Final Exam and HESI ReviewPOWERPOINTNU2740revised.pptx

Schizophrenia 19 when a patients speech is loosely

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SCHIZOPHRENIA 19. When a patient’s speech is loosely associated, confused, and disorganized, it is important to inform that patient that you have not understood what he has said. This provides the patient with an opportunity to clarify and be assured that the nurse has understood him and will respond appropriately.
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ASSERTIVE COMMUNITY TREATMENT 20. The assertive community treatment team could bring the patient’s medication to her in her neighborhood. Depot medication is a strategy to reduce noncompliance and is often preferable to daily oral medication. The other distracters do not directly relate to the noncompliance problem.
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HOPELESSNESS/SUICIDAL IDEATION 21.The patient’s words suggest hopelessness. Whenever hopelessness is present, so is suicide risk. The nurse should directly address the possibility of suicidal ideation with the patient. The other options attempt to offer reassurance before making an assessment.
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READ PHASES CRISIS 22 In phase 1, the person is anxious but beginning to make efforts to cope based on his usual coping style. In phase 2, the usual coping responses have fallen short, and anxiety continues to rise; functioning deteriorates, and coping efforts become disorganized or random. In phase 3, the random, disorganized attempts at coping have been ineffective, and anxiety has risen to severe or panic levels. Further efforts to cope are maladaptive, and the person may begin to redefine the crisis or compromise in resolving it. If the crisis does not resolve, the person enters. In phase 4, develops further maladaptive responses, becomes overtly depressed, and can act out violently towards others or himself.
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23.Using the button less frequently suggests that the patient is less needy because she is more secure and less anxious. Not using the call button at all suggests that she is reluctant to bother staff, which is not desirable if she truly needs assistance.
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CONSISTENT INTERVENTIONS 24. Time-out is designed so that staff can be consistent in their interventions. Time-out may require going to a designated room or sitting on the periphery of an activity until the child gains self-control and reviews the episode with a staff member.
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PTSD 25. Persons with posttraumatic stress disorder often experience somatic symptoms or sympathetic nervous system arousal that can be confusing and distressing. Explaining that these are the body’s responses to psychological trauma helps the patient understand how such symptoms are part of the illness and something that will respond to treatment. This decreases powerlessness over the symptoms and helps instill a sense of hope, reinforcing his participation in treatment. It also helps the patient to understand how relaxation, breathing exercises, and imagery can be helpful in symptom reduction. The goal of treatment for posttraumatic stress disorder is to come to terms with the event rather than repress it, so repression of memories and use of “numbing” are targeted for reduction rather than promoted.
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ADOLESCENT IN HOMELESS SHELTER 26. If the child shows no evidence of poor mental health, the best action would be to foster existing healthy characteristics and environmental supports. No other option is necessary or appropriate under the current circumstances.
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