,NEEB’S
Mental Health
Nursing
FIFTH EDITION
Linda M. Gorman, RN, MN, PMHCNS-BC, FPCN
Clinical Nurse Specialist/Nursing Consultant
Private Practice
Studio City, California
Robynn F. Anwar, MSN.Ed
Nursing Faculty/CNA/MST and Simulation Lab Coordinator
Camden County College
Blackwood, New Jersey
,F.A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com
Copyright © 2019 by F.A. Davis Company
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As new scientific information becomes available through basic and clinical research, recommended treatments
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Library of Congress Cataloging-in-Publication Data
Names: Gorman, Linda M., author. | Anwar, Robynn F., author | Preceded by (work): Gorman, Linda M.
Neeb’s fundamentals of mental health nursing.
Title: Neeb’s mental health nursing / Linda M. Gorman, Robynn F. Anwar.
Other titles: Mental health nursing
Description: 5th edition. | Philadelphia, PA : F.A. Davis Company, [2019] | Preceded by Neeb’s fundamentals
of mental health nursing / Linda M. Gorman, Robynn F. Anwar. Fourth edition. 2014. | Includes bibliographical
references and index.
Identifiers: LCCN 2018034469 (print) | LCCN 2018035960 (ebook) | ISBN 9780803690134 (paperback) |
ISBN 9780803669130 (alk. paper)
Subjects: | MESH: Mental Disorders—nursing | Psychiatric Nursing—methods | Nursing, Practical
Classification: LCC RC440 (ebook) | LCC RC440 (print) | NLM WY 160 | DDC 616.89/0231—dc23
LC record available at https://lccn.loc.gov/2018034469
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, To Corie, who saw me as an author many years ago.
~ (LG)
To my mother Mayme, I realize how much easier this
journey would have been if you were here. Wasim my
husband and daughter Andrea, I appreciate your belief
in my abilities. Bessie Blount “Mom Bessie,” who
invented the emesis basin and at the age 94, renewed
her practical nurse license. To Aunt Shirley, Toni
(sister), and Ted (brother), my family. Linda, thank
you for being my mentor and friend. —Thank you.
~ (RA)
, Acknowledgments
The staff of F.A. Davis including Terri Allen,
Shana Murph, and Marcia Kelley provided us with
the support and of course attention to detail we
needed to complete this project. They all worked
closely with us to enhance the fifth edition.
—Linda Gorman
Robynn Anwar
iv
, Preface
The Fifth Edition of Neeb’s Mental Health Nurs- expanded information on common mental health
ing is a psychiatric nursing text tailored specifi- disorders, and emphasis on safety issues are
cally to the needs of the LPN/LVN student. We some of the areas emphasized.
understand that many students at this level of Chapters 1 to 9 provide the basics of mental
preparation do not have the opportunity for clini- health nursing concepts, with an emphasis on com-
cal experience in a psychiatric setting, but they munication. Chapters 10 to 22 are “clinical” chapters
will encounter patients with mental health issues in that they cover specific diagnoses and/or popula-
in their rotations and throughout their careers. tions. Many of the chapters include the following
Students will encounter patients and their families new or enhanced key features which make the book
with psychiatric diagnoses as well as a variety of easy to use to gain important knowledge:
psychosocial issues and behavior that challenge
them. This text provides the basic knowledge and • Neeb’s Tip gives a “clinical pearl” that
skills to address many of these challenges, with succinctly describes a key take-away from
an emphasis on communication. This new edition the chapter.
also brings enhancements via the Internet through • Critical Thinking Questions are expanded and
DavisPlus including updated Interactive Clinical interspersed in the chapters to emphasize a
Scenarios addressing a variety of mental health concept and challenge the student to apply the
disorders. The book incorporates “LPN/LVN concept just covered. Many of these include
Connections” as part of F.A. Davis’s commitment case-based scenarios.
to enhancing education for these students. • Toolbox provides additional resources for
The impact of psychiatric disorders continues students who want more information.
to be a concern in the United States. Depression, • Pharmacology Corner in Chapters 10 to 20 and
anxiety, eating disorders, and substance abuse con- 22 covers important current information about
tinue to be major health problems. The care of medications used for the specific population
those with serious mental illnesses presents many that will pertain to the LPN/LVN scope of
challenges for the courts, law enforcement, and practice.
throughout health care especially around the grow- • Clinical Activities are suggestions for the
ing homeless populations. How society responds student to utilize when caring for patients
to debilitating mental illness has been the subject with a particular disorder.
of much debate. Clearly the need for nurses to • Classroom Activities include suggestions for
have education in caring for people with mental projects or actions that students and faculty
health issues is essential. can use in the classroom to enhance learning.
Our goal with this text is to provide basic in- • Case Studies are in-depth, with questions to
formation about mental health theories, personal- help the student apply knowledge learned in
ity development, coping and communication the chapter.
styles, psychiatric diagnoses, psychosocial reac- • Safe, Effective Nursing Care (SENC) highlight
tions, and nursing actions, all as they pertain to the key activities for the student to focus on
practice of the LPN/LVN. The emphasis through- ways to promote safety and improved patient
out is on enhancing skills that students can utilize outcomes.
in any setting to recognize and assist those with • Multiple Choice Questions—At least 10 questions
psychosocial and psychiatric issues. Communica- are provided at the end of each chapter, with the
tion approaches are emphasized. answers on the page for easy reference, and the
The Fifth Edition of Neeb’s Mental Health answers and rationales in Appendix A.
Nursing brings updated information from the • Sample Care Plans are provided in the clinical
last edition which expanded on the foundations chapters.
that Kathy Neeb created so successfully in the • Appendix E matches common behaviors with
first three editions. New pharmacologic therapies, nursing diagnoses.
v
,vi Preface
For the instructor, this Fifth Edition provides ac- to the LPN/LVN student. Now with this Fifth Edi-
cess to revised and updated PowerPoint presenta- tion, we are continuing our focus on providing the
tions, test bank questions, and other expanded students with concise yet comprehensive informa-
features. tion that will meet the needs of students who are
As with the Fourth Edition, this new edition facing an ever more complex health-care system.
utilizes the terminology from the Fifth Edition of We, as practitioners and educators in the field of
the Diagnostic and Statistical Manual for Mental mental health, have seen the impact of mental
Disorders by the American Psychiatric Associa- health issues on our patients and society. We hope
tion that was published in 2013 which reflects the that the students who utilize this book will gain a
most current thinking in psychiatry. Use of current new perspective that includes up-to-date knowl-
terminology for diagnoses is used throughout the edge as well as empathy for the suffering these dis-
book. It is essential for the LPN/LVN student to orders can cause. We hope this book will contribute
be exposed to the most current information as to knowledgeable and compassionate LPNs/LVNs.
they interface with other health-care professionals
in the course of student rotations. Linda Gorman
As authors of the Fourth Edition of this text, we Robynn Anwar
sought to promote ways to impart more knowledge
LPN/LVN CONNECTIONS
F.A. Davis is pleased to introduce LPN/LVN • Concepts
Connections, a consistent and recognizable ap- • Bulleted Key Points
proach to design and content that will make it • NCLEX-style Review Questions, with an-
easier for students and instructors to use multiple swers right on the page for ease of reference
F.A. Davis textbooks throughout the LPN/LVN • Chapter references, located online
curriculum. • A Reading Level Evaluation is performed dur-
We have increased continuity whenever possi- ing the manuscript development, to ensure
ble, without erasing the authors’ autonomy or readability
changing legacy content that has been popular in • A uniform, space-saving internal design fea-
past editions. This makes it easier for instructors and tures special heads and colors that are shared
students to move through the textbooks and ancil- across titles for features with similar content,
lary products while recognizing shared themes and to increase recognition
featured content.
Standardized Faculty Resources
Textbook Design, Style & Pedagogy • Active Classroom Instructor’s Guide (ACIG)
• All textbook chapters include: provides pre-, during, and post-class sugges-
• Numbered Learning Outcomes tions for activities and assignments
• Key Terms listed on the chapter opener, • eBook
boldfaced where first defined in the • NCLEX-style test bank
chapter • PowerPoint presentations
, Preface vii
F.A. DAVIS LPN/LVN ADVISORY BOARD
The authors and publisher extend a special thank Kaye Henry, BSN
you to the F.A. Davis LPN/LVN Advisory Board,
Program Director
whose members have provided guidance through
School of Practical Nursing
their experience and expertise:
Georgia Piedmont Technical College
Deborah D. Brabham, PhD, RN, CNE Covington, Georgia
Instructional Program Manager, Frisch Institute Dawn Johnson, DNP, RN, Ed
for Senior Care
Practical Nursing Program Director
Florida State College at Jacksonville
Great Lakes Institute of Technology
Jacksonville, Florida
Erie, Pennsylvania
Mark Donoghue, MS, RN
Paula K. Mundell, MSN, RN
Faculty
Isabella Graham Hart School of Practical Nursing Coordinator, Nursing Program
Rochester, New York Delaware Technical Community College
Dover, Delaware
Shelley Eckvahl, MSN, BSN
Patricia Taylor, MSN-Ed, RN
Lead Instructor
Chaffey College Practical Nursing Coordinator
Chino Hills, California Kapi’olani Community College
University of Hawaii
Marie Hedgpeth, MSN, MHA, RN Honolulu, Hawaii
Practical Nursing Instructor
Robeson Community College
Lumberton, North Carolina
, Reviewers
Jo Ann Abbott, RN, MSN, DNP Dawn Johnson, DNP, RN, Ed
Delaware Technical and Community College Director of Nursing
State of Delaware Division of Developmental Great Lakes Institute of Technology
Disabilities Erie, PA
Dover, DE
Sonia Rudolph, MSN, APRN, FNP-BC
Shelley Eckvahl, RN, MSN Associate Professor of Nursing
Professor, Vocational Nursing Program Jefferson Community & Technical College
Chaffey Community College Louisville, KY
Rancho Cucamonga, CA
Donna R. Wallis, MBA, MSN, RN
Dorothy Eyong, EdD, MSN, RN Director of Vocational Nursing
Delaware Technical Community College Baptist Health System
Dover, DE San Antonio, TX
Previous Edition Reviewers
Patti Alford, RN, BSBM Cheryl Gilbert, RN, BHA
Longview, TX Chino, CA
Ruth Fee Blackmore, MSN, RN, CNOR Peggy Grady, RN, ASN
Rochester, NY Griffin, GA
Reneé T. Burwell, AASN, BSN, Deborah B. Harris, BSN, MSN, RN
MSEd, EdD Fishersville, VA
Port Charlotte, FL
Eula Jackson, ADN, BS, MSN,
Joyce Canavan, BS Ed, MSN, RN CNE, PhD
El Paso, TX Evergreen, AL
Tammie Cohen, RN, BSN Linda Johnson, RN, PHN, MSN,
Northport, NY DHA
Pittsburg, CA
Wendy C. Farr, RN, BSN, MSN/Ed,
Ins Ethel Jones, EdS, DSN, RN, CNE
Thomaston, GA Montgomery, AL
Brian Fonnesbeck, RN, MN, BSN, Tammy Krell, MSN, RN
ADN Evanston, WY
Lewiston, ID
viii
, Previous Edition Reviewers ix
Susan R. Leferson, RN, BSN, MSBA, Cindy Price, MSN, RN
COHC Zanesville, OH
Manassas, VA
Cynthia Roberts, MS, RN
Rimina Lewis, MSN/Ed, RN Rochester, NY
Savannah, GA
Phyllis Rowe, DNP, RN, ANP
Gayla Love, MSN, BSN, RN, CCM Riverside, CA
Griffin, GA
Ellen Santos, MSN, RN, CNE
Kimberly K. McClure, MSN, RN Marlborough, MA
Victoria, TX
Judith M. Shaffer, RN, BSN, MSN/Ed
Carol A. Miller, BSN student
Easton, MA Raleigh, NC
John H. Nagelschmidt, MSN, RN Claudia Stoffel, MSN, RN, CNE
Marlborough, MA Paducah, KY
Diana Nobleza, MSN, RN Kendra Strenth, RN, MSN, DNP, BC
Toms River, NJ Mobile, AL
Sallie Noto, RN, MS, MSN Barbara Taylor, RN, MSN
Scranton, PA DeFuniak Springs, FL
Mary A. Olson, MA, RN Sandra D. Thompson, RN
Saint Paul, MN Princeton, WV
Kristi Pfeil, MSN, RN Peggy Valentine, RN, BSN, MSNc
Victoria, TX Roanoke, VA
Maryellen Picchiello, MS, RN Faye Warner, RN, MSN
Toms River, NJ Waterbury, CT
Jennifer Ponto, RN, BSN
Levelland, TX
Consultants to Previous Editions
Brenda Agee, RN, MSN Gloria Ferritto, RN, BSN, PHN
Georgetown, DE Vista, CA
Ethel Avery, RN, MSN, EdS Frances Francis, RN, BS
Montgomery, AL Hazard, KY
Sharon M. Erbe, RN, BSN, MSN(c) Sue Garland, RN, MSN, ARNP
Hudson Falls, NY Paintsville, KY
