1/9. The use of music and colour theory as a behaviour modifier.For many centuries various aspects of healing have been linked to the use of the arts, in particular music and colour because of their innate ability to bring about a mental, emotional and physical calmness. Although much has been written on the use of colour and music as relaxants specifically within a nursing/medical context, there appears to be little information available as to why music and colour have this calming effect. This article examines music and colour as relaxants by briefly describing the neurological and physical mechanisms that bring about the effect of relaxation. This brief exploration is placed within the context of learning disability care. The aim is to provide ideas for a more peaceful and relaxing environment for an adult with learning disabilities who also has autism and exhibits severe challenging behaviour. The results of a small case study and implications for other areas of nursing are discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/9. Thrombosis associated with physical restraints.OBJECTIVE: Physical restraint is controversial, but still frequently used in psychiatric units. We describe two cases of thromboembolic phenomena, one with a fatal outcome, in association with physical restraint. METHOD: The world literature on physical restraint and thrombosis was reviewed by undertaking a search of electronic databases. RESULTS: To our knowledge, we are the first to report thrombosis associated with physical restraint. CONCLUSION: immobilization and trauma to the legs while restraining a patient are adequate explanations for the occurrence of thrombosis. Special attention should be paid to thrombosis when employing restraints in psychiatric wards. Further systematic research into physical restraints in psychiatry is clearly needed.- - - - - - - - - - ranking = 4keywords = physical (Clic here for more details about this article) |
3/9. neuroleptic malignant syndrome due to olanzapine.neuroleptic malignant syndrome (NMS) is a rare and potentially fatal complication precipitated by the use of antipsychotic medications, most notably haloperidol. Criteria previously described include: exposure to the neuroleptic class of medications; hyperthermia; muscle rigidity; a cluster of laboratory and physical findings that may include mental status changes, autonomic instability, creatine phosphokinase elevation and leukocytosis, and exclusion of other causes for the patient's condition. A prodrome of mental status changes, autonomic instability, tremors, diaphoresis, excess salivation, and extrapyramidal signs may precede NMS. Prior reports of NMS linked to olanzapine have been in patients who had been previously treated with other neuroleptic agents or in patients who had previous episodes of NMS precipitated by other neuroleptics. Several cases included patients treated with olanzapine in addition to another neuroleptic. This report describes a case of NMS associated with olanzapine in a patient who had not previously been exposed to the neuroleptic drug class. At the time this patient presented, there were no reports in the literature of NMS associated with olanzapine alone. Treatment of NMS includes: immediate withdrawal of all neuroleptics; supportive care; fever control; management of autonomic instability (tachycardia, tachypnea, blood pressure fluctuations); and pharmacologic management with dantrolene and bromocriptine.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
4/9. Deep venous thrombosis and pulmonary embolism following physical restraint.OBJECTIVE: We describe a case of deep venous thrombosis (DVT) and pulmonary embolism (PE) following the use of physical restraint in a patient with a diagnosis of acute delusional psychotic disorder. METHOD: A new case report of DVT and PE associated with prolonged physical restraint is presented. The literature on physical restraint, DVT, and PE was reviewed using a search of medline and Psychinfo from 1966 to the present. RESULTS: Four other reported cases of DVT and PE were found in association with physically restrained patients. CONCLUSION: Risk of DVT and PE in association with immobilization during physical restraint may occur in spite of no pre-existing risk factors. Medical guidelines for the prevention of thrombosis following physical restraint are presented. Despite the absence of controlled trials of treatment effectiveness, the catastrophic outcome of DVT and PE warrants early and vigorous intervention in patients undergoing physical restraint.- - - - - - - - - - ranking = 5.5keywords = physical (Clic here for more details about this article) |
5/9. Treatment of the agitated patient with an organic brain disorder.Agitated patients with organic brain disorders represent relatively common diagnostic and management problems. Therapeutic failures usually result from a failure to understand the patient's disturbed behavior, the staff's emotional response to the patient's behavior, or neglect of the biological cause and ineffective use of medication. Effective management depends on continued monitoring of the patient's mental status and physical condition.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
6/9. Progressive supranuclear palsy with agitation: response to trazodone but not to thiothixine or carbamazepine.A 66-year-old man with progressive supranuclear palsy is described. Although generally apathetic, withdrawn, and spontaneous in speech and behavior, he had sudden episodes of agitation, during which he was verbally threatening and physically abusive. Treatment with thiothixine and then with carbamazepine was ineffective in controlling his violent behavior. He responded temporarily to trazodone, and a recurrence of aggressive behavior was suppressed by increasing the dose of trazodone; this response may be related to trazodone's putative effect on the serotonin system. Although both carbamazepine and trazodone have been advocated for the control of aggression in organically impaired patients, they were not equally effective in this case.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
7/9. Need for sedation in a patient undergoing active compression--decompression cardiopulmonary resuscitation.The authors report the case of a 57-year-old man with a history of ischemic heart disease who presented to the emergency department with an acute myocardial infarction and hypotension. Despite aggressive pharmacotherapy, the patient's heart rate decreased, and he developed pulseless electrical activity within 15 minutes of his arrival. cardiopulmonary resuscitation (CPR) was begun with an active compression-decompression (ACD) device, and the patient became agitated, making purposeful movements. When ACD-CPR was discontinued for a rhythm check, the patient had no pulse and became motionless. Agitation and purposeful movements occurred on two subsequent occasions with the initiation of ACD-CPR. The patient required physical restraints, sedation, and paralysis for personnel to perform endotracheal intubation and facilitate treatment. The implications of this case are discussed.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
8/9. Difficult dementia: six steps to control problem behaviors.For patients with a confirmed diagnosis of dementia, your challenge is to promote a quality life during their remaining years. This task often includes managing problem behaviors. A systematic approach starts with pinpointing the nature of the specific behavior, reviewing possible physical and emotional stressors, and checking for coexisting affective or psychotic disorders. It often helps to reduce environmental stimulation and to simplify the patient's tasks. drug therapy with an antipsychotic or benzodiazepine is indicated if a clear-cut behavioral strategy has not proven fully effective, the behavior has been well documented, and the behavior presents a clear danger to the patient or others or prevents necessary care from occurring.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
9/9. Antiandrogen treatment of aggressivity in men suffering from dementia.Three demented patients who manifested an aggressive syndrome and motor disturbances including agitation, pacing, and restlessness received a therapeutic trial of the antiandrogen agents medroxyprogesterone acetate and luprolide acetate. Within 4 weeks of the start of the antiandrogen therapy, verbal and physical aggressivity had ceased; activity disturbances such as agitation, pacing, and restlessness were markedly reduced. One patient also manifested marked disinhibited and disruptive sexual behavior. Following treatment, that behavior also ceased. Further control studies assessing the efficacy and safety of antiandrogen agents are recommended.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |