mental health nursing issue for special population including women child , victims

1. Mental Health Nursing Issues
For Special Populations
By
Ms Neha Bhatt
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2. PROBLEMS OF ADOLESCENTS
l . Anxiety disorders
2. Conduct disorders
3. Mood disorders
4. Schizophrenia
5. Eating disorders
6. Deliberate self harm
7. Alcohol and substance abuse
8. Sexual problems
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3. Nursing responsibility
l . Assessment for high risk behavior
2. Provide medical treatment as ordered
3. Give support and behavioral therapies
4. Establish a therapeutic relation with client
5. Involve family members in planning and
implementing therapies
6. Plan for appropriate referral services
7. Treat adolescent as individual client
8 Educate family on communication pattern
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4. PROBLEMS OF WOMEN
l. Premenstrual syndrome
2. Postpartum depression
3. Puerperal psychosis
4. Maternity blues
5. Menopausal syndrome
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5. PREMENSTRUAL SYNDROME
• It is a condition that affects a woman's
emotions, physical health and behavior just
before her menstrual period.
• Start 5 to 11 days before menstruation and go
away once menstruation begins.
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6. PREMENSTRUAL SYNDROME
• The cause of PMS is unknown and change in
hormone levels at the beginning of the
menstrual cycle may caused PMS.
• Levels of estrogen and progesterone increase
during certain times of the month which can
cause mood swings, anxiety, and irritability .
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7. Risk factors for premenstrual
syndrome include
• A history of depression or mood disorders
(such as postpartum depression or bipolar
disorder)
• A family history of depression symptoms
• Breast swelling and tenderness, acne, food
cravings, irritability, mood swings, cry spells
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8. Management
• Diuretics
• Analgesics
• Oral contraceptive pills
• Ovarian suppressors
• Anti depressants (sos)
General management
• Provide exercise
• Provide emotional
support
• Provide enough sleep
• Adequate nutrition
• Avoid salt before
menstrual period
• Avoid caffeine and
alcohol
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9. POSTPARTUM DEPRESSION
• Young age of mother,
• Low thyroid levels,
• Stress from work or
home,
• Broken sleep patterns
• History of depression
• Positive family history
of depression
• Anxiety about fetus,
• Problems with previous
pregnancy
It Can occur during pregnancy or within one
year of delivery
CAUSES
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10. POSTPARTUM DEPRESSION
• Feeling irritable,
• Sadness,
• hopelessness,
• Crying spells,
• Avolition
• Withdrawal from
friends and family,
• Sleep disturbances,
• Less interest in baby
• Eating too little or too
much
Symptoms
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11. POSTPARTUM DEPRESSION
Treatment
• Counseling
• Cognitive therapy
• SSRI , TCA
• Good supervision and support
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12. POSTPARTUM PSYCHOSIS
• Auditory / visual
hallucinations,
• Delusions,
• Insomnia,
• Sleep disturbances
• Suicidal thought
• Obsessed thoughts of
baby
• Agitation,
• Anger,
• Irrational guilt,
• Mood swings
Most severe condition, Usually begins within 1- 2
days to 3 months of delivery.
Symptoms
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13. POSTPARTUM PSYCHOSIS
Management
• Individual and group counseling
• Close follow up
• CBT
• Antipsychotics, ECT
• Psychotherapy
General measures
• Exercise & rest
• Balance diet
• Support group help
• Don’t join work soon
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14. MATERNITY BLUE
• Occurs mostly on 4th or 5th day after delivery
in 30-85 % women
Causes
• Prenatal depression, Low self esteem, Child
care stress, Low social support, Poor marital
relationship , Unplanned pregnancy
• Symptoms
• Dysphoria , Mood liability, Irritability,
Hypochondriasis, Anxiety, Insomnia, Impaired
concentration, Isolation, headache,
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15. Management
1. Antipsychotic drugs
2. Mood stabilizers
3. Supportive intervention
4. CBT
5 Reassurance
6. Monitor and supervision
7. Nutritional management
8. Suicidal precautions
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16. MENOPAUSAL SYNDROME
Cessation of ovulation , generally occurs
between 45-53 years of age.
• Hot flashes
• Sleep disturbances
• Vaginal atrophy and
dryness
SYMPTOMS • Cognitive and affective
disturbances like
worrying , depression ,
anxiety , irritability ,
difficulty in
concentration and
decrease self
confidence 16

17. MENOPAUSAL SYNDROME
Management
• Hormonal replacement therapy
• Reassurance
• Psychological support
• Early identification of emotional problems and
prompt treatment
• Counseling
• Psychotherapy
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18. PROBLEMS OF ELDERLY
Developmental tasks
l . Establishing satisfactory living relationship
2. Adjusting to retirement income
3. Establishing comfortable routines
4. Maintaining marital and social relationship
5. Keeping active and involved
6. Staying in touch with other family members
7. Sustaining and maintaining physical and mental
health
8. Finding meaning of life
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19. Common mental health problems
l . Depression
2. Dementia
3. Delirium
4. Paranoid disorders
PROBLEMS OF ELDERLY
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20. • Maintain health by living a healthy lifestyle
• Provide them strong support social system
• Help them to adjust and adapt to change
• Avoid stress producing situation
• Plan for structured day
• Help them to Participate in activities such as
employment or volunteering
SOLVING PROBLEMS OF ELDERLY
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21. VICTIMS OF VIOLENCE
Forms of domestic violence
1 . Physical aggression,
2. Threats
3. Sexual abuse
4. Emotional abuse
5. Controlling or domineering
6. Intimidation
7. Neglect
8. Financial deprivation
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22. Effect of violence
• Physical, social, emotional effects,
• Lowering self esteem,
• Loss of confidence,
• Avoidance ,
• Mutism ,
• Depression,
• Suicidal ideation
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23. Prevention of violence
• Learn about type of violence that may occur
• Recognize early warning signs of violence
• Work on low self esteem issues
• Recognize obstacles to responding to violence
• Build support systems Open communication
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24. VICTIMS OF ABUSE
• Types
l . Physical abuse
2. Emotional abuse
3.Sexual abuse
4.Financial abuse
5.Neglect
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25. VICTIMS OF ABUSE
CAUSES
• Family violence
• Unsatisfactory
schooling
• housing and
environment,
• Parental factors,
• Mental illness,
• Marital disharmony,
• Crime,
• Chronic illness,
• Poverty,
• Poor interpersonal
interactions
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26. VICTIMS OF ABUSE
CLINICAL FEATURES
• Multiple bruising,
• Burns,
• Abrasions,
• Bites,
• Torn lip,
• Low self esteem
• Anger, Guilt, Fear,
• Depression,
• anxiety,
• nightmares,
• Suicidal
tendency,
• Unwanted
pregnancy,
• Self harm, Social
withdrawal
• hemorrhage,
Fracture,
• Genital
bleeding,
• Crying spells,
• New sexual
behaviors in
child,
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27. Management
l . Reassurance
2. Talk to parents regarding abuse
3. Treat external injuries
4. Help family to modify behavior
5. Never blame parents
6. Provide legal counseling to victim and family
7. Counseling and guidance
8. Provide reinforcement of healthy traits
9. Treat if Contagious diseases present
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28. Handicapped
• They try to excel by compensation
• They usually are victims of teasing, bullying,
casting, insulting remarks, and avoidance by
others
• They experience low self esteem and
disturbed body image
• Only few cope with disability and ignore it
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29. Handicapped : Strategies to help
• Focus on what they can do at times
• Identify child's strength and promote them
• Keep expectations high, the child is capable of
achieving
• Never accept rude or negative remarks
towards these children.
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30. Handicapped : Strategies to help
• Give compliment and positive encouragement
for their achievements
• Make adjustments and accommodations
when ever possible, for the child to participate
in but Never pity them
• Encourage independent activities
• Ensure safe measures for the child
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31. HIV/ AIDS
• Psychosocial issues related to the diagnosis
• Behavioral problems, Fear, Loss, Isolation,
Resentment, Depression, Anxiety, Anger,
Suicidal thoughts, Low self esteem
• Psychiatric syndromes due to HIV/ AIDS
• Depression, Anxiety, Paranoia, Mania,
Irritability, Psychosis, Substance abuse,
Insomnia, Suicidal ideation
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32. HIV/ AIDS: Nursing management
1. Multidisciplinary team approach
2. Detailed neuropsychiatry assessment
3. Help patient change risky behavior
4. Provide counseling
5. Clarify doubts if needed
6. Explain window period
7. Review patient's assessment for own risk
8. Provide risk reduction information
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33. HIV/ AIDS: Nursing management
9. Build rapport
10. Explore patients feelings
11. Implement psychosocial interventions
12. Provide safe sex information
13. Advise for regular medical monitoring
14. Teach about ART and nutritious diet
15. Enable social support networks for patient
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34. Thank you
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