NSG 6340 Week 6 Discussion ;Psychiatric Disorders In The Adult

NSG 6340 Week 6 Discussion Latest

This week’s content discussed common psychiatric disorders in the Adult and Older Adult client. Often times a secondary diagnosis is masked due to their psychiatric disorder. Review the following case study and answer the following questions.

Mr. White is a 72-year-old man, with a history of hypertension, COPD and moderate dementia, who presents with 4 days of increased confusion, nighttime restlessness, visual hallucinations, and urinary incontinence. His physical exam is unremarkable except for tachypnea, a mildly enlarged prostate, inattentiveness, and a worsening of his MMSE score from a baseline of 18 to 12 today.

Mr. White’s presentation is most consistent with an acute delirium (acute change in cognition, perceptual derangement, waxing and waning consciousness, and inattention). NSG 6340 Week 6 Discussion ;Psychiatric Disorders In The Adult .

What is the most likely diagnosis to frequently cause acute delirium in patients with dementia?

What additional testing should you consider if any?

What are treatment options to consider with this patient?

Submission Details:

Post your response to the Discussion Area by the due date assigned. Respond to at least two posts by the end of the week.

ORDER A PLAGIARISM-FREE PAPER NOW

Schizophrenia is one of the chronic psychological disorders affecting approximately one percent of the American population. Statistics show that it affects men one and a half times more than women. It is characterized by symptoms of thought, and behavioral problems. People who suffer this disease do not sometimes make sense when they are talking and may be delusional and sometimes experience hallucinations. The psychological disorder affect families and societies alike since the people with the disorder cannot at times take care of themselves neither can they hold on to a job thus depending heavily on others. The disorder is treatable through medication as well as psychological interventions. Researchers are using tools that understand the causes of the disorder to develop more effective medicines.NSG 6340 Week 6 Discussion ;Psychiatric Disorders In The Adult .

Introduction:

Psychological disorders can be defined as patterns of behavioral symptoms that influence various areas in people’s lifestyle and create distress on the ones affected (Laurie 142). Examples of psychological disorders include schizophrenia, phobias, anxiety disorders, obsessive compulsion, depression and post-trauma stress disorder. This paper focuses on schizophrenia.

Schizophrenia also known as split personality disorder is a chronic and severe mental illness involving auditory hallucinations, very disturbed moods or social problems, thoughts and behaviors (Laurie 143). The problem of thoughts associated with schizophrenia is described as psychosis. A person suffering from schizophrenia has the kind of thinking that is completely out of touch with the reality. A person may for instance could be hearing nonexistent voices or seeing images that are not there.NSG 6340 Week 6 Discussion ;Psychiatric Disorders In The Adult .For instance in the film, “A Beautiful Mind”, the star character John Nash, experiences both visual and auditory hallucinations. He sees three characters in his life that are completely non-existent. These are: Charles (his roommate), Marcee (the roommate’s niece) and Parcher (his boss from the US Defense Department). In one scene, he leaves his son in the bathtub alone but he claims that Charles is watching over the child. This is a visual hallucination. In yet another scene, he claims that Parcher is instructing him to kill his wife Alicia. This is an auditory hallucination.

Types of schizophrenia

There are five types of schizophrenia depending on the kind of symptoms a patient exhibits during assessment. They include paranoid, catatonic, disorganized, undifferentiated, and residual schizophrenia.

Under paranoid schizophrenia, a person gets preoccupied with one or more delusions or hallucinations but doesn’t get disorganized. This kind of Schizophrenia is brought out really well in the film “A Beautiful Mind”. Nash is very paranoid; he feels that Soviet agents want to kill him because he apparently assisted in sabotaging one of their plots by picking out patterns of information from newspapers and magazines.

In disorganized schizophrenia, a person is disorganized in both speech and behavior but doesn’t get worse to the extent of being catatonic. One of the speech disorders is schizophrenia is loosening of association.

Catatonic schizophrenia is a situation where a person displays two or more of the following symptoms: difficulty in moving, resistance to motion, or excessive moving around, weird movements and imitating other people’s actions (echopraxia). In an article from the journal “American Journal of Psychiatry”, it is well elaborated how pronounced motor in coordination can be in schizophrenia. Following a research, it was seen that in fact motor in coordination can be used to tell the neurodevelopment of Schizophrenia (Schiffman 1041). There could also be cognitive symptoms that are residual as in the case of the 22year-old man in an article by “Clinical Case Studies” (Sass and Nelson 489).

In undifferentiated schizophrenia, a person will do two or more of the things or symptoms done under paranoid, disorganized, and catatonic types of schizophrenia. However such a person classified under undifferentiated schizophrenia doesn’t qualify to be diagnosed of the three former types.

Lastly is the residual type of schizophrenia. Under this type, positive symptoms involving behavior that is beyond normal such as hallucinations, sensitiveness, and paranoia are absent. Instead, the patient has negative symptoms that are mainly about reduced functionalism, quietness, withdrawal and not being interested in things or events. NSG 6340 Week 6 Discussion ;Psychiatric Disorders In The Adult .

Causes of schizophrenia

Schizophrenia is not an expressly hereditary mental disorder but rather a mix of genetic, psychological and environmental factors (Dryden-Edwards 232). Environmentally, the risk of developing the disorder may start prior to birth if for example a person’s mother had some infections while pregnant with the person. Other examples of factors that can lead to the development of schizophrenia disorder are: physical and/ or emotional neglect, sexual abuse, physical abuse, emotional abuse, bullying, and difficult childhood life (Walsh and Fahy 124). Another factor that has been researched on is representation of the minority in a group especially ethnically (Dryden-Edwards 235). In this case, ethnic minorities are more likely to develop schizophrenia if not well represented in a neighborhood.

Symptoms of schizophrenia

The symptoms of schizophrenia can be either positive or negative. Positive symptoms are those that are visibly psychotic such as delusions, hallucinations, disorganized speech, disorganized behaviors, and catatonic characteristics.  NSG 6340 Week 6 Discussion ;Psychiatric Disorders In The Adult .This is clearly depicted in an article published by the journal “Clinical Case Studies” where a 53 year-old man suffering from paranoid schizophrenia presented with auditory hallucinations and persecutory delusions (Hatzipetrou and Oei 339).

Negative symptoms on the other hand are less openly psychotic such as lack of speech, less motivation and inhibited facial expressions.

Diagnosis of schizophrenia

Practitioners often gather comprehensive medical, family, and mental health information to diagnose this disorder. Some of the information gathered include: gender, cultural, religious and ethnic background, sexual orientation and economic well being or financial status. Physical examination and laboratory tests may be included to determine patient’s health status.

Treatment for schizophrenia

There are medications known as antipsychotics that help in reducing the magnitude of psychotic symptoms. These medications are widely prescribed solely or combined with other psychiatric medicines. Examples of antipsychotics are Chlorpromazine (Largactil or Thorazine), Olanzapine (Zyperexa), Risperidone (Risperdal), Ziprasidone (Geodon) and Aripiprazole (Abilify). These examples are the newer versions of antipsychotics often referred to as second-generation antipsychotics that work quickly in comparison to other psychiatric medications. It is important to note that not all antipsychotics that treat adults are advisable for administering in children.

ORDER A PLAGIARISM-FREE PAPER NOW

The side effects of antipsychotics include sleepiness, dizziness, increased appetite, weight gain due to high blood sugar, increased blood lipid levels and increased prolactin level. Older generation antipsychotics such as Perphenazine (Trilafon) may cause muscle stiffness and tremors. These side effects can be so serious as to interfere with patient’s daily activities. For instance, in the film “A Beautiful Mind”, some of the side effects Nash experiences include impaired emotional function which strains his marriage and decreased intellectual capacity which frustrates his work. NSG 6340 Week 6 Discussion ;Psychiatric Disorders In The Adult .To counter the side effects of antipsychotics, are other drugs such as

Another classification of medication is Mood-stabilizer for example Lithium, Carbamazepine (Tegretol) and Lamotriqine. They treat mood changes but may take a longer time to work compared to antipsychotics. According to National Institute of Health (2009), they require close monitoring of blood levels and may cause birth defects when administered to pregnant women.

Besides medication, psychological interventions are important in treating schizophrenia. These interventions include family psycho-education, assertive community treatment, substance abuse treatment, social skills training, supported employment, cognitive behavioral therapy and weight management. These interventions are important to avoid the risk of patient defaulting medication especially because of the side effects such as is the case of Nash in “A Beautiful Mind”. This leads to a relapse as was shown in the film. NSG 6340 Week 6 Discussion ;Psychiatric Disorders In The Adult.