Neeb's Fundamentals of Mental Health Nursing - Gorman, Linda, Anwar, Robynn.pdf - 2993_FM_i-xvi 5:31 PM Page i 4 TH EDITION Neeb\u2019s Fundamentals of

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Unformatted text preview: 2993_FM_i-xvi 14/01/14 5:31 PM Page i 4 TH EDITION Neeb’s Fundamentals of Mental Health Nursing Linda M. Gorman, RN, MN, PMHCNS-BC, FPCN Clinical Nurse Specialist/Nursing Consultant Private Practice Studio City, California Robynn F. Anwar, MST, MSN, Ed Nursing Faculty/CNA and Multi-Skilled Coordinator Camden County College, Camden Campus Camden, New Jersey 2993_FM_i-xvi 14/01/14 5:31 PM Page ii F.A. Davis Company 1915 Arch Street Philadelphia, PA 19103 Copyright © 2014 by F. A. Davis Company Copyright © 1997, 2001, 2006, by F.A. Davis Company. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Publisher, Nursing: Lisa B. Houck Director of Content Development: Darlene D. Pedersen Project Editor: Jacalyn C. Clay Electronic Project Editor: Sandra A. Glennie Illustration and Design Manager: Carolyn O’Brien As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Library of Congress Cataloging-in-Publication Data Gorman, Linda M., author. Neeb’s fundamentals of mental health nursing / Linda M. Gorman, Robynn F. Anwar. — Fourth edition. p. ; cm. Fundamentals of mental health nursing Preceded by: Fundamentals of mental health nursing / Kathy Neeb. 3rd ed. c2006. Includes bibliographical references and index. ISBN 978-0-8036-2993-6 (pbk. : alk. paper) I. Anwar, Robynn F., author. II. Neeb, Kathy, 1952- Fundamentals of mental health nursing. Preceded by (work): III. Title. IV. Title: Fundamentals of mental health nursing. [DNLM: 1. Mental Disorders—nursing. 2. Nursing, Practical. 3. Psychiatric Nursing—methods. WY 160] RC440 616.89’0231—dc23 2013021696 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: 8036-1169-2/04 0 + $.25. 2993_FM_i-xvi 14/01/14 5:31 PM Page iii To Corie, who saw me as an author many years ago. (LG) To Mayme, I realize how much easier this journey would have been if you were here. Wasim and Andrea, I appreciate your belief in my abilities. “Mom Bessie,” who renewed her practical nurse license at age 94. Linda, thank you for being my mentor through this process. Shirley, Toni, and Ted—Thank you. (RA) 2993_FM_i-xvi 14/01/14 5:31 PM Page iv 2993_FM_i-xvi 14/01/14 5:31 PM Page v Preface N eeb’s Fundamentals of Mental Health Nursing is a psychiatric nursing text tailored specifically to the needs of the LVN/LPN student. We understand that many students at this level of preparation do not have the opportunity for clinical experience in a psychiatric setting, but they will encounter patients with mental health issues in their rotations. Students will encounter patients and their families with psychiatric diagnoses as well as a variety of psychosocial issues and behaviors that challenge them. This text will provide the basic knowledge and skills to address many of these challenges, with an emphasis on communication. This new edition also brings enhancements via the Internet through DavisPlus. Our goal with this text is to provide basic information about mental health theories, personality development, coping and communication styles, psychiatric diagnoses, and nursing actions, all as they pertain to the practice of the LVN/LPN. The impact of psychiatric disorders continues to be a concern in the United States. Depression, anxiety, eating disorders, and substance abuse continue to be major health problems. How society responds to debilitating mental illness has been the subject of much debate. Clearly the need for nurses to have education in caring for people with mental health issues is essential. The Fourth Edition of Neeb’s Fundamentals of Mental Health Nursing brings new authors who have expanded on the foundations that Kathy Neeb created so successfully in the first three editions. The new authors bring broad experience in psychiatric nursing, education, and clinical practice. New chapters in this Fourth Edition include postpartum issues as well as separate chapters on depressive and bipolar disorders. We have added more features to enhance the concepts and make them more meaningful and current. Chapters 1 to 9 provide the basics of mental health nursing concepts, with an emphasis on communication. Chapters 10 to 22 are “clinical” chapters in that they cover specific diagnoses and/or populations. Many of the chapters include the following new or enhanced key features: • Neeb’s Tip will give a “clinical pearl” that succinctly describes a key take-away from the chapter. • Critical Thinking Questions are expanded and interspersed in the chapters to emphasize a concept and challenge the student to apply the concept just covered. Many of these include case-based scenarios. • Toolbox provides additional resources for students who want more information. These can be further explored on the book’s Web site. • Pharmacology Corner in Chapters 10 to 20 and 22 covers important current information about medications used for the specific population that will pertain to the LVN/LPN scope of practice. • Clinical Activities are suggestions for the student to utilize when caring for patients with a particular disorder. • Classroom Activities include suggestions for projects or actions that students and faculty can use in the classroom to enhance learning. • Case Studies are in-depth, with questions to help the student apply knowledge learned in the chapter. • Multiple Choice Questions—At least 10 questions are provided at the end of the chapters, with the answers/rationales in Appendix A. Additional NCLEX questions are on the book’s Web site. • Sample Care Plans are provided in the clinical chapters. • Appendix E, which is new, matches common behaviors with nursing diagnoses. v 2993_FM_i-xvi 14/01/14 5:31 PM Page vi vi Preface Internet-based enhancements include podcasts, updated references, and other resources such as drug monographs and Neeb’s blog. Neeb’s blog will provide an opportunity for the student to reflect on learning and experiences that can be shared with others. For the instructor, this Fourth Edition provides access to PowerPoint presentations, test bank questions, and other expanded features. This edition coincides with the publication of the DSM-5, Diagnostic and Statistical Manual for Mental Disorders by the American Psychiatric Association that was published in 2013. The terminology used throughout this edition reflect the changes in this major psychiatric reference. Although the LVN/LPN student will not be using the Manual routinely, a familiarity with the terminology that is used by other health-care professionals is essential. The chapter titles reflect the new terminology where changes have been made. We, as practitioners and educators in the field of mental health, have seen the impact of mental health issues on our patients and society. We hope that the students who utilize this book will gain a new perspective that includes up-to-date knowledge as well as empathy for the suffering these disorders can cause. We hope this book will contribute to knowledgeable and compassionate LVNs/LPNs. 2993_FM_i-xvi 14/01/14 5:31 PM Page vii Reviewers PATTI A LFORD , RN, BSBM Instructor Kilgore College Longview, Texas D EBORAH B. H ARRIS , BSN, MSN, RN Director, Practical Nursing Program Valley Vocational Technical Center Fishersville, Virginia R UTH F EE B LACKMORE , MSN, RN, CNOR Faculty of Nursing Isabella Graham Hart School of Practical Nursing Rochester, New York E ULA J ACKSON , ADN, BS, MSN, CNE, P H D Nursing Facilitator/Clinical Instructor Reid State College and University of Phoenix Evergreen, Alabama R ENEÉ T. B URWELL , AASN, BSN, MSE D, E DD Coordinator of Health Science Programs Charlotte Technical Center Port Charlotte, Florida J OYCE C ANAVAN , BS E D , MSN, RN Mental Health, Lead Instructor Anamarc College El Paso, Texas TAMMIE C OHEN , RN, BSN Nursing Instructor, Faculty Advisor Chairperson Western Suffolk BOCES Northport, New York L INDA J OHNSON , RN, PHN, MSN, DHA Assistant Director Vocational Nursing Program Los Medanos College Pittsburg, California E THEL J ONES , E D S, DSN, RN, CNE Nursing Instructor H. Councill Trenholm State Technical College Montgomery, Alabama TAMMY K RELL , MSN, RN Coordinator of PN Program Western Wyoming Community College Evanston, Wyoming W ENDY C. FARR , RN, BSN, MSN E D , I NS Practical Nursing Instructor Southern Crescent Technical College Thomaston, Georgia SUSAN R. LEFERSON, RN, BSN, MSBA, COHC Nurse Educator Medical Careers Institute, School of Health Sciences of ECPI University Manassas, Virginia B RIAN F ONNESBECK , RN, MN, BSN, ADN Associate Professor of Nursing and Health Sciences Lewis-Clark State College Lewiston, Idaho R IMINA L EWIS , MSN/E D , RN Instructor, Practical Nurse Program Savannah Technical College Savannah, Georgia C HERYL G ILBERT, RN, BHA Assistant Director, Vocational Nursing Program Chaffey College, Chino Campus Chino, California G AYLA L OVE , MSN, BSN, RN, CCM Program Coordinator, Practical Nursing Southern Crescent Technical College Griffin, Georgia P EGGY G RADY, RN, ASN Assistant Director, PN Program Clinical Instructor Southern Crescent Technical College Griffin, Georgia K IMBERLY K. M C C LURE , MSN, RN Vocational Nursing Instructor Victoria College Victoria, Texas vii 2993_FM_i-xvi 14/01/14 5:31 PM Page viii viii Reviewers C AROL A. M ILLER , BSN Nursing Instructor Southeastern Technical Institute Easton, Massachusetts P HYLLIS ROWE , DNP, RN, ANP Professor, Nursing Riverside City College Riverside, California J OHN H. N AGELSCHMIDT, MSN, RN Nursing Instructor Assabet Valley Regional Technical High School Marlborough, Massachusetts E LLEN S ANTOS , MSN, RN, CNE Instructor of Practical Nursing Assabet Valley Regional Technical School Marlborough, Massachusetts D IANA N OBLEZA , MSN, RN Instructor and CFO Pinelands School of Practical Nursing & Allied Health, Inc. Toms River, New Jersey J UDITH M. S HAFFER , RN, BSN, MSN E D S ALLIE N OTO , RN, MS, MSN Director, CTC School of Practical Nursing Career Technology Center Scranton, Pennsylvania C LAUDIA S TOFFEL , MSN, RN, CNE Professor of Nursing, Practical Nursing Program Coordinator West Kentucky Community and Technical College Paducah, Kentucky M ARY A. O LSON , MA, RN PN Program Director St. Paul College Saint Paul, Minnesota K RISTI P FEIL , MSN, RN VN Nursing Faculty Victoria College Victoria, Texas M ARYELLEN P ICCHIELLO , MS, RN LPN Instructor Ocean County Vocational Technical School Toms River, New Jersey J ENNIFER P ONTO , RN, BSN Instructor, Vocational Nursing South Plains College Levelland, Texas C INDY P RICE , MSN, RN Practical Nurse Instructor Mid-East Career and Technology Center Zanesville, Ohio C YNTHIA ROBERTS , MS, RN Program Director Isabella Graham Hart School of Practical Nursing Rochester General Health System Rochester, New York STUDENT Practical Nursing Educator ECPI University Raleigh, North Carolina K ENDRA S TRENTH , RN, MSN, DNP, BC Instructor Bishop State Community College Mobile, Alabama B ARBARA TAYLOR , RN, MSN LPN Instructor Walton Career Development Center DeFuniak Springs, Florida S ANDRA D. T HOMPSON , RN Coordinator Mercer County Technical Education Center Princeton, West Virginia P EGGY VALENTINE , RN, BSN, MSN C Director of Nursing Skyline College Roanoke, Virginia FAYE WARNER , RN, MSN LPN Instructor Kaynor Regional High School Waterbury, Connecticut 2993_FM_i-xvi 14/01/14 5:31 PM Page ix Consultants to Previous Editions B RENDA A GEE , RN, MSN Nursing Instructor Delaware Technical and Community College Georgetown, Delaware C HRISTINE D. H ERDLICK , RN, BA Nursing Instructor Marshalltown Community College Marshalltown, Iowa E THEL AVERY, RN, MSN, E D S Instructor H. Councill Trenholm State Technical College Montgomery, Alabama D EBRA H ODGE Licensed Practical Nursing West Virginia Academy of Careers and Technology Beckley, West Virginia S HARON M. E RBE , RN, BSN, MSN( C ) Nursing Coordinator WSWHE BOCES Hudson Falls, New York G LORIA F ERRITTO , RN, BSN, PHN Assistant Director, Vocational Nursing Program Maric College Vista, California F RANCES F RANCIS , RN, BS Practical Nursing Instructor Hazard Regional Technology Center Hazard, Kentucky S UE G ARLAND , RN, MSN, ARNP Division Chair, Allied Health and Related Technologies Practical Nursing Program Coordinator Big Sandy Community and Technical College Paintsville, Kentucky N ANCY T. H ATFIELD , RN, BSN, MA Instructor, Practical Nursing Program Career Enrichment Center Albuquerque Public Schools Albuquerque, New Mexico P HYLLIS L ILLY, RN, BSN Instructor Isabella Graham Hart School of Practical Nursing Rochester General Hospital Rochester, New York M AUREEN L. M C G ARY, RN, MSN, NP-C Former Program Head, Practical Nursing Virginia Western Community College Wirtz, Virginia B ETTY R ICHARDSON , RN, P H D, LPC, LMFT, CS, CNAA Instructor, Practical Nursing Program Austin Community College Austin, Texas ROBIN A. S PIDLE , RN, P H D Payson, Arizona J UDY S TAUDER , RN, MSN Coordinator Practical Nursing Program of Canton City Schools Canton, Ohio ix 2993_FM_i-xvi 14/01/14 5:31 PM Page x 2993_FM_i-xvi 14/01/14 5:31 PM Page xi Acknowledgments W e want to acknowledge our Development Editor, Julie P. Scardiglia. Julie guided us through the writing process. Her enthusiasm, encouragement and, of course, her attention to detail kept us on track throughout the revision process. Her suggestions, responsiveness, availability for many conference calls, and organization skills helped us produce a revision that taps into today’s student’s needs. She worked closely with us every step of the writing process. We are thankful for all her help. Jacalyn Clay, our Project Editor from F.A. Davis, provided us with the support and resources to develop a project that expands on Kathy Neeb’s original ideas. We appreciate all the guidance she provided to us. —L INDA G ORMAN ROBYNN A NWAR xi 2993_FM_i-xvi 14/01/14 5:31 PM Page xii 2993_FM_i-xvi 14/01/14 5:31 PM Page xiii Table of Contents unit 1 Foundations for Mental Health Nursing chapter 1 History of Mental Health Nursing The Trailblazers The Facilities The Breakthroughs The Laws chapter 2 Basics of Communication Communication Theory Types of Communication Challenges to Communication Therapeutic Communication Adaptive Communication Techniques chapter 3 Ethics and Law Professionalism Ethics Confidentiality Responsibility Accountability Abiding by the Current Laws Patients’ Rights Patient Advocacy Community Resources chapter 4 Developmental Psychology Throughout the Life Span Developmental Theorists: Newborn to Adolescence Developmental Theorists: Adolescence to Adulthood Stages of Human Development chapter 5 Sociocultural Influences on Mental Health Culture Ethnicity Nontraditional Lifestyles Homelessness Economic Considerations Abuse Poor Parenting chapter 6 Nursing Process in Mental Health Step 1: Assessing the Patient’s Mental Health Step 2: Nurses Diagnosis: Defining Patient Problems Step 3: Planning (Short- and Long-Term Goals) Step 4: Implementations/Interventions Step 5: Evaluating Interventions chapter 7 Coping and Defense Mechanisms Coping Defense Mechanisms 3 3 8 8 11 15 16 16 19 21 28 33 33 34 38 41 41 41 42 45 45 51 52 56 63 75 75 78 79 81 82 83 83 89 90 95 95 96 100 105 105 107 xiii 2993_FM_i-xvi 14/01/14 5:31 PM Page xiv xiv Table of Contents chapter 8 Mental Health Treatments Psychopharmacology Milieu Psychotherapies Terrorism Legal Considerations chapter 9 Complementary and Alternative Treatment Modalities Mind, Body, and Belief Common Complementary and Alternative Treatments Primary Sensory Representation unit 2 113 114 123 123 136 137 143 144 144 152 Threats to Mental Health chapter 10 Anxiety, Anxiety-Related, and Somatic Symptom Disorders Anxiety Disorders Etiology of Anxiety and Stress Differential Diagnosis Types of Anxiety and Anxiety-Related Disorders Medical Treatment of People With Anxiety-Related Disorders Alternative Interventions for People With Anxiety and Anxiety-Related Disorders Nursing Care for People With Anxiety and Anxiety-Related Disorders Somatic Symptom and Related Disorders chapter 11 Depressive Disorders Types of Depressive Disorders Etiology of Depressive Disorders Treatment of Depressive Disorders Nursing Care of the Patient With Depressive Disorders chapter 12 Bipolar Disorders Characteristics of Bipolar Disorders Etiology of Bipolar Disorders Treatment of Bipolar Disorders Nursing Care of the Patient With Bipolar Disorders chapter 13 Suicide The Reality of Suicide Etiology of Suicide Treatment of Individuals at Risk for Suicide Nursing Care of the Suicidal Patient chapter 14 Personality Disorders Types of Personality Disorders Psychiatric Treatment of Personality Disorders Nursing Care of Patients With Personality Disorders chapter 15 Schizophrenia Spectrum and Other Psychotic Disorders Symptoms Etiology of Schizophrenia Psychiatric Treatment of Schizophrenia Nursing Care of the Schizophrenic Patient 159 160 161 161 162 167 168 168 170 181 181 185 185 186 193 193 195 196 198 205 205 207 208 209 217 218 223 223 231 233 234 235 238 2993_FM_i-xvi 14/01/14 5:31 PM Page xv Table of Contents chapter 16 Neurocognitive Disorders: Delirium and Dementia Delirium Dementia Nursing Care of Patients With Delirium and Dementia chapter 17 Substance Use and Addictive Disorders Alcohol Other Substances Nursing Care of Patients With Substance Use Disorders (Including Alcohol) chapter 18 Eating Disorders Anorexia Nervosa Bulimia Similarities Between Anorexia and Bulimia Morbid Obesity Nursing Care of Patients With Eating Disorders unit 3 245 245 247 253 261 264 270 278 287 287 290 292 292 294 Special Populations chapter 19 chapter 20 Childhood and Adolescent Mental Health Issues 303 Depression, Bipolar Disorder, and Suicide in Children and Adolescents Attention Deficit/Hyperactivity Disorder Autism Spectrum Disorder Conduct Disorder 304 308 312 315 Postpartum Issues in Mental Health Postpartum Blues Postpartum Depression Postpartum Psychosis Nursing Care of Women With Postpartum Mental Disorders chapter 21 Aging Population Alzheimer’s Disease and Other Cognitive Alterations Cerebrovascular Accident (Stroke) Depression in the Elderly Medication Concerns Paranoid Thinking Insomnia End-of-Life Issues Social Concerns Nursing Skills for Working With Older Adults Restorative Nursing Palliative Care chapter 22 Victims of Abuse and Violence The Abuser The Victim Categories of Abuse...
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