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211 cognition notes
Health Care Concepts II (NSG 211)
Germanna Community College
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NSG 211 Psychosis and Cognition Last class recap: Schizophrenia ↴ Positive S/S: treated with allopurinol, chlorpromazine, fluphenazine ● Hallucinations ● Delusions ● Speech ● Bizarre behavior (waxy flexibility / stuck) ● Catatonic behavior Negative S/S: ● anhedonia ● Social isolation ● Abolition - loss of motivation ● Inertia- lack of energy ● Blunted affect Atypical antipsychotic: treat negative and positive symptoms Omeprazole clozapine (kills you by agranulocytosis, patient will look pale and ill, watch WBC) Side effects: Metabolic syndrome: cholesterol goes high, weight gain, body can’t deal with insulin NMS (neuroleptic malignant syndrome): related to all antipsychotics, rigid muscles, altered cognition, and fever (can give bromocriptine and dantrolene) Traditional antipsychotics: EPS- tardive dyskinesia, acute dystopia (give benztropine), Akesthesia (constant movement) pseudoparkinsonism Delirium vs Dementia ● Safety is priority ● Reorient patient ● Common in the ICU ● Delirium : there is a underlying cause like a UTI, electrolyte imbalance, lack of sleep, mixed medications, substance use, it is acute onset and reversible by treating it , it is fluctuating -60% of nursing home residence -secondary to another condition -illusions and hallucinations -antipsychotics -expectation and goal is getting pt back to baseline Lewy body: plaque and tangle deposits in the nerve cells, it is physical -about the body
Vascular Dementia: damage related to blood flow , about the vessels - -no cure -blood pressure -cholesterol -diabetes -smoking Amnesia: memory loss Aphasia: loss of language Apraxia: loss of purposeful movement in the absence of sensory / motor impairment Agnosia: loss of sensory ability to recognize objects Talking to someone with dementia patient: Identify self each time Speak slowly using short words and phrases Focus on one piece of info at a time Tay to reinforce reality Ensure patient is wearing glasses and hearing aids Keep room well lit Two patients get into argument:separate them (distract them, asking them for help) Id aggressive use distraction Safe home environment Assessment: PET scan CT MH exam ● Alhimierz -mild / moderate / serve, late stage (stages 1-7) - mild cognitive decline and starts to increase -80% of cognitive disorder -can use medications to manage symptoms and slow the progression -earlier start of med is better to get a jump start on slowing it down -NO MED TO CURE -tends to have genetic link -impacts attention, language, learning, memory -core related to insulin resistance - 5X more likely to develop with alcoholism -language clanging ● ACETYLCHOLINE INHIBITORS : Aricept, exelon patch l Risk factors: Higher taxes of diabetes and hypertension Lower educational levels increases the risk for AD Socioeconomic levels Adequate medical care Poor diet, obesity, and insulin resistance
ASD (autism spectrum disorder): ● ABA therapy- applied behavioral analysis , it is good to give positive reinforcement ● 2 categories of common struggle is : there’s a disruption in social and sensory ● Two main meds need to know: Atypical antipsychotic: RISPERIDONE AND ARIPIPRAZOLE issues with NMS ● Repetitive behaviors, perseveration Oppositional Defiant vs Conduct Disorder: both child and adolescent disorders Oppositional defiant (ODD) is defined by defiance and argumentative with authoritative figures: -multiple settings over a period of time -more angry than a typical teenager Conduct disorder is someone who violates the rights of others: - Lack of empathy and guilt - No emotion, flat and blunted affect - No concious - Hurting people, animals, stealing, setting fires - Many things can cause it like abuse, neglect, and trauma - Trust vs mistrust impacts them later in life - Controlled environment is important for patient with this disorder - After long therapy patients can begin to have empathy and recognize how and why they are feeling certain ways Tourettes:
211 cognition notes
Course: Health Care Concepts II (NSG 211)
University: Germanna Community College
