010-Psychiatric-Mental Health Nursing, 5th Edition-Sheila L. Videbeck-160547861X-Lippincott Willi

24UNIT 1 • CURRENT THEORIES AND PRACTICEare solely genetically linked. Investigation continues aboutthe influence of inherited traits versus the influence of theenvironment—the “nature versus nurture” debate. Theinfluence of environmental or psychosocial factors is discussedin Chapter 3.Stress and the Immune System(Psychoimmunology)Researchers are following many avenues to discover possiblecauses of mental illness. Psychoimmunology, a relativelynew field of study, examines the effect of psychosocialstressors on the body’s immune system. Acompromised immune system could contribute to thedevelopment of a variety of illnesses, particularly in populationsalready genetically at risk. So far, efforts to linka specific stressor with a specific disease have beenunsuccessful.Infection as a Possible CauseSome researchers are focusing on infection as a cause ofmental illness. Most studies involving viral theories havefocused on schizophrenia, but so far none has providedspecific or conclusive evidence. Theories that are beingdeveloped and tested include the existence of a virus thathas an affinity for tissues of the CNS, the possibility that avirus may actually alter human genes, and maternal exposureto a virus during critical fetal development of the nervoussystem.Swedo and Grant (2005) studied the relation of streptococcalbacteria and obsessive–compulsive disorder(OCD) and tics. They found enlarged basal ganglia, indicatinga possible autoimmune response to streptococcalinfection. When blood plasma (high in streptococcal antibodies)was replaced by transfusion with healthy donorplasma, the incidence of tics decreased by 50%, and otherOCD symptoms were reduced by 60%. Studies such asthis are promising in discovering a link between infectionand mental illness.THE NURSE’S ROLE IN RESEARCHAND EDUCATIONAmid all the reports of research in these areas of neurobiology,genetics, and heredity, the implications for clientsand their families are still not clear or specific. Often,reports in the media regarding new research and studiesare confusing, contradictory, or difficult for clients andtheir families to understand. The nurse must ensure thatclients and families are well informed about progress inthese areas and must also help them to distinguish betweenfacts and hypotheses. The nurse can explain if or how newresearch may affect a client’s treatment or prognosis. Thenurse is a good resource for providing information andanswering questions.Keeping clients informedPSYCHOPHARMACOLOGYMedication management is a crucial issue that greatlyinfluences the outcomes of treatment for many clientswith mental disorders. The following sections discuss severalcategories of drugs used to treat mental disorders(psychotropic drugs): antipsychotics, antidepressants,mood stabilizers, anxiolytics, and stimulants. Nursesshould understand how these drugs work; their sideeffects, contraindications, and interactions; and the nursinginterventions required to help clients manage medicationregimens.Several terms used in discussions of drugs and drugtherapy are important for nurses to know. Efficacy refersto the maximal therapeutic effect that a drug can achieve.Potency describes the amount of the drug needed toachieve that maximum effect; low-potency drugs requirehigher dosages to achieve efficacy, whereas high-potencydrugs achieve efficacy at lower dosages. Half-life is thetime it takes for half of the drug to be removed from thebloodstream. Drugs with a shorter half-life may need to begiven three or four times a day, but drugs with a longerhalf-life may be given once a day. The time that a drugneeds to leave the body completely after it has been discontinuedis about five times its half-life.The U.S. Food and Drug Administration (FDA) isresponsible for supervising the testing and marketing of