Finlay (2001) investigated how schizophrenic symptoms are paralleled by complex structural and functional abnormalities in brain regions such as the thalamus, the prefrontal cortex and the temporal lobe. As a result of the delayed onset of symptoms in early adulthood, abnormal development occurs in the nervous system which may contribute greatly to the neurobiology of the disorder. Weinberger’s (1988) longstanding hypothesis focused on the dysfunction of the prefrontal cortex and the association with schizophrenic cognitive deficits. Furthermore, Finlay’s (2001) research focused on the concept of a dysfunction of the mesoprefrontal DA neurons that may relate to the cognitive deficits associated with schizophrenia. As the clinical symptoms of this disorder emerge during early adulthood, abnormal developmental processes are thought to contribute to the pathos-physiology of the disorder. It was discovered the the DA intervention of the prefrontal cortex undergoes significant change up until adulthood which leads to Finlay’s hypothesis that the abnormal development of this system may be related to the emergence of schizophrenia. Experimental and clinical research portrayed the relationship between this system, and abnormalities in cognitive performance. Another interesting finding by Finlay (2001), was that impaired function of mesoprefrontal DA may be the causation of decreased density of DA- which contains nerve endings within the prefrontal cortex of afflicted individuals.
The event that stood out the most to me during my clinical experience this month was when my assigned patient and her family began asking questions about the care the patient was receiving and other non-medical related questions.
During my first day of clinical, I encountered an issue that I believe is very significant. As a student nurse, our duty for this day was to follow our health care aide around the ward and assist in completing resident care. The resident required assistance in many of her daily tasks. The health care aide asked if I would perform one of those and do perineal care for her. I turned down her offer because I did not feel comfortable with my skill level. The resident had a bowel movement during the night. There was a significant odour in the room that overwhelmed me. I really wanted to leave the room because it was so unpleasant, but I stayed in the room so that the resident would not be embarrassed. This feeling of embarrassment, I assume,
General: no history of weight change, fever or chills, weakness, fatigue, or change in appetite;
My commitment to volunteerism is important to me. I am not apart of Kiwanis, however, I am still involved throughout school and church. I am in 5 clubs, which include the Associated Student Body (ASB), Med Club, Kind Club, Fellowship of Christian Athletes (FCA), and Chelan Project. Meanwhile at church, I help with worship band, tech support and children's ministries. Volunteerism is the chance to be a leader and show the type of person you are.
The brain is composed of mostly grey and white matter. Grey matter contains most of the neuronal connections for the brain. It can be found on the outer surface of the cerebellum and around the spinal cord. “Observations have been made of reductions in the size and total neuron numbers, but not in neuronal density,” (Höistad, 2009, p. 3). This is an outstanding discovery when analyzing schizophrenia. White matter contains many neurons as well. Researchers pay close attention to these neurons and the myelination of the axons. “Interstitial white matter neurons have been found to be increased in prefrontal white matter and temporal white matter in subjects with schizophrenia, supporting further the presence of a neurodevelopmental abnormality in schizophrenia,” (Höistad, 2009, p. 3). This means that they white matter neurons never became myelinated and mature in parts of the brain. Problems like these can mess with the connections in the brain between neurons. Research like this highlight schizophrenia as being a developmental disorder of the brian, but more research is being done including other areas as well. “The pruning of axonal connections during brain development and maturation may be necessary for adequate formation of appropriate neuronal circuits,” (Höistad, 2009, p.
The main brain areas affected include the basal ganglia, the prefrontal cortex, and the limbic system. The excessive release of the brain chemical dopamine is linked to impaired function of the prefrontal cortex in people with schizophrenia. The multiplicity of symptoms seen in schizophrenic people may be an outcome of how highly connected the brain is. The prefrontal cortex is the brain region behind the forehead. This area of the brain is mainly responsible for difficult tasks including decision-making, planning and changing behaviors according to social cues or past experience. Inappropriate use of the prefrontal cortex will result in loss of these skills and the distinctive disordered thinking of schizophrenia. In fact, the prefrontal cortex is joined to a different brain area affected in schizophrenia known as the basal ganglia. This region is well known for making dopamine and controls coordinated movement, drive and the compensation pathway. This difficult pathway strengthens patterns of performance that make a person feel good. Evidence done on the human brain shows
On 7/27/2015, HOH and client attended to ILP meeting with their daughter Emily. Child was observed well dressed for the weather. Client explaining to cm that her floating hospital was cancel and she doesn’t know the reason.
(2) However, there are some problems with this evidense. Amphetamines only mimic the positive symptoms of schizophrenia. They do not produce any of the negative symptoms. Likewise, anti-psychotic drugs are only affective on the positive symptoms of the disease. There is still some evidense that schizophrenics do posess higher levels of dopamine, however, these increases are only found in the striatum of the brain (7). The striatum is a region of the brain that receives its inputs from and outputs to the cortex. Injury to the striatum results in problems with intiation and control of motor behavior. (9) Also, there is evidence that the prefrontal cortex produces lower levels of dopamine. (4) The prefrontal cortex is involved in the organization and coordination of information to and from the cortex. (7)
“New test and machines also enabled researchers to study the structure of schizophrenic brains.” There were studies done to compare those of a normal brains and ones affected by Schizophrenia, it showed several structural differences. “The most common finding was the enlargement of the lateral ventricles, which are
According to Wilk et al. (2005), cognitive impairment is thought to be a central feature of schizophrenia. It spans across a number of separate cognitive domains, such as attention, working memory, executive functions and verbal fluency (Reichenberg, 2010). This notion is also supported in another study done by Bowie and Harvey (2006), which suggests that as a result of schizophrenia being associated across discrete domains of cognitive impairment, it has led some to gather that it is a disease “with a global profile of neuropsychological impairment”.
As seen in this case study, TM was listed as a full code and no GOC conversation was had between the physicians and the patient until the day of his discharge to home. This led to an unnecessary swallowing study in which the patient needed to be uncomfortably scoped. Due to the lack of GOC conversation the patient also chose to go home with general nursing services instead of end-of-life (EOL) hospice support. In the inpatient medical oncology floors of a large teaching hospital like this one, most patients are covered by rotating interns and residents that are not comfortable having GOC conversations with patients and leave it up to the primary physician to come and discuss.
1. I do believe that large pharmaceutical companies as well as doctors prescribing opioid medication should be held partially responsible in cases when patients are over-prescribed drugs. Although they are in no way actually forcing those patients who are over-prescribed these drugs to misuse them and it is ultimately the fault of the individual misusing the medication, they are, however, allowing for the the misuse.In regards to pharmaceutical companies, I think that they should be held responsible for marketing and allowing such drugs available to virtually the mass public opposed to only those that need it in order to increase their profits. If they would not advertise the medication to medical professionals as something that they could
This week I had 2 patients of my own and I rarely needed any help. I am starting to feel comfortable with caring for my own patients and performing my assessments.
From the first months of life, premorbid developmental impairments are recorded in more than half of those who develop childhood onset schizophrenia; childhood onset is usually insidious and suggests early disruption of brain development (Masi, Mucci and Pari, 2006). There are genetic and environmental factors to schizophrenia.
There are primary neurological brain abnormalities in individuals with schizophrenia. According to Fusar-Poli (2009), schizophrenia is delineated by prefrontal activity and elevated striatal dopaminergic functions. These elevations in striatal dopamine activity and prefrontal cortical dysfunctions (Fusar-Poli, 2009). Along with other abnormalities in white matter as well as, having been observed in the right superior frontal gyrus, left middle frontal gyrus, bilateral parahippocampal gyrus, adjacent to the right caudate head, right thalamus, left insula, left lentiform nucleus, left fusiform gyrus, and bilateral claustrum (Antonius, 2011). The study of these findings may assist us to understand their role in the severity of the schizophrenia disorder symptoms (Antonius, 2011).