DOA REMEDIOS T. ROMUALDEZ MEDICAL FOUNDATIONTACLOBAN CITY

COLLEGE OF NURSINGMORGANITES 2016

NCM 105

COURSE NAME: CARE OF CLIENTS WITH MALADAPTIVE PATTERNS OF BEHAVIORCOURSE DESCRIPTION: The course is designed to focus on health and illness across the lifespan of clients, populationgroups with acute and chronic psychosocial difficulties and psychiatric illness. COURSE CREDIT: 4 units lecture: 2 units RLE CONTACT HOURS/ SEM: 72 LECTURE HOURS/ 102 RLE hoursPREREQUISITE: General Psychology, NCM 103CO-REQUISITE: NCM 104PLACEMENT: 3RD YEAR, 2ND SEMESTERCOURSE OBJECTIVE:

At the end of the course and given actual clients with maladaptive patterns of behavior, the students shall be able to:1. Utilize the nursing process in the care of individuals and families in community and hospital settings. Assess client/s with his/her/their condition through mental status examination, physical examination, interpretation of diagnostic procedures. Identify actual and potential nursing diagnosis. Plan appropriate nursing interventions with the client/s and family. Implement plan of care with the client/s and family. Evaluate the progress of his/her/their condition and outcomes of care.2. Apply knowledge and understanding of maladaptive patterns of behavior in providing safe and quality care of the clients.3. Increase self-awareness and therapeutic use of self in the care of clients.4. Ensure a well-organized and accurate documentation system.5. Relate with client/s and their family and the health team appropriately.6. Observe bioethical concepts/principles, core values and nursing standards in the care of the client.7. Promote personal and professional growth of self and others.

INTERMEDIATE COMPETENCIESTOPICDATEINSTRUCTOR

Given an actual client with maladaptive patterns of behaviors, students will be able to:1. Describe characteristics of mental health and mental illness.2. Identify important historical landmarks in psychiatric care.3. Discuss the current trends in the treatment of people with mental illness.4. Discuss the American Nurses Association standards of practice for psychiatric-mental health nursing.5. Discuss common student concerns about psychiatric nursing.

I. Overview of Mental Health and Psychiatric Nursing

A. Mental Health and Mental Illness1. Evolution of Mental Health and Mental Illness2. The Mental Health-Illness Continuum3. Criteria of Mental Health4. Statistical Manual of Mental Disorder

B. Level of Practice1. The Mental Health Nursea. Essential Qualitiesb. Roles and Responsibilities as a Team Leader2. Guiding Principles/Standards of Care3. Interdisciplinary Team in Mental Health

Nov. 13,143:00-5:00

MRS. DE ASIS

INTERMEDIATE COMPETENCIESTOPICDATEINSTRUCTOR

1. Discuss the structures, processes and functions of the brain.

2. Describe the current neurobiologic research and theories that are the basis for current psychopharmacologic treatment of mental disorders.

3. Discuss the nurses role in educating clients and families about current neurobiologic theories and medical management.

4. Identify pertinent teaching for clients and families about brain imaging techniques.

5. Explain the basic beliefs and approaches of the different personality theories.

6. Describe how the nurse uses the necessary components involved in building and enhancing the nurse-client relationship.

7. Describe and implement the phases of nurse-client relationship as outlined by Hildegard Peplau.

8. Explain the negative behaviors that can hinder or diminish the nurse-client relationship.

9. Describe the goals of therapeutic communication.

II. Mental Health-Psychiatric Nursing PracticeA. Personality Theories and Determinants of Psychopathology: Implication for Mental-Psychiatric Nursing Practice1.Psychoanalytical Perspective2.Behavioral3. Interpersonal4. Cognitive5. Humanistic6. Biophysiological7. Psychosocial8. Psychospiritual9. Sociocultural10. Eclectic11. Communication12. Neuro-biologic theories

B. General Assessment Considerations1. Major Components of Mental Status Examination2. Elements and Guide to Mental Status Examination3. Principles and Techniques of Psychiatric Nursing Interview4. Presentation, Appearance, Mobility, Behaviora. Stream of Talkb. Emotional State and Reactionc. Thought contentd. Neuro-vegetative dysfunctione. General Sensorium and Intellectual Statusf. Insight and judgement5. Diagnostic Examination: Psychological Test and Examination Laboratory6. Nursing Diagnosis7. Planning and InterventionsC. Building Nurse-Client Relationship1. Essential Elements2. Nurse-Client Interaction vs Nurse-Client Relationshipa. Phases and Stages of Nurse-Client Relation3. Therapeutic use of self4. Therapeutic Communicationsa. Typesb. Techniquesc. Obstaclesd. Interactions/Therapeutic Communication in Special Situation1. Violent Behavior2. Hallucinations3. Delusions4. Conflicting Values5. Incoherent speech patterns6. Manipulations7. Crying

Nov. 20,213:00-5:00

Nov. 27*3:00-6:00

Nov. 283:00-5:00

Dec. 4*3:00-6:00

Dec. 53:00-5:00MRS. DE ASIS

MR. ASTILLA

MRS. ALFONSO

INTERMEDIATE COMPETENCIESTOPICDATEINSTRUCTOR

10. Identify therapeutic and non therapeutic verbal communication skills.

11. Discuss nonverbal communication skills and understanding levels of meaning and context.

12. Identify categories used to assess the clients health status.

13. Describe the different therapeutic modalities.

14. Identify the psychosocial theory on which each treatment strategy is based.

8. Sexual Innuendos or Inappropriate touch9. Lack of Cooperation/Denial10. Depressed Affect/ Apathy/Psychomotor Retardation11. Suspiciousness12. Hyperactivity13. Transference

D. The Nursing Process Applied to Psychiatric Nursing Practice1. Assessing Responses to the different maladaptive Patterns of Behaviora. Self-awareness and use of selfb. Biopsychosocial and Behavioral Data2. Nursing Diagnosis and Outcome Identification3. Planning and Implementing Nursing Interventionsa. Biologicalb. Psychosocial4. Evaluation and Treatment OutcomeE. Documentation in Psychiatric Nursing Practice1. Problem-Oriented Recordinga. SOAPb. FDAR2. Narrative Recording3. Process Recording

III. Therapeutic ModalitiesA. Psychosocial Skills and Nursing Strategies1. Supportive Psychotherapya. Nurse-Patient Relationship Therapyb. Group Therapyc. Family Therapy2. Counseling3. Mental Health-Teaching/Client Education4. Self-enhancement, Growth/Therapeutic groups5. Assertiveness Training6. Stress Management7. Behavioral Modification8. Cognitive Restructuring9. Milieu Therapy10. Play Therapy11. Psychosocial Support Intervention12. Psychospiritual Support Intervention13. Alternative Medicine/Therapies14. Inner Shouting15. Thought Stopping

Dec. 11,123:00-5:00

Dec. 18*3:00-6:00

Dec. 193:00-5:00

MRS. DE ASIS

MRS. ALFONSO

INTERMEDIATE COMPETENCIESTOPICDATEINSTRUCTOR

Given an actual client with maladaptive patterns of behaviors, students will be able to:

1. Describe anxiety as a response to stress.

2. Describe the levels of anxiety with behavioral changes relates to each level.

3. Discuss the use of defense mechanisms by people with anxiety disorders.

4. Describe the current theories regarding the etiologies of major anxiety disorders.

5. Evaluate the effectiveness of treatment including medications for clients with anxiety disorders.

6. Apply the nursing process to the care of clients with anxiety and anxiety disorders.

7. Provide teaching to clients, families, caregivers and communities to increase understanding of anxiety and stress-related disorders.

8. Discuss the etiologic theories of depression and bipolar disorders.9. Describe the risk factors for and characteristics of mood disorders.

B. Biophysical/Somatic Interventions1. Psychopharmacologya. Principlesb. Antipsychoticsc. Antidepressantsd. Mood stabilizing Drugse. Antianxietyf. Stimulants2. ECT and other Somatic Therapies

IV. Care of Clients with Maladaptive Patterns of Behavior Across the LifespanA. Crisisa. Typesb. Phases of Crisis Developmentc. Characteristicsd. Crisis Intervention

B. Anxiety-Related Disorders1. Concept of Anxietya. Defining Characteristicsb. Levels of Anxietyc. Manifestations of Levels of Anxiety Physiologic Psychologicd. Ego Defense Mechanism Four Levels of Defense2. Anxiety Disorders Across the Lifespana. Panic Disorderb. Phobiasc. PTSDd. Acute Stress Disordere. OCDf. GAD

MIDTERM EXAMINATION3. Somatoform Disordersa. Somatization Disordersb. Conversion Disordersc. Hypochondriasd. Pain Disordere. Body Dysmorphic Disorder4. Dissociative Disordera. Depersonalizationb. Psychogenic Amnesiac. Psychogenic Fugued. Dissociative Identity Disorder/Multiple Personality Disorder

C. Mood Disorders and Suicide1. Reactive Attachment Disorder2. Bipolar Disorders I and II3. Related Disordersa. Dysthymicb. Cyclothymicc. Substance-Induced Mood Disorderd. Medical-Condition Induced Disorder

Jan. 8*3:00-6:00

Jan. 93:00-5:00

Jan. 16-18

Jan. 22*3:00-6:00

Jan. 233:00-5:00

Jan. 29*3:00-6:00

Jan.303:00-5:00

MRS. ALFONSO

MR. ASTILLA

MR. ASTILLA

INTERMEDIATE COMPETENCIESTOPICDATEINSTRUCTOR

10. Evaluate the effectiveness of treatment including medications for clients with mood disorders.

11. Apply the nursing process to the care of clients with mood disorders.

12. Discuss the various theories of the etiology of schizophrenia.

13. Describe the positive and negative symptoms of schizophrenia.

14. Describe the functional and mental status assessment for a client with schizophrenia.

15. Describe personality disorders in terms of the clients difficulty in perceiving, relating to, and thinking about self, others and the environment.

16. Discuss factors thought to influence the development of personality disorders.

17. Explain the trends in substance abuse and discuss the need for related prevention programs.18. Discuss the characteristics, risk factors and family dynamics prevalent with substance abuse.

D. Seasonal Affective Disorder1. Postpartum/ Maternity Blues2. Postpartum Depression3. Postpartum Psychosis

E. Major DepressionF. Suicide

V. Schizophrenia and Other PsychosesA. Schizophreniaa. Catatonicb. Paranoidc. Undifferentiatedd. Disorganizede. ResidualB. Other Psychotic Disordera. Schizophreniformb. Schizoaffectivec. Delusionald. Brief Psychotic Disordere. Shared Psychotic Disorder

VI. Personality DisorderA. CategoriesB. Cluster A: Odd/Eccentric BehaviorsC. Cluster B: Dramatic/Emotional/Erratic Behaviora. Paranoidb. Schizoidc. SchizotypalD. Cluster C: Anxious/Fearful Behaviora. OCDb. Dependentc. AvoidantE. Childhood Personality Disordera. Conduct Disorderb. Oppositional Defiant DisorderF. Other realted Disordersa. Depressiveb. Passive-agrgressive

VII. Substance-Related DisordersA. Substance Abuse, Dependence, Intoxication, Withdrawal AND Polysubstance DependenceB. CNS depressantsa. Alcoholb. Sedative Hypnotics and Anxiolyticsc. OpiodsC. CNS Stimulantsa. Caffeineb. Nicotinec. AmphetamineD. HallucinogensE. CannabisF. InhalantsG. Nursing Issues

VIII. Anger-HostilityA. AggressionB. Related Disorders

Feb. 5*3:00-6:00

Feb. 63:00-5:00

Feb. 12*3:00-6:00

Feb. 133:00-5:00

Feb. 19*3:00-6:00

Feb. 203:00-5:00

Feb. 263:00-5:00

MRS. DE ASIS

MR. ASTILLA

MRS. DE ASIS

MRS. ALFONSO

INTERMEDIATE COMPETENCIESTOPICDATEINSTRUCTOR

1. Discuss the different etiologies of Psychosexual Disorders and dysfunctions.

2. Evaluate the effectiveness of treatment including medications for clients with Psychosexual Disorders and dysfunctions.

3. Apply the nursing process to the care of clients with Psychosexual Disorders and dysfunctions

4. Provide teaching to clients, families, caregivers and communities to increase understanding of Psychosexual Disorders and dysfunctions.

5. Compare and contrast the symptoms of anorexia nervosa and bulimia nervosa6. Discuss various etiologic theories of eating disorders.7. Identify effective treatment for clients with eating disorders.8. Describe the characteristics of and risk factors of cognitive disorders.9. Distinguish between delirium and dementia in terms of symptoms, course, treatment and prognosis.IX. Psychosexual Disorders and DysfunctionsA. Overview: Freuds Psychosexual DevelopmentHuman Sexual ResponseB. Sexual Dysfunctionsa. Sexual Desire Disorderb. Sexual Arousal Disorderc. Orgasm Disorderd. Sexual Pain Disorder: Dyspareunia, VaginismusC. Paraphiliasa. Pedophiliasb. Incestc. Exhibitionistsd. Fetishism/Transvestice. Frotteurismf. Sexual Masochismg. Sexual Sadismh. Voyeurismi. Rare Paraphilias Coprophilia Emethophilia Hypritophillia Klismaphilia Necrophilia Plusphophilia Urophilia Zoophilia

D. Gender Identity DisorderE. Abuse and Violencea. Rapeb. Partner Abusec. Child and Elder Abused. Sexual AssaultX. Eating DisordersA. Anorexia NervosaB. Bulimia DisordersC. Related Disordersa. Rumination Disordersb. Picac. Feeding Disordersd. Night Eating Syndromee. Tourette Syndrome

XI. Cognitive Developmental DisorderA. Fetal Alcohol SyndromeB. ADHDC. AutismD. DeliriumE. DementiaF. Mental RetardationG. Learning DisorderH. Motor Skills disorderI. Communication DisorderJ. HuntingtonsK. AlzheimersL. Aspergers DiseaseM. Rettes SyndromeN. Picks DiseaseO. Parkinsons DiseaseFeb. 27*3:00-6:00

March 5*3:00-6:00

March 63:00-5:00

March 12*3:00-6:00

March 133:00-5:00

MRS. ALFONSO

MRS. DE ASIS

MR. ASTILLA

INTERMEDIATE COMPETENCIESTOPICDATEINSTRUCTOR

1. Identify the types of losses for which people may grieve.2. Discuss the various theories related to understanding the grief process.3. Describe the five dimensions of grieving.4. Apply the nursing process to facilitate grieving for clients and families.XII. Grief and Lossa. Typesb. Grieving Processc. Dimensions

PSYCHIATRIC AFFILIATION

FINAL EXAMINATION

March 16-28

March 30-31

TOTAL OF 72 hrs ( 4 hrs per week except those where * (3:00-6:00) is indicated to complete the total number of hours [ 72 hours] in 16 weeks. )

REFERENCES:1. Videbeck, N. et al: Psychiatric Mental Health Nursing. LWW.2. Brady, Noreen: Psychiatric Nursing LWW3. Cacanindin, Eden: Psychiatric Nursing4. Keltner, N. et al: Psychiatric Nursing 2nd Ed. Mosby5. Shives, Louis: Basi Concepts of Psychiatric Nursing.

PREPARED BY: APPROVED BY:

MS. LOURADEL ULBATA-ALFONSO, MAN, RNDR. SOCORRO S. GASCO, RN, DMHRMInstructor Dean, College of Nursing