Nle Notes Psych Edited

8/13/2019 Nle Notes Psych Edited

1/19

1

PSYCHIATRIC NURSING

Psych focuses in feelings or self-awareness.

Beliefs determine feelings which affects behavior (manifestation of feelings)

Sigmund Freud is the father of PSYCHOANALYSIS

What haens to childhood will affect adulthood

STRUCTURE OF PERSONALITY

ID

!mulsive" #want to$" wants leasure.

PLEASURE PRINCIPLE

%uiding rincile is PAIN AVOIDANCE

SUPEREGO

Should not

Small voice of %od

&o sto

EGO

'ecutive decision maer.

!n touch with REALITY principle.

ID DOMINANT PERSONALITIES

Manic

Anti - Socialeerienced by serial illers

Narcissistic

SUPEREGO DOMINANT PERSONALITIES

Obsessive *omulsive

Anoreia +ervosa

EGO, if destroyed result in imaired reality ercetion.

Schiohrenia

LIBIDO

Seual energy resonsible for survival.

PSYCHOSEXUAL STAGES OF DEVELOPMENT ACCDNG TO FREUD [O.A.P.L.G.]

ORAL STAGE

, 1/ months evident.

ID i !e"el#pe!.

$FIXATION % Person is stuc in certain develomental shae.

$REGRESSION % 0eturn to an earlier develomental stage.

$EGO % Developed on the 6thmonth.


2/19

ANAL STAGE

1/ months , 2 years old.

3ble to control bladder" bowel.

Best time for toilet training.

SUPEREGO i !e"el#pe!.

TOILET TRAINING

%ood 4other Bad 4other

Successful

5irty *lean

- 5isorganied - organied

- 5isobedient - obedient

- 3nti-social - 6.*

- An&l e'p(li"e ) An&l re*en*i"e

PHALLIC STAGE

2 , 7 years old.

'erience leasure by maniulating genitals.

8ove , hate relationshi.

Oe!ip( C#+ple' boy loves arent of the oosite se.

!mitates daddy called IDENTIFICATION.

C&*r&*i#n ,e&r.

Elec*r& C#+ple' girl loves arent of the oosite se.

!mitates mommy called i!en*i,ic&*i#n.

Peni en"-.

$C#nci#(, uer level of thining.

$Prec#nci#(, ti of tongue.

$Unc#nci#(, rotects us from traumatic eeriences.

LATENCY STAGE

7 , 1 years old.

School age.

Searation aniety.

0eading" Writing" 3rithmetic.

8asts for 7 years.

GENITAL STAGE

1 years old and above

Seual reawaening.

9ery imortant stage.


3/19

2

PHARMACOLOGY NOTES

ANTI ANXIETY DRUGS [S.A.T.L.V.M. % E.V.A..I.]

Ser&'

A*i"&n

T&n'ene

Li/ri(+

V&li(+

Mil*#0n

E1(&nil

Vi*&ril

A*&r&'

(p&r

In!er&l

ERIC ERI2SON

&here is more to life than :ust se.

P-c3##ci&l T3e#r- of develoment.

;ou can develo a ositive side or a negative side.

5evelomental tas begins at , 1/ months.

POSITIVE NEGATIVE FACTOR

, 1/ mos. &rust 4istrust Feeding

1/ mos. , 2 yrs. 3utonomy Shame < 5oubt &oilet &raining

2 yrs. , 7 yrs. !nitiative %uilt !ndeendence

7 yrs. , 1 yrs. !ndustry !nferiority School

1 yrs. , yrs. !dentity 0ole *onfusion Peers

yrs. , = yrs. !ntimacy !solation 8ove

= yrs. , >= yrs. %enerativity Stagnation Parenting

>= yrs. - above 'go !ntegrity 5esair 0eflection

EHAVIORAL MODELS

I"&n P&"l#"

*lassical *onditioning

3ll behaviors are learned.

F S4inner

Behavior can be learned and unlearned.

6erant conditioning.

!f given reward there is reetition.

!f unished behavior becomes etinct.

LOES OF RAIN

5. FRONTAL LOE

8anguage

8earning

Personality


4/19

>

?udgment

6. TEMPORAL LOE

@earing

Smell

7. PARIETAL LOE

&ouch

&aste

8. OCCIPITAL LOE

9isual

7 STEPS TO INTERACT 9ITH ENVIRONMENT

1. Sensory , eyes" ears" tongue

. !ntegration

2. 4otor , voluntary or involuntary

VOLUNTARY NERVOUS SYSTEM

3lso called as SOMATIC

4otor nerve to muscle fiber you need ACETYLCHOLINE which is an #6n switch$.

Brain

Sinal *ord

4otor +erve

Synase

4uscle Fiber

INVOLUNTARY NERVOUS SYSTEM

3lso called AUTONOMICnervous system.

AUTONOMIC NERVOUS SYSTEM

SYMPATHETIC(3wae" ADRENERGIC:

PARASYMPATHETIC(0ela" CHOLINERGIC:

He&r* R&*e !ncrease 5ecreaseRepir&*#r- R&*e !ncrease 5ecrease

GI 5ecrease (5ry mouth" *onstiation) !ncrease (4oist mouth" 5iarrhea)

GU 5ecrease (Arinary 0etention) !ncrease (Arinary Freuency)

Ne(r#*r&n+i**er 'inehrine" +oreinehrine 3cetylcholine

DRUGS 9ITH ANTICHOLINERGIC EFFECTS

3nti , 3niety

3nti , Psychotic

3nti , *holinergic

3nti , 5eressants

PHARMACOLOGY NOTES

MONOAMINE OXIDASE INHIITORS

M&rpl&n

N&r!il

P&rn&*e


5/19

=

DEFENSE MECHANISMS

5. DISPLACEMENT % transfer of feelings to a less threatening ob:ect rather than the one who rovoed it.

6. DENIAL % failure to acnowledge an unaccetable trait or situation.

7. DISSOCIATION %sychological flight from the self.8. REGRESSION %return to an earlier develoment state.

;. REPRESSION %unconscious forgetting.

. REACTION FORMATION %doing the oosite of what you have done.

?. UNDOING %doing the oosite of what you have done.

@. IDENTIFICATION % assuming trait for ersonal" social" occuational role.

5. PROBECTION %attribute to others oneCs unaccetable trait.

55. INTROBECTION %assume another ersonCs trait as your own.

56. SUPPRESSION %conscious forgetting.

57. SULIMATION %utting destructive energies or hostile feelings towards a more roductive endeavors.

58. CONVERSION %uneressed or reressed feelings are converted to hysical symtoms.

5;. COMPENSATION %over achievement in one area to cover a defective art.

5. 3ctive 8istening , nodding" eye contact

=. Broad 6ening , how are you todayD

1. 5onCt worry be hay

. *hanging the toicEsub:ect

2. !gnore the client

>. 9alue based :udgment , never assume

=. Flattery

7. 3dvising


6/19

7

7. %eneral 8eads , %o on" !Cm listening

. 0estating , !Cm sad #;ouCre sadD$

. %iving 6inion

FEAR % rotects us from something bad.

ANXIETY

9ague sense of imending doom.

&riggers the symathetic nervous system.

3ssess level of aniety of client.

TYPES OF ANXIETY

MILD ANXIETY

G 1 level of aniety.

Widened ercetual field.

0estless (say you seem restless).

'nhanced learning caacity.

MODERATE ANXIETY

G level of aniety.

*lient ace.

%ive P0+ meds.

SEVERE ANXIETY

G 2 level of aniety.

5onCt now what to doEsay.

5irective orders (lease sit down).

PANIC

G > level of aniety.

4ay commit suicide.

Promote safety.

+ever touch atient.

@yerventilation (0esiratory 3lalosis)

Breathe into aer bag.

NURSING DIAGNOSIS

!neffective individual coing.

Powerlessness.

!maired sin integrity

PLANNINGIMPLEMENTATION

5ecrease level of aniety.

5ecrease environmental stimuli.

0elaation techniues

EVALUATION

'ffective individual coing.

GENERALI=ED ANXIETY DISORDER

7 month ecessive worrying.

0estless" difficulty concentration" slee disorders" alitations" edge of the seat" easy fatigability.

PANIC ATTAC2S DISORDER

1= , 2 minutes symathetic nervous system escalation.

'amle is AGORAPHOIA fear of oen saces.


7/19

POST TRAUMATIC STRESS DISORDER

9ictims become survivors and eerience flashbacs or nightmares.

MALINGERING

Pretending to be sic (conscious).

Pri+&r- G&in aniety decreases" able to escae source of aniety. Sec#n!&r- G&inable to get attention.

SOMATOFORM DISORDER

+o rotection

Anconscious

+o organic basis of being sic

DIFFERENT TYPES OF SOMATOFORM

1. Conversion Disorder

*annot sea" see" hear.

+ervous system affected.

2. La Belle Indieren!e

5o not care what haens to them.

HYPOCHONDRIASIS

has minor discomfort and interrets it as ma:or illness.

Focus on clients feelings.

ODY DYSMORPHIC DISORDER

!llusion of structural defect.

Favorite ast time is doctor hoing.

Focus on clients feelings.

PSYCHOSOMATIC

0eal ainsEillness

0eal symtoms because of aniety

PSYCHOSOMATIC

Incre&e An'ie*-

SNS

Incre&e P HR

H-per*eni#n


8/19

/

F&* Dep#i*

A*3er#cler#i

C&lci(+

Ar*eri#cler#i

Decre&e O'-en

Anin& Pec*#ri

MI

Necr#i

CHF

C#+&

PHOIA

!rrational fear

'tiologyH Inowledge of certain ob:ect

Bad eerience

!mmediate nursing ob:ectiveH 0emoval of stimulus will remove aniety

S-*e+ic Deeni*i&*i#n gradually eose client to stimuliEfeared ob:ect

'mloy relaation techniues

SYMPATHETIC NERVOUS SYSTEM

%3B3 (%amma 3mino Butyric 3cid) , sto

'inehrine and +oreinehrine , %o

ANTI) ANXIETY MEDICATIONS

!ncrease %3B3 and client becomes drowsy (no alcohol and coffee)

4ay develo orthostatic hyotension

8et atient sit then dangle feet and then stand

5evelo anti cholinergic effects

!f abrutly withdrawn to anti aniety it may result to rebound henomenon (1 wee) may lead to

seiures

5o it in gradual and in taered dose

3nti aniety leads to deendence

AUTISM

Anresonsive and does not want to be touched

AUTISTIC SAVANTH high intelligence and has a ratio of 1H1

Ae+en*

3earance , flat affect and loves constancy and ritualistic


9/19

J

Behavior , withdrawn

*ommunication , echolalia

NURSING DIANOSIS

!maired verbal communication

!maired social interaction Self mutilation

0is for in:ury


4aslowCs hierarchy of needs

E'prei"e T3er&p-, use of art as mode of communication

EVALUATION

'nhanced communication

!mroved social interaction

Safety

ATTENTION DEFICIT HYPERACTIVITY DISORDER

years and below onset

D(r&*i#nH 7 months and above

Se**inH house and school

Ae+en*

3earanceH dirty" clumsy" hyeractive" imatient" easily distracted and has no focus

Behavior

*ommunicationH talative

NURSING DIAGNOSIS

0is for in:ury

!maired social interaction


S*r(c*(reH lace to lay" slee" eat and study

Sc3e!(leH there is always a time for everything that you do

Se* li+i*

S&,e*-

EVALUATION

4inimie ris for in:ury

!mroved social interaction

FRONTAL LOE OF ADHD5ecreased glucose

K5ecreased :udgment

K

!ncrease imulsivenessADHD H-per&c*i"i*-

+eed a drug that brings glucose level u.

%ive RITALIN as stimulant

4ay result in loss of aetite

%iven after meals

%iven 7 hours before bedtime


10/19

1

EATING DISORDERS

ANOREXIA NERVOSA ULIMIA NERVOSA

'at" eat" eat

8ess /=L eected body weight

2 months 3menorrhea

'at" eat" vomit

+ormal weight

!rregular menstruation

ULIMIA NERVOSA

4etabolic alalosis (vomiting results to decreased hydrochloric acid)

4etabolic acidosis (diarrhea results to decreased bicarbonate)

5ental caries

Wound in nucles

MANAGEMENT

Fluid and electrolyte imbalance

4eal contract

Weight gain for client

3fter eating stay with client for 1 hour and accomany when going to the comfort room

PHARMACOLOGY NOTES

ANTI % PSYCHOTIC DRUG

S*el&ine

Seren*il

T3#r&ine

Tril&,#n

Cl#&ril

Mell&ril

H&l!#l

Pr#li'in

SCHI=OPHRENIA

'go disintegration

!maired reality ercetion

%enetic vulnerability

Stress , Di&*3ei M#!el

Biological theory , incre&e !#p&+ine le"el 'act cause unnown

ASSESSMENT

3ffectH 3roriate" !naroriate" Flat" Blunt (incomlete)

3mbivalenceH ulled into oosing forces

AUTISMH 8ooseness" no idea" not related to one another

ASSESSMENT

NEGATIVE POSITIVE

@yoactive @yeractive

Withdrawn Sociable

&hought Blocing Flight of ideas

3athy


11/19

11

I. ASSESS

*ontent of thought

NURSING DIAGNOSIS

5isturbed thought rocess


Present reality Provide safety

EVALUATION

!mroved thought rocess

II. ASSESS

@allucinationsE !llusions

NURSING DIAGNOSIS

5isturbed sensory ercetion


Present reality

Safety

EVALUATION

!mroved sensory ercetion

III. ASSESS

Susicious

NURSING DIAGNOSIS

0is for other directed violence


Present reality

Safety

EVALUATION

'liminateEminimie ris for other directed violence

IV. ASSESS

Suicidal

NURSING DIAGNOSIS

0is for self directed violence


Present reality

Safety

EVALUATION

'liminateEminimie ris for self directed violence

LOOSENESS OF ASSOCIATION

&here is connection with statements


12/19

1

FLIGHT OF IDEAS

?uming from on toic to another

AMIVALENCE

Pulled between strong oosing forces

MAGICAL THIN2ING

acting lie magicianECHOLALIA

*lient reeats what you say

ECHOPRAXIA

*lient reeats what you do

9ORD SALAD

?ust words no rhyme

CLANG ASSOCIATION

Words that rhyme

NEOLOGISM

Formation of new words (needs clarification)

DELUSION PERSECUTORY

#&he +B! is out to get me$

DELUSION RELIGIOUS

#! am ?esus *hrist the savior$

DELUSION GRANDEUR

# ! am the ueen of the world$

DELUSION IDEAS OF REFERENCE

#&he nurses are taling about me$

CONCRETE ASSOCIATION

3lso nown as #ilosoo$

THOUGHT LOC2ING

Anable to thin

HALLUCINATIONS ILLUSIONS

S&!4A8AS

9!SA38

3A5!&60;

&3*&!8'

3BS'+&

3BS'+&

3BS'+&

3BS'+&

P0'S'+&

P0'S'+&

P0'S'+&

P0'S'+&

Present reality to clients eeriencing hallucinations

&echniue in handling clients with hallucinations

Hallucinations

Acnowledgement #! now the voices are real to you$

Reality orientation #! now the voices are real but ! donCt hear them$

Diversion #8ets go to the garden$ 5J #, c3i#p3renic clien* 3e&r "#ice

PAR2INSONKS DISEASE

!f acethylcholine (on switch) is increased there is ecessive movement resulting to decrease in

doamine (off switch)

ANTI)PSYCHOTIC


13/19

12

5ecrease doamine level

Parinson lie effect

'tra yramidal side effect

With aathesia

0estless" inability to rest

A2INESIA

4uscle rigidity

DYSTONIA

&orticollis (wry-nec)

OCULOGYRIC CRISIS

Fied stare

OPISTHOTONUS

3rched bac

Lip, smacing

T#n(e, rotruding

C3ee4, uffing

&he 2 are irreversible and called TARDIVE DYS2INESIA

NEUROLEPTIC MALIGNANT SYNDROME H-per*3er+i&

ANTI % PAR2INSON DRUGS

3+&!*@68!+'0%!*S 56P34!+'0%!*S

(Decre&e AC3) (Incre&e D#p&+ine)

Artane" Aineton Parlodel

enadryl Larodoa

Cogentin Elderyl

Symmetrel

OT"E# $IDE E%%ECT$ O% DEC#EA$E DO&A'INE

Photosensitivity

3%03+A86*;&6S!S , decrease WB*

*lients rone to infection due to decrease WB*

First sign for infection is #re *3r#&*

TYPES OF SCHI=OPHRENIA

DISORGANI=ED CATATONIC PARANOID RESIDUAL UNDIFFIRENTIATED

UNCLASSIFIED

- Sad but smiles(!naroriate affect)- +o reaction (flataffect)- Flight of ideas(disorganied seech)- %iggling

- 3mbivalence- Way fleibility- Favorite word is #+o$- +egativism (client donot follow what you tellthem to do)N(rin

- Susicious- 4istrust"scared"withdrawnN(rin+&n&e+en*- %ain &0AS&

- +o moreositivesymtoms

:ustwithdrawn

- 4ied classification"cant be classified


14/19

1>

(hebehrenic giggle)- *ombination ofositive and negativesigns and symtoms

+&n&e+en*4eet needs

by 1 to 1 shortinteraction butfreuent- Foods shouldbe in a sealedcontainer- 4edicationsshould be intamer resistantfoil.Vi#len*H- Iee door oen- Position neardoor- 5onCt touchclient- *all forreinforcement- 6ne armslength away fromthe client.

PHARMACOLOGY NOTES

I)POLAR MANIC

Li*3i(+ (n!er# ,ir* 4i!ne- *e* &n! c3ec4 ,#r /l##! le"el

LevelH .7 , 1. meE8

Increase urination

Tremors" fine hand

Hydration of 28Eday

Increase

Uu (diarrhea)

Mouth dry

$i(ns o Lithi)m to*i!it+

+ausea" vomiting" diarrhea

!ncrease sodium

$$$$9AIT FOR 6 % 8 9EE2S EFORE LITHIUM THERAPY TA2ES EFFECTS

IPOLAR DISORDER MANIC PROFILE

years old

Female

Stress

6bese

ASSESSMENT

5ecrease aetite (give finger foods)

5ecrease slee (lace in a rivate room)

@yeractive

!ncrease seual activity , only means of addressing aniety so decrease level of aniety

0is for in:uryEother directed violence

!maired social interaction (care giver roleH strain and stay with client) Self esteem decrease (to cover u their sadness there is comensation to cover defective doing)

Because there is !ecre&e el, e*ee+ there will be incre&e c#+pen&*i#n resulting to

incre&e in*er,erence 0i*3 ADLK &n! 3&r+ *# #*3er

C#+pen&*i#n i *3e c(lpri*

M&n&e+en* incre&e el, e*ee+ *# !ecre&e c#+pen&*i#n &n! !ecre&e in*er,erence

0i*3 ADLK &n! 3&r+ *# #*3er


15/19

1=

HO9 TO INCREASE SELF ESTEEM OF MANIC PATIENTS

T - no sorts (basetball" volleyball)" no fine motor sills only gross motor sills

A-llot energies toward more roductive endeavors ((/li+&*i#n)

S ) escorted wal outdoors

2 - unching bag (dislacement)

PHARMACOLOGY NOTES

ANTI % DEPRESSANTS

Aen!in

N#rpr&l&+in

T#,r&nil

Sine1(&n

An&,r&nil

A"en*-l

Vi"&c*il

El&"il

Pr#&c

P&'il

=#l#,*

ALCO"OL LEAD$ TO,

l&c4#(* awae but unaware

C#n,&/(l&*i#n inventing stories to increase self esteem

Deni&l #! am not an alcoholic$

Depen!ence cant leave with out leading to en&/lin where in the significant other tolerates the

abuser c# !epen!ence is another term

T#ler&nce gradual increase in amount of stimuli to eerience the same euhoria

MANAGEMENT

De*#'i,ic&*i#n withdrawal with medical doctor suervision

Avoid alcohol theray

Aversion theray a more technical term for avoid alcohol theray

AntabuseH 5isulfiram maes the client never drin alcohol because it causes vomiting

Alcoholics anonymous

!nterval of 1 hours after last dose of alcohol or eerience nausea and vomiting and hyotension

3lcoholism may result to 9itamin B1 (&hiamine) deficiency

-E#NICE/$ ENCE&"ALO&AT"Y

Problem with motor

O#$AO%%/$ &$YC"O$I$

Problem with memory

> , hours after last dose of alcohol eectH

Deliri(+ Tre+enH symathetic nervous system

Prevent hallucinationsE!llusions by lacing client in a well lit room

F#r+ic&*i#nH feeling of bugs crawling under the sin

AL=HEIMERS DISEASE

- 3on (away) and 5endrites (toward) nerve

- +eurofibrillary tangles


16/19

17

- +eurotic laues

ALCOHOL DELIRIUM AL=HEIMERSONSET 3brut %radualLEVEL OF CONSCIOUSNESS Fluctuating AnaffectedDURATION @ours to days ProgressiveMEMORY Short term memory loss Short term and long term

(orient atient)

; AK OF AL=HEIMERS

1. Amnesia , memory loss

. Anomia , donCt now the name

2. Agnosia , sensory roblems smell" taste" sight

>. Ahasia

EXPRESSIVEcant sayEeress

Frontal lobe is affected articularly /r#c&K &re&

RECEPTIVE cant hear

&emoral lobe is affected articularly 0ernic4eK &re&

=. Araia , canCt do simle things

Re+inicin T3er&p- % *&l4 &/#(* p&*

Patients with 3lheimerCs may eerience hallucinations" illusions thus becomes restless and may

wander

3s sun goes down client becomes restless" agitated" disoriented called #(n!#0nin

5rug of choice is COGNEX and ARICEPTa cholinesterase inhibitor that increases 3ch causing delay in

disease rogression

SEROTONIN

0esonsible for hainess

5ecrease serotonin clients becomes sad give anti-deressants

SELECTIVE SEROTONIN REUPTA2E INHIITOR

Safest drug

Side effects low

R

I to > wees

!ncreases serotonin and affects only serotonin

PRO=AC PAXIL =OLOFT

TRICYCLIC ANTI DEPRESSANT

Two , four wees

C

A

@as higher incidence of side effects

3lso increases noreinehrine

ASENDIN NORPRALAMIN TOFRANIL SINEUAN ANAFRANIL AVENTYL VIVACTIL ELAVIL


17/19

1

MONO AMINE OXIDASE INHIITORS

436 ills serotonin

!ncreased 436 results to decreased serotonin the more deressed the client becomes

436! ills 436 and increases all neurotransmitters (serotonin" einehrine" noreinehrine" doamine

but client becomes rone to hyertensive crisis

3void tyramine rich foods

Avocado" 3lcohol

eer

Chocolates" *heese (aged)

Fermented foods

Picles

Preserved foods

Soy sauce

&here is increase incidence of side effects after , 7 wees

MARPLAN NARDIL PARNATE

PERSONALITY DISORDERS

1. Sc3i#p3reni&

&hey avoid eole because there is no en:oyment

. A"#i!&n* &hey avoid eole because they are afraid of criticisms

&hey have talent but has no confidence

2. An*i)S#ci&l

*onstantly breas law

Pro:ect charm

&hey are witty and articulate

4aniulative

>. #r!erline

&hey erceive life as an emty glass &hey lie slitting friends

Sudden change in mood #labile affect$

Prone to suicide

=. Depen!en*

#*ant live if living is without you$

7. Hi*ri#nic

*onstantly wants to be the center of attention

'cited" dramatic" maniulative

. N&rcii*ic

#! love myself$

&hey get :ealous even with achievement of family members

/. O/ei"e % C#+p(li"e

#! am so organied$

J. P&r&n#i!

Susicious


18/19

1/

4ay lead to domestic violence

GRIEF PROCESS [D.A..D.A]

1. Deni&l, shocEdisbelief. Aner, uestion #why meD$2. &r&inin, if" then>. Deprei#n, wees or more sign and symtoms becomes ma:or clinical deression=. Accep*&nce, client acts according to situation

ASSESSMENT

5ecrease self actualiation

5ecrease self esteem

WithdrawnH stay with client

SuicidalH ris for self directed violence

!ncreaseEdecrease eat" increaseEdecrease slee" hyoactive" decrease seual urge

Be sensitive to clients needs

FOR SUICIDAL OSERVE FOR

Ver/&l c#++(nic&*i#n

#! wont be a roblem$

#&his is my last day on earth$

#!Cll soon be gone$

N#n)"er/&l c#++(nic&*i#n

%iving away of valuables

Sudden change in mood

DO9NERS [A..O.N.)M.M.C.H.]

Alcohol

arbiturate

Oiates

Narcotics

Mari:uana

Morhine

Codeine

Heroine#es)ltin( to,

Bradycardia

Bradynea

4oist mouth

Puils constrict

*onstiation

ANTI 0 DEE$$ANT $IDE E%%ECT$

438' , 'rectile dysfunction" rone to imotence

9HEN THE CLIENT IS SUICIDAL 9HAT 9ILL THE NURSE DO

DirectH #5o you lan to commit suicideD$

IrregularEinterval visits

Endorsement eriod" '308; 460+!+% clients are most liely to commit suicide


19/19

1J

Arinary retention

@yotension

*oma

Weight gain

N&rc#*ic #"er!#e give narcotic antagonist (+30*3+" +386M6+' @;506*@860!5')

UPPERS [C.H.A.R.]

Cocaine

Hallucinogens

Amhetamines

Re(l*in *#

&achycardia

3wae

&achynea

5ry mouth

Puils dilate

@yertension

Seiures

Weight loss

Documents

Nle Notes Psych Edited