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DOA REMEDIOS T.

ROMUALDEZ MEDICAL FOUNDATION


TACLOBAN CITY
COLLEGE OF NURSING
MORGANITES 2016
NCM 105
COURSE NAME: CARE OF CLIENTS WITH MALADAPTIVE PATTERNS OF BEHAVIOR
COURSE DESCRIPTION: The course is designed to focus on health and illness across the
lifespan of clients, population
groups with acute and chronic psychosocial difficulties and psychiatric illness.
COURSE CREDIT: 4 units lecture: 2 units RLE
CONTACT HOURS/ SEM: 72 LECTURE HOURS/ 102 RLE hours
PREREQUISITE: General Psychology, NCM 103
CO-REQUISITE: NCM 104
PLACEMENT: 3RD YEAR, 2ND SEMESTER
COURSE OBJECTIVE:
At the end of the course and given actual clients with maladaptive patterns of behavior,
the students shall be able to:
1. Utilize the nursing process in the care of individuals and families in community and
hospital settings.
Assess client/s with his/her/their condition through mental status examination, physical
examination, interpretation of diagnostic procedures.
Identify actual and potential nursing diagnosis.
Plan appropriate nursing interventions with the client/s and family.
Implement plan of care with the client/s and family.
Evaluate the progress of his/her/their condition and outcomes of care.
2. Apply knowledge and understanding of maladaptive patterns of behavior in providing safe
and quality care of the clients.
3. Increase self-awareness and therapeutic use of self in the care of clients.
4. Ensure a well-organized and accurate documentation system.
5. Relate with client/s and their family and the health team appropriately.
6. Observe bioethical concepts/principles, core values and nursing standards in the care of
the client.
7. Promote personal and professional growth of self and others.
INTERMEDIATE
COMPETENCIES
Given an actual client with
maladaptive patterns of
behaviors, students will be
able to:
1. Describe
characteristics of
mental health and
mental illness.
2. Identify important
historical landmarks
in psychiatric care.
3. Discuss the current
trends in the
treatment of people
with mental illness.
4. Discuss the American
Nurses Association
standards of practice
for psychiatric-mental
health nursing.
5. Discuss common
student concerns
about psychiatric
nursing.

TOPIC
I.

Overview of Mental Health


and Psychiatric Nursing
A. Mental Health and Mental
Illness
1. Evolution of Mental Health
and Mental Illness
2. The Mental Health-Illness
Continuum
3. Criteria of Mental Health
4. Statistical Manual of Mental
Disorder
B. Level of Practice
1. The Mental Health Nurse
a. Essential Qualities
b. Roles and
Responsibilities as a
Team Leader
2. Guiding
Principles/Standards of
Care
3. Interdisciplinary Team in
Mental Health

DATE

INSTRUC
TOR

Nov.
13,14
3:005:00

MRS. DE
ASIS

INTERMEDIATE
COMPETENCIES
1. Discuss the
structures, processes
and functions of the
brain.
2. Describe the current
neurobiologic
research and theories
that are the basis for
current
psychopharmacologic
treatment of mental
disorders.
3. Discuss the nurses
role in educating
clients and families
about current
neurobiologic theories
and medical
management.
4. Identify pertinent
teaching for clients
and families about
brain imaging
techniques.
5. Explain the basic
beliefs and
approaches of the
different personality
theories.

6. Describe how the


nurse uses the
necessary
components involved
in building and
enhancing the nurseclient relationship.
7. Describe and
implement the phases
of nurse-client
relationship as
outlined by Hildegard
Peplau.
8. Explain the negative

TOPIC
II.

Mental Health-Psychiatric
Nursing Practice
A. Personality Theories and
Determinants of
Psychopathology: Implication
for Mental-Psychiatric Nursing
Practice
1. Psychoanalytical
Perspective
2. Behavioral
3. Interpersonal
4. Cognitive
5. Humanistic
6. Biophysiological
7. Psychosocial
8. Psychospiritual
9. Sociocultural
10.Eclectic
11.Communication
12.Neuro-biologic theories
B. General Assessment
Considerations
1. Major Components of
Mental Status Examination
2. Elements and Guide to
Mental Status Examination
3. Principles and Techniques
of Psychiatric Nursing
Interview
4. Presentation, Appearance,
Mobility, Behavior
a. Stream of Talk
b. Emotional State and
Reaction
c. Thought content
d. Neuro-vegetative
dysfunction
e. General Sensorium and
Intellectual Status
f. Insight and judgement
5. Diagnostic Examination:
Psychological Test and
Examination Laboratory
6. Nursing Diagnosis
7. Planning and Interventions
C. Building Nurse-Client
Relationship
1. Essential Elements
2. Nurse-Client Interaction vs
Nurse-Client Relationship
a. Phases and Stages of
Nurse-Client Relation
3. Therapeutic use of self
4. Therapeutic
Communications
a. Types
b. Techniques
c. Obstacles
d. Interactions/Therapeutic
Communication in

DATE
Nov.
20,21
3:005:00

Nov. 27
*3:006:00

INSTRUC
TOR
MRS. DE
ASIS

MR.
ASTILLA

Nov. 28
3:005:00

MRS.
ALFONSO
Dec. 4
*3:006:00
Dec. 5
3:005:00

behaviors that can


hinder or diminish the
nurse-client
relationship.

Special Situation
1. Violent Behavior
2. Hallucinations
3. Delusions
4. Conflicting Values
5. Incoherent speech
patterns
6. Manipulations
7. Crying

9. Describe the goals of


therapeutic
communication.

INTERMEDIATE
COMPETENCIES

TOPIC

11.Discuss nonverbal
communication skills
and understanding
levels of meaning and
context.

D. The Nursing Process


Applied to Psychiatric
Nursing Practice
1. Assessing Responses to the
different maladaptive
Patterns of Behavior
a. Self-awareness and use
of self
b. Biopsychosocial and
Behavioral Data
2. Nursing Diagnosis and
Outcome Identification
3. Planning and Implementing
Nursing Interventions
a. Biological
b. Psychosocial
4. Evaluation and Treatment
Outcome
E. Documentation in Psychiatric
Nursing Practice
1. Problem-Oriented
Recording
a. SOAP
b. FDAR
2. Narrative Recording
3. Process Recording

12.Identify categories
used to assess the
clients health status.

14.Identify the
psychosocial theory
on which each
treatment strategy is
based.

INSTRUC
TOR

Dec.
11,12
3:005:00

MRS. DE
ASIS

Dec. 18
*3:006:00

MRS.
ALFONSO

8. Sexual Innuendos or
Inappropriate touch
9. Lack of
Cooperation/Denial
10.Depressed Affect/
Apathy/Psychomotor
Retardation
11.Suspiciousness
12.Hyperactivity
13.Transference

10.Identify therapeutic
and non therapeutic
verbal communication
skills.

13.Describe the different


therapeutic
modalities.

DATE

III.

Therapeutic Modalities
A. Psychosocial Skills and Nursing
Strategies
1. Supportive Psychotherapy
a. Nurse-Patient
Relationship Therapy
b. Group Therapy
c. Family Therapy
2. Counseling
3. Mental HealthTeaching/Client Education
4. Self-enhancement,
Growth/Therapeutic
groups
5. Assertiveness Training

Dec. 19
3:005:00

6. Stress Management
7. Behavioral Modification
8. Cognitive Restructuring
9. Milieu Therapy
10.Play Therapy
11.Psychosocial Support
Intervention
12.Psychospiritual Support
Intervention
13.Alternative
Medicine/Therapies
14.Inner Shouting
15.Thought Stopping
TOPIC

INTERMEDIATE
COMPETENCIES

Given an actual client with


maladaptive patterns of
behaviors, students will be
able to:
1. Describe anxiety as a
response to stress.
2. Describe the levels of
anxiety with
behavioral changes
relates to each level.
3. Discuss the use of
defense mechanisms
by people with
anxiety disorders.
4. Describe the current
theories regarding the
etiologies of major
anxiety disorders.
5. Evaluate the
effectiveness of
treatment including
medications for
clients with anxiety
disorders.
6. Apply the nursing
process to the care of
clients with anxiety
and anxiety disorders.
7. Provide teaching to
clients, families,
caregivers and
communities to
increase
understanding of
anxiety and stressrelated disorders.

B. Biophysical/Somatic
Interventions
1. Psychopharmacology
a. Principles
b. Antipsychotics
c. Antidepressants
d. Mood stabilizing Drugs
e. Antianxiety
f. Stimulants
2. ECT and other Somatic
Therapies
IV.

Care of Clients with


Maladaptive Patterns of
Behavior Across the Lifespan
A. Crisis
a. Types
b. Phases of Crisis
Development
c. Characteristics
d. Crisis Intervention
B. Anxiety-Related Disorders
1. Concept of Anxiety
a. Defining Characteristics
b. Levels of Anxiety
c. Manifestations of Levels of
Anxiety
Physiologic
Psychologic
d. Ego Defense Mechanism
Four Levels of
Defense
2. Anxiety Disorders Across
the Lifespan
a. Panic Disorder
b. Phobias
c. PTSD
d. Acute Stress Disorder
e. OCD
f. GAD

MIDTERM EXAMINATION
3. Somatoform Disorders
a. Somatization Disorders
b. Conversion Disorders
c. Hypochondrias
d. Pain Disorder
e. Body Dysmorphic
Disorder
4. Dissociative Disorder

DATE

INSTRUC
TOR

Jan. 8
*3:006:00

MRS.
ALFONSO

Jan. 9
3:005:00

Jan. 1618
Jan. 22
*3:006:00
Jan. 23
3:005:00

MR.
ASTILLA

a.
b.
c.
d.
8. Discuss the etiologic
theories of depression
and bipolar disorders.
9. Describe the risk
factors for and
characteristics of
mood disorders.

C. Mood Disorders and


Suicide
1. Reactive Attachment
Disorder
2. Bipolar Disorders I and II
3. Related Disorders
a. Dysthymic
b. Cyclothymic
c. Substance-Induced
Mood Disorder
d. Medical-Condition
Induced Disorder
TOPIC

INTERMEDIATE
COMPETENCIES
10.Evaluate the
effectiveness of
treatment including
medications for
clients with mood
disorders.
11.Apply the nursing
process to the care of
clients with mood
disorders.

16.Discuss factors
thought to influence
the development of
personality disorders.

Jan. 29
*3:006:00
Jan.30
3:005:00

DATE

INSTRUC
TOR

Feb. 5
*3:006:00

MRS. DE
ASIS

E. Major Depression
F. Suicide
V.

13.Describe the positive


and negative
symptoms of
schizophrenia.

15.Describe personality
disorders in terms of
the clients difficulty
in perceiving, relating
to, and thinking about
self, others and the
environment.

MR.
ASTILLA

D. Seasonal Affective Disorder


1. Postpartum/ Maternity
Blues
2. Postpartum Depression
3. Postpartum Psychosis

12.Discuss the various


theories of the
etiology of
schizophrenia.

14.Describe the
functional and mental
status assessment for
a client with
schizophrenia.

Depersonalization
Psychogenic Amnesia
Psychogenic Fugue
Dissociative Identity
Disorder/Multiple
Personality Disorder

VI.

Schizophrenia and Other


Psychoses
A. Schizophrenia
a. Catatonic
b. Paranoid
c. Undifferentiated
d. Disorganized
e. Residual
B. Other Psychotic Disorder
a. Schizophreniform
b. Schizoaffective
c. Delusional
d. Brief Psychotic Disorder
e. Shared Psychotic Disorder
Personality Disorder
A. Categories
B. Cluster A: Odd/Eccentric
Behaviors
C. Cluster B:
Dramatic/Emotional/Erratic
Behavior
a. Paranoid
b. Schizoid
c. Schizotypal
D. Cluster C: Anxious/Fearful
Behavior
a. OCD
b. Dependent
c. Avoidant
E. Childhood Personality Disorder
a. Conduct Disorder
b. Oppositional Defiant
Disorder
F. Other realted Disorders
a. Depressive
b. Passive-agrgressive

Feb. 6
3:005:00

Feb. 12
*3:006:00

MR.
ASTILLA

Feb. 13
3:005:00

MRS. DE
ASIS

VII.
17.Explain the trends in
substance abuse and
discuss the need for
related prevention
programs.
18.Discuss the
characteristics, risk
factors and family
dynamics prevalent
with substance abuse.

VIII.

INTERMEDIATE
COMPETENCIES
1. Discuss the different
etiologies of
Psychosexual
Disorders and
dysfunctions.

Substance-Related Disorders
A. Substance Abuse,
Dependence, Intoxication,
Withdrawal AND
Polysubstance Dependence
B. CNS depressants
a. Alcohol
b. Sedative Hypnotics and
Anxiolytics
c. Opiods
C. CNS Stimulants
a. Caffeine
b. Nicotine
c. Amphetamine
D. Hallucinogens
E. Cannabis
F. Inhalants
G. Nursing Issues
Anger-Hostility
A. Aggression
B. Related Disorders
TOPIC

IX.

2. Evaluate the
effectiveness of
treatment including
medications for
clients with
Psychosexual
Disorders and
dysfunctions.
3. Apply the nursing
process to the care of
clients with
Psychosexual
Disorders and
dysfunctions
4. Provide teaching to
clients, families,
caregivers and
communities to
increase
understanding of
Psychosexual
Disorders and
dysfunctions.

X.

Psychosexual Disorders and


Dysfunctions
A. Overview:
Freuds Psychosexual
Development
Human Sexual Response
B. Sexual Dysfunctions
a. Sexual Desire Disorder
b. Sexual Arousal Disorder
c. Orgasm Disorder
d. Sexual Pain Disorder:
Dyspareunia, Vaginismus
C. Paraphilias
a. Pedophilias
b. Incest
c. Exhibitionists
d. Fetishism/Transvestic
e. Frotteurism
f. Sexual Masochism
g. Sexual Sadism
h. Voyeurism
i. Rare Paraphilias
Coprophilia
Emethophilia
Hypritophillia
Klismaphilia
Necrophilia
Plusphophilia
Urophilia
Zoophilia
D. Gender Identity Disorder
E. Abuse and Violence
a. Rape
b. Partner Abuse
c. Child and Elder Abuse
d. Sexual Assault
Eating Disorders
A. Anorexia Nervosa

Feb. 19
*3:006:00
Feb. 20
3:005:00

MRS.
ALFONSO
Feb. 26
3:005:00

DATE
Feb. 27
*3:006:00

INSTRUC
TOR
MRS.
ALFONSO

March 5
*3:006:00

MRS. DE
ASIS
March 6
3:005:00

5. Compare and contrast


the symptoms of
anorexia nervosa and
bulimia nervosa
6. Discuss various
etiologic theories of
eating disorders.
7. Identify effective
treatment for clients
with eating disorders.
8. Describe the
characteristics of and
risk factors of
cognitive disorders.
9. Distinguish between
delirium and
dementia in terms of
symptoms, course,
treatment and
prognosis.

1.
2.

3.
4.

INTERMEDIATE
COMPETENCIES
Identify the types of
losses for which
people may grieve.
Discuss the various
theories related to
understanding the
grief process.
Describe the five
dimensions of
grieving.
Apply the nursing
process to facilitate
grieving for clients
and families.

B. Bulimia Disorders
C. Related Disorders
a. Rumination Disorders
b. Pica
c. Feeding Disorders
d. Night Eating Syndrome
e. Tourette Syndrome
XI.

Cognitive Developmental
Disorder
A. Fetal Alcohol Syndrome
B. ADHD
C. Autism
D. Delirium
E. Dementia
F. Mental Retardation
G. Learning Disorder
H. Motor Skills disorder
I. Communication Disorder
J. Huntingtons
K. Alzheimers
L. Aspergers Disease
M. Rettes Syndrome
N. Picks Disease
O. Parkinsons Disease
TOPIC

XII.

MR.
ASTILLA
March 12
*3:006:00
March 13
3:005:00

DATE

INSTRUC
TOR

Grief and Loss


a. Types
b. Grieving Process
c. Dimensions

March
16-28

PSYCHIATRIC
AFFILIATION
FINAL EXAMINATION

March
30-31

TOTAL OF 72 hrs ( 4 hrs per week except those where * (3:00-6:00) is indicated to complete
the total number of hours
[ 72 hours] in 16 weeks. )
REFERENCES:
1. Videbeck, N. et al: Psychiatric Mental Health Nursing. LWW.
2. Brady, Noreen: Psychiatric Nursing LWW
3. Cacanindin, Eden: Psychiatric Nursing
4. Keltner, N. et al: Psychiatric Nursing 2nd Ed. Mosby
5. Shives, Louis: Basi Concepts of Psychiatric Nursing.

PREPARED BY:
MS. LOURADEL ULBATA-ALFONSO, MAN, RN
DMHRM

APPROVED BY:
DR. SOCORRO S. GASCO, RN,

Instructor

Dean, College of Nursing

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