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ATI chapter 29 Crisis Management
Terms in this set (23)
acute, time-limited (lasting 4-6 weeks) event that a client experiences an emotional response that can't be managed with normal coping mechanisms.
is a personal struggle for equilibrium and adaptation.
What might be considered a crisis for one person may not be so for another.
- Sudden event with little or no time to prepare
- Perception of the event as overwhelming or life-threatening
- Loss or decrease in communication with significant other
- Sense of displacement from the familiar
- An actual or perceived loss.
3 types of Crisis
often unanticipated loss or change experienced in every day, often unanticipated, LIFE events.
ex: severe physical illness, loss of job
achieving new developmental STAGES, which requires learning additional coping mechanisms.
the occurrence of NATURAL disasters, crimes, or national disasters. Large scale psychological trauma caused by natural disaster.
Rape, not part of everyday life
crisis (risk factors)
- Accumulation of unresolved losses
- Life stressors, concurrent mental and physical health issues
- Excessive fatigue or pain,
- Age and developmental stage
- support system
- prior experience with stress/crisis
crisis (nursing history)
suicidal or homicidal ideation requiring hospitalization, client's perception of the precipitating event, cultural or religious needs, support system and present coping skills.
crisis phase 1
escalating anxiety from a threat activates increased defense responses.
crisis phase 2
anxiety continues escalating as defense response fail, functioning becomes disorganized, and the client resorts to trial and error attempts to resolve anxiety.
crisis phase 3
trial-and-error methods of resolution fail, and the clients anxiety escalates to severe or panic levels, leading to flight or withdrawal behaviors.
crisis phase 4
client experiences overwhelming anxiety that can lead to anguish and apprehension, feeling of powerlessness and being overwhelmed, dissociative symptoms (depersonalization, detachment from reality), depression, confusion, and/or violence against others or self.
provides rapid assistance for individuals or groups. the initial task for the nurse it to provide a sense of safety by assessing clients potential suicide or homicide.
Crisis intervention (initial interventions)
Identify current problem and direct interventions for resolution, take an active, directive role with the client, help client set realistic and attainable goals.
Critical Incident Stress Debriefing
is a group approach that can be used with a group of people who have been exposed to a crisis situation.
Crisis Client Safety
Initiate hospitalization to protect clients who have suicidal or homicidal thoughts.
Prioritize interventions to address the client's physical needs first.
* Decrease Anxiety
Develop a therapeutic nurse-client relationship, remain with the client, listen and observe, eye contact, ask questions related to the client's feelings, ask questions related to the event, demonstrate genuineness and caring, clear communication if needed with clear directives, avoid false reassurance and non therapeutic response, relaxation techniques, ID and teach coping skills
Crisis plan of action
short-term, no longer than 24-72 hr, focused on the crisis and realistic and manageable.
administer anti-anxiety and/or antidepressants (paxil) medication as prescribed.
Crisis client education
Identify and coordinate with support agencies and other resources. Plan and provide follow up care.
primary care: collaborate with client to identify potential problems; instruct on coping mechanisms and assist in lifestyle changes
secondary care: collaborate with client to identify interventions while in an acute crisis that promote safety
tertiary care: collaborate with client to provide support during recovery from severe crisis that include outpatient clinics, rehab centers, and workshops
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