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Tuesday, May 29, 2012

Nursing Assessment for Hallucinations

Nursing Assessment for HallucinationsAt this stage the nurse explore the factors that exist below, namely:

1. Predisposing Factors

Are risk factors that affect the type and number of sources that can be generated by individuals to cope with stress. Obtained either from patients or their families, the social development of cultural factors, biochemical, psychological and genetic risk factors that influence the type and number of sources that can be generated by individuals to cope with stress.
  • Development factor
    If the task of development is congested, and disturbed interpersonal relationships then the individual will experience stress and anxiety.

  • Sociocultural factors
    Various factors in the community can lead to a lonely feel excluded by the environment where the client was raised.

  • Biochemical factors
    Have an influence on the occurrence of mental disorders. In the presence of excessive stress experienced by a person then in the body will produce a substance that can be hallucinogenic neurochemistry.

  • Psychological factors
    Interpersonal relationships are not harmonious and the presence of conflicting multiple roles and are often accepted by the children will lead to high stress and anxiety disorders, and ended with reality orientation.

  • Genetic factors
    What genes are affected in skizoprenia not yet known, but the findings suggest that family factors showing a highly influential in this disease.

2. Precipitation Factor

Stimulus that is perceived by the individual as the challenges, threats / demands that require extra energy for coping. Presence of environmental stimuli are often the client's participation in groups such as, for too long encouraged communication, there are objects in the environment is also the atmosphere of quiet / isolation is often a trigger hallucinations because it can increase stress and anxiety that stimulates the body to excrete hallucinogenic.

3. Behavior

Client response to the hallucinations may be a suspicion, fear, insecurity, anxiety and confusion, self-destructive behavior, lack of attention, not able to make decisions and can not distinguish between real and unreal circumstances. According to Rawlins, and Heacock, 1993 tried to solve the problem of the existence of hallucinations based upon the nature of an individual as a creature that was built on the basis of the elements of bio-psycho-socio-spiritual that hallucinations can be seen from the dimensions:
  • Physical Dimensions
    Constructed by the human sensory system to respond to external stimuli provided by the environment. Hallucinations can be caused by some physical conditions such as fatigue, drug use, fever to delirium, alcohol intoxication and difficulty sleeping for a long time.

  • Emotional Dimensions
    Excessive feelings of anxiety on the basis of problems that can not be overcome is the cause hallucinations occurred. The content of the hallucinations can be a force command and scary. Clients no longer able to oppose the order to the client's condition to do something to fear.

  • Intellectual Dimensions
    In this intellectual dimension explained that individuals with hallucinations would show a decrease in ego functions. At first hallucination is a business of his own ego to fight the impulse to hit, but it is a matter that raises awareness that can take all the attention and often the client will control all client behavior.

  • Social Dimensions
    Social dimension in individuals with hallucinations showed a tendency to be alone. Individuals are preoccupied with hallucinations, as if it is a place to meet the need for social interaction, self control and self-esteem is not found in the real world. Content of hallucinations made by the individual control system, so if the command hallucinations in the form of threats, the individual himself or others inclined to it. Therefore, an important aspect in implementing nursing interventions with clients seeking a process of interpersonal interactions that lead to a satisfying experience, and not alone mengusakan client so the client always interacts with its environment and hallucinations did not take place.

  • Spiritual Dimensions
    God created human beings as social creatures, so that interaction with other human beings is a fundamental requirement. At the individual is likely to be alone until the above process does not occur, the individual is not aware of the existence and hallucination into the control system of the individual. Hallucinations when an individual loses control of life.

4. Coping Sources
An evaluation of one's choice of coping strategies. Individuals can cope with stress and anxiety with coping resources in the environment. Source of capital for coping such as problem solving, social support and cultural beliefs, can help a person integrate the stressful experience and adopt coping strategies that work.

5. Coping Mechanisms
Every effort is directed at the implementation of stress, including the immediate problem-solving efforts and the use of defense mechanisms to protect themselves.
the religious field.

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