs, Harasses partner about affairs, real or imagined,
Manipulates partner with lies / contradictions
22. Example of sexual abuse all of the above
23. Financial abuse examples Forging to elder signature and cashing his her check
Forcing client to sign any document
Misusing or stealing the elders clients possession
Forcing the elderly to contribute for utilities
Forcing the elderly to contribute money for food
Making them put their paycheck into a certain account
stealing money