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Psychiatric-Mental Health NursingAn Interpersonal Approach

Jeffery S. Jones | Joyce J. Fitzpatrick | Vickie L. Rogers

www.springerpub.com/jones

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Based on the theories of Hildegard Peplau and Joyce Travelbee, this is the first recent book devoted to interpersonal relations as the foundation for therapeutic practice in psychiatric nursing.

Chapter Features:

Diagnostic Criteria lists

the key symptoms of a disorder

for consideration when making a

diagonsis. Features DSM-IV and

NANDA-I guidelines.

Psychiatric-Mental Health Nursing: An Interpersonal Approach

Student Materials include a handy per-chapter review guide with a glossary, summaries of Learning Objectives and Need to Know sections from each chapter, 2 to 6 hyperlinks to online videos or commercial films illustrating content, and care planning practice exercises. Faculty Materials include the same features PLUS additional films and videos (with brief descriptions), answers and rationales to NCLEX questions, and responses for the How Would You Respond? case scenarios.

Plan of Care offers interventions for a specific nursing diagnosis and includes the rationales for the interventions.

CHAPTER 13: ANXIETY DISORDERS 275

NURSING DIAGNOSIS: Anxiety (severe); related to exposure to traumatic event; manifested by perceived threats and recurrent panic attacks. Ineffective coping; related to anxiety of perceived need to check and re-check things; manifested by participation in repeated ritualistic behavior to reduce anxiety.

Patient will demonstrate participation in fewer ritualistic behaviors with an improved level of independent function.

(cont.)

INTERVENTION RATIONALE

Assess the level of the patient’s anxiety; stay with the patient and provide for safety and security

Determining the level of the patient’s anxiety provides a baseline from which to intervene

Maintain a calm, reassuring approach; keep verbal exchanges short and direct

Maintaining a calm, reassuring approach prevents adding to the patient’s anxiety

Keeping exchanges short and direct reduc-ing the risk of overwhelming an already overwhelmed patient; a patient experiencing signifi cant anxiety has diffi culty focusing and concentrating

Administer prescribed antianxiety agents if indicated

Administering antianxiety agents helps to reduce or control feelings of anxiety

Encourage the use of appropriate defense mechanisms

Using appropriate defense mechanisms can help to reduce anxiety

Once level of anxiety has diminished, assist the patient in exploring precipitating fac-tors for the anxiety

Identifying precipitating factors can help to prevent recurrence

Assist the patient in identifying signs and symptoms of increasing anxiety

Being able to identify signs and symptoms facilitates early intervention

Work with the patient to determine usual methods of problem solving; identify effec-tive and ineffective methods

Identifying usual methods of coping pro-vides information about possible maladap-tive strategies and opportunities for teaching more adaptive ones

Teach the patient various methods for reducing anxiety, such as controlled breathing, relaxation, and physical activity

Using various methods for reducing anxiety provides the patient with options to manage anxiety effectively

Employing breathing and relaxation tech-niques interferes with sympathetic nervous stimulation associated with increasing anxiety

PLAN OF CARE 13-1:THE PATIENT WITH AN ANXIETY DISORDER (WITH PANIC) AND OBSESSIVE COMPULSIVE DISORDER

Jones_R1_CH 13_23-12-11_252-287.indd 275 12/23/2011 2:45:41 PM

Drug Summary lists the common drugs

used in the treatment of a disorder and their

implications for nursing care. Expanded drug

monographs are available for reference.

266 SECTION III: ACUTE AND CHRONIC ILLNESS

DRUGS IMPLICATIONS FOR NURSING CARE

BENZODIAZAPINES

aprazolam (Xanax)

clonazepam (Klonopin)

diazepam (Valium)

lorazepam (Ativan)

• Institute safety precautions to prevent injury secondary to seda-tive effects of the drug; warn the patient of these effects including decreased response time, slowed refl exes

• Encourage the patient to change positions slowly to minimize the effect of orthostatic hypotension

• Teach the patient that the full effects of the drug may not be noted for several weeks. Work with the patient to use other methods such as guided imagery and progressive relaxation to assist in relieving anxiety until drug reaches its therapeutic effectiveness

• Counsel the patient that one or more agents may need to be tried to determine the most effective drug

• Allow the patient to verbalize feelings and issues related to drug therapy; work with the patient and family to develop a method for adhering to drug therapy

• Urge the patient not to stop taking the drug abruptly because of possible withdrawal symptoms such as insomnia, increased anxiety, abdominal and muscle cramps, tremors, vomiting, sweating, and delirium

• Monitor the patient for compliance with therapy; be aware that physi-cal and psychological dependence can occur

• Assess the patient for possible suicidal ideation, especially if the patient also has a concurrent depressive disorder

• Urge the patient to avoid consuming alcohol

ANTICONVULSANTS

lamotrigine (Lamictal)

topiramate (Topomax)• Institute safety precautions to prevent injury secondary to seda-

tive effects of the drug; warn the patient of these effects including decreased response time, slowed refl exes

• Instruct female patients to notify the prescriber if starting or stopping oral contraceptives or other hormone preparations, if they become pregnant, or experience changes in their menstrual pattern

• Advise the patient not to discontinue abruptly or restart without noti-fying the prescriber

DRUG SUMMARY 13-1:AGENTS USED FOR ANXIETY DISORDERS*

(cont.)

Jones_R1_CH 13_23-12-11_252-287.indd 266 12/23/2011 2:45:38 PM

How Would You Respond? presents case

scenarios followed by critical

thinking questions.

Therapeutic Interaction provides an exemplar therapeutic

dialogue between nurse and

patient, with rationales for the

nurse’s interaction methods.

Consumer Perspective gives a firsthand account

of what it’s like to live with

a particular disorder.

Patient and Family Education offers tips and

guidelines to help the patient and

family manage a disorder.

Evidence-Based Practice offers a relevant study, with study

summary and outcome, applications

to practice, and questions to ponder.

Summary Points gives key

takeaways from each chapter.

NCLEX-Style Prep questions

at the end of each chapter evaluate

the reader’s comprehension

and help predict performance on

related questions in an NCLEX exam.

Key Features: • Integrates and applies the Peplau/Travelbee interpersonal relations theories to the

four-step Assessment, Planning/Diagnosing, Implementation, and Evaluation (APIE) nursing process

• Addresses critical thinking, clinical decision making, therapeutic interventions, case management roles, and mental health care settings across the lifespan

• Features NCLEX-style preparation questions, vivid clinical scenarios, and evidence-based practice summaries

• Addresses the most current ISPN and APNA competencies

696 pp | Softcover | 9780826105639 | $65.00

Table of Contents:

“As one of Hildegard Peplau’s students, I remain in awe of her vision and commitment to inspiring the nursing profession to acknowledge and own the interpersonal relationship as an essential part of nursing. This textbook, building on the interpersonal theories of Peplau and Joyce Travelbee, continues the journey of embedding and extricating the importance of the relationship across the spectrum of psychiatric care and caring.”

Beverly Malone, RN, PhD, FAAN; CEO, National League for Nursing

SECTION I:THE PRACTICE OF PSYCHIATRIC-MENTAL HEALTH NURSING

Chapter 1: Mental health trends and the current and historic role of the professional nurseChapter 2: Interpersonal relations: the cornerstone of psychiatric nursing; use of interpersonal nursing theories and models to guide practice in the nurse - patient relationshipChapter 3: Therapeutic use of self and therapeutic communication: from self discovery to interpersonal skill integrationChapter 4: Boundary management

Section II:HEALTH PROMOTION AND ILLNESS PREVENTION

Chapter 5: Nursing Interventions: clinical decision making, critical thinking, and counseling interventionsChapter 6: Crisis interventionChapter 7: Case managementChapter 8: Risk factors for prevalent mental illness and nursing interventions for preventionChapter 9: Systems concepts and working in groupsChapter 10: Theories of mental illness: psychodynamic, social, cognitive, behavioral, humanistic, and biological influences

SECTION III: ACUTE AND CHRONIC ILLNESS

Chapter 11: Thought disorders (schizophrenia, schizoaffective, delusional, etc)Chapter 12: Affective disorders (depressive, bi-polar, and suicide)Chapter 13: Anxiety disorders (generalized anxiety, OCD, panic disorders, PTSD)Chapter 14: Personality disordersChapter 15: Addictive disordersChapter 16: Cognitive disorders (dementia, Alzheimer's)Chapter 17: Impulse control disordersChapter 18: Sexual disordersChapter 19: Eating disordersChapter 20: Psychological problems of physically ill persons

SECTION IV:GROWTH AND DEVELOPMENT AND MENTAL HEALTH CONCERNS ACROSS THE LIFE SPAN

Chapter 21: Working with childrenChapter 22: Concerns regarding adolescentsChapter 23: Issues specific to the elderlyChapter 24: Victims and victimizers

SECTION V: STANDARDS OF CARE AND HEALTH CARE SETTINGS

Chapter 25: Standards of mental health care; ANA guidelines: in-patient, outpatient and settings other than primary mental health careChapter 26: Mental health concerns of vulnerable populations at risk

SECTION VI: ETHICAL AND LEGAL ASPECTS OF MENTAL HEALTH CARE

Chapter 27: Cultural, ethnic, and spiritual conceptsChapter 28: Ethical and legal principles

Available as an eBookon all major platforms & devices

Advanced Practice Psychiatric NursingPsychotherapy, Psychopharmacology, and Complementary and Alternative ApproachesKathleen Tusaie; Joyce J. Fitzpatrick (Editors)

576 pp | Softcover | 9780826108708 | $85.00

ORDER A FREE EXAM COPYwww.springerpub.com/textbook

Inpatient Psychiatric NursingClinical Strategies & Practical InterventionsLinda Damon; Joanne Matthew; Judy Sheehan; Lisa Uebelacker, MS, PhD (Editors)

416 pp | Softcover | 9780826109712 | $45.00

Psychiatric-Mental Health Nursing: Special Student PackIncludes Two Books: Psychiatric-Mental Health Nursing & InpatientPsychiatric Nursing

Spiral Bound | 9780826199485 | $100.00