Exam objcetives

Principle of de-escalation: calm demeanor

Speak softly and stay calm, even if patient is yelling.

Principle of de-escalation: respect space

Give patient space to feel safe; do not invade their personal area.

Principle of de-escalation: set limits

Use simple, clear statements to set behavioral boundaries.

Principle of de-escalation: acknowledge feelings

Say things like 'I can see you're upset' to validate them.

Seclusion/restraint appropriate when

1) Immediate risk to self or others, 2) Verbal de-escalation fails.

Abuse interview area: coping

Assess how the patient deals with stress or danger.

Abuse interview area: support

Find out if they have safe people to turn to.

Abuse interview area: safety

Ask about suicidal or homicidal thoughts.

Abuse interview area: physical signs

Look for injuries or signs of neglect.

Safety plan: location

Know where to go in an emergency (friend's, shelter).

Safety plan: contacts

Keep emergency numbers accessible.

Safety plan: bag

Pack ID, money, medications, legal papers.

Safety plan: code

Use code word to alert someone about danger.

Abuse therapy: family therapy

Improves communication and support.

Abuse therapy: CBT

Helps change harmful thoughts and behaviors.

Abuse therapy: group therapy

Support from others with similar experiences.

ASD features

Poor eye contact, repetitive behaviors, trouble with changes.

ADHD features

Fidgeting, interrupting, can't focus or sit still.

Intellectual disability features

Delayed learning, low IQ, trouble with daily tasks.

Behavioral therapy

Teaches appropriate behaviors using rewards.

CBT for children

Helps kids change negative thoughts/behaviors.

Play therapy

Children express feelings using toys.

Family therapy

Improves family communication and reduces conflict.

Social skills training

Teaches children how to interact with others.

Medications for neuro disorders

Stimulants, antidepressants, antipsychotics.

Marital rape

Sexual assault between spouses.

Statutory rape

Sex with a minor, even if consensual.

Date rape

Assault that happens during a social interaction.

Drug-facilitated assault

Offender uses substances to impair victim.

Rape reaction: emotional

Numbness, shock, fear.

Rape reaction: physical

Trouble sleeping, headaches, nausea.

CPT therapy

Changes negative thoughts about the trauma.

Prolonged exposure

Talks about trauma in a safe, gradual way.

EMDR therapy

Uses eye movement to process trauma.

Therapy evolution: past

Institutions and talk therapy.

Therapy evolution: now

Medications + therapy + trauma-informed care.

Somatic Symptom Disorder

Multiple physical symptoms with no medical reason.

Illness Anxiety Disorder

Fear of serious illness with little/no symptoms.

Conversion Disorder

Sudden neurological symptoms (e.g., paralysis) with no cause.

Factitious Disorder

Faking illness to get attention.

Nursing dx for somatic

Ineffective coping, chronic pain.

Anorexia Nervosa

Extreme weight loss, fear of gaining weight.

Bulimia Nervosa

Bingeing followed by vomiting or laxatives.

Binge-Eating Disorder

Eating large amounts without purging.

Bipolar I symptoms

Full mania + possible depression.

Bipolar II symptoms

Hypomania + major depression.

Cyclothymia

Mood swings that are less extreme than bipolar.

Bipolar meds: lithium

Stabilizes mood swings.

Bipolar meds: antipsychotics

Used for severe mania.

Bipolar meds: antidepressants

Used cautiously with mood stabilizer.

Personality disorder: paranoid

Distrusts others.

Personality disorder: schizoid

Emotionally detached, prefers to be alone.

Personality disorder: schizotypal

Odd beliefs and behaviors.

Personality disorder: antisocial

Breaks rules, no empathy.

Personality disorder: borderline

Unstable emotions, impulsive.

Personality disorder: histrionic

Dramatic, needs attention.

Personality disorder: narcissistic

Feels superior, lacks empathy.

Personality disorder: avoidant

Avoids people, fear of rejection.

Personality disorder: dependent

Needs others to make decisions.

Personality disorder: OCPD

Perfectionist, rigid.

Antisocial nursing outcome

Follows rules without manipulating.

Borderline nursing outcome

Manages emotions without self-harm.