Chap 23 Flashcards
Psychiatric conditions
65.1 million Americans diagnosable mental disorder. 1 in 4
7% mood disorder
18% anxiety or panic issues
- 6% Bipolar
- 2 adults have co-occurring mental health and addiction disorders
Causes of altered mental status
Low blood sugar
Lack of oxygen
Stroke or inadequate blood to the brain
Head trauma
Mind-altering substances
Environmental temperature changes
Situational stress reactions
Display
- fear
- grief
- anger
Apply crisis management techniques to keep patient calm. Always assume medical or traumatic causes before assuming psychiatric causes
Psychiatric emergency
A severe break in the patients abilities to process information and interact with their environment. Often associated with a cognitive disorder such as schizophrenia
Acute psychosis
Acute psychosis has occurred when the patient develops one or more symptoms
- hallucinations
- delusions
- Catalonia
- thought disorder
Hallucinations
Inappropriate sensory observations such as visions or voices
Delusions
Falsely held beliefs such as paranoia, the belief that one is being persecuted when that is not the case
Catatonia
Characterised by either an almost complete noninteraction with the environment or wild and completely inappropriate movements and interactions
Thought disorder
Impact a patients ability to process information and to communicate and can cause unusual speech patterns or strange writing
Common signs and symptoms of psychiatric emergencies
- Panic or anxiety
- Unusual appearance, disordered clothing or poor hygiene
- Agitated or unusual activity, such as repetitive motions, threatening movements, or withdrawn stance
- Unusual speech patterns, such as too-rapid or pressured-sounding speech (as if being forced out), or an inability to carry on a coherent conversation
- Bizarre behaviour or thought patterns
- Suicidal or self-destructive behavior
- Violent or aggressive behavior with threats or intent to harm others
Suicide statistics
8th leading cause of death
3rd leading cause in the age group ranging from 15 to 24. Also high in over 40.
Alarming levels in senior citizens
Suicide reasons and methods
Reasons
- Depression causes by chemical imbalance
- death of a loved one
- financial problems
- end to a love affair
- poor health
- loss of esteem
- divorce
- fear of failure
- alcohol and drug abuse
Methods
- drug overdose
- hanging
- jumping from high places
- ingesting poisons
- inhaling gas
- wrist cutting
- self mutilation
- stabbing
- shooting
Reasonable force
Force necessary to keep a patient from injuring himself or others
Restraint if at harm of themselves or others and need police
Restraints
Leather cuffs, waist sizes belt, and at least 3 short belts
Restraints for the wrist and ankles can be made from gauze roller bandages
Restraints must be approved by medical direction
Approach with a minimum of four persons, one assigned to each limb.
Position the patient face up.
Excited delirium (agitates delirium)
Bizarre and/or aggressive behavior, shouting, paranoia, panic, violence towards others, insensitivity to pain, unexpected physical strength and hyperthermia, usually associated with cocaine or amphetamine use.
It is believed that a patient with this condition has an elevated temperature and sometimes alcohol or drug intoxication. The patient will cease struggling and often within minutes the patient is found to have inadequate or absent respiration’s and subsequently dies.
