A 35-year-old man, former Army sergeant, was involved in a multi-vehicle acciden

Question

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 nursing diagnosis statements (each statement must include an actual nursing diagnosis, related factor and as evidenced by) that might apply to former military personnel experiencing flashbacks. (No risk-for diagnoses permitted.)

Explanation / Answer

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

As fighters come back from war abroad, human services settings will keep on encountering patients and families adapting to PTSD. Consequently, it is imperative to perceive the potential for PTSD inside military work force, as they may start to show up in regular citizen crisis rooms. To underscore this need, a current investigation of injured Afghanistan and Iraq veterans, screened for PTSD and sadness at one, four, and seven-month interims after release. While the investigation uncovered that 78% of the fighters did not screen for PTSD or discouragement at month one, most displayed manifestations at month seven. Thus, it is trusted that an officer's wounds and the preparing of battle related occasions are not completely acknowledged until the point when a fighter is with regards to their home condition (Reinberg, 2006).

The men with pre-war solitary practices may exhibit unpredictable feelings, for example, outrage and crabbiness, though men who are viewed as more merciful may show side effects of sadness and withdrawal (Herman, 1992, 58). Notwithstanding, the most stunning measurement remains that 15-20% of Iraq war veterans experience the ill effects of PTSD and that the rate of suicide among them is on the ascent (Mitchell, 2007). However, troopers are not by any means the only populace in danger: regular citizen survivors of battle are additionally at an expanded hazard for PTSD (Laila et al., 339). In this way, it is basic to know about the impacts of PTSD on those different populaces influenced by battle, and follow-up care ought to be of essential core interest.

How might the RN foster therapeutic communication with this client?

Image Rehearsal Therapy (IRH)

Numerous patients think that its supportive to diary about their bad dreams. Different patients utilize symbolism practice treatment to mitigate injury related tedious dreams. Picture practice treatment includes:

• Asking the patient to record all that they can recall about the fantasy

• Help patients concentrate just on their fantasy on the off chance that it takes after their awful accident

• Encouraging the patient to record everything about what they touch, smell, hear, and feel.

• Have the patient change what occurs in the fantasy. For instance, an assault casualty may rework their fantasy to incorporate a scene where they pound their aggressor with a heavy hammer.

A definitive objective of IRH is to enable patients to defeat the sentiment vulnerability. Medical attendants must anxiety that while this procedure does not evacuate the horrible memory, it can dispense with the fantasy identified with the injury.

Methods of treatment for PTSD have developed throughout the years, from Freud's underlying "talk treatment" to the use of virtual reality. The latest approach includes psychotherapy and additionally medicine (NIMH, 2007). The essential start of psychotherapy is to enable the casualty through his or her "truth telling" (Herman, 1992, 181). Likewise, psychological behavioral treatment (CBT) urges casualties to recover control by returning to the scene of the injury through mental symbolism, composing, or physically heading off to the site of the awful mishap. Otherwise called subjective rebuilding, this approach tries to invalidate negative, horrendous mishap arranged musings with positive, sensible contemplations. Likewise, stretch immunization preparing uses adapting aptitudes and nervousness diminishment to help with PTSD indications (NIMH, 2007). Studies demonstrate that when an injury survivor recounts his or her story inside a sheltered situation or a sound relationship, the memory of the injury is reprocessed; in this manner, in another system, PTSD manifestations are soothed (Herman, 1192, 183).

Throughout the years, people giving PTSD indications have been managed an assortment of pharmaceutical specialists. Amid World War II, sodium amytal was utilized to investigate the horrendous recollections of troopers by making a synthetically adjusted state, named "narcosyntheis" (Herman, 1992. p. 25). The utilization of antidepressants and specific reuptake inhibitors, especially setraline (Zoloft), has been viewed as powerful in the treatment of PTSD (Stuart and Liberman, 2002, p. 141). Prozasin (Minipress), an antihypertensive taken before bed, has demonstrated a diminishment of PTSD manifestations too. Propranolol, a beta-blocker, has likewise demonstrated effective in decreasing anxiety following a horrendous accident, in this way showing a concealment of the beginning of PTSD (NIMH, 2007). Quickly following a horrible mishap, the most as often as possible recommended prescription for patients with PTSD, are sedatives, benzodiazepenes, which are incidentally successful, yet addictive when incessantly used (Herman, 1992, 161).

Different types of treatment that are being created through military research incorporate the utilization of virtual reality and the off-name organization of pharmaceuticals. Through the usage of virtual reality, specialists reproduce a battle domain and as analysts reveal an officer's PTSD side effect activator, they make a program custom fitted to that person. In a perfect world, the virtual experience will help the officer with finding the words to recount his or her own particular story of injury (Mitchell, 2007). Notwithstanding the pharmaceutical reserve as of now being used, military specialists are likewise examining the use of the TB tranquilize, D-cycloserine (Seromycin) to synthetically hurry the preparing of fears and fears (Military Medical Technology, 2006). Through the blend of D-cylcoserine and CBT, analysts would like to relieve the side effects of PTSD and abatement the probability of repeating scenes (Military Medical Technology, 2006).

For the measurable attendant, treating PTSD patients who are casualty or culprit of a wrongdoing, it is essential to comprehend the methods of treatment and solutions accessible to the patient. This information is foremost in getting to assets and understanding intentions. Also, when working with the criminal equity framework, this data is critical in the depiction of the casualty (or culprit) in occasions of indictment or guard.

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

Flashback triggers for former military personnel:

RN should teach the following to the client to decrease the effects:

Provide two nursing diagnosis statements:

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