Psyc Test final

Neuroleptic Malignant Syndrome

• Distract Patient from hallucinations
• Use validation to facilitate communication
• Provide safe, structured environment and titrate stimuli in environment to patient

• Protect patient from harming self/others
• Do not challenge delusional thinking
• Provide reality based activities to help patient understand what is real/not
• Monitor medications

• Encephalopathies
• Sepsis and Toxic metabolic events
• Exposure to heavy metals, toxins, intoxicants, inhalants, and volatile solvents
• Overdose and SE of meds
• Malabsorption and dietary probs
• Seizures

• Multiple Cognitive deficits such as memory impairment, aphasia, apraxia, agnosia, executive functioning
• Significant Impairment
• Gradual onset and progressive decline
• Not exclusively during delirium

• Acute Onset/Sudden
• Fluctuating Impairment
• Disorientation
• Visual or tactile hallucinations
• Usually reversible with treatment

• Disturbances of consciousness
• Change in cognition
• Disturbance develops over short time
• Direct physiological consequence of general medical condition

• Alertness--alert, vigilant, lethargic, stupor, coma
• Attention--follow conversation
• Orientation--Person, place, time
• Memory--recent and remote events, Thinking, Perceptions
• Psychomotor behavior--hypo/hyperkinetic, unusual or inappropriate (undressing)

• Chronic Onset, slow/progressive course, progressive disorientation, progressive cognitive impairment
• Problems naming objects
• Progressive apraxia and agnosia

• Orientation: person, place, time
• Evaluate mood and affect
• Evaluate speech and language
• Cognitive Testing: General Information, recall, recent and remote memory, attention, reading and simple calculations, visual-spatial ability
• Presence/absence of hallucinations
• Suicidal/homicidal ideation and intent
• Insight and Judgement

• Chronic Onset
• Inconsistent Impairment
• Orientation Intact
• Patchy Cognitive Impairment
• Language Intact
• Can have auditory hallucinations usually mood congruent
• normal CT and EEG

due to a general medical condition--specified as transient or chronic--memory disturbance that does not occur during the course of a delirium or dementia

Typically associated with cerebrovascular disease

problems learning new things

Problem recalling previously learned material

Associated with prolonged ETOH intake

• Reorient the patient
• Restructure the environment
• Restore normal functioning and health
• Re-motivate and involve patient
• Reminiscence
• Regulate dysfunctional psychiatric symptoms

Disruption in the usually integrated functions of consciousness, memory, identity, or perceptions of the environment

• (amnesia is the most common symptom)
• ex. DID, depersonalization symptoms, somatoform disorders

• Chronic
• Anxiety, depression, suicidal ideations are frequently manifested
• Drug abuse/dependence is common

• Personality Traits (heightened emotionality, strong dependency, preoccupation with
• self/symptoms)

Primary Gains: Symptoms allow avoidance of unpleasant activity

Secondary Gains: Symptom promotes emotional support/attention

Tertiary Gains: In dysfunctional family the symptom might distract from a real issue that is unresolved

• A loss of or change in body function resulting from a psychological conflict, the physical symptoms cannot be explained by any pathophysiology/medical disorder
• Most obvious symptoms suggest a neurological disease and occur following a situation that produces extreme psychological stress
• Client may express a lack of concern of impairment (clue problem is psychological)

• exaggerated belief that the body is deformed/defective in some specific way
• symptoms of depression and traits associated with o-c-d personality are common

• inability to recall important personal data that is too extensive to be explained by ordinary forgetfulness
• not due to substance/medical condition
• follow psychological stress

Depersonalization is a disturbance is the perception of oneself

Derealization is an alteration in the perception of the external enviornment