With Anxiety

Psyche

Mind

• MAIN FOCUS OF PSYCHIATRIC NURSING:  Behavior of the client  identify the feelings of client  identify the response of client

• CENTER OF PSYCHIATRIC NURSING:  human-human relationship

MENTAL HEALTH NURSING • Goal: to promote mental health • Psychosocial Nursing – previous name • InterPersonalRelationship – between the nurse and the client • Nurse – Self awareness – Self-concept- strength/weaknesses; therapeutic use of self which is the tool in psychiatric nursing ( knowledge of oneself) • Client – Individual – sick – Family – sick - disorganized – Environment – sick – disorganized – factors of maladaptive behavior

THREE LEVELS OF PREVENTION

PRIMARY – – – –

Healthy client Community concept Remove factors before it can cause illness Goal: Promote Mental Health & Prevent Mental Illness • Intervention: - start it with yourself – stress reduction – health teaching – teach family about mental health and emotional health (self-controlled) – accident prevention – support system – family

SECONDARY – Sick client – Lessen the duration of mental illness – Goal : Prevent disability • Intervention: Suicide prevention Crisis intervention Providing milieu therapy &

TERTIARY – Rehabilitation – Goal: To function at fullest capacity and be productive!

6 CONCEPTS OF MENTAL HEALTH

SELF-AWARENESS • Self-concept • Personal identity • How you perceive yourself

SELF-ACTUALIZATION Self-realization Self-fulfillment Achievement If your goal is met, you are self-actualized

PERCEPTION OF REALITY •Acceptance of reality

AUTONOMOUS BEHAVIOR

•Independence •Ability to make decisions

Adapt to environment Integrative Capacity Ability to tolerate frustration-unmet goals Ability to solve conflicts – presence of two goals

3 STRUCTURES OF PERSONALITY

ID

•Animal in man •Instinctual drive •Basic system of personality •Primitive desire •Amoral, illogical •Unreasonable •Function according to pleasure Example: Babies “Iwant it ,,,,,,,,, Iwant it now” avoid pain ; they only want to experience pleasure no sense of time

EGO

•I, self •Sense of identity •Reality Functions: •Higher functions of man •memory •orientation •reasoning •intellectual capacity •judgment e.g. oriented to time, place decision-making

b) Integrator of our personality •mediator to self and environment •balance between the id and superego c) Solve your conflicts d) Tolerate frustrations e) Reduce anxiety Example: “ I can wait for what I want”

SUPEREGO •higher self •2 aspects conscience – what is wrong ego ideal – what is right •censoring part – moral values; making us perfectionist •morality – concern with punishment and sense of guilt Example: “ I should not want that”

3 LEVELS OF MIND

Concious • focus on awareness • logical • experiences- that you can recall voluntarily

Subconcious • • • •

censoring part of the mind preconscious with clue you can recall accessible to both conscious and unconscious • experiences – partly forgotten; partly remembered e.g. – tip of my tongue

UNCONSCIOUS • largest part of the mind • experiences- not recall voluntarily • Evidences: – Slip of the tongue – Forgetfulness (e.g. important dates) – Dreams – Anxiety – Phobia – Hallucination – Delusions – Illusions • Can only be recalled if undergo psychoanalysis – hypnosis

ANXIETY

1. afraid of “unknown” 2. anticipation of danger 3. apprehension/ uneasiness- vague, accompanied by uncertain things d.Threat to self-esteem  Frustrated  Rejected  Problems  Conflicts b. Threat to physical changes Fever Pain Changes in the body

FEAR

1. afraid of what you know 2. external danger 3. outcome definite

LEVELS OF ANXIETY • Mild anxiety / (+)  helps one deal constructively with stress.  A mildly anxious person: • has broad perceptual field • has heightened ability to take in sensory stimuli • more alert to what is going on and can make better sense of what is happening with others and the environment.

• Moderate anxiety / (+ +) – remains alert but perceptual field narrows – shuts out the events on the periphery while focusing on central concerns. – uses selective inattention to cope – can still focus on what they have previously shut out

• Severe anxiety (+ + +) – sensory reception is greatly reduced – focus on small or cattered details of an experience. – have difficulty in problem solving and ability to organize is reduced – selective inattention is increased and less amendable to voluntary control – unable to focus on events in the environment – new stimuli may be overwhelming and may cause anxiety level to rise even higher – increase in pulse, BP, RR and epinephrine secretion, vasoconstriction and

• Panic / (+ + + +) – completely disrupted perceptual field – disintegration of the personality experienced as intense terror – details maybe enlarged, scattered or distorted – logical thinking and effective decision-making maybe impossible – behavior appear purposeless and communication unintelligible