-1Beliefs Feelings Behavior Therapeutic Communication Techniques What you see, you say What you hear, you

you say restating Sigmund Freud Father of Psychoanalysis Structure of Personality (Id, go, Superego! "ominant I" #ania $ntisocial &arcissistic

" mpulsive 'ant to 'ant P( $S)*

eat drin% urinate defecate

P( $S)*$B( P*I&CIP( Pain $voidance It+s all ,I-

)P * /. hould not mall voice of /od C.&SCI &C P*I&CIP(

".#I&$&T S)P * /. .0sessive 1 compulsive $nore2ia &ervosa I E

/. 3ecutive Secretary

Impaired *eality Schi4ophrenia

* $(IT5 P*I&CIP( (IBI". se2ual energy responsi0le for survival PS5C6.S 3)$( T6 .*5 78 .*$( ST$/ 9 : 7; #onths old Survival I 'ant to eat, sleep, urinate, defecate I" formation

-2 Cry < Suc% mouth Child Cries Feed the Infant Successful Ignore the Infant )nsuccessful &arcissistic

Defense Mechanism: o FI3$TI.& 'hen a person is stuc% in a certain developmental stage o * /* SSI.& return to an earlier developmental stage EGO is develop in the 6th month =8 $&$( ST$/ $teen : > years old (7; mos : > y8o8! Toilet training Super go develop Toilet Training /ood #other Successful SE Too *igid Training Clean .rgani4ed .0edient .BS SSI? : C.#P)(SSI? ($nal *etentive! "irty "isorgani4ed "iso0edient $&TIS.CI$( ($nal 2pulsive! Bad #other )nsuccessful

BIG SE

Small S E

>8 P6$((IC

> : @ y8o8 PenisA ?agina Parents is the significant person Called as Preschooler

-3-

.edipus Comple2 little 0oy loves mommy lectra Comple2 little girl loves daddy Identification 0oy associates 'ith daddy, girl assoc8 'ith mommy Castration fear of the little 0oy to daddy Penis nvy envy of little girl to'ards daddy "r8 Baren 6orney opposition to penis envy (evel of $'areness o Conscious highest level of a'areness o Preconscious Tip of the tongue o )nconscious deepest level of a'areness Birth Trauma First traumatic e2perience of child * P* SSI.& unconscious forgetting of an an2iety provo%ing concept S)P* SSI.& conscious forgetting of an an2iety provo%ing concept

C8 ($T &C5 ST$/ @ : 7= years old SC6..latency Se2ual energy is dormant *eading, *iting, *ithmetic S)B(I#$TI.& placing se2ual energies to'ard a more productive endeavors D8 / &IT$( ST$/ 7= y8 o8 : a0ove /ising /enital

-4-

PHARMA MOMENTS

$&TI$&3I T5
?($ST # ?$IB ?alium : ate ? #ilto'n 1 #eal (i0reum 1 ( quanil : $qua Bneel $tivan 1 $te /uy Sera%s : Sera )lo Tran2ene 1 Transit ?istaril 1 largavista $ttara2 : #ga 0ato (roc%s! Inderal : hindi ralph Busfar : sasa%ay ng 0us

*IB *IBS.& PS5C6.S.CI$( T6 .*5 .F " ? (.P# &T E 1 $ge 917; mos8 7; mos8 : > y8o8 Trust $utonomy $) nal T. ilet training &. favorite 'ord #5 Initiative Industry Identity Intimacy /enerativity go Integrity #istrust ShameA dou0t

$ffecting #aFor Factor Feeding Toilet Training

> : @ y8o8 @ : 7= y8o8 7= : =9 y8o8 =9 : =D y8o8 =D : CD y8o8 CD y8o8 and a0ove

/uilt Inferiority *ole confusion Isolation Stagnation "espair

Independence In da1school Peer (ove Parenting *eflection

#$S(.W+S 6 I*$*C65 .F &

"S

78 Physiologic &eeds o $ir, food, 'ater, shelter, rest, sleep, activity and temperature maintenance that are crucial for survival =8 Safety and Security &eeds o Safe in physical and psychological aspects >8 (ove and Belonging &eeds o /iving and receiving affection, attaining a place in a group, maintaining the feeling of 0elonging C8 Self : esteem &eeds o Self esteem : feelings of independence, competence and self respect o steem from others : recognition, respect, appreciation

-5D8 Self $ctuali4ation o .ne+s ma2imum potential and reali4e one+s a0ilities and qualities B 6$?I.*$( #." (S 78 Ivan Pavlov Classical Conditioning #odel $ll 0ehavior are learned Food dog Salivation Bell Food "og Salivation Bell Salivation =8 B8F8 S%inner .perant Conditioning $ll 0ehaviors are unlearned *e'ard (E reinforcement! and Punishment (1 *einforcement! B*$I& (.B S $CTI.& Frontal (anguage, (earning, Personality, Gudgment Temporal hearing, smelling Parietal Taste, touch .ccipital ?ision Sensory Integration #otor Involuntary ?.()&T$*5 & *?.)S S5ST # Somatic &ervous System ?oluntary

$cetylCholine Brain Spinal Cord #otor &erve #uscle Fi0er

I&?.()&T$*5 & *?.)S S5ST # $utonomic &ervous System Sympathetic 6* ** /I Constipation /) )rinary retention &euro piA &or

Parasympathetic "iarrhea )rinary Frequency $cetyl Choline

-6-

PHARMA MOMENTS

#.&.$#I& .3I"$S I&6IBIT.*S

$*

# & P

P($& "I( &$T

$&TIP$*BI&S.&
C$P$B( S

Cogentin $rtane Parlodel $%ineton Benadryl (arodopa

ldepryl Symmetryl

T6 *$P )TIC C.##)&IC$TI.&

Therapeutic .ffer your self I+ll stay 'ith you Silence #a%ing o0servations o 5ou seem sad $ctive listening o &odding o ye contact o (ean for'ard Who, 'hat, 'hen, 'here /eneral leads o /o on, I+m listening, 'hat elseH Broad opening 1 0est .pening line o 6o' are you todayH o 6o' are youH *estating Clarrification *efocusing 'e are tal%ing &on1Therapeutic "on+t 'orry 0e happy verything+s gonna 0e alright Ignoring the client Changing the su0Fect &ice 'eather 'e+re having o $dFectives : value 0ased perception, should not 0e use 5ou are the most 0eautiful client Why $rguing Flattery 5ou should do this no' In my opinion

-7a0out the e2am Focusing tell me a0out " F &S # C6$&IS#S Fight for stress "ISP($C # &T Transfer of feelings to a less Boss shouts at threatening o0Fect rather than the you, you shout at one 'ho provo%e it your su0ordinate " &I$( Failure to ac%no'ledge an ,I+m not an unaccepta0le trait or situation alcoholic"ISS.CI$TI.& Psychological flight from self ,Sino %a, Sino a%oH $ type of amnesia * /* SSI.& *eturn to an earlier developmental *eturn to stage thum0suc%ing * P* SSI.& )nconscious forgetting of an 6indi %o maalala an2iety provo%ing concept *$TI.&$(II$TI.& Illogical reasoning for a socially I drin% 0ecause I unaccepta0le trait don+t 'ant to 'aste the 0eer in ,sayang ang 0eer sa ref, %aya %o the ref ininum* $CTI.& doing the opposite of your sasa0unutan F.*#$TI.& intention %ita8 8 8 ay %u%lulutin lang %ita plastic )&".I&/ "oing the opposite of 'hat you ,ay pinatid %ita, have done due to guilt hali%a punta %ita sa clinic orocan, plastic, Tupper'are I" &TIFIC$TI.& $ssume trait for personal, social, Tulad niya occupational role P*.G CTI.& $ttri0uting to others one+s ,hindi a%o accepta0le trait alcoholic, sila yon Pasa load I&T*.G CTI.& $ssume another person+s trait as ,a%o dinyour o'n &ot Fust you, me too S)PP* SSI.& Conscious forgetting of an an2iety 6indi %o alam yan provo%ing concept S)B(I#$TI.& Placing se2ual energies to'ard a $ngry at life, put more productive endeavors anger in singing C.&? *SI.& *epressed angers put to'ards Biglang mangingig physical symptoms affecting nervous system leading to sensory num0ness and motor paralysis C.#P &S$TI.& .verachievement in one area to Pilay pero cover a defective part magaling %umanta S)BSTIT)TI.& *eplacing a difficult goal 'ith a /usto %o more accessi0le one "isneyland8

-8nchanted nalang8
ST.P /$B$ Inhi0itory /amma $mino Butyric $cid

S&S
$&3I T5

/. pinephrineA &orepinephrine 2itatory $nticholinergic side effect Constipation )rinary *etention "ry #outh Blurred ?ision

Within 7 'ee% *e0ound phenomenon Sei4ure $0rupt "ependence Withdra'al

$nti1$n2iety "ro'sy &o $lcohol &o Coffee "evelop .rthostatic 6ypotension Prevetion of .868 78 Sit "o'n =8 "angle feet >8 Stand )p /radually * ($3 "

/radually Tapered "ose

$&3I T5
?ague sense of impending doom

#ild #oderate E7 E= Widened acing Perceptual Field *& #eds *estless nhanced (earning Capacity ,5ou Seem *estless ,

Severe E> ont %no' 'hat to sayAdo I* CTI?

Panic EC uicide afety "on+t touch client *espi $l%alosis Bo'n Bag

-9-

$ssess &2 "2

J (evel of $n2iety J Ineffective Individual Coping Po'erlessness Impaired S%in Integrity PlanningA ImplementationJ level of an2iety environmental Stimuli *ela2ation Technique Sho'ing pictures of flo'er, 'aterfalls 6earing sounds of chirping 0irds valuation J ffective individual coping

& *$(II " $&3I T5 "IS.*" *

months e2cessive 'orrying #ight 0e mild, moderate and severe an2iety SAS2 *estless "ifficulty of concentration Sleep "isorders Palpitations dge of the seat asy fatiga0ility

P$&IC "IS.*" *
7D : >9 #inutes escalation of S&S $/.*$P6.BI$ fear of open spaceA pu0lic places S.CI$( P6.BI$ fear of pu0lic

P.ST T*$)#$TIC ST* SS "IS.*" *

Trauma "isaster $ccident War *ape

Flash0ac%s ?ICTI#S Survivors &ightmares

- 10 arthqua%e Soldier @ years old $ssignmentsA 6ome'or%s &o $ssignmentsA 6ome'or%s 5ou Thin% ,Teacher may get angry $n2iety ,I am sic% #$(I&/ *I&/ pretending to 0e sic% (Conscious! $0sent S.#$T.F.*# K no pretension K no organic 0asis K unconscious PS5C6.S.#$TIC K *eal painsA illness K *eal symptoms K C maFor types L 6ypertension L #igraine L Stress )lcer L $sthma

scape from Teacher P*I#$*5 /$I& (Behavior an2iety!

#ama Care $ttention S C.&"$*5 /$I&

S.#$T.F.*# "IS.*" *S S.#$T.F.*#

&ervous System C.&? *SI.& "IS.*" * (a Belle Indifference emotional disattachment from disa0ility Illusion of structural defect B."5 "5S#6.*PIC "IS.*" *

#inor "iscomfort Interpreted as maFor illness 65P.C6.&"*I$SIS ,#aliit na 0utas, pinalala%iFavorite Past TimeJ "octor 6opping &ursing FocusJ Feelings

- 11 -

PS5C6.S.#$TIC "IS.*" *S
$n2iety S&S BP 6ypertension ?asoconstriction Cere0ral $rtery #igraine (eft /astric $rtery Stress )lcer P&S Bronchoconstriction $sthma

.BS SSI? : C.#P)(SI?

BeliefA thought "oor .pen Burglar may go inside .0session (thought! Feelings $n2iety

an2iety *eturns to house ($ction! $n2iety Compulsion

P6.BI$
Irrational fears tiology o Bno'ledge o 2perience Immediate &ursing Intervention remove the stimuli S5ST #$TIC " S &SITII$TI.& o /radual e2posure to feared o0Fect

PHARMA MOMENTS

$&TIPS5C6.TIC $/ &T
SSTTC#6P Stela4ine 1 se2y star Serentil : serena Thora4ine : 0a0aeng Tora Trilafon 1 tri10and phone Clo4aril : closed reel #ellaril : maraming reel 6aldol : hahaha Proli2in : pero lic% scene

- 12 -

$(C.6.(IS#
tiologyJ Intergenerational Transmission From one generation to another generation

$lcohol
Blac%out a'a%e 0ut una'are Confa0ulation inventing stories to self1esteem "enial ,I am not an alcoholic-

"ependence ,I can+t live 'ithout it na0ling significant other tolerates a0users $nother term C. : " P &" &C5 T.( *$&C Su0stance to achieve a previous effect " T.3IFIC$TI.& Withdra'al 'ith #" supervision Chec% $lcohol, #outh'ash, li2er void alcohol version therapy lcoholics $nonymous self help group nta0use "IS)(FI*$# &ever drin% alcohol 7= hour intervalA 7= h last alcohol inta%e or elseJ nausea, vomiting and hypotension Wernic%e+s ncephalopathy motor Borsa%off+s Psychosis memory

B7 ?itamin "eficiency Complications

"elirium Tremens =C : M= h after last dose of alcohol

untreated 'ithdra'al syndrome ormocation 0ugs cra'ling under the s%in amily Therapy mother, father, 0rother

- 13 -

$)TIS#
$utistic Savant autistic 'ith a special talent $ssess $ppearance flat affect, consistent movement Behavior repetitive, ritualistic Communication echolalia, incomprehensi0le &2 "2 Impaired ver0al communication Impaired social interaction Self mutilation *is% for inFury PlanningA Implementation #aslo'+s hierarchy of needs Constancy, promote safety valuation 2pressive therapy dra'ing, muscic etc nhanced communication Improved social interaction Safety

$TT &TI.& " FICIT 65P *$CTI? "IS.*" *

.nset "uration Settings Id "ominant J M y8o8 and 0elo' J @ months and a0ove J = 6ouse and school J #om or *& 'ill act as superego

$"6" /lucose Frontal (o0e impaired Fudgement $"6" SAS2 *italin Frontal (o0e Gudgement $"6" SAS2 (stimulant! $ssess $ppearance dirty Behavior clumsy, impatient, easily distracted, hyperactive Communication tal%ative, 0lurts out in class &2 "2 *is% for inFury Impaired social interaction PlanningA Implementation tructure separate room for eating, playing, sleeping and etc chedule time for everything

- 14 et limits afety valuation #inimi4e *is% for InFury Improved social interaction Safety *esidual $"6" gro's up not antisocial #edsJ *italin, de2edrin, pemoline, adderal Best time to giveJ once a dayJ $FT * # $(SJ prevent lost of appetite "on+t give at 0edtime STI#)($&T causes insomnia /ive @ hours prior 0edtime if 0id

$TI&/ "IS.*" *S
7; mos8 : > y8o8 Toilet Training Clean .0edient .rgani4ed Thought I $m Fat @ y8o8 class valedictorianA model student social inactiveA no BF 'eighing

Feeling Behavior Self steem "iet, "iet, "iet ating "isorders ating Pattern Weight #enstruation Bulimia at, eat, vomit &ormal 'eight Irregular menstruation "ao #ing 3i "a #ing SugatA su%a ?omiting "ental caries Wounded %nuc%les #eta0olic al%alosis #eta0olic acidosis

$nore2ia &ervosa "iet, diet, diet N;DO of e2pected 0ody > mos8 ammenorhea Baren Carpenter

?omiting Fluid ?olume "eficit $**65T6#I$ (fatal complication!

- 15 "iarrhea Interventions *estore fluid and electrolyte 0alance Colla0orative regarding menu contract Target 'eight gain $fter mealsJ stay >9 mins : 7 hour

PHARMA MOMENT

(IT6I)#
( evel 98@ : 78= m qA( Increase urination Tremors, fine hand 6ydration > (Aday Increase )u diarhea #outh, dry ausea, vomiting, diarrhea (ithium To2icity aE

Bidney

$&TIP$*BI&S.&
$&TIC6.(I& */IC $BC $rtane $%ineton Benadryl Cogentin ".P$#I& */IC P(S Parlodel (arodopa Symmetyl ldepryl

SC6II.P6* &I$
go disintegration Impaired reality perception /enetic vulnera0ility Stress : "iathesis #odel o Too much stress in the reality 'ill lead client to escape it and go to the fantasy 'orld Biological Theory o "opamine level is 6igh The e2act cause is un%no'n ffect appropriate, inappropriate, flat, 0lunt (incomplete emotion! m0ivalence torn 0et'een = opposing forces

- 16 utism ssociative (ooseness Symptoms &egative 6ypoactive Withdra'n $pathy $ssess J Content of Thought &2 "2 J "istur0ed thought process PlanningA ImplementationJ Present reality Provide safety valuation J Improve thought process $ssess J 6allucinationA Illusions &2 "2 J "istur0ed sensory perception PlanningA ImplementationJ Present reality Provide safety valuation J Improve sensory perception $ssess J Suspicious &2 "2 J *is% for other directive 0ehavior PlanningA ImplementationJ Present reality Provide safety valuation J liminateA minimi4e ris% for other1directed violence $ssess J Suicidal &2 "2 J *is% for self directive 0ehavior PlanningA ImplementationJ Present reality Provide safety valuation J liminateA minimi4e ris% for self1directed violence Flight or (ooseness I am going to the mall8 I am going to the mall8 Positive 6yperactive Socia0le Flight of Ideas Tal%ative

- 17 Where is the lightH /o here8 #ineral Water8 The mall is 0ig8 Big is the tree8 The tree is tall8

#agical Thin%ing Believes to have a magical po'er I can turn you into a frog cholalia I repeat 'hat you say Parrots chopra2ia I repeat 'hat you do Word Salad 'ords, no rhyme Clang $ssociation 'ords 'ith rhyme J "un%, plan%, sun% &eologism creation of ne' 'ords Plin%ing, hustash Clarification done in case of neologism "elusionJ Persecutory &BI is out to get meA someone 'ill harm the client *eligious I am Gesus Christ /randeur I am the queen of the 'orld8 Ideas of reference &urses are tal%ing a0out me8 Concrete $ssociation pilosopo ,'hat 'ill you 'earH- ,clothesThought Bloc%ing 6alucination s $0sent 3 3 3 Illusion Present

Stimulus ?isual $uditory Tactile

In case of hallucinations doJ

6allucinations $c%no'ledgment
I %no' you the voices are real to you *eality orientation But I don+t hear them

- 18 -

"iversion
(ets go to the garden B t if nothin! in the p"eceedin! inte"vention a"e seen Assess #hat the voices a"e sa$in! SC6II.P* &I$

Disorganized
Sad 0ut smiles o Inappropriate affect &o reaction o Flat affect Flight of ideas o HEBEPHRENIC /iggling Positive and &egative classified SAS2

Catatonic
$m0ivalence Wa2y Fle2i0ility o Ini'an na posture, ganun forever &o : favorite 'ord &egativism

Paranoid
Suspicious Tendency to 0e violent #istrustScaredWithdra'n &rsg8 IntJ "evelop trust 7 to 7 short interaction frequent visit foods in sealed container meds 'rapped for violent pt8 "oors open &ear the door "on+t touch the pt8 ye contact 7 arms length a'ay call reinforcement

differentiated

Can+t 0e classified 7st paranoid, then &o more positive sAs2, disorgani4ed then Fust 'ithdra'n catatonic, etc etc

Residual #i2ed classification

&ormally $cetylcholine P .&

"opamine P .FF

5our al'ays .& With par%ins.&

6igh "opamineP Schi4ophrenia

- 19 -

$ntipsychotics P ma%es "opamine goes do'n 2trapyramidal Side ffects $B$T6ISI$ o *estless, ina0ility to sit o #a%ati siya, ahh %ati siya $BI& SI$ o #uscle rigidity o $hh %iniss siya "5ST.&I$ o > features T.*TIC.((IS Wry nec% Anticholinergic .C)(./5*IC C*ISIS D" !s that #ill ma%e the Fi2ed stare AcH do#n .PIST6.T)&.S o $rtane $rched 0ac% o $%ineton T$*"I? "5SBI& SI$ o Benadryl o Irreversi0le side effects of o Cogentin antipsychotics o (ip smac%ing Dopaminergic o Tongue protruding Dopamine !oes p o Chee%s puffing o Parlodel & )*.( PTIC #$(I/&$&T o (arodopa S5&"*.# o Symmetryl o 6yperthermia among client o ldepryl ta%ing antipsychotic o 6yperthermia 'ith muscle rigidity .ther Side ffects Photosensitivity o Sunscreen o Wide 0rimmed hat $granulocytosis o *eport immediately Sore throat 7st sign to appear .&

- 20 -

PHARMAMOMENTS

$&TI" P* SS$&TS
$&TS$$? PPI

$sendin : ascending &orpramin : sa0a' ng %norr Tofranil : Tofu Sinequan : nood ng Sine Quan ang title $nafranil : %ina $na Praning $ventyl : %ina $ven Til #idnight tayo ?ivactil : Bye Bac% till ne2t 'ee%
lavil : h love mo 0a a%o Pro4ac : Pero sa%a na Pa2il 1 Ta%sil Ioloft : mag Solo %a BIP.($* "IS.*" * : #ania more common Female =9 years old and a0ove Stressful life .0ese T$SB Caregiver *ole Strain Safety Impaired social interaction Safety
Self $ctuali4ation Self steem 6yperactive Se2 $n2iety

*is% for inFuryA other directed violence ating finger food Sleep Private room

(ithium : = : C 'ee%s 0efore effect

- 21 -

S Compensation interfere $"(s, harm others S Compensation interfere $"(s, harm others T$SB increases client+s self esteem /ross motor s%ills via su0limation scorted 'al% outdoors Punching 0ag

&o group games compition 'ill increase an2iety > or more signs confirms disorder / F S P randiose light of ideas leeplessness ressured speech 2agerated S 2traneous stimuli (easily distracted! " istracti0ility

P *S.&$(IT5 "IS.*" *S SC6II.I" I don+t 'ant people Believes he can stand on his o'n &ever had a 0est friend $void groups and social activities no enFoyment Cares more a0out computers and pets $?.I"$&T I avoid people, I fear criticism 6ave talent 0ut no confidence $&TIS.CI$( I 0rea% the la' as motto

- 22 $s a child,J steal, lie, al'ays get reprimanded $dult : grand ro00ery, illegal activitist against the la', drug addiction, drives fast, unsafe se2, thrill see%er /ood tal%er, charmer, 'itty manipulator

B.*" *(I& : my life is an emptyglass

"ependent I can+t live 'ithout you self esteem poor decision ma%ing s%ills 6istrionic e2cited, dramatic 0ut manipulative center of attention &arcissistic I love myself Insensitive, arrogant I am the 0est .0sessive : Compulsive I am organi4ed Perfectionist Provide time to do rituals Paranoid Suspicious Passive $ggressive $l'ays say yes 0ut resistance is hidden

- 23 -

Serotonin
#$. %ills Serotonin

#$. Serotonin #$. Serotonin

Serotonin

$&TI" P* SS$&TS 'o : C 'ee%s 'o neurotransmitter RI C$C"IC

7st (ine of "rug Prescri0ed afest E"ECTI#E ide effects lo' ER T !I! E%PTA&E to C 'ee%s !(IBIT R
PP)

! MI!E

!TIDEPRESSA!T 6igher incidence of Side effects SerotoninA pi affected

'IDASE

!(IBIT R
A!TSA#E M!P

$ll neurotransmitter affected 6ighest Side effects $void tyramine rich food may lead to 65P *T &SI? C*IS S

T5*$#I& *IC6 F.."S vocado ged Cheese eer hocolate

SSRI

TCA

MA I

$ntidepressant $nticholinergic Side ffects (Syphathetic! #ale rectile "ysfunction

- 24 -

ermented Foods ic%les reserved Foods oy Sauce

- 25 -

$ntidepressant no effect CT ( C*.C.&?)(SI? T6 *$P5 Pre o Informed consent o &P. @ : ; hours prior #eds o $tropine dry mouth o Bar0ituate Sedative o Succinylcholine muscle rela2ant, prevent sei4ure Post o Side1lying : lateral o SA headache, di44iness, T #P.*$*5 # #.*5 (.SS distinct sign M9 : 779 volts =9 : >9 seconds R hour asleep post

PHARMAMOMENTS

S)BST$&C $B)S
"o'ners ($B.&# I& ! $lcohol Bar0ituates .piates &arcotics #ariFuana )ppers (C6$! Cocaine 6allucinogen $mphetamines #orph Code 6ero &$*C$& antidote

- 26 .? *".S $lcohol 6* ** BP (.C Cocaine

Coma

Sei4ure

Bradycardia Bradypnea
Pupil constriction

#oist mouth Constipation 6ypotension Coma $sleep Weight gain

)P6.*I$

Psych 'ell 0eing &$*C$& &arcotic $ntagonist narcotic overdose

Tachycardia Tachypnea Pupil "ilation "ry mouth 6ypertension Sei4ure $'a%e Weight (oss

" T.3IFIC$TI.& 'ithdra'al 'ith #" Supervision # T6$".&

Withdra'al reverse of effect or opposite of overdose

" P* SSI.& Serotonin, if unresponsive to drugs, CT

The /rief Process "enial noS this can+t 0e true $nger 'hy me, 'hy me, 'hy no' Bargaining if something happens, then I+ll give something 0ac% "epression I+m do'n = 'ee%s or more sAs2 maFor depression $cceptance client acts according to situation

- 27 -

Self $ctuali4ation Self steem 'ithdra'n

C T$SB Stay

*is% for self directed violence ating Sleep 6ypoactive Se2

Sensitivity to client needs

S)ICI"
?er0al I 'ont 0e a pro0lem anymore This is my last day on earth I+ll soon 0e gone &on ?er0al Ta%e this ring, its yours (giving of valua0le! Sudden change in mood

Who 'ill commit SuicideH Se2 : #ale (more successful!A female (hesitant! $ge : 7D :=C yAo or a0ove CD "epression Patient 'ith previous attempt T.6 : ethanol 1 alcoholics *irrational Social support lac%ing .rgani4ed plan greater ris% &o family Sic%ness, terminal S)ICI" T*I$" (oss of spouse (oss of Fo0 $loneness Is Patient is S)ICI"$(T nurse shouldJ "I "irect question : ,$re you going to commit suicideH Irregular interval of visit to pt8 room arly $# and period of endorsement : the time pt+s commit suicide Best approach for suicidal pt8 J "irect approach &ursing #anagementJ Close surveillance 6ospital area maFority sucide 'ill happens atJ 'ee%ends 71 > am Sunday Wee%end less staff personnel arly $# every one is asleep

- 28 -

/ive simple tas%8 "on+t give comple2 may cause depression e28 Gigsa' Water plants Wash the dishes e2cept sharps C6I(" $B)S &thin% B' Burns, 0ruise, 0one fractures, B)&/IS "on+t 0athe the child, don+t 0rush teet8 Body of evidence 'ill 0e lost Bantay Bata 7@> ( ? (S .F # &T$( * T$*"$TI.& Profound o N =9 o thin%s li%e an infants o can+t 0e trained ero : = yAo o stay 'ith the patient ensorimotor Severe evere o =9 : >D #oderate #odera e o >D : D9 hirtyfive : D9 o can 0e train raina0le 'o : M yAo o mental age is = : M yAo o pre1operational stage #ild o D9 : M9 o meantal age is M : 7= o educa0le o can go to school Borderline o M9 1 U9 &ormal o U9 : 799 G.6& PI$/ T+S C./&ITI? T6 .*5 9:= Sensorimotor Ba0y can sense, see, perceive and hear8 .0Fect permanence =:C Preconceptual (anguage C:M Intuitive )nidimentional classification characteristic8 Child can fi2 toys according to si4e, color, height P one at a time M : 7= Conservation #ultidimensional Concrete $ssociation Formal /ood a0stract thin%ing8 Can interpret 'ords 7= .peration

- 29 $(I6 I# * &.#I$ don+t %no' name of o0Fects /&.SI$ pro0lem 'ith senses P6$SI$ can+t say it P*$3I$ can+t do it Cocaine &asal Septum perforation #ariFuana impaired (ung Structure eroine 'ithdra'al i%a0 atsing u hu hu
CRITICAL REVIEW

T ST T$BI&/ T C6&IQ) S 78 $ssess the ans'er, use circle 2. Initial priority T*)ST

$ir food, 'ater

>8 C8

D8 @8

M8

air $BC /ood WordA Bad Word S Technique ee% support it tay upervised ee P o0served eem P notice assi t feeling = same ans'erA = same mista%e Words to 'atch out for Inappropriate #ost &ot included 2cept $ll 0ut one )m0rella

$SS SS

- 30 * ($TI.&S6IP Preorientation Self a'areness .rientation Trust Setting Contract *esistance Wor%ing "iscussion Termination valuation

P*$CTIC .F &)*SI&/ (evel of Prevention 7 = > *elapse $$

6ealthy Ill Community "emog8 Crisis Intervention S (F 6 (P /*.)PS nique niversality r not alone * ST$T e2act 'ords * F( CT use other 'ords " P* SSI.& ndogenous Internal Chemical *eactive e2ternal

Bar0ituate 'ithdra'al (IB*I)# (Chloridia4epo2ide! T.F*$&I( $ntidepressantA $nticholinergic pupil dilation midriasis Catharsis Feelings Free $ssociation Ideas $TTIT)" T6 *$PI S $ctive friendliness as% permission assive Friendliness aranoid anipulative nic atter of Fact

- 31 &o "emand "epressed Bind Firmness $nore2ic Crisis C : @ 'ee%s /oal *eturn the client to the pre1crisis level of functioning PSC Perception 'hat do you thin% a0out itH Coping 'hat 'ill you do a0out itH Support 'ho 'ill 0e there for youH Bulit %ulit %ulit %ulit Perseveration stic% to 7 topic )lit )lit )lit ?er0igeration "ISS.CI$TI.& "issociative $mnesia don+t %no' themselves Fugue Far "issociative Identity "isorder #ultiple Personality "8.8