Term
| What clients are at risk for other directed violence or use violence as a response to anger has what kind of history? |
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Definition
Clients who have a past history of...
being cruel to animals
setting fires
witnessing family violence
emotional deprivation in childhood
early age of onset of psychiatric symptoms
legel convictions
substance abuse
violent, aggressive, unpredictable, impulsive behavior
frequent psychiatric hospital admissions(noncompliant w/treatment)
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Term
| What kind of issues is one experiencing that they may respond in violence? |
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Definition
Helplessness
inability to express anger to the person they depend on
poor frustration tolerance
ineffective coping skills
feelings of personal threat, rage, fear
intoxication
homicidal ideation(kill perosn who brought them there)
severe psychopathology
hallucination/delusions
suspicious agitation
escalating signs of anger (yelling loud noises)
environmental cues
strong needs for attention
ruminates |
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Term
| What do you do if someone has a strong need for attention and they become angry? |
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Definition
Address their behaviors early
ACKNOWLEDGE THEIR NEED |
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Term
| What are common nursing dx for a client who is angry? |
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Definition
Risk for other-directed violence
Ineffectiv coping
Impaired social Interaction |
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Term
| What are some client outcomes for angry, other-directed violence? |
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Definition
No harm to self/others
communicates needs appropriately to staff
identifies own feelings of anger
express (not show) feelings when angry
identifies triggers to anger
identifies self-responsibility for behavior
manages anger appropriately
-refrains from outburst
-refrains from violating personal space
-displaces anger to meaningful activities
establishes at least ONE therapeutic relationship with member of the treatment team |
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Term
| What are the high risk times when a client is likely to become aggressive? |
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Definition
On Admission
Change of shift-not paying attn
meal times
evening-less staff
visiting hours (may not have gotten visited)
in elevators
DURING PERIODS OF CHANGE |
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Term
| What are 4 main nursing interventions when handling and angry client? |
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Definition
1. Safety
2. Expressing Feelings
3. Assist with problem solving
4. Client/Family Teaching |
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Term
| What are nursing safety measures to consider when handling an angry person? |
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Definition
put them on violence precautions
assing to a private room
stay between the client and the door
stand at a 45 degree angle
maintain eye contact-DON'T STARE
LIMIT SETTING-consistent and firm, calm
expect the client to remain in control
medication management |
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Term
| How does a nurse promote catharsis (expressing feelings)? |
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Definition
Building a therapeutic relationship
promote a trusting relationship ("John, you seem very angry. Let's go to your room and talk about it.)
encourage client to describe and clarify his experience to increase awareness
Determine if I understand client correctly and give positive verbal feedback
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Term
| What are de-esalating strategies to assist with problem solving? |
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Definition
"TALKING DOWN" (get them to talk)
make short consice statements
Validate the clients's feelings and unmet needs
DO NOT approach a violent client alone
avoid "always and never"
avoid threat
When calmed down offer choices and options for diversional activities |
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Term
| What are suggestions for diversional activities? (offer when client has calmed down) |
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Definition
exercise
change of surroundings
release from schedule and demands
relaxation
music
quiet periods
walking |
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Term
| What is an example of "talking down"? |
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Definition
"What's going on?"
"What happened that has gotten you so angry?"
"An hour ago, you were fine. Now you are upset. What has changed?" |
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Term
| What information would you include in a teaching plan for client and famly? |
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Definition
Information about healthy/anger responses (the disorder)
how to manage symptoms
relaxation exercises
expectations after discharge
Life skills |
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Term
| What are life skills that need to be taught to angry/violent person? |
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Definition
social skills
problem solving skills
communication skills
assertiveness training
conflict resolution |
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Term
| What is primary prevention? |
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Definition
| attempts to alleviat ilnesses before they occur by removing possible causes and risk factors |
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Term
| What is secondary prevention? |
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Definition
SCREENING
the early discover and treatment of violent behavior
focus is on proactive treatment because prognosis is affected by the duration of the mental disorder |
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Term
| What is tertiary prevention? |
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Definition
| the elimination or reduction of the aftermath of illness |
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Term
| What are examples of primary prevention |
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Definition
conflict resolution programs in schools
stress management classes
parent training classes
lifestyle counseling programs -undo responses from family
encourage zero-tolerance policies
educate that violence is not a normal aspect of healthy relationships |
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Term
| What are examples of secondary prevention? |
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Definition
inpatient units
outpatient groups (anger management-start of program)
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Term
| What are examples of tertiary prevention? |
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Definition
case management
support services
probation or parole |
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