NUR 2459 Mental and Behavioral Health Nursing

NUR2459- Concept Guide- Module 7 - 10

Module 07 - Nursing Care for Clients with Personality Disorders and Eating Disorders

Describe personality disorder:

• Borderline- anticipated behaviors, nursing interventions, treatment options

Clinical picture

• Severe impairments in functioning

• Emotional lability

• Impulsivity

• Self-destructive behaviors

• Antagonism

• Splitting: Inability to view both positive and negative aspects of

others as part of a whole

• Epidemiology and comorbidity

• 10% suicide and mortality rate

• 85% of BPD patients have another mental illness

• Etiology

• High genetic association

• Separation-individuation factors

• Assessment

• Semi-structured interview

• Use of MMPI

• Self-assessment

• Nursing diagnoses

• Self-mutilation

• Risk for suicide

• Risk for self- and/or other-directed violence

• Impaired social interaction

2

• Disturbed personal identity

• Ineffective coping

• Outcomes and planning

• Nursing Outcomes Classification (NOC) scales for measuring

improvement

• Importance of the therapeutic relationship

• Avoid manipulative behaviors

• Guidelines for Nursing Care

• Provide clear and consistent boundaries

• Use clear, straightforward communication

• Calmly review therapeutic goals

• Teamwork and safety and consistency between staff

• Respond matter-of-factly to superficial self-injuries

• Pharmacological interventions

• Psychotropics geared toward symptom relief

• Psychotherapy

• CBT

• Dialectical behavior therapy (DBT)

• Schema-focused therapy

How should a nurse care for the self-inflicted wounds of a

client with borderline personality disorder?

● The wounds should be treated in a matter-of-fact manner. Care should be

taken not to give positive reinforcement to this behavior by offering

sympathy or additional attention.

• Antisocial- anticipated behaviors, nursing interventions, treatment options

Characteristics

• Antagonistic behaviors

• Disinhibited behaviors

• Profound lack of empathy

• Absence of remorse or guilt

• Assessment

• Patients do not tend to answer honestly

• Self-assessment

• Nursing diagnoses

• Risk for other-directed violence

• Defensive coping

• Impaired social interaction

• Ineffective health maintenance

• Outcomes

• Abusive behavior self-restraint

• Aggression self-restraint