CU NR 546

How does reviewing the genetic makeup of a client help guide the PMHNP in selecting medication for clients? - Genetic testing can assist by providing more information on how clients may respond to certain psychotropic medications, as well as providing information on how a client may break down and metabolize medications based on the cytochrome P450 system. There may be an environmental exposure that turned a gene "on" that should have been "off" for one twin to develop schizophrenia and not the other . Both environmental and psychosocial stressors can impact mental health. Although twins may have identical genes, their gene expression may be different. Neuroscience - is the study of the structure and function of the brain and is a field which is making great advancements (Pliszka, 2016). A strong foundational understanding of neuroscience and how the structure and function of the brain can result in mental health symptoms is necessary to treat mental illnesses. Some mental disorders such as Alzheimer's disease, schizophrenia, and major depressive disorder are thought to be a result of malformations or malfunctions within the brain. The psychiatric mental health nurse practitioner (PMHNP) must comprehend how medications impact the brain in order to safely and effectively prescribe psychotropic medications. Brain tissue - is composed of gray and white matter. gray matter - The cerebellum, cerebrum, brain stem, and the butterfly-shaped portion of the central spinal cord are comprised of gray matter which contains neural cell bodies, axon terminals, dendrites, and all nerve synapses. It is the working area of the brain and the focus of psychiatry and neurology. Gray matter - associated with learning. Changes in the gray matter are linked to psychiatric diagnoses including Alzheimer's disease, schizophrenia, and major depressive disorder. White Matter - contains nerve fibers that connect neurons from different regions into functional circuits. The myelin that coats neuronal axons is necessary for electrical impulse transmission. Think of the white matter as a transit system. If there are breaks in the system, then people cannot get to their destinations. Within the brain, these breaks affect neural communication, affecting behavior. Damage to the myelin can impair transmission which can impact not only sensory and motor function, but also cognition. White matter abnormalities are associated with autism and vascular dementia. The central sulcus separates which lobes? - frontal lobe from parietal lobe Frontal lobe - Associated with movement, intelligence, abstract thinking. etc. Broca's area - Speech Temporal lobe - Involves object identification and auditory signals Cerebellum - coordination and balance Wernicke's area - Speech comprehension occipital lobe - Primary visual area parietal lobe - Keeps us alert to what is going on around us Sensory Cortex - Pain, heat, and other sensations motor cortex - Movement Hippocampus - Involved in both memory and anxiety Nucleus accumbens - Involved in the reward process. Thalamus - Involved in sensory organ and motor command processing