PTSD Concept Map - Ptsd PDF

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Summary

Ptsd ...

Description

CONCEPT MAP

Disease Process/Concept

Nursing Interventions

PTSD

Non-threatening, respectful approach Consistent staff Build trust by spending quality time with patient Stay with patient during periods of flashbacks and nightmares Offer reassurance of safety and security Allow patient to address trauma at his/her own pace Teach and practice coping skills Assess for self-harm behaviors, aggression Acknowledge feelings of guilt or self-blame expressed by patient. Assess for maladaptive coping strategies, such as substance abuse. Provide positive reinforcement to enhance self-esteem. Assess spiritual needs of patient, and assist to meet those needs

Pathophysiology Fight or flight response Down regulation of beta and alpha 2 receptors Hypothalamic-pituitary-adrenal axis dysregulation- cortisol levels decreased, state of adrenal exhaustion Changes in conditioned fear

Signs and Symptoms Depressed mood, Tearfulness, Hopelessness, Anxiety and worry, Restlessness, Anger, expressed inappropriately, increased dependency, Violation of the rights of others, societal norms, Ambivalence, Inability to function, Manipulative behavior, Social isolation, Physical complaints, such as headache, backache, fatigue, etc., Physical altercations, reckless driving, truancy

Treatments and Medication ~Cognitive Behavioral Therapy (CBT) ~Cognitive Processing Therapy (CPT) ~Prolonged Exposure Therapy (PE) ~EMDR ~Medication ~Group Therapy ~Brief Psychodynamic Psychotherapy ~Family Therapy

Patient Education - Teach relaxation techniques and other anxietyreducing strategies. - Teach the client and family about causes and manifestations of the disorder. - Instruct the client to avoid caffeine and alcohol. - Teach grounding techniques for clients who have dissociative disorders. The client is taught to observe and experience physical objects or situations and to keep a written journal.

Expected Outcomes Diagnostics and Labs Trauma Re-experiencing symptoms Persistent avoidance and numbing hyperarousal Duration > 1 month clinically significant distress or impairment

Decrease intrusive thoughts, images and phobic avoidance, hyper arousal, anger, depression and irritability....