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 What is PTSD?

ë PTSD is a disorder that occurs after

experiencing a physically or psychologically
traumatic event outside the realm of human
experiences.
ë It is a disturbing patter of behavior
demonstrated by someone who has
experience a traumatic event.
ë ften, people with PTSD have
persisten frightening thoughts and
memories of their ordeal and
experiences fear, horror, and a
sense of helplessness.
ë Flashbacks occur to patients with
PTSD.
ë This disorder is often accompanied
by depression, substance abuse, or
one or more other anxiety
disorders.
 þlassification of PTSD

Ä Acute PTSD- is defined as the experience of

symptoms for less than a 3-month period.
Ä þhronic PTSD- is defined as the experience of
symptoms lasting longer than 3 months.
Ä Delayed PTSD- up to 6 months may elapse
between the trauma and the manifestation of
symptoms.
Soldiers
Survivors
Traumatic Events
Ratural þalamities
Three Stages of Recovery After Trauma

Ä Victim Stage: The person experiences the

signs and symptoms of PTSD but lacks insight
and understanding
Prediscovery of the trauma
Early Awareness
Discovery
Ä Survivor Stage: the person confronts his
traumatic past and takes constructive steps
such as a commitment to therapy to be able
to take control again of his inner self and
environment
Ä Thriver Stage: the person finally gains control
of his self having found renewed focus and
direction in life. Symptoms may still emerge,
but the person has learned to manage them.
 Rursing Diagnosis

Ä Risk for self mutilation

Ä Ineffective coping
Ä Post trauma response
Ä þhronic Low self esteem
Ä Powerlessness
Signs and Symptoms:
vRecurrent, intrusive, distressing
memories of event
vRightmares
vFlashbacks
vHypervigilance,
vHyperalertness
vLabile emotions
vEmotional detachment
vIrritable, aggressive,or violent
Physiologic Indicators
vDilated pupils
vHeadaches
vSleep pattern disturbances
vTremors
vElevated BP
vTachycardia
vDiaphoresis with cold, clammy skin
vHyperventilation
vRausea, vomiting, diarrhea
vExhaustion
 Rursing Interventions

( Desensitization through gradual exposure to

stressful stimuli.
( Administer medications:
(Benzodiazepines-to relieve anxiety and fear
(þlonidine and Propanolol-decrease peripheral
autonomic response to fears
(Lithium þarbonate-to decrease hyperarousal and
startle response
( Rursing Interventions:
a. Strengthen survivors͛ sense of
control
b. þreate a sense of safety
c. Provide support
d. Assist in forming goals and
connections
e. Help client understand relationship
of trauma to life
f. þounteract the damaging effects of
the traumatic event:
( Recognize triggers that remind the
survivor of the terrifying experience
and elicit fight or flight responses
( Teach relaxation techniques
( Allow survivor to find safe means of
expressing anger
( Re-experiencing Phenomena:
encourage survivor to verbalize
feelings
( For intrusive thoughts, thought
stopping behavior is a technique that
can interrupt the thoughts.
( To manage sleep problems;
( Allow physical exercise during the day,
but not right before sleeping
( Relaxing music or a relaxation tape at
bedtime
( Prayer or meditation
( Elimination of stimulants
( Use of the bed only for sleeping and
at a regular time
( Anxiety and Panic Attacks:
( Visual Imagery
( þhange of pace or scenery
( þolor exchange
( Music
( Exercise or massage
( Transcendental meditation
( Therapeutic Touch or Laying of Hand
( Hypnosis
( Biofeedback
( Eye Movement, Desensitization
Reprocessing Technique
( Self Mutilation
( Hel client to view things positively
( Help client identify behaviors that cause
shame
( Reduce emotional intensity
 Sources

Ä Psychiatric Rursing: A textbook and a reviwer

2nd edition, M.L. Evangelista-Sia
Ä Psychiatric Mental Health Rursing 4th edition,
Sheila Videbeck
Ä Textbook of Medical-Surgical Rursing 11th
edition, Smeltzer et al.
Sources