CHAPTER 12 Mental Health^453
The majority of patients are cared for on an outpatient basis. Hospitalization
should be considered for those who:
- Are too sick to care for themselves.
- Present a serious threat to themselves or to others.
- Neglect to care for themselves.
- Are violent or have bizarre behavior.
- Have suicidal ideation.
- Have paranoid ideation.
- Have delusions.
- Have a marked impairment in judgment.
Patients with a coexisting mental health disorder are also admitted to a medical
surgical floor only if the medical condition warrants medical management. Caring
for the patient admitted with a medical or surgical condition does not preclude the
need to care for the patient’s depression or schizophrenia as well. Patients may also
develop medical conditions as a result of their mental health issues. Patients with
inadequate nutritional intake due to an eating disorder may have significant elec-
trolyte imbalances or cardiac dysfunction.
Just the Facts
Anxiety
WHAT WENT WRONG?
Patients exhibit symptoms when an imbalance develops between the number of
open receptor sites and the number of available neurotransmitters. Neurotransmitters
are released from one side of a synapse and land on a specific receptor site across
the synapse. A second mechanism exists (a reuptake mechanism) to remove excess
neurotransmitters left within the space between where they are released and where
they fill the receptor sites. When there are insufficient neurotransmitters available
to fill the open neurotransmitter receptor sites, the patient develops symptoms.
Patients experience an uncontrollable feeling of anxiousness which ispresent more
days than not.
Symptom onset is typically in late teens through early thirties. Anxiety is more
common in women and in patients with a family history of anxiety.
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