Psychiatry for Nurses S Nambi
INDEX
A
Adjustment disorders 62
aetiology 63
nursing care 63
subtypes 62
Alcohol abuse 91
causes of 92
availability 92
biochemical factors 92
genetic factors 92
high risk groups 93
learned behaviour 92
personality factors 93
poor coping strategies 93
process of development 93
psychiatric disorders 93
social causes 93
physical complications of
blood 94
cardiovascular 94
gastrointestinal 94
joints 95
liver 94
muscle 94
nervous system 95
nutrition 95
pancreas 94
pregnancy 95
reproductive system 95
skin 94
psychiatric complications of 95
alcoholic dementia 96
alcoholic hallucinosis 95
alcoholic psychosis 96
amnestic disorder 96
delirium tremens (DT) 95
morbid jealousy 96
pathological intoxication 95
withdrawal phenomenon 95
management of alcoholism 97
alcoholics anonymous 98
aversion therapy 97
detoxification 97
disulfiram 97
nurses role in the prevention of 100
nursing care 98
delirium tremens 99
during later stage of hospitalisation 99
in the acute stage 98
social complications
drunken driving 96
work problems 96
Alzheimer's dementia 109
Amnesia
anterograde 137
classification of 137
confabulation 138
fugue state 138
organic 137
psychogenic 137
nursing care 139
retrograde 137
B
Basic psychology 14
defence mechanisms 15
characteristics of 15
dissociation 16
rationalisation 17
regression 17
repression 15
sublimation 16
their usage 15
personality
ego 15
id 15
super ego 15
Bio-feed back treatment 198
Brain
brain stem 18
cerebral cortex 18
limbic system 18
neurotransmitters
characteristics of 19
types of 19
Bulimia 141
C
Community psychiatry
mental health 163
definition of 164
mentally healthy person 164
characteristics of 164
prevention of mental illness
primary prevention 165
secondary prevention 166
tertiary prevention or rehabilitation 166
D
Drug abuse 90, 100
addict 101
cannabis 102
psychiatric complications of 102
common drugs abused 101
drug addiction 90
drug dependence 90
types of abused substances 91
factors involved in 101
narcotics 102
psychiatric complications of 103
E
Eating disorders
anorexia nervosa 139
clinical picture 140
treatment 140
Epilepsy 114
and mental illness 116
causes of 114
diagnosis 117
management of 117
nursing care 117119
psychiatric disorders 116
types of
focal 115
grand mal 115
status epilepticus 116
temporal lobe 115
G
General hospital psychiatry 239
common mental health problems 239
maladaptive psychological reactions to illness 240
guilt-fear 240
organic mental disorders 240
delirium 240
psychosomatic disorders 240
H
Healthy person, characteristics of 22
I
Insomnia 134
causes of
behavioural 134
drug-related 135
endocrine 134
physical 134
psychiatric 135
social 135
treatment of 135
non-drug 136
sleep environment 136
sleep hygiene 136
M
Mania 74
aetiology of 75
biological factors 75
psychological factors 75
clinical features 75
forms of 76
management of
diet 76
drug treatment 76
emotional needs 77
hospitalisation 76
therapeutic environment 77
primary mania 75
Medical complications
psychiatric drugs leading to 241
Medical set up 4
Memory disorders 136
immediate memory 137
recent memory 137
remote memory 137
Mental disorders 28, 36, 37, 39
abnormality 36
concept of 36
aetiology (causes)
bio-chemical 37
biological factors 37
perpetuating factors 39
precipitating factors 39
predisposing factors 39
psychosocial factors 38
social factors 38
classification of 39
concept 28
mental illness 29
affect of mood 34
characteristics of 29
consciousness 34
disturbance in motor activities 35
disturbance of memory 33
disturbance of perception 32
general behaviour 29
ideas of reference 32
symptoms of 29
treatment, physical methods 168
drug treatment 169183
electro convulsive therapy 183
psychosurgery 187
treatment, psychological methods 188
psychotherapy 188
Mental health, definition 21
Mental health education 22
its programmes 22
overcoming prejudices 23
Mental health problems 142
delirium
management of 156
nursing care 157
paranoid disorders 157
dementia
causes of 153
diagnostic features of 154
management of 155
in adolescents
management of 146
social factors that affect adolescents 146
in children 142
role of a nurse 145
in old age 151
depression 152
human ageing 151
psychiatric illness 152
in women 147
menopause 150
psychiatric disorders 148
Mental health services
in India 24
facilities available 25
NMHP 26
Mental retardation 120
assessment of the need 124
causes of 122
antenatal damage 122
cranial malformations 122
cretinism 123
Downs syndrome 123
genetic 122
gross disease of the brain 122
metabolic disorders 122
perinatal 122
phenylketonuria 123
post-natal damage 122
classification of 120
custodial care 125
education of 124
health education regarding 126
parent's counselling 127
nursing care of 124
prevention of 125
recognition of 121
rehabilitation of 124
training 124
Mentally ill persons 231
criminal responsibility of 231
civil responsibility 231
Milieu therapy 202
Mood disorder 68
classification of 68
depression 69
aetiology of 71
bipolar disorders 70
complications of 72
dysthymic disorder 70
management 72
nursing care 73
N
Neurotic disorders 48
anxiety disorders 48
generalised anxiety disorder 49
panic disorder 51
hypochondriasis 59
hysteria 55
characteristics of 56
conversion hysteria 57
dissociative disorder 57
fugue 57
hysterical amnesia 57
hysterical personality 56
management of 58
multiple meaning of 56
multiple personality 58
obsessive compulsive disorder 54
causes of 55
treatment of 55
phobic disorder 52
agora phobia 53
nursing care of 59
phobia 52
simple phobia 53
social phobia 54
treatment of 54, 194
Neurotic persons 46
causes
environmental stress 47
individual susceptibility 47
interpersonal problems 47
intrapsychic conflict 47
characteristics of 46
Normal sexual behaviour
genital response 128
orgasm 128
sex drive 128
sexual arousal 128
Nurse role in
community mental health services 237
general hospital setting 237
mental hospital 237
psychiatric institutional setting 236
Nursing care of
AIDS patient 225
counselling 226
neuropsychiatric complications 225
deluded patients 224
dying patients 227
mentally ill accident prone 220
suicidal patient 222
violent patient 217
withdrawn patient 218
O
Organic mental disorders 105
delirium 105
causes of 106
clinical features 106
management of 107
dementia 107, 153
causes of 108, 153
clinical features 109
management 110
head injury 112
psychiatric aspects of 112
parkinsonism 112
psychiatric aspects of 112
P
Personality disorders 64
aetiology 66
characteristics of 64
main personality disorders 65
psychotherapy 66
management of 67
nursing care of 67
Physical complaints 240
psychiatric conditions presenting with 240
Psychiatric care 5
early asylums 6
psychiatric hospital 7
functions of 7
lunatic asylums 8
therapeutic community 7
Psychiatric complaints 241
medical drugs leading to 241
physical conditions presenting with 241
Psychiatric emergencies 204
approach to 204
types of 204
acute dystonia 214
alcohol and addiction forming drugs 212
attempted suicide 205
delirium 206
epilepsy related emergencies 211
excitement 206
lithium toxicity 215
panic attack 210
refusal of food 215
stupor 206
Psychiatric examination 42
format for examining psychiatric patients 42
basic information 42
complaints 42
family history 43
history of present illness 42
mental status examination 43
personal life history 42
personality 43
previous illnesses 42
writing a relevent case sheet 45
Psychiatric nursing 1, 9, 11, 229
definition 9
qualities of an ideal psychiatric nurse 10
development of 11
future of 13
legal aspects of 229
crime 230
psychiatric disorders 230
need for 1
paramedical personnel 3
psychotherapist 3
rehabilitation programmes 3
surrogate mother 3
Psychiatric set up 4
Psychiatry in India 232
law relating to 232
admission in the psychiatric hospital 232
Psychologically ill 2
Psychophysiological disorders 158
psychosocial theories
biological theory 159
family dynamic theory 159
learning theory 159
personality theory 159
psychosomatic disorders 159
asthma 160
coronary heart disease 160
irritable bowel syndrome 161
nursing care in 161
peptic ulcer 161
Psychotherapy 189
behaviour therapy 194
bio-feed back treatment 198
cognitive therapy 192
crisis intervention 193
family therapy 190
group therapy 189
encounter groups 190
psychodrama 190
T-groups 190
traditional group therapy 190
hypnotherapy 192
individual psychotherapy 189
psychoanalysis 191
relaxation therapy 195
meditation 197
relaxation exercises 195
yoga 197
R
Rehabilitation 199
half-way home 203
industrial therapy 201
occupation therapy
advantages 200
aim 200
nurses role 201
recreational therapy 201
therapeutic community 202
characteristic of 202
S
Schizophrenia 78
aetiology of
biochemical factors 79
environmental factors 80
genetic factors 79
psychological factors 80
clinical features of 81
autism 82
behavioural change 83
bizarre mannerisms 83
catatonic excitement 83
emotional disturbance 82
hallucinations 83
sleep disturbances 83
thought disturbance 81
volitional disturbance 82
management of 85
nursing care 8689
treatment methods 86
types of 83
catatonic 84
classification of 84
hebephrenic 83
paranoid 83
residual 84
simple 84
undifferentiated 84
Sexual disorders 128, 131
classification of
parasomnias 133
primary sleep disorders 133
secondary sleep disorders 133
disorders of sexual preference 131
gender identity disorder 130
sexual inadequacies 129
sexual orientation disorder-homo sexuality 131
×
Chapter Notes

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1Psychiatry for NURSES
2Psychiatry for NURSES
S Nambi MD DPM FIPS Psychiatrist and Assistant Professor of Psychiatry Institute of Mental Health Chennai
3Published by
Jitendar P. Vij
Jaypee Brothers Medical Publishers (P) Ltd.
B-3 EMCA House, 23/23B Ansari Road, Daryaganj
Post Box 7193, New Delhi 110 002, India
Phones: 3272143, 3272703, 3282021 Fax: 011-3276490
Visit out web site: http://www.clinichem.com
Branches
Psychiatry for Nurses
© 1998, S Nambi
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
This book has been published on good faith that the material provided by author is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author (s) will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters to be settled under Delhi jurisdiction only.
First Edition : 1998
Production Manager: P. S. Ghuman
9788171796274
Typeset at JPBMP typesetting unit
Printed at Lordson, C-5/19, Rana Pratap Bagh, Delhi 110 007
4
To
The Suffering Mentally
Ill Persons
5Preface
‘Care of the human mind is the most noble branch of medicine’
Stress of modern life and rapid social changes, accelerated by modern technological achievements, have powerful effects on people's mental health and the quality of their life.
Psychiatric nursing has emerged as a specialised branch of nursing in the recent past in India. Psychiatric training for nurses is essential not only to manage the severely mentally ill or psychotic patients but also to so many other psychological problems which include depression, anxiety and other neurotic disorders, psychosomatic disorders, problems due to alcohol and drug dependence, emotional problems of children, adolescents and elderly population. Apart from these, patients suffering from physical illnesses are also having associated emotional problems, because of the intimate relationship of the body and the mind. The nurse should be able to recognise and take care of these mental health problems. It requires knowledge and application of technical skills.
This book Psychiatry for Nurses is written basically for student nurses, who are undergoing training in Mental Health Nursing and who have to write in their examination about psychiatry and psychiatric nursing. This book may also be useful for nurses who work with the mentally ill people in different set-ups like general hospital psychiatric departments, psychiatric hospitals and nursing homes and in community mental health programmes. The purpose of this book is to present a clear and concise account of the common mental health problems, their management and nursing care. The important aim of this book is to introduce nursing students a theoretical and practical approach of the care of the mentally disturbed persons. A sincere attempt has been made in this book to organise current practice of psychiatric nursing so as to enable the nurses to develop an understanding of the complexity of human behaviour and the treatments designed to alter adaptive behaviour. The chapters in this book are formulated 6on the syllabus recommended by the Nursing Council of India for the diploma and degree students of Nursing. The nursing students can confidently face their psychiatric nursing examination and manage the emotionally disturbed patients more effectively with the help of this book.
I am indebted to the Director, Institute of Mental Health, Chennai, for his support and encouragement to write this book. I extend my thanks to my wife Dr Shanthi who has provided the essential assistance. I also thank Ms MR Vijayalakshmi and Mr Ananda Padmanaban for their secretarial assistance. My sincere thanks to Jaypee Brothers Medical Publishers for publishing this book.
S Nambi