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Management of Aggression and Violence

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Management of Aggression and Violence Chapter 34 Anger Affective state experienced as the motivation to act in ways that warn, intimidate or attack those who are ... – PowerPoint PPT presentation

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Title: Management of Aggression and Violence


1
Management of Aggression and Violence
  • Chapter 34

2
Anger
  • Affective state experienced as the motivation to
    act in ways that warn, intimidate or attack those
    who are perceived as challenging or threatening
  • Targets
  • Others
  • Impersonal objects/life situations
  • Oneself

3
Experience of Anger
  • Anger is a signal that something is wrong.
  • It is a normal human emotion.
  • It is inappropriate expression of anger that may
    be threatening to the self or others.
  • Difficulties expressing anger are associated with
    psychiatric problems.
  • Behavioral expressions of anger may vary.

4
Aggression vs. Violence
  • Aggression
  • Verbal statements that are intended to threaten
  • Does not occur in a vacuum
  • Must consider the context
  • Violence
  • A physical act of force intended to cause harm to
    a person or an object
  • Conveys a message that the perpetrators point of
    view is correct, not the victims

5
Models
  • Biological
  • Cognitive neuroassociation
  • Neurostructural model - emotional circuit
  • Neurochemical model - ? serotonin

6
Models
  • Psychological
  • Psychoanalytic
  • Behavioral theories
  • Drive
  • Social learning
  • Cognitive

7
Models
  • Social
  • Western societys values - competitive,
    individualistic
  • Interactional theory - Morrison

8
Nursing Management
  • Biologic Assessment
  • Exposure to toxic chemicals
  • Missed doses of medications
  • Intoxication and withdrawal
  • Characteristics
  • History or evidence of CNS lesion or dysfunction
  • Sudden onset and unprovoked
  • Outburst less controlled
  • Episode with clear beginning and end
  • Expression of remorse after episode
  • Psychosocial Assessment
  • Thought processing
  • Perception
  • Sensory impairment
  • Social factors, such as home, family or
    community problems
  • Financial
  • Legal

9
Nursing Diagnosis
  • Risk for self-directed violence
  • Risk for other-directed violence

10
Planning Interventions
  • Development of a partnership between nurse and
    patient, who work together to find solutions to
    prevent the recurrence of explosive episode
  • Guidelines for reducing risk
  • Using non-threatening body language
  • Respecting patients personal space and
    boundaries
  • Positioning for immediate access to door
  • Leaving door open when talking to patient
  • Knowing where colleagues are, let colleagues know
    where you are
  • Removing clothing or accessories that could be
    harmful

11
Biologic Interventions
  • Administering and Monitoring Medications
  • Atypical antipsychotics
  • SSRIs
  • Beta-adrenergic receptor blockers
  • Lithium carbonate
  • Divalproex sodium and carbamazepine

12
Psychological Interventions
  • Affective Interventions
  • Validating
  • Listening to patients illness experience
  • Exploring beliefs

13
Psychological Interventions
  • Cognitive Interventions
  • Giving commendations
  • Offering information
  • Providing education
  • Contracting

14
Psychological Interventions
  • Behavioral Interventions
  • Using bibliotherapy
  • Interrupting patterns
  • Providing choices

15
Social Interventions
  • Reducing stimulation
  • Anticipating needs
  • Interactional processes

16
Nurses Responses to Assault
  • Affective
  • Irritability
  • Depression
  • Anger
  • Anxiety
  • Apathy
  • Cognitive
  • Suppressed or intrusive thoughts of assault
  • Behavioral
  • Social withdrawal
  • Physiologic
  • Disturbed sleep
  • Headaches
  • Stomach aches
  • Tension
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