MH- Personality disorders
Gambling, binge eating, and engaging in unsafe sex are examples of what?
impulsivity
Which personality disorder is most commonly found in clinical settings?
borderline personality
narcissistic personality disorder
-Characterized by a grandiose sense of self-importance -A preoccupation with fantasies of success or power -Aneed for constant attention or admiration
histrionic personality disorder
-Excessive emotionality and preoccupation with being the center of attention -Emotional shallowness -Overly dramatic behavior *attention seeking
histrionic personality disorder Nursing actions
-Feedback about social interactions -social skills training through role-playing -Exploration of strengths and assets
paranoid personality disorder nursing actions
-Formal, business like approach -Client involvement in plan of care -Validate idea before action
borderline personality disorder
-Lack of stability in interpersonal relationships, self-image, and emotion -Impulsivity -Angry outbursts -Intense fear of abandonment -Recurring suicidal gestures
The nurse is in charge of an inpatient psychiatric unit is frustrated and angry with a client who has borderline personality disorder. Which steps should the nurse take?
Examine the nurses own feelings to discover the source of the nurses anger
The nurse is conducting an education group for women at risk for self-mutilation. What is the most important goal for this group?
Learning strategies to refrain from self-harm
dependent personality disorder
A personality disorder characterized by a pattern of clinging and obedience, fear of separation, and an ongoing need to be taken care of.
antisocial personality disorder
A personality disorder in which the person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members. May be aggressive and ruthless or a clever con artist. -Disregard for rights of other, rules, and laws
Avoident personality disorder nursing actions
Self-affirmations Positive self-talk Reframing and decatastrophizing Social skills training
Mental health promotion of personality disorders
Treatment focuses on: -mood stabilization -decreasing impulsivity -developing social and relationship skills
Cluster A personality
Odd or eccentric behaviors 1. Paranoid 2. Schizoid 3. Schizotypal
Clients with borderline personality disorder (BPD) are usually admitted to the inpatient setting because they exhibit what?
self-harm
A client on an inpatient psychiatric unit has features of borderline personality disorder. The client is frequently angry, has an unstable sense of self, and is highly impulsive. The client can be verbally abusive to staff, who feel manipulated by the client's behaviors. Which intervention does the nurse determine as priority?
setting limits
paranoid personality disorder
type of personality disorder characterized by extreme suspiciousness or mistrust of others -Guarded -Restricted affec
A client with borderline personality disorder starts flirting with the nurse, saying the client dreams about the nurse at night and wants to kiss the nurse. What would be the best response by the nurse?
"I feel uncomfortable with what you said. My role is to support you in recovery."
A 43-year-old female client is observed walking and dancing around the unit dressed in red high heels and a provocative style of dressing. The client is seen sitting on the lap of a male client on the unit, and they are laughing. Which is the most therapeutic nursing intervention?
"I need you to get off his lap, this behavior is not appropriate."
Which is considered the etiology of personality disorders?
A combination of psychosocial and biologic variables
schizoid personality disorder nursing actions
- Focus on self-care and social skills - Encouragement of daily routines - Identifying appropriate outlets for discussing unusual beliefs
Etiology of personality disorders
- Interaction of hereditary dispositions - Environmental influences - Biological theories (temperament) - Psychodynamic theories (character)
A nurse is conducting an inservice program on personality disorders. When describing obsessive-compulsive personality disorder, which characteristic(s) would the nurse most likely include? Select all that apply.
- Preoccupation with control - Strict attention to rules - Difficulty with decision making - relationships primarily formal and polite
borderline personality disorder Nursing actions
-SAFETY -Therapeutic relationship (structured, with limit setting) -Strict adherence to boundaries -communication skills - Coping, emotion control -Reshaping thinking patterns -Structuring of daily activities
narcissistic personality disorder Nursing actions
-Self awareness skills to avoid anger and frustration -Matter-of-fact approach -Limit setting
When developing the plan of care for a client with borderline personality disorder (BPD), which areas would the nurse identify as likely problematic?
-Sleep -Nutrition -Self-harm
antisocial personality disorder Nursing actions
-Therapeutic relationship; promoting responsible behavior (limit setting, confrontation) -Problem-solving; control of emotions (taking a time out) - Improving role performance
A nurse is preparing a presentation for a group of staff nurses on personality disorders. When describing antisocial personality disorders (ASPD), the nurse would explain that for a person to be diagnosed with the disorder, the person must be at least which age?
18 years
A client comes to the clinic for a follow-up visit. Despite being warm and friendly with the nurse on a previous visit, today the client presents with anger and sarcastic undertones with the same nurse. The client is presenting which behavior commonly seen in borderline personality disorder?
Affective instability
Cluster C personality Disorders
Anxious and fearful behaviors 1. Avoidant 2. Dependent 3. Obsessive compulsive
dependent personality disorder nursing actions
Assistance in expressing grief and loss Assistance in daily functioning Teaching problem solving
Impulsivity and difficulty controlling anger are characteristic of which mental health diagnosis?
Borderline personality disorder Explanation: Impulsivity and difficulty controlling anger are characteristic of borderline personality disorder
The nurse prepares to admit a client with a diagnosis of schizoid personality disorder. What clinical presentation would the nurse expect?
Constricted affect and passive tone of voice
Treatment resistant
Describes psychological disorders that have not responded to multiple trials of medications. -It is difficult to change a persons personality
obsessive-compulsive personality disorder nursing actions
Different perspective on decision making Cognitive restructuring Risk-taking
What occurs when thinking, feeling, or behaviors occur outside a person's awareness?
Dissociation
Cluster B personality disorders
Erratic or dramatic behaviors 1. Antisocial 2. Borderline 3. Histrionic 4. Narcissistic
Age related considerations for personality disorders
Not formally diagnosed until 18 years old Not observed through childhood Not first diagnosed in older adults
A client with borderline personality disorder has been admitted to the inpatient unit after being found in the client's parents' bedroom, burning the client's arm with an iron. This injury required a brief stay in the hospital's burn unit prior to transfer to your psychiatric unit. Which is the nursing care priority for this client during the first 24 hours of admission?
Protection from self-mutilation
Which technique used to help the client with borderline personality disorder gain control over self-critical thoughts?
Thought stopping
obsessive-compulsive disorder (OCD)
a disorder in which repetitive, intrusive thoughts (obsessions) and ritualistic behaviors (compulsions) designed to fend off those thoughts interfere significantly with an individual's functioning
Schizotypical Personality Disorder
a personality disorder characterized by extreme discomfort in close relationships, odd forms of thinking and perceiving, and behavioral eccentricities -Cognitive or perceptual distortions
avoidant personality disorder
a personality disorder characterized by inhibition in social situations; feelings of inadequacy; oversensitivity to criticism
schiziod personality disorder
odd-eccentric personality disorder characterized by a desire to avoid close relationships as well as by emotional aloofness, reclusivity, and a lack of humor usually do not date or marry -Involved with "things" more than people
