NURS_3481 Psychiatric Mental Health Nursing Q&A.

NURS_3481 Psychiatric Mental Health Nursing Q&A. 1. Discuss each of the following major neurotransmitters (GABA, Acetylcholine, Dopamine, and Serotonin) and the role they play in common psychiatric diagnosis. 1. Dopamine-involved with fine muscle movements, integration of emotions, thoughts, & decision making. INCREASED DOPA= schizophrenia & mania; DECREASED DOPA = Parkinson’s & depression. When you think Dopa think schizophrenia pts. 2. Acetylcholine- involved with learning and memory; regulated mood, mania, sexual aggression. Stimulates the PNS. INCREASED ACH= depression; DECREASED ACH= Alzheimer’s dz, Huntington’s & Parkinson dz. When you think of ACH think of memory. 3. GABA- involved with inhibitions, reduces aggression, excitation and anxiety. Also deals with pain perception, anticonvulsant, muscle relaxing properties; can impair cognition and psychomotor.DECREASED GABA= anxiety disorders, mania, Huntington’s INCREASED GABA = reduction of anxiety. When you think GABA think stress & anxiety. a. Glutamate: helps synthesis GABA: the “feel good” elevates mood 4. Serotonin- Plays a role in sleep regulation, hunger, mood states, aggression, pain perception & sexual activity.INCREASED SE = Anxiety; DECREASED SE = depression When you think serotonin think depression. 2. Compare and contrast the impact/effect of psychiatric medications on neurotransmitters in the parasympathetic nervous system and identify resulting side/adverse effects that you may see in your patient (review chapter 4 for specific receptor site impact and related effects).  Ach block- blurred vision, dry mouth, constipation, sinus tachycardia, urinary retention.  NE reuptake inhibition- reduce depression, anxiety, GI disturbances, sexual dysfunction Dopamine reuptake inhibition- decrease depression, psychomotor activation, anti parkinson’s effects.  Serotonin block- reduces depression, reduce suicidal behavior, hypotension and ejaculatory dysfunction. Antidepressants block ACh while increasing NE and SE this can cause blurred vision, dry mouth, constipation, sinus tachycardia, & urinary retention. Second-generation & third-generation antipsychotic meds can also cause a muscarinic cholinergic block while increasing dopa and serotonin leading to dry mouth, blurred vision, tachycardia, urinary retention, constipation. 1 3. Compare and contrast the muscarinic receptor blockade effects and dopamine-blocking effects of psychotropic drugs and identify important teaching for your patient. ● Dopamine-blocking effects include a decrease in dopamine, decrease in the mania/ schizophrenia characteristics, possible increase in EPS symptoms, gynecomastia, galactorrhea (inappropriate milk production), amenorrhea (absence of menstruation) ○ affect primarily the positive symptoms of schizophrenia: hallucination, delusion, disorganized speech (associative looseness), and bizarre behavior. ● Muscarinic blocking effects include all anticholinergic symptoms (dry mouth, blurry vision, urinary retention, etc.), may affect memory, used to counteract dopamine blocking side effects