Crisis - Acute, time-limited occurrences experienced as overwhelming emotional reactions to a stressful situational event, developmental event, or the person's perception of an event
- Any difficult time in life when a crucial decision must be made: * Fall apart and decompensated * Problem-solve a...
NSG 322 Exam 3 Questions and Correct
Answers
Crisis ✅- Acute, time-limited occurrences experienced as overwhelming emotional
reactions to a stressful situational event, developmental event, or the person's
perception of an event
- Any difficult time in life when a crucial decision must be made:
* Fall apart and decompensated
* Problem-solve and grow through the process
- This time of struggle for balance and stability seems dangerous, but usually presents
an opportunity for growth
Prevalence and outcomes ✅- Everyone experiences crisis
- Each perception is personal and unique
- Client outcomes are impacted by:
* Individual, family, and community perception of & response to the crisis
* Coping abilities and resiliency
* Availability of outside supports
- Clients with the BEST outcomes:
* Feeling safe, connected, calm, and hopeful
* Having access to social, physical, and emotional supports
* Finding ways to help themselves
- Mental health is crucial to the overall wellbeing, functioning, and resilienc of
individuals, societies, and counties recovering from emergencies
Resiliency ✅- Learned through past successful experience with and resolution of crisis
- Learned coping skills in the family are also germane factors
- Can be built through:
* Supportive relationships
* The ability to make and meet realistic goals
* Confidence and self-esteem
* Good communication
* Problem solving skills
* Ability to manage strong emotions
,History of crisis ✅- Erich Lindemann
* Early crisis theorist
* Conducted a classic study in the 1940s on the grief reactions of close relatives of
victims who died in the Coconut Grove nightclub fire in Boston
* Formed crisis theory and clinical intervention
* Believed preventative interventions could eliminate or decrease potentially devasting
psychological consequences from the sustained effects of severe anxiety
-Geral Caplan
* Further elaborated on crisis theory in early 1960s
- Joint Commission on Mental Illness and Health
* Addressed need for community mental health centers in 1961
- Donna Aguilera and Janice Mesnick
* Provided framework for nurses for crisis assessment and intervention
Foundation for crisis intervention ✅- Crisis is self limiting and is usually resolved within
4 to 6 weeks
- Goal is to return individual to pre-crisis level of functioning.
- Resolution of a crisis may result in return to pre-crisis functioning or to a higher or
lower level
- How a crisis is resolved is unique to the specific crisis as well as how the individual
responses and the interventions of others
- During a crisis, people are often more open to outside intervention than they are at
times of stable functioning
- When normal coping methods have failed, opportunity exists to learn different adaptive
means of problem-solving
- A person in a crisis situation is assumed to be mentally healthy and to have functioned
well in the past but is presently in a state of disequilibrium
- Crisis intervention deals with the person's present problem and resolution of the
immediate crisis only, the "here and now". Addressing issues or needs of other things
can take place at a later time
- A nurse must be willing to take a more directive role in intervention, especially initially.
As anxiety decreases, the client can assist more in problem-solving and planning
- A client is encouraged to set realistic goal and plan an intervention with the nurse that
is focused on the current situation
,Factors that limit coping/problem solving ability ✅- Mental illness
- Substance abuse
- History of poor coping
- Diminished cognitive abilities
- Preexisting physical health problems
- Limited social supports
- Developmental and/or physical challenges
4 basic types of crises ✅- Maturational (Developmental)
- Situational
- Adventitious (Social)
- Existential
Maturational (Developmental) crises ✅- Based on Erik Erikson's stages of growth and
developmental
- Related to PREDICTABLE transitions individuals experience as they move from one
stage of human development to another
- Occurs when adapting to a new life role and developing new coping mechanisms
- At various times, each individual must make adjustments and adapt to new
responsibilities and life partners
- Drug and alcohol addiction will interrupt an individual's progression through the
maturational stage
- Professional help is recommended when there is a severe difficulty with adjustment
- Example:
* Transitioning from adolescence to adulthood
* Marriage
* Birth of child
Situational crises ✅- Arise SUDDENLY and UNEXPECTEDLY from an external source
, - Events or circumstances that threaten the physical, social, and psychological integrity
of individuals
- Often revolve around grief and loss
- May originate in the physical body as result of disease or injury OR in social or
emotional situations
- Sometimes, maturational and situational crises occur at the same time. Occasionally
one crisis triggers another.
Adventitious (social) crises ✅- Also called events of disaster
- Rare, unexpected happenings that NOT part of everyday life
- May result from:
* Natural disasters such as floods, fires, earthquakes
* National disasters such as plane crashes, riots, wars
* Interpersonal disasters such as rape, assault
* Acts of terrorism
Existential crisis ✅- One questioning life purpose or spirituality
- Can be brought on by experiencing a significant event, either positive or negative
- Can lead to newfound motivation or higher goals of self-actualization
- Can also lead to feelings of isolation, depression, or uncertainty
Four phases of a psychological crisis ✅- Phase 1: Person is confronted by conflict and
responds with increased anxiety. The increase in anxiety stimulates the use of problem-
solving techniques and defense mechanisms
- Phase 2: If usual defensive responses fail and threat persists, anxiety continues to
increase. Trail-and-error beings
- Phase 3: If trial-and-error attempts also fail, anxiety can escalate to severe or panic
levels. Autonomic relief behaviors or some form of compromise may occur
- Phase 4: If the problem is not solved and new coping skills are ineffective, anxiety can
overwhelm the person and result in serious illness
- ASSESS FOR SI OR PLANS IN PHASE 4
Nursing assessment and crisis ✅- Persons equilibrium may be adversely affected
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