NSG526 Exam 3 Study Guide 2022/2023

NSG526 Exam 3 Study Guide 2022/2023 Module 9 - Perese Chapter 11 Crisis Intervention/phases (9 questions)  Levels of prevention: o Primary – actually preventing the thing o Secondary – early identification and treatment o Tertiary – avoidance of complications  Norms are considered the "right" patterns of behavior for a society.  Crisis: o A crisis is generally regarded as time limited, lasting no more than 4 to 6 weeks o Internal or external demands that are perceived as threats to a person’s physical or emotional functioning can initiate a crisis. The precipitating event is not only stressful, but unusual or rare. o Maturational – Describes unfavorable person-environment relationships that relate to maturational events, such as leaving home for the first time, completing school, or accepting the responsibility of adulthood. o Situational - Occurs whenever a specific stressful event threatens a person’s biopsychosocial integrity and results in some degree of psychological disequilibrium. o Adventitious - Initiated by an unexpected unusual events that can affect an individual or a multitude of people. National and natural disasters.  During an adventitious crisis (e.g., flood, hurricane, forest fire) that affects the well-being of many people, the interventions of the PMH-APRN will be a part of the community’s efforts to respond to the event. o The goal for people experiencing a crisis is to return to the pre-crisis level of functioning. o The role of the PMH-APRN is to provide a framework of support systems that guide the client through the crisis and facilitate the development and use of positive coping skills.  Assess risk of homicide/suicide/self-injury  Assess coping skills  Assess perception of problem and support mechanisms  Assess biologic items – sleep, eating, hygiene, etc  Assess psychological – emotions and coping  Asses social – individual, family, community. Social support o Disaster:  A disaster is a sudden ecological or man-made phenomenon that is of sufficient magnitude to require external help to address the psychosocial needs as well as the physical needs of the victims.  Mass Casualty Incident Triage categories:  Expectant: Injuries are extensive and chances of survival are unlikely even with definitive care. Separate and provide comfort o Unresponsive patients with penetrating head wounds, high spinal cord injuries, wounds involving multiple anatomical sites and organs, 2nd/3rd degree burns in excess of 60% of body This study source was downloaded by from CourseH on :56:41 GMT -05:00 surface area, seizures or vomiting within 24hr after radiation exposure, profound shock with multiple injuries, agonal respirations; no pulse, no BP, pupils fixed and dilated  Immediate: Injuries are life-threatening but survivable with minimal intervention. Individuals in this group can progress rapidly to expectant if treatment is delayed. o Sucking chest wound, airway obstruction secondary to mechanical cause, shock, hemothorax, tension pneumothorax, asphyxia, unstable chest and abdominal wounds, incomplete amputations, open fractures of long bones, and 2nd/3rd degree burns of 15%–40% total body surface area.  Delayed: Injuries are significant and require medical care but can wait hours without threat to life or limb. Individuals in this group receive treatment only after immediate casualties are treated. o Stable abdominal wounds without evidence of significant hemorrhage; soft tissue injuries; maxillofacial wounds without airway compromise; vascular injuries with adequate collateral circulation; genitourinary tract disruption; fractures requiring open reduction, débridement, and external fixation; most eye and CNS injuries.  Minimal: Injuries are minor and treatment can be delayed hours to days. Individuals in this group should be moved away from the main triage area. o Upper extremity fractures, minor burns, sprains, small lacerations without significant bleeding, behavioral disorders or psychological disturbances.  Psychological assessment: Assess the victim for behaviors that indicate a depressed state, presence of confusion, uncontrolled weeping or screaming, disorientation, or aggressive behavior. Ideally, the PMH-APRN should assess the coping strategies the victim uses to normally manage stressful situations.  The ABCs of psychological first aid include focusing on A (arousal), B (behavior), and C (cognition). When arousal is present, the intervention goal is to decrease excitement by providing safety, comfort, and consolation. When abnormal or irrational behavior is present, survivors should be assisted to function more effectively in the disaster and when cognitive disorientation occurs, reality testing and clear information should be provided.  After the initial interventions, the PMH-APRN should support the development of resilience, coping, and recovery while providing technical assistance, training, and consultation.  Goals of care include helping the victims prioritize and match available resources with their needs, and preventing further complications, monitoring the environment, disseminating information, and implementing disease control strategies