100% VERIFIED
_________________________ the tendency of group members to avoid conflict and adopt a
normative pattern of thinking that is often consistent with the ideas of the group leader.
Groupthink
_____________________ is the ability of the group to stick together. Group cohesion
Types of Crises: Situational/external Often unanticipated loss or change experienced in
everyday, often unanticipated, life events (divorce or job change)
Types of Crises: Maturational/internal Achieving new developmental stages, requires
learning additional coping mechanisms .
Examples include getting married or retiring.
Types of Crises: Adventitious The occurrence of natural disasters, crimes, or national
disasters
People in communities with large-scale psychological trauma caused by natural disasters
Risk factors for crisis Accumulation of unresolved losses
Current life stressors
Concurrent mental and physical health issues
Excessive fatigue or pain
Age and developmental stage
,Phase 1 of a crisis Escalating anxiety from a threat activates increased defense responses,
Phase 2 of a crisis Anxiety continues escalating as defense responses fail, functioning
becomes disorganized, and the client resorts to trial-and-error attempts to resolve anxiety,
Phase 3 of a crisis Trial-and-error methods of resolution fail, and the client's anxiety
escalates to severe or panic levels, leading to flight or withdrawal behaviors.
Phase 4 of a crisis The client experiences overwhelming anxiety that can lead to anguish and
apprehension, feelings of powerlessness and being overwhelmed, dissociative findings
(depersonalization, detachment from reality), depression, confusion, and/or violence against
others or self.
What are some less restrictive interventions that can be implemented prior to use of restraints?
verbal interventions
offering an as needed medication
decreasing client's stimulation in the environment
close observation and one-to-one supervision.
What are the risk factors for aggressive behavior? -Past history of aggression, poor impulse
control, and violence
-Poor coping skills, limited support systems
-Comorbidity that leads to acts of violence (psychotic command hallucinations, violent angry
reactions with cognitive disorders)
-Living in a violent environment
-Limit setting by the nurse within the therapeutic milieu
,What are some objective findings of aggressive behavior? -Hyperactivity such as pacing,
restlessness
-Hypersensitivity, easily offended
-Eye contact that is intense, or no eye contact at all
-Facial expressions (frowning or grimacing)
-Body language (clenching fists, waving arms)
-Rapid breathing
-Aggressive postures (leaning forward, appearing tense)
-Verbal clues (loud, rapid talking, yelling and shouting)
-Drug or alcohol intoxication
What are the steps for handling aggressive behavior? -Responding quickly
-Remaining calm and in control
-Encouraging the client to express feelings verbally, using therapeutic communication
techniques (reflective techniques, silence, active listening)
-Allowing the client as much personal space as possible
-Maintaining eye contact and sitting or standing at the the client
-Communicating with honesty, sincerity, and nonaggressive stance
-Avoiding accusatory or threatening statements
-Describing options clearly and offering choices
-Reassuring the client that staff members are present to help prevent loss of control
-Set limits for the client
-----Tell the client calmly and directly what they must do in a particular situation, such as, "I
need you to stop yelling and walk with me to the day room where we can talk."
-----Use physical activity, such as walking, to deescalate anger and behaviors.
-----Inform the client of the consequences of their behavior, such as loss of privileges.
-----Use pharmacological interventions if the client does to calm limit-setting.
, -----Plan for four to six staff members to be available and in sight of the client as a "show of
force" if appropriate.
What syndrome identified the relationship between chronic stress and illness? General
adaptation syndrome (GAS)
Who developed the GAS? Hans Selye
He called press evoked by positive emotions or events eustress and stress evoked by negative
feelings and events distress. He showed that corticosteroid secretion from the pituitary gland
increased during stress and contributed to development of illnesses. This early work set the
stage for our understanding of the role of the hypothalamic-pituitary-adrenal (HPA) in chronic
stress.
When the hypothalamus secretes corticotropin-releasing hormone (CRH), the pituitary gland
increases secretion of adrenocorticotropic (corticotropin), which in turn stimulates the
adrenocortical secretion of cortisol. Over time, excessive exposure of cortisol contributes to the
dysregulation of the autonomic nervous system.
What does the Transactional Stress Model describe? The psychological experience of stress.
This model views stress as an interactive process arising from real or perceived internal or
external environmental demands that are appraised as threatening or benign.
What are the two levels of the appraisal process? The primary appraisal, a person evaluates
the events occurring in his or her life as a threat, harm, challenge.
The secondary appraisal, the person explains the out-come of events.
What are the three goals of primary appraisal? (1) the goal is relevant