E3 Concepts Flashcards
Psychosis
Losing contact with reality, happens in many different psychiatric disorders
More than one symptom: difficulty processing information and coming to a conclusion, delusions, hallucinations, incoherence, catatonia, aggressive or violent behavior
Schizophrenia
Chronic psychotic disorder, begins in adolescence or early adulthood contains cognitive, positive and negative symptoms
Cognitive symptoms of schizophrenia
Disorganized thinking, problems with memory, poor attention span
Positive symptoms of schuzophrenia
Exaggeration of normal function: Agitation, delusions, paranoia, hallucinations, incoherent speech
Negative symptoms of schizophrenia
Depression of normal function, more chronic/persistent: Poor self-care, poverty of speech, social/emotional withdrawal, flat affect
EPS - Extrapyramidal symptoms or Pseudoparkinsonism
Tremors, masklike face, rigidity, shuffling gait, bradykinesia
Antipsychotic agents
Blocks the action of dopamine (risk of EPS)
Two major categories: Typical/First Generation (FGA) or Atypical/Second Generation (SGA)
Atypical Second Generation Antipsychotics (SGA)
Treats both positive and negative symptoms of schizophrenia
EPS is not as likely, still has other side effects (weight gain, DM2, constipation, fatigue, insomnia, increased appetite, headache)
Typical side effects of SGA’s
Prolonged QT, weight gain, diabetes, and leukopenia/neutropenia (ANC <1000)
Z-Track Injection Method
Pulls skin to leave a (zig-zag) in the skin, reduces any ‘spillage’
Used for long acting antipsychotics, 21 G needle with no massage
Nursing interventions r/t antipsychotics
Monitor for EPS, NMS and WBCS, inform may take 3-6 weeks to achieve effectiveness, encourage smoking cessation, do not combine medications with alcohol, narcotics or other CNS depressants, do not discontinue abruptly
Anxiety
Signs: sense of dread, choking, rapid HR, shaky, feeling faint
Still functional until it is situationally inappropriate or disabling
Benzodiazepine withdrawal
Develops in 2-10 days
Symptoms: Tremor, agitation, nervousness, sweating, insomnia, anorexia, paranoia, seizures
Benzodiazepine Interventions
Monitor vital signs, labs for signs of leukopenia, encourage pt to rise slowly to avoid dizziness, do not use for more than 3-4 months, check for cheeking, no antacids or caffeine at the same time (delays absorption) pt should take with meals to decrease Gi discomfort
Serotonergic Reuptake Inhibitors
Long term treatment of anxiety takes 8-12 weeks for full effect
SE: nausea, headache, insomnia, weight gain, sexual dysfunction, increased anxiety (start low)
Examples of SSRIS
Escitalopram (lexapro) Fluoxetine (prozac) paraxetine (paxil) sertraline (zoloft) citalopram (celexa)
SNRIS examples
Venlafaxine (effexor XR) duloxetine (cymbalta)
Tuberculosis
Mycobacterium tuberculosis (acid fast bacillus) spreads person to person via droplets, contained until AIDS epidemic in 1980s
Disease of lungs, liver, kidneys and other organs
Issues with: susceptibility (AIDS) drug resistance, poor compliance, lack of medications world wide
High Risk: homeless shelters, prison/jails, some nursing homes