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A concise overview of key concepts in mental health nursing, focusing on anger, aggression, and abuse. It covers topics such as the neurobiological aspects of aggression, nursing interventions for managing anger, different types of abuse (physical, emotional, financial, digital), and the cycle of violence. Additionally, it addresses sexual assault, forensic nursing, and personality disorders relevant to mental health care. This material is useful for nursing students and professionals seeking a quick review of these critical topics in mental health nursing. It also includes questions and answers useful for exam preparation.
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An emotional response to frustration of desires, threat to one's needs (emotional or physical), or a challenge
Anger
Action or behavior that results in verbal or physical attack
Aggression
In the hospital, violence is most frequent in
Psychiatric units
Emergency departments
Geriatric units
Comorbidities for anger and aggression
PTSD
substance abuse
depression, anxiety, PD's and psychosis
The limbic system is responsible for
aggression
The amygdala is responsible for
emotion
Serotonin
Dopamine
Gaba
responsible for emotions and anger
Nursing diagnosis for patients with anger
Ineffective coping
Risk for violence
Nursing implementations for anger
Psychological interventions
Benadryl 50mg
5 mg Haldol
2 mg Ativan
Beware in elderly and those with prolonged QT
antianxiety agents and antipsychotics are used in the treatment of acute symptoms of anger and aggression
Haldol
Ativan
B-
Acute anger patient nursing implementation
Health teaching and promotion
Case management
Team work and safety
Involuntary confinement alone in a room that the patient is physically prevented from leaving
Seclusion
Any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely
Restraints
Guidelines for use of mechanical restraints
Types of abuse
Physical
Examples of emotional abuse
Ignores partner's feelings, Ridicules or insults women / men as a group, Ridicules partner's beliefs, Withholds approval, Criticizes, Insults and/or drives away partner's family friends, Humilities partner in public / private, Refuses to socialize with partner, Takes away car keys / money / personal property, Threatens to leave, Threatens partner's family / friends, Punishes children when angry with partner, Threatens to kidnap children if partner leaves, Abuses pets to hurt partner, Tells partner about affairs, Harasses partner about affairs, real or imagined, Manipulates partner with lies / contradictions
Example of sexual abuse
all of the above
Financial abuse examples
Forging to elder signature and cashing his her check
Forcing client to sign any document
Misusing or stealing the elders clients possession
Forcing the elderly to contribute for utilities
Forcing the elderly to contribute money for food
Making them put their paycheck into a certain account
stealing money
Giving tax return
Examples of digital abuse
Who you can or can't be friends with on social media
Sending inapproporate memes
Pressuring to sext
Going through phone
Tagging in unkind pictures
Comorbidities for abuse
Anxiety
depression
suicidal idealization.
Men are less likely to report
Honeymoon stage
Cycle of abuse ****
tensions building (pushing, verbal abuse, victim ignores or accepts, they don't want it to escalate, victim tries to minimize the abuse)
incident ( Tension peaks, verbal, emotional, and physical abuse, anger, blaming, arguing, threats, intimidation)
reconciliation (Abuser apologizes, gives excuses, blames the victim, denies the abuse occurred, abuser says the abuse was not as bad as the victim claims)
calm (Incident is "forgotten", no abuse is taken place, "honeymoon phase")
Pregnancy may trigger or increase
violence
Violence may escalate when wife makes a
move for independence
Greatest risk for violence is when the women attempt to
leave relationship
Characteristic of vulnerable persons: children
Characteristic of vulnerable persons: older adults
Always screen for
abuse
Any bruising especially if the baby is not pulling up or taking steps
T- torso
E- Ears
N- Neck
Prevention of abuse
Primary prevention
Secondary prevention
Tertiary prevention
Sexual assault and sexual violence
Unwanted sexual advances and sexual harassment
Stranger rape
Marital rape
Date rape
Drug-facilitated sexual assault
Incest
Human sex trafficking
Female genital mutilation
Rape
nonconsensual sexual penetration of the body using physical force, the threat of bodily harm or incapacitation with drugs or alcohol
Physical effects of sexual assault
Depression
Suicide
Anxiety
fear
low self esteem
effects of incest
-negative self-image
-depression
-eating disorders
-personality disorders
-self-destructive behaviors
-substance abuse
Forensic Nursing
help investigate crimes like sexual and physical assault and accidental death
Forensic nursing functions *******
-Provide direct services to crime victims and perpetrators of crime
-Consultation services to colleagues in nursing, medical, and law-related agencies
-Expert court testimony
-Offer input on policy changes in the corrections setting
-Offer evaluation services for inmates
Care of adult and pediatric victims of sexual assault
SANE nurse
legal sanity
able to distinguish right from wrong
legal insanity
inability to tell right from wrong
irresistible impulse
Guilty By Mental Illness (GBMI)
Hostage negotiator role
Being on call around the clock to assist law enforcement officers on the scene
Providing suggestions regarding negotiation techniques
Assessing the mental status of the perpetrator
Providing a link to mental health agencies
Participating in a critique of the hostage incident
Assessing released hostages
Assessing the stress level of the hostage negotiator
Providing training in communication skills to law enforcement officers
Criminal profiler
attempts to provide law enforcement officials with specific information about the type of individual who may have committed a certain crime
Ricky Williams
Excitable and dramatic yet are often also high functioning. Extroversion, flamboyance, and colorful personalities.
Histrionic personality disorder
Paris Hilton
Trisha Paytis
a pattern of submissive and clinging behavior related to an excessive need to be taken care of. This need results in intense fear of separation.
Dependent personality disorder
Bella from Twilight
Donkey from Shrek
Dory
Lifelong pattern of social withdrawal
No interest in being with someone in a sexual or mutual relationship
Loner
Schizoid personality disorder
Manny the mammoth
Symptoms are very strange and unusual
Have magical thinking, strange speaking patterns or languages
Have to protect these patients
Schizotypal personality disorder
WIlly Wonka
The world is out to get me
District and suspicious of others based on the beliefs unsupported by evidence, that others want to exploit, harm, or deceive the person.
Paranoid personality
Nemos dad
boarderline personality disorder
unstable identity and interpersonal relationships, as well as by chronic feelings of emptiness and a history of suicidality,
