All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission and further information about the Publisher's permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Although for mechanical reasons all pages of this publication are perforated, only those pages imprinted with an Elsevier Inc. copyright notice are intended for removal.
Notices
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
International Standard Book Number: 978-0-323-47949-3
Senior Content Strategist: Yvonne Alexopoulos
Content Development Manager: Lisa Newton
Senior Content Development Specialist: Danielle M. Frazier
Publishing Services Manager: Julie Eddy
Project Manager: Mike Sheets
Design Direction: Patrick Ferguson
Printed in the United States of America
Dedication
This book is dedicated to people who are living with and recovering from mental illness and to the nursing students and registered nurses who focus on supporting this recovery.
Reviewers
Leslie A. Folds Ed D.; PMHCNS-BC; CNE
Associate Professor of Nursing School of Nursing
Belmont University
Nashville, TN
Phyllis M. Jacobs RN, MSN
Assistant Professor Emeritus School of Nursing
Wichita State University
Wichita, Kansas
Susan Justice MSN, RN, CNS
Clinical Assistant Professor
College of Nursing
University of Texas at Arlington College of Nursing and Health
Innovation Arlington, Texas
Chris Paxos PharmD, BCPP, BCPS, BCGP
Pharmacotherapy Specialist
Department of Pharmacy
Cleveland Clinic Akron General Akron, Ohio
Associate Professor of Pharmacy Practice
Department of Pharmacy Practice
Northeast Ohio Medical University, College of Pharmacy
Rootstown, Ohio
Associate Professor of Psychiatry
Department of Psychiatry
Northeast Ohio Medical University, College of Medicine
Rootstown, Ohio
Preface
As with previous editions, the sixth edition of the Varcarolis' Manual of Psychiatric Nursing Care Planning supports students and practitioners in planning realistic, evidence-based, and individualized nursing care for their patients. This thoroughly updated edition of the Manual provides readers with a foundation for clinical work in contemporary psychiatric settings. The chapters are logically and intuitively arranged in five parts:
• Part I provides a snapshot of basic psychiatric concepts and tools. These chapters focus on the nursing process, therapeutic relationships, and therapeutic communication.
• Part II explores specific diagnostic groups, an overview of major disorders within these groups, and guidelines for developing and providing psychiatric nursing care.
• Part III discusses psychiatric crises such as suicide and family violence and outlines the nursing process as it pertains to these crises.
• Part IV is devoted to psychopharmacology. Eight chapters provide essential information regarding specific classifications of drugs such
as antipsychotics and antidepressants.
• Part V provides a summary of nonpharmacological approaches. Whereas psychotherapeutic models are mentioned in the clinical chapters, Chapter 29 provides an overview of evidence-based therapies such as cognitive–behavioral therapy. Chapter 30 introduces the increasingly common brain stimulation therapies, such as electroconvulsive therapy and vagus nerve stimulation.
Overall, the format of the Manual has been streamlined and blank space reduced. The organization of the clinical chapters now mirrors the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Although some classical references remain, citations are thoroughly updated.
In this edition, we have moved toward a terminology that more accurately reflects the way healthcare professionals describe patient problems in the real world. This move eliminates the use of NANDA-I nursing diagnoses, which requires nurses to learn a second language in addition to the primary terms that are used by other healthcare providers. We hope that this approach will promote and support interprofessional collaboration for nursing students and nurses.
Another random document with no related content on Scribd:
DIA. Xa.
Is a three-seamed overcoat, and must be reproduced and made as fine work requires it, and the person who wears it must be well built, and with a rather small waist and seat. All clothing worn under the overcoat should be neat and well fitting. Erect persons should have the height of back at 13. The sleeve shown in Dia. X corresponds to Dia. Xa. The collar must be sewed on easy, on and along the sides. The whole front edge may be made ½ inch smaller than Dia. X.
DIA. XI.
Dia. XI represents the garment in a three-fourths circle and on a square of 20. The circle itself would make the vest too short, but it represents the correct run of the bottom.
Dia. Xa.
DIA. XII.
Dia. XII represents the same as the foregoing in a three-fourths circle, but on a square of 17½, also the equilateral triangle of 35
Dia. 11.
numbers. Each of the Dia. XI and XII are one square cut from the center of a circle, and in order to make it as simple as possible the vest is again used. The bottom of the forepart is on the circle, but that would make a short vest, and for this reason the back shows 1½ longer.
DIA. XIIa.
Dia. XIIa is made to illustrate all points obtained from the center of a circle, or from a point of the angle of 135 deg. All it requires is to lengthen the lines, so that they are long enough for the full scale. Any other point in any other garment may be found in the same way.
Dia. XIIa.
DIA. XIII.
This diagram I consider very valuable for illustration, because it represents an entire garment from neck to ankle in one continuous form, and on slopes in perfect harmony with the slopes of the body, running to a point at each end, each point at an angle of 15 deg., and both joined at the widest part, representing the largest part of the body, but cut off at the neck and at the feet. The upper part again represents the vest, as the simplest garment worn by man. The starting point for the garment is at a point where the angle of 15 deg. has a width of 17½ numbers. The connecting points of the two angles of 15 deg. are at the front of the waist, or at the pit of the stomach, where the body turns backward, upward and downward, and at the largest part of the seat. The lower point of the angle of 15 deg. is a center for the pants, from which center all connection for the seams may be swept with certainty. And, although this point is not convenient to sweep from for every pants we cut, a cutter must know from what point he can obtain his balance without going to the point—all of which is fully described in the article on “Pants.”
DIA. XIV.
This is simply the lower part of Dia. XIII, but the sides are closely connected on the angle of 15 deg., showing the pants in one solid sheet, which will fit the form of the bare body from waist to ankle. This diagram is in such a position that a new beginner may learn how to produce a nice slope for the side seam. But it is intended to serve for other and more important illustrations. It is to illustrate more fully the so-called back slope.
The upper part, or the waist, is in a perfect square from the front base. If the front and the back bases are laid on top of each other, all the sweeps from point 80 will fit together and the whole front and back will lay in position as most all pants are cut. From the position of this diagram, there is no side, nor back slope; it is simply a square block, consequently, the so-called back slope is only an imagination. But the most important point to illustrate is the following:
Considering the ankles 1¼ inches apart, will give to each side ⅝, and the front base line would run down parallel with the center of the front, though slanting backward, and parallel with the front of the leg. Now, it is true, the lower part of Dia. XIV is on an angle of 15 deg., but the upper part is also on a square, and we will now consider the back square line finished clear down to the bottom of a pants, and cut out a square sheet of stiff paper, as long as a pants may be and as wide as the seat requires to go around it, say 40 inches both ways, and place it on and around the body of a person whose front of abdomen does not reach outside of a straight line, running parallel with the front slope of the legs, and in this position the sheet will fit to the body all along down in front, as well as the back of the waist from the seat upward. The center of the front and the center of the back run parallel up and forward and the square sheet will fit it, but at the top of the side, and at the bottom of the side and at the bottom of the back the square sheet, wound around
the body will be too large, and must be reduced as follows: On top of side of waist one or two gores are cut to represent the difference between the seat hip and waist measure. The bottom at the side and at the back is reduced from a square to a slope of 15 deg., all of which is taken off from behind. It should be observed on Dia. XIV that the center of the front and the center of the back seams run parallel upward and forward above the seat lines, and from the seat lines downward, both the front and back forks start outward of the square, all of which is to be turned inward to pass forward and backward between the legs.
The square sheet must be considered for the outside cover, as though the legs were grown together. Again, a square sheet must be considered so adjusted to the upper body that the square sheet closes in all around the front from top to bottom, and from the seat to the waist in the back, but stands off at the bottom behind where the square is to be reduced to an angle of 15 deg. from seat to bottom. Whatever such a square, wound around the upper body is too large at the waist, must be reduced by one large or by two small gores at the top of side, and it will be found that the reduction of the angle of 7½ deg. is always the difference between the seat and waist measure, and if the waist is as large as the seat, no reduction is required, and if the waist is larger than the seat, allowance must be made at the side and in front. If that division is not properly made the crotch will show the fault, because the sides will take up their share, whether they have too much or too little cloth.
DIA. XV.
The figure on this diagram is poorly drawn, but it serves to illustrate. It gives the side view of the crotch, and illustrates why a larger waist must receive more cloth in front than a normal waist. Fig. I shows the pants from the front or back view, but this gives the side view, the back running backward and the front forward and away from the body. In this position the pants must be considered as in opposite position to Dia. XIV, and connected on the crotch seams. Dia. XV is intended to illustrate the bases for the small waist as well as for the large waist. On the small waist the body of the waist is even with the front pants base, but when the waist becomes larger the base will have to be considered as located inside of the front of the abdomen, as shown on the figure. When the base strikes the front of the body, as on a small waist, the front can be swung sidewise and backward on a straight line, and the back can be swung forward and sidewise, but in order to conform to the seat the back must form the sack for the seat first.
When both the front and the back is settled to the shape of the body, the center of each runs up and down and parallel above the seat line. The larger waist extends outside of the base and after the front is swung sidewise, to the side of the back, the front of the pants must be considered to be brought forward to the front of the body, the hinge being at the side, and when the front of the pants is swung forward with the hinge or swing fastened to the side, the centre of front is too small and must be supplied with extra width. Pants, as well as coats, are fitted from the side forward to the front and from the side backward to the back, and if the diameter of the center of the body from back to front is larger than on the normal form, the ends of the front will not reach the centre of the body in front and more waist proportion must be allowed there. The back must be considered stationary and requires no allowance behind, but
may require allowance at the side if the waist is well filled up there. (See Dia. XX.)
In case of a back or forward leaning waist, Dia. XV will show that the crotch must be considered stationary, and the crotch must also be considered as a hinge on which the upper body swings back and forward, and that if the backward leaning waist requires ½ inch less cloth on top of front, the top of back must receive that ½ inch again, or else the so-called back slope will become too large.
Dia. XV .
The descriptions of Dias. XIII, XIV and XV should be well considered by every cutter. I have figured on them for over twelve years and the result is here given. Others might have done it in less time, but so far as I know, nobody has done it yet.
DIA. XVI.
Dia. XVI shows the front and back of equal width except the tops of each.
DIA. XVII.
This presents the small front and wide back.
DIA. XVIII.
Dia. XVIII illustrates the principle of the fold in the seat, and the back and dress front nearly alike.
Dia. 16. Dia. 17. Dia. 18.
DIA. XIX.
Represents pants of the present style and fashion. The waist is as short as it ought to be for fine pants. Contrast the length of the waist with Dia, XXI. Dia. XIX is calculated for a size 38 seat with a knee 19 inches wide. If this is laid out with a 35 scale, the knee will become 17½ inches wide, which is a good width for a close fitting pants, which will soon come in style again. When small pants legs come in style again, the crotch of such pants will have to be reduced about one seam, and at the bottom the centre will be the same centre, while at the knee the centre of the angle of 10 deg. is also a guide, but there the outside requires about ½ less than the inside, because the inside of the leg is straight, while the outside is hollow.
DIA. XX.
This diagram was made over a pants pattern of the following proportion: Seat, 46 in.; Hip, 47; actual waist measure, 46; waist as made up, 49 in.; knee, 22½; and bottom, 20½ in.
DIA. XXI.
This diagram was made for the purpose of illustrating a pants with a high waist, and how it is to be cut on top in order to have such a pants feel good around the short ribs, and still fitting at the hollow of the waist. The more spring such a pants has near the short ribs, the better it will be. But the buckle straps must be set low, or at the hollow of the waist, so they do not draw that width backward. For the sake of making a change, I have thrown the top of front of the dress side out ¾ and the undress side is to be ⅜.
DIA. XXI.
DIA. XXII and XXIII.
Are the same thing. They are here reproduced to give a correct idea of the so-called “back slope.” Both are turned from point 80, or from the point of the angle of 7½ deg. All connections, or nicks for the seams are on the sweeps from point 80. The leg seams are dislocated, but the balance is the same, and both will fit the same when on the body, and I claim that there never was a truer pants system produced than is represented by these two diagrams.
The complete angles of the different degrees are not made, but the base line, running down to 80, is on the same spot on all foreparts. From point 80 the forepart of Dia. XXII is thrown forward, and in Dia. XXIII it is thrown sidewise, all of which may be imitated on a pants leg, after it is sewed up. Now it will be noticed that each of the two diagrams has a double side, on which it makes no difference where the nicks are located, as long as they are on top of each other, but the disconnected sides must be nicked by the sweeps from point 80.
Five years ago I sent the principle of Dia. XXII and XXIII to the publisher of the “AMERICAN TAILOR,” and the answer may be found in the “AMERICAN TAILOR” of November, 1886, page 98. But as other questions were involved in the same article, and as the “AMERICAN TAILOR” pleased to notice me in 1883 about a certain challenge, I will reproduce the whole of it.
PATRIARCH MILITANT.
CLERGYMAN’S COAT.
In 1882 I had the following advertisement in the Tiffin papers, of which I sent a copy to the “AMERICAN TAILOR”:
TO THE PUBLIC.
Having spent the best part of the last ten years in working out a scientific calculation of the outlines of the human body, I have, after endless ups and downs, discovered, and worked out, an entirely new and heretofore unthought of PRINCIPLE OF GARMENT CUTTING.
I am now ready to announce that my customers may rest assured that they will not only get a fashionable and well made suit of clothing, but that they shall also feel at home in it when they have it on.
Lest it be said that this is only a new game of brag, and to show that all present systems which are known are without a reliable base, I make the following
Challenge to any Tailor or Cutter of Gents’ Clothing from Anywhere:
To cut and make a frock coat, a sack coat, a vest, a pair of pantaloons, and a whole garment from neck to ankle without any cross seams, for a person of any shape or form, whom none of us have ever measured or made clothing for, we will decide by lot—
1st. By what system or rule the coat pattern shall be cut;
2d. The number and size of gores—if any—the fore-parts shall have, and how many seams the sack coat shall have—5, 4, 3, 2—or entirely seamless, except shoulder and sleeve seams;
3d. How many seams the pants legs shall have;
4th. All widths and lengths of the several parts of each garment;
5th. All unforeseen questions arising from the above conditions.
Each to pay his own expenses, and all goods to be selected from the same piece and made up in the same style.
No garment is to be tried on the person it is made for until at a public trial, when the judges, selected by lot and who must not know who made them, shall decide, and their decision must be final.
