Identity disturbance with chronic feelings of emptiness Anhedonia Marked mood

Identity disturbance with chronic feelings of

This preview shows page 48 - 50 out of 72 pages.

- Identity disturbance with chronic feelings of emptiness (Anhedonia) - Marked mood swings and impulsive unpredictable behavior with potential for self-destruction. - Intense , brief, unstable interpersonal relationships with impulsiveness, manipulation, physical fights and temper tantrums A borderline patient indicates an improvement when she state, “I ran around the block rather than cutting myself”. Borderline personality with a history of cutting her wrist shows an intense & a changeable affect during the middle phase of nurse-pt relationship. The patient says, "You’re a smart nurse. I want to be just like you.” This statement shows Transference A patient borderline state, “You’re a phony. You don’t know what happened to me.” Best response of the nurse will be, “I’ll ensure what is necessary will be done to you Intervention for borderline d/o includes setting of limits through saying, “The policy of the unit is that, ‘You can’t leave in the unit in 1 st 24 hrs.’” C. Histrionic Personality Disorder - More common in women, 2-3 % of the population THEORY : Llacks Electra complex (no father figure) Papa’s girl CHARACTERISTICS: - Emotional, dramatic, theatrical - wants to be the center of attention - Manipulative , Sexually seductive or provocative - Exaggeration of emotion, Style of speech is excessively impressionistic - Labile emotion, Positive: Creative, imaginative - Extroverted, manipulative, vain with behavior directed toward gaining attention to self; - Emotionally unstable; uses somatic complaints to avoid responsibility D. Narcissistic Personality Disorder - Usually Men - Another: Metrosexual CHARACTERISTICS : - Vanity in personal appearance - Exaggerated or grandiose sense of self-importance - Boastful, egotistical, superiority complex - preoccupied with fantasies: Power, success, beauty - Excessive admirations; envies other, arrogant, lack of empathy - Overblown sense of importance , grandiosity; with strong need for attention and admiration from others CLUSTER C: ANXIOUS / FEARFUL
Image of page 48
A. Obsessive –Compulsive Personality Disorder - More in women - Obsession – irresistible thought, Compulsion – irresistible action THEORIES: Genetic: Serotonin imbalance Anal fixation strict toilet training Overpowering mother CHARACTERISTICS: - Cardinal Signs: RITUALISTIC - #1 DEFENSE MECHANISM: Undoing, Repression, Symbolization # 1 Ritual: handwashing Other Ritualistic behaviors : 4 C’s: C ontrolling perfectionism C ollects or hoarding C leaning C hecking Rigid, over-conscientious, perfectionist, inflexible, cold affect Driven by obsessive concerns Sets high standards for self and others Preoccupied with details, rules and organization STEP TO STEP PRIORITY NURSING DIAGNOSIS: Altered Sleeping Patterns Altered Skin Integrity Ineffective Individual Coping PRIORITY NURSING INTERVENTIONS : 1. Give appropriate time to do rituals to decrease anxiety In OCD, intervention includes giving an extra ½ hr to the pt to do the ritual before starting the task.
Image of page 49
Image of page 50

You've reached the end of your free preview.

Want to read all 72 pages?

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture