UPDATED QUESTIONS ANSWERS CU NR 546

How does reviewing the genetic makeup of a client help guide the PMHNP in selecting medication for clients? - ANSWER Genetic testing can assist by providing more information on how clients may respond to certain psychotropic medications, as well as providing information on how a client may break down and metabolize medications based on the cytochrome P450 system. There may be an environmental exposure that turned a gene "on" that should have been "off" for one twin to develop schizophrenia and not the other . Both environmental and psychosocial stressors can impact mental health. Although twins may have identical genes, their gene expression may be different. Neuroscience - ANSWER is the study of the structure and function of the brain and is a field which is making great advancements (Pliszka, 2016). A strong foundational understanding of neuroscience and how the structure and function of the brain can result in mental health symptoms is necessary to treat mental illnesses. Some mental disorders such as Alzheimer's disease, schizophrenia, and major depressive disorder are thought to be a result of malformations or malfunctions within the brain. The psychiatric mental health nurse practitioner (PMHNP) must comprehend how medications impact the brain in order to safely and effectively prescribe psychotropic medications. Brain tissue - ANSWER is composed of gray and white matter. gray matter - ANSWER The cerebellum, cerebrum, brain stem, and the butterfly-shaped portion of the central spinal cord are comprised of gray matter which contains neural cell bodies, axon terminals, dendrites, and all nerve synapses. It is the working area of the brain and the focus of psychiatry and neurology. Gray matter - ANSWER associated with learning. Changes in the gray matter are linked to psychiatric diagnoses including Alzheimer's disease, schizophrenia, and major depressive disorder. White Matter - ANSWER contains nerve fibers that connect neurons from different regions into functional circuits. The myelin that coats neuronal axons is necessary for electrical impulse transmission. Think of the white matter as a transit system. If there are breaks in the system, then people cannot get to their destinations. Within the brain, these breaks affect neural communication, affecting behavior. Damage to the myelin can impair transmission which can impact not only sensory and motor function, but also cognition. White matter abnormalities are associated with autism and vascular dementia. The central sulcus separates which lobes? - ANSWER frontal lobe from parietal lobe Frontal lobe - ANSWER Associated with movement, intelligence, abstract thinking. etc. Broca's area - ANSWER Speech Temporal lobe - ANSWER Involves object identification and auditory signals Cerebellum - ANSWER coordination and balance Wernicke's area - ANSWER Speech comprehension occipital lobe - ANSWER Primary visual area parietal lobe - ANSWER Keeps us alert to what is going on around us Sensory Cortex - ANSWER Pain, heat, and other sensations motor cortex - ANSWER Movement Hippocampus - ANSWER Involved in both memory and anxiety Nucleus accumbens - ANSWER Involved in the reward process. Thalamus - ANSWER Involved in sensory organ and motor command processing Striatum - ANSWER Involved in complex motor actions, also links cognition to motor actions Limbic System - ANSWER This includes circuits that are associated with pleasure and reward, emotion and learning Basal ganglia - ANSWER A group of structures involved in voluntary motor movements Amygdala - ANSWER Involved in emotional regulation and perception of odors Corpus callosum - ANSWER Controls the communication between the two brain hemispheres white matter - ANSWER Contains nerve fibers that connect neurons from different regions into functional circuits Grey matter - ANSWER Contains nerve cells and dendrites Brain tissue - ANSWER Made up of grey matter and white matter What is the global burden of disease of mental health, neurological, and substance use disorders? - ANSWER 30% How many children and adolescents are impacted by mental health disorders worldwide? - ANSWER 20% How much does lost productivity related to anxiety and depression cost the global economy each - ANSWER $1 trillion USD The development of mental health conditions are linked to causes - ANSWER such as genetics, biochemical processes, environment, and lifestyle. Mental illness is common, and treatment often includes the use of psychotropic medications. When prescribing medications, the psychiatric mental health nurse practitioner (PMHNP) must consider each client's unique circumstances including, but not limited to their: - ANSWER symptoms age physical health previous response to treatment lifestyle Treatment for mental health conditions requires - ANSWER individualized care that incorporates the client's desires and goals. Which is the priority data used to determine a treatment plan for mental health disorders? - ANSWER client symptoms Adherence - ANSWER can be defined as persistence or compliance.