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36 Cards in this Set
- Front
- Back
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What is antisocial personality disorder?
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Characterized by the disregard of the rights of other people. Axis II.
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What are the indications or signs and symptoms presented in Antisocial disorder?
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Lying; cheating; stealing; promiscuous behaviors; appears charming and intellectual; smooth talking; manipulative; unlawful; aggressive and reckless behaviors; argumentative; impulsivity; lack of guilt, remorse and conscience; rationalizes and denies own behavior; acts as if entitled; disregards others rights; often has substance abuse and dependency problems; consistent irresponsibility.
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What are the drug treatment options for antisocial personality disorder?
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drug therapy is not supported as a direct treatment for this disorder.
Drugs may be given to treat disorganized thinking, stabilize mood, ease symptoms of concurrent psychiatic disorders. Lithium or beta-adrenergic blocker may help aggressive outbursts. |
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What are the non-drug treatment options for antisocial personality disorder?
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Psycotherapy focused on individual and family
Group therapy may help Drug or alcohol rehabilitation |
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Explain the Nursing Care required for the pt with antisocial disorder.
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Be straitforward; set limits on acceptable behavior; reinforce postive behavior; teach social skills; clearly convey expectations and consequences; anticipate manipulative efforts; avoid power struggles; help pt manage anger; remember pt may be charming & convincing; encourage pt to express feelings, analyze behavior, and be accountable for his/her actions.
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What are the expected outcomes for a pt with antisocial personality disorder?
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pt exhibits nondestructive ways to express feelings
pt successfully manages anger pt expresses feeling verbally and takes responsibility of their actions. |
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Describe the pathophysiology of antisocial personality disorder.
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Some individuals with this disorder are imprisoned for committing unlawful acts, but many never have legal problems. This disorder has a chronic course but tends to lessen later in life, particularly after 40 years of age.
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What are the causes/risk factors with antisocial personality disorder?
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Family hx of disorder; male sex; low socioeconomic status; delinquency; alcohol and drug use; unsatisfactory early parenting; sexual assault and other crimes.
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What is the diagnostic criteria for a pt with antisocial personality disorder?
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Chronis disregard for a violation of the rights of others; disruptive behavior before 15 years of age; evidence of conduct disorder before 15 years of age; currently at least 18 years of age.
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What are the personality disorders within the Cluster A group (all things odd and eccentric)?
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Paranoid PD, Schizoid PD, & Schizotypal PD (PSS)
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Describe characteristics of paranoid PD.
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Very distrustful, always on the look out for someone that is out to get them.
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What are the nursing guidelines when caring for a pt. with paranoid PD?
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Avoid bing too nice or friendly, give clear straightforward explanations, use simple language, project neurral but kind affect, warn about any changes of, or side effects to medications.
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Describe characteristics of Schizoid PD.
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Detached emotionally, loners, and they are fine with it. Not interested in sex or pleasurable activities.
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What are the nursing guidelines when caring for a pt. with Schizoid PD?
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avoid bing too nice or friendly, do not try to increase socialization, perform thorough assessment to odetify disorders the patient is reluctant to discuss.
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Describe characteristics of Schizotypal PD.
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Anxious in social circumstances, Eccentric, Magical thinking, Socially inept, Eccentric thinking.
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What are the nursing guidelines when caring for a pt. with Schizotypal PD?
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Respect need for social isolation, be aware of patient's suspiciouness, and employ appropriate interventions. Perform careful diagnostic assessment as needed to uncover any other disorders.
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What are the personality disorders within the Cluster B group (Dramatic, emotional, erratic)?
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Antisocial, Borderline, Narcissistic, & Histrionic (BAHN)
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Describe characteristics of Antisocial PD.
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Do not feel concerns for anyone else. Only their needs matter and they will get what they want. If you get in the way that is your problem. They do not get labeled till they are over 18. they do not usually have natural emotional feelings. Have difficulty living in society.
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What are the nursing guidelines when caring for a pt. with Antisocial PD?
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1) try to prevent or reduce untoward effects of manipulation. Set clear and realistic limits on behavior, ensure that staff adheres to limits. Document manipulation or aggression. 2) Guard against manipulation. 3) Substance abuse is best managed through a treatment program.
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Describe characteristics of Borderline PD.
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Intense instability of relationships. Carry a sense of inner emptiness, not a whole person. They try to find someone in order to feel whole. Can cause splitting (all good or all bad no grey). Very unstable, impulsive. Adolescent cutters tend to become borderline when they get older.
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What are the nursing guidelines when caring for a pt. with Borderline PD?
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Put limits on behavior, set realistic goals, be aware of manipulative behaviors, use clear straightforward communication, avoid rejecting and rescuing, assess for SI and self mutilization behaviors.
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Describe characteristics of Narcissistic PD.
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Need admiration, tend to be grandiose, all abut me, nothing about you. Very dramatic.
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What are the nursing guidelines when caring for a pt. with Narcissistic PD?
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remain neutral, avoid power struggles or becoming defensive, convey unassuming self confidence.
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Describe characteristics of Histrionic PD.
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Very emotional, provocative, seductive. Want love and affection.
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What are the nursing guidelines when caring for a pt. with Histrionic PD?
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Understand seductive behavior as a response to distress. Keep communication professional, encourage and model the use of concrete and descriptive rather than vague and impressionistic language, teach assertiveness.
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What are the personality disorders within the Cluster C group (fearful, anxious)?
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Dependent, obsessive compulsive, & avoidant.
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Describe characteristics of dependent PD.
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Do not know how to take care of themselves. need more structured environment to become independent.
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What are the nursing guidelines when caring for a pt. with Dependent PD?
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Identify and help address current stresses, try to satisfy patients needs at the same time that limits are set up in a manner that a patient does not feel punished and withdraw. Be aware for countertransference, teach assertiveness.
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Describe characteristics of obsessive compulsive PD.
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Not OCD!!! No obsessive thoughts or rituals. Just overly structured. Need things done one way the "right" way. Helpful in some professions, can have traits and not the disorder.
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What are the common defense mechanisms of Obsessive compulsive PD?
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Intellectualization, rationalization, reation formation, isolation, and undoing.
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What are the nursing guidelines when caring for a pt. with Obsessive compulsive PD?
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guard against power struggles.
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Describe characteristics of avoidant PD.
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Avoid social situations at all costs. Prefer to work alone. Don't like social interaction. Painfully shy.
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What are the nursing guidelines when caring for a pt. with Avoidant PD?
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Friendly, accepting, reassuring approach is the best way to treat pts., being pushed into social situations can cause extreme and severe anxiety.
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Name some Nursing Dx. for someone with Antisocial and Borderline PD.
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Ineffective individual coping; Self-mutilation; impaired social interaction; defensive coping; risk for suicide.
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What type of outcomes should a nurse be aware of when treating PD patients?
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*They rarely seek help on their own because they don't see anything wrong with their behavior; *Change happens slowly and large changes are unrealistic.
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What are some nursing interventions used when caring for a patient with PD's?
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1) Difficult to form a therapeutic relationship; 2) tend to be suspicious oand hostile; 3) Need sense of control so giving options may enhance compliance; 4) Groups in the milieu force client to interact appropriately with others, also makes visible their own behaviors.
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