Acute stress disorder
diagnosis is appropriate when symptoms appear within the first month after the trauma and do not persist longer than 4 weeks
Adaptive disclosure
combat-specific therapy for veterans with posttraumatic stress disorder (PTSD); eight sessions designed to help identify unhelpful beliefs about the trauma and find ways to move forward
Adjustment disorder
a group of symptoms, such as stress, feeling sad, or hopeless, and physical symptoms that occur following a stressful life event; the reaction is stronger than would be expected for the event that occurred
Depersonalization
feelings of being disconnected from himself or herself; the client feels detached from his or her behavior
Derealization
client senses that events are not real, when, in fact, they are
Disinhibited social engagement disorder (DSED)
Occurs before the age of 5 in response to the trauma of child abuse or neglect, called grossly pathogenic care; child exhibits unselective socialization, allowing or tolerating social interaction with caregivers and strangers alike
Dissociation
a subconscious defense mechanism that helps a person protect his or her emotional self from recognizing the full effects of some horrific or traumatic event by allowing the mind to forget or remove itself from the painful situation or memory
Dissociative disorders
these disorders have the essential feature of a disruption in the usually integrated functions of consciousness, memory, identity, or environmental perception; they include amnesia, fugue, and dissociative identity disorder
Dissociative amnesia
The client cannot remember important personal information (usually of a traumatic or stressful nature)
Dissociative identity (multiple personality disorder)
The client displays 2 or more distinct identities or personality states the recurrently take control of his or her behavior
Depersonalization/derealization disorder
The client has a persistent or recurrent feeling of being detached from his or her mental processes or body (depersonalization) or sensation of being in a dream-like state in which the environment seems foggy or unreal (derealization)
Exposure therapy
a treatment approach designed to combat the avoidance behavior that occurs with PTSD, help the client face troubling thoughts and feelings, and regain a measure of control over his or her thoughts and feelings
Grounding techniques
helpful to use with the client who is dissociating or experiencing a flashback; grounding techniques remind the client that he or she is in the present, as an adult, and is safe
Hyperarousal
symptoms that arise from high levels of anxiety, including insomnia, irritability, anger outbursts, watchfulness, suspiciousness, and distrustfulness. Often seen with PTSD
Post traumatic stress disorder (PTSD)
a disturbing pattern of behavior demonstrated by someone who has experienced a traumatic event; for example, a natural disaster, a combat, or an assault; begins three or more months following the trauma
Posttrauma syndrome
An ongoing, maladaptive pattern of behavior in response to a traumatic event that posed a threat to the well-being of an individual
Reactive attachment disorder (RAD)
Occurs before the age of 5 in response to the trauma of child abuse or neglect, called grossly pathogenic care; child exhibits minimal social & emotional responses to to others, lacks positive affect, and may be sad, irritable or afraid for no apparent reason
Repressed memories
memories that are buried deeply in the subconscious mind or repressed because they are too painful for the victim to acknowledge; often relate to childhood abuse
Survivor
view of the client as a survivor of trauma or abuse rather than as a victim; helps to refocus client's view of himself or herself as being strong enough to survive the ordeal, which is a more empowering image than seeing oneself as a victim
Which behavior might the nurse assess in a 3-year-old child with RAD?A. Choosing the mother to provide comfortB. Crying when the parents leave the roomC. Extreme resistance to social contact with parents and staffD. Seeking comfort from holding a favorite stuffed animal
C
Which intervention would be most helpful for a client with dissociative disorder having difficulty expressing feelings?A. DistractionB. Reality orientationC. JournalingD. Grounding techniques
C
Which statement is true about touching a client who is experiencing a flashback?A. The nurse should stand in front of the client before touchingB. The nurse should never touch a client who is having a flashbackC. The nurse should touch the client only after receiving permission to do soD. The nurse should touch the client to increase feelings of security
C
Clients from other countries who suffered traumatic oppression in their native country may develop PTSD. Which of the following is least helpful in dealing with their PTSD?A. Assimilating quickly into the culture of their current country of residence.B. Engaging in their native religious practices.C. Maintaining a strong cultural identity.D. Social support from an interpreter or fellow countryman.
A
The nurse working with a client during a flashback says, "I know you're scared, but you're in a safe place. Do you see the bed in your room? Do you feel the chair you're sitting on?" The nurse is using which technique?A. DistractionB. Reality orientationC. RelaxationD. Grounding
D
Nursing interventions for hospitalized clients with PTSD includeA. Encouraging a thorough discussion of the original traumaB. Providing private solitary time for reflectionC. Time-out during flashback to regain self-controlD. Use of deep breathing and relaxation teachniques
D
The nurse who is assess a client with PTSD would expect the client to report which data?A. Inability to relaxB. Increased alcohol consumptionC. Insomnia even when fatiguedD. Suspicion of strangersE. Talking about problems to friendsF. Wanting to sleep all the time
A, B, C, D
Education for clients with PTSD should include which information?A. Avoid drinking alcoholB. Discuss intense feelings only during counseling sessions C. Eat well-balance, nutritious mealsD. Find and join a support group in the communityE. Get regular exercise, such as walkingF. Try to solve an important problem independently
A, C, D, E
Nursing Interventions: Promote Client's Safety
- Discuss self-harm thoughts- Help the client develop a plan for hoping to a safe place when having destructive thoughts or impulses
Nursing Interventions: Help Client Cope with Stress and Emotions
- Use grounding techniques to help client who is dissociating or experiencing flashbacks- Validate client's feelings of fear, but try to increase contact with reality- During dissociative experience or flashback, help the client change body position, but do not grab or force the client to stand up or move- Use supportive touch if the client responds well to it- Teach deep breathing and relaxation techniques- Use distraction techniques such as participating in physical exercise, listening to music, talking with others, or engaging in a hobby or other enjoyable activity- Help to make a list of activities and keep materials on hand to engage the client when the client's feelings are intense
Nursing Interventions: Help Promote Client's Self-Esteem
- Refer to the client as "survivor" rather than "victim"- Establish social support system in community- Make a list of people and activities in the community for the client to contact when he or she needs helps