By W. Roy. American Global University. 2018.
The clinical presentation is typical of the syndrome of dementia buy cheap naltrexone 50 mg, and the course is extremely rapid discount naltrexone 50 mg with visa, with progressive deterioration and death within 1 year after onset. This type of dementia is related to the persisting effects of substances such as alcohol, inhalants, sedatives, hypnotics, anxiolyt- ics, other medications, and environmental toxins. The term “persisting” is used to indicate that the dementia persists long after the effects of substance intoxication or substance withdrawal have subsided. Symptomatology (Subjective and Objective Data) The following symptoms have been identiﬁed with the syndrome of dementia: 1. Memory impairment (impaired ability to learn new informa- tion or to recall previously learned information). Impaired ability to perform motor activities despite intact motor abilities (apraxia). Amnestic Disorders Deﬁned Amnestic disorders are characterized by an inability to learn new information (short-term memory deﬁcit) despite normal at- tention and an inability to recall previously learned information (long-term memory deﬁcit). Transient amnestic syndromes can also occur from epi- leptic seizures, electroconvulsive therapy, severe migraine, and drug overdose. This type of amnestic disorder is related to the persisting effects of substances such as alcohol, sedatives, hypnotics, anxiolyt- ics, other medications, and environmental toxins. The term “persisting” is used to indicate that the symptoms persist long after the effects of substance intoxication or substance withdrawal have subsided. Symptomatology (Subjective and Objective Data) The following symptoms have been identiﬁed with amnestic disorder: 1. There is an inability to recall events from the recent past and events from the remote past. Common Nursing Diagnoses and Interventions for Delirium, Dementia, and Amnestic Disorders (Interventions are applicable to various health-care settings, such as inpatient and partial hospitalization, community outpatient clinic, home health, and private practice. Assess client’s level of disorientation and confusion to deter- mine speciﬁc requirements for safety. Knowledge of client’s level of functioning is necessary to formulate appropriate plan of care. Place furniture in room in an arrangement that best accommodates client’s disabilities. Observe client behaviors frequently; assign staff on one- to-one basis if condition warrants; accompany and assist client when ambulating; use wheelchair for transporting long distances. Remove potentially harmful articles from client’s room: cigarettes, matches, lighters, sharp objects. Institute seizure precautions as described in procedure manual of individual institution. If client is prone to wander, provide an area within which wandering can be carried out safely. Disori- entation may endanger client safety if he or she unknowingly wanders away from safe environment. Use tranquilizing medications and soft restraints, as pre- scribed by physician, for client’s protection during periods of excessive hyperactivity. Teach prospective caregivers methods that have been successful in preventing client injury. These caregivers will be responsible for client’s safety after discharge from the hospital. Client is able to accomplish daily activities within the envi- ronment without experiencing injury. Prospective caregivers are able to verbalize means of provid- ing safe environment for client. Assess client’s level of anxiety and behaviors that indicate the anxiety is increasing. Recognizing these behaviors, nurse may be able to intervene before violence occurs. Maintain low level of stimuli in client’s environment (low lighting, few people, simple decor, low noise level). In a disoriented, confused state, client may use these objects to harm self or others. Have sufﬁcient staff available to execute a physical confronta- tion, if necessary. Assistance may be required from others to provide for physical safety of client or primary nurse or both. Correcting misinterpretations of reality enhances client’s feelings of self-worth and personal dignity. Use tranquilizing medications and soft restraints, as pre- scribed by physician, for protection of client and others during periods of elevated anxiety. Use restraints judiciously, because agitation sometimes increases; however, they may be required to ensure client safety. Sit with client and provide one-to-one observation if assessed to be actively suicidal. Client safety is a nursing priority, and one-to-one observation may be necessary to prevent a suicidal attempt. Teach prospective caregivers to recognize client behaviors that indicate anxiety is increasing and ways to intervene before violence occurs. Prospective caregivers are able to verbalize behaviors that indicate an increasing anxiety level and ways they may assist client to manage the anxiety before violence occurs. W ith assistance from caregivers, client is able to control impulse to perform acts of violence against self or others. Possible Etiologies (“related to”) [Alteration in structure/function of brain tissue, secondary to the following conditions: Advanced age Vascular disease Hypertension Cerebral hypoxia Long-term abuse of mood- or behavior-altering substances Exposure to environmental toxins Various other physical disorders that predispose to cerebral abnormalities (see Predisposing Factors)] Deﬁning Characteristics (“evidenced by”) Altered interpretation Altered personality Altered response to stimuli Clinical evidence of organic impairment Impaired long-term memory Impaired short-term memory Impaired socialization Longstanding cognitive impairment No change in level of consciousness Progressive cognitive impairment Delirium, Dementia, and Amnestic Disorders ● 63 Goals/Objectives Short-term Goal Client will accept explanations of inaccurate interpretations within the environment. Long-term Goal With assistance from caregiver, client will be able to interrupt non–reality-based thinking. Use oth- er items, such as a clock, a calendar, and daily schedules, to assist in maintaining reality orientation. Maintaining reality orientation enhances client’s sense of self-worth and personal dignity. Teach prospective caregivers how to orient client to time, person, place, and circumstances, as required. These care- givers will be responsible for client safety after discharge from the hospital.
A comprehensive meta-analysis of the predictive validity of the graduate record examinations: Implications for graduate student selection and performance generic 50mg naltrexone with amex. The relationship between the scholastic assessment test and general cognitive ability 50mg naltrexone. The validity and utility of selection methods in personnel psychology: Practical and theoretical implications of 85 years of research findings. Big-brained people are smarter: A meta-analysis of the relationship between in vivo brain volume and intelligence. Intelligence and changes in regional cerebral glucose metabolic rate following learning. The impact of childhood intelligence on later life: Following up the Scottish mental surveys of 1932 and 1947. Long-term effects of an early childhood intervention on educational achievement and juvenile arrest: A 15-year follow-up of low-income children in public schools. How much does schooling influence general intelligence and its cognitive components? Cohort effects in cognitive development of children as revealed by cross-sectional sequences. A comprehensive meta-analysis of the relationship between emotional intelligence and health. Emotional intelligence and transformational and transactional leadership: A meta- analysis. Some historical and scientific issues related to research on emotional intelligence. Regulating the interpersonal self: Strategic self-regulation for coping with rejection sensitivity. Predicting cognitive control from preschool to late adolescence and young adulthood. Willpower in a cognitive-affective processing system: The dynamics of delay of gratification. Explain how very high and very low intelligence is defined and what it means to have them. Define stereotype threat and explain how it might influence scores on intelligence tests. Most people in Western cultures tend to agree with the idea that intelligence is an important personality variable that should be admired in those who have it. But people from Eastern cultures tend to place less emphasis on individual intelligence and are more likely to view intelligence as reflecting wisdom and the desire to improve the society as a whole rather than only themselves (Baral & Das, 2004; Sternberg,  2007). And in some cultures, such as the United States, it is seen as unfair and prejudicial to argue, even at a scholarly conference, that men and women might have different abilities in domains such as math and science and that these differences might be caused by genetics (even though, as we have seen, a great deal of intelligence is determined by genetics). In short, although psychological tests accurately measure intelligence, it is cultures that interpret the meanings of those tests and determine how people with differing levels of intelligence are treated. In a normal distribution, the bulk of the scores fall toward the middle, with many fewer scores falling at the extremes. These sex differences mean that about 20% more men than women fall in the extreme (very smart or very dull) ends of the distribution (Johnson,  Carothers, & Deary, 2009). Boys are about five times more likely to be diagnosed with the  reading disability dyslexia than are girls (Halpern, 1992), and are also more likely to be classified as mentally retarded. About 1% of the United States population, most of them males, fulfill the criteria for mental retardation, but some children who are diagnosed as mentally retarded lose the classification as they get older and better learn to function in society. Mental retardation is divided into four categories: mild, moderate, severe, and profound. One cause of mental retardation is Down syndrome, a chromosomal disorder leading to mental retardation caused by the presence of all or part of an extra 21st chromosome. The incidence of Down syndrome is estimated at 1 per 800 to 1,000 births, although its prevalence rises sharply in those born to older mothers. People with Down syndrome typically exhibit a distinctive pattern of physical features, including a flat nose, upwardly slanted eyes, a protruding tongue, and a short neck. Societal attitudes toward individuals with mental retardation have changed over the past decades. We no longer use terms such as “moron,‖ “idiot,‖ or “imbecile‖ to describe these people, although these were the official psychological terms used to describe degrees of retardation in the past. Supreme Court ruled that the execution of people with mental retardation is “cruel and unusual  punishment,‖ thereby ending this practice (Atkins v. It is often assumed that schoolchildren who are labeled as “gifted‖ may have adjustment problems that make it more difficult for them to create social relationships. This study found, first, that these students were not unhealthy or poorly adjusted but rather were above average in physical health and were taller and heavier than individuals in Attributed to Charles Stangor Saylor. The students also had above average social relationships—for instance,  being less likely to divorce than the average person (Seagoe, 1975). Terman‘s study also found that many of these students went on to achieve high levels of education and entered prestigious professions, including medicine, law, and science. Of the sample, 7% earned doctoral degrees, 4% earned medical degrees, and 6% earned law degrees. These numbers are all considerably higher than what would have been expected from a more general population. As you might expect based on our discussion of intelligence, kids who are gifted have higher scores on general intelligence (g). Some children are particularly good at math or science, some at automobile repair or carpentry, some at music or art, some at sports or leadership, and so on. There is a lively debate among scholars about whether it is appropriate or beneficial to label some children as “gifted and talented‖ in school and to provide them with accelerated special classes and other programs that are not available to  everyone. Although doing so may help the gifted kids (Colangelo & Assouline, 2009), it also may isolate them from their peers and make such provisions unavailable to those who are not classified as “gifted. The fact that women earn many fewer degrees in Attributed to Charles Stangor Saylor.
To date these debates have highlighted two possible career pathways: the clinical health psychologist and the professional health psychologist purchase naltrexone 50mg with amex. The clinical health psychologist A clinical health psychologist has been deﬁned as someone who merges ‘clinical psychology with its focus on the assessment and treatment of individuals in distress naltrexone 50 mg amex. A trained clinical health psychologist would tend to work within the ﬁeld of physical health, including stress and pain management, rehabilitation for patients with chronic illnesses (e. A professional health psychologist A professional health psychologist is someone who is trained to an acceptable standard in health psychology and works as a health psychologist. Although still being considered by a range of committees, it is now generally agreed that a professional health psychologist should have competence in three areas: research, teaching and consultancy. In addition, they should be able to show a suitable knowledge base of academic health psychology normally by completing a higher degree in health psychology. Having demonstrated that they meet the required standards, a professional/chartered health psychologist could work as an academic within the higher education system, within the health promotion setting, within schools or industry, and/or work within the health service. The work could include research, teaching and the development and evaluation of interventions to reduce risk-related behaviour. Health psychology is an expanding area in terms of teaching, research and practice. Health psychology teaching occurs at both the undergraduate and postgraduate level and is experienced by both mainstream psychology students and those studying other health- related subjects. Undergraduates are often expected to produce research projects as part of their assessment, and academic staﬀ and research teams carry out research to develop and test theories and to explore new areas. Such research often feeds directly into practice, with intervention programmes aiming to change the factors identiﬁed by research. This book aims to provide a com- prehensive introduction to the main topics of health psychology. In addition, how these theories can be turned into practice will also be described. This book is now supported by a compre- hensive website which includes teaching supports such as lectures and assessments. A note on theory and health psychology Health psychology draws upon a range of psychological perspectives for its theories. Further, it utilizes many key psycho- logical concepts such as stereotyping, self-identity, risk perception, self-eﬃcacy and addiction. This book describes many of these theories and explores how they have been used to explain health status and health related behaviours. Some of these theories have been used across all aspects of health psychology such as social cognition models and stage theories. In contrast, other theories and constructs have tended to be used to study speciﬁc behaviours. However, as cross-fertilization is often the making of good research, many of these theories could also be applied to other areas. A note on methodology and health psychology Health psychology also uses a range of methodologies. It uses quantitative methods in the form of surveys, randomized control trials, experiments and case control studies. A separate chapter on methodology has not been included as there are many comprehensive texts which cover methods in detail. The aim of this book is to illustrate this range of methods and approaches to data analysis through the choice of examples described throughout each chapter. The contents of the ﬁrst half of this book reﬂect this emphasis and illustrate how diﬀerent sets of beliefs relate to behaviours and how both these factors are associated with illness. Chapter 2 examines changes in the causes of death over the twentieth century and why this shift suggests an increasing role for beliefs and behaviours. The chapter then assesses theories of health beliefs and the models that have been developed to describe beliefs and predict behaviour. Chapter 3 examines beliefs individuals have about illness and Chapter 4 examines health professionals’ health beliefs in the context of doctor–patient communication. Chapters 5–9 examine health-related behaviours and illustrate many of the theories and constructs which have been applied to speciﬁc behaviours. Chapter 5 describes theories of addictive behaviours and the factors that predict smoking and alcohol consumption. Chapter 6 examines theories of eating behaviour drawing upon develop- mental models, cognitive theories and the role of weight concern. Chapter 7 describes the literature on exercise behaviour both in terms of its initiation and methods to encourage individuals to continue exercising. Health psychology also focuses on the direct pathway between psychology and health and this is the focus for the second half of the book. Chapter 10 examines research on stress in terms of its deﬁnition and measurement and Chapter 11 assesses the links between stress and illness via changes in both physiology and behaviour and the role of moderating variables. Chapter 12 focuses on pain and evaluates the psychological factors in exacerbating pain perception and explores how psychological interventions can be used to reduce pain and encourage pain acceptance. Chapter 13 speciﬁcally examines the interrelationships between beliefs, behaviour and health using the example of placebo eﬀects. Chapter 16 explores the problems with measuring health status and the issues surrounding the measurement of quality of life. Finally, Chapter 17 examines some of the assumptions within health psychology that are described throughout the book. Each chapter could be used as the basis for a lecture and/or reading for a lecture and consists of the following features: s A chapter overview, which outlines the content and aims of the chapter. Each ‘focus on research’ section takes one speciﬁc paper that has been chosen as a good illustration of either theory testing or practical implications. In addition, there is a glossary at the end of the book, which describes terms within health psychology relating to methodology. Discuss the extent to which factors other than biological ones may have contributed to your illness. This paper discusses the problematic relationship between inequality and health status and illustrates an integration of psychological factors with the wider social world. This chapter describes the different skills of a health psychologist, where they might be employed and the types of work they might be involved in.
The underlying reason for this position: …is that English law goes to great lengths to protect a person of full age and capacity from interference with his personal liberty naltrexone 50 mg low price. We have too often seen freedom disappear in other countries not only by coups d’etat but by gradual erosion; and often it is the first step that counts cheap 50 mg naltrexone free shipping. The foregoing applies to all adults who are mentally competent; when a patient lacks the capacity to make decisions about whether to consent to treat- ment (e. Requisites for Consent To intervene without consent may give rise to criminal proceedings (for alleged trespass to the person) and may also give rise to tortious liability (a civil claim for damages). To protect against such proceedings, the medical practitioner should ensure that the patient is capable of giving consent, has been sufficiently well informed to understand and therefore to give a true con- sent, and has then expressly and voluntarily consented to the proposed inves- tigation, procedure, or treatment. Capacity If there is serious doubt about the patient’s capacity to give consent, it should be assessed as a matter of priority. The patient’s general practitioner or other responsible doctor may be sufficiently qualified to make the assessment, but in serious or complex cases involving difficult issues about the future health and well-being, or even the life of the patient, the issue of capacity to consent should be assessed by an independent psychiatrist (in England, ideally, but not necessarily, one approved under section 12 of the Mental Health Act of 1983) (9). If after assessment serious doubts still remain about the patient’s competence (e. Understanding Risks and Warnings A signature on a form is not, of itself, a valid consent. For a valid, true, or real consent in law, the patient must be sufficiently well informed to under- stand that to which he or she is asked to give consent. To defend a doctor against a civil claim alleging lack of consent based on a failure to warn adequately, it is necessary to have more than a signature on a standard consent form. Increasingly, in medical negligence actions, it Fundamental Principals 41 is alleged that risks were not explained nor warnings given about possible adverse outcomes. Therefore, it is essential for the doctor or any other healthcare professional to spend adequate time explaining the nature and purpose of the intended investigation, procedure, or treatment in terms that the patient can understand. The patient’s direct questions must be answered frankly and truthfully, as was made clear in the Sidaway case (11), and thus the discussions should be undertaken by those with adequate knowledge and experience to deal with them; ideally, the clinician who is to perform the operation or procedure. Increasingly, worldwide the courts will decide what the doctor should warn a patient about—applying objective tests, such as what a “prudent patient” would wish to know before agreeing. For example, in the leading Australian case (12), the court imposed a duty to warn about risks of remote (1 in 14,000) but serious complications of elective eye surgery, even though professional opinion in Australia at the time gave evidence that they would not have warned of so remote a risk. In the United States and Canada, the law about the duty to warn of risks and adverse outcomes has long been much more stringent. In the leading case (13), the District of Columbia appeals court imposed an objective “prudent patient” test and enunciated the following four principles: 1. Every human being of adult years and sound mind has a right to determine what shall happen to his or her body. Consent is the informed exercise of choice and that entails an opportunity to evaluate knowledgeably the options available and their attendant risks. In the leading Canadian case (14), broad agreement was expressed with the propositions expressed in the American case. The prac- titioner is not required to make an assessment based on the information to be given to an abstract “prudent patient;” rather, the actual patient being con- sulted must be assessed to determine what that patient should be told. How- ever, the Sidaway and Bolitho (15) cases make clear that doctors must be supported by a body of professional opinion that is not only responsible but also scientifically and soundly based as determined by the court. The message for the medical and allied health care professions is that medical paternalism has no place where consent to treatment is concerned; patients’ rights to self-determination and personal autonomy based on full dis- closure of relevant information is the legal requirement for consent. A doctor must be satisfied that the patient is giving a free, voluntary agreement to the pro- posed investigation, procedure, or treatment. Express consent is given when the patient agrees in clear terms, verbally or in writing. A verbal consent is legitimate, but because disputes may arise about the nature and extent of the explanation and warnings about risks, often months or years after the event, it is strongly recommended that, except for minor matters, consent be recorded in written form. In the absence of a contemporaneous note of the discussions leading to the giving of consent, any disputed recollections will fall to be decided by a lengthy, expensive legal process. The matter then becomes one of evidence, with the likelihood that the patient’s claimed “per- fect recall” will be persuasive to the court in circumstances in which the doctor’s truthful concession is that he or she has no clear recollection of what was said to this particular patient in one of hundreds of consultations undertaken. A contemporaneous note should be made by the doctor of the explana- tion given to the patient and of warnings about risks and possible adverse outcomes. It is helpful to supplement but not to substitute the verbal explana- tion with a printed information leaflet or booklet about the procedure or treat- ment. The explanation should be given by the clinician who is to undertake the procedure—it is not acceptable to “send the nurse or junior hospital doc- tor” to “consent the patient. How- ever, in circumstances in which the procedure has a forensic rather than a therapeutic content and the doctor is not the patient’s usual medical attendant but may be carrying out tasks that affect the liberty of the individual (e. If no assumptions are made by the doctor and express agree- ment is invariably sought from the patient—and documented contemporane- ously—there is less chance of misunderstandings and allegations of duress or of misleading the individual. Adult Patients Who Are Incompetent Since the implementation of the 1983 Mental Health Act in England and Wales (and the equivalent in Scotland) no parent, relative, guardian, or court can give consent to the treatment of an adult patient who is mentally incompe- tent (16). The House of Lords had to consider a request to sterilize a 36-yr-old woman with permanent mental incapacity and a mental age of 5 years who had formed a sexual relationship with a fellow patient. The court held that no one, not even the courts, could give consent on behalf of an adult who was incompetent. Age of Consent In England, section 8 of the Family Law Reform Act 1969 provides that any person of sound mind who has attained 16 year of age may give a valid consent to surgical, medical, or dental treatments. For those under 16 years of age the House of Lords decided (18) that valid consent could be given by minors, provided that they understood the issues. The case concerned the provision of contraceptive advice to girls younger than 16 years in circumstances in which a parent objected. The House of Lords held that parental rights to determine whether a child younger than 16 years received treatment terminated if and when the child achieved a sufficient understanding and intelligence to enable him or her to comprehend the issues involved. It is the capacity to understand, regardless of age or status, that is the determinant factor. Intimate Samples and Intimate Searches Section 62 of the Police and Criminal Evidence Act of 1984 (and the equivalent statute in Scotland) provides that intimate samples can only be taken from an individual if authorized by a police inspector (or higher ranking police officer) and if consent is obtained.