POST TRAUMATIC STRESS DISORDER

Post Traumatic Stress Disorder with nursing intervention

1. Assistant nursing lecturer SUSHEEL DAYALWANSI

2. POST TRAUMATIC STRESS DISORDER 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 (Monozygotic twins 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 Aggressiveness

5. DIAGNOStic evaluation History collection 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 Establish therapeutic 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.