Undifferentiated Schizophrenia

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undifferentiated schizo

Text of Undifferentiated Schizophrenia

Our Lady of Fatima UniversityResearch and Development Center

NURSING MANAGEMENT 1

Nursing Management of Patient with Undifferentiated Schizophrenia

Dela Cruz, Victor Jr S. BSN3Y3-9B

Our Lady of Fatima University Valenzuela City

C O L L E G E O F

Maam Rosario Fernando Clinical Instructor

N U R S I N G

Our Lady of Fatima UniversityResearch and Development Center

NURSING MANAGEMENT 2

Nursing Management of Patient with Undifferentiated Schizophrenia

Introduction R.A, 34 years old, male from Concessionaires area, PNPA. Patient is the 5th siblings, 2nd year college level when he became mentally ill 12 years prior to admission. He had regular check-up at this center on January 27, 2003. Given drugs of monthly Levozepromazine. His last check-up was on March 17, 2008 and has subsequent check-up care of Trece Martines. Schizophrenia (from the Greek roots skhizein ("to split") and phrn ("mind") is a severe mental illness characterized by a variety of symptoms including but not limited to loss of contact with reality. Schizophrenia is not characterized by a changing in personality; it is characterized by a deteriorating personality. Simply stated, schizophrenia is one of the most profoundly disabling illnesses, mental of physical that the nurse will ever encounter (Keltner,2007). There are 5 subtypes of schizophrenia naming; paranoid, disorganized, catatonic, undifferentiated, and residual. Schizophrenia undifferentiated is the type of schizophrenia wherein characteristic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms) are present, but criteria for paranoid, catatonic, or disorganized subtypes are not met.C O L L E G E O F N U R S I N G

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Schizophrenia is not a terribly common disease but it can be a serious and chronicone. Worldwide about 1 percent of the population is diagnosed with schizophrenia. About 1.5 million people will be diagnosed with schizophrenia this year around the world. Ninety-five percent (95%) suffer a lifetime; thirty-three percent (33%) of all homeless Americans suffer from schizophrenia; fifty percent (50%) experience serious side effects from medications; and ten percent (10%) kill themselves (Keltner, 2007). According the study of cureresearch.com done 697,543 out of 86,241,697 of Filipinos or approximately 0.8% are suffering from schizophrenia. 5 schizophrenia ranks among the top 10 causes of disability in developed countries worldwide. Schizophrenia is a disease that typically begins in early adulthood; between the ages of 15 and 25. Men tend to get develop schizophrenia slightly earlier than women; whereas most males become ill between 16 and 25 years old, most females develop symptoms several years later, and the incidence in women is noticeably higher in women after age 30. The average age of onset is 18 in men and 25 in women. Schizophrenia onset is quite rare for people under 10 years of age, or over 40 years of age.C O L L E G E O F N U R S I N G

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Anatomy and Physiology The nervous system is an intricate, highly organized network of billions of neurons and neuroglia. The structures that make up the nervous system include the brain, cranial nerves, spinal nerves, ganglia, enteric plexuses and sensory receptors. The two main subdivisions of the nervous system are the central nervous system and the peripheral nervous system. The central nervous system consists of the brain and spinal cord. The brain is the center for registering sensations, correlating them with one another and with stored information, making decisions and taking actions. It also is the center for the intellect, emotions, behavior, and memory. The major parts of the brain include: the brain stem, cerebellum, diencephalon, and cerebrum. The spinal cord is connected to a section of the brain called the brainstem and runs through the spinal canal. Cranial nerves exit the brainstem. Nerve roots exit the spinal cord to both sides of the body. The spinal cord carries signals (messages) back and forth between the brain and the peripheral nerves.C O L L E G E O F N U R S I N G

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The brain stem is continuous with the spinal cord and consists of the medulla oblongata, pons, and midbrain. The medulla oblongata forms the inferior part of the brain stem. The medulla contains the cardiac, respiratory, vomiting and vasomotor centers and deals with breathing, heart rate and blood pressure. The pons is a bridge that connects parts of the brain with one another. The midbrain extends from the pons to the diencephalon. The midbrain is a short section of the brainstem between the diencephalon and the pons. Posterior to the brain stem is the cerebellum. Traditionally, the cerebellum has been known to control equilibrium and coordination and contributes to the generation of muscle tone. It has more recentlyC O L L E G E O F N U R S I N G

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become evident, however, that the cerebellum plays more diverse roles such as participating in some types of memory and exert in a comples influence on musical and mathematical skills. Superior to the brainstem is the diencephalon, which consists of the thalamus, hypothalamus, and epithalamus. The thalamus acts a relay center for all sensory impulses, except smell to the cerebral cortex. The hypothalamus is involved in the acceleration or deceleration of the heart. Impulses from the posterior hypothalamus produce a rise in arterial blood pressure and increase of the heart rate. Impulses from the anterior portion have the opposite effect. The hypothalamus is also involved in body temperature regulation. If the arterial blood flowing through the anterior portion of the hypothalamus is above normal level, the hypothalamus initiates impulses that cause heat loss through sweating and vasodilation of cutaneous vessels of the skin. A below-normal blood temperature causes the hypothalamus to relay impulses that result in heat production and retention through the initiation of shivering, the contraction of cutaneous blood vessels. The hypothalamus is also involved in the regulation of hunger and control of gastrointestinal activity. Low levels of blood glucose, fatty acids and amino acids are partially responsible for the sensation of hunger elicited from the hypothalamus. When sufficient amounts of food have been ingested, the hypothalamus inhibits the feeding center. It also regulates sleeping and wakefulness. A specialized sexualN U R S I N G C O L L E G E O F

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center in the hypothalamus responds to sexual stimulation of the tactile receptors within the genital organs. Also, the hypothalamus is associated with specific emotional responses, such asanger, fear, pain and pleasure. The hypothalamus produces neurosecretory chemicals that stimulate the anterior pituitary gland to release various hormones. The epithalamus is the posterior portion of the diencephalon. Supported on the diencephalon and brain stem is the cerebrum, which is the largest part of the brain. The cerebrum is the largest part of the brain and controls voluntary actions, speech, senses, thought, and memory. The surface of the cerebral cortex has grooves or infoldings (called sulci), the largest of which are termed fissures. Some fissures separate lobes. The convolutions of the cortex give it a wormy appearance. Each convolution is delimited by two sulci and is also called a gyrus (gyri in plural). The cerebrum is divided into two halves, known as the right and left hemispheres. A mass of fibers called the corpus callosum links the hemispheres. The right hemisphere controls voluntary limb movements on the left side of the body, and the left hemisphere controls voluntary limb movements on the right side of the body. Almost every person has one dominant hemisphere. Each hemisphere is divided into four lobes, or areas, which are interconnected.C O L L E G E O F N U R S I N G

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The frontal lobes are located in the front of the brain and are responsible for voluntary movement and vie their connections with other lobes, participate in the execution of sequential tasks; speech output; organizational skills; and certain aspects of behavior, mood, and memory. The parietal lobes are located behind the frontal lobes and in front of the occipital lobes. They process sensory information such as temperature, pain, taste, and touch. In addition, the processing includes information about numbers, attentiveness to the position of ones body parts, the space around ones body, and one's relationship to this space. The temporal lobes are located on each side of the brain. They process memory and auditory (hearing) information and speech and language functions. The occipital lobes are located at the back of the brain. They receive and process visual information. Neurotransmitters are chemicals which relay, amplify, and modulate signals between a neuron and another cell. Some neurotransmitters are commonly described as "excitatory" or "inhibitory". The only direct effect of a neurotransmitter is to activate one or more types of receptors. Examples of neurotransmitters are acetylcholine, dopamine, gamma-aminobutyric acid, dopamine, glutamate, aspartate, and serotonin. The chemical compound acetylcholine is a neurotransmitter in both the peripheral nervous system (PNS) and central nervous system (CN