4 Pathophysiology Prep Sheets
Will use Turnitin.com so avoid AI and plagarisim.
The pathophysiologies will need to be uploaded to TurnItIn.com. The four conditions are schizophrenia, major depressive disorder, substance use disorder and bipolar disorder (mania and hypomania only). For bipolar disorder you will only need to describe the manifestations of the two states of the “upper pole” which are called mania and hypomania. Be sure to address the difference between mania and hypomania. The “lower pole” is major depressive disorder which is addressed in another pathophysiology. You will need the class textbook and outside research to complete the pathophysiologies. APA (7th edition ) formatting is expected and required for in- text citations and the end paper reference list.
A. Define the diagnosis: think about how you would describe this condition in lay terms to tell your patient. Do not describe what you would tell another healthcare professional or your instructor…. this is for your patient.
B. Etiology/Risk Factors: discuss the current theory addressing risk factors or what causes the disorder. There are always two parts to etiology/risk factors in psychiatric conditions: biologic and environment factors. You may use the textbook but be sure to use sources outside the book so you can present a well-rounded discussion. Biology is the genetic component. This section is for the genetic rates of the disorder and specific genes implicated in the condition. Environmental etiology is basically the stress part of the equation or the psychological school of thought that explains how the condition develops. Different schools of psychiatric theory describe how these stressors can trigger mental illness in a susceptible individual. Examples of some psychological theories you will find in your textbook are psychoanalytical, cognitive, behavioral, humanistic, sociocultural, diathesis-stress model, etc. These might be found in the psychological or environmental factors section of the textbook chapter.
C. Pathophysiology (biochemical factors): describe the neurotransmitter alterations occurring in the disorder. This can be found under the biochemical or neurobiological section of the textbook chapter. In addition to neurotransmitter alterations, you may find hormonal alterations and inflammatory mechanisms at play. Brain structural abnormalities would go under this subheading as well. Do not describe signs and symptoms here. Again, include research you have done outside the book in addition to what you have learned from the book. If you are confused about whether something belongs in the etiology versus the pathophysiology section, don’t spend too much time on that thought. There is some overlap between the two so just be sure the information is present. No need to put it both places, just chose one and go with it.
FOR SUBSTANCE USE DISORDER PATHOPHYSIOLOGY, you must describe at least 5 brain structures involved in the brain reward system. The textbook has 4 as the brainstem and spinal cord are too general so those should not be listed. You will need to go outside the book to find a full description of brain reward system. Suggested site: Khan Academy Reward Pathway The psychological and sociocultural factors should be discussed in the etiology.
D. Laboratory and diagnostic tests. What kind of labs would you expect to see to rule out other factors that might mimic the disorder (ex: H/H to r/o anemia in depression)? Other examples might include body systems damaged caused by the disorder (ex: LFT’s in alcohol abuse). What types of tests for exposure to infectious diseases (ex: Tb, COVID)? Would there be monitoring of therapeutic drug levels used for treatment of the disorder? There are no specific diagnostic tests for psychiatric conditions at this time. Thus, search up and list the name of the book used to diagnose all mental illnesses…this is part of the diagnostic process in psychiatry…a person is diagnosed according to the criteria used in this book. Do not put the signs and symptoms in this box (that comes later). Also think about illicit drug screening. In most cases, toxicology and pregnancy tests are done.
E. Anticipated Ineffective Behaviors. List the sign and symptoms in this section. For substance use disorder, list the signs/symptoms of three states: a) intoxication, b) withdrawal, and c) overdose and for each of the following drug classes: 1) Alcohol (intoxication, withdrawal, overdose) In addition to intoxication, withdrawal, and overdose, include signs and symptoms of Alcohol Withdrawal Delirium and Wernicke-Korsakoff Syndrome 2) CNS depressants (intoxication, withdrawal, overdose) 3) CNS stimulants (intoxication, withdrawal, overdose) 4) Opiates (intoxication, withdrawal, overdose) 5) Hallucinogens (intoxication, withdrawal, overdose) Separate out LSD and PCP
F. Patient and Family Teaching/Health Teaching and Health Promotion. Discuss important information the client and family need to know in order to better understand and cope with the disease process. Research and include community-based support groups for the conditions.
G. Top 3 Nursing Diagnoses. You only need the diagnosis since the “related to” and “manifested by” are personal to your individual client.
H. Communication guidelines. Prepare yourself to communicate with clients by identifying important communication techniques for each disorder. If you do not find this in the book, research on the internet or look in the lecture slides.
I. Drug section: Use the “Psychotropic Medication Table” and the textbook for all drug information. List the drug classes as you find them on the Psychotropic Medication Table with two corresponding examples from each class (unless there is only one in the class). For example under Major Depressive Disorder the classes include SSRI, SNRI, SARI, etc., so you would list each class and give two drugs from the class with the side effects listed on the table. For some drug classes, there might be only one drug in that class. Then you would list that one drug.
The course medication tables and book list side effects in a way that are precise and are the most important side effect information you need to know about these drugs. Use your outside drug book only if necessary. For antipsychotic drugs, there are 3 types of side effects that need to be included:
1). Rare and toxic side effects (highlighted at the top of the page) 2.) Class side effects (highlighted at the top of the page) 3.) Side effects specific to each drug, these side effects are in the top row of table in the medication guide that list each drug (ACh, Sedation, EPS, etc.) Example – Class: Atypical Antipsychotic Drug: Abilify (aripiprazole) 1) List class SE (common to all in class) 2) List the rare and toxic side effects (common to all in class) 3) Specific side effects: look inside the table in the clinic syllabus and you would note like this: very low EPS, low sedation, low OH, low weight gain, low diabetes
Sometimes, the drugs are not separated out by drug class but by treatment category in the bipolar section and much of the addiction treatment sections. Note, for bipolar disorder, lithium is in its own “class” and the other medications listed are anticonvulsants. Thus, you need to have lithium plus two anticonvulsants. In the treatment for substance use disorder, separate all by drug class and describe one or two from each class. For example, all drugs under alcohol addiction recovery are in their own class so all should be listed. For opiate addiction recovery, several are in their own class as well. Please look up the class. Include Suboxone as this is the most common one used. Lastly, include references at the bottom in APA style. In addition to your book, include at least two outside references for your pathophysiology. Each reference used needs a corresponding in-text citation.