POST TRAUMATIC STRESS DISORDER

POST TRAUMATIC STRESS DISORDER

• 1.
  SUSHEEL DAYALWANSI
• 2.
  POST TRAUMATIC STRESSDISORDER Post traumatic stress disorder is a severe anxiety disorder that can develop after exposure to any event which results in psychological trauma, Such as earthquake, floods, war, rape, tsunami, or serious physical assault.
• 3.
  ETIOLOGY  GENETIC (Monozygotictwins are more susceptible)  Neuro-endocrinological factors:-  Low secretion of cortisol  High secretion of catecholamine in urine  Abnormality in the hypothalamic pituitary adrenal axis  NEURO-ANATOMICAL:- Damage to the prefrontal cortex, Hippocampus.  PSYCHOLOGICAL FACTORS:-  Physical ,emotional ,& sexual abuse  Accident, Drug addiction, illnesses, sexual assault  Exposed to war (such as soldiers & disaster)  Being punished severely during childhood.
• 4.
  SIGN AND SYMPTOMS •Emotional numbness • Distressing dreams • Irritability • Impaired social function • Loss of interest • Flashback fear • Social isolation • Hostility
• 5.
  DIAGNOSTIC EVALUATION  Historycollection about the events exposure  Assess Physical and psychological symptoms  Observation method  Check the Level of depression  Others psychological methods
• 6.
  TREATMENTS A. PHARMACOTHERAPY:-  SSRIs(First line drug for the treatment of PTSD such as citalopram, fluvoxamine)  Tricyclic antidepressants  Beta blockers (propranolol)  Mood stabilizers (Lithium carbonate & carbamazepine)  Benzodiazepines  Anticonvulsant such as clonidine B. PSYHOTHERAPY:-  Counselling  Exposure therapy  Cognitive therapy  Relaxation therapy  Interpersonal psychotherapy  EMDR (Eye movement Desensitization & Reprocessing , is an psychotherapy treatment that alleviate the distress associated with traumatic memories)
• 7.
  NURSING MANAGEMANT 1. ASSESSMENT:- Assist the patient past exposure situation & flashbacks.  Assist the physical movement and symptoms of the patient exposure about any events. 2. NURSING DIAGNOSIS:-  Post trauma syndrome related to distressing event considered to be outside the range of usual human experience evidenced by flashbacks, nightmares, psychological numbness related to the event.  Complicated grieving related to post traumatic events evidenced by irritability, verbalization of guilt.
• 8.
  NURSING INTERVENTION  Establishtherapeutic nurse patient relationship.  Provide calm, quiet & non stimulating environment.  Do not leave client alone.  Observe the client for suicidal tendency, ideation or thoughts.  Provide situational support to the client & family members.  Support the client in rehabilitative process.