Mental Health Nursing I NURS 1300 Unit VI Abuse Related Disorders

Objective 1 Define substance abuse Substance abuse is the overindulgence in, and dependence on, a psychoactive material leading to effects that are detrimental to the individual’s physical or mental health, or the welfare of others

Objective 2 List the risk factors for substance abuse Family or work conflict Family history Poor coping skills Favorable attitudes toward substance abuse Peer pressure Personality or psychiatric disorder

Objective 3 State the factors present in the substance abuser Giving up past activities Work or school conflicts Aggressiveness and irritability Forgetfulness Feelings of hopelessness, depression, and suicidal thoughts Frequent hangovers and “blackouts” Pressuring others to drink Legal trouble Drug paraphernalia

Objective 4 List the major drugs that are abused Alcohol Stimulants Depressants Hallucinogens Narcotics Inhalants Designer drugs

Objective 5 Compare the symptoms of alcohol abuse and drug abuse

Alcohol Physically addicting Distortions in thinking Stimulants Psychological dependence Euphoria followed by profound depression & sense of exhaustion Irritability, combativeness, & paranoia

Depressants Physical dependency Sedation Impaired coordination Narcotics Pleasant euphoria Feeling of immunity to stressors

Hallucinogens Dream-like perceptions Altered sense of time Feelings that one has attained special insight Intensified & labile emotions Depersonalization Inhalants Produces mind-altering response

Objective 6 List treatments for the client who abuses Inpatient hospitalization for detox Medications Antabuse Methadone Catapres Narcan

Objective 6 (cont’d) Support groups Alcoholics Anonymous (AA) Narcotics Anonymous (NA) Al-Anon groups for family of abusers Aftercare and recovery Partial day programs Halfway houses

Objective 7 Describe nursing care for the substance abuser

Physical assessment vital signs symptom scale Medication administration Patient teaching actions and consequences Provision of adequate hydration and nutrition Reassurance and support for anxiety Relapse prevention

Objective 8 Define abuse and victim Abuse is a general term for the use or treatment of someone or something that causes some kind of harm or is unlawful or wrong. A victim is one who is harmed by or made to suffer from an act, circumstance, agency, or condition.

Objective 9 Differentiate among different kinds of abuse Sexual abuse Physical abuse Verbal abuse Emotional abuse Child abuse Incest Spousal abuse Elder abuse

Objective 9 (cont’d) Sexual abuse = improper use of another person for sexual purposes, generally without their consent or under physical or psychological pressure Physical abuse = when one person inflicts physical violence or pain on another Verbal abuse = when a person uses profanity or says things that threaten or make a person feel scared Emotional abuse = coercion, humiliation, intimidation, relational aggression, parental alienation, or covert incest

Objective 9 (cont’d) Child abuse = abuse, usually physical, emotional or sexual, directed at a child Incest = sexual activity between close family members Spousal abuse = abuse, usually physical or psychological, directed at one’s spouse Elder abuse = abuse, most often physical or in the form of psychological threats, directed at the elderly, especially in nursing homes and similar institutions

Objective 10 Compare characteristics of an abuser and the victim

Characteristics of an abuser Jealousy Controlling behavior Quick involvement Isolation Blames others for feelings Cruelty to animals Hostility while drinking Breaking or striking objects when angry Threats of violence Use of force during an argument

Characteristics of a victim Blames self for violence or harmful acts Dependent on abuser wants to be controlled feels need to be taken care of Poor self-image Expects abuser to change Returns to abuser after assault(s) Makes excuses for abuser Defends abuser’s actions

Objective 11 Identify nursing care to help survivors of abuse Assess client for possible abuse history Provide abuse hotline phone numbers Remove client from hostile situation Refer client to community resources Treat client for depression, anxiety, and suicidal thoughts Provide supportive, nurturing environment to discuss feelings

Objective 12 Identify situations that constitute elder abuse

Objective 12 (cont’d) Physical abuse injury impairment physical pain threat of physical force inappropriate use of chemical and physical restraints rough handling providing care moving the body administering medication

Objective 12 (cont’d) Emotional abuse psychological verbal isolating the elder from family, friends, and/or regular activities treating the elder like an infant Neglect or abandonment of elders by caregivers Financial exploitation of an elder

Objective 12 (cont’d) Self-neglect by elder leaving the stove on unattended denying or ignoring need for food, water, hygiene, safety, or medications Sexual abuse of the elderly showing the elder pornographic material telling dirty jokes Healthcare fraud or healthcare abuse of the elderly

Objective 13 Know the procedures as stated in Nebraska law for reporting suspected abuse See Report of Abuse handout