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DISORDERS: IDENTITY TO
REALITY
JOLO R. GALABAY, RM,RN ,MSN
SITUATIONS
SITUATION
PERSISTS
Mental
Mechanisms/Defense
Mechanisms
MAN
EXPERIENCES
ANXIETY
Therapeutic use of self
-therapeutic communication
Schizophrenic Disorders
Paranoid Disorders
Anxiety Disorders
Somatization Disorders
Dissociative Disorders
Personality Disorders
Substance Use
Disorders
Mood Disorders
DYSFUNCTIONALITYEating Disorders
Sexual Disorders
OBJECTIVES:
PERSONALITY
The quality or state of being
a person
The totality of a persons
unique biopsychosocial
emotional and spiritual traits
that influences ones
behavior.
DISORDER
The disturbance
of regular
or normal function
An abnormal physical or
mental condition
PERSONALITY DISORDER
Maladaptive
traits
influenced by psychological
and emotional disturbance
and impaired interpersonal
relationship.
CHARACTERISTICS:
1.
2.
3.
4.
5.
Poor self-esteem
Poor relationship
skills
Low tolerance for
anxiety
Manipulative and
demanding
Self destructive
behavior
ETIOLOGY:
Genetic
factors
Environmental factors
Biological factors (neurotransmitters)
Psychoanalytic factors
CLUSTER A:
THE ECCENTRIC,
ODD AND MAD
GROUP
PARANOID
Distrustful/Extreme
mistrust
Suspicious
Short
tempered
Hypersensitive to criticism
Prone to angry or aggressive
outburst
Jealous
very private
Management:
Establish
rapport
Help them recognize
and accept their own
feelings
Support adaptation
SCHIZOID
introvert, aloof,
has solitary lifestyle
Loner and passive
Sexual experiences is not of interest
Friendships are few
Emotionally cold and detached
take jobs with little person contact
Humorless
Management:
Initiate
structural social
interactions
Positive therapeutic nurse
client relationship
SCHIZOTYPAL
Signs
M:
and Symptoms:
Management
Medications-
antipsychotic
drugs
Must accept his/her
condition
Avoid extreme stress
Start structured social
interactions
CLUSTER B:
THE ERRATIC
AND BAD
GROUP
ANTISOCIAL
ANTI-SOCIAL
Interventions: Confrontation
Points out a clients
problematic behavior while
remaining neutral and matter-offact
Avoids accusing the client.
Use confrontation to keep
clients focused on the topic and in
the present.
ANTI SOCIAL
Interventions:
Problem-Solving
1. Identify the
problem.
2. Explore alternative
solutions and related
consequences.
3. Choose and
implement an
alternative.
4. Evaluate the results.
Interventions: Manage
Emotions
When frustrated,
teach the client to
take a time out or
leave the area and go
to a neutral place to
regain internal
control to engage in
constructive problem
solving.
BORDERLINE
SUICIDE
THE ACT OF KILLING ONESELF USUALLY BECAUSE OF A
STRESS PERCEIVED AS OVERWHELMING SUICIDE
Who will commit Suicide?
TRIAD
1.
2.
3.
4.
INDICATIVE SIGNS:
Once easy to get along with, now sullen
and angry
Gives away important, personal items
Gets affairs in order, wills, insurances,
finances
Direct verbalization of Im no good; Im
better off dead
NURSING DIAGNOSIS: Potential for injury
to self related to poor impulse control
NURSING GOAL: Client will not harm self
IMPLEMENTATION:
1. Determine lethality potential
ask: Have you thought of suicide/
ask: How would you do it?
2. Determine if the client has the means to carry it out
3. Determine how in touch with reality the client is
4. Determine if the client is still communicating
5. Determine the clients support system
6. Provide suicide precautions:
@ one-to-one 24-hour precautions
@ contract
@hospitalization
7. Offer support, safety,
esteem
HISTRIONIC
NARCISSSISTIC
of grandiose self-importance
Excessive self admiration
Lacks empathy
Fantasies of unlimited power, beauty or
brilliance
Interpersonally exploitive
Envious of others or believes others are
envious of him or her
CLUSTER C:
THE ANXIOUS
AND SAD
GROUP
AVOIDANT:
rejection
Escapes intimate relationship
Avoidance of social events
Reluctant to encourage in new
activities
DEPENDENT
Management
Reduce
anxiety
psychotherapy
Facilitates expression of ideas and
feelings
Offer assistance only when needed
OBSESSIVE-COMPULSIVE
Obsessive-Compulsive
(perfectionist) PD
Preoccupied with
Obsessive-Compulsive Disorder
orderliness, perfectionism,
(OCD)
inflexibility, need to be in
Obsessions: Recurrent thoughts,
control
ideas, visualizations, or
Formal and serious
inappropriate impulses that
disturb a persons life; has no
interpersonal relationship
control over them.
Judgmental of self and
Compulsions: Behaviors or rituals
others
continuously carried out to get
rid of the obsessive thoughts and OCPD clients do not see
reduce anxiety.
that there is any problem
OCD is an anxiety disorder that
with their excessive detail
is ego-dystonic (uncomfortable
or controllingways. They do
to person), whereas OCPD is a
not see that they need to
rigid way of functioning in the
change.
world.
Nursing interventions:
Remember, a
NURSING INTERVENTIONS
Educate
skills
anger management
Stress management
Problem solving
Medication adherence
THANK
YOU FOR
LISTENING!
TRAITS:
Poor interpersonal relationship
Suspiciousness
Social anxiety
Failure to conform to social norms
Self-destructive behaviors
Demanding and Manipulative
Inappropriate response to stress
and inflexible approach to problem
solving
Overwhelming
fears of
abandonment
Pessimistic, immature,
lonely , and impulsive
NURSING INTERVENTIONS
Educate
skills
anger management
Stress management
Problem solving
Medication adherence