oppositional defiant disorder - Answers anger/irritable mood
defiant and vindicitive behavior
revenge, lying, never their fault.
enjoy the chaos they creat, hard to control
intermittent explosive disorder - Answers very impulsive, such as road rage
action is completed with sense of relief, then sense of guilt
affects relationships
htn and diabetes can be a cormorbidity
conduct disorder - Answers 6+ months of anger and aggression
no reguard for rules, like criminal behavior
can persist onto adulthood
de escalation techniques - self discipline - Answers dont take comments personally
focus on the client. its not about you
be aware of patients that trigger you and your own triggers
de escalation techniques -
verbal
non verbal - Answers verbal --
calm, confident, show no fear
controlled voice tone and volume
be assertive, not aggressive
help patient validate feelings
respective, non threatening and non judging
non verbal --
relaxed posture
understand personal space and body placement
, stay close to the door
stay a legs length away
de escalation techniques - empathetic comments - Answers it must be hard to feel like no one is
paying attention to you
you must have been feeling pretty bad to have....
staff safety - anger and aggression - Answers watch your hair, earrings, neckalaces
dont handle alone
show force, but not obtrusive
alert to room layout if take down is needed
stand to the side of the patient, ask them to sit down
avoid confrontation
state observations
what is the number one predictor of violence - Answers history of violence
-- people more likely to become violent if they were in the past
s/s of violence impending - Answers hyperactivity or anxiety
verbal abuse, yelling, sarcasm
stoney silence, change in voice
intense or no eye contact
feelings that may precipitate anger - Answers ignoring, disrespect, vulnerable
guilt, hurt, tired, jealous
feeling inferior or inadequate
alcohol drugs or isolation
anger and aggression --
anxiety level vs defensive level - Answers anxiety level --
person is pacing, may want to leave unit
close to the nurses station