ADDISABABAMEDI

CALANDBUSI
NESSCOLLEGES
SULULTACAMPUS
I
NDI
VI GNMENTMENTALHEALTH
DUALASSI
DEPARTMENTBSCNURSI
NG

SUBMI
TI FEBRUARY01/
ONDATE: 2025
NAME:ADUNETSEGA
I
DNUMBER:
21978
TABLECONTENTS page

TI
TLEPAGE.
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.1

1Cul
tur
e-bondi
ngpsy
chot
icsy
ndr
ome.
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1
2.Ext
rapy
rami
dalsi
deef
fect
(EPS)
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6
3.Emer
gencypsy
chi
atr
y..
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9
4.Psy
chot
icdi
sor
derduet
oGMC.
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13
5.Chi
ldhooddepr
essi
on,
att
ent
iondef
ici
t
hy
per
act
ivi
ty,
ment
alr
etar
dat
ionand
per
vasi
vedev
elopment
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.16.
5.
1Chi
ldhooddepr
essi
on.
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16
5.2attent
iondefici
thy peract
ivi
ty,,
mental
ret
ardati
on..
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.18
5.
3Ment
alRet
ardat
ion(
Int
ell
ect
ual
Di
sabi
li
ty)
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.20
5.
4Per
vasi
veDev
elopment
alDi
sor
der
s(EDD)
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.21
6.Ger
iat
ri
cpsy
chi
atr
y,psy
chosoci
alaspectof
agi
ng,
Myt
hsaboutagi
ng.
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.22
7.HI
V/AI
DSinpsychi
atr
yandManagementofHI V/ AIDS
i
npsychi
atr
yusi
ngnursi
ngprocess.
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27
Quest
ion1Cul
tur
e-Bondi
ngPsy
chot
ic
Syndr
ome?
Def
ini
ti
on:
Culture-boundpsy choti
csy ndromesar ement al healt
h
disorder sthatarespeci f
ictocer t
ainculturalor
societalgr oups.Thesecondi tionsar edeepl yroot edin
culturalbelief
s,traditi
ons,andpr acti
ces,andt hei r
present ati
oni softenshapedbyt hesocialcont extof
theaf fectedpopul ati
on.Sy mpt omscani nclude
psychot i
cbehav i
or ssuchasdel usions,halluci
nat ions,
orext remeemot i
onal states,butt heyareint erpreted
withint heframewor kofthecul ture.

Et
iol
ogy
Theexactcausesofcul
ture-
boundpsychoti
c
syndromesarecomplexandmulti
fact
orial
.Theycan
i
nclude:
1.Cult
uralandSoci
alFact
ors:Cul
turalnor
msand
bel
iefsystemspl
ayasigni
ficantr
oleinhow
symptomsmani f
estandareinter
preted.
Specifi
cstressor
suni
quetoacul t
ure,
suchassoci
etal
pressuresorcommunityexpect
ati
ons,maycont
ri
bute.
2.Psychologi
calFactors:
Trauma,anxi
ety,
or
unresol
vedpsychologicalconf
li
ctswit
hinacul
tur
al
fr
amewor k.
Cult
uralnar
rati
vesmaypr ovi
decont
extf
orcer
tai
n
symptoms( e.
g.,spi
ri
ts,
curses)
.
3.Bi
ologi
cal
Factor
s:Genet
icpr
edi
sposi
ti
ont
oment
al
heal
thcondi
ti
ons.
Neur
ochemi
cali
mbal
ancesorphy
sicalheal
thi
ssues.
4.Envir
onmentalStr
essors:
Changesint
hesocial
envi
ronment,l
ikemigrat
ionorurbani
zat
ion,
cancause
cul
turaldi
ssonanceandstress.
Pover
ty,
natur
aldi
sast
ers,
orot
hercr
iseswi
thi
na
community
.
5.Spi
ri
tualorRel
igi
ousBel
ief
s:
Str
ongadher encetospir
it
ualorr
eli
gious
i
nterpretat
ionsofmentali
ll
ness(
e.g.,possessi
onby
spi
rit
s, wit
chcraf
t).

Nur
singI
nter
vent
ion
1.Cul
tur
all
yCompet
entCar
e:
Underst
andthepat
ient
’scul
tur
albackgr
oundand
bel
iefsyst
ems.
Respectthepati
ent
’si
nterpret
ati
onofthei
rsy mpt
oms,
especi
all
yifti
edtocul
turalorspi
rit
ualbel
ief
s.
2.Thor
oughAssessment
:
Assesssy mpt
omswi t
hint
hecont
extoft
hepat
ient
’s
cul
turalandsoci
alf
ramework.
Incl
udefamil
yorcommuni t
yleadersi
nthe
assessmentprocessi
fappropr
iat
e.
3.Pat
ientandFami
lyEducat
ion:
Provi
deeducat
ionaboutt
hesy
ndr
omei
nacul
tur
all
y
sensi
ti
veway.
Cl
ari
fymisconcept
ionswhi
ler
espect
ingcul
tur
al
i
nter
pret
ati
ons.
4.Col
labor
ati
onwi
thTr
adi
ti
onal
Heal
ers:
I
fappl
icabl
e,i
nvol
vet
radi
ti
onal
heal
ersorspi
ri
tual
l
eader
s.
Faci
li
tat
et heint
egr
ationoftr
adi
ti
onalpr
act
iceswi
th
evi
dence-basedmedicalcar
e.
5.Emot
ionalandPsy
chol
ogi
cal
Suppor
t:
Off
ercounseli
ngorpsy
chot
her
apyt
ail
oredt
othe
cul
tur
alcontext
.
Teachst
ressmanagementtechni
quesali
gnedwi
th
cul
tur
alpract
ices(
e.g.
,pr
ayer
,medit
ati
on)
6.Medi
cat
ionManagement
:
Usephar
macologi
cal
int
erv
ent
ionscar
eful
lyandonl
y
whennecessar
y
Expl
aint
hepurposeandeff
ect
sofmedi
cat
ioni
n
cul
tur
all
yaccept
ablet
erms.

Questi
on2Ext
rapy
rami
dal
SideEf
fect
s
(EPS)?
Def
ini
ti
on:
Extrapyramidalsideef f
ects(EPS)ar edrug-i
nduced
mov ementdi sordersthatcommonl yoccurasadv er
se
effectsofant i
psychoticmedicati
ons, parti
cular
ly
thoset hatbl
ockdopami nereceptorsint hecentr
al
nervoussy stem.Theseef fectsi
nv olvethe
extrapyramidalmot orsystem,whichr egulates
voluntarymot orcontrolandcoordination.

Et
iol
ogy
EPSispri
maril
ycausedbytheblockadeofdopamine
D2recept
orsinthenigr
ost
ri
atalpathwayoft
hebrain.
Thi
simbalancebetweendopamineandacetyl
chol
ine
di
srupt
snor
malmot
orcont
rol
.
Cont
ri
but
ingFact
ors:
1.Medi
cat
ions:
Fi
rst
-gener
ati
on(ty
pical
)ant
ipsy
chot
ics:
Hal
oper
idol
,
chl
orpromazi
ne.
Second-
generat
ion(at
ypi
cal)ant
ipsychot
ics(
less
commonly):Ri
speri
done,
olanzapine.
Ant
i-emeti
cswi
thdopamine-
blocki
ngpr
oper
ti
es:
Metoclopr
ami
de,pr
ochl
orper
azine.
2.DosageandDur
ati
on:
Hi
gherdosesandpr
olongedusei
ncr
easet
her
isk.
3.I
ndi
vi
dualSuscept
ibi
li
ty:
Age(
elder
lyandchi
ldr
enar
emor
evul
ner
abl
e).
Pr
e-exi
sti
ngneur
ologi
cal
condi
ti
ons(
e.g.
,Par
kinson’
s
di
sease).
Genet
icpr
edi
sposi
ti
on.
Ty
pesofEPS
1.Dyst
oni
a:Sudden,
sust
ainedmusclecontr
act
ions
causi
ngtwi
stingmovementsorabnormalpost
ures.
Commonl
yaf
fect
sneck,
face,
orbackmuscl
es.
2.Akathisi
a:Asubj
ecti
vefeel
ingofr
estl
essness,of
ten
accompani edbyaninabi
li
tyt
ositst
il
lorremain
motionless.
3.Parkinsoni
sm:Symptomsr esembl
ingParki
nson’
s
disease,suchastr
emor s,
rigi
dit
y,br
adyki
nesi
a
(slowedmov ement)
,andshuf f
li
nggait
.
4.Tar
div
eDyski
nesi
a:I
nvolunt
ary,
repet
it
ive
movements,
oft
enoftheface,t
ongue,orl
imbs.
Usual
lyappearsaft
erl
ong-
ter
m useofdopami
ne-
bl
ocki
ngmedi cati
ons.

Nur
singI
nter
vent
ions
1.Moni
torf
orSymptoms:Regul
arl
yassessforear
ly
si
gnsofEPS,par
ti
cul
arl
yinpati
entsonanti
psychoti
cs.
Usetool
sli
ketheAbnor
malInv
olunt
aryMov
ement
Scal
e(AIMS)t
otracksy
mptoms.
2.ReportandColl
aborat
e:Noti
fythehealthcare
provi
derpromptl
yaboutneworwor seni
ngEPS
symptoms.Col
laborat
etoadjustthemedi cati
on
dosageorconsideral
ter
nati
vetreatments.
3.Admi
nist
erMedi
cat
ionsf
orEPS:
Ant
ichol
iner
gic
agent
s:Benzt
ropine,tr
ihexy
pheni
dyl(
eff
ect
ivef
or
dyst
oniaandparkinsonism)
Bet
a-bl
ocker
s:Pr
opr
anol
ol(
usef
ulf
orakat
hisi
a).
Benzodi
azepi
nes:Lorazepam,
diazepam (
forsev
ere
akat
hisi
aordystoni
a)
Dopamineagent
s:Amant
adi
ne(
somet
imesusedf
or
par
kinsoni
sm).
4.Pati
entEducati
on:Educat
ethepat
ientandfamil
y
aboutthepotent
ialf
orEPSwi t
hanti
psychot
ics.
Encouragepatient
storeportunusual
mov
ement
s,
rest
lessness,
orstiff
nessearl
y.
5.Non- Phar
macologi
cInt
erv
enti
ons:Teachrel
axat
ion
techniquesandencour
agephysi
calacti
vit
ytomanage
restl
essness.
Pr
omot egoodpostureander
gonomi
cai
dst
o
mini
mizediscomf
or t
.
6.MedicationAdjust
ments:Adv
ocatef
orswi
tchi
ngto
second-generat
ionanti
psychot
icsi
fEPSi
ssevere.
Encour
agedoser
educt
ionwhencl
ini
cal
l
yappr
opr
iat
e.
Mini
mizelong-t
erm useofdopami
ne-
blocki
ngagent
s
wherepossi
ble.
Quest
ion3Emer
gencyPsy
chi
atr
y?
Def
ini
ti
on:
Emer gencypsy chiatryisabr anchofpsy chi
at rythat
dealswi t
hacut ement alhealthcrisesrequiring
i
mmedi ateinter
v entiontoensur et hesafetyand
stabi
lit
yoft hepat ientandot hers.Theseemer genci
es
mayi ncludesev erepsy chiat
ricsympt oms, sui ci
dal
behav i
or,vi
olentt endencies,orsubst ance-related
cri
ses.

Et
iol
ogy
Emergencypsychiat
ricsi
tuati
onscanari
sef
rom a
var
iet
yoffactors,
ofteninter
acti
ngincompl
exways:
1.Psychi
atr
icDisor
ders:
Acuteexacer
bationofment
al
i
ll
nesses(e.
g.,schi
zophr
enia,bi
pol
ardisorder
,maj
or
depressi
vedisor
der)
.
Psy
chot
icepi
sodes,
sev
ereanxi
ety
,orpani
cdi
sor
der
s.
2.Subst
anceAbuse:I
ntoxi
cat
ionorwit
hdr
awalf
rom
al
cohol,
drugs,
orothersubst
ances.
3.Sit
uati
onalFact
ors:
Acut
estr
essreact
ionsduet o
tr
aumat i
cevents(
e.g.
,l
ossofalov
edone, abuse,
vi
olence).
4.Neurobi
ologi
cal
Condi
tions:
Organi
cbrai
n
syndr
omessuchasdelir
ium ordementi
a.
Neurol
ogicalcondi
ti
onsl
ikeepi
lepsyort
raumat
ic
br
aininj
ury.
5.Psychosoci
alSt
ressor
s:Rel
ati
onshipconfl
ict
s,
fi
nancialpr
obl
ems,oracademic/car
eerpressures.
6.Sui
cidalorHomi
cidalBehavi
or:
Indi
vi
dual
satr
iskof
sel
f-
harm orharmt
oot hers.
7.MedicalCondi
ti
ons:
Medi cali
ll
nessescausing
psychi
atri
csymptoms( e.
g.,t
hyroi
ddisorder
s,
i
nfecti
ons,ormetabol
icimbalances)
.
Nur
singI
nter
vent
ionsi
nEmer
gencyPsy
chi
atr
y
1.AssessmentandTr
iage:Rapidl
yassesst
hepati
ent
’s
mentalstat
us,
behavi
or,andriskofharmtosel
for
other
s.
Pri
orit
izecar
ebasedont
hesev
eri
tyofsy
mpt
omsand
ri
sklevel.
2.Ensur
eSafet
y:Remov
eanyhar
mfulobj
ect
sfr
om t
he
envi
ronment
.
Usephysi
calorchemi
calr
estr
aint
sonl
yasal
ast
resor
tandfol
lowprot
ocol
s.
3.Est
abli
shRappor
t:
Communi cat
ecalmlyand
empathet
ical
lyt
ode-escal
ateagi
tat
ionoraggr
essi
on.
Gai
nthepat
ient
’st
rustt
ofaci
l
itat
ecooper
ati
on.
4.Cri
sisI
nter
venti
on:Pr
ovi
deimmediatesupportt
o
stabi
li
zet
hepatientemoti
onal
lyandphysi
call
y.
Addressurgentneedssuchasf
ood,
hydr
ati
on,
and
resti
frequi
red.
5.Suici
deandVi olenceRiskManagement
:Conduct
suici
deorv i
olenceriskassessment
susi
ng
standar
dizedtools.
I
mpl ementsuicideprecaut
ions,
suchasone-
on-
one
observat
ion,
ifindicat
ed.
6.Medicati
onAdmini
strati
on:Admini
stermedicat
ions
asprescri
bedtomanageacut esymptoms(e.g.,
ant
ipsychoti
cs,
anxi
oly
tics,orsedati
ves)
Moni
torf
orsi
deef
fect
soradv
erser
eact
ions.
7.Supporti
veCounseli
ng:
Offerr
eassur
anceandbri
ef,
sol
ution-f
ocusedcounsel
ingtoaddr
essimmediat
e
concerns.
Val
idat
ethepati
ent’
sfeel
ingswi
thoutr
einf
orci
ng
mal
adapti
vethoughts.
ser
vices.
Educat
ethem aboutt
hepat
ient
’scondi
ti
onand
tr
eatmentpl
an.

Quest
ion4Psychot
icDisor
derDuet
o
Gener
alMedi
calCondit
ion(GMC)?
Def
ini
ti
on:
Psy choti
cdisorderduet oagener almedicalcondi
ti
on
(GMC)r eferstopsy choti
csy mpt omssuchas
delusions,hal
lucinati
ons,disorganizedthinki
ng,or
bizarrebehaviorcauseddi r
ect l
ybyanunder l
yi
ng
medi cali
ll
nessorphy si
ologicalcondit
ion.

Et
iol
ogy
Psychoti
csy mptomscanari
sefr
om vari
ousmedi
cal
condit
ionsthataff
ectt
hebrai
nordi
sruptnor
mal
physi
ologicalf
uncti
oni
ng.
CommonCauses:
1.Neur
ologi
calDi
sor
der
s:St
roke.
Traumat
icbr
ain
i
njur
y
Epi
lepsy(
especi
all
ytempor
all
obeepi
lepsy
)
Br
aint
umor
sorl
esi
ons.
Mul
ti
plescl
erosi
s.
2.Endocri
neDisor
der
s:Hy
per
thy
roi
dism or
hypothy
roi
dism.
Cushi
ng’
ssy
ndr
ome.
Addi
son’
sdi
sease.
Par
athy
roi
ddi
sor
der
s.
3.I
nfect
iousDi
seases:
HIV/
AIDS,
Syphi
li
s.
Meni
ngi
ti
sorencephal
it
is.
4.Metabol
icandNut
ri
ti
onalDi
sor
der
s:Hy
pogl
ycemi
a
orhy
pergly
cemia.
El
ect
rol
ytei
mbalances(
e.g.
,hy
ponat
remi
a,
hy
pocal
cemia)
.
Vi
tami
ndef
ici
enci
es(
e.g.
,vi
tami
nB12ort
hiami
ne)
.
5.Autoi
mmuneDi sor
der
s:Sy
stemi
clupus
ery
thematosus(
SLE)wit
hCNSi nv
olvement
.
Ant
i-
NMDAr
ecept
orencephal
it
is.

Nur
singI
nter
vent
ions
1.Comprehensi
veAssessment:Conductat
horough
physi
calandmentalheal
thassessmenttoi
denti
fythe
under
lyi
ngmedicalcondi
ti
on.
Monit
orforsy
mpt omssuchashall
uci
nat
ions,
del
usi
ons,agi
tat
ion,orconf
usi
on.
2.I
denti
fyandTreattheUnderl
yi
ngCause:Coll
abor
ate
wit
hthehealt
hcareteam toaddr
essthemedical
condi
ti
oncausingthepsychosi
s(e.g.
,tr
eat
ing
i
nfect
ions,
managingmet abol
icimbal
ances).
Administ
ermedi
cati
onsort
her
api
espr
escr
ibedf
or
theunderl
yi
ngcondi
ti
on.
3.Sy
mpt om Management:Administ
erant
ipsy
chot
ic
medicat
ionscaut
iousl
yifprescr
ibed.
Moni
torf
orsi
deef
fect
sanddr
ugi
nter
act
ions.
4.EnsureSafet
y:I
mplementmeasur
est
opr
eventsel
f-
harm orhar
mt oothers.
Useenvi
ronmentalmodi
fi
cati
onst
oreduce
over
sti
mulat
ionandagit
ati
on.
5.Suppor
ti
veCommunicati
on:
Useclear
,si
mpl
e
l
anguagewhenint
eract
ingwit
hthepati
ent
.
Avoidargui
ngwiththepat
ientaboutdel
usi
ons;
i
nstead,acknowl
edgethei
rfeeli
ngsandredi
rectt
hei
r
at
tenti
on.
6.Educat
ionandCounsel
ing:
Educat
ethepat
ientand
fami
lyaboutthel
inkbet
weent
hemedi
cal
condi
ti
on
andpsychot
icsymptoms.
Prov
idegui
danceonmanagingthemedi
cal
condi
ti
on
toprev
entr
ecurr
enceofsy
mpt oms.
7.Monit
orf
orCompli
cat
ions:
Regul
arl
yassesst
he
pat
ient
’sment
alandphy
sical
stat
us.
Moni
torf
orwor
seningpsychot
icsy
mptomsor
pr
ogr
essi
onoftheunderl
yi
ngmedical
condi
ti
on.

Question5.Whati
sChildhooddepr essi
on,
att
entiondef
ici
thy
peracti
vit
y, mental
ret
ardati
onandpervasi
vedev elopment,
eti
ologyandwhatisnursi
ngint er
venti
ons
Quest
ion5a)
.Chi
l
dhoodDepr
essi
on
Def
ini
ti
on:
Chil
dhooddepr essi
onisamooddi sorderinchildren
character
izedbyper si
stentsadness,i
r r
it
abili
ty,anda
l
ackofi nt
er estinprev
iouslyenj
oyedact i
vit
ies.Itmay
i
mpai rsocial,academic,andemotionalfunctioning.

Et
iol
ogy
:
1.Bi
ologi
cal
Fact
ors:
Imbal
anceofneur
otr
ansmi
tt
ers
(
ser
otoni
n,dopami
ne)
Genet
icpr
edi
sposi
ti
on(
fami
lyhi
stor
yofdepr
essi
on)
.
2.Env
ironment
alFact
ors:
Trauma,
abuse,
ornegl
ect
.
Par
ent
alsepar
ati
onordi
vor
ce.
Academi
corsoci
alst
ressor
s.
3.Psychol
ogi
calFact
ors:
Lowsel
f-
est
eem or
perf
ecti
oni
sm.
Lear
nedhel
plessness.

Nur
singI
nter
vent
ions:
1.Bui
ldr
appor
tandt
rustwi
tht
hechi
ld.
2.Encourageexpressi
onoffeel
ingsthroughage-
appropr
iateact
ivi
ties(
e.g.
,dr
awing,playther
apy)
.
3.Educat
ethefamil
yaboutdepr
essi
onandi
nvol
ve
them i
nthecar
eplan.
4.Moni
torf
orsui
cidal
thought
sorsel
f-
har
m.
5.Coll
aborat
ewi t
hmentalheal
thpr
ofessi
onal
sfor
counsel
ingortherapy
.
6.Admini
sterprescr
ibedmedi
cati
ons(
e.g.
,
anti
depr
essants)andmonit
orforsi
deeff
ects.
Quest
ion5b).Att
entionDefi
cit
Hyper
acti
vi
tyDisorder(ADHD)
Def
ini
ti
on
ADHDi saneurodevel
opmentaldi
sordermarkedby
per
sistentpat
ter
nsofinat
tent
ion,hyper
acti
vi
ty,
and
i
mpul si
vit
ythati
nter
fer
ewithdail
yfuncti
oni
ng.

Et
iol
ogy
:
1.Geneti
cFactors:
Famil
yhi
stor
yofADHDorot
her
mentalheal
thdisor
ders.
2.Neur
ologi
calFact
ors:Dy
sregul
ati
onofdopami
ne
andnorepi
nephri
nepathways.
3.Envi
ronmentalFact
ors:Pr
enat
alexposur
etot
oxi
ns
(e.
g.,
alcohol
,smoking).
Pr
emat
urebi
rt
horl
owbi
rt
hwei
ght
.
4.Soci
alFact
ors:
Disr
upt
edf
ami
lydy
nami
cs.

Nur
singI
nter
vent
ions:
1.Educatet
hef
ami
lyaboutADHDandcopi
ng
str
ategi
es.
2.Establ
ishr
out
inesandst
ruct
uredenv
ironment
sfor
thechil
d.
3.Usepositi
ver
einfor
cementt
oencour
age
appropr
iat
ebehavior.
4.Coll
abor
atewit
ht eacher
sfori
ndi
vi
dual
ized
educati
onplans(
IEPs).
5.Admi
nisterpr
escri
bedmedi
cati
ons(e.
g.,
sti
mul
ant
s
l
ikemet
hy l
phenidat
e)andmoni
toref
fect
s.
6.Encour
agephy
sical
act
ivi
tyt
ochannel
excess
energy
.

Quest
ion5c)
.Ment
alRet
ardat
ion(
Int
ell
ect
ual
Di
sabi
lit
y)
Def
ini
ti
on:
Intel
lectualdi
sabil
it
y(I
D)ischaracter
izedby
signi
f i
cantli
mitat
ionsini
ntell
ectualf
uncti
oning(I
Q
<70)andadapt ivebehavi
or,appeari
ngbeforetheage
of18.

Et
iol
ogy
:
1.Genet
icFact
ors:
Chr
omosomal abnor
mal
it
ies(
e.g.
,
Downsyndrome,Fr
agi
leXsyndr
ome) .
2.PrenatalFact
ors:
Mat
ernali
nfect
ions(
e.g.
,rubel
la,
syphil
is)
.
Exposur
etot
erat
ogens(
e.g.
,al
cohol
,dr
ugs)
.
3.Per
inatalFact
ors:
Bir
thcompl
icat
ions(
e.g.
,asphy
xia,
prematur
ity)
.
4.PostnatalFact
ors:
Headi
njur
y,i
nfect
ions(
e.g.
,
meningit
is).
Mal
nut
ri
ti
onorenv
ironment
aldepr
ivat
ion.

Nur
singI
nter
vent
ions:
1.Pr
omot edevel
opmentofdai
lyl
iv
ingski
ll
sand
i
ndependence.
2.Pr
ovi
deconsi
stentr
out
inest
omi
nimi
zeanxi
ety
.
3.Usesi
mpl
e,cl
earcommuni
cat
ion.
4.Coll
abor
atewit
ht her
apistsforspeci
ali
zed
i
nterv
enti
ons(e.
g.,speech,occupati
onalt
herapy
).
5.Suppor
tthefami
lyi
nunder
standi
ngandmanagi
ng
thecondi
ti
on.
6.Moni
torf
orassoci
atedheal
thcondi
ti
ons(
e.g.
,
sei
zur
es)

Questi
on5d).Per
vasi
veDev
elopment
al
Di
sorders(
PDD)
Def
ini
ti
on:
PDDi sagr oupofneur odevel
opmentaldisorders,
i
ncludingautism spectrum di
sor
der(ASD) ,
character
izedbychallengesinsoci
alinteracti
on,
communi cation,
andr epeti
tiv
ebehavior
s.

Et
iol
ogy
:
1.Genet
icFact
ors:
Mut
ati
onsi
ngenesassoci
atedwi
th
brai
ndevel
opment.
2.Neurologi
calFact
ors:
Abnor
mal
it
iesi
nbr
ain
str
uctureandfuncti
on.
3.Envi
ronmentalFactor
s:Advancedparent
alage,
prenat
alinf
ect
ions,orexposuretotoxi
ns.
4.UnknownFactors:
Inmanycases,
theexactcause
remainsuni
dent
ifi
ed.

Nur
singI
nter
vent
ions:
1.Devel
opindi
vi
dual
izedcar
epl
ansbasedont
he
chi
ld’
sneeds.
2.Fost
ercommunicat
iont
hroughspeecht
her
apyor
augmentat
ivemet
hods.
3.Usestructuredschedul
esandenv
ironment
sto
reduceanxiety
.
4.Encour
agesoci
alski
ll
sdev
elopmentt
hroughgr
oup
act
ivi
ti
es.
5.Providesensoryi
ntegrat
ionther
apyi
f
hypersensi
ti
vit
iesar
epr esent
.
6.Educatef
amili
esaboutPDDandr
esour
ces
avai
labl
eforsuppor
t.
General
Nursi
ngRol
eforAl
lCondit
ions:
Actasan
advocat
efort
hechi
ldandf
amily
.

Questi
on6.Whati sGeriatr
icpsychiat
ry,
psychosocialaspectofaging,My t
hsabout
agi
ng, eti
ologyandnur singint
erventi
ons
Ger
iat
ri
cPsy
chi
atr
y
Def
ini
ti
on:
Geri
atri
cpsy chiatry
,alsoknownaspsy chogeriat
ri
cs,
i
sabr anchofpsy chiatrythatfocusesont he
di
agnosi s,
treatment ,andpr eventi
onofment alhealth
di
sordersinol deradul t
s.Itaddressescogni t
ive,
emotional,andbehav i
oralhealthconcernsassociated
wit
hagi ng,oftenconsi deringcomor bi
dphy si
cal
condi
tions.

Psy
chosoci
alAspect
sofAgi
ng
Agingisassoci
atedwithv
ari
ouspsy
chosoci
al
chall
enges,i
ncl
uding:
1.EmotionalChanges:Feel
ingsofloneli
ness,l
oss,or
depr
essionduet obereavement,reti
rement,or
decl
ini
nghealth.
Fearofdependence, fr
ailt
y,ordeat
h.
2.Soci
alChanges:
Reducedsoci
alnetwor
ksduet o
ret
ir
ement,Lossofsoci
alr
oles,
leadi
ngtoident
it
y
cri
sesori
solati
on.
3.Cognit
iveChanges:
Age-
rel
atedcogni
ti
vedecl
ine,
memor yissues,
ordement
ia.
4.Phy
sicalChal
lenges:Chr
oni
cil
lnessesordi
sabi
li
ti
es
i
mpactingquali
tyofli
fe.
5.Economi
cIssues:
Financi
alinsecur
it
yfr
om
ret
ir
ementormedicalexpenses.
6.Cul
tur
alandFamili
alI
nfl
uences:
Vari
abi
li
tyinhow
agi
ngispercei
vedandmanagedacrosscult
ures.

My
thsAboutAgi
ng
1.My
th:Agi
ngal
way
sleadst
odement
ia.
Fact
:Whil
ether
iskofdementi
aincreaseswi
thage,
mostol
deradul
tsdonotdevel
opit.
2.My
th:Ol
deradul
tscannotl
ear
nnewt
hings.
Fact
:Ol
deradul
tscancont
inuet
olear
nandadaptwi
th
appr
opr
iat
esupport
.
3.My
th:Agi
ngal
way
scausesdepr
essi
on.
Fact:Depr
essionisnotanor
malpar
tofagi
ngand
shouldbetreated.
4.My
th:Ol
deradul
tsar
enotpr
oduct
ive.
Fact
:Manyolderadul
tsr
emai
nact
iveandcont
ri
but
e
si
gnif
icant
lyt
osociet
y.
5.Myth:Agi
ngl
eadst oalackofi
nter
esti
n
rel
ati
onshi
psorsexuali
ty.
Fact:Olderadul
tsof
tenmaint
ainmeani
ngf
ul
rel
ationshi
psandaninter
esti
nint
imacy
.

Et
iol
ogyofPsy
chi
atr
icI
ssuesi
ntheEl
der
ly
1.Biol
ogical
Factors:
Neurologi
calchanges(
e.g.
,br
ain
atr
ophy,neurot
ransmitt
erimbalances)
Chroni
cil
lnesses(
e.g.
,di
abet
es,
car
diov
ascul
ar
di
seases)
.
Medi
cat
ionsi
deef
fect
sori
nter
act
ions.
2.Psy
chol
ogi
calFact
ors:
Copi
ngwi
thl
oss,
gri
ef,
or
tr
auma.
Anxi
etyaboutmor
tal
it
yordependence.
3.Soci
alFact
ors:
Isol
ati
onorl
ackofsuppor
t.
Changesi
nli
vi
ngcondi
ti
onsorf
ami
lydy
nami
cs.
4.Cogni
ti
veDecl
ine:
Mil
dcogni
ti
vei
mpai
rmentor
dementi
a.
5.Subst
anceUse:
Alcoholorpr
escr
ipt
ionmedi
cat
ion
misuse.

Nur
singI
nter
vent
ions
1.AssessmentandMoni
tor
ing:
Conductat
hor
ough
psy
chosoci
al,
cogni
ti
ve,
andphy
sical
assessment
.
Uset
oolsli
ket
heGeri
atr
icDepr
essi
onScal
eorMi
ni-
Ment
alStat
eExami
nati
on(MMSE).
2.Bui
ldRappor
tandTr
ust
:Useact
ivel
ist
eni
ngand
empat
het
iccommuni
cat
ion.
Respectt
hepat
ient
’saut
onomyanddi
gni
ty.
3.Pr
omot
eSoci
alEngagement
:Encour
age
parti
cipat
ioni
ngr
oupact
ivi
ti
esorcommuni
ty
programs.
Faci
li
tat
efami
lyi
nvol
vementi
ncar
e.
4.ManageMent
alHeal
thSympt
oms:
Admi
nist
er
prescr
ibedmedicat
ions(
e.g.
,anti
depr
essants,
anti
psychot
ics)andmonit
orforsi
deeffect
s.
Encouragepar
ti
cipat
ioni
npsy
chot
her
apyor
counseli
ng.
5.Cogni
ti
veSt
imul
ati
on:
Usememor
yexer
cises,
puzzl
es,
orr
emi
niscencet
her
apy
.
Pr
omot
eli
fel
ongl
ear
ningornewhobbi
es.
6.Physi
calHeal
thSuppor
t:
Addr
esschr
oni
cil
lnesses
andencour
agephysi
calact
ivi
tywi
thi
nli
mit
s.Moni
tor
nut
ri
ti
onandhydrat
ion.
7.Addr
essSaf
etyConcer
ns:
Prev
entf
all
s,manage
wander
ing(i
fdement
iai
spr
esent
),andensur
easaf
e
l
iv
ingenvi
ronment
.
8.Educat
etheFami
ly:
Prov
idei
nfor
mat
ionaboutt
he
agi
ngprocess,mentalheal
thcondi
ti
ons,
and
car
egi
vi
ngst rat
egi
es.
9.Col
labor
atewi
thMul
ti
disci
pli
nar
yTeams:
Wor
kwi
th
soci
alworker
s,phy
sical
ther
api
sts,
psy
chol
ogi
sts,
and
geri
atr
ici
ans.
10.End-
of-
Lif
eCar
e:Suppor
tdi
scussi
onsonadv
ance
car
epl
anni
ngandpal
li
ati
vecar
e.
Addr
essspi
ri
tualorexi
stent
ial
concer
ns.

Questi
on7.WhatisHI V/
AIDSinpsychi
atr
y
andManagementofHI V/AI
DSi n
psychi
atr
yusingnursi
ngprocess,et
iol
ogy
andnursi
nginter
venti
ons
HI
V/AI
DSi
nPsy
chi
atr
y
Def
ini
ti
on:
HIV/AIDSinpsychi
atr
yfocusesont hement al health
chall
engesfacedbyindi
vidual
sliv
ingwithHI V/ AIDS.
Thesechall
engescanincludepsychiat
ricdisorder s
causedbythev i
rusi
tsel
f,medicati
onsideef fects,or
psychosoci
alstr
essorsassoci
atedwi t
ht hediagnosi s.

Et
iol
ogyofPsy
chi
atr
icDi
sor
der
sinHI
V/AI
DS
1.Biologi
calFactor
s:Di
recteff
ect
sofHI Vont
hebrai
n:
HIV-associ
atedneurocognit
ivedi
sorder
s(HAND)
,
i
ncludingHIV-associ
ateddementia.
Oppor
tuni
sti
cinfect
ions:Cr
ypt
ococcal
meni
ngi
ti
s,
t
oxopl
asmosis,orCMVencephali
ti
s.
Si
deeff
ectsofanti
ret
rovi
ralt
her
apy(
ART)
:Mood
swi
ngs,anxi
ety
,orpsychosi
s.
2.Psychol
ogicalFact
ors:Anxi
etyordepr
essi
onrel
ated
tosti
gma, f
earofdeath,orli
vi
ngwi t
hachroni
c
condi
tion.
Adj
ust
mentdi
sor
der
sfol
lowi
ngdi
agnosi
s.
3.Social
Fact
ors:
Isol
ati
onorr
eject
ionbyf
ami
lyand
fr
iends.
Economicchal
lengesandbar
ri
erst
oheal
thcar
e
access.
4.SubstanceUseDisor
der
s:Highpreval
enceof
subst
anceuseamongi ndi
vidualsatr
iskofHIV
i
nfecti
on,cont
ri
buti
ngtoment alheal
thchal
lenges.

ManagementofHIV/
AIDSi
nPsy
chi
atr
yUsi
ng
t
heNursingPr
ocess
1.Assessment
Psychi
atr
icHistor
y:Assessfordepressi
on,
anxi
ety
,
psy
chosis,orsubstanceusedisor
ders.
Neur
ologi
calAssessment:Lookf
orcognit
ive
i
mpairments,
confusi
on,ormemoryissues.
Physi
calHeal
th:Monitorf
orsy
mptomsof
oppor
tuni
sti
cinfect
ionsorARTsi
deef
fect
s.
Psy
chosoci
alAssessment
:Ev
aluat
esoci
alsuppor
t,
copi
ngmechani
sms,
andst
igma-
rel
atedst
ress.
2.Di
agnosi
s
Exampl
esofnur
singdi
agnoses:
Anxietyrel
atedt
odiagnosi
sofHIVasev
idencedby
rest
lessnessandfearofdeat
h.
Riskf
orsoci
ali
sol
ati
onr
elat
edt
ost
igmaandf
earof
rej
ect
ion.
Impai
redcognit
ivefuncti
onr
elat
edt
oHI
V-associ
ated
neur
ocognit
ivedisor
ders.
3.Pl
anni
ng
Developindivi
duali
zedcar
eplansfocusedonment
al
healt
hstabili
zati
on,adher
encetoART, and
psychosocialsupport
.
Setreali
sti
cgoal
s,suchasimpr
ov i
ngcopi
ng
mechanismsandr educi
ngsymptomsofdepr
essi
on
oranxiety
.
4.I
mpl
ement
ati
on
a.Phar
macol
ogi
calI
nter
vent
ions:
Admini
sterARTasprescr
ibed,
moni
tor
ingf
or
adher
enceandsideeff
ects.
Provi
demedicati
onsf
orpsy chiat
ri
csy mptoms(
e.g.
,
anti
depr
essants,
anxi
oly
tics,anti
psychot
ics)
.
b.Psychosoci
alSuppor
t:
Encour
agecounseli
ngorpsychother
apy(e.
g.,
cogni
ti
ve-
behavi
oralther
apy
,groupther
apy).
Faci
li
tatepeersuppor
tgr
oupsf
ori
ndi
vi
dual
sli
vi
ng
wit
hHI V/AI
DS.
c.Educat
ion:
Teachpati
ent
saboutHI
V,ART,
andt
hei
mpor
tanceof
adher
ence.
Educat
eabouttheconnect
ionbet
weenment
alheal
th
andphysi
calheal
th.
d.Cr
isi
sManagement
:
Addr
esssui
cidali
deat
ionorsev
eredepr
essi
on
pr
omptl
y.
Prov
idei
mmediatecaref
orpsy
chot
icsy
mpt
omsor
aggr
essi
vebehav
ior.
e.Heal
thPr
omot
ion:
Encourageahealthyli
fest
yle,
incl
udi
ngabal
anceddi
et
andregularexer
cise.
Pr
omotesafesexualpr
act
icesandhar
mreduct
ion
st
rat
egi
es.
5.Ev
aluat
ion
Regul
arl
yassessthepat
ient
’smentalheal
th,
adher
encetotreat
ment,
andoveral
lfuncti
oni
ng
Moni
torfori
mprov
ementincopi
ngski
l
lsand
r
educt
ioninpsy
chiat
ri
csy
mpt oms

Nur
singI
nter
vent
ions
1.Bui
ldTrustandRapport:
Provi
denonj
udgmental
,
empathet
iccaretoreducesti
gmaandbuil
dtrust.
2.ManagePsychiat
ri
cSympt
oms:Addressdepr
ession,
anxi
ety
,orpsychosi
swit
happropr
iat
einter
vent
ions
andmedicat
ions.
3.Pr
omoteARTAdher ence:
Useremi
nders,
counsel
ing,
ormoti
vat
ionalst
rat
egiestoimpr
oveadher
ence.
4.Provi
deEmotionalSupport:
Vali
dat
ethepat
ient
’s
feel
ingsandof
ferreassurance.
Encour
ageexpr
essi
onoff
ear
sorconcer
ns.
5.Facil
it
ateSuppor
tSy st
ems:Inv
olv
efami
lymember
s
orcaregi
versasappropri
ate.
Connectpat
ient
stocommunityr
esour
cesor
HIV/
AIDSsupportor
gani
zat
ions.
6.Monit
orf
orCogni
ti
veChanges:I
denti
fyandaddr
ess
symptomsofHANDorothercogni
tiv
eimpairment
s
ear
ly.
7.AddressStigmaandDi scr
iminati
on:Educatet
he
pati
entaboutt hei
rri
ghtsandway stohandle
di
scriminat
ion.Advocat
eforpoli
ciesthatreduce
sti
gmaandi mpr oveaccesstocare.

THEEND!
!!
!