m


Õ Vague sense of impending doom

Õ Subjective response to stress

Õ Is a state of apprehension,
uneasiness, uncertainty or
tension experienced by an
individual in response to an
unknown object or situation.



 


Õ ×ILD
Õ Physical - ĹPR, RR, BP,
pupillary dilatation, sweating

Õ Cognitive - mttentive and

alert

Õ ëmotional - ×inimal use of

defenses
Õ× DëRm
ë
Õ Physical - Nausea, Anorexia, Vomiting,
Diarrhea, Constipation, Restlessness
Õ Cognitive - narrowed perceptual field &
selective inattention
Õ ëmotional - use of any defense
mechanism available
Õ SëVëRë
Õ Physical - s/sx becomes the flow of
attention
Õ Cognitive ± perceptual field is greatly
narrowed, focus of attention is trivial
events
Õ ëmotional ± defense mechanism operate
Õ PmIC
Õ Physical ± s/sx of
exhaustion ignored
Õ Cognitive ± personality
disorganized
Õ ëmotional ± defense
mechanism fail
  
 


Õ  
    

Õ m 

  



Õ Be

ÕCalm
Õmdminister medications
ÕListen
Õ×inimize environmental stimuli
m

   
Õ mn individual may suddenly experience
frightening and uncomfortable
symptoms.
Õ ×ay include terror, sense of unreality
or fear of loosing control.
Õ mttack: 1 minute and 1 hour
    
Õ Phobia is an irrational fear of an object,
place, activity or situation.
Õ Avoidance will allow the individual to be
free from anxiety.
Õ ëxamples:
Õ mgoraphobia - is the fear of open places
and of being alone in public places.
Õ Social phobia - is an irrational fear of
criticism, humiliation or embarrassment.
Õ mcrophobia - fear of heights
Õ mlgophobia - fear of pain
Õ Claustrophobia - fear of enclosed place
Õ
hanatophobia - fear of crowds
Õ Pathophobia - fear of disease
Õ ×onophobia - fear of being alone
Àeneralized mnxiety Disorder
(ÀmD)
Õ unrealistic, excessive anxiety and is
unable to control worry.
Õ Clients may experience:
Fatigue
Irritability
Restlessness
Muscle tension
Sleep disturbance
 bsessive Compulsive
Disorder
Õ Is characterized by recurrent obsessions and
compulsions that interfere with normal life.

Õ bsession
Refers to persistent, painful intrusive thought,
emotion or urge that one is unable to suppress or
ignore.
Õ Compulsion
Refers to repetitious uncontrollable act and
sometimes a purposeful act to prevent a certain
mistake in an event or situation.
Post--
raumatic Stress Disorder
Post
(P
SD)
Õ Is the delayed reaction of the person who has been
involved or exposed to a traumatic events.
Õ Symptoms of this disorder are:
intense psychological distress
feeling of detachment or estrangement from others
insomnia
decreased concentration
avoidance of thoughts and feelings
recurrent distressing dreams
inability to recall an important aspect of the trauma
 ursing Interventions
Õ Calm and nonjudgmental approach to
convey acceptance.
Õ use short and simple sentences or words.
Õ Help the client develop an increase
tolerance to anxiety.
Õ Help the client to:
develop a problem-
problem-solving and coping
skills of the client.
develop the ability to remain calm in
anxiety--producing situations.
anxiety
Õ mpproach: kind--firmness
kind
Õ Systematic desensitization (phobic
disorders)
Õ Clients with ritualistic behavior
(obsessive--compulsive disorder)
(obsessive
should not be prohibited or
reprimanded.
Õ Biofeedback, change of the scenery,
therapeutic touch, hypnosis, massage
or relaxation exercises.
Õ mdminister medications, as ordered.
m 


 
 

 
Õ Free floating anxiety disorder
Õ Clients:
express emotional turmoil or conflict through
physical symptoms.
usually seek for repeated medical attention.
May exhibit antisocial behavior and may
attempt suicide.
Õ Associated with anxiety and depression
   
ÕA condition in which an anxiety-
anxiety-
provoking impulse is converted
unconsciously into functional symptoms.
Õ unconscious counterpart of malingering
Õ ëxamples: Paralysis, blindness, loss of
touch or pain sensation, dyspnea,
seizures or convulsions
 º    
Õ An individual presents an
unrealistic or
exaggerated physical
complaints.
Õ The person becomes,
preoccupied with the fear
of developing or having
already a disease or
illness in spite of medical
reassurance.
 x  

Õ Preoccupation with an imagined defect in

his or her appearance.
Õ Slight physical abnormality = excessive
concern / anxiety
   
m 
Õ Inability
to recall extensive amount of
important information
Õ Caused by trauma
Õ Characterized by:
Disorientation
Purposeless wandering
Impairment in ability to perform ADL
Õ Rapid recovery generally occur
PëRS mLI

DIS RDëRS
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ypes of Personality
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 Dramatic--ërratic Personality Disorder
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ype B)
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ºistrionic emotional and dramatic)
Õ ëxcessive emotionally and attention
seeking behaviors that are dramatic
and egocentric
Õ ëxaggerated expression of emotion
Õ Overreaction to minor events

   
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 mnxious or Fearful
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ype C)
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m
IS×
Õ Characterized by:
Impairment in communication skills
Presence of stereotyped behavior, interests
and activities.
Associated with impairment on social
interactions
Õ treatable but not curable
Õ more common among boys
Õ usually diagnosed at age 2
Õ Main problem: Interpersonal functioning
Õ Most acceptable cause:
Biological factors - brain anoxia, intake of
drugs
 Signs and Symptoms
dd play
ot cuddly
ëcholalia

Crying tantrums
ºead towards anything
Inanimate object attachment
Loves to spin objects / self
Difficulty interacting with others
Õ ÿants blocks
Õ mcts as deaf
Õ Resists normal teaching method / routine
changes
Õ o fear of danger
Õ Insensitive to pain
Õ o eye contact
Õ Àiggling or silly laughing
 ursing Interventions
Õ ënvironment:
safe
consistent
Õ ëncourage the client to participate for self-
self-care
Õ Speak calmly when giving instructions
Õ use simple words or phrases
Õ Repeat instructions as necessary.
Õ ºaloperidol - symptomatic relief for
hyperactivity, stereotypical and self-
self-destructive
behavior
 ×ë
mL
Rë
mRDm
I 
Õ Not a mental illness.
Õ Problem of inadequate mental functioning.
Õ Onset: 18
Õ IQ below 70
Õ Manifested by sub-
sub-average intellectual
functioning in:
Communication
Self--care
Self
Home living
Social skills
Health and safety
 p

Causes

Õ ºIV/AIDS / rubella infection

Õ mlcoholic mother
Õ
hyroid deficiency
Õ ëxcessive lead poisoning
Õ Damage to the brain
Õ eurological / neurodevelopmental impairment
Õ ëxact gestational age is not reached
premature)
Õ piate intoxication
Õ utritional deficiency lack in Folic Acid)
Õ mnoxia
Õ
oxemia pregnancy
pregnancy--induced hypertension)
Õ ënvironmental factors
Õ Severe RH incompatibility
 Levels
Õ ×ild/moron
Õ IQ: 51--70
51
Õ Difficulty adapting to school
Õ ëducable ± needs assistance

Õ ×oderate/Imbecile
Õ IQ:36--50
36
Õ Poor awareness of needs of others
Õ Trainable ± needs moderate supervision
Õ Severe/Idiot
Õ IQ: 20-
20-35
Õ unable to learn academic skills with poor
motor development and minimal speech
Õ Needs complete and close supervision

Õ Profound
Õ Below 20
Õ Has minimal capacity for sensorimotor
function
Õ Needs custodial care with a totally structured
environment
Õ ursing Diagnosis: Self-
Diagnosis: Self-care deficit
 Principles of ursing Care
Õ Protective care
Õ ëducation of the family
Their involvement is an important factor
in the plan of care to promote progress
and to minimize the stress.
Õ Repetition
Õ Role modeling
Õ Restructuring
ÕFocus of ëducation
Reading
mrithmetic
ÿriting
 m

ë
I  DëFICI

ºPëRmC
IVI
 DIS RDëR
Õ Common in boys
Õ usually diagnosed before age 7
Õ Problems:
Inattention
Hyperactivity
Impulsivity
Õ Causes:
Õ Frontal lobe ± hypoperfusion
Õ use of drug
Õ Neurologic impairment
Õ Pre
Pre--natal trauma
Õ ëarly malnutrition
 Signs and Symptoms
Õ bstinacy
Õ egativism
Õ ëgocentrism
Õ
Õ Fighting syndrome
Õ mggressiveness
Õ
olerance is low
Õ Difficultyconcentrating
Õ ëxcessive talking
Õ Fidgeting
Õ Interrupt/intrudes on others
Õ Child exhibits hyperactivity
Õ Indulges in destructive behavior
Õ
emper tantrums
Õ ursing Diagnosis: Potential for injury
Diagnosis:
Õ Principles of ursing Care:
Õ Provide nutrition and safety
Õ ënvironment:
structured
enable appropriate reaction to the
environmental stimuli
Õ Plana firm and consistent environment in
which limits and standards are set.

Õ Drug of choice:
choice: ×ethylphenidate
(Ritalin)