Post Traumatic Stress Disorder in nursing .pptx

Medical surgical nursing

1. WELCOME

2. P OST T RAUMATIC S TRESS D ISORDER Presented by, Ms. Anagha T Jose Fourth Year BSc Nursing PTSD

3. Introduction Post Traumatic Stress Disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. It is characterized by failure to recover after experiencing or witnessing a terrifying event. The condition may last months or years with triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions.

4. DEFINITION Post Traumatic Stress Disorder (PTSD) is a stress related disorder characterized by inability to adjust or recover after witnessing / experiencing a traumatic or life threatening event. DSM IV 5

5. ETIOLOGY Traumatic experience Exposure to actual or threatened death Experiencing serious injury / burns Sexual violence Childhood trauma Witnessing or experiencing crime, murder, disaster(manmade or natural), torture, war, combat, etc . 6

6. RISK FACTORS The impact of a trauma and severity of symptoms depends on the temperament of the individual and environmental factors. They are; Traumatic experience The individual Recovery environment

7. TRAUMATIC EXPERIENCE Severity and duration of the stressor Anticipatory preparation for the event Exposure to death Presentation title 8

8. THE INDIVIDUAL Poor ego strength Ineffective coping resources Pre- existing psychopathology Behavior or temperament Presentation title 9

9. Recovery environment Lack of social support Inadequate family system Cultural and sub cultural influences Presentation title 10

10. CLINICAL FEATURES 2) AVOIDANCE Avoiding places, activities or people that remind of the traumatic event. Keeping excessively busy to avoid thinking about the traumatic event. 11 INTRUSIVE MEMORIES OF THE TRAUMATIC EVENT Recurrent, unwanted and distressing memories of the event. Flashbacks and nightmares

11. CLINICAL FEATURES 4)CHANGES IN PHYSICAL AND EMOTIONAL REACTION Difficulty maintaining close relationships Detached from family and friends Easily frightened Self destructive behavior Trouble sleeping Irritability 12 3)NEGATIVE THOUGHTS & BELIEFS ABOUT SELF, PEOPLE, OR WORLD Hopelessness Worthlessness Loss of interest in once important and positive activities Jumpy character

12. CLINICAL FEATURES 13 5) MOOD AND COGNITIVE CHANGES Feelings of guilt, shame or self blame related to the traumatic vent Distorted thoughts Pessimistic or negative outlook on life

13. PHYSIOLOGICAL AND NEUROBIOLOGICAL CHANGES IN PTSD 14 PTSD is complex and involves various physiological and neurobiological changes. While these neurobiological changes are associated with PTSD, they do not fully explain the developmental and maintenance of the disorder. The interplay between genetic factors, environmental influences, the individual vulnerability also plays a significant role in the pathophysiology of PTSD.

14. 15 Dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis Abnormal cortisol levels with either heightened or blunted cortisol responses to stress. NEURO- ENDOCRINE SYSTEM

15. 16 May become hyperactive or hypersensitive to potential threats or stressors. Increased fear and anxiety responses AMYGDALA

16. 17 Chronic stress and trauma exposure can lead to structural and functional changes in the hippocampus. Reduced hippocampal volume has been observed in some individuals with PTSD. This may contribute to difficulties in memory processing and the formation of traumatic memories. HIPPOCAMPUS

17. 18 Particularly the medical prefrontal and the anterior cingulate cortex, is involved in emotional regulation and fear extinction processes In individuals with PTSD, these brain regions may exhibit reduced activity impairing the ability to regulate fear responses and leading to difficulties in fear extinction . PREFRONTAL CORTEX

18. 19 Dysregulation of various neurotransmitters such as serotonin, norepinephrine, etc. leads to mood disturbance, hyperarousal and alterations in fear processing. NEURO- TRANSMITERS

19. 20 Traumatic experiences can induce long lasting changes in brain plasticity, altering the structure and connectivity of neural circuits. These changes contributes to the persistence of PTSD symptoms. NEURO- PLASTICITY

20. MANAGEMENT PSYCHOSOCIAL THERAPIES. Cognitive Behavior Therapy Systematic Desensitization Thought Stopping. STRESS MANAGEMENT Relaxation Therapy Hypnotherapy Assertiveness Training(promoting positive thinking) SUPPORTIVE THERAPY 21

21. MANAGEMENT 4.PHARMACOLOGICAL MANAGEMENT SSRI(First line treatment) –paroxetine MAOIs- Phenelzine TCAs- Amitriptyline Benzodiazepine 22

22. NURSING MANAGEMENT As a nurse, there are several important implications to consider when caring for individual w ith PTSD. They are; Presentation title 23

23. ESTABLISH TRUST AND PROVIDE A SAFE ENVIRONMENT Individual with PTSD may have trust issues due to the past traumatic experience. It is crucial to establish a trust in nurse patient relationship by demonstrating empathy, active listening and respecting their boundaries. Creating a safe and secure environment can help alleviate anxiety and promote a sense of comfort . Presentation title 24

24. RECOGNIZE TRIGGERS AND AVOID RE-TRAUMATIZATION Be aware of potential triggers that may cause distress to the patient. This could include certain smells, sights, sounds or even specific topics of conversation. Whenever possible, minimize exposure to triggers and modify the environment to reduce potential distress. Ensuring privacy, and provide a quiet and calm space can be beneficial. Presentation title 25

25. PROVIDE HEALTH EDUCATION Educate patients and families about PTSD, various types, its clinical features, etc. Educate about re-occurrence of the traumatic episodes. Help them understand that PTSD is a legitimate mental health condition and not a sign of weakness. Provide information on coping skills, relaxation techniques, and self-care strategies that can be beneficial in managing PTSD symptoms . Presentation title 26

26. COLLABORATE WITH INTER-DISCIPLINARY TEAM PTSD requires a multi-disciplinary team approach to care. Collaborate with all team members to provide holistic approach of care. Regular communication and co-ordination of care are essential for effective management of PTSD. Presentation title 27

27. USE OF EFFECTIVE COMMUNICATION Employ active listening, empathy and non-judgmental attitude when communicating with patients. Be patient, supportive and understanding. Presentation title 28

28. ASSIST WITH MEDICATION MANAGEMENT Educate the patient about the medication, route, dosage, side effects and potential interactions. Administer medication as per physician’s order . Presentation title 29

29. ADVOCATE FOR SELF CARE AND EMOTIONAL SUPPORT Encourage the patient to engage in self care activities that promote relaxation and emotional wellbeing. This may include regular exercises, mindfulness techniques, engaging in hobbies or connecting with support groups. Advocate for the patient’s emotional support needs, both within the healthcare setting and the community . Presentation title 30

30. Thank you