Psychosocial Integrity / Topic 8
Make sure to:
In healthcare settings, clients, staff members, and visitors may face risks of injury due to clients inappropriate or abnormal behavior. Therefore, it is important for nurses to recognize clients who are at risk for displaying such behaviors and implement strategies for prevention and management.
In this learning experience, learners will acquire knowledge and insights into behavioral interventions. This includes a focus on identifying clients who may exhibit inappropriate or abnormal behaviors, and employing behavior modification techniques and interventions to both prevent and manage these behaviors effectively.
8.1 Assessment of Clients for Inappropriate or Abnormal Behavior
Nurses should assess clients across the lifespan for various types of inappropriate or abnormal behavior, considering developmental age, specific behaviors, and their underlying reasons (Burke, 2023):
According to Burke (2023), additional risks factors for these behaviors include:
Triggers:
Along with gathering information about their clients' behaviors, nurses should identify the triggers that caused these behaviors to understand if they are disruptive or dangerous to the clients themselves, as well as others (Burke, 2023). For example, behavior could range from yelling at another client to physical aggression towards a visitor or staff member. Triggers social factors can stem from various sources, including and:
Assessments:
Nurses assess their clients for inappropriate or abnormal behaviors by examining changes in appearance, mood, and psychomotor behaviors (Burke, 2023):
Conducting a psychological assessment is crucial for nurses, which includes assessing clients' level of consciousness using the Glasgow Coma Scale and their cognition using the Mini-Mental State Examination (MMSE) (Burke, 2023).
Psychological assessments are adapted for different age groups, such as children, adolescents, and the elderly (Burke, 2023). The approach varies as follows:
Children and Adolescents:
For the elderly, use standardized tests to assessment:
When assessing clients, it is important to be kind and unbiased. Adherence to healthcare facility policies and procedures for documenting and reporting assessment findings is crucial. Collaborate with other healthcare team members, as interventions are often based on the data gathered from these assessments.
8.2 Behavior Modification
Behavioral modification and therapy are recognized as treatment modalities for clients with mental illness (Kaplan Nursing, 2023). These approaches are based on the premise that psychological issues are learned behaviors, and thus, problematic behaviors can be rectified through relearning. During behavior modification, positive behaviors are reinforced through rewards and praise, while negative behaviors, such as acting out are met with negative reinforcement (Burke, 2023). According to Kaplan Nursing (2023), two primary treatment methods include:
8.3 Behavioral Management Techniques
Nurses employ a variety of behavioral management techniques to care for clients exhibiting inappropriate or abnormal behavior, with the primary goal being prevention of such behaviors (Burke, 2023). These techniques aim to help clients gain control on their behavior. According to Burke (2023), effective prevention strategies include:
Additionally, Burke (2023) describes further behavior management techniques nurses can utilize:
If prevention strategies are unsuccessful and clients display inappropriate or abnormal behavior, nurses should work in tandem with other healthcare team members to implement the following interventions (Burke, 2023):
Additionally, it's important to follow the healthcare facility's policies and procedures for assessing, documenting, and evaluating behavioral interventions.
After completing this learning experience, the learner will have acquired deeper insights into behavioral interventions. The main goals are to prepare learners for successful performance on the NCLEX examination and to enhance their skills in caring for their clients.
After reviewing the provided resources, identify areas where further improvement is needed. Concentrating on these areas will significantly increase their competence in both preventing and managing inappropriate or abnormal behaviors in clients.
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