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Mental Health Nursing

Mental Health Nursing

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Published by: api-3842758 on Oct 18, 2008
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Mental Health Nursing
Psychiatric Nursing
SUPPLEMENTAL
BULLETS
\ue000TYPICAL PROFILE OF PATIENT WITH ANOREXIA NERVOSA \u2013
FEMALE , ADOLESCENT,UPPER CLASS ,PERFECTIONIST
\ue000A PaTIENT WITH AN EATING DISORDER UNCONSCIOUSLY
ASSOCIATES FOOD WITH LOVE AND AFFECTION
\ue000LITHIUM LEVEL TOXIC AT 2.0 mEq / L
\ue000NEUROLOGIC SIGNS AND SYMPTOMS INCLUDE NAVDA,
TREMOR, HYPERREFLEXIA,FASCICULATIONS, BRADYCARDIA ,
ARRYTHMIAS ,SEIZURES AND COMA
\ue000Korsakoff\u2019s Psychosis : inability to process new information ( to

form new memories). This is a reversible condition resulting from brain damage induced by a thiamine deficiency which is generally secondary to chronic alcoholism.

\ue000Werniche\u2019s Encepalopathy : This disease is also due to an
alcoholic-induced thiamine deficiency. It is an irreversible disease in
which the brain tissues break down, become inflammed, and bleed
Pharmacological treatment of alcohol withdrawal \u2013
benzodiazepines or barbiturates

\ue000First symptom of Alzheimer\u2019s Disease \u2013 progressive memory loss
\ue000Effective long term treatment for alcoholics \u2013 AA
\ue000Methadone causes analgesia without euphoria,withdrawal symptoms less

severe than heroin
\ue000Medical/ health professionals prone to have anxiety and depression treated by
generalist rather than physicians

Delirium \u2013 reversible organic mental syndrome reflecting deficits in
attention, organized thinking, orientation , speech, memory and
perception. Patients are frequently confused, anxious , excited and
have hallucinations. A change in consciousness can be
observed(clouding of consciousness)

\ue000Dementia \u2013irreversible impaired functioning secondary to changes /

deficits in memory, spatial concepts, personality , cognition ,
language , motor and sensory skills, judgement or behavior. No
change in consciousness

Substances that mimic generalized anxiety \u2013 amphetamines , cocaine ,
anticholinergics, alcohol and sedative withdrawal

\ue000Geriatric drug induced hallucinations commonly due to propanolol
\ue000Major risk or TCA\u2019s \u2013 orthostatic hypotension leading to falls
\ue000Symptoms of alcohol withdrawal and their temporal relations

\ue001Hallucinations \u2013 after 24 hours
\ue001Autonomic hyperactivity \u2013 after 6-8 hours
\ue001Global confusion 1-3 days after

Side effects of Ritalin \u2013 insomnia abdl. Pain,
depression, anorexia, HA and HPN
\ue000First episode of Bipolar disease \u2013 mania before depression
\ue000Lithium used for mania and \u2013 bulimia , anorexia nervosa, alcoholism with mood
d/o, headaches
\ue000Borderline personality d/o \u2013 Chronic Boredom
\ue000Parotid gland swelling and erosion of teeth enamel, elevated serum amylase
and hypokalemia \u2013 Bulimia
\ue000Conversion d/o \u2013 internal psychological conflict that manifests as somatic
symptoms.
Dysthymia \u2013 chronic d/o more than 2 years
\ue000Symptoms of depression

\ue000I
\ue000Nterest down
\ue000Sleep
\ue000Appetite
\ue000Depressed mood
\ue000Concentration diff.
\ue000Activity
\ue000Guilt
\ue000Energy low
\ue000Suicide

Dystonic rxn \u2013 side effect of neuroleptics-muscle spasm
of tongue, face and neck and back,laryngospasm and
extraocular muscle spasm

\ue000Dystonic rxn \u2013 treated with Benadryl or Cogentin
\ue000Hallucinogens affect \u2013 serotonin
\ue000Munchausen syndrome \u2013 harm oneself \u2013 factitious d/o \u2013

manchausen by proxy \u2013 seeks medical care for another (e.g. child)
Haloperidol \u2013 prefrred neuroleptic \u2013 few side effects ,
can be used IM during emergencies( but high
frequency of extrapyramidal effects)
\ue000Clozapine \u2013 no tardive dyskinesia but can develop agranulocytosis ,
seizures,hypotension, over sedation.
\ue000Benzodiazepine contrindications \u2013 pregnancy ( 1st trim)acute narrow angle
glaucoma, and hypersensitivity
\ue000Extrapyramidal Rxns- involuntary spontaneous motor movements \u2013 dystonis,
akathisia and parkinson like syndrome
Obsessive \u2013 Compulsive d/o \u2013begins before 25 y.o. \u2013
SSRI and exposure therapy beneficial

\ue000Positive operant conditioning \u2013 reinforce positive behavior
\ue000PTSD possible even though there is no actual witnessing of event
\ue000Flashbacks , nightmares,intense fear,avoidance and diminished

memory of event with an exagerrated startle response onset occurs
at least 6 months - PTSD
Post partum psychosis \u2013 first few weeks post-partum(7-
10 d/6-8wk,)primiparous,poor social support and
previous depression
\ue000Schizophrenia \u2013

\ue002Association looseness
\ue002Ambivalence
\ue002Autism
\ue002Affect inappropriate
\ue002Hallucinations + A\u2019s+ Regression + Delusions + Stimuli comprehension low

\ue000(HARDS)
Somatization d/o \u2013 multiple , unexplained medical
symptoms(four unexplained pain Sx)
\ue000Suicide \u2013 bipolar d/o, depression, substance abuse and schiz.
\ue000Reliable predictors of potentially violent patient \u2013 male gender , Hx
of violence , history of substance abuse
\ue000Organic brain syndrome most frequent mood \u2013 irritability
\ue000Labile affect \u2013 rapid shifts of mood
Medication used to relieve extrapyramidal effects of
psychotropic medications:

\ue000Benadryl
\ue000Artane
\ue000Cogentin

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