Question

M1D1: Post-Traumatic Stress Disorder

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Scenario:

A 35-year-old man, former Army sergeant, was involved in a multi-vehicle accident on a major highway. He was relatively unhurt, but witnessed several bodies strewn across the road immediately after the accident. This caused him to experience “flashbacks” from an active Army combat zone several years earlier. He begins to have nightmares of the accident and becomes unable to function at home. His wife accompanies him to a Crisis Unit where he is subsequently admitted to the Mental Health Unit of a local hospital with a diagnosis of Post-Traumatic Stress Disorder.

Initial Discussion Post:

Address the following:

What are the most important factors for the RN to assess when dealing with a client who is exhibiting flashbacks?

How might the RN foster therapeutic communication with this client?

List three common flashback triggers for former military personnel and describe how the RN can assist to decrease the effects.

Provide two 3-part nursing diagnosis statements that might apply to former military personnel experiencing flashbacks. Each statement must include an actual NANDA-I nursing diagnosis, a related factor, and “as evidenced by.” (No risk-for diagnoses permitted.)

Answer 1

1) Flash backs are nothing but reexperiencing the past experiences which cab be good, bad or scary. It is psychologicl state most often present in patients with Post Traumatic Stress Disorder.

whenever a patient exhibits flshbacks , the following factors are to be considered by RN

a) Always try to be with the client, assess vitals signs and provide Psychological Support to him.

b) Assess the emotional state of the client and never ask to give complete details of the flash back.

c) Is the client on any type of psychotic drug?

d)Ask the client if the flash back was auditrory or visual.

e)Is it Focussed or bllurred?

f) Duration of the flash back?

g)Has it occured spontaneously or it was triggered by some stimuli.

h)Are the flashbacks same or different every time?

i)Were the eyes open or close at the time of flashback?

j) Also assess the support of the family and friends.

h)Utilzing the screening tool for Identifying PTSD

So, All the above things are important to assess , while client is exhibiting flash backs.

2) RN can foster therpeutic communication in the following wsys

a) Be Educted about PTSD

b)Actively listening to the patient.

c) asking open ended questions?

c) Making eye to eye contact.

d)Listening to the vocal cues.

e) observing Body language and posture of the client

f) Use of Non verbal comminication.

g) Providing therapeutic touch to the client.

h) Donot force him to go into much depth of the incidence.

3) The Three common triggers are:

a) Driving a car on a highway

b) Watching a patriotic movie

c) Excess fear or anxiety

Nursing Interventions are:

a) Help the client to identify the triggers.

b) Reorientation to be given

c) Teach Advanced relaxation techniques to the client.

d)Use of cognitive therapy.

e) Use of prlonged exposure therapy

4) Two Nursing Diagnosis For PTSD are:

a) Post trauma Syndrome related to distressing event outside the range of ususal human experience evidenced by flash backs and nightmares.

b) Ineffective coping related to stress as evidenced by unabling activities of daily living.

Thank You!!