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25 Cards in this Set
- Front
- Back
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Awareness of a threat leads to what in the aggressive person?
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Emotional & Physiological arousal
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What type of cognition (feelings) lead to the emotional & physical arousal of the aggressive person?
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fear, feeling hurt, humiliation, powerlessness, ignored, insecure, not heard, vulnerable.
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The feelings of fear, hurt, humiliation and powerlessness leads to __________ ?
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ANXIETY
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If anxiety is not noticed by staff right away what happens to the aggressive patient?
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Cognitions fuel and pt. feels dis-ease.
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What are the S/S of escalating anger/aggression?
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Hyperactivity (pacing, restlessness); Increased tension (clenched jaw or fist); Verbal abuse; loud/rapid voice; intense eye contact; carrying a weapon; hx. of violence
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Name nursing dx. that would relate to a pt. with angry and aggressive behaviors.
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Ineffective Individual Coping; Risk for Violence
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What is the 5 phase agression cycle?
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Triggering, escalation, crisis, recovery
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Name some steps to take in the preassaultive stage of aggression to de-escalate the situation.
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1) Listen to the patient; 2) Use de-escalation techniques; 3) maintain your safety; 4) Offer PRN medications
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Name the de-escalation techniques.
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maintain client's self - esteem; remain calm; respond early; establish client's concern; maintain large personal space; give options; non-aggressive posture.
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How would the nurse manage an aggressive pt. in the assaultive phase?
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seclusion and/or restraint initiated
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Name the interventions used when restraints are necessary.
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SAFETY; adequate/trained staff; continual observation 1:1; written record Q15; ROM Q2 hours; provide hydration, nutrition, toileting, comfort.
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How does a nurse manage the postassaultive phase with a pt.?
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1) talk to client about incident; 2) talk about stressors; 3) explore alternative behaviors; 4) Talk with staff and clients about incident
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What medications are given for long-term treatment in the angry and aggressive pt.?
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Inderal; Anti-manic; Anti-psychotics; SSRI's
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Explain the use of the medication Inderal to control aggression.
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1) Beta Blocker; 2) takes 4-6 weeks to work/4mos to control aggression used for pts. with Schizophrenia, brain injury, & mental retardation; 3) Monitor BP (causes low BP).
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Explain the use of anti-manic medication to control aggression.
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Meds: lithium, anticonvulsants; used for Bipolar, borderline/antisocial PD, Prison inmates, and Brain injury pts.
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Explain the use of the atypical antipsychotic medication to control aggression.
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(Risperdal, zyprexa, geodon) used in pts. with schiz., mania, borderline, mental retardation.
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Explain the use of SSRI medication to control aggression?
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Use Paxil, Prozac, zoloft in pts. dx with Antisocial PD; dementia; brain injury
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Name the interventions used when working with a violent pt. and using a nursing dx. of Ineffective Individual Coping R/T being overwhelmed.
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collaboratie to problem solve; validate pts. feelings; help pt name feelings and underlying feelings of anger.
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Name the interventions used when working with a violent pt. and using a nursing dx. of Ineffective Individual Coping R/T maladaptive pattern.
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leave roon and return at specified time w/verbal abuse; stop talking, finish procedure, leave; Provide interactions when client not abusive; schedule regular contract which is separate from client's behavior.
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What interventions are used with a pt. who has cognitive deficits?
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Orientation aids; regular routine; decreased sensory stimulation; if agitated stay calm, make eye contact, meet needs, and use short simple sentences.
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Describe the "Drive and Instinct Theory" about the nature of aggression.
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thought that anger was an innate driving force and that repression was harmful. but it was determined to be the opposite found that anger is not beneficial to survival. Physiological damage (heart dmg) = Weak (wrong).
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Describe the "Behavioral Theory" about the nature of aggression.
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Children can learn aggression by imitating others (modeling). Natura reinforcement for kids; never taught that acting out is not OK.
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Describe the "Cognitive Theory" about the nature of aggression.
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Misconceptions (cognition) drive anger which can lead to aggression.
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Describe the "biological Theory" about the nature of aggression.
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some pople may be biologically predisposed to anger and aggression. Head trauma or epilepsy, Alzheimer's can have more anger (brain dmg). Amygdala can be more stimulated leading to anger. GABA, low SE, D, NE, glutamate & ACh impact anger and aggression.
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Explain the use of the medication in acute settings to control aggression?
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IM injection given in a combination of Haldol, Ativan, Benadryl or Cogentin or Trilafon, Ativan, Benadryl or Cogentin if having difficulty taking haldol.
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