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Protruding and rolling tongue, blowing, smacking, licking, spastic facial distortion. •Limbs –Choreic: Rapid pursposeless and irregular movements –Athetoid: slow, complex and serptentine movements –Trunk: Neck and shoulder movements, dramatic hip jerks and rockingand twisting pelvic thrusts NEUROLEPTIC MALIGNANT SYNDROME:•Fatal syndrome •Can occur anytime•Early sign: rigidity or mental status changes–LOC:Obtundation –SNS response: Labile BP, Tachypnea, tachycardia, diaphoresis , fever–Muscle abnormality: catatonic, myoclonus, Tremors –Speech Problem: dysphagia, dysarthria –Lab: HyperK, HypoNA, Met acidosis, Renal Failure•Hyperprolactinemia–“Nesting,” breast tenderness, depression in men, stop menses, galactorrhea in women, osteoporosis, fracture•Metabolic syndrome: –weight gain, metabolic derangement, type II DM, increase lipids. DROP:Anticholinergic Side Effects ◦Orthostatic Hypotension◦Urinary Hesitancy/ retention◦Decreased memory ◦Constipation DRY:◦Dry mouth ◦Dry EyesBLIND:◦Photophobia ◦Blurred vision ANTI-PARKINSONS DRUGS:•Anticholinergic–Akineton–Artane–Benadryl–Cogentin
MENTAL HEALTH WEEK 2 NOTES–Dopaminergic–Parlodel–Larodopa–Symmetrel–EldeprylA client has been receiving chlorpromazine (Thorazine), an antipsychotic , to treat his psychosis. Which finding should alert the nurse that the client is experiencing pseudoparkinsonism?a)restlessness, difficulty sitting still, pacingb)involuntary rolling of the eyesc)tremors, shuffling gait, mask like faced)extremity and neck spasms, facial grimacing, jerky movementsThe nursing student heard in report that her patient had “Loose associations” Which indication is the nurse referring to?A.paranoia.B.mood instability.C.depersonalization.D.poorly organized thinking.The nurse is admitting a patient in the locked unit after a suicide attempt. Which assessment finding represents a negative symptom of schizophrenia?A.AvolitionB.DelusionC.Poor memory recall D.HallucinationFINAL EXAM REVIEW: 1.Clozorile (normal wBC/ ANC) if pt had above 200 aNC and 3500 WBC2.RN – PT relationship and phases of it3.Side effects of ani-psychotic drugs4.Maslow & Erickson stages 5.Have to identify something from freud so know id and stuff6.Preconscious/ subcontious7.Know claiming8.Know all the definitions of todays lecture (wk2)9.Cultural sensitivity10. Characterisitcs of anurse whos culturally competent11. Know reporting relationship12. What do you do for homicidal pt with specifc person in mind (tell police and the individual)13. Know working w psychotic pt for the nursing assess/ actions/ interventions14. Who needs to be put in seclusion and who oesnt 15. Pay attention to competency café: time restraints and types of nots16. Therapeutic communication ******
MENTAL HEALTH WEEK 2 NOTES17. When is therapeutic comm justified/ unjunstified18. Symp of a psych pt – what would be part of the nursing process19. How you would deal w a schizophrenic pt? would you send the to a room wuth others to read a book ? NOPE20. ERICKSON- STAGES AND AGES THAT GO WITH THAT and what is the task