Scribd Logo
Upload

Welcome to Scribd!

  • 829 views

    Obsessive Compulsive Disorder

    Uploaded by

    francis00090
    1. Refer client and family to support groups and counseling. 2. Refer client to occupational therapy for assistance in resuming role responsibilities. 3. Refer family to family therapy for assistance in resolving conflicts and adjusting roles. 4. Refer client to cognitive-behavioral therapy for assistance in managing obsessive-compulsive behaviors.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd

    Obsessive Compulsive Disorder

    Uploaded by

    francis00090
    829 views14 pages
    1. Refer client and family to support groups and counseling. 2. Refer client to occupational therapy for assistance in resuming role responsibilities. 3. Refer family to family therapy for assistance in resolving conflicts and adjusting roles. 4. Refer client to cognitive-behavioral therapy for assistance in managing obsessive-compulsive behaviors.

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    1. Refer client and family to support groups and counseling. 2. Refer client to occupational therapy for assistance in resuming role responsibilities. 3. Refer family to family therapy for assistance in resolving conflicts and adjusting roles. 4. Refer client to cognitive-behavioral therapy for assistance in managing obsessive-compulsive behaviors.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    829 views14 pages

    Obsessive Compulsive Disorder

    Uploaded by

    francis00090
    1. Refer client and family to support groups and counseling. 2. Refer client to occupational therapy for assistance in resuming role responsibilities. 3. Refer family to family therapy for assistance in resolving conflicts and adjusting roles. 4. Refer client to cognitive-behavioral therapy for assistance in managing obsessive-compulsive behaviors.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 14

    Obsessive -

    Compulsive
    Disorder

    It is a mental disorder with two components:
    obsessions, which consist of thoughts, impulses,
    or mental images; and compulsions, which are
    repetitive behaviors that the person feels driven
    to perform in response to the obsessions. In some
    cases, the compulsion may represent a strict rule
    that the patient must apply rigidly in every
    situation (tying one's shoes a certain number of
    times, for example) in order to feel "right." The
    exact content of obsessions varies from person to
    person, although certain themes are common.
    People with OCD experience their disturbing
    thoughts and images as intrusive and troublesome,
    but they recognize that their thoughts are
    products of their own minds. Obsessive thoughts
    are different from worries about such real-life
    problems as losing one's job or bad grades in
    school. In addition, obsessive thoughts are not
    ETIOLOGICAL
    THEORIES

    Psychodynamics

    Freud placed origin for obsessive-compulsive
    characteristics in the anal stage of
    development. The child is mastering bowel
    and bladder control at this developmental
    stage and derives pleasure from
    controlling his or her own body and
    indirectly the actions of others.

    Erikson’s comparable stage for this disorder
    is autonomy versus shame and doubt. The
    child learns that to be neat and tidy and to
    handle bodily wastes properly gains
    parental approval and to be messy brings
    criticism and rejection.

    The obsessional character develops the art of the
    need to obtain approval by being excessively tidy
    and controlled. Frequently the parents’ standards
    are too high for the child to meet, and the child
    continually is frustrated in attempts to please
    parents.

    The defensive mechanisms used in obsessive-
    compulsive behaviors are unconscious attempts by
    the client to protect the self from internal
    anxiety. The greater the anxiety, the more time
    and energy will be tied up in the completion of the
    client’s rituals. First, the client uses regression, a
    return to earlier methods of handling anxiety.
    Second, the obsessive thoughts are either devoid
    of feeling or are attached to anxiety. Thus,
    isolation is used. Third, the client’s overt attitude
    toward others is usually the opposite of the
    unconscious feelings. Thus, reaction formation is
    Biological

    Although biological and neurophysiological
    influences in the etiology of anxiety disorders
    have been investigated, no relationship has yet
    been established. The mind-body connection is
    well accepted, but it is difficult to establish
    whether the biological changes cause anxiety or
    the emotional state causes physiological
    manifestations. However, recent findings suggest
    that neurobiological disturbances may play a role
    in obsessive-compulsive disorder, with
    physiological and biochemical factors also playing
    significant roles.
    Family Dynamics

    The individual exhibiting dysfunctional behavior is
    seen as the representation of family system
    problems. The “identified patient” (IP) is carrying
    the problems of the other members of the family,
    which are seen as the result of the
    interrelationships (disequilibrium) between family
    members rather than as isolated individual
    problems.

    Multiple factors contribute to anxiety disorders.

    PREDISPOSING

    RISK FACTORS
    •
    – Stressful Life Events
    • Pregnancy
    • Psychosocial Factors:

    -personality functions

    -psychodynamic functions

    -behavioral functions
    – Step throat
    • Environment
    • PRECIPITATING
    • RISK FACTORS:

    – Biological Factors
    • -Genetics (Family History)
    – Tourette’s Syndrome
    • Nursing Diagnosis: Anxiety related
    to repetitive actions secondary to
    Obsessive Compulsive Disorder
    • Subjective Cues:
    • “I always wash my hands every
    minute” as manifested by the
    patient.
    • Objective Cues:
    • -Repetitive Actions
    • -Decreased Social and Role
    Independent:

    • Establish relationship through use of empathy,


    warmth, and respect. Demonstrate interest in
    client as a person through use of attending
    behaviors.
    • Acknowledge behavior without focusing attention on
    it. Verbalize empathy toward client’s experience
    rather than disapproval or criticism.
    • Use a relaxed manner with the client; keep the
    environment calm.
    • Assist client to learn stress management, (e.g.,
    thought-stopping, relaxation excercises, imagery)
    • Identify what the client perceives as relazing (e.g.,
    warm bath, music). Engage in constructive
    activities such as quiet games that require
    • Encourage participation in a regular exercise
    program.
    • Give positive reinforcement for noncompulsive
    behavior. Avoid reinforcing compulsive
    disorder.
    • Assist client to find ways to set limits on own
    behavior. At the same time allow adequate
    time during the daily routine for the ritual.
    • Discuss home situation, include family/ SO as
    appropriate.

    Collaborative:
    • Administer as indicated, e.g.,: Fluvozamine
    (Luvox), Clomipramine (Anafranil),
    Fluoxetine (Prozac)

    Nursing Diagnosis: Impaired skin integrity related to
    repetitive behaviors related to cleansing, such as
    washing, brushing teeth, showering secondary to
    Obsessive Compulsive Disorder.

    Cues:

    -Disruption of skin surfaces; destruction of skin/tissues (e.g.,
    mucous membranes)

    Nursing Interventions:

    Independent:

    Assess changes in skin/tissue (e.g., alterations in skin turgor,
    edema, dryness, altered circulation, and presence of
    infections).

    Encourage use of mild soap and hand creams, while using
    methods previously described in ND.

    Discuss measures client can take during/after cleaning
    behaviors( e.g., use of rubber gloves and application of
    antiseptic cream).


    Nursing Diagnosis: Risk for altered Role Performance related to
    Psychological Stress Secondary to Obsessive Compulsive
    Disorder.

    Cues:

    No signs and symptoms.

    Nursing Interventions:

    Independent:

    1. Determine client’s role within family and extent to which illness-


    related thoughts and actions affect role relationships.
    2. Discuss client’s perceptions of role, how obsessive-compulsive
    behaviors affect role, and whether perceptions are realistic.
    3. Identify conflicts that exist within the family system and specific
    relationship that are affected. Encourage family member to
    begin to discuss identified problem areas.
    4. Explore options for changes or adjustments in role and practice
    behaviors using role-play.
    5. Encourage participation by all family members in problem-solving
    process and plans for change.
    6. Provide positive reinforcement for movement toward resuming role
    responsibilities and decreasing ritualistic behaviors.

    You might also like