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·         cerebellium - responsible for memory, sense of smell,

·         cerbrum - controls balance and coordination

·         spinal cord and cerebellum, - controls bladder function

·         frontal lobe for voluntary activities

·         Medulla – respiratory center

·         Occipital – vision center



·         Those who have more debilitating disease and are dependent on others are more subject for abuse by others.



·         Provide simple signs for location of rooms, bathrooms, place of sleep, bathing or eating.

·         Mirrors and pictures could be confusing to the patient.

·         Family members at times give Alzheimer patient Gingko Biloba to increase memory BUT it can increase bleeding.


Anorexia Nervosa (see Bulimia Nervosa to differentiate)

·         Distorted body image

·         Gaining weight is the first priority.

·         Pectus Carnatum or Pigeon Chest - sternum is visible; - is common in girls with Anorexia


·         Patients are usually not allowed to choose their own food since they will only choose food that they want to eat.

·         Make sure you observe the patient taking in food and stay with the patient to avoid any attempt of purging. 

·         Usually not roomed in alone to prevent any possible purging or doing activities that will make the individual loose weight.

·         Patient is ask to  avoid participating in extrenuous activities.

·         High risk for electrolyte imbalance especially K.



·         Usually engages in routine and can get upset when the routine is interrupted.


Bulimia Nervosa (see Anorexia Nervosa to differentiate)

·         Patient usually have normal weight but feels hopeless to correct the problem.

·         Dental caries is common since the teeth tends to erode from constant vomiting.

·         Hoarse voice barely audible can be a sign of tracheosesophageal fistula from esophageal

      tear; laryngitis is a danger sign.

·         An adolescent with scars on his/her knuckles may be a sign that the individual is purging food or is inducing vomit after eating.


Bipolar Disorder

·         Patient will probably be given Lithium. Foods high in sodium can excrete lithium, so, be mindful of the salt content of the food being given to the patient. 


Drug Abuse

·         Narcotic withdrawal is similar to flu symptoms (runny nose, yawning fever, muscle ache).

·       Alcohol withdrawal peaks at 24 - 48 hours. To minimize the effect, put patient in a quiet, 

      dim lit rooms.


  1.     Cocaine Withdrawal 

·              Decreased ability to interact with environment; poor feeding; vomiting

·              When  taking cocaine, a person feels euphoric so he tends not to sleep a lot and do not have a quiet or sedentary habit Thus, they may have weight loss. 

·              When there is withdrawal a person will feel depressed.


  2.     Heroine  

·              Overdose can lead to low BP, tachycardia, diaphoresis

·              Withdrawal involves tremors, jitteriness, restlessness and hypertonicity


  3.     Angel Dust or PCP  

·              Leads to violence, antisocial behavior, agitation.



Transphenoidal hypophysectomy

·         Check for any “halo” sign or a light yellow nasal discharge which indicates cerebrospinal fluid discharge

·         Discourage any use of toothbrush for cleaning. Offer mouthwashes instead.

·         Discourage any forceful coughing.

            POST SURGERY

                        pain med often given every 4 - 6 hrs.

                        It is not uncommon for PT not to have bowel movement within 24hrs.

                        Watch for urine output <30ml/hr

                        Surgery increases the demand for corticosteroid


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