Chapter 03 Interfacing Biological Behaviors.ppt

Psychiatric Nursing

1. Chapter 3
Interfacing Biological-Behavioral
Concepts into Psychiatric Nursing

2. 2
The Central Nervous System
•Neurodegenerative processes
–May occur at any age
–Leads to cognitive and affective impairment
•May arise from underlying general medical conditions
or treatments

3. 3
The Central Nervous System
•Neurodegenerative processes
–Brain shrinks with age
•No definitive mental or cognitive decline linked solely
to aging process
–Alzheimer’s disease most well known of
numerous neurodegenerative disorders

4. 4
The Central Nervous System
•Neurochemical processes
–Regulation based on complex network of
transmitter pathways
–Type of neurotransmitter and receptor
determines the nature of the response

5. 5
The Central Nervous System
•Neurochemical processes
–Examples of Excitatory Transmitters:
•Norepinephrine
•Dopamine
•Acetylcholine
•Serotonin

6. 6
The Central Nervous System
•Neurochemical processes
–Inhibitory transmitters:
•Amino acids including gamma-aminobutyric acid
(GABA)

7. 7
The Central Nervous System
•Neurochemical processes
–Abnormal concentrations of any of the above are
associated with:
•Impulsivity
•Mental disorders: depression, anxiety, addictive
disorders, and schizophrenia

8. 8
The Central Nervous System
•Neurochemical processes
–Antidepressants, neuroleptics, anxiolytics and
other pharmacological agents
•Increase or decrease release of neurotransmitters
•Modifies concentration in the synaptic cleft

9. 9
Interfacing
Biological-Behavioral Concepts
•Neuroendocrinology
–Study of how neural and endocrine systems
work together to maintain homeostasis
•Psychoneuroimmunology
–Study of the roles of the immune system and
nervous system in health and illness in the face
of biological and psychosocial stress

10. 10
Interfacing
Biological-Behavioral Concepts
•Genetics
–Twin, adoption, and family studies
•Isolate genetic and environmental influences
•Determine preventive and precipitating factors
–Environmental factors
•Parental treatment
•Caregiving patterns
•Family structure

11. 11
Interfacing
Biological-Behavioral Concepts
•Genetics
–Genetics and addiction
•Genetic vulnerability

12. 12
Integration of
Brain Function and Behavior
•Conclusive evidence of biological basis for
mental illness
–Kindling
•Electrophysiological process that produces neuron
sensitization after repetitive subthreshold stimulations
•First described in epilepsy studies
•Useful to explain neurobiological processes in mood
dysregulation

13. 13
Integration of
Brain Function and Behavior
•Conclusive evidence of biological basis for
mental illness
–Trauma: an event that results in long-standing
distress to an individual
•Activation of perception and response areas of the
brain
•Knowledge of brain’s fear response explain
neurobiological basis for anxiety disorders

14. 14
Major Paradigms of Psychiatric
Mental Health Nursing  Neurobiology
•Clinical and Practice Issues
–Controversy regarding neurobiology and its
relevance to psychiatric nursing
–Nurses must include the spiritual, cultural,
psychosocial, as well as the biological, in
treatment

15. 15
Interfacing
Biological-Behavioral Concepts
•Nursing interventions
–Pharmacological therapy
•Sertraline (Zoloft)
•Venlafaxine (Effexor)
–Behavioral therapy
• Electroconvulsive therapy (ECT)

16. 16
Interfacing
Biological-Behavioral Concepts
•Nursing interventions
–Biological therapy (complementary therapies)
•St. John’s Wart – mild depression
•Rest-sleep manipulation – bipolar disorder
•Touch therapy – dementia

17. 17
Interfacing
Biological-Behavioral Concepts
•Psychiatric nursing education
–Psychiatric nurses defined major biological and
behavioral concepts (1990s)

18. 18
Interfacing
Biological-Behavioral Concepts
•Psychiatric nursing education
–Educators defined outcomes that integrate these
biological-behavioral concepts into nursing
practice

19. 19
Interfacing
Biological-Behavioral Concepts
•Psychiatric nursing education
–Students studied the brain and neuroscience
and their impact on human adaptation to stress
–Advances of the 21st Century in neurobiology
provides greater understanding of its impact on
the treatment of mental illness

20. 20
The Nurse’s Role
•The Generalist Nurse
–Works with clients, families, groups, and
communities
–Facilitates and reinforces adaptive coping
patterns

21. 21
The Nurse’s Role
•The Generalist Nurse
–Specific interventions include:
•Psychoeducation
•Psychotropic medication
•Milieu therapy
•Crisis intervention

22. 22
The Nurse’s Role
•The Advanced-Practice Psychiatric
Registered Nurse
–Encompasses that of the Generalist Nurse in
addition to providing direct clinical care:
•Psychotherapy
•Prescriptive authority
•Evaluation of client responses to therapy