NUR236 Mental Health Exam

What is a mental health assessment? - -process of obtaining information about specific aspects of individuals mental experiences and behaviours When to conduct a MHS - -during admission, in course of taking history, change in clinical presentation Why should you conduct a MSH - -identify signs and symptoms, monitor change/improvement, may inform treatments/interventions What is the depot injection - -Anti-psychotic medication administered through a deep intramuscular injection given fortnightly What is the "dopamine hypothesis"? - -psychotic symptoms of schizophrenia are because of excess dopamine activity in the synapse What is schizophrenia characterised by? - -characterised by psychosis = reasoning and thinkings are disordered - loss of contact with reality + exhibit hallucinations What are the three phases of schizophrenia? - -1. prodromal - loss of social, organisational and intellectual functioning. 2. Acute - distortion of perception - further loss of functioning, increase in hallucinations, delusions, decreased self-care, acute stress/anxiety. 3. Chronic - "burnout" of positive symptoms + increase in negative symptoms Positive symptoms of schizophrenia - -thought disorders - delusions (illogical and incoherent thinking) e.g. disorganised speech and behaviour, exaggeration of distortion of normal function, hallucinations negative symptoms of schizophrenia - -reduction in normal functioning e.g. apathy, loss of pleasure, social inactivity, lack of motivation and energy, low mood and depression what are Extra pyramidal side effects (EPSM)? - -anti-psychotics work on dopamine and dopaminergic pathways -- produce motor side effects Side effects of EPSM - -Dystonia - muscle spams in the neck, jaw, and back Parkinsonism - tremor, bradykinesia (flat voice, facial expressions, movement), bradyphrenia (slowed thinking), salivation Akathisia - restlessness, pacing, fidgeting Tardive dyskinesia - lip-smacking, difficulty eating, speaking and breathing NUR236 NUR236 What is BPAD? - -bipolar disorder - extreme cycles in one mood "manic depression", extreme "Highs" and "lows", caused by neurotransmitter imbalance, HP axis significance, and differences in blood flow to brain Treatment of BPAD? - -depressive symptoms = anti-depressants manic = anti-psychotics, anxiolytics + mood stabiliser What are mood stabilisers? - -Lithium - naturally occurring salt that treats bpad others: CBT, occupational therapy and electro-convulsive therapy Why conduct a mental health risk assessment (MHRA)? - -process of assessing possible factors of risk factors of a persons mental health problems on themselves when to conduct a MHRA? - -during admission, on discharge/transfer, informally constantly, change in presentation, in course of taking history principles of a risk assessment? - -identify risk = manage it, risk = normal and dynamic, risk = not emiliminated but minimised risk assessment - static - -gender, ethnicity and history - generally fixed and in the past e.g. previous history of self harm risk assessment - dynamic - -anything that might come along and change levels of current risk e.g. anniversaries what are the 5 classes of psychotropic medication - -lytics/sleepers 2. anti-depressants 3. anti-psychotics 4. mood stabilisers 5. stimulants What are anxiolytics? - -Anti-anxiety agents - benzodiazepines e.g. diazepam e.g. clonazepam e.g. lorazepam e.g. nitrazepam all have different half life which influences speed, period, and intensity of action What are benzodizapines? - -enhances effects of GABA on receptor sites - used for anxiety, sleep disturbance, and as a muscle relaxant effects: drowsiness, muscles weakness, constipation, nausea What are anti-depressants? types? - -most common psychotropic medication/side effects: agitation/anxiety, nausea, indigestion, diarrhoea or constipation, dry mouth, excessive sweating - selective serotonin reuptake inhibitors (SSRIs) NUR236 NUR236 - prevent the re-uptake of serotonin -- maximises potential in synapse - nausea, vomiting, headache, dizziness, dry mouth -- selective noradrenaline re-uptake inhibitors - similar to SSRI's but target the re-uptake of noradrenaline - dizziness, headache, nausea, insomnia -- monoamine oxidase inhibitors (MAOIs) - affects chemical messengers (neurotransmitters) used to communicate between brain cells (dry mouth, insomnia, dizziness) -- tricyclics - first generation anti depressant - often sedating and addicting - constipation, drowsiness, sweating Whats an example of a stimulant? - -Amphetamines - inhibit re-uptake of dopamine by holding dopamine onto the receptor sites - stimulating them - stimulation of dopamine -- better concentration and focus effects - nervousness, insomnia, loss of apetite What are "typical" anti-psychotics - -- 1st generation - EPSP bad side effects - block dopamine receptors as per the dopamine hypothesis but it blocks other receptors causing bad motor side effects - used for: schizophrenia, acute psychotic episodes - side effects: EPSE. dry mouth, constipation, blurred vision What are "AAAA-TYPICAL" anti-psychotics - -- 2nd generation - more specific to dopamine 2 receptors and also act on serotonin -- associated with mood and logical thinking - first: clozapine - effects: weight gain, insulin dysregulation, loss of libido What is the Z track? - -For dark-coloured medication solutions or solutions that irritate the tissue - pull skin away from site to displace the tissue - inject medication (med sealed deeply within muscle - allows no exit path into subcutaneous tissue) - dont massage after injection What causes depression? - --no specific cause -genetics - neurochemical factors - decrease in functioning along serotonin and noradrenaline pathways - abuse/traumatic events