Schizophrenia is a severe mental illness characterized by psychosis, including delusions and hallucinations. It can cause deterioration in social and cognitive functioning. It has biological and genetic risk factors. Treatment involves antipsychotic medication and psychosocial support. Nursing care focuses on safety, managing symptoms, and promoting functioning.
In 1911, Eugen Bleuler, first used the word "schizophrenia."The word schizophrenia does come from the Greek words meaning "split" and "mind," & refers to the way that people with schizophrenia are split off from reality; they cannot tell what is real and what is not real.
In 1911, Eugen Bleuler, first used the word "schizophrenia."The word schizophrenia does come from the Greek words meaning "split" and "mind," & refers to the way that people with schizophrenia are split off from reality; they cannot tell what is real and what is not real.
This is the Final for Dr. Bachman's Psychopathology Course for Webster University. This has been uploaded to assist with studying for the Counselor's Examination.
Mental health overview including WHO definition, mental disorders as per ICD 10, diagnosis/warning signs, prevention & National Mental Health Programme
Will talk about the severe psychological disorders-- The familiar name for all might be -"Schizophrenia" - it is not just one category but has multiple categories combined under -"Schizophrenia spectrum"
My forensic psychiatric research done in Indian jails shows most convicts under murder cases belong to schizophrenia spectrum (98% schizophrenia and 2% paranoid & schizoid personality disorders), and most have murdered their spouses, family members, friends or colleagues and surrendered themselves on the spot.
This presentation on the "Schizophrenia spectrum" has been particularly shared with you all to extend my message to help these affected people at the right time and maintaining their condition to prevent them from committing such crimes as there is no proper mental health care--Clinical, Legal or authoritative help available for convicts suffering from mental disorder.
This is the Final for Dr. Bachman's Psychopathology Course for Webster University. This has been uploaded to assist with studying for the Counselor's Examination.
Mental health overview including WHO definition, mental disorders as per ICD 10, diagnosis/warning signs, prevention & National Mental Health Programme
Will talk about the severe psychological disorders-- The familiar name for all might be -"Schizophrenia" - it is not just one category but has multiple categories combined under -"Schizophrenia spectrum"
My forensic psychiatric research done in Indian jails shows most convicts under murder cases belong to schizophrenia spectrum (98% schizophrenia and 2% paranoid & schizoid personality disorders), and most have murdered their spouses, family members, friends or colleagues and surrendered themselves on the spot.
This presentation on the "Schizophrenia spectrum" has been particularly shared with you all to extend my message to help these affected people at the right time and maintaining their condition to prevent them from committing such crimes as there is no proper mental health care--Clinical, Legal or authoritative help available for convicts suffering from mental disorder.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. definition
►It is a devastating brain disease that affecting
a person's thinking, language, emotions, social
behavior and ability to perceive reality
accurately with fundamental symptoms
known as Bleuler’s four A,
s:
1- Autistic thinking
2- loosening Of Associations (LOA)
3- Ambivalence
4- disturbances of Affect
3. • A severe psychotic illness characterised by
delusions, hallucinations (usually auditory),
thought disorder and behavioural disturbance
• Often deterioration in social, occupational and
cognitive function
• Occurs in Clear consciousness
4. Hitory
• Kraeplin (1855 –1926) – dementia praecox
• Bleuler (1857 – 1959) – schizophrenia
• Kraeplin suggested that aud. Hallucinations,
delusions, thought disorder, affective
falttening and impaired insight were common
to hebephrenia, paranoia, catatonia and
dementia simplex – group of disorders which
he called dementia praecox
5. History
• Bleuler – the four As – abnormal thought
association, affective abnormality,
ambivalence, autism
• Schneider (1887 – 1967) – first rank symptoms
• Current classification – ICD 10/ DSM IV
6. Classification
• Positive symptoms – hallucinations, delusions,
bizarre behaviour, formal thought disorder,
inappropriate affect
• Negative symptoms – affective flattening,
poverty of speech/thought, a volition (lacking
motivation) – apathy, anhedonia (lacking
pleasure or interest in enjoyable activities),
social withdrawal, inattentiveness
7. ICD 10
• Paranoid schizophrenia – prominent
delusions, and hallucinations. Usually not
much thought disorder or negative symptoms
• Hebephrenic (disorganised) SZP – affective
abnormality, thought disorder, mannerisms.
May have chronic course
8. ICD 10 contd.
• Catatonic schizophrenia – psychomotor symptoms eg
violent excitement, posturing, waxy flexibility,
automatic obedience, perseveration, stupor
• Residual SZP – “defect state” – positive symptoms
give way to negative symptoms
• Simple schizophrenia – insidious development of
negative symptoms without positive symptoms
9. Epidemiology
• Lifetime risk – 1%
• Incidence – 20/100 000 per year
• Equal prevalence in males and females
• Males diagnosed earlier than women (males
age 15-25 years, females age 25 – 35 years)
• Winter birth excess – increase of 7 – 15%
10. Aetiological Theories
• Biological:
– biochemical: (Main theories are dopamine,
serotonin and excitatory amino acid hypotheses).
– genetic
– Neurodevelopmental
• psychological
• social
11. Genetics
• Greatest risk factor is having a relative with
SZP
• MZ twin – 48% risk; DZ twin 17%
• Child of one parent with SZP – 13%
• Child of two parents with SZP – 46%
12. DSM-IV schizophrenia
• A. Characteristics of symptoms: two or more
of the following, each present for a significant
portion of time during a 1-month period (or
less if successfully treated):
• Delusions
• Hallucinations
• Disorganised speech
• Grossly disorganised or catatonic behaviour
• Negative symptoms (i.e. affective flattening,
alogia (reduced speech), or avolition)
13. N.B. only one (A) symptom is required if delusions are
bizarre or hallucinations consist of a voice keeping up
a running commentary on the person's behaviour or
thoughts, or two more voices conversing with each
other.
• B. Social/occupational dysfunction
• C. Duration: continuous signs of the disturbance
persist for at least 6-months. This 6-month period
must include at least one month of symptoms that
meet criterion A.
14. Diagnosis and Investigation
• Diagnosis – presence of typical symptoms
• Exclusion of other disorder e.g. organic causes
»CVA
»Drug-induced e.g. cannabis, steroids
»Alcoholic hallucinosis
»dementia
15. Investigations
• No diagnostic test
• Screen for drugs of abuse (urine)
• Bloods for CBC, biochemistry, blood glucose,
TFT and VDRL
• EEG, ECG, CT and MRI brain
16. Treatment
• May require admission if acutely disturbed or
present a risk to self or others
• Admission may be useful in assessment
• Essential to assess suicide risk as there is a
mortality of about 10% from suicide in SZP
17. Treatment contd.
• Antipsychotic drugs (typical and atypical).
• May require depot injection
• Atypicals have fewer extra-pyramidal side
effects and tend to be better for negative
symptoms than typicals
• IM medication may be required in a very
disturbed, involuntary patient
18. • Maintenance treatment – generally
maintenance on one medication
• Compliance may be a significant problem
because of long-term nature of treatment and
lack of insight.
19. Treatment contd.
• Psychosocial treatment:
• Education of patient and carers
• Cognitive behavioural therapy
• Rehabilitation
• social skills training
• family therapy
• occupational therapy.
20. Prognosis
• Good outcome is associated with:
– Female
– Older age of onset
– Married
– Living in a developing (as opposed to developed)
country
– Good premorbid personality
– No previous psych history
– Good education and employment record
– Acute onset, affective symptoms, good compliance
with meds
21. Nursing Management
Assessment
Assessment of clients who have schizophrenia
occurs at individuals, family, and environmental
levels. The nurse must be aware of the client'
status and of changes in the client's personal life,
Family situation and environment to planed care
and intervene effectively.
22. The symptoms of schizophrenia are separated
into:-
1-positive symptoms: which represent and
excesses or distortion of normal functioning,
2- negative symptoms: which represent an deficit
in functioning.
3- cognitive symptoms
4- Depressive symptoms
23. Assessing Positive Symptoms
The positive symptoms appear early in the first
phase of the illness, it is the symptoms that gets
people's attention and often need
hospitalization .They are , usually respond to
antipsychotic and behavioral therapy . positive
symptoms:
►Hallucinations
►Delusions
►Bizarre behavior
►Thought disorders
24. Assessing Negative Symptoms of
Schizophrenia:
►aVolition;
►Poverty of content of speech.
►Poverty of speech.
►Thought blocking.
►A logia
►Apathy
►Anhedonia
►Attention deficits
25. Cognitive symptoms
►Difficulty with attention
►Difficulty with memory
►Difficulty with Executive functions (e.g.
decision making and problem solving)
►Self care problems
27. Nursing Diagnosis:
Nursing diagnoses are formulated from the
information obtained during the
assessment phase of the nursing process.
► The following is a listing of some of the
more common diagnoses applicable to
schizophrenia.
28. ►1. Altered thought processes.
►2. Sensory perceptual alterations.
► 3.. Impaired verbal communication.
►4. Social isolation.
►5. Ineffective individual coping.
►6. Self care deficit ( Bathing , hygiene,
dressing, grooming, feeding, toileting).
► 7. Altered family processes.
►8. Risk for violence directed at others
►9. Risk for violence self- directed.
29. 1/ Altered thought process.
Related factors:
► - Impaired ability to process and synthesize
internal and external stimuli.
► - Biologic factors( neurophysiologic,
genetic)
► - Sensory- perceptual alternations.
► - Psychosocial / environmental stressors.
30. Evidenced by :
►- Inability to distinguish internally stimulated irrational
ideas leading to faulty conclusions (autistic).
► Perceives that others in the environment can hear his
or her thoughts ( through broadcasting ).
►- Demonstrated neologisms, word salad, thought
blocking ,thought insertion, thought withdrawal ,
poverty of speech, or mutisim..
►- Believes that his or has thoughts are responsible for
world events or disasters.
31. Goals:
► Demonstrate reality –based thinking in verbal
and non-verbal behavior.
►- Demonstrate absence of psychosis
( delusions, incoherent, illogical speech , magical
thinking, ideas of references , thought blocking,
thought insertions, thought broadcasting).
32. Nursing Interventions:
►1/ Approach the client in a slow, calm matter
of –fact manner ,to avoid distorting the
client's sensory- perceptual field , which
could foster altered thoughts and perceptions.
►2/ Maintain facial expressions and behaviors
that are consistent with verbal statements.
Patients are very sensitive to other's
responses to their symptoms.
33. ►3/ Continue to assess the client's ability
to think logically and to utilize realistic
judgmental problem- solving abilities
►4/ Listen attentively to key themes and
reality –oriented phrases or thoughts.
Talk about real events of people.
ِِ
34. ►5/ interpret the client's misconceptions and
misperceived environmental events in a calm,
matter-of fact manner, identifications of
reality , by a trusted person is helpful.
►6/ Instruct the client to approach staff when
frightening thoughts occur. A respectful ,
interested approach will enable the patient to
discuss an usual and frightening thoughts.
35. ►7/ Refrain from touching client who is
experiencing a delusion especially if it is
persecutory type. Touch may be interpreted as
a physical or sexual assault.
►8/ A void challenging the client's delusional
system or arguing with challenging the belief ,
may force the client to adhere to it and
defend it.
36. ►9/ Distract client from delusion by engaging him
in a less threatening or more comforting topic or
activity at the first sign of anxiety or discomfort.
►10/ Focus on the meaning, feeling or intent
provoked by the delusion rater than on the
delusional content.
►11/ A void seeking the details of the client's
delusion so as not to reinforce the false belief and
further distance client from reality.
37. ►12 / Offer praise as soon as the client begins to
differentiate reality based on non- reality based
thinking.
►13/ Respond to the Clint's delusions of persecution
with calm, realistic statement.
►14/ Use simple declarative statements , when talking
to the client who demonstrates fragmented
,disconnected , incoherent, or tangential speech
patterns ,which reflect loose associations.
38. 2/ Sensory/ perceptual alteration.
Related factors:
► - Psychosocial stressors, loneliness and isolation
( perceived or actual).
►- Withdrawal from environment.
►- Lack of adequate support persons.
►- Chronic illness and institutionalization.
►- Disorientation.
►- Ambivalence.
►- Biologic factors ( neurophysiologic, genetic).
39. Evidenced by:
► - attentive to surroundings ( preoccupied with
hallucination).
►- Startles when approached and spoken to others.
►- Appears to be listening to voices or sounds when
neither are present (cocks head to side as if
concentrating on sounds tat are inaudible to others).
►- May act upon "voiced" commands ( may attempt
mutilating gesture to self or others that could be
injurious)
►- Describes hallucinatory experience: " it's my father's
voce and he's telling me I'm not good".
40. Goals:
► - Able to hold conversation without
hallucinating.
► - Remains in group activities.
► - Attends the task in hand (e.g. group
process, recreational or occupational therapy
activities. States that hallucinations are under
control.
41. Nursing Interventions:
►1. Continuously orient patient to actual
environmental events of activities.
►2/ Call the client and staff members by their
names to reinforce reality.
►3/ Utilize clear, concrete statements.
►4/ utilize clear, direct verbal communication
rather than unclear or nonverbal gestures.
42. ►5/ Focus on real events or activities to reinforce
reality and divert client from the hallucinating
experience.
►6/ Reassure the client ( frequently if necessary)
that he or she is safe and won't be harmed:
observe for verbal or nonverbal behaviors
associated with hallucinations.
43. ►7/ Attempt to determine precipitants of the
sensory alteration ( stressors that may trigger
the hallucination): explore the content of the
auditory hallucinations to determine the
possibility of harm to self, others or the
environment (auditory command and
hallucinations) to prevent destructive behavior.
44. ►8/ When danger of violence is imminent ,
protect the client and others by following
facility procedures and policies for seclusions
or chemical or mechanical restrict to prevent
harm or injury to client or others.
►9/ Teach the client techniques that will help
stop hallucinations.