Mental Health Exam 2 SG

Dopamine - increase - Schizophrenia

Serotonin - decreased - Depression

Norepinephrine - decrease - Depression

y-Aminobutyric acid (Glutamate )- decrease - Anxiety disorders

Acetylcholine - decrease - Alzheimers

Broca’s area is responsible for speech.
Patients with damaged broca’s area has difficulty understanding syntactically complex or semantically reversible sentences (e.g., “touch your nose after you touch your foot”).

Many drugs, such the older neuroleptic antipsychotics, interact with ACh and its receptor sites to produce anticholinergic side effects, which occur when muscarinic acetylcholine receptors are blocked.

1st generation ( typical ) antipsychotics - blocks D2 receptors - not selective

2nd generation (atypical) antipsychotics - blocks D2 and 5HT2A receptor (dopamine and serotonin ) - somewhat selective

blocks D2 receptors - not selective

blocks D2 and 5HT2A receptor (dopamine and serotonin ) - somewhat selective

brain’s principal inhibitory neurotransmitter

Turns off nerve cells and slows or stops actions in postsynaptic neurons.

Donepezil (Aricept) and other similar drugs inhibit the cholinesterase enzyme that breaks down ACh. This increases the amount of available ACh, thereby delaying the onset of symptom

Genetics

Auditory hallucinations

Increased sexual focus

Decreased motivation

Alterations in memory

Altered emotional responses

Sensory aphasia

Affect fluctuates dramatically

Changes in affect, such as flattening

Alteration in language production

Alteration in motor functioning

Impulsive behavior

Impaired decision making

Concrete thinking

pt may experience intense fear, helplessness, or horror
pt can be agitated or behave in disorganized manner.
Pt can have sleep disturbances, irritability or angry outbursts, difficulty concentrating, hypervigilance, and an exaggerated startle response

Risk for suicide •Anxiety •Death anxiety •Stress overload •Self-mutilation •Hopelessness •Powerlessness •Social isolation •Disturbed sensory perception •Disturbed thought processes •Insomnia•Impaired memory •Deficient knowledge •Fear •Fatigue •Chronic low self-esteem •Disturbed body image •Risk-prone health behavior •Ineffective role performance •Ineffective coping •Defensive coping •Ineffective denia

l•Impaired social interaction •Compromised family coping •Interrupted family processes •Spiritual distress •Decisional conflict •Noncompliance •Posttrauma syndrome •Risk for posttrauma syndrome

Palpitations, racing heart, BP changes. fainting,

Rapid and shallow breathing, pressure in chest, SOB, gasping, lump in throat

Loss/Increased of appetite, abd discomfort, feeling of fullness, nausea, heartburn, diarrhea

Hyperreflexia, insominia, tremors, pacing, clumsiness, restlessness, flushing, sweating muscle tension

Decreased libido, increased frequency or urgency of urination

Decreased attention, inability to concentrate, forgetfulness, impaired judgment, thought blocking, fear of injury or death

Rapid speech, muscle tension, fine hand tremors, restlessness, pacing, hyperventilation

Irritability, impatience, nervousness, fear, uneasiness

•Maintain safety for pt and environment •Assess your own level of anxiety and maintain calm •Recognize relief behaviors of pts. •Inform pt importance of limiting caffeine, nicotine, and other CNS stimulants •Teach pt to distunguish between anxiety with identifiable and nonidentifiable sources •Instruct pt in reducing anxiety techniques: progressive relaxation , mindfulness meditatiom, slow deep breathing exercises, focusing on single object in room, listening to soothing music or relaxation tapes, visual imagery or nature- related DVDs, and exercises. •Help pt build coping methods •Help pt identify support groups who will help pt perform personal tasks and activities that current circumstances make difficult •Assist the pt with gaining control of overwhelming feelings and impulses through brief and direct verbal instructions •Help pt structure environment •Assess presence and degree of depression and suicidal ideation •Administer anxiolytic medication •Help pt understand importance of medication regimen

requires brief, directive verbal interchanges aimed at increasing feelings of safety and security

Benzodiazepines must be used short term due to tolerance and dependence.
Counsel pt about risk of mixing alcohol with medications and avoid driving or operating machinery.
Teach pt about effects of Kava Kava, St. John’s wort and grapefruit with benzodiazepines.
MAOIs can increase BP with Busipirone

ANS excessively stimulated (increase v/s, diaphoresis, urinary urgency & frequency, present diarrhea, dry mouth, decreased appetite and dilated pupils) •muscles rigid and tense •Senses affected •Hearing and pain sensation decreases •Perception field is greatly narrowed •Problem solving is difficult •Selective attention •Distortion of time •Dissociative tendencies, •Detachment •Vigilambulism •Feels threatened and startled with new stimuli •Activity increases or decreases •Appears and feels depressed •Demonstrates denial •Complains of aches or pains •Agitated or irritable •Need for space increases •Eyes may move around or fixed gaze

•Identify situations and events that trigger anxiety and select ways to prevent or manage them. •Describe anxiety symptoms and levels of anxiety. •Discuss the connection between anxiety-provoking situations or events and anxiety symptoms. •Explain relief behaviors openly. •Identify adaptive and positive techniques and strategies that relieve anxiety. •Demonstrate behaviors that represent reduced anxiety symptoms. •Use learned anxiety-reducing strategies. •Demonstrate the ability to problem solve, concentrate, and make decisions. •Verbalize feeling relaxed. •Sleep through the night. •Use appropriate supports from the nursing and medical communities, family, and friends. •Acknowledge the inevitability of the occurrence of anxiety. •Discuss the ability to tolerate manageable levels of anxiety. •Seek help from appropriate sources when anxiety is not manageable, including websites such as www.adaa.org (i.e., the website of Anxiety Disorders of America) •List the medication that are used to control the symptoms as well as the appropriate dosage and scheduled times. •Continue postdischarge anxiety management, including medication and therapy

Light
Pleasure
“feel good transmitters”: dopamine, serotonin, opioid peptides, and other neurochemical predopaminate
Dark
Withdrawal symptoms
Norepinephrine and corticotropin-releasing factors (CRF) as well as the stress circuits are activated