NR 320 PSYCHIATRIC MENTAL HEALTH NURSING CHAPTER 2 MENTAL HEALTH/MENTAL ILLNESS ANXIETY A DIFFUSE APPREHENSION THAT IS VAGUE IN NATURE

E AND IS ASSOCIATED WITH FEELINGS OF UNCERTAINTY AND HELPLESSNESS. GRIEF A SUBJECTIVE STATE OF EMOTIONAL, PHYSICAL, AND SOCIAL RESPONSES TO THE LOSS OF A VALUED ENTITY. ANXIETY AND GRIEF HAVE BEEN DESCRIBED AS TWO MAJOR, PRIMARY PSYCHOLOGICAL RESPONSE PATTERNS TO STRESS LEVELS OF ANXIETY: MILD SENSES ARE SHARPENED; day to day living MODERATE PERCEPTUAL FIELD DIMINISHED; less alert to events; assistance with problem solving SEVERE ATTENTION SPAN EXTREMELY DIMINISHED; difficulty completing simple tasks; discomfort is experienced PANIC UNABLE TO FOCUS; misperceptions are common; loss of reality; hallucinations or delusions; feeling of terror ADAPTATION RESPONSES TO ANXIETY: MILD ANXIETY NUMEROUS INDIVIDUAL COPING BEHAVIORS MILD TO MODERATE ANXIETY DEFENSE MECHANISMS MODERATE TO SEVERE PHYSICAL ILLNESSES/NEUROSES PANIC ANXIETY PSYCHOSIS GRIEF: subjective state of emotional, physical and social responses to the loss of a valued entity STAGES OF GRIEF: o DENIAL-shock/disbelief; reality of loss not acknowledged o ANGER-why me, its not fair, envy and resentment o BARGAINING-bargain made with God o DEPRESSION-full impact of loss is experienced; loss is intense; advancement toward resolution o ACCEPTANCE-feeling of peace regarding the loss that has occurred ANTICIPATORY GRIEF-loss is anticipated; mourning process is completed prematurely MALADAPTIVE GRIEF-doesnt progress through stages of grieving to achieve resolution CHARACTERISTICS OF MENTAL HEALTH: 1. POSITIVE ATTITUDE TOWARDS SELF 2. ABILITY TO ACHIEVE SELF-ACTUALIZATION 3. INTEGRATION 4. AUTONOMY 5. PERCEPTION OF REALITY 6. ENVIRONMENTAL MASTERY MENTAL ILLNESS: BASED ON CULTURAL RELATIVITY DSM-IV AXIS 1 AXIS II AXIS III FOCUS OF CLINICAL ATTENTION PERSONALITY DISORDERS/MENTAL RETARDATION GENERAL MEDICAL CONDITIONS

AXIS IV AXIS V-

PSYCHOSOCIAL GLOBAL ASSESSMENT OF FUNCTIONING

Maslow: o Self actualization-self fulfilment and highest potential o Self esteem; esteem of others-self respect and respect from others o Love and belonging-giving and receiving affection, companionship o Safety and security-avoid harm, maintain comfort, order, structure o Physiological needs-basic fundamental needs Anxiety Disorders-anxiety and avoidance behavior (phobias, OCD, panic, PTSD) Somatoform Disorders-physical symptoms for no demonstrable organic pathology (hypochondriasis, somatization disorder, pain disorder) Dissociative Disorders-disruption in integrated functions of consciousness, memory, identity (dissociative amnesia, dissociative identity disorder)