NUR252
0Test
1BP
What is Mental health and what makes someone have behavior that is equivalent to diagnosed mental
illness?
● Mental health and mental illness are not specific entities but rather they exist on a continuum.
● Continuum is dynamic and shifting; ranging from moderate to severe.
● Many biological and environmental factors influence mental health.
● Mental health: a successful performance of mental functions, resulting in the ability to engage
in productive activities, enjoy fulfilling relationships, adapt to change, and cope with adversity.
○ The successful adaptation to stress from the internal or external environment,
evidenced nu thoughts, feelings, and behaviors that are age-appropriate and congruent
with local and cultural norms.
○ The foundation of thinking, communication skills, learning, emotional growth, resilience,
and self-esteem throughout the lifespan.
○ State of well-being in which individuals are able to realize their abilities as well
as contribute to their community within the context of life stressors.
● Mental illnesses: maladaptive responses to stressors rom the internal or external environment,
evidenced by thoughts, feelings, and behaviors that are incongruent with the local and
cultural norms and interfere with the individual’s social, occupational or physical functioning
○ Basically, mental illness can be seen as the result of flawed biological, psychological, or
social processes.
○ Are treatable, and individuals can experience symptom relief, and complete cure in
some cases, with treatment & support.
○ Considered
When is mental illness considered as a possible diagnosis?
● When there is a dysfunction of the brain or neurotransmitters
What assessments do nurses perform?
● They use screening tools to measure conditions including assessing for suicide.
● Mental Status Examination
● MMSE
● Orientation
● Levels of consciousness assessment
What are neurotransmitters? How do they work? (6 questions )
● Neurotransmitter: chemical messenger between neurons by which one neuron triggers another.
NEUROTRANSMITTER MENTAL HEALTH DISORDER
,DOPAMINE (DA): controls emotional HIGH - Schizophrenia, Mania
responses and the brain’s reward and pleasure
centers, stimulates the heart, and increases blood LOW - Parkinson’s, Depression
flow to vital organs.
NOREPINEPHRINE (NE): Mood, attention, HIGH - MANIA, ANXIETY, SCHIZOPHRENIA
and arousal. Stimulates sympathetic branch of the
autonomic nervous system or “ flight or fight” in LOW - DEPRESSION
response to stress.
SEROTONIN (5-HT): The happy one, the one HIGH - ANXIETY STATES
we want. Found in the brain and spinal cord,
helps regulate mood, arousal, attention, LOW - DEPRESSION
behavior, and body temp.
GAMMA AMINOBUTYRIC ACID (GABA) HIGH- REDUCTION OF ANXIETY
Inhibitory neurotransmitter: controls
neuron excitability and is associated with the LOW- MANIA, SCHIZOPHRENIA, ANXIETY
regulation of anxiety.
ACETYLCHOLINE (ACH): Cholinergic; plays HIGH- DEPRESSION
a role in skeletal muscle movement, arousal,
memory, and the sleep/wake cycle. LOW - ALZHEIMER’S, HUNTINGTONS,
PARKINSONS
GLUTAMATE: Excitatory neurotransmitter; HIGH- neurotoxicity, neurodegeneration
activates NMDA receptors.
LOW- PSYCHOSIS
● Serotonin: Found in the hypothalamus, thalamus, limbic system, cerebral cortex, cerebellum,
and spinal cord.
○ Serotonin is derived from the dietary amino acid tryptophan
○ It influences sleep and arousal, libido, appetite, mood, aggression, and pain perception.
○ Serotonin low → Depression → Give SSRIs (brings it back to synaptic cleft)
● Dopamine: is found in the frontal cortex, limbic system, basal ganglia, thalamus,
posterior pituitary, and spinal cord
○ It is involved in movement and coordination, emotions, voluntary judgment, and
release of prolactin
○ (See Saw Effect w/ prolactin)
○ Dopamine increased → psychosis (hallucinations & delusions)
● Histamine: found in the hypothalamus.
, ○ The role of histamine in mediating allergic and inflammatory reactions has been
well documented
○ Its role in the CNS as a neurotransmitter has only recently been confirmed, and
only limited information is available
○ Its exact function is unclear but may have some influence on mood.
○ Histamine low → sedation and weight gain → give Benadryl (antihistaminic)
● GABA: has widespread distribution in the CNS, with high concentrations in the
hypothalamus, hippocampus, cortex, cerebellum, basal ganglia, spinal cord, and retina
○ GABA is associated with short inhibitory interneurons, although some long-axon
pathways within the brain have now been identified.
○ GABA increased → to decrease anxiety
● Norepinephrine: is found in the thalamus, hypothalamus, limbic system, hippocampus,
cerebellum, and cerebral cortex. It influences mood, cognition, perception, cardiovascular
functioning, and sleep and arousal. The neurotransmitter associated with the “fight or
flight” syndrome of symptoms that occurs in response to stress.
○ NE low → Depression → Give SNRIs
What are the medications used for psychotic disorders? Psychopharmacology (Chap 4 page 34) - See
chart
What are benzodiazepines used for and FDA approved for?
● Antianxiety → promote the activity of GABA by binding to a specific receptor on the GABAA
receptor complex
Medications (5 questions)
CLASSES
● Anxiolytics → ‘PAMS LAMS’ AKA Benzodiazepines for the treatment of anxiety
○ Librium-chlordiazepoxide, Lorazepam
○ Used for anxiety. Use them short term, they act quick, avoid preg, caffeine, and alcohol.
○ Buspirone
■ Buspirone used for GAD general anxiety disorder.
● Antidepressants → SSRIs, SNRIs, TCAs, MOAIs for treatment of depression
○ SSRI → 1st choice for depression.
■ Prozac-fluoxetine, Paroxetine
■ Anticholinergic effects
■ Give it in the AM
■ Takes 6 weeks to work → wait 2 weeks before MOAI
■ Do EKG cardiac arrhythmias possible
○ SNRI → 2nd generation antidepressant
■ Takes 1-3 weeks for effect → 2-3 months for benefit
■ Encourage compliance and avoid alcohol.
○ TCA → Not the first line of treatment
■ Amitriptyline, Desipramine
■ Oldest class of antidepressants and are still prescribed
■ Not first-line of treatment
0Test
1BP
What is Mental health and what makes someone have behavior that is equivalent to diagnosed mental
illness?
● Mental health and mental illness are not specific entities but rather they exist on a continuum.
● Continuum is dynamic and shifting; ranging from moderate to severe.
● Many biological and environmental factors influence mental health.
● Mental health: a successful performance of mental functions, resulting in the ability to engage
in productive activities, enjoy fulfilling relationships, adapt to change, and cope with adversity.
○ The successful adaptation to stress from the internal or external environment,
evidenced nu thoughts, feelings, and behaviors that are age-appropriate and congruent
with local and cultural norms.
○ The foundation of thinking, communication skills, learning, emotional growth, resilience,
and self-esteem throughout the lifespan.
○ State of well-being in which individuals are able to realize their abilities as well
as contribute to their community within the context of life stressors.
● Mental illnesses: maladaptive responses to stressors rom the internal or external environment,
evidenced by thoughts, feelings, and behaviors that are incongruent with the local and
cultural norms and interfere with the individual’s social, occupational or physical functioning
○ Basically, mental illness can be seen as the result of flawed biological, psychological, or
social processes.
○ Are treatable, and individuals can experience symptom relief, and complete cure in
some cases, with treatment & support.
○ Considered
When is mental illness considered as a possible diagnosis?
● When there is a dysfunction of the brain or neurotransmitters
What assessments do nurses perform?
● They use screening tools to measure conditions including assessing for suicide.
● Mental Status Examination
● MMSE
● Orientation
● Levels of consciousness assessment
What are neurotransmitters? How do they work? (6 questions )
● Neurotransmitter: chemical messenger between neurons by which one neuron triggers another.
NEUROTRANSMITTER MENTAL HEALTH DISORDER
,DOPAMINE (DA): controls emotional HIGH - Schizophrenia, Mania
responses and the brain’s reward and pleasure
centers, stimulates the heart, and increases blood LOW - Parkinson’s, Depression
flow to vital organs.
NOREPINEPHRINE (NE): Mood, attention, HIGH - MANIA, ANXIETY, SCHIZOPHRENIA
and arousal. Stimulates sympathetic branch of the
autonomic nervous system or “ flight or fight” in LOW - DEPRESSION
response to stress.
SEROTONIN (5-HT): The happy one, the one HIGH - ANXIETY STATES
we want. Found in the brain and spinal cord,
helps regulate mood, arousal, attention, LOW - DEPRESSION
behavior, and body temp.
GAMMA AMINOBUTYRIC ACID (GABA) HIGH- REDUCTION OF ANXIETY
Inhibitory neurotransmitter: controls
neuron excitability and is associated with the LOW- MANIA, SCHIZOPHRENIA, ANXIETY
regulation of anxiety.
ACETYLCHOLINE (ACH): Cholinergic; plays HIGH- DEPRESSION
a role in skeletal muscle movement, arousal,
memory, and the sleep/wake cycle. LOW - ALZHEIMER’S, HUNTINGTONS,
PARKINSONS
GLUTAMATE: Excitatory neurotransmitter; HIGH- neurotoxicity, neurodegeneration
activates NMDA receptors.
LOW- PSYCHOSIS
● Serotonin: Found in the hypothalamus, thalamus, limbic system, cerebral cortex, cerebellum,
and spinal cord.
○ Serotonin is derived from the dietary amino acid tryptophan
○ It influences sleep and arousal, libido, appetite, mood, aggression, and pain perception.
○ Serotonin low → Depression → Give SSRIs (brings it back to synaptic cleft)
● Dopamine: is found in the frontal cortex, limbic system, basal ganglia, thalamus,
posterior pituitary, and spinal cord
○ It is involved in movement and coordination, emotions, voluntary judgment, and
release of prolactin
○ (See Saw Effect w/ prolactin)
○ Dopamine increased → psychosis (hallucinations & delusions)
● Histamine: found in the hypothalamus.
, ○ The role of histamine in mediating allergic and inflammatory reactions has been
well documented
○ Its role in the CNS as a neurotransmitter has only recently been confirmed, and
only limited information is available
○ Its exact function is unclear but may have some influence on mood.
○ Histamine low → sedation and weight gain → give Benadryl (antihistaminic)
● GABA: has widespread distribution in the CNS, with high concentrations in the
hypothalamus, hippocampus, cortex, cerebellum, basal ganglia, spinal cord, and retina
○ GABA is associated with short inhibitory interneurons, although some long-axon
pathways within the brain have now been identified.
○ GABA increased → to decrease anxiety
● Norepinephrine: is found in the thalamus, hypothalamus, limbic system, hippocampus,
cerebellum, and cerebral cortex. It influences mood, cognition, perception, cardiovascular
functioning, and sleep and arousal. The neurotransmitter associated with the “fight or
flight” syndrome of symptoms that occurs in response to stress.
○ NE low → Depression → Give SNRIs
What are the medications used for psychotic disorders? Psychopharmacology (Chap 4 page 34) - See
chart
What are benzodiazepines used for and FDA approved for?
● Antianxiety → promote the activity of GABA by binding to a specific receptor on the GABAA
receptor complex
Medications (5 questions)
CLASSES
● Anxiolytics → ‘PAMS LAMS’ AKA Benzodiazepines for the treatment of anxiety
○ Librium-chlordiazepoxide, Lorazepam
○ Used for anxiety. Use them short term, they act quick, avoid preg, caffeine, and alcohol.
○ Buspirone
■ Buspirone used for GAD general anxiety disorder.
● Antidepressants → SSRIs, SNRIs, TCAs, MOAIs for treatment of depression
○ SSRI → 1st choice for depression.
■ Prozac-fluoxetine, Paroxetine
■ Anticholinergic effects
■ Give it in the AM
■ Takes 6 weeks to work → wait 2 weeks before MOAI
■ Do EKG cardiac arrhythmias possible
○ SNRI → 2nd generation antidepressant
■ Takes 1-3 weeks for effect → 2-3 months for benefit
■ Encourage compliance and avoid alcohol.
○ TCA → Not the first line of treatment
■ Amitriptyline, Desipramine
■ Oldest class of antidepressants and are still prescribed
■ Not first-line of treatment
