Psychiatric Nursing

Learn the therapeutic skills you need for your role in psychiatric nursing care! Psychiatric Nursing uses a practical, three-pronged approach to psychotherapeutic management that clearly explains how to care for patients with psychiatric disorders. It emphasizes the nurse's three primary tools: themselves, medications, and the environment. Written by Norman L. Keltner, Carol E. Bostrom, and Teena McGuinness, each an educator and advanced practice nurse, this text covers the latest trends and treatments and provides a solid, real-world foundation for the practice of safe and effective p.;Front Cover ; Psychiatric Nursing ; Copyright ; Contributors ; Reviewers ; Preface ; ORGANIZATION; WHAT'S NEW; FEATURES; RESOURCES FOR THE STUDENT AND INSTRUCTOR; Contents ; Chapter 1 -- Introduction to Psychiatric Nursing; LEARNING OBJECTIVES; BENCHMARKS IN PSYCHIATRIC HISTORY; CRITICAL THINKING QUESTIONS; CRITICAL THINKING QUESTION; ISSUES THAT AFFECT THE DELIVERY OF PSYCHIATRIC CARE; SUMMARY; CRITICAL THINKING QUESTION; REFERENCES; Chapter 2 -- Psychotherapeutic Management in the Continuum of Care; LEARNING OBJECTIVES; PSYCHOTHERAPEUTIC MANAGEMENT. Front Cover 1 Psychiatric Nursing 5 Copyright 6 Contributors 7 Reviewers 9 Preface 11 ORGANIZATION 12 WHAT’S NEW 12 FEATURES 12 RESOURCES FOR THE STUDENT AND INSTRUCTOR 12 Contents 15 Chapter 1 - Introduction to Psychiatric Nursing 21 LEARNING OBJECTIVES 21 BENCHMARKS IN PSYCHIATRIC HISTORY 21 CRITICAL THINKING QUESTIONS 24 CRITICAL THINKING QUESTION 26 ISSUES THAT AFFECT THE DELIVERY OF PSYCHIATRIC CARE 27 SUMMARY 29 CRITICAL THINKING QUESTION 30 REFERENCES 30 Chapter 2 - Psychotherapeutic Management in the Continuum of Care 32 LEARNING OBJECTIVES 32 PSYCHOTHERAPEUTIC MANAGEMENT 32 PSYCHOTHERAPEUTIC MANAGEMENT: THREE INTERVENTIONS 33 CRITICAL THINKING QUESTION 34 CRITICAL THINKING QUESTION 34 CONTINUUM OF CARE TREATMENT OPTIONS 36 CRITICAL THINKING QUESTION 36 TRADITIONAL OUTPATIENT SERVICES 36 INTENSIVE OUTPATIENT PROGRAMS 37 CRITICAL THINKING QUESTION 38 REFERENCES 39 Chapter 3 - Models for Working with Psychiatric Patients 40 LEARNING OBJECTIVES 40 PSYCHOANALYTIC MODEL 40 DEVELOPMENTAL MODEL 43 INTERPERSONAL MODEL 44 COGNITIVE-BEHAVIORAL MODELS 47 STRESS MODELS 48 CRITICAL THINKING QUESTION 50 INTEGRATIVE APPROACH 50 CRITICAL THINKING QUESTION 50 REFERENCES 51 Chapter 4 - Legal Issues 53 LEARNING OBJECTIVES 53 SOURCES OF LAW 53 CRITICAL THINKING QUESTION 54 TORTS (CIVIL LAW) 55 COMMITMENT ISSUES 57 CRITICAL THINKING QUESTION 58 PATIENT RIGHTS 59 CRITICAL THINKING QUESTION 60 CRITICAL THINKING QUESTION 61 PSYCHIATRIC ADVANCE DIRECTIVES 61 REFERENCES 63 Chapter 5 - Psychobiologic Bases of Behavior 64 LEARNING OBJECTIVES 64 NEUROANATOMY OF THE BRAIN 64 CRITICAL THINKING QUESTIONS 71 NEURONS AND NEUROTRANSMITTERS 74 AUTONOMIC NERVOUS SYSTEM 74 VENTRICULAR SYSTEM 75 CLINICAL APPLICATION 75 CRITICAL THINKING QUESTION 77 CRITICAL THINKING QUESTION 78 REFERENCES 79 Chapter 6 - Nurse-Patient Communication 80 LEARNING OBJECTIVES 80 CATEGORIES OF COMMUNICATION 80 CRITICAL THINKING QUESTION 82 THERAPEUTIC COMMUNICATION 82 CRITICAL THINKING QUESTION 83 INTERFERENCE WITH THERAPEUTIC COMMUNICATION 83 REFERENCES 86 Chapter 7 - Nurse-Patient Relationship 87 LEARNING OBJECTIVES 87 THERAPEUTIC RELATIONSHIPS 87 BEING THERAPEUTIC VERSUS PROVIDING THERAPY 88 STAGES OF DEVELOPMENT OFA THERAPEUTIC RELATIONSHIP 88 CRITICAL THINKING QUESTION 92 INTERACTIONS WITH SELECTED BEHAVIORS 93 REFERENCES 95 Chapter 8 - Nursing Process 97 LEARNING OBJECTIVES 97 ASSESSMENT 97 NURSING DIAGNOSIS 100 OUTCOME IDENTIFICATION 101 PLANNING AND INTERVENTION 101 EVALUATION 102 CRITICAL THINKING QUESTION 102 REFERENCES 103 Chapter 9 - Stress, Anxiety, Coping, and Crisis 104 LEARNING OBJECTIVES 104 STRESS AND ANXIETY 104 COPING WITH ANXIETY 106 CRITICAL THINKING QUESTION 106 RELATIONSHIP BETWEEN ANXIETY AND ILLNESS 108 CRISIS 109 CRITICAL THINKING QUESTION 109 REFERENCES 110 Chapter 10 - Suicide and Other Self-Destructive Behaviors 112 LEARNING OBJECTIVES 112 EPIDEMIOLOGY OF SUICIDE 113 VULNERABLE POPULATIONS 113 CRITICAL THINKING QUESTION 113 ASSESSMENT OF SUICIDAL PATIENTS 114 SUICIDE INTERVENTIONS 114 SELF-DESTRUCTIVE BEHAVIORS 116 CRITICAL THINKING QUESTION 117 CRITICAL THINKING QUESTION 118 REFERENCES 119 Chapter 11 - Working with the Aggressive Patient 121 LEARNING OBJECTIVES 121 ANGER AND RELATED CONCEPTS 121 ETIOLOGY OF AGGRESSION 123 NURSING INTERVENTIONS FOR ANGER AND NONVIOLENT AGGRESSION 126 NURSING INTERVENTIONS BASED ON THE ASSAULT CYCLE 126 CRITICAL THINKING QUESTION 129 CRITICAL THINKING QUESTION 129 STAFF MEMBERS AS VICTIMS OF ASSAULT 130 REFERENCES 130 Chapter 12 - Working with Groups of Patients 132 LEARNING OBJECTIVES 132 BENEFITS OF GROUPS 132 THERAPEUTIC FACTORS 133 TYPES OF GROUPS 133 GROUP MANAGEMENT ISSUES 135 TYPES OF PATIENTS IN GROUPS 136 COMMON MANAGEMENT ISSUES 136 CRITICAL THINKING QUESTIONS 136 REFERENCES 138 Chapter 13 - Working with the Family 139 LEARNING OBJECTIVES 139 DEFINITION OF FAMILY 139 CONTEMPORARY FAMILIES 139 FAMILY CHARACTERISTICS 140 STAGES OF FAMILY DEVELOPMENT 141 CRITICAL THINKING QUESTION 141 EFFECTS OF MENTAL ILLNESS ON THE FAMILY AND INDIVIDUAL 141 CRITICAL THINKING QUESTION 142 FAMILY REACTIONS TO PSYCHIATRICTREATMENT AND HOSPITALIZATION 142 NURSE RESPONSE TO PATIENTSAND FAMILIES SEEKING TREATMENT 143 ABILITIES NEEDED WHEN WORKINGWITH FAMILIES 143 APPLICATION OF THE NURSINGPROCESS TO THE FAMILY 145 CRITICAL THINKING QUESTIONS 147 REFERENCES 147 Chapter 14 - Cultural Competence in Psychiatric Nursing 148 LEARNING OBJECTIVES 148 BASIC CONCEPTS 148 CRITICAL THINKING QUESTION 149 CRITICAL THINKING QUESTION 150 CRITICAL THINKING QUESTION 151 CULTURE-BOUND MENTAL HEALTH ISSUES 151 ALTERNATIVE THERAPIES 151 ETHNOPHARMACOLOGY 151 NURSE’S ROLE IN CULTURAL ASSESSMENT 152 SUMMARY 153 REFERENCES 154 Chapter 15 - Spirituality 155 LEARNING OBJECTIVES 155 TOWARD A DEFINITION OF SPIRITUALITY 156 PATIENT SPIRITUALITY AND THEPSYCHIATRIC NURSE 157 INTERSECTION OF SPIRITUALITY AND MENTAL OR EMOTIONAL DISTRESS 158 CRITICAL THINKING QUESTION 158 HEALTH CARE APPLICATIONS 159 CRITICAL THINKING QUESTION 159 USING CLERGY RESOURCES 160 CRITICAL THINKING QUESTIONS 160 FINAL THOUGHT 160 CRITICAL THINKING QUESTION 160 REFERENCES 161 Chapter 16 - Introduction to Psychotropic Drugs 162 LEARNING OBJECTIVES 162 NURSING RESPONSIBILITIES 163 CRITICAL THINKING QUESTION 163 PHARMACOKINETICS: WHAT THE BODY DOES TO THE DRUG 163 CRITICAL THINKING QUESTION 165 CRITICAL THINKING QUESTION 165 PHARMACODYNAMICS: WHAT THE DRUGDOES TO THE BODY 167 BLOOD-BRAIN BARRIER 167 NEURONS AND NEUROTRANSMITTERS 168 RECEPTORS 168 PATIENT EDUCATION 171 CRITICAL THINKING QUESTION 173 REFERENCES 174 BIBLIOGRAPHY 174 Chapter 17 - Antiparkinsonian Drugs 175 LEARNING OBJECTIVES 175 PARKINSON’S DISEASE AND EXTRAPYRAMIDAL SIDE EFFECTS 175 CRITICAL THINKING QUESTION 175 CRITICAL THINKING QUESTION 176 ANTICHOLINERGICS TO TREATEXTRAPYRAMIDAL SIDE EFFECTS 178 CRITICAL THINKING QUESTION 178 CRITICAL THINKING QUESTION 179 OTHER TREATMENT OPTIONS FOREXTRAPYRAMIDAL SIDE EFFECTS 180 PREVENTION 180 REFERENCES 181 BIBLIOGRAPHY 181 Chapter 18 - Antipsychotic Drugs 182 LEARNING OBJECTIVES 182 CLASSIFICATION SYSTEMS 182 NEUROCHEMICAL THEORY OF SCHIZOPHRENIA 184 OVERVIEW 185 CRITICAL THINKING QUESTION 186 CRITICAL THINKING QUESTION 187 CRITICAL THINKING QUESTION 190 CRITICAL THINKING QUESTIONS 191 TRADITIONAL (FIRST-GENERATION) DRUGS: INTRODUCED IN 1950 191 ATYPICAL ANTIPSYCHOTIC (SECONDGENERATION)DRUGS: INTRODUCED IN 1990 192 CRITICAL THINKING QUESTION 195 CRITICAL THINKING QUESTION 196 REFERENCES 196 BIBLIOGRAPHY 197 Chapter 19 - Antidepressant Drugs 198 LEARNING OBJECTIVES 198 BIOCHEMICAL THEORY OF DEPRESSION 198 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 201 TRICYCLIC ANTIDEPRESSANTS 206 MONOAMINE OXIDASE INHIBITORS 210 CRITICAL THINKING QUESTIONS 212 REFERENCES 213 Chapter 20 - Antimanic Drugs 214 LEARNING OBJECTIVES 214 LITHIUM 214 CRITICAL THINKING QUESTION 217 CRITICAL THINKING QUESTION 219 ANTICONVULSANTS 219 ANTIPSYCHOTICS 220 OTHER TREATMENTS FOR BIPOLARDISORDER 220 REFERENCES 221 BIBLIOGRAPHY 222 Chapter 21 - Antianxiety Drugs 223 LEARNING OBJECTIVES 223 MODELS OF ANXIETY 224 BENZODIAZEPINES 224 NONBENZODIAZEPINE: BUSPIRONE 230 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 230 OTHER DRUGS WITH ANTIANXIETYPROPERTIES 231 CRITICAL THINKING QUESTIONS 231 REFERENCES 233 Chapter 22 - Antidementia Drugs 234 LEARNING OBJECTIVE 234 DRUGS USED TO TREAT DEMENTIAS 234 AGENTS THAT RESTORE ACETYLCHOLINE 234 AGENTS THAT MAY RETARDNEURODEGENERATION 237 DRUGS TO PREVENT ALZHEIMER’S DISEASE 238 CRITICAL THINKING QUESTIONS 238 REFERENCES 239 Chapter 23 - Introduction to Milieu Management 240 LEARNING OBJECTIVES 240 HISTORICAL OVERVIEW 240 JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS: ENVIRONMENT OF CARE ISSUES 241 NURSING AND THE THERAPEUTIC ENVIRONMENT 241 ELEMENTS OF THE TREATMENT ENVIRONMENT 242 CRITICAL THINKING QUESTION 244 CRITICAL THINKING QUESTION 244 THE NURSE AS MANAGER OF THE TREATMENT ENVIRONMENT 244 CRITICAL THINKING QUESTION 245 REFERENCES 246 Chapter 24 - Variables Affecting the Therapeutic Environment 247 LEARNING OBJECTIVES 247 CURRENT TRENDS 247 AGGRESSION AND VIOLENCE 247 CRITICAL THINKING QUESTION 248 INPATIENT SUICIDAL BEHAVIOR 249 STAFF RELATIONSHIPS 250 CRITICAL THINKING QUESTION 250 BURNOUT AND SECONDARYTRAUMATIZATION 250 CRITICAL THINKING QUESTION 251 CLINICAL SUPERVISION 251 MANAGEMENT PRACTICES ANDORGANIZATIONAL STRUCTURE 252 NURSING’S INFLUENCE 252 EFFECTIVE FUNCTIONING IN THE ACUTEPSYCHIATRIC SETTING 252 CRITICAL THINKING QUESTION 253 REFERENCES 253 Chapter 25 - Therapeutic Environment in Various Treatment Settings 255 LEARNING OBJECTIVES 255 INPATIENT SETTINGS 255 CRITICAL THINKING QUESTION 257 CRITICAL THINKING QUESTION 260 COMMUNITY TREATMENT SETTINGS 260 CONCLUSION 261 REFERENCES 262 Chapter 26 - Introduction to Psychopathology 263 LEARNING OBJECTIVES 263 BEHAVIOR 264 ETIOLOGY 264 PSYCHOTHERAPEUTIC MANAGEMENT 264 NURSES NEED TO UNDERSTAND PSYCHOPATHOLOGY 265 CRITICAL THINKING QUESTION 265 REFERENCES 266 Chapter 27 - Schizophrenia and Other Psychoses 267 LEARNING OBJECTIVES 267 SCHIZOPHRENIA 267 CRITICAL THINKING QUESTION 269 CRITICAL THINKING QUESTION 277 SPECIAL ISSUES RELATED TO SCHIZOPHRENIA 278 CRITICAL THINKING QUESTION 280 CONTINUUM OF CARE FOR PEOPLE WITH SCHIZOPHRENIA 280 PSYCHOTHERAPEUTIC MANAGEMENT 281 OTHER PSYCHOTIC DISORDERS 283 CRITICAL THINKING QUESTION 284 FUTURE DIRECTIONS 284 REFERENCES 287 Chapter 28 - Depression 289 LEARNING OBJECTIVES 289 DEPRESSIVE DISORDERS 289 CRITICAL THINKING QUESTION 292 DYSTHYMIC DISORDER 292 BEHAVIOR SYMPTOMATIC OF DEPRESSION 293 ETIOLOGY OF DEPRESSION 294 ASSESSMENT OF DEPRESSION 297 PUTTING IT ALL TOGETHER 299 PSYCHOTHERAPEUTIC MANAGEMENT 299 CRITICAL THINKING QUESTION 302 SUICIDE AND DEPRESSION 302 CRITICAL THINKING QUESTION 303 REFERENCES 305 Chapter 29 - Bipolar Disorders 307 Learning Objectives 307 GENERAL DESCRIPTION OF BIPOLAR DISORDER 307 DSM-IV-TR Terminology and Criteria 308 CRITICAL THINKING QUESTION 308 BIPOLAR DISORDERS 311 CRITICAL THINKING QUESTION 312 PUTTING IT ALL TOGETHER 315 PSYCHOTHERAPEUTIC MANAGEMENT 315 YOUNG MANIA RATING SCALE (YMRS) 318 REFERENCES 319 Chapter 30 - Anxiety-Related, Somatoform, and Dissociative Disorders 321 LEARNING OBJECTIVES 321 ANXIETY-RELATED DISORDERS 321 GENERALIZED ANXIETY DISORDER 321 PUTTING IT ALL TOGETHER 323 PSYCHOTHERAPEUTIC MANAGEMENT 323 PANIC DISORDER 324 PUTTING IT ALL TOGETHER 325 PSYCHOTHERAPEUTIC MANAGEMENT 325 OBSESSIVE-COMPULSIVE DISORDER 325 CRITICAL THINKING QUESTION 326 PUTTING IT ALL TOGETHER 326 PSYCHOTHERAPEUTIC MANAGEMENT 326 PHOBIC DISORDERS 328 PUTTING IT ALL TOGETHER 328 PSYCHOTHERAPEUTIC MANAGEMENT 328 ACUTE STRESS DISORDER ANDPOSTTRAUMATIC STRESS DISORDER 328 CRITICAL THINKING QUESTION 331 PUTTING IT ALL TOGETHER 331 PSYCHOTHERAPEUTIC MANAGEMENT 331 ADJUSTMENT DISORDERS 333 SOMATOFORM DISORDERS 333 SOMATIZATION DISORDER 333 PAIN DISORDER 334 HYPOCHONDRIASIS 335 CONVERSION DISORDER 335 PUTTING IT ALL TOGETHER 335 PSYCHOTHERAPEUTIC MANAGEMENT 335 DISSOCIATIVE DISORDERS 336 DISSOCIATIVE AMNESIA 336 DISSOCIATIVE FUGUE 337 DEPERSONALIZATION 337 DISSOCIATIVE IDENTITY DISORDER 338 PUTTING IT ALL TOGETHER 338 PSYCHOTHERAPEUTIC MANAGEMENT 338 CRITICAL THINKING QUESTION 339 REFERENCES 339 Chapter 31 - Cognitive Disorders 342 LEARNING OBJECTIVES 342 OVERVIEW OF NONDEMENTIA COGNITIVE DISORDERS 342 DEMENTIA 344 CRITICAL THINKING QUESTIONS 345 POTENTIALLY REVERSIBLE DEMENTIAS 345 IRREVERSIBLE DEMENTIAS 346 CRITICAL THINKING QUESTION 347 CRITICAL THINKING QUESTIONS 352 CRITICAL THINKING QUESTION 355 CRITICAL THINKING QUESTION 355 PUTTING IT ALL TOGETHER 355 PSYCHOTHERAPEUTIC MANAGEMENT 355 CRITICAL THINKING QUESTION 355 CRITICAL THINKING QUESTIONS 358 REFERENCES 360 Chapter 32 - Personality Disorders 363 LEARNING OBJECTIVES 363 ETIOLOGY: CONTEMPORARY VIEWS 364 PERSONALITY DISORDER CLUSTERS 364 CLUSTER A: ODD-ECCENTRIC 364 PARANOID PERSONALITY DISORDER 364 SCHIZOID PERSONALITY DISORDER 364 SCHIZOTYPAL PERSONALITY DISORDER 364 PUTTING IT ALL TOGETHER 366 PSYCHOTHERAPEUTIC MANAGEMENT 366 CLUSTER B: DRAMATIC-ERRATIC 366 ANTISOCIAL PERSONALITY DISORDER 366 CRITICAL THINKING QUESTION 366 PUTTING IT ALL TOGETHER 367 PSYCHOTHERAPEUTIC MANAGEMENT 367 BORDERLINE PERSONALITY DISORDER 367 CRITICAL THINKING QUESTION 368 PUTTING IT ALL TOGETHER 368 PSYCHOTHERAPEUTIC MANAGEMENT 368 CRITICAL THINKING QUESTION 370 NARCISSISTIC PERSONALITY DISORDER 370 PUTTING IT ALL TOGETHER 371 PSYCHOTHERAPEUTIC MANAGEMENT 371 HISTRIONIC PERSONALITY DISORDER 371 PUTTING IT ALL TOGETHER 372 PSYCHOTHERAPEUTIC MANAGEMENT 372 CLUSTER C: ANXIOUS-FEARFUL 372 DEPENDENT PERSONALITY DISORDER 372 PUTTING IT ALL TOGETHER 372 PSYCHOTHERAPEUTIC MANAGEMENT 372 AVOIDANT PERSONALITY DISORDER 372 PUTTING IT ALL TOGETHER 372 PSYCHOTHERAPEUTIC MANAGEMENT 372 OBSESSIVE-COMPULSIVE PERSONALITY DISORDER 373 PUTTING IT ALL TOGETHER 373 PSYCHOTHERAPEUTIC MANAGEMENT 373 References 373 Chapter 33 - Sexual Disorders 375 LEARNING OBJECTIVES 375 DSM-IV-TR CRITERIA AND TERMINOLOGY 375 SEXUAL DYSFUNCTIONS 375 CRITICAL THINKING QUESTION 376 PARAPHILIA 376 GENDER IDENTITY DISORDER 378 PUTTING IT ALL TOGETHER 379 PSYCHOTHERAPEUTIC MANAGEMENT 379 CRITICAL THINKING QUESTION 379 REFERENCES 380 Chapter 34 - Substance-Related Disorders 381 LEARNING OBJECTIVES 381 INTRODUCTION 381 DSM-IV-TR CRITERIA 384 ALCOHOL 386 DEPRESSANTS 392 BARBITURATES 392 BENZODIAZEPINES 393 GAMMA HYDROXYBUTYRATE 393 INHALANTS 393 OPIOIDS (NARCOTICS) 394 STIMULANTS 396 COCAINE 396 CRITICAL THINKING QUESTION 397 AMPHETAMINES AND RELATED DRUGS 397 HALLUCINOGENS 400 CRITICAL THINKING QUESTION 401 RELATED ISSUES 402 EFFECTS ON FAMILY 402 TREATING THE CHEMICALLY DEPENDENT PERSON 403 DIAGNOSTIC TOOLS FOR CHEMICAL DEPENDENCY 403 PSYCHOTHERAPEUTIC MANAGEMENT 403 INTERVENTION AND TREATMENT PROGRAMS 406 CRITICAL THINKING QUESTION 407 SPECIAL NOTES 407 FINAL THOUGHTS 408 CRITICAL THINKING QUESTION 408 REFERENCES 409 Chapter 35 - Dual Diagnosis 411 LEARNING OBJECTIVES 411 DUAL DIAGNOSIS DEFINED 411 ETIOLOGY 411 TREATMENT ISSUES 413 CRITICAL THINKING QUESTION 413 PUTTING IT ALL TOGETHER 413 PSYCHOTHERAPEUTIC MANAGEMENT 413 CRITICAL THINKING QUESTION 414 CONTINUUM OF CARE 415 REFERENCES 416 Chapter 36 - Eating Disorders 418 LEARNING OBJECTIVES 418 ANOREXIA NERVOSA 418 CRITICAL THINKING QUESTION 422 PUTTING IT ALL TOGETHER 424 PSYCHOTHERAPEUTIC MANAGEMENT 424 EATING DISORDERS IN MEN 429 CRITICAL THINKING QUESTION 430 BINGE-EATING DISORDER 430 REFERENCES 431 Chapter 37 - Behavior and Somatic Therapies 433 LEARNING OBJECTIVES 433 BEHAVIOR THERAPIES 433 FOUNDATIONS OF BEHAVIOR THERAPY 433 APPLICATION OF BEHAVIOR THERAPY IN PSYCHIATRIC NURSING PRACTICE 433 CRITICAL THINKING QUESTION 435 CRITICAL THINKING QUESTION 436 SOMATIC THERAPIES 436 ELECTROCONVULSIVE THERAPY 436 CRITICAL THINKING QUESTIONS 437 CRITICAL THINKING QUESTION 440 CRITICAL THINKING QUESTION 441 REFERENCES 441 Chapter 38 - Nutraceuticals and Mental Health 443 LEARNING OBJECTIVES 443 BACKGROUND 444 NUTRACEUTICALS 444 HERBAL THERAPIES (HERBACEUTICALS) 444 HERBALS TO TREAT ANXIETY AND DEPRESSION 445 ANXIOLYTIC HERBALS WITHOUT SUFFICIENT EVIDENCE OF EFFICACY AND SAFETY 447 HERBALS THAT MIGHT CAUSE PROBLEMS FOR CONSUMERS OF PSYCHIATRIC CARE 447 CRITICAL THINKING QUESTION 449 FUTURE DIRECTIONS OF INTEGRATIVE HEALTH CARE 449 CRITICAL THINKING QUESTION 450 REFERENCES 451 Chapter 39 - Survivors of Violence and Trauma 455 LEARNING OBJECTIVES 455 VIOLATION BY CRIME 455 PUTTING IT ALL TOGETHER 457 PSYCHOTHERAPEUTIC MANAGEMENT 457 TORTURE, RITUAL ABUSE, MIND CONTROL, AND HUMAN TRAFFICKING 459 PUTTING IT ALL TOGETHER 460 PSYCHOTHERAPEUTIC MANAGEMENT 460 PUTTING IT ALL TOGETHER 462 PSYCHOTHERAPEUTIC MANAGEMENT 462 ADULT SURVIVORS OF CHILDHOOD SEXUAL ABUSE 463 PUTTING IT ALL TOGETHER 467 PSYCHOTHERAPEUTIC MANAGEMENT 467 CRITICAL THINKING QUESTION 468 PUTTING IT ALL TOGETHER 472 PSYCHOTHERAPEUTIC MANAGEMENT 472 CRITICAL THINKING QUESTION 473 CRITICAL THINKING QUESTION 474 REFERENCES 476 Chapter 40 - Child and Adolescent Psychiatric Nursing 479 LEARNING OBJECTIVES 479 COMMON PSYCHIATRIC DISORDERS 480 CRITICAL THINKING QUESTION 480 CRITICAL THINKING QUESTION 481 CRITICAL THINKING QUESTION 482 BULLYING 482 PSYCHOTHERAPEUTIC MANAGEMENT 484 CONCLUDING COMMENT 486 REFERENCES 487 Chapter 41 - Mental Disorders in Older Adults 489 LEARNING OBJECTIVES 489 INTRODUCTION 489 CRITICAL THINKING QUESTION 489 CRITICAL THINKING QUESTION 491 CONTINUUM OF CARE 491 CRITICAL THINKING QUESTION 492 PSYCHOPATHOLOGY IN OLDER ADULTS 492 DEPRESSION 492 MANIC EPISODES 495 PSYCHOTIC DISORDERS 495 ANXIETY DISORDERS 497 SUBSTANCE ABUSE 497 CRITICAL THINKING QUESTION 500 ASSESSMENT OF OLDER ADULTS WITH MENTAL DISORDERS 500 PSYCHOSOCIAL ASSESSMENT 500 PHYSICAL ASSESSMENT 501 PSYCHOTHERAPEUTIC MANAGEMENT 502 REFERENCES 507 Chapter 42 - War-Related Psychiatric Disorders in Soldiers 510 LEARNING OBJECTIVES 510 OVERVIEW 511 POSTTRAUMATIC STRESS DISORDER 511 TRAUMATIC BRAIN INJURY 513 TREATING PTSD AND TBI 515 REFERENCES 517 APPENDIX - Diagnostic Criteria for Mental Disorders,Text Revision (DSM-IV-TR) 520 DISORDERS USUALLY FIRST DIAGNOSED ININFANCY, CHILDHOOD, OR ADOLESCENCE 520 DELIRIUM, DEMENTIA, AND AMNESTIC ANDOTHER COGNITIVE DISORDERS 521 MENTAL DISORDERS DUE TO A GENERALMEDICAL CONDITION NOT ELSEWHERECLASSIFIED 521 SUBSTANCE-RELATED DISORDERS 521 SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS 523 MOOD DISORDERS 523 ANXIETY DISORDERS 523 SOMATOFORM DISORDERS 523 FACTITIOUS DISORDERS 524 DISSOCIATIVE DISORDERS 524 SEXUAL AND GENDER IDENTITY DISORDERS 524 EATING DISORDERS 524 SLEEP DISORDERS 524 IMPULSE-CONTROL DISORDERS NOT ELSEWHERECLASSIFIED 525 ADJUSTMENT DISORDERS 525 PERSONALITY DISORDERS 525 OTHER CONDITIONS THAT MAY BE A FOCUSOF CLINICAL ATTENTION 525 ADDITIONAL CODES 525 MULTIAXIAL SYSTEM 526 AXIS III: GENERAL MEDICAL CONDITIONS(WITH ICD-9-CM CODES) 526 AXIS IV: PSYCHOSOCIAL ANDENVIRONMENTAL PROBLEMS 526 AXIS V: GLOBAL ASSESSMENT OFFUNCTIONING (GAF) SCALE 526 Glossary 528 Index 539

Learn the therapeutic skills you need for your role in psychiatric nursing care! Psychiatric Nursing uses a practical, three-pronged approach to psychotherapeutic management that clearly explains how to care for patients with psychiatric disorders. It emphasizes the nurse's three primary tools: themselves, medications, and the environment. Written by Norman L. Keltner, Carol E. Bostrom, and Teena McGuinness, each an educator and advanced practice nurse, this text covers the latest trends and treatments and provides a solid, real-world foundation for the practice of safe and effective psychiatric nursing care.

• Unique! A practical three-pronged approach to psychotherapeutic management includes: 1) the therapeutic nurse-patient relationship, 2) psychopharmacology, and 3) milieu management.
• Unique! Norm's Notes offer helpful tips from the lead author at the beginning of each chapter, making it easier to understand difficult topics.
• Unique! Putting It All Together summaries are provided at the end of each chapter.
• Patient and Family Education boxes highlight information that should be provided to patients and families.
• Family Issues boxes highlight the issues families must confront when a member suffers from mental illness.
• Nursing care plans emphasize assessment, planning, nursing diagnoses, implementation, and evaluation for specific disorders.
• Case studies depict psychiatric disorders and show the development of effective nursing care strategies.
• Clinical examples from the authors' own experiences illustrate concepts with real-life clinical situations.
• Learning objectives at the beginning of each chapter preview the important principles to follow.
• Study Notes summarize each chapter's important content.
• Critical thinking questions help you expand your clinical reasoning skills.

• Suicide and Other Self Destructive Behaviors chapter identifies risk factors associated with suicidality and various forms and characteristics of self-mutilation.
• War Related Psychiatric Disorders chapter describes the symptoms and treatment options for posttraumatic stress disorder and traumatic brain injury patients.
• New approach for Introduction to Milieu Management chapter recognizes the shift of the therapeutic environment from inpatient units to community settings, plus nurses' changing roles.
• New approach for Nutraceuticals and Mental Health chapter focuses on foods that provide health and medical benefits.
• Student resources on the companion Evolve website include downloadable audio chapter summaries, NCLEX® examination-style review questions, psychotropic drug monographs, and learning activities.

The book contains predominantly black-and-white illustrations, with some two-color illustrations.

Learn the therapeutic skills you need for your role in psychiatric nursing care! Psychiatric Nursing uses a practical, three-pronged approach to psychotherapeutic management that clearly explains how to care for patients with psychiatric disorders. It emphasizes the nurse's three primary tools: themselves, medications, and the environment. Written by Norman L. Keltner, Carol E. Bostrom, and Teena McGuinness, each an educator and advanced practice nurse, this text covers the latest trends and treatments and provides a solid, real-world foundation for the practice of safe and effective psychiatric nursing care.

• Unique! A practical three-pronged approach to psychotherapeutic management includes: 1) the therapeutic nurse-patient relationship, 2) psychopharmacology, and 3) milieu management.
• Unique! Norm's Notes offer helpful tips from the lead author at the beginning of each chapter, making it easier to understand difficult topics.
• Unique! Putting It All Together summaries are provided at the end of each chapter.
• Patient and Family Education boxes highlight information that should be provided to patients and families.
• Family Issues boxes highlight the issues families must confront when a member suffers from mental illness.
• Nursing care plans emphasize assessment, planning, nursing diagnoses, implementation, and evaluation for specific disorders.
• Case studies depict psychiatric disorders and show the development of effective nursing care strategies.
• Clinical examples from the authors' own experiences illustrate concepts with real-life clinical situations.
• Learning objectives at the beginning of each chapter preview the important principles to follow.
• Study Notes summarize each chapter's important content.
• Critical thinking questions help you expand your clinical reasoning skills.

• Suicide and Other Self Destructive Behaviors chapter identifies risk factors associated with suicidality and various forms and characteristics of self-mutilation.
• War Related Psychiatric Disorders chapter describes the symptoms and treatment options for posttraumatic stress disorder and traumatic brain injury patients.
• New approach for Introduction to Milieu Management chapter recognizes the shift of the therapeutic environment from inpatient units to community settings, plus nurses' changing roles.
• New approach for Nutraceuticals and Mental Health chapter focuses on foods that provide health and medical benefits.
• Student resources on the companion Evolve website include downloadable audio chapter summaries, NCLEX® examination-style review questions, psychotropic drug monographs, and learning activities.