Verified Solutions
Overall treatment goal for PTSD - ANSWER is to enable patients to regain control of
their emotional responses and to place the trauma in the larger perspective of their
lives as an event that happened at a certain time and that is unlikely to recur.
One of the first steps in PTSD treatment - ANSWER is to help the patient to develop a
sense of trust,
safety, and separation from the traumatic event
Psychotherapy for PTSD - ANSWER psychotherapy: Exposure, CBT, EMDR, Trauma
management therapy, structured writing,
VRE/tech based, interpersonal therapy, psychodynamic
Pharmacological choice for PTSD - ANSWER SSRI
Cluster A - ANSWER Odd or eccentric PD
Paranoid PD - ANSWER Suspicious of others; fear others will exploit, harm, or deceive
them; fear of confiding in others
(fear personal information will be used against them); misread compliments as
manipulation;
hypervigilant; prone to counterattack; hostile; and aloof.
Psychotic episodes may occur in times of stress.
Nurses should give straightforward explanations of tests, history taking, and
procedures, side
effects of drugs, changes in treatment plan, and possible further procedures, to
counteract client fear.
Traits of a person with Paranoid Personality Disorder. o
They do not trust others easily and it's best to use a respectful neutral approach. o
They are critical of others because they project blame for their own shortcomings onto
others
Schizoid PD - ANSWER Avoids close relationships, is socially isolated, has poor
occupational functioning, and appears
cold, aloof, and detached.
Social awareness is lacking and relationships generate fear and confusion in the client.
,Nurses should strive for simplification and clarity to help decrease client anxiety.
Therapy: Individual psychotherapy is the appropriate modality to use with Schizoid
personality
disorder
These clients tend to be frightened and suspicious in social situations.
Explanations can ease their anxiety.
Schizotypical PD - ANSWER ideas of reference; magical thinking or odd beliefs;
perceptual distortions; vague, stereotyped
speech; frightened, suspicious, blunted affect; distant and strained social relationships.
o
Cluster B - ANSWER Dramatic, Emotional, Erratic
Borderline Personality symptoms - ANSWER Unstable, intense relationships; identity
disturbances; impulsivity; self-mutilation; rapid mood
shifts; chronic emptiness; intense fear of abandonment; splitting; and anger
Inability to tolerate perceived rejection
BPD Major defense - ANSWER A major defense is splitting (alternating between
idealizing and devaluing).
Self Mutilation in BPD - ANSWER Self-mutilation and suicide-prone behavior are often-
used impulsive self-destructive behaviors.
Self mutilation occurs: - ANSWER because a client may feel that pain is better than not
feeling
anything, it also results from feelings of abandonment, it can be a manipulative gesture,
and it is also happens when a safety plan has been put in place.
Self mutilation is mainly due to: - ANSWER fear of abandonment or the increase of
independence
Note: - ANSWER If a client with BPD who was making progress but recently had an
anxiety producing
, situation arise and now cut herself is that even though this behavior is dysfunctional, it
is mostly the patient's best effort to cope
Best response from PMH-APRN in BPD - ANSWER The best response by the PMHNP
when speaking with a client with BPD who has been in
counseling for management of self-harm behaviors who now wants to cut themselves is
to assist the client to identify an appropriate coping strategy
Anger in BPD - ANSWER Anger is intense and pervasive and help with anger
management is an important intervention
Other focuses of BPD Management - ANSWER Relationship building, safety, and limit
setting are other foci.
Clients with BPD have not successfully - ANSWER achieved the developmental stage
of separation-
individuation during which a child normally develops a sense of self, a permanent sense
of
significant others (object constancy), and integration of seeing both bad and good
components
of self
Projective Identification: - ANSWER falsely attribute to others their own unacceptable
feelings, impulses, or
thoughts
Boundries and BPD - ANSWER Respecting a client's boundaries is important in
establishing a therapeutic relationship with a
patient with BPD.
Risk Factors for BPD - ANSWER sexual abuse, parental separation, biological
component (A decrease in serotonin
activity and an increase in α2-noradrenergic receptor sites may be related to the
irritability and
impulsiveness; an increase in dopamine may be responsible for transient psychotic
states)
DBT/ Mindfulness - ANSWER DBT is a psychosocial treatment developed by Marsha
M. Linehan specifically to treat
individuals with borderline personality disorder.
DBT includes:
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