Learning Guide

CENTRAL TEXAS COLLEGE
Department of Nursing
LEARNING GUIDE
Mental Health Nursing
RNSG 2213
Spring 2007
Instructor: Pamela Hadnot
Revised 08/06 ph,ma/db

01/07 ph/db
CENTRAL TEXAS COLLEGE
Department of Nursing
Table of Contents
Unit Page
I. Foundations in Theory...............................................................................1
II. Foundations for Practice..........................................................................................................4
III. Psychosocial Nursing Tools.....................................................................................................9
IV. Psychobiological Disorders: Moderate to Severe..................................................................14
V. Psychobiological Disorders: Severe to Psychotic..................................................................18
VI. Psychiatric Emergencies........................................................................................................22
VII. Interventions for Special Populations....................................................................................27
VIII. Lifespan Issues and Interventions…………………………………………………………..32
IX. Other Intervention Modalities………………………………………………………………35
*** Central Texas College District does not discriminate in admissions or access to, or treatment or
employment in, its programs and activities on the basis of race, color, religion, national origin,
gender, disability, and age or veterans status.
i
UNIT I: Foundations in Theory:
Mental Health & Mental Illness
Learning Activities
1. Required Readings/Activies:
A. Varcarolis, Carson, & Shoemaker, Chapter 1 pp. 1-14.
B. http://evolve.elsevier.com/Varcarolis
C. Student Study CD-ROM accompanying your text
2. Video:
Objectives
Upon completion of this unit, the student should be able to:
1. Define the Key Terms and Concepts for Chapter 1 page 2 correctly use each in written and oral
communications.
2. Assess his/her own mental health using the seven signs of mental health identified in this chapter
(Table 1-1 and Figure 1-1).
3. Summarize factors that can affect the mental health of an individual and the ways that these factors
influence conducting a holistic nursing assessment.
4. Discuss some dynamic factors (including social climate, politics, myths, and biases) that contribute
to making clear-cut definition of mental health elusive.
5. Explain how epidemiological studies can improve medical and nursing care.
1
Relevant Theories & Therapies for Nursing Practice
Learning Activities
A. Varcarolis, Carson, & Shoemaker, Chapter 2 pp.15-33.
2. Video:
Objectives
communications.
2. Compare and contrast the developmental stages as defined by Freud and
Erickson.
3. Identify ways that each theorist contributes to the nurse’s ability to assess a
client’s behaviors.
4. Identify Paplau’s expectation of the nurse/client relationship.
2
Biological Basis for Understanding Psychotropic Drugs
Learning Activities
2. Video:
Objectives
1. Define the Key Terms and Concepts for Chapter 3 page 34 and correctly use each in written and oral
communications.
2. Discuss at least eight functions of the brain and the way these functions can be altered by
psychotropic drugs.
3. Describe how a neurotransmitter functions as a neuromessenger.
4. Apply to a medication teaching plan how the blockage of dopamine at the receptor site can result in
motor abnormalities and hyperprolactinemia.
5. Describe the result of blockage to muscarinic receptors and the alpha receptors by the standard
neuroleptic drugs.
6. Contrast and compare the side effect profiles of the standard antipsychotic with those of atypical
antipsychotic drugs.
7. Apply to a medication teaching plan the knowledge of why a person taking a monoamine oxidase
inhibitor would have special dietary and drug restrictions.
8. Describe the significance of pharmacological treatment of mental health problems and correctly
classify the medications for this unit.
9. Describe the mechanism of action, the therapeutic use, the essential client teaching (including side
effects and toxic effects), and essential client assessments related to the medications for this unit.
10. Accurately calculate doses of prescribed medications for mental health problems.
3
UNIT II: Foundations for Practice:
Psychiatric Mental Health Nursing & Managed Care Issues
Learning Activities
Required Activities
1. Required readings:
A. Varcarolis, Carson, & Shoemaker, Chapter 4 pp 63-71.
2. Videos
Objectives
1. Define the Key Terms and Concepts Chapter 4 on page 63 correctly use each in written and oral
communications.
2. Define psychiatric mental health nursing and discuss the client population served by the psychiatric
nurse.
3. Describe recent developments that have increased the biological emphasis in psychiatric mental
health nursing.
4. Discuss the impact of managed care on psychiatric nursing roles.
4
Mental Health Nursing in Acute Care Settings
Learning Activities
Required Activities
2. Videos
Objectives
1. Define the Key Terms and Concepts for Chapter 5 on page 74 correctly use each in written and oral
communications.
2. Explain how the mental health team collaborates to plan and implement care for the hospitalized
client.
3. Describe the role of the nurse as advocate and provider of care for the client.
4. Discuss the process for preparing clients to return to the community for ongoing
care.
5
Mental Health Nursing in Community Settings
Learning Activities
Required Activities
A. Varcarolis, Carson, & Shoemaker, Chapter 6 pp. 85-98
2. Videos
Objectives
1. Define the Key Terms and Concepts for chapter 6 on page 85 correctly use each in written and oral
communications.
2. Explain the evolution of the community mental health movement.
3. Identify elements of the nursing assessment that are critically important to the success of community
treatment.
4. Distinguish between the hospital and community settings with regard to characteristics, goals of
treatment, and nursing interventions.
5. Discuss the continuum of psychiatric treatment.
6. Describe the role of the psychiatric nurse in four specific settings:
7. Partial hospitalization program
8. Psychiatric home care
9. Assertive community treatment
10. Community mental health center
11. Identify two resources to assist the community psychiatric nurse in resolving ethical dilemmas.
12. Discuss barriers to mental health treatment.
6
Culturally Relevant Mental Health Nursing: A Global Perspective
Learning Activities
Required Activities
2. Videos
Objectives
communications.
2. Describe the importance of culturally relevant care and mental health nursing practice.
3. Discuss potential problems in applying American or Western psychological theory to clients of other
cultures.
4. Compare and contrast American nursing beliefs, values, and practices with the beliefs, values, and
practices of clients from diverse cultures.
5. Identify risk factors and barriers to quality mental health care that culturally diverse clients
frequently encounter.
7
Legal and Ethical Guidelines for Safe Practice
Learning Activities
Required Activities
2. Videos
Objectives
communications.
2. Compare and contrast the terms ‘ethics’ and ‘bioethics’ and identify five principles of bioethics.
3. Discuss at least five client rights that come under the Patient’s Bill of Rights.
4. Give examples of the client’s: (a). right to treatment, (b) right to refuse treatment, and (c) right to
informed consent.
5. Identify the steps nurses are advised to take if they suspect negligence or illegal activity on the part
of a professional colleague or peer.
6. Apply legal considerations of client privilege: (a) after a client has died, (b) if the client tests positive
for human immunodeficiency virus, or (c) if the client’s employer states “a need to know”.
7. Discuss a client’s civil rights and how they pertain to restraint and seclusion.
8. Describe the processes of voluntary admission to psychiatric care and involuntary psychiatric care in
the state of Texas.
9. Describe the nurse’s role as a client advocate for persons receiving psychiatric care.
8
UNIT III: Psychosocial Nursing Tools:
Assessment Strategies and the Nursing Process
Learning Activities
Required Activities
2. Videos
Objectives
1. Define the Key Terms and Concepts for chapter 9 on page 138 correctly use each in written and oral
communications.
2. Discuss the mental status examination and psychosocial assessment.
3. Identify the components of a nursing assessment of a client with a mental
health problem and construct a plan of care using the nursing process (six-step
problem-solving approach to client care).
4. Documentation of the client’s care and progress including legal considerations.
9
Developing Therapeutic Relationships
Learning Activities
Required Activities
2. Videos:
Review the three part “Helping Interview” videos (Nursing Lab Manager’s office) or the
three part “Interactive Techniques” videos (Computer Reference Desk- CTC Oveta Culp
Hobby Memorial Library)
Objectives
1. Define the Key Terms and Concepts for chapter 10 on page 155 correctly use each in written and
oral communications.
2. Contrast and compare the purpose, focus, communication styles and goals for
(a) a social relationship, (b) an intimate relationship, and (c) a therapeutic
relationship.
3. Define and discuss the role of empathy, genuineness, and positive regard on
the part of the nurse in a nurse/client relationship.
4. Identify two attitudes and four actions that may reflect the nurse’s positive
regard for a client.
5. Analyze what is meant by boundaries and the influence of transference and
counter-transference on boundary blurring.
6. Contrast and compare the three phases of nurse/client relationship.
7. Describe the four areas of concern during your first interview with a client.
8. Explore aspects that foster a therapeutic nurse/client relationship and those
that are inherent in a non-therapeutic nursing interactive process as identified
in the research of Forcuk and associates.
9. Describe four testing behaviors a client may demonstrate and discuss possible
nursing interventions for each behavior.
10
The Clinical Interview & Communication Skills
Learning Activities
Required Activities
2. Videos:
Review the three part “Helping Interview” videos (Nursing Lab Manager’s office) or the
three part “Interactive Techniques” videos (Computer Reference Desk- CTC Oveta Culp
Hobby Memorial Library)
Objectives
1. Define the Key Terms and Concepts for chapter 11 on page 171correctly use each in written and oral
communications.
2. Describe four testing behaviors a client may demonstrate and discuss possible nursing interventions
for each behavior.
3. Discuss the interview process and various aspects of the process including factors that might impede
the interview.
4. Compare and contrast verbal and nonverbal communication including cultural aspects of diverse
populations.
5. Describe four techniques that improve therapeutic communication and four techniques that impede
therapeutic techniques.
11
Understanding Stress & Holistic Approaches to Stress Management
Learning Activities
Required Activities
2. Videos
Objectives
2. Recognize the short- and long-term physiologic consequences of stress.
3. Identify the relationship between stress and anxiety.
4. Discuss ways in which culture can affect a person’s perception of and reaction to stress.
5. Assess life-change units in a client’s life by use of the Life Change Questionnaire.
6. Differentiate among four categories of coping and give at least two examples of each.
7. Explain how cognitive techniques can lower a person’s level of stress.
12
Understanding Anxiety & Anxiety Defenses
Learning Activities
Required Activities
2. Videos
Objectives
1. Define the Key Terms and Concepts page 197 and page 212 correctly use each in written and oral
communications.
2. Recognize the longterm physiologic consequences of stress.
3. Identify the relationship between stress and anxiety.
4. Assess life-change units in a client’s life by use of the Life Change Questionnaire.
5. Differentiate among four categories of coping and give at least two examples of each.
6. Explain how cognitive techniques can lower a person’s level of stress.
7. Explore the difference between normal, acute, and chronic anxiety.
8. Contrast and compare the four levels of anxiety in relation to perceptual field, ability to learn, and
physical and other defining characteristics.
9. Identify, define, and give examples of mental defense mechanisms used to cope with anxiety.
10. Describe the educational needs of persons experiencing any of the four levels of anxiety.
13
UNIT IV: Psychobiological Disorders: Moderate to Severe:
Anxiety Disorders
Learning Activities
Required Activities
2. Videos
Objectives
2. Identify genetic, biological, psychological, and cultural factors leading to anxiety disorders.
3. Describe clinical manifestations of each anxiety disorder.
4. Describe feelings that may be experienced by nurses in caring for clients with anxiety disorders.
5. Describe five basic nursing interventions to use with clients with anxiety disorders.
6. Discuss three defense mechanisms commonly found in clients with anxiety disorders and their
effectiveness.
7. Discuss realistic outcome criteria for a client with (a) generalized anxiety disorder, (b) panic
disorder, and (c) post-traumatic stress disorder.
8. Discuss three classes of medications appropriate for anxiety disorders to include side effects and
contraindications.
9. Describe clinical manifestations of each anxiety disorder: generalized anxiety disorder (GAD),
obsessive-compulsive disorder (OCD), and post traumatic stress disorder (PSTD)
10. Discuss realistic outcome criteria for clients experiencing the above medical psychiatric diagnoses
11. Evaluate the effectiveness of care based on established outcome criteria
12. Discuss three defense mechanisms commonly found in clients with anxiety disorders and their
effectiveness
13. Describe education needs commonly assessed in clients experiencing anxiety disorders
14
Somatoform & Dissociative Disorders
Learning Activities
Required Activities
2. Videos
Objectives
2. Describe the symptoms, characteristics, plan of care, and expected outcomes for clients with
somatoform and dissociative disorders.
3. Differentiate between dissociative amnesia and dissociative fugue.
4. Be able to give a clinical example of each type of somatoform disorder.
5. Describe five psychosocial interventions that would be appropriate for a client with somatic
complaints.
6. Describe a plan of care for a client with conversion disorder including family teaching
15
Personality Disorders
Learning Activities
Required Activities
2. Videos
Objectives
2. Describe the main characteristic of one personality disorder from each cluster and give an example.
3. Formulate two nursing diagnoses for cluster B, Personality Disorders.
4. Discuss the nature and importance of crisis intervention for people with personality disorders.
5. Describe the feelings that are experienced by nurses and others when working with people with
personality disorders.
6. Describe two realistic nursing outcomes for clients with borderline personality disorder.
7. Plan basic interventions for an impulsive, aggressive, and manipulative client.
16
Eating Disorders
Learning Activities
Required Activities
2. Videos
Objectives
2. Compare and contrast the signs and symptoms (clinical picture) of anorexia nervosa and bulimia
nervosa.
3. Identify three life threatening conditions stated in terms of nursing diagnosis, for a client with an
eating disorder.
4. Identify three realistic outcome criteria for: (a) a client with anorexia nervosa, and (b) a client with
bulimia nervosa.
5. Recognize which therapeutic interventions are appropriate for the acute phase of anorexia nervosa
and which are appropriate for the long term phase of treatment.
6. Explain the basic premise of cognitive behavioral therapy and the treatment of anorexia nervosa and
bulimia nervosa.
7. Emphasis with and describe, in the reader’s own words, the possible thoughts and feelings of a
young anorectic girl during the acute phase of her illness.
17
UNIT V: Psychobiological Disorders: Severe to Psychotic:
Mood Disorders: Depression
Learning Activities
Required Activities
2. Videos
Objectives
2. Compare and contrast major depressive disorder with dysthymia.
3. Describe assessment of a depressed individual with regards to the following areas: (a) risk factors,
(b) affect, (c) thought processes, (d) feelings, (e) physical behavior, and (f) communication.
4. Formulate five nursing diagnoses for a client who is depressed and include outcome criteria.
5. Name unrealistic expectations that a nurse may have while working with a depressed person and
compare them with the reader’s personal reactions.
6. Evaluate the advantages of selective serotonin reuptake inhibitors over the tricyclic antidepressants.
7. Discuss two common adverse reactions to the monoamine oxidase inhibitors. State one serious toxic
reaction and identify the appropriate medical intervention.
8. Describe the types of depression for which electroconvulsive therapy is most helpful.
9. Discuss a medication teaching plan for a client taking a monoamine oxidase inhibitor including
foods and drugs that are contraindicated.
10. Apply principles of therapeutic communication with a depressed client.
11. Describe the legal and ethical issues that may be present for those providing care for persons
experiencing major depression
12. Describe nursing assessments, interventions, and evaluations for the client undergoing ECT
13. Describe the education needs commonly assessed in persons experiencing depression
18
Mood Disorders: Bipolar
Learning Activities
Required Activities
2. Videos
Objectives
2. Define bipolar disorder and variations of the disorder.
3. Compare and contrast mood disorders, both manic phase and depressive phase, for mood, behavior,
thought processes, and possible dysfunction.
4. Explain the rationale for communication to be used with the manic client.
5. Develop a medication care plan for lithium carbonate to include: (a) expected side effects, (b) early
and severe signs of toxicity, and (c) five areas of client teaching.
6. Discuss which conditions respond more favorably to (a) anticonvulsant therapy, (b) lithium
carbonate therapy, or (c) electroconvulsive therapy.
7. Evaluate specific indicators for the use of seclusion for a manic client.
8. Distinguish between the focus of treatment for a person in the acute manic phase and that for a
person in the continuation or maintenance phase of a Bipolar I disorder.
19
The Schizophrenias
Learning Activities
Required Activities
A. Varcarolis, Carson, & Shoemaker, Chapter 20 pp 384 - 421.
2. Videos:
View the Videos “Understanding and Communicating with an Individual
Who is Hallucinating” and “Understanding and Communicating with an
Individual Who has Delusions” by Mary Moller, R.N. on reserve at the
Computer reference desk of the CTC – Oveta Culp Hobby Memorial Library.
Please focus particularly on the nursing interventions portion of each
video.
Objectives
2. Describe the progression of symptoms from the prepsychotic phase (prodromal symptoms) to the
acute phase or schizophrenia.
3. Differentiate between the positive and negative symptoms of schizophrenia with regard to (a) their
response to traditional and atypical antipsychotic medications, (b) their effect of quality of life, and
(c) their significance for the prognosis of the disease.
4. Formulate three nursing diagnoses that are appropriate for a person with schizophrenia and discuss
potential interventions.
5. Develop a teaching plan for a client with schizophrenia who is taking a traditional antipsychotic drug
such as haloperidol (Haldol).
6. Compare and contrast the properties of the conventional (traditional) with the newer atypical
antipsychotic drugs in the following areas: (a) target symptoms, (b) indications for use, (c) adverse
effects and toxic effects, (d) need for client and family teaching and following, and (e) cost.
7. Differentiate among the three phases of schizophrenia in terms of symptoms, focus of care, and
intervention needs.
8. Describe interventions for a client who is hallucinating, is delusional or is demonstrating looseness
of association
9. Describe the education needs commonly assessed in individuals experiencing the schizophrenias to
include the significant others
10. Describe the legal and ethical issues that may be present for those providing care for persons
experiencing the schizophrenias.
20
Cognitive Disorders
Learning Activities
Required Activities
2. Videos
Objectives
2. Compare and contrast the clinical picture of delirium with the clinical picture of dementia.
3. Summarize the essential somatic and psychotherapeutic interventions for a client with delirium and
identify three outcomes for clients with delirium.
4. Compare and contrast Alzheimer’s Disease with other types of dementia.
5. Discuss a teaching plan for a client with Alzheimer’s Disease including interventions for: (a)
communication, (b) health maintenance, and (c) safe environment.
6. Discuss the unique needs of a caregiver for a person with dementia including possible nursing
interventions.
21
UNIT VI: Psychiatric Emergencies:
Crisis
Learning Activities
Required Activities
A. Varcarolis, Carson, & Shoemaker, Chapter 22 pp 456-472 and pp. 473-
489.
2. Videos
Objectives
2. Discuss mental health crises and nursing responsibilities in response (crisis intervention).
3. Discuss four common problems in the nurse/client relationship that are frequently encountered by
beginning nurses when starting crisis intervention and discuss at least two interventions for each
problem.
4. Compare and contrast the differences among primary, secondary, and tertiary intervention including
appropriate intervention strategies.
5. Discuss four potential crisis situations common in the hospital setting that a client may face and be
able to give concrete examples of how they may be minimized.
22
Suicide
Learning Activities
Required Activities
2. Videos
Objectives
2. Describe the profile of suicide in the United States noting psychosocial and cultural factors that
affect risk.
3. Identify three common precipitating events to suicide.
4. Discuss the most frequent coexisting psychiatric disorders that accompany suicides.
5. Using the SAD Persons Scale, explain ten risk factors to consider when assessing for suicide.
6. Describe three expected reactions a nurse may have when beginning work with suicidal clients.
7. Be able to give examples of primary, secondary, and tertiary (postvention) interventions for suicidal
clients.
8. Describe basic level interventions that take place in the hospital or community for suicidal clients.
9. Identify key elements of suicide precautions and environmental safety factors in the hospital.
10. Identify two verbal and two non-verbal clues that might indicate a person is contemplating suicide
11. Assess an individual’s suicide potential
12. Describe situations that may indicate an increased risk for suicide,
13. Establish valid nursing diagnoses for suicidal persons
14. Develop plans to include measurable outcomes and appropriate nursing interventions to address the
nursing diagnoses identified in the above objective
15. Describe the legal and ethical issues that may be present for those providing care for suicidal clients
16. Describe the behaviors of survivors of suicide
17. Identify strategies for interventions on behalf of the survivors of suicide
18. Describe possible staff responses to suicide/suicide attempts
19. Describe possible staff responses to clients with suicidal ideations
20. Describe appropriate interventions with staff who are addressing the needs of suicidal clients or
survivors of suicide
23
Anger and Aggression
Learning Activities
Required Activities
2. Videos
Objectives
2. Compare and contrast interventions for a client with healthy coping skills with those for a client with
marginal coping behaviors.
3. Explain why behavioral and cognitive behavioral techniques are useful modalities for anger
management.
4. Discuss the use of de-escalation techniques (practice principles) with a moderately angry client.
5. Describe four criteria for the use of seclusion or restraint over verbal intervention.
6. Discuss how inappropriate responses to an angry client can affect nursing
interventions.
24
Family Violence
Learning Activities
Required Activities
2. Videos
Objectives
2. Discuss risk factors and basic prevalence rates for the different types of family violence: (a) physical
violence, (b) sexual violence, (c) neglect, and (d) emotional violence.
3. Describe conditions in which family violence might actually relieve stressors (not necessarily the
ideal solution).
4. Compare and contrast three characteristics of perpetrators with three characteristics of a vulnerable
person.
5. Describe four areas to assess in interviewing a person who has experienced family violence.
6. Develop a safety plan, including the essential elements, for an abused spouse.
7. Identify two common emotional responses the nurse might experience when faced with a person
subjected to family violence.
8. Describe at least three possible referrals for a violent family (child, adult, elder abuse) and write
down the telephone numbers for the corresponding agencies in the community.
9. Name and discuss three psychotherapeutic modalities that are useful for working with violent
families.
25
Sexual Assault
Learning Activities
Required Activities
2. Videos
Objectives
2. Define sexual assault (rape).
3. Discuss the reasons that rapes go unreported.
4. Distinguish between the acute and long term phases of the rape trauma syndrome and identify some
common reactions during each phase.
5. Identify and give examples of five areas to assess when working with a person who has been
sexually assaulted.
6. Discuss long term versus short term goals for the rape victim.
7. Analyze one’s own thoughts and feelings regarding the myths about rape and its impact on survivors.
8. Identify six overall guidelines for nursing interventions related to sexual assault.
9. Describe the role of the sexual assault nurse examiner.
10. Discuss the responsibilities of the nurse when a rape survivor is discharged from the emergency
department citing specific referrals in the community.
11. Identify three outcome criteria that would signify successful interventions for a client who has
suffered a sexual assault.
12. Distinguish between therapeutic and non-therapeutic responses to clients who experience family
violence or sexual assault
13. Describe legal and ethical issues that may be present for those providing or managing care for
persons who experience family violence or sexual assault
26
UNIT VII: Interventions for Special Populations:
Care of the Chemically Impaired
Learning Activities
Required Activities
2. Videos:
View the video workshop “Managing Detox” on reserve at the
computer reference desk of the CTC – Oveta Culp Hobby Memorial
Library (90 minutes)
Objectives
2. Compare and contrast the terms substance abuse and substance dependency as defined by the DSM
IV TR.
3. Explain the difference between tolerance and withdrawal and give a clinical definition of each.
4. Discuss four components of the assessment process to be used with a person who is chemically
dependent.
5. Describe the difference between the behaviors of an alcoholic person and a nontolerant drinker in
relation to blood alcohol level.
6. Compare and contrast the symptoms seen in alcohol withdrawal and those seen in alcohol delirium.
7. List the appropriate steps to take if one observes an impaired coworker.
8. Describe aspects of enabling behaviors and give examples.
9. Compare and contrast the signs and symptoms of intoxication, overdose, and withdrawal for cocaine
and amphetaimine.
10. Distinguish between the symptoms of narcotic intoxication and those of narcotic withdrawal.
11. Describe the use of the ASE Scale and the Wang Scale
12. Describe the role of Twelve Step Programs (Alcoholics Anonymous-AA, Narcotics Anonymous-
NA, for example) in the recovery from substance abuse(s)
13. Describe the legal and ethical issues that may be present for those providing care for persons who
abuse substances
14. Describe the responsibilities of the registered nurse in the State of Texas in relation to impaired
professionals (to include student professionals)
15. Describe the client education needs commonly assessed in persons who abuse substances
16. Discuss treatment of a person who is withdrawing from alcohol delirium including nursing care and
pharmacologic therapy
17. Recognize the phenomena of relapse as it affects substance abusers during different phases of
27
treatment
28
Severe Mental Illness: Crisis Stabilization and Rehabilitation
Learning Activities
Required Activities
2. Videos
Objectives
2. Discuss the behavior and symptoms of severe mental illness as they relate to the person’s daily
functioning and to family and other interpersonal relationships.
3. Describe three common problems associated with severe mental illness.
4. Explain six evidence based practices for the care of the severely mentally ill person.
5. Explain the role of the nurse in the care of the severely mentally ill person.
6. Discuss the importance of medication and adherence to the medication regime for the severely
mentally ill client.
7. Describe the education and rehabilitation needs that are commonly assessed among those persons
who experience a severe mental illness
8. Describe the legal and ethical issues that may be present for those providing care for persons who
experience a severe mental illness
9. Define the term ‘dual diagnosis’ and discuss the principles for working with a client with dual
diagnoses
10. Describe how the nursing assessment is adapted when dual diagnosis is suspected
11. Determine appropriate nursing diagnosis for individuals with a dual diagnosis
12. Describe how nursing interventions are adapted for clients with a dual diagnosis
13. Describe education needs commonly assessed in clients with dual diagnoses
29
Psychological Needs of the Medically Ill
Learning Activities
Required Activities
2. Videos
Objectives
2. Describe at least two common mental health sequelae and two psychological
responses to a serious medical illness.
3. Discuss the seriously medically ill client’s coping skills and identify areas of
teaching to include areas of strength.
4. Develop a psychosocial (psychological-social-spiritual) nursing assessment.of
someone with a serious medical illness.
5. Discuss requests for assisted suicide or euthanasia by a seriously medically ill
client.
6. Analyze how stress can intensify the symptoms of medical illness
7. Apply knowledge of psychological responses to illness in non-psychiatric settings
30
Care for the Dying and for Those Who Grieve
Learning Activities
Required Activities
2. Videos
Objectives
2. Compare and contrast the goals of end of life care inherent in the hospice model and those of the
medical model, and be specific about these differences.
3. Analyze the effects of specific tasks that health care workers (nurses and social workers) can
perform when working with a dying person and his or her loved ones, including the emotional
reaction of health care workers.
4. Using the seven motifs as a guide, discuss how varied individuals confront the prospect of dying.
5. Distinguish between bereavement and mourning.
6. Differentiate between characteristics of normal and dysfunctional grieving.
7. Describe guidelines for helping people to cope with loss of a client, friend, family member, or
classmate, including catastrophic loss.
8. Discuss at least seven behavioral outcomes that indicate successful bereavement.
9. Identify situations and circumstances that could affect a person’s coming to terms with loss
10. Describe the education needs commonly assessed when a person experiences the grieving process
31
Psychiatric Forensic Nursing
Learning Activities
Required Activities
2. Videos
Objectives
1. Define the Key Terms and Concepts for Chapter 31 on page 623 correctly use each in written and
2. Define forensic nursing, psychiatric forensic nursing, correctional nursing, and correctional mental
health nursing.
3. Describe the nature of the nurse-client relationship in each of these nursing specialties.
4. Discuss the significance of the terms legal sanity and competence to proceed.
32
UNIT VIII: Lifespan Issues and Interventions:
Disorders of Children and Adolescents
Learning Activities
Required Activities
2. Videos
Objectives
2. Explore what factors and influences contribute to child and adolescent mental disorders and how
they relate to multimodule intervention strategies for these young clients.
3. Explain how the characteristics associated with resilency can mitigate against ideological influences.
4. Identify characteristics of mental health in children and adolescents.
5. Discuss various components involved in constructing a holistic assessment of a child or adolescent.
6. Explore areas in the assessment of suicide that may be unique to children or adolescents including
medications.
7. Compare and contrast at least six treatment modalities for children and adolescents.
8. Discuss client outcomes and corresponding nursing interventions for three childhood or adolescent
mental health disorders.
33
Adult Issues
Learning Activities
Required Activities
2. Videos
Objectives
2. Discuss the significance of sleep deprivation with regard to social problems, medical conditions, and
psychiatric disorders.
3. Identify at least two sleep disorders that are life threatening.
4. Describe the components of multimodal treatment for the adult with ADHD.
5. Define at least three sexual disorders and describe their treatment.
6. Discuss taking a sexual history and how your feelings influence your ability to perform this
assessment.
34
Psychosocial Needs of the Older Adult
Learning Activities
Required Activities
2. Videos
Objectives
1. Define the Key Terms and Concepts for chapter 34 page 692 correctly use each in written and oral
communications.
2. Describe the impact of ageism in providing care to older adults.
3. Analyze how ageism affects your attitudes and willingness to care for the elderly.
4. Explain the importance of and what constitutes a comprehensive geriatric assessment.
5. Identify the risk factors for elder suicide and the nurse’s role in prevention of suicide.
6. Discuss the importance of pain assessment and identify three tools used to assess pain in the elderly
and some of the difficulties in treating pain in the elderly.
7. Discuss elder abuse including risk factors, types of abuse, and the nurse’s role.
8. Describe how interviewing and assessment techniques are adapted for older adult clients
9. Describe psychosocial education needs commonly assessed among older adults
10. Describe the legal and ethical issues that may be present for those providing care for those providing
care for older adults
35
UNIT IX: Other Intervention Modalities:
Therapeutic Groups
Learning Activities
Required Activities
2. Videos
Objectives
2. Identify basic concepts related to group work.
3. Identify the phases of group development.
4. Discuss the therapeutic factors that operate in all groups.
5. Be able to name four facilitating techniques used by the group leader.
6. Describe a group intervention for a member who is silent or a member who is monopolizing the
group.
7. Describe four types of groups commonly led by registered nurses (RNs).
8. Discuss treatment of a person who is withdrawing from alcohol delirium including nursing care and
pharmacologic therapy.
9. Recognize the phenomena of relapse as it affects substance abusers during different phases of
treatment.
36
Family Therapy
Learning Activities
Required Activities
2. Videos
Objectives
2. Differentiate between functional and dysfunctional family patterns of behavior as they relate to the
five family functions.
3. Compare and contrast insight-oriented family therapy and behavioral family therapy.
4. Analyze the meaning and value of the family’s sociocultural context when assessing and planning
intervention strategies.
5. Formulate seven outcome criteria that a counselor and family might develop together.
6. Identify some strategies for family intervention
7. Explain the importance of the nurse’s role in psychoeducational family therapy.
37
Integrative Care
Learning Activities
A. Varcarolis, Carson, & Shoemaker, Chapter 37 pp.749-767.
2. Video:
Objectives
communications.
2. Describe integrative care.
3. Discuss the techniques used in major complementary therapies and the nurse’s role.
4. Discuss how the public can be misled through quackery and fraud related to the use of alternative
and complementary therapies.
5. Explore information resources available through literature and on-line sources.
38

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CENTRAL TEXAS COLLEGE

Instructor: Pamela Hadnot

Revised 08/06 ph,ma/db

II. Foundations for Practice..........................................................................................................4

III. Psychosocial Nursing Tools.....................................................................................................9

IV. Psychobiological Disorders: Moderate to Severe..................................................................14

V. Psychobiological Disorders: Severe to Psychotic..................................................................18

VI. Psychiatric Emergencies........................................................................................................22

VII. Interventions for Special Populations....................................................................................27

VIII. Lifespan Issues and Interventions…………………………………………………………..32

IX. Other Intervention Modalities………………………………………………………………35

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