The PSYCH MAP explains a lot of concepts needed in the study of Psychiatric Nursing. I hope that this will help you in your study. First, you have to right click on the picture above and save it in your computer. Open and print the picture in landscape format. Place the picture above your bed, beside your study table, in front of your bowl and study it during your BMs, in front of the mirror, above the ceiling and in every place you can think of. Memorize it and Enjoy! The center or the word NORMAL represents a state in which there is an equilibrium or the absence of any problem. If you encounter problems or stressors, you will become ANXIOUS and your Sympathetic Nervous System SNS will be activated. Epinephrine and norepinephrine will be released. In severe cases, medications are given. The main purpose of the medication given for anxiety is to decrease the action of the SNS. GABA decreases your SNS and further to your left, you will see a list of medications used to decrease anxiety (VLASTMEVAIB). Zepam, zepine and zolam are the common ending letters of these anxiolytic medications. It will take 3 to 4 weeks until these drugs take effect. While taking these drugs, you should watch out for anticholinergic effects such as constipation and urinary retention. It is important to remember that there are safety precautions when taking these drugs. You should not drive because these drugs can make you drowsy, it also means that you should not engage yourself in an activity which requires alertness (ex. driving, operating a machine). You may also experience orthostatic hypotension. You should not drink alcohol because it is a depressant and this will potentiate the effect of the drug. On the other hand, you are also not allowed to drink coffee. It is a stimulant that counteracts the effect of your anxiolytic drugs, and besides, you are taking medications to decrease the stimulants causing your anxiety. Anxiolytic drugs or anti-anxiety drugs may lead to dependence. Withdrawal from these drugs are done gradually to prevent seizures. There are lots of theories explaining the cause of SCHIZOPHRENIA. One theory states that there is an increase in the neurotransmitter DOPAMINE. Dopamine is a neurotransmitter responsible for cognition and regulation of emotional responses, it is generally a stimulant. Different kinds of drugs are given to a schizophrenic patient (SSTTCHAMPZR), these drugs are called Neuroleptics or Antipsychotics. The main action of these drugs is to decrease Dopamine or its effects. Ldol and azine are the common ending letters of these drugs. Side effects of these drugs include, agranulocytosis (which has an early symptom of sore throat) and photosensitivity (use wide brimmed hat). When Dopamine is severely decreased during the use of neuroleptic drugs, ACETYLCHOLINE – DOPAMINE balance is affected, when this happens, Pseudoparkinsonism and EPSE will manifest (NMS fatal). In order to bring equilibrium, two types of drugs are given, the ANTICHOLINERGIC drugs (AABC) which decreases Acetylcholine and the DOPAMINERGIC drugs (PLES) which increases the Dopamine. To remember the two types of drugs you must remember the word CAPABLES. When norepinephine is increased, there is a distinct period during which, a mood of a person is constantly elated or persistently high, we consider this to be a manic episode or MANIA. When this happens, we place the person to be at risk for injury because of impulsive actions. The patient is also monitored for nutritional imbalance due to loss of attention and focus on his own basic needs. Lithium is the drug of choice for mania. A narrow level of 0.6 to 1.2 meq/L must be maintained. Toxicity is manifested by gastro intestinal symptoms such as nausea, vomiting and diarrhea (VANDA). To avoid this, give liberal amount of fluid intake (3L/day). This is also the reason why we don’t combine this drug with a Diuretic. Diamox (a drug also used for Vertigo) is the antidote for lithium toxicity. Avoid strenuous activities which may lead to cardiac collapse. Monitor the kidney function because this drug is nephrotoxic. It takes 2-4 weeks before you see the effects of this drug. Serotonin makes us happy. MAO is a substance which decreases the amount of serotonin present in our body. If serotonin level falls, depression takes place. Depression is a state in which a person’s mood is persistently low. There are different types of medications given to people who are depressed. First, the SSRI, this medication aims to inhibit the reuptake of serotonin in our body which means that the usual serotonin will be made available in the synapses for a longer period of time. Second is the TCA, this drug works just like the SSRI except that it has a different target neurotransmitter which is the norepinephrine. Third is the MAOI, a MAOI inhibits the action of a MAO therefore it inhibits the breakdown of neurotransmitters. It is important to remember that the effects of these drugs will take place after a week of continuous medication, as in the case of MAOI, it can take up to 6 weeks. At these times, we should monitor the patient for possible suicide because when a patient is lifted from depression, he will have the power to execute the suicidal ideations that is in his mind. Hypertensive Crisis (severe increase in blood pressure which may cause organ damage or stroke ) is the adverse effect of MAOI, this happens when the drug is combined with tyramin rich food. Pentolamine is given during hypertensive episodes. During the use of antidepressants, you should monitor for any increase in the intraocular pressure which is an indication of developing glaucoma. Male sexual function may also be affected. An ECT may be used while waiting for the therapeutic effects of the antidepressants or if the patient is not responding to medications. Prior to ECT, short-acting sedatives are given so the client may sleep (Barbiturates) and a muscle relaxant (Succinylcholine) so that there would be a less chance of injury due to the rigid effects of seizure contractions. Best position after ECT is side lying. Check the vital signs, orient the patient and reassure that memory loss is only temporary. Before giving oral intake, it is important to check the gag reflex to prevent aspiration. Pregnancy is not a contraindication to ECT. Feel free to copy my notes and post comments in the Comment Form Thanks! Written by Jay of PHILIPPINENURSE.BLOGSPOT.COM

These are classic symptoms of Eustachian Tube Dysfunction (ETD) If you have searched this blog down, then I guess that you may be suffering from some of these problems or symptoms? The symptoms could indicate any number of ear disorders including ETD. Millions of people suffer this condition from a short term temporary bout to a long term or very rarely even a permanent condition. I have written this blog because I have had suffered this for 7 years on and off. Hopefully my experience will help you in some way to deal with this problem. I have spent countless hours during sleepless nights looking up Google entries on Eustachian Tube and Tinnitus related problems in the hope that there is some magic instant cure for this. Unfortunately there is no such thing. However there are a number of things that you can do which may help to speed up your recovery and get back to normality as quickly as possible. I have also included a few links to help you find some of the things that I found useful and some that didn't work for me but may for you. If outside the UK you can still find these items via Amazon or just Google them, or even on Ebay these items can be found . So what are we talking about here? If you lose your hearing in one or even both ears, perhaps in the middle of the night, it comes as quite a shock and can cause panic and great distress. You may also have a pressured blocked feeling in your ear and a loud noise such as a hissing, roaring or ringing sound or a mixture. It is very unpleasant to say the least! Whatever you do, please don't panic. Stay calm and try to keep in mind that in the vast majority of these cases it will go eventually! It just might take some time. I will be as brief as I can but my story with this disorder is as follows. I have suffered two severe bouts of ETD, one after the flu in 2010 lasting 6 weeks before it finally passed and secondly for a 6 month period again following a virus from January until July 2011. During that time it came and went, usually in cycles of 3-5 days with severe disorder followed by the same period of easing off, before starting up again. I visited my GP a number of times and was finally referred to the ENT after 3 months, however this was only as a routine case, meaning a further wait of 2 months before I could be seen by someone who might know what they are talking about. I had an MRI which showed no abnormalities. By this time it had eased off and my hearing had returned to normal. When I eventually returned for my follow up the Consultant ENT doctor told me I was suffering from Tinnitus! Well thank you very much as I would never had guessed that! Even to this date now (6 years after the blocked ear cleared) I am left with creaking and popping ear tubes and worse still an intermittent low level humming, buzzing or rumble noise in my left ear. This sounds like a misfiring car engine running on the driveway outside or sometimes a mini Darth Vader inside my ear waving his light sabre around. I have now learnt to live with this largely, but sometimes when it peaks it can affect the quality of life quite severely. I have read many times about the brain's perception of noise and that sometimes it can focus in on internal ear noise making it sound worse than perhaps what it actually is. Certainly keeping yourself busy and active reduces its affects. Therefore I have suffered this worse than some people but not as bad as some unfortunate souls have had to put up with. Adding to this in 2017 I can say that my tinnitus has now eased off to the point where I have learnt to live with it. I can go weeks without being aware of it, but then something triggers it back again, however the coping strategies I have developed means it now affects me very little. I hope what I have written below based upon my experience can help you and perhaps give you some hope at what can be the darkest of times due this condition. ETD occurs when your tubes that run between your middle ear cavity and your throat stop working properly usually resulting in a build up of fluid (mucus) under your ear drum. It does this because your Eustachian tube is obstructed either by an allergy, an infection, a virus or sometimes a change in shape or function. Often this will follow a cold or throat infection, but can also occur in isolation. Your Eustachian tubes connect your throat to your middle ear and provide the only air into the space behind your eardrum. These tubes open when you swallow, yawn or during eating. When they open, they let air in to maintain the pressure indie the ear and also let out any mucus originating from the ear and tube, therefore it is essential that they operate properly. Common symptoms include: Painful pressure or fullness feeling felt inside the ear (like being underwater) Hearing reduced, soft, muffled or even tinny. Tinnitus heard at various levels. This can be a roar, whooshing and or a 'tuning fork' type ringing sound. Rumbling, droning, cracking, popping, humming.. the list of descriptive sounds goes on and on. It varies from person to person. Most adults will suffer Eustachian Tube Dysfunction to some extent during their lives. Thankfully most will only get this in a mild form and the symptoms will be minor and short lived. The unlucky ones (me for one!) can get this in a severe form and cause absolute misery for days, weeks and sometimes months and for the real unlucky people dare I say years! Children also get this with the condition known as 'Glue Ear' and this is very common. Treatment will often involve grommets being fitted in the eardrum to release the fluid. This blog however is aimed at adults dealing with this unpleasant condition. The cavity to the right of the ear drum fills with fluid. Click to enlarge. So what can and should be done? Firstly see your doctor. This because the cause of this could be an infection. Your doctor will examine your ear drum to see if it inflamed or push inwards because of reduced inner ear pressure. If that is the case, you may be prescribed anti-biotics, although often these can have limited effect with inner ear problems. You may be prescribed nasal spray or decongestants (see below) Initially you will not be referred to an ENT or it would be very unlikely. My experience and reading that of others is that the extent of a GP in dealing with this is limited to the above treatments. It may be that this will work for you and your ears clear within a short time. The point I want to make at this point is that this condition will not react quickly to treatments. It is easy to get upset when nothing changes despite days or weeks of taking nasal spray or decongestant, but please condition yourself to accept that it will take time to resolve. Yes its horrible, but keep focused on that point because it is important in the long haul of getting this resolved. Described below are some self help measures which you may want to consider. In themselves these are not a cure, but collectively may help your body deal with this problem and eventually clear your middle ear of the fluid that is causing the problem. I tried all of these things and to be perfectly honest I am unsure if anything was particularly effective or totally useless. There is nothing that will instantly relieve these symptoms. If anything will work it takes time, days even weeks to finally start to get things moving again. Patience is required unfortunately, which is little comfort when your ear is blocked, you feel inner ear pressure, loud noise and you cannot sleep! Get those tubes open again. You need to open your Eustachian tubes as often as you can to get air into the middle ear cavity and also allow excess mucus to find it's way out. When you achieve this you will hear and feel them pop or crack (this is good!) You can do this by swallowing hard or falsely yawning, pushing your jaw forward hard. Use the 'Valsalva movement', which is done by pinching your nose and blowing quite hard with your mouth closed, filling your cheeks until both tubes pop open. It can take a while, but keep going. Hold them open for a few seconds, release and then swallow. Do this 4 or 5 times a day at least. You might think this is not working, but keep at it as the ET's need to be re-trained to open up again. Anti-inflamatories. I believe that these drugs can help. A common cause of the ET not working is inflammation in or around the ET's and by reducing this you can help things to get back to normal. It's worth a try, but keep going as it can take days to take effect. Be careful about the maximum period to take these, however complete a full course before stopping unless you need to stop. Chew gum. Do this as much as you can and preferably use a menthol gum. The chewing action will help the tubes to open naturally and the menthol will assist as well. Again, don't just use a packet and think that's rubbish! Keep going for weeks and don't stop until you are sure it is doing nothing which could be sometime. Use steam and lots of it. Using steam will help to free up mucus and open the tubes up. Do this as often as you can. If you have access to a steam room, then use this and sit in there for an hour. If you don't like most people go and use a free trial at a health club telling them that you might join and use theirs! Using Olbas Oil with a nasal steamer is very good. A facial sauna machine is a good substitute as this will keep the steam hot for longer than a normal fill inhaler. This is a good one to consider HERE Whilst breathing in, open the ET's by yawning. Using a bowl with a towel over your head is OK as well but it cools quite quickly. I buy my Olbas mail order HERE Heat pad. Use a hot water bottle wrapped in a thin towel and hold it tight against your ear as hot as you can stand it. The heat will radiate through to the middle ear and will help to free up that stubborn mucus. Try this for at least 2 weeks. Nasal sprays. These can be useful to start to free up the sinuses and ET's. Saline spray is safe and some say quite effective. Others include decongestant and steroid sprays, however take care not to over use these as this can cause a re-bound affect and end up prolonging the problem and not helping it. In other words your tubes get so dry that they will not be allowed to function and more mucus is produced to deal with that problem. Sleep upright. Don't lay flat because the fluid will shift into places that will not help. Prop yourself as high as you can, which will naturally allow the fluid to drain. The problem ear should be upper most in my experience, but please try either way and compare if there is any difference for you. Use a distraction to relieve the tinnitus (Noise Therapy) If you need to spend the night sat in front of the TV to drop off to sleep then do whatever it takes. Relaxing music through headphones or a pillow speaker can work, as can 'white noise' which can cancel out the ringing or loud hissing sounds often suffered with this. You can download these files or purchase them. Experiment with various tones as some will work and others will not. Try this site http://www.simplynoise.com/ For not a lot of money you can get a small sound machine to take your mind off the noise and mask the sound. This one is sold by Homedics. There is a good MP3 download here of tinnitus distraction sound and music HERE A fan left on during the night is very good but point it away if it is cold or you will freeze! Long term distraction has been a joy for me in re-training my brain to not notice my tinnitus so much. Avoid alcohol and caffeine. These are stimulants and will enhance any tinnitus that you have. The temptation may be to lose yourself with drink. This will not be productive. Now is a good time to try herbal and green teas. Drink other hot fluids such as diluted fruit juices with honey which can act as natural decongestants and help with keeping your body hydrated. Excess salt in your diet can aggravate this condition many believe and has been directly linked with tinnitus. I am fairly convinced that excess salt enhances my 'T' although I cant be 100%. Oral decongestants - you decide? The jury is out on these. Some advice will say use them. My doctor said treatments such as Sudafed are a complete waste of time to deal with this. Yes they may dry up mucus but don't forget that we actually want this stuff to clear by running out, not drying to hard deposits in the ear. This can cause the ear to produce yet more mucus to shift the dried up deposits in what is referred to as a 'rebound affect'. I did use them initially, however I will not the next time if this comes back as I am convinced that prolonged use of these did me more harm than good. Piriton I found very good at drying up the mucus, however this caused my ear to block again and also caused the tinnitus to worsen. Nasal irrigation - Many will suggest this as being helpful. The Neti Pot is the most popular. I used the SinusRinse system by Neilmed which is easier than a Netipot and did seem to help. I would say for a small outlay it is worth a try, particularly if your sinuses are blocked as well. Amazon sell this HERE along with many other websites. If you are going to use this give it at least 2-3 weeks before giving it up as a dead duck. Look after yourself. Eat well and ensure you are getting what you need to stay strong. High dose vitamin C is viewed by many as good to help battle this. Dairy food is thought by many to be one of the biggest causes of excess mucus. Little evidence exists to say that it is that I can find, but for me avoiding this when your body is trying to shift it is probably a sensible sacrifice to make. Certain food groups are thought to be inflammatory which may be triggering this problem. Look at these foods and restrict inflammatory foods. Fresh garlic, ginger and fresh pineapple are excellent natural decongestants. Gentle exercise may help, particularly in the fresh air, but avoid strenuous aerobic activity as again this creates more of the stuff you are trying to shift. Keep well hydrated by drinking you daily consumption. Use this consumption calculator HERE Devices may help. There are a number of devices available aimed at relieving this problem. The Earpopper may help if you are unable to open your tubes up yourself. Earpopper The Eardoc produces high level vibrations through the ear which is claimed will open up the tubes and allow the fluid to drain. Eardoc Any other device which can produce vibrations to the ear may help to get things moving. I have used both of these devices and found neither to be effective, but they might work for you. Clean Air. I noticed that going out in the fresh air would often help relieve symptoms, so you might conclude that being able to live indoors and particularly sleep with clean air free of dust and other allergens may help you deal with this. I obtained an air purifier Ioniser which I left on before before going to bed and kept running through the night. The air certainly felt fresher and with the added bonus that the fan noise would take my mind off the tinnitus. This is a good model to consider at a reasonable price. HERE Homeopathy. There are some natural medicines available that may help. Just search 'Ear Problem Homeopathic' to see what is recommended. Kali Bich is thought to be particularly effective at helping with ear, nose and throat disorders. Echinacia is worth considering also but only take this for 2 weeks max. Think positive. It is very easy at 3am with no sleep and an ear that feels like it's going to explode, to feel that the world is ending and that you will be cursed with this forever. You must keep positive and believe in yourself that will eventually go. Virtually all cases of this will clear up, unless you have a rare complication which will not allow this. If you have this for a prolonged period, you must pester your doctor and demand to see a specialist. This is because he/she is the only person to see if there is an underlying cause which needs other measures. Medical interventions are limited to solve this and the exact causes of this illness are still unknown. As a last resort grommet's can be installed in the ear drum, but for many reasons this should be carefully considered. In the US there is a new baloon surgery surgery treatment where the Eustachian tubes are opened up manually. This condition can make you feel quite lonely and isolated because nobody else can see anything wrong with you and when you describe the symptoms you often get the feeling that although appearing to sympathise with you, what they are really thinking is 'yeah whatever, get over it'. Many a time I have become quite frustrated asking myself 'why me, why have I got this and nobody else appears to even know what this is let alone suffer it themselves?' Be assured that there are millions of other sufferers, you just don't know where they are. As of July 2017 this one blog alone has been looked at by over 300,000 people! You are not alone. Many have left comments on this blog which are worth reading. Unfortunately it has been hijacked by the normal scam traders offering miracle cures for tinnitus which I have removed and now I moderate any comments coming into this blog. In summary, what I suspect helped me the most to unblock my ear was regular inhalation of steam using Olbas Oil, taking Ibuprofen to reduce internal swelling and getting air into the middle ear. I can't be sure, but these remedies appeared to relieve the symptoms. Once you are over the worst of it, if you have continued problems with noise in the ear you can help yourself by simply looking after yourself. If you need to use any masking or distracting techniques that work for you. Above everything else stay strong and tell yourself that you will deal with this problem eventually as the vast majority do. You will get upset, miserable and possibly even quite depressed. It will feel like the condition has taken over your life and there is no escape. There will be light at the end of this tunnel, however for some the tunnel is fairly short but for others it seems like it is dark for a very long time. I am not medically trained and these thoughts are only my own based purely on my experience and reading about this horrible condition. Please take time to add your comments and experience below. Good luck. Regards Dave. Useful links http://www.patient.co.uk/health/Eustachian-Tube-Dysfunction.htm http://www.rnid.org.uk/community/forums/tinnitus/eustachian_tube_dysfunction_tinnitus/ http://www.nhs.uk/conditions/otitis-media/pages/causes.aspx http://www.tinnitustalk.com/ http://tinnitus.org.uk/forums/1 http://tinnitussupport92262.yuku.com/forums/1/Support#.UEsT0NZmRAd References; Ear problems, deafness, noise in ear, clogged ear, tinnitus, ear wax, ear drum, hearing problem, muffled sound, disorder, decease, illness, nose, sinus, blocked ear, mucus, etd, tinnitus, earpopper, eardoc, ear fullness, otex, olive oil, ent, otitis media effusion, advice, discomfort, pain, hurting, hissing, ringing, help, advice, advise, rumble, rumbling, crackling, popping, meniere's, treatment, cure, deaf, buzzing, http://ezinearticles.com/?Eustachian-Tube-Dysfunction&id=6301015 www.weeklyguff.com

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