SULTAN KUDARAT EDUCATIONAL INSTITUTION College of Nursing Tacurong City

Reporter: Argelyn Zynamay A. Gaurana

Course / Yr: BSN-III

Clinical Instructors: Mrs. Melba S. Gleyo, RN, RM, MAN Mrs. Virginia Insular, RN, RM, MAN Mr. Reynald Ecija, RN Anger, Hostility and Aggression Abuse and Violence Definition: Anger a normal human emotion, is a strong, uncomfortable emotional response to a real or perceived provocation. Anger results when a person is frustrated hurt, or afraid. Hostility also called verbal aggression, is an emotion expressed through verbal abuse, lack of cooperation, violation of rules or norms, or threatening behavior. Physical Aggression is behavior in which a person attacks or injures another person or that involves destruction of property.

Etiology: Neurobiology Theories Psychosocial Theories Possible consequences of anger Physical problems Migraine headaches Ulcers Emotional problems such as (depression and low self-esteem)

Signs, symptoms, and behavior: Five Phase Aggression Cycle 1. Triggering 2. Escalation 3. Crisis 4. Recovery 5. Posterisis

Treatment: Treatment of aggressive clients often involves treating the commorbid psychiatric disorder with mood stabilizers or antipsychotic medications. Lithium Carbamazepine (Tegretol) Valproate (Depakote) Clozapine (Clorazil) Risperidone (Risperdal) Olanzapine (Zyprexa) Benzodiazepines Haloperidol (Haldol) Lorazepam (Ativan)

Nursing Interventions: 1. The nurse should assess the clients behavior to determine which phase of the aggression cycle he or she is in so that appropriate interventions can be implemented. 2. The nurse can approach the client while maintaining an adequate distance so that the client does not feel trapped or threatened. 3. Create a safe environment for the client. Remove harmful objects e.g. (glass, belts, rope, bobby pins). 4. Encourage the client to participate the activities such as, walking or talking with another person, are more likely to be effective in decreasing anger. 5. Encourage the client to express their angry feelings, by engaging in aggressive but safe activities such as, hitting a punching bag or yelling. Such activities called catharsis, to provide a release for anger. 6. The nurse should have a genuine interest in the client and a willingness to listen to the clients concerns, thoughts and feelings. 7. The nurse should approach the client in a non threatening, calm manner in order to decrease the clients emotion and behavior. 8. The nurse should allow the client time to express himself or herself. 9. Help the client relax, sleep and return to a calm state. 10. The nurse should provide directions to the client in a clam and firm voice.

Definition: Abuse and Violence Wrongful use and maltreatment of another person. Victims of abuse are found across the life span, and they can be spouses or partners, children or elderly parents. Women and children are the most likely victims or abuse and violence. Characteristics of Violent Families 1. 2. 3. 4. Intergenerational transmission process Social isolation Abuse of power and control Alcohol and other drug abuse

Domestic Abuse 1. Intimate Partner Violence (emotional, physical, sexual abuse) 2. Child Abuse (sexual abuse, neglect) 3. Elder Abuse (physical and sexual abuse, self-neglect, and inadequate medical treatment).

Clinical Picture / Sign and Symptoms: Intimate Partner Violence 1. Emotional name calling, belittling, screaming, yelling, destroying property, and refusing to speak. 2. Physical broken limbs, and ribs, internal bleeding, brain damage. 3. Sexual Abuse biting nipples, pulling hair, slapping and hitting including rape.

Elder Abuse Bruises or fractures > May be denied food, fluids, medications May be restrained in a bed or chair.

Treatment Woman can obtain a restraining order (protection order) from her country of residence that legally prohibits the abuser from approaching or contacting her. Advocacy counseling, shelter, talking with their health care provider. Child abuse and neglect ensure safety and wel-lbeing. Long term treatment involves professionals from several disciplines such as psychiatry, social work and psychology. Elder abuse relieving caregivers stress and providing additional resources.

Nursing Interventions:

1. The nurse should be particularly sensitive to the abused clients need to feel safe, secure, and in control of his or her body. 2. Maintain the clients personal space and privacy. 3. Assess the clients anxiety level and ask permission before touching him or her for any reason. 4. The nurse may not always be aware of a history of abuse when initially working with a client. 5. Encourage the client to express his or her feelings through talking, writing, crying, or other ways in which the clients is comfortable. 6. Provide social skills and leisure time counseling, and listen to clients feelings. 7. Use distraction techniques such as participating in physical exercise, listening to music or talking with others. 8. Provide clients safety the nurse should assess the clients potential for self harm or suicide and take action accordingly. 9. The nurse should help the client focus on the present rather than dwell on horrific things in past. 10. The nurse should be listen and convey acceptance and support the client.

THANK YOU VERY MUCH.,. :D

Prepared by: ARGELYN ZYNAMAY A. GAURANA BSN III