Cognition

Psychosis

Perceptual motor function

Mini-Mental status examination

Premorbid IQ learning diability screening

Positive symptoms: Delusions, hallucination, disorganized thought, disorganized or abnormal motor behavior

Negative symptoms: Psychosis, extrapyramidal symptoms, neuroleptic malignant syndrom

Lead levels

Developmental Delay

2 month: Lift head, alerts to sound/smiles, recongize parent

4 month: rolls, graspa, laughs, head turn to sound

6month: Sits, transfer objects, stranger anxiey, feeds self

9month: Pulls to stand, bangs objects, says mama/waves, pat a cake games

12month: stands/walks alone, one word, follows one step gommands with gesters, points to desered object

15 month: scribbles 3-5 words, uses spoon and cup

18month: runs, build tower,

24 mont: Throws, 50 voacyaly, removes an article of clothing

36 month: pedal in triclye, speaks 3 word sentence

48 motnth: hops,

60 month: skips, defines simple words, 5 word sentences dresses self

Spectrum disorders

Abnormal frontal and nueron are not formed

Attention-deficit/hyperactivity disorder (ADHD)

Neuro transmitter problem (dopamine, norephinepherin)

Alzheimer disease sever and progressive forgets self while in dementia they remember thier childhood.

Schizophrenia

psychotic disorder characterized by disturbances in thought, behavior, and perception

RF: family hx, prenatal/birth complications

Postive s/s: (something ADDED to a typical person)

Delusions: false beliefs. Ex: I am a spy for the secret service

hallucination: False sensory perceptions. Auditory, visual, tactile, gustatory (taste), or olfactory. Ex: pt hears voices tell him “we are coming to get you”

Disorganzied speech: Flight of ideas (rapid shifts from one unrelates topic to another), pressured speech (rapid), neologism (new/unrecognizable words), echolalia (reports words), word salad (real words combined randomly in an incoherent way), clang association (similar or rhyming words are comdined)

Negative s/s: (something MISSINGS from a typical person)

Catatonia: immobility or abnomral movements (waxy flexibility)

6As: Anhedonia (lack of pleasure), Flat Affect (lack of expression), Apathy (lack of interest), Anergia (lack of energy), Alogia (lack of speech), Avolition (lack of motivation)

Dx: 2 or more sympomts present for 6 months or more, behavior disrupts social and//or occupational environment. Rule our phsiological causes 9electrolye imbalance, hypogrlycemia, substance use).

Tx: First or second generation antipsychotics, CBT, individual and group therapy, social skills training. ACT for individuals wtih severe and persistent schizophrenia

NC: Ask the pt abt the hallucinations, because command hallucinations may place the pt or others at risk. Acknowledge, but do not validate hallucinations. Provide distration from hallucinations/provide a safe and calm environment. Do not whisper to others in pt presence. Warn the pt before touching, reorient pt to reality as needed, moniotor for suicidal ideation, depot (slow-release IM) medications are ideal to imrpove comliance.

Non-pharm

Cognitive behavioral therapy

Electroconvulsive therapy

Suicide precautions

Assertive commmunity treatment

ECO: emergency custody order, right to detain him for up to 8 hrs

TDO: temporaty detainment order, lasts up to 72 hr

recommnedation must come from magistrate

Medication

1st generation antipsychotics-dopamine receptor antagonists

Loxapine (adasuve) inhaled

Fluphenazine

Haldol decanoate

Haloperidol

2nd generation antipsychotics-serotonin-dopamine antagonsist

Asenapine

Clozapine

Iloperidone

Lumateperone

Lurasidone

Olanzapine

Paliperidone

Quetiapine

3rd generation antipsychositcs-partial dopamine D2 agonsist

Aripiprazole

Cariprazine

Brexpiprazole

Lumateperone

Anticholinergics

Benztropine

Diphenhydramine

Atypical antipsychotic-end generation

Risperidone

Aripiprazole

wt gain hyperglycemia metabolic syndrom black box warning for irratbility in atusitm

Acetylcholinesterase inhibitor for dementa but for mild-moderate

Galantamine

Cholinesterase inhibitor alzhemirs the mine piperals

Donepezil

Rivastigmine

CNS stimulants

Methylphenidate and Amphetamine

Indications: ADHD, conduct disorders, narcolepsy

MOA: CNS stimulation, which increases mental alertness and attention

SE: Insomnia, arrhythmias, decrease appetite, weight loss

NC: Monitor weight during th

erapy

PT: Do not take at night. For children, periodic drug holidays (withholding medication on weekends and summer months) may be appropriate to increase growth and decrease SE during those times

Abuse, dependence

Dextroamphetamine

Hallculation seeing hearing

Delusions is BELIVING

Primary feature of psychosisis: loss of contact with reality

What neurotransmitter is primarily linked to schizophrenia? Dopamine

Nicatine helps alivate the symptoms,

Gaba and cytocole can also cause like psychosis?

What is an example of negative symtoms: Social withdrawl, flat affect, lack of motivation

Example of positive: Paranoia, seeing things, hearing voices

Positive something added to their life, negative is something taking away from thier life

Which sympoms is condider postive: Hallucinations

What phase of schizophernia does the pt appear? Acute phase showing s/s

Resdiual phase/maintaince pahse

Prodromal phase: showing like insomia liek just starting to show symptoms

Medical clearnce: Pt needs to be medically healthy to

Schizophernai is having a psychotic epsoids what can ya do? providing a calm and safe environment

Nursing intervention for apt with schizophrenia experiencing delusions? Reassuring saftey and reality orientation

What medication is for mood stabilizing effects by blocking D2 dopamine and 5-HT serotonin receptors? quetiapine/seroquel

Trazodone: Atipycal antipsycotic Lorazepam: Benzodiapine Sertaline:

Anticolgenatic are used for the side effect, dry up secretions

Medical clearnace order set: Toxicology screening, urinalysis, ECG, CBC, CMP, preagnacy test, x-ray d/t injury, CT scan of head.

hospilist: