Sample Solution
Relationship between substance abuse and mental illness
Antisocial behavior, substance abuse, and impulsive and aggressive personality traits often co-occur, forming a coherent spectrum of personality and psychopathology. Almost any act that puts the needs of an individual over the needs of a group could be considered antisocial. For example, in an article in TIME, researchers measured the number of times people attempted to keep two seats to themselves while on a bus, and those behaviors were labeled antisocial. While antisocial behaviors could be triggered by almost anything, they may be tied directly to the use and abuse of drugs. Chronic use of some drugs (such as cocaine, steroids, ketamine, and prescription drugs) can lead to both short-and long-term changes in the brain, which can lead to mental health issues including paranoia, depression, anxiety, aggression, hallucinations, and other problems.
tage, physiologic stress states that increase the production of hormones such as catecholamine, cortisol, growth hormone, and glucagon will cause hyperglycemia.
In the third stage, there is further increase in insulin resistance. The restraining effects of insulin on hepatic glucose production become impaired, and plasma glucose levels increase. Fasting and postprandial hyperglycemia result from increased insulin resistance, unrestrained hepatic glucose production and glucose toxicity.
Wound healing is slowed when the patient is diabetic. Macrovascular and microvascular changes are due to elevated blood sugar levels that can cause fatty deposits to stick to the endothelial lining of vessels and cause narrowing and then blockage of circulation. Narrowed blood vessels lead to decreased blood flow and oxygen to a wound. An elevated blood sugar level also decreases the function of RBCs that carry nutrients to the tissue. This lowers the efficiency of the white blood cells that fight infection. Without sufficient nutrients and oxygen, the wound would heal slowly.
Diabetic neuropathy is when the nerves in the body are affected and the patient develops a loss of sensation because their blood glucose levels are uncontrolled. The elevated blood glucose over time affects the myelin sheath surrounding the nervers and degrades the sheath, exposing the nerves. Sometimes, patients do not feel the blister, infection, or wound problem, which may lead to increased severity and complications. Pt has uncontrolled Type 2 DM which interferes with his non-healing wound.
(Osborn, 2014 p1896; Porth, 2011)
CAD
CAD is a chronic process that affects the arteries perfusing the heart, brain, and kidneys. CAD includes arteriosclerosis(thickening, reduced elasticity, and calcification of the arterial wall), atheroschlerosis(type of arteriosclerosis that causes reduced myocardial blood flow), and arteritis(inflammation of the arterial wall, usually due to infection or auto-immune response). Atherosclerosis causes reduced blood flow to the myocardium because of buildup of plaque like cholesterol, lipids, and cellular debris infiltrating the intimal lining of the arterial wall. The myocardium normally extracts 75% of available oxygen from the coronary arteries. If the oxygen requirement is not met, then the myocardial blood flow needs to be increased. However, the arteries in CAD are not able to dilate because of the plaque buildup and calcification. As a result the heart needs to increase force of contraction in order to increase blood flow, and thus increasing cardiac output. “The result of all the unmet oxygen needs is the shift to anaerobic metabolism and myocardial tissue hypoxia, which results in angina.” CAD and HTN contribute to HF because the heart needs to increase the force and contractility to maintain tissue perfusion.
(Osborn, 2014 p920)
