* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download NS330 Quiz 5 - WordPress.com
Separation anxiety disorder wikipedia , lookup
Social anxiety disorder wikipedia , lookup
Rumination syndrome wikipedia , lookup
Sluggish cognitive tempo wikipedia , lookup
Bipolar II disorder wikipedia , lookup
Eating disorders and memory wikipedia , lookup
Antisocial personality disorder wikipedia , lookup
Combat stress reaction wikipedia , lookup
Mental disorder wikipedia , lookup
Wernicke–Korsakoff syndrome wikipedia , lookup
Major depressive disorder wikipedia , lookup
Glossary of psychiatry wikipedia , lookup
Behavioral theories of depression wikipedia , lookup
Spectrum disorder wikipedia , lookup
Generalized anxiety disorder wikipedia , lookup
Diagnostic and Statistical Manual of Mental Disorders wikipedia , lookup
Diagnosis of Asperger syndrome wikipedia , lookup
Psychological trauma wikipedia , lookup
Treatment of bipolar disorder wikipedia , lookup
Symptoms of victimization wikipedia , lookup
Munchausen by Internet wikipedia , lookup
Evolutionary approaches to depression wikipedia , lookup
Asperger syndrome wikipedia , lookup
History of mental disorders wikipedia , lookup
Factitious disorder imposed on another wikipedia , lookup
Substance use disorder wikipedia , lookup
Child psychopathology wikipedia , lookup
Conversion disorder wikipedia , lookup
Post-concussion syndrome wikipedia , lookup
Dissociative identity disorder wikipedia , lookup
Memory disorder wikipedia , lookup
Cognitive Disorders Factors causing injuries to brain: electrolyte imbalances; ischemia; ↓’d O2 supply Classifications: delirium; dementia; amnestic disorder Amnestic Disorder- loss in both short & long term memory; always 2o other causes (generally head trauma) Delirium- acute change in LOC & cognition that develops over a short period (levels fluctuate); potentially reversible; attention shifts rapidly from one stimulus to another; speech is difficult to understand due to rapid stimulus shifting -causes- dehydration; drug toxicities; abuse of drugs; exposure to toxins; polypharmacy; hypoxia; infection; certain drugs (digitalis, antiHTN, antihistamines, benzos, antiparkinsons, anticholinergics) -characterized by alterations in: memory; abstract thinking; judgment; perceptionprogressive decline in intellectual fxn’ing & ↓’d capacity to perform ADL’s; disorientation to time & place; mayhallucinations/ illusions; often causes 2 o personality traits to manifest aphasia-loss of ability to articulate or comprehend speech; apraxia- inability to perform purposeful movements -memory impairment; paranoia; catastrophic rx’sDisorganized behavior due to a severe shock or threatening situation with which the person cannot cope; impulsiveness; disinhibition- unrestrained behavior; spontaneous undressing Stages: 1.mild- loss of drive, develop anergia, begin to have trouble w/ planning & memory loss 2.moderate- often dx’d here if not id’d in stage 1; trouble w/ date/address; hygiene starts to suffer; dress may be inappropriate; mood lability; paranoia begins; still fxn’l but may be dangerous 3.mod-severe- trouble w/ agnosia; require repeat instructions (signs are helpful); wandering begins; generally require institutionalization; agraphia (inability to express written thought); hyperorality; hypermetamorphosis 4.late- u/a to communicate well, forget to feed self; total care Pharm- ↑supply of acetylcholine -Cognex (tacrine) -Aricept (donezepil) -Exelon (rivastigmine) -sundowning- symptoms become more pronounced in evening -interventions: correct fluid/elect imbalance; safety precautions; ↓stimuli; reorientation (clocks, calendars); assess (labs, LOC, physical needs, mood/behavior); ↑HOB slightly; 5-10min periods of interaction *Folstein Mini Mental Exam Dementia- Deterioration of intellectual faculties, such as memory, concentration, and judgment; sometimes accompanied by emotional disturbance and personality changes Classification: primary- irreversibly & progressive; secondary- result of pathological process: metabolic, AIDS, viral encephalitis, pernicious anemia, folic acid deficiency, hypothyroidism, Korsakoff Types of dementia: Vascular- results from several sm strokes over period of timegradual ↓ in fxn’ing -risks: same as strokes Korsakoffs syndrome- vit B1 or thiamine deficiency over time (often seen in chronic drinkers) Creutsfeldt-Jakob (mad cow) Alzheimer’s- progressive deterioration in: intellectual fxn’ing, memory, ability to solve problems & to learn new skills -genetic link; ↓’d levels of acetyltransferase -cerebral atrophy; neurofibiliary tangles in hippocampus; senile plaques & granulovascular degeneration -progression- 8 yrs from onset to end Defenses: -denial; confabulation-To fill in gaps in one's memory with fabrications that one believes to be facts; preservation; Somatoform Disorders- expression of psychological stress through physical symptoms -physical symptoms suggest medical disorder but no demonstratable proof; symptoms linked to psychobiological factors Somatization disorder- *unconscious, multiple physical complaints w/o apparent or provable cause; h/o pain in at least 4 diff sites, 2 or more GI symptoms other than pain, 1 sexual/reproductive, 1 neuro; comorbid w/ personality disorders & depression (head, chest, back, joint, pelvis, N&V, SOB, palpitations, dizziness, constipation); usually results in social/work interference; ♀>♂ Hypochondriasis- fear of having a serious illness based on misinterpretation of bodily symptoms or fxns; fears & worries often based on single disease; tx is therapy fear lasts >6mos; preoccupations persists despite tests; strong fear of illness/death; concerns reoccur & may interfere w/ fxn’ing; learned behavior; h/o trauma or abuse; comorbid w/ depression Conversion disorder- u/a to explain range of neuro symptoms affecting voluntary motor or sensory fxn (seizures, impaired coordination/balance, paralysis, double vision, blindness, deafness, difficulty swallowing, hallucinations); 2 key identifiers- no plausible explanation & symptoms occur as result of psychological factors; comorbid w/ depression, DID, personality disorders -LaBelle indifference- lack of concern about symptoms Factitious disorder- physical symptoms created for attention or to achieve a purpose (workman’s comp, SSI, emotional needs); -Munchausen’s- induce physical symptoms; extensive knowledge of health care, predictive relapse; symptoms persist only when observed; seek med attention @ numerous locations; reluctant to have family meet w/ HCP’s -Munchausen by proxy- parents induce symptoms in children; parent very friendly & cooperative & appear quite concerned may have h/o Munchausen; suggestive signs- multiple allergies; symptoms disappear when HCP present; parent overly attached; general health conflicts w/ labs; siblings h/o SIDS; children 15mo-6yrs @ greatest risk through; difficulty organizing; avoids difficult tasks; loses things; distracted; forgetful -hyperactivity/impulsivity- fidgets & squirms; leaves seat; runs & climbs excessively; acts as if driven by motor; talks excessively; blurts out answers; difficulty waiting turn; difficulty playing quietly; interrupts or intrudes Body dysmorphic disorder- preoccupation w/ imagined defect in appearance; serotonin deficiency; often seek cosmetic surgery; common complaints skin, hair, face, genitalia, hips, wt, body hair Anxiety disorders- phobias, sleep disturbances, avoidant disorders, overanxious disorder, PT SD Tx for somatoform d/o- behavioral by exposure, reading, taking & confronting personal fears; cognitive restructuring to explore other possibilities for symptoms w/ positive self talk & elimination of negative thoughts Psychological responses to medical illness- responses are triggered when illness is life altering; most common responses- depression- (risk factor for noncompliance) , anxiety, substance use, denial, anger -fear of dependency- exhibit inability to accept warmth, nurturing, tenderness, refusal of tx; holistic assess is useful indicator -psychosocial assess- psychosoc, coping strategies, quality of life overall ADL’s, social activities, social supports, perception of quality of life, feelings & pain -MI- guilt a precursor to major depression; family members need chance to express feelings; giving family members sense of control over care can ↓ stress levels Problems of children & adolescents Risk factors- poverty, parents mentally ill or substance abuse; abuse; minority; teenage parents; families w/ parental conflict or divorce; chronic illness or disability Mental retardation- deficit in intellectual fxn; IQ<70; not synonymous w/ mental illness Learning disorders- impairment in specific academic area; early ID Pervasive developmental disorder- problem in global dev’t -Rett’s disorder- problems after period (6mo) of normal dev’t; ♀ only; psycho-motor retardation & expressivereceptive language -Asperger’s disorder- qualitative impairment in social interactions; no delays in cognition & language dev’t -Autism- dev-global impairment: social, verbal/nonverbal; onset <3yrs; lack of responsiveness to other; little evidence of pleasure; insistence of routine; bizarre response to environment; delayed/absent spoken language; restricted pattern of behavior Disruptive & attention deficit disorders Oppositional defiant- negative/hostile lasting at least 6 mos; not destructive to property; angry, defensive, easily annoyed Conduct disorder (antisocial if >15yrs)- repetitive & persistent violation of rights of others; often see cruelty to animals, aggressiveness to younger children, impervious to pain, fire setting, sexual acting out ADHD- inattention & hyperactivity/impulsivity -inattention (6/9): makes careless mistakes; difficulty sustaining attention; does not seem to listen; does not follow Depression-behavior may mask; may act out; depressive themes in play, fantasy, art, verbalization Bi-polarAdolescent depression- suicidal adol have earlier onset & longer duration of depression; more turmoil in families; social instability in year before attempt; often sexually abused during adolescence Psychosis- same dx criteria as adults; pos symptoms such as delusion, hallucination, disorganized thinking Maladaptive responses- inappropriate sexual activity; homosexual problems; wt problems; occult involvement; experiment w/ alcohol & other drugs