Learning_Guide

CENTRAL TEXAS COLLEGEDepartment of Nursing

LEARNING GUIDE

Mental Health Nursing RNSG 2213

Spring 2007

Instructor: Pamela Hadnot

Revised 08/06 ph,ma/db01/07 ph/db

CENTRAL TEXAS COLLEGEDepartment of Nursing

Table of Contents

Unit Page

I. Foundations in Theory...............................................................................1

II. Foundations for Practice..........................................................................................................4

III. Psychosocial Nursing Tools.....................................................................................................9

IV. Psychobiological Disorders: Moderate to Severe..................................................................14

V. Psychobiological Disorders: Severe to Psychotic..................................................................18

VI. Psychiatric Emergencies........................................................................................................22

VII. Interventions for Special Populations....................................................................................27

VIII. Lifespan Issues and Interventions…………………………………………………………..32

IX. Other Intervention Modalities………………………………………………………………35

*** Central Texas College District does not discriminate in admissions or access to, or treatment or employment in, its programs and activities on the basis of race, color, religion, national origin, gender, disability, and age or veterans status.

i

UNIT I: Foundations in Theory:Mental Health & Mental Illness

Learning Activities1. Required Readings/Activies:

A. Varcarolis, Carson, & Shoemaker, Chapter 1 pp. 1-14.B. http://evolve.elsevier.com/Varcarolis C. Student Study CD-ROM accompanying your text

2. Video:

ObjectivesUpon completion of this unit, the student should be able to:

1. Define the Key Terms and Concepts for Chapter 1 page 2 correctly use each in written and oral communications.

2. Assess his/her own mental health using the seven signs of mental health identified in this chapter (Table 1-1 and Figure 1-1).

3. Summarize factors that can affect the mental health of an individual and the ways that these factors influence conducting a holistic nursing assessment.

4. Discuss some dynamic factors (including social climate, politics, myths, and biases) that contribute to making clear-cut definition of mental health elusive.

5. Explain how epidemiological studies can improve medical and nursing care.

1

http://evolve.elsevier.com/Varcarolis

UNIT I: Foundations in Theory:Relevant Theories & Therapies for Nursing Practice


A. Varcarolis, Carson, & Shoemaker, Chapter 2 pp.15-33.B. http://evolve.elsevier.com/Varcarolis C. Student Study CD-ROM accompanying your text

2. Video:



2. Compare and contrast the developmental stages as defined by Freud and Erickson.

3. Identify ways that each theorist contributes to the nurse’s ability to assess a client’s behaviors.

4. Identify Paplau’s expectation of the nurse/client relationship.

2


UNIT I: Foundations in Theory:Biological Basis for Understanding Psychotropic Drugs


A. Varcarolis, Carson, & Shoemaker, Chapter 3 pp. 34-62.B. http://evolve.elsevier.com/Varcarolis C. Student Study CD-ROM accompanying your text

2. Video:

ObjectivesUpon completion of this unit, the student should be able to:1. Define the Key Terms and Concepts for Chapter 3 page 34 and correctly use each in

written and oral communications.2. Discuss at least eight functions of the brain and the way these functions can be altered by

psychotropic drugs.3. Describe how a neurotransmitter functions as a neuromessenger.4. Apply to a medication teaching plan how the blockage of dopamine at the receptor site

can result in motor abnormalities and hyperprolactinemia.5. Describe the result of blockage to muscarinic receptors and the alpha receptors by the

standard neuroleptic drugs.6. Contrast and compare the side effect profiles of the standard antipsychotic with those of

atypical antipsychotic drugs.7. Apply to a medication teaching plan the knowledge of why a person taking a monoamine

oxidase inhibitor would have special dietary and drug restrictions.8. Describe the significance of pharmacological treatment of mental health problems and

correctly classify the medications for this unit.9. Describe the mechanism of action, the therapeutic use, the essential client teaching

(including side effects and toxic effects), and essential client assessments related to the medications for this unit.

10. Accurately calculate doses of prescribed medications for mental health problems.

3


UNIT II: Foundations for Practice:Psychiatric Mental Health Nursing & Managed Care Issues

Learning Activities

Required Activities

1. Required readings: A. Varcarolis, Carson, & Shoemaker, Chapter 4 pp 63-71.B. http://evolve.elsevier.com/Varcarolis C. Student Study CD-ROM accompanying your text

2. Videos


1. Define the Key Terms and Concepts Chapter 4 on page 63 correctly use each in written and oral communications.

2. Define psychiatric mental health nursing and discuss the client population served by the psychiatric nurse.

3. Describe recent developments that have increased the biological emphasis in psychiatric mental health nursing.

4. Discuss the impact of managed care on psychiatric nursing roles.

4


UNIT II: Foundations for Practice:Mental Health Nursing in Acute Care Settings

Learning Activities

Required Activities


2. Videos


1. Define the Key Terms and Concepts for Chapter 5 on page 74 correctly use each in written and oral communications.

2. Explain how the mental health team collaborates to plan and implement care for the hospitalized client.

3. Describe the role of the nurse as advocate and provider of care for the client.4. Discuss the process for preparing clients to return to the community for

ongoing care.

5


UNIT II: Foundations for Practice:Mental Health Nursing in Community Settings

Learning Activities

Required Activities

1. Required readings: A. Varcarolis, Carson, & Shoemaker, Chapter 6 pp. 85-98B. http://evolve.elsevier.com/Varcarolis C. Student Study CD-ROM accompanying your text

2. Videos


1. Define the Key Terms and Concepts for chapter 6 on page 85 correctly use each in written and oral communications.

2. Explain the evolution of the community mental health movement.3. Identify elements of the nursing assessment that are critically important to the success of

community treatment.4. Distinguish between the hospital and community settings with regard to characteristics,

goals of treatment, and nursing interventions.5. Discuss the continuum of psychiatric treatment.6. Describe the role of the psychiatric nurse in four specific settings:7. Partial hospitalization program8. Psychiatric home care9. Assertive community treatment10. Community mental health center11. Identify two resources to assist the community psychiatric nurse in resolving ethical

dilemmas.12. Discuss barriers to mental health treatment.

6


UNIT II: Foundations for Practice:Culturally Relevant Mental Health Nursing: A Global Perspective

Learning Activities

Required Activities


2. Videos



2. Describe the importance of culturally relevant care and mental health nursing practice.3. Discuss potential problems in applying American or Western psychological theory to

clients of other cultures.4. Compare and contrast American nursing beliefs, values, and practices with the beliefs,

values, and practices of clients from diverse cultures.5. Identify risk factors and barriers to quality mental health care that culturally diverse

clients frequently encounter.

7


UNIT II: Foundations for Practice:Legal and Ethical Guidelines for Safe Practice

Learning Activities

Required Activities


2. Videos



2. Compare and contrast the terms ‘ethics’ and ‘bioethics’ and identify five principles of bioethics.

3. Discuss at least five client rights that come under the Patient’s Bill of Rights.4. Give examples of the client’s: (a). right to treatment, (b) right to refuse treatment, and (c)

right to informed consent.5. Identify the steps nurses are advised to take if they suspect negligence or illegal activity

on the part of a professional colleague or peer.6. Apply legal considerations of client privilege: (a) after a client has died, (b) if the client

tests positive for human immunodeficiency virus, or (c) if the client’s employer states “a need to know”.

7. Discuss a client’s civil rights and how they pertain to restraint and seclusion.8. Describe the processes of voluntary admission to psychiatric care and involuntary

psychiatric care in the state of Texas.9. Describe the nurse’s role as a client advocate for persons receiving psychiatric care.

8


UNIT III: Psychosocial Nursing Tools:Assessment Strategies and the Nursing Process

Learning Activities

Required Activities


2. Videos



2. Discuss the mental status examination and psychosocial assessment.3. Identify the components of a nursing assessment of a client with a

mental health problem and construct a plan of care using the nursing process (six-step problem-solving approach to client care).

4. Documentation of the client’s care and progress including legal considerations.

9


UNIT III: Psychosocial Nursing Tools:Developing Therapeutic Relationships

Learning Activities

Required Activities


2. Videos:Review the three part “Helping Interview” videos (Nursing Lab Manager’s office) or the three part “Interactive Techniques” videos (Computer Reference Desk- CTC Oveta Culp Hobby Memorial Library)



2. Contrast and compare the purpose, focus, communication styles and goals for (a) a social relationship, (b) an intimate relationship, and (c) a therapeutic relationship.

3. Define and discuss the role of empathy, genuineness, and positive regard on the part of the nurse in a nurse/client relationship.

4. Identify two attitudes and four actions that may reflect the nurse’s positive regard for a client.

5. Analyze what is meant by boundaries and the influence of transference and counter-transference on boundary blurring.

6. Contrast and compare the three phases of nurse/client relationship.7. Describe the four areas of concern during your first interview with a

client.8. Explore aspects that foster a therapeutic nurse/client relationship and

those that are inherent in a non-therapeutic nursing interactive process as identified in the research of Forcuk and associates.

9. Describe four testing behaviors a client may demonstrate and discuss possible nursing interventions for each behavior.

10


UNIT III: Psychosocial Nursing Tools:The Clinical Interview & Communication Skills

Learning Activities

Required Activities

1. Required readings: A. Varcarolis, Carson, & Shoemaker, Chapter 11 pp. 171-196.B. http://evolve.elsevier.com/Varcarolis C. Student Study CD-ROM accompanying your text

2. Videos:Review the three part “Helping Interview” videos (Nursing Lab Manager’s office) or the three part “Interactive Techniques” videos (Computer Reference Desk- CTC Oveta Culp Hobby Memorial Library)


1. Define the Key Terms and Concepts for chapter 11 on page 171correctly use each in written and oral communications.

2. Describe four testing behaviors a client may demonstrate and discuss possible nursing interventions for each behavior.

3. Discuss the interview process and various aspects of the process including factors that might impede the interview.

4. Compare and contrast verbal and nonverbal communication including cultural aspects of diverse populations.

5. Describe four techniques that improve therapeutic communication and four techniques that impede therapeutic techniques.

11


UNIT III: Psychosocial Nursing Tools:Understanding Stress & Holistic Approaches to Stress Management

Learning Activities

Required Activities


2. Videos



2. Recognize the short- and long-term physiologic consequences of stress.3. Identify the relationship between stress and anxiety.4. Discuss ways in which culture can affect a person’s perception of and reaction to stress.5. Assess life-change units in a client’s life by use of the Life Change Questionnaire.6. Differentiate among four categories of coping and give at least two examples of each.7. Explain how cognitive techniques can lower a person’s level of stress.

12


UNIT III: Psychosocial Nursing Tools:Understanding Anxiety & Anxiety Defenses

Learning Activities

Required Activities


2. Videos


1. Define the Key Terms and Concepts page 197 and page 212 correctly use each in written and oral communications.

2. Recognize the longterm physiologic consequences of stress.3. Identify the relationship between stress and anxiety.4. Assess life-change units in a client’s life by use of the Life Change Questionnaire.5. Differentiate among four categories of coping and give at least two examples of each.6. Explain how cognitive techniques can lower a person’s level of stress.7. Explore the difference between normal, acute, and chronic anxiety.8. Contrast and compare the four levels of anxiety in relation to perceptual field, ability to

learn, and physical and other defining characteristics.9. Identify, define, and give examples of mental defense mechanisms used to cope with

anxiety.10. Describe the educational needs of persons experiencing any of the four levels of anxiety.

13


UNIT IV: Psychobiological Disorders: Moderate to Severe:Anxiety Disorders

Learning Activities

Required Activities


2. Videos



2. Identify genetic, biological, psychological, and cultural factors leading to anxiety disorders.3. Describe clinical manifestations of each anxiety disorder.4. Describe feelings that may be experienced by nurses in caring for clients with anxiety

disorders.5. Describe five basic nursing interventions to use with clients with anxiety disorders.6. Discuss three defense mechanisms commonly found in clients with anxiety disorders and

their effectiveness.7. Discuss realistic outcome criteria for a client with (a) generalized anxiety disorder, (b) panic

disorder, and (c) post-traumatic stress disorder.8. Discuss three classes of medications appropriate for anxiety disorders to include side effects

and contraindications.9. Describe clinical manifestations of each anxiety disorder: generalized anxiety disorder

(GAD), obsessive-compulsive disorder (OCD), and post traumatic stress disorder (PSTD)10. Discuss realistic outcome criteria for clients experiencing the above medical psychiatric

diagnoses11. Evaluate the effectiveness of care based on established outcome criteria12. Discuss three defense mechanisms commonly found in clients with anxiety disorders and

their effectiveness13. Describe education needs commonly assessed in clients experiencing anxiety disorders

14


UNIT IV: Psychobiological Disorders: Moderate to Severe:Somatoform & Dissociative Disorders

Learning Activities

Required Activities


2. Videos



2. Describe the symptoms, characteristics, plan of care, and expected outcomes for clients with somatoform and dissociative disorders.

3. Differentiate between dissociative amnesia and dissociative fugue.4. Be able to give a clinical example of each type of somatoform disorder.5. Describe five psychosocial interventions that would be appropriate for a client with somatic

complaints.6. Describe a plan of care for a client with conversion disorder including family teaching

15


UNIT IV: Psychobiological Disorders: Moderate to Severe:Personality Disorders

Learning Activities

Required Activities


2. Videos



2. Describe the main characteristic of one personality disorder from each cluster and give an example.

3. Formulate two nursing diagnoses for cluster B, Personality Disorders.4. Discuss the nature and importance of crisis intervention for people with personality

disorders. 5. Describe the feelings that are experienced by nurses and others when working with people

with personality disorders.6. Describe two realistic nursing outcomes for clients with borderline personality disorder.7. Plan basic interventions for an impulsive, aggressive, and manipulative client.

16


UNIT IV: Psychobiological Disorders: Moderate to Severe:Eating Disorders

Learning Activities

Required Activities

1. Required readings: A. Varcarolis, Carson, & Shoemaker, Chapter 17 pp 299-323.B. http://evolve.elsevier.com/VarcarolisC. Student Study CD-ROM accompanying your text

2. Videos



2. Compare and contrast the signs and symptoms (clinical picture) of anorexia nervosa and bulimia nervosa.

3. Identify three life threatening conditions stated in terms of nursing diagnosis, for a client with an eating disorder.

4. Identify three realistic outcome criteria for: (a) a client with anorexia nervosa, and (b) a client with bulimia nervosa.

5. Recognize which therapeutic interventions are appropriate for the acute phase of anorexia nervosa and which are appropriate for the long term phase of treatment.

6. Explain the basic premise of cognitive behavioral therapy and the treatment of anorexia nervosa and bulimia nervosa.

7. Emphasis with and describe, in the reader’s own words, the possible thoughts and feelings of a young anorectic girl during the acute phase of her illness.

17


UNIT V: Psychobiological Disorders: Severe to Psychotic:Mood Disorders: Depression

Learning Activities

Required Activities


2. Videos



2. Compare and contrast major depressive disorder with dysthymia.3. Describe assessment of a depressed individual with regards to the following areas: (a) risk

factors, (b) affect, (c) thought processes, (d) feelings, (e) physical behavior, and (f) communication.

4. Formulate five nursing diagnoses for a client who is depressed and include outcome criteria.5. Name unrealistic expectations that a nurse may have while working with a depressed person

and compare them with the reader’s personal reactions.6. Evaluate the advantages of selective serotonin reuptake inhibitors over the tricyclic

antidepressants.7. Discuss two common adverse reactions to the monoamine oxidase inhibitors. State one

serious toxic reaction and identify the appropriate medical intervention.8. Describe the types of depression for which electroconvulsive therapy is most helpful.9. Discuss a medication teaching plan for a client taking a monoamine oxidase inhibitor

including foods and drugs that are contraindicated.10. Apply principles of therapeutic communication with a depressed client.11. Describe the legal and ethical issues that may be present for those providing care for

persons experiencing major depression12. Describe nursing assessments, interventions, and evaluations for the client undergoing ECT13. Describe the education needs commonly assessed in persons experiencing depression

18


UNIT V: Psychobiological Disorders: Severe to Psychotic:Mood Disorders: Bipolar

Learning Activities

Required Activities


2. Videos



2. Define bipolar disorder and variations of the disorder.3. Compare and contrast mood disorders, both manic phase and depressive phase, for mood,

behavior, thought processes, and possible dysfunction.4. Explain the rationale for communication to be used with the manic client.5. Develop a medication care plan for lithium carbonate to include: (a) expected side effects,

(b) early and severe signs of toxicity, and (c) five areas of client teaching.6. Discuss which conditions respond more favorably to (a) anticonvulsant therapy, (b) lithium

carbonate therapy, or (c) electroconvulsive therapy.7. Evaluate specific indicators for the use of seclusion for a manic client.8. Distinguish between the focus of treatment for a person in the acute manic phase and that

for a person in the continuation or maintenance phase of a Bipolar I disorder.

19


UNIT V: Psychobiological Disorders: Severe to Psychotic:The Schizophrenias

Learning Activities

Required Activities

1. Required readings: A. Varcarolis, Carson, & Shoemaker, Chapter 20 pp 384 - 421.B. http://evolve.elsevier.com/Varcarolis C. Student Study CD-ROM accompanying your text

2. Videos:View the Videos “Understanding and Communicating with an Individual Who is Hallucinating” and “Understanding and Communicating with an Individual Who has Delusions” by Mary Moller, R.N. on reserve at the Computer reference desk of the CTC – Oveta Culp Hobby Memorial Library. Please focus particularly on the nursing interventions portion of each video.



2. Describe the progression of symptoms from the prepsychotic phase (prodromal symptoms) to the acute phase or schizophrenia.

3. Differentiate between the positive and negative symptoms of schizophrenia with regard to (a) their response to traditional and atypical antipsychotic medications, (b) their effect of quality of life, and (c) their significance for the prognosis of the disease.

4. Formulate three nursing diagnoses that are appropriate for a person with schizophrenia and discuss potential interventions.

5. Develop a teaching plan for a client with schizophrenia who is taking a traditional antipsychotic drug such as haloperidol (Haldol).

6. Compare and contrast the properties of the conventional (traditional) with the newer atypical antipsychotic drugs in the following areas: (a) target symptoms, (b) indications for use, (c) adverse effects and toxic effects, (d) need for client and family teaching and following, and (e) cost.

7. Differentiate among the three phases of schizophrenia in terms of symptoms, focus of care, and intervention needs.

8. Describe interventions for a client who is hallucinating, is delusional or is demonstrating looseness of association

9. Describe the education needs commonly assessed in individuals experiencing the schizophrenias to include the significant others

10. Describe the legal and ethical issues that may be present for those providing care for

20


persons experiencing the schizophrenias.

21

UNIT V: Psychobiological Disorders: Severe to Psychotic:Cognitive Disorders

Learning Activities

Required Activities


2. Videos



2. Compare and contrast the clinical picture of delirium with the clinical picture of dementia.3. Summarize the essential somatic and psychotherapeutic interventions for a client with

delirium and identify three outcomes for clients with delirium.4. Compare and contrast Alzheimer’s Disease with other types of dementia.5. Discuss a teaching plan for a client with Alzheimer’s Disease including interventions for:

(a) communication, (b) health maintenance, and (c) safe environment.6. Discuss the unique needs of a caregiver for a person with dementia including possible

nursing interventions.

22


UNIT VI: Psychiatric Emergencies: Crisis

Learning Activities

Required Activities

1. Required readings: A. Varcarolis, Carson, & Shoemaker, Chapter 22 pp 456-472 and pp. 473-

489.B. http://evolve.elsevier.com/Varcarolis C. Student Study CD-ROM accompanying your text

2. Videos



2. Discuss mental health crises and nursing responsibilities in response (crisis intervention).3. Discuss four common problems in the nurse/client relationship that are frequently

encountered by beginning nurses when starting crisis intervention and discuss at least two interventions for each problem.

4. Compare and contrast the differences among primary, secondary, and tertiary intervention including appropriate intervention strategies.

5. Discuss four potential crisis situations common in the hospital setting that a client may face and be able to give concrete examples of how they may be minimized.

23


UNIT VI: Psychiatric Emergencies: Suicide

Learning Activities

Required Activities

1. Required readings: A. Varcarolis, Carson, & Shoemaker, Chapter 23 pp. 473-489.B. http://evolve.elsevier.com/Varcarolis C. Student Study CD-ROM accompanying your text

2. Videos



2. Describe the profile of suicide in the United States noting psychosocial and cultural factors that affect risk.

3. Identify three common precipitating events to suicide.4. Discuss the most frequent coexisting psychiatric disorders that accompany suicides.5. Using the SAD Persons Scale, explain ten risk factors to consider when assessing for

suicide.6. Describe three expected reactions a nurse may have when beginning work with suicidal

clients.7. Be able to give examples of primary, secondary, and tertiary (postvention) interventions for

suicidal clients.8. Describe basic level interventions that take place in the hospital or community for suicidal

clients.9. Identify key elements of suicide precautions and environmental safety factors in the

hospital.10. Identify two verbal and two non-verbal clues that might indicate a person is contemplating

suicide11. Assess an individual’s suicide potential12. Describe situations that may indicate an increased risk for suicide,13. Establish valid nursing diagnoses for suicidal persons14. Develop plans to include measurable outcomes and appropriate nursing interventions to

address the nursing diagnoses identified in the above objective15. Describe the legal and ethical issues that may be present for those providing care for

suicidal clients16. Describe the behaviors of survivors of suicide17. Identify strategies for interventions on behalf of the survivors of suicide18. Describe possible staff responses to suicide/suicide attempts

24


19. Describe possible staff responses to clients with suicidal ideations20. Describe appropriate interventions with staff who are addressing the needs of suicidal

clients or survivors of suicide

25

UNIT VI: Psychiatric Emergencies: Anger and Aggression

Learning Activities

Required Activities


2. Videos



2. Compare and contrast interventions for a client with healthy coping skills with those for a client with marginal coping behaviors.

3. Explain why behavioral and cognitive behavioral techniques are useful modalities for anger management.

4. Discuss the use of de-escalation techniques (practice principles) with a moderately angry client.

5. Describe four criteria for the use of seclusion or restraint over verbal intervention. 6. Discuss how inappropriate responses to an angry client can affect nursing

interventions.

26


UNIT VI: Psychiatric Emergencies: Family Violence

Learning Activities

Required Activities


2. Videos



2. Discuss risk factors and basic prevalence rates for the different types of family violence: (a) physical violence, (b) sexual violence, (c) neglect, and (d) emotional violence.

3. Describe conditions in which family violence might actually relieve stressors (not necessarily the ideal solution).

4. Compare and contrast three characteristics of perpetrators with three characteristics of a vulnerable person.

5. Describe four areas to assess in interviewing a person who has experienced family violence.6. Develop a safety plan, including the essential elements, for an abused spouse.7. Identify two common emotional responses the nurse might experience when faced with a

person subjected to family violence.8. Describe at least three possible referrals for a violent family (child, adult, elder abuse) and

write down the telephone numbers for the corresponding agencies in the community.9. Name and discuss three psychotherapeutic modalities that are useful for working with

violent families.

27


UNIT VI: Psychiatric Emergencies: Sexual Assault

Learning Activities

Required Activities


2. Videos



2. Define sexual assault (rape).3. Discuss the reasons that rapes go unreported.4. Distinguish between the acute and long term phases of the rape trauma syndrome and

identify some common reactions during each phase.5. Identify and give examples of five areas to assess when working with a person who has

been sexually assaulted.6. Discuss long term versus short term goals for the rape victim.7. Analyze one’s own thoughts and feelings regarding the myths about rape and its impact on

survivors.8. Identify six overall guidelines for nursing interventions related to sexual assault.9. Describe the role of the sexual assault nurse examiner.10. Discuss the responsibilities of the nurse when a rape survivor is discharged from the

emergency department citing specific referrals in the community.11. Identify three outcome criteria that would signify successful interventions for a client who

has suffered a sexual assault.12. Distinguish between therapeutic and non-therapeutic responses to clients who experience

family violence or sexual assault13. Describe legal and ethical issues that may be present for those providing or managing care

for persons who experience family violence or sexual assault

28


UNIT VII: Interventions for Special Populations:Care of the Chemically Impaired

Learning Activities

Required Activities


2. Videos:View the video workshop “Managing Detox” on reserve at the computer reference desk of the CTC – Oveta Culp Hobby Memorial Library (90 minutes)



2. Compare and contrast the terms substance abuse and substance dependency as defined by the DSM IV TR.

3. Explain the difference between tolerance and withdrawal and give a clinical definition of each.

4. Discuss four components of the assessment process to be used with a person who is chemically dependent.

5. Describe the difference between the behaviors of an alcoholic person and a nontolerant drinker in relation to blood alcohol level.

6. Compare and contrast the symptoms seen in alcohol withdrawal and those seen in alcohol delirium.

7. List the appropriate steps to take if one observes an impaired coworker.8. Describe aspects of enabling behaviors and give examples.9. Compare and contrast the signs and symptoms of intoxication, overdose, and withdrawal for

cocaine and amphetaimine.10. Distinguish between the symptoms of narcotic intoxication and those of narcotic

withdrawal.11. Describe the use of the ASE Scale and the Wang Scale12. Describe the role of Twelve Step Programs (Alcoholics Anonymous-AA, Narcotics

Anonymous- NA, for example) in the recovery from substance abuse(s)13. Describe the legal and ethical issues that may be present for those providing care for

persons who abuse substances14. Describe the responsibilities of the registered nurse in the State of Texas in relation to

impaired professionals (to include student professionals) 15. Describe the client education needs commonly assessed in persons who abuse substances

29


16. Discuss treatment of a person who is withdrawing from alcohol delirium including nursing care and pharmacologic therapy

17. Recognize the phenomena of relapse as it affects substance abusers during different phases of treatment

30

UNIT VII: Interventions for Special Populations:Severe Mental Illness: Crisis Stabilization and Rehabilitation

Learning Activities

Required Activities


2. Videos



2. Discuss the behavior and symptoms of severe mental illness as they relate to the person’s daily functioning and to family and other interpersonal relationships.

3. Describe three common problems associated with severe mental illness.4. Explain six evidence based practices for the care of the severely mentally ill person.5. Explain the role of the nurse in the care of the severely mentally ill person.6. Discuss the importance of medication and adherence to the medication regime for the

severely mentally ill client.7. Describe the education and rehabilitation needs that are commonly assessed among those

persons who experience a severe mental illness8. Describe the legal and ethical issues that may be present for those providing care for

persons who experience a severe mental illness9. Define the term ‘dual diagnosis’ and discuss the principles for working with a client with

dual diagnoses10. Describe how the nursing assessment is adapted when dual diagnosis is suspected11. Determine appropriate nursing diagnosis for individuals with a dual diagnosis12. Describe how nursing interventions are adapted for clients with a dual diagnosis13. Describe education needs commonly assessed in clients with dual diagnoses

31


UNIT VII: Interventions for Special Populations:Psychological Needs of the Medically Ill

Learning Activities

Required Activities


2. Videos



2. Describe at least two common mental health sequelae and two psychological responses to a serious medical illness.

3. Discuss the seriously medically ill client’s coping skills and identify areas of teaching to include areas of strength.

4. Develop a psychosocial (psychological-social-spiritual) nursing assessment.of someone with a serious medical illness.

5. Discuss requests for assisted suicide or euthanasia by a seriously medically ill client.

6. Analyze how stress can intensify the symptoms of medical illness7. Apply knowledge of psychological responses to illness in non-psychiatric settings

32


UNIT VII: Interventions for Special Populations:Care for the Dying and for Those Who Grieve

Learning Activities

Required Activities


2. Videos



2. Compare and contrast the goals of end of life care inherent in the hospice model and those of the medical model, and be specific about these differences.

3. Analyze the effects of specific tasks that health care workers (nurses and social workers) can perform when working with a dying person and his or her loved ones, including the emotional reaction of health care workers.

4. Using the seven motifs as a guide, discuss how varied individuals confront the prospect of dying.

5. Distinguish between bereavement and mourning.6. Differentiate between characteristics of normal and dysfunctional grieving.7. Describe guidelines for helping people to cope with loss of a client, friend, family member,

or classmate, including catastrophic loss.8. Discuss at least seven behavioral outcomes that indicate successful bereavement.9. Identify situations and circumstances that could affect a person’s coming to terms with loss10. Describe the education needs commonly assessed when a person experiences the grieving

process

33


UNIT VII: Interventions for Special Populations:Psychiatric Forensic Nursing

Learning Activities

Required Activities


2. Videos



2. Define forensic nursing, psychiatric forensic nursing, correctional nursing, and correctional mental health nursing.

3. Describe the nature of the nurse-client relationship in each of these nursing specialties.4. Discuss the significance of the terms legal sanity and competence to proceed.

34


UNIT VIII: Lifespan Issues and Interventions:Disorders of Children and Adolescents

Learning Activities

Required Activities


2. Videos



2. Explore what factors and influences contribute to child and adolescent mental disorders and how they relate to multimodule intervention strategies for these young clients.

3. Explain how the characteristics associated with resilency can mitigate against ideological influences.

4. Identify characteristics of mental health in children and adolescents.5. Discuss various components involved in constructing a holistic assessment of a child or

adolescent.6. Explore areas in the assessment of suicide that may be unique to children or adolescents

including medications.7. Compare and contrast at least six treatment modalities for children and adolescents.8. Discuss client outcomes and corresponding nursing interventions for three childhood or

adolescent mental health disorders.

35


UNIT VIII: Lifespan Issues and Interventions:Adult Issues

Learning Activities

Required Activities


2. Videos



2. Discuss the significance of sleep deprivation with regard to social problems, medical conditions, and psychiatric disorders.

3. Identify at least two sleep disorders that are life threatening.4. Describe the components of multimodal treatment for the adult with ADHD.5. Define at least three sexual disorders and describe their treatment.6. Discuss taking a sexual history and how your feelings influence your ability to perform this

assessment.

36


UNIT VIII: Lifespan Issues and Interventions:Psychosocial Needs of the Older Adult

Learning Activities

Required Activities


2. Videos


1. Define the Key Terms and Concepts for chapter 34 page 692 correctly use each in written and oral communications.

2. Describe the impact of ageism in providing care to older adults.3. Analyze how ageism affects your attitudes and willingness to care for the elderly.4. Explain the importance of and what constitutes a comprehensive geriatric assessment.5. Identify the risk factors for elder suicide and the nurse’s role in prevention of suicide.6. Discuss the importance of pain assessment and identify three tools used to assess pain in the

elderly and some of the difficulties in treating pain in the elderly.7. Discuss elder abuse including risk factors, types of abuse, and the nurse’s role.8. Describe how interviewing and assessment techniques are adapted for older adult clients9. Describe psychosocial education needs commonly assessed among older adults10. Describe the legal and ethical issues that may be present for those providing care for those

providing care for older adults

37


UNIT IX: Other Intervention Modalities:Therapeutic Groups

Learning Activities

Required Activities


2. Videos



2. Identify basic concepts related to group work.3. Identify the phases of group development.4. Discuss the therapeutic factors that operate in all groups.5. Be able to name four facilitating techniques used by the group leader.6. Describe a group intervention for a member who is silent or a member who is monopolizing

the group.7. Describe four types of groups commonly led by registered nurses (RNs).8. Discuss treatment of a person who is withdrawing from alcohol delirium including nursing

care and pharmacologic therapy.9. Recognize the phenomena of relapse as it affects substance abusers during different phases

of treatment.

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UNIT IX: Other Intervention Modalities:Family Therapy

Learning Activities

Required Activities


2. Videos



2. Differentiate between functional and dysfunctional family patterns of behavior as they relate to the five family functions.

3. Compare and contrast insight-oriented family therapy and behavioral family therapy.4. Analyze the meaning and value of the family’s sociocultural context when assessing and

planning intervention strategies.5. Formulate seven outcome criteria that a counselor and family might develop together.6. Identify some strategies for family intervention7. Explain the importance of the nurse’s role in psychoeducational family therapy.

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UNIT IX: Other Intervention Modalities:Integrative Care


A. Varcarolis, Carson, & Shoemaker, Chapter 37 pp.749-767.B. http://evolve.elsevier.com/Varcarolis C. Student Study CD-ROM accompanying your text

2. Video:



2. Describe integrative care.3. Discuss the techniques used in major complementary therapies and the nurse’s role.4. Discuss how the public can be misled through quackery and fraud related to the use of

alternative and complementary therapies.5. Explore information resources available through literature and on-line sources.

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Learning_Guide

Documents