Psychiatric-mental health nursing

575 Pages·2007·107.88 MB·English

by  Sheila L. Videbeck

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S t e o ta L ¥ o d @ b e c k, PBuED, RW
Nursing Instructor
Des Moines Area Community College
Ankeny, Iowa
Illustrations by Cathy J, fVliller
Wolters Kluwer Lippincott Williams & Wilkins
Health
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Fourth Edition
Copyright © 2008 Wolters Kluwer Health I Lippincott Williams & Wilkins.
Copyright © 2006, 2004, 2001 by Lippincott Williams <Sr Wilkins. All rights reserved. This book is protected by copy-
right. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies
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services). Printed in China.
9 8 7 6 5 4 3 21
Library of Congress Cataloging-in-Publication Data
Videbeck, Sheila L.
Psychiatric-mental health nursing/ Sheila L. Videbeck; illustrations by Cathy J. Miller. — 4th ed.
p.; cm.
Includes bibliographical references and index.
1SBN-13: 978-0-7817-6425-4
1. Psychiatric nursing. I. Title.
[DNLM: 1. Psychiatric Nursing. 2. Mental Disorders—nursing. WY 160 V652p 2008)
RC440.V536 2008
616.89'0231—dc22
2007022798
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted prac-
tices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences
from application of the information in this book and make no warranty, expressed or implied, with respect to the
currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular
situation remains the professional responsibility of the practitioner; the clinical treatments described and recom-
<
mended may not be considered absolute and universal recommendations.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in
this text are in accordance with the current recommendations and practice at the time of publication. However, in view
of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy
and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage
and for added warnings and precautions. This is particularly important when the recommended agent is a new or infre-
quently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance
for limited use in restricted research sellings. It is the responsibility of the health care provider to ascertain the FDA
status of each drug or device planned for use in his or her clinical practice.
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Barbara Amendola, APN-C Jewel Diller, RN, MSEd, MSN, FNP
Professor of Nursing Associate Professor
Ocean County College Ivy Tech Community College of Indiana
Toms River, New jersey . Fort Wayne, Indiana
Denise Doliveira, RN MSN
Judy A. Bourrand, RN, MSN
Assistant Professor
Assistant Professor (Course Coordinator, Psychiatric-
Community College of Allegheny County, Boyce
Mental Health Nursing)
Campus
Samford University, Ida V. Moffett School of Nursing
Monroeville, Pennsylvania
Birmingham, Alabama
Janet Duffey, RN, MS, APRN, BC
Janice Caie-Lawrence
Assistant Professor of Nursing
Instructor
Napa Valley College
Henry Ford Community College
Napa, California
Dearborn, Michigan
Allison Edmonds, MS, ARNP
Janet Niemi Chubb, MS, RN (DHSc candidate)
Faculty Clinical Instructor
Assistant Professor of Nursing
University of South Florida
North Georgia College and State University College of Nursing
Dahlonega, Georgia Tampa, Florida
Judith A. Collins, BSN, MA, ARNP, BC Meredith Flood, PhD, APRN, BC
Lecturer; Clinical Instructor Assistant Professor
University of Iowa, College of Nursing University of North Carolina at Charlotte
Iowa City, Iowa Charlotte, North Carolina
Gretchen Guhin, BSN, RN
Cindy Cunningham, MSN, APRN, BC
Nurse Educator
Nursing Instructor
Scott Community College
Delaware Technical & Community College
Davenport, Iowa
Georgetown, Delaware
t
Mary Herda, MSN
Jan Dalsheimer, MS, RN
Instructor
Associate Clinical Professor
Kellogg Community College
Texas Woman's. University
Battle Creek, Michigan
Dallas, Texas
Suzanne F. Lockwood, EdD, APRN
Professor of Nursing
Karen S. Dealing
Montana State University-Northern
Assistant Professor
Havre, Montana
Brigham Young University
Provo, Utah
Barbara A. May, PhD, APRN, BC
Professor of Nursing
Leona F. Dempsey, RN, APNP, PhD
Linfield College
Assistant Professor
Portland, Oregon
University of Wisconsin, Oshkosh and Medication
Prescriber, Oshkosh Counseling and Wellness
Debby A. Phillips, PhD, APRN, CS
Center
Assistant Professor
University of Wisconsin Oshkosh Seattle University, College of Nursing
Oshkosh, Wisconsin Seattle, Washington
Kathy Quee, MScN Marilyn Siekierzynski, MSA, MSN, APRN-BC
Instructor Professor
British Columbia Institute of Technology Macomb Community College
Vancouver, British Columbia Clinton Township, Michigan
Canada
Jeanne M. Soucy, MS, RN, CS, CAGS
Karen Rich, PhD, RN Professor of Nursing
Instructor Mass Bay Community College
The University of Southern Miss Framingham, Massachusetts
Long Beach, Mississippi
<
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•
The fourth edition of Psychiatric-Mental Health Nursing PEDAGOGICAL FEATURES
%
maintains a strong student focus, presenting sound nurs-
Psychiatric-Mental Health Nursing incorporates several ped-
ing theory, therapeutic modalities, and clinical applica-
agogical features designed to facilitate student learning:
tions across the treatment continuum. The chapters are
short and the writing style direct in order to facilitate read- • Learning Objectives focus the students' reading and study.
ing comprehension and student learning.
o Key Terms identify new terms used in the chapter. Each
This text uses the nursing process framework and
term is identified in bold and defined in the text.
emphasizes assessment, therapeutic communication, neuro-
biologic theory, and pharmacology throughout. Inter- • Application of the Nursing Process sections use the
ventions focus on all aspects of client care, including com- assessment framework presented in Chapter 8, so stu-
munication, client and family education, and community dents can compare and contrast various disorders more
resources, as well as their practical application in various easily.
clinical settings.
• Critical Thinking Questions stimulate students' think-
This new edition is supported with a newly enhanced
ing about current dilemmas and issues in mental health.
ancillary package designed to assist instructors with course
planning and execution, and student evaluation; and to ® Key Points summarize chapter content to reinforce im-
portant concepts.
assist students with comprehensive knowledge synthesis.
• Chapter Study Guides provide workbook-style questions
for students to test their knowledge and understanding of
ORGANIZATION OF THE TEXT
each chapter
Unit 1: Current Theories and Practice provides a strong foun-
dation for students. It addresses current issues in psychi-
atric nursing as well as the many treatment settings in which
nurses encounter clients. It discusses thoroughly neurobio- • Clinical Vignettes are provided for each major disorder
logy theories, psychopharmacology, and psychosocial theo- discussed in the text to "paint a picture'" for better under-
ries and therapy as a basis for understanding menial illness standing.
and its treatment.
• Drug Alerts highlight essential points about psycho-
Unit 2: Building the Nurse-Client Relationship presents the tropic drugs.
basic elements essential to the practice of mental health
• Cultural Considerations sections appear in each chapter,
nursing. Chapters on therapeutic relationships and thera-
as a response to increasing diversity.
peutic communication prepare students to begin working
• Therapeutic dialogues give specific examples of nurse-
with clients both in mental health settings and in all other
client interaction to promote therapeutic communication
areas of nursing practice. The chapter on the client's
skills.
response to illness provides a framework for understanding
the individual client. An entire chapter is devoted to assess-
• Internet Resources to further enhance study are located
ment, emphasizing its importance in nursing.
at the end of each chapter.
Unit 3: Current Social and Emotional Concerns covers topics
• Client/Family Teaching boxes provide information that
that are not exclusive to mental health settings, includ-
help strengthen students' roles as educators.
ing legal and ethical issues; anger, aggression, and hos-
° Symptoms and Interventions are highlighted for chapters
tility; abuse and violence; and grief and loss. Nurses in all
in Units 3 and 4.
practice settings find themselves confronted with issues
related to these topics. Additionally, many legal and ethical
• Sample Nursing Care Plans are provided for chapters in
concerns are interwoven with issues of violence and loss.
Units 3 and 4.
Unit 4: Nursing Practice for Psychiatric Disorders covers all
• Self-Awareness features appear at the end of each chap-
the major categories identified in the DSM-IV-TR. Each ter and encourage students to reflect on themselves,
chapter provides current information on etiology, onset their emotions, and their attitudes as a way to foster both
and clinical course, treatment, and nursing care. personal and professional development.
ENHANCED ANCILLARY PACKAGE dents the opportunity to approach nursing care related
FOR THE FOURTH EDITION to mental health and illness in a novel way.
• Clinical Simulations on Schizophrenia, Depression, and the
Acutely Manic Phase that walk students through case
This fourth edition comes with a newly revised collection studies and put them in real-life situations.
of ancillary materials designed to help you plan class and
• Drug Monographs of commonly prescribed psycho-
clinical learning activities and evaluate students5 learning.
tropic drugs.
The Instructor Resource CD-ROM contains information and
activities that will help you engage your students through- These and other valuable student resources, including
out the semester, including NCLEX-style psychiatric nursing questions designed
to help students prepare to face exams armed with con-
• PowerPoint Slides
fidence and knowledge, are also available on thePoint-
h ttp ://thep oint. lww. com.
• Image Bank
° Test Generator
Additional content and technology resources are avail-
able online at thePoint—http://thepoint.lww.com—allowing ThePoint^ (h t tp:// thep oint. lww .com), a trademark of
instructors easy access to an extensive selection of materials Wolters Kluwer Health, is a web-based course and content
for each chapter, including management system providing every resource that instruc-
tors and students need in one easy-to-use site. Advanced
• Pre-Lecture Quizzes
technology and superior content combine at thePoint to
allow instructors to design and deliver online and off-line
• Discussion Topics
courses, maintain grades and class rosters, and communi-
• Written, Group, Clinical, and Web Assignments
cate with students. Students can visit thePoint to access
supplemental multimedia resources to enhance their learn-
° Guided Lecture Notes
ing experience, check the course syllabus, download con-
tent, upload assignments, and join an online study group.
Students
In addition, ThePoint Solution package includes an
online eBook, so students and instructors can search their
Free and bound in the book, the fourth edition CD-ROM
text electronically, plus journal articles to aid student
supplies the following learning tools:
learning.
• Movie Viewing Guides highlighting films depicting indi- ThePoint. . . where teaching, learning, and technology
viduals with mental health disorders and providing stu- click!
WW?
I am grateful to all the students in my classes who have taught me what I need to know to be
a better teacher. Their continued input helps make this text practical, interesting, and focused
on student learning.
I also want to thank the dedicated people at Lippincott Williams & Wilkins who provide all
the assistance and resources 1 need to make this text a success. To Renee Gagliardi, Katherine
Burland, Season Evans, Candice Davis, Mary Kinsella, and Margaret Zuccarini, I extend my
appreciation for a job well done.
And as always, my friends continue to be a -major part of my life—their support, encour-
agement, criticism, and loyalty help me in everything I do. My relationships with them help
make this text possible.
u-
t