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Supplementation with fish oil, calcium, or vitamin C and E, and early antihypertensive therapy are ineffective. Laboratory findings of preeclampsia may include the following: Diagnostic proteinuria (described above). Elevated hematocrit resulting from decreased intravascular volume secondary to third spacing of fluid. Remember that creatinine normally decreases in pregnancy, so even slight increases warrant investigation. Prolonged prothrombin and partial thromboplastin times that may be due to primary coagulopathy, hepatic synthesis dysfunction, or abruptio placentae leading to disseminated intravascular coagulation. Decreased fibrinogen, increased fibrin degradation products, or both, as a result of coagulopathy or abruptio placentae. Definitive management for gestational hypertension, preeclampsia, and eclampsia is delivery. In general, mild preeclampsia (see definitions above) at term is treated by delivery. The benefits of bed rest, antihypertensive medications, and hospitalization are not clearly established. A gestational age of >34 weeks with progressive labor, abnormal fetal testing, or growth restriction should prompt delivery. The first priority in treating severe preeclampsia is to assess and stabilize the mother. At 34 weeks delivery is indicated, although immediate cesarean section is not usually warranted. Careful monitoring, at least hourly assessments, and strict intake/output recordings should be maintained. Expectant management of severe preeclampsia with intrauterine growth restriction has been associated with increased risk of fetal death (rate of perinatal death is 5. Seizure prophylaxis during labor and for 24 hr postpartum is recommended for patients with preeclampsia. Some patients with severe persistent preeclampsia need seizure prophylaxis for longer periods before and after delivery. Magnesium sulfate has been shown to decrease the risk of eclampsia by more than 50%. Urine output exceeding 100 mL/hr for 2 hr suggests resolving preeclampsia with no or rare complications. For <50 kg, load 1,000 mg; for 50 to 70 kg, load 1,250 mg; and for >70 kg, load with 1,500 mg phenytoin. Useful antihypertensive agents for acute management include Hydralazine hydrochloride has an onset of action within 10 to 20 minutes. Labetalol hydrochloride has an onset of action within 5 to 10 minutes and lasts for 3 to 6 hr. The escalating bolus protocol uses labetolol doses of 20, 40, 80, 80, and 80 mg given at 10-minute intervals, to a maximum of 300 mg/24 hr.
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Clouding of consciousness, characterised by permanent de cits which can be irreversible. No decreased ability to respond to environmental ancillary laboratory test is diagnostic, although tests stimuli, and may help in nding the aetiology. These Marked perceptual disturbances such as illu include impairment of consciousness and attention (on sions, misinterpretations, and hallucinations also a continuum from clouding to coma; reduced ability occur. These are most commonly visual though to direct, focus, sustain, and shift attention), global other perceptual domains can also be involved. Diurnal variation is marked, usually with the onset is usually rapid, the course diurnally worsening of symptoms in the evening and night uctuating, and the total duration of the condition (called sun downing). Generalised autonomic dysfunction, speech and A history of underlying physical or brain disease, thought disturbances (such as slurring of speech, and/or evidence of cerebral dysfunction. Carphologia or occillation (picking movements Presence of certain predisposing factors lowers the at cover-sheets and clothes), threshold for the development of delirium (Table 3. Occupational delirium (elaborate pantomimes as Aetiology if continuing their usual occupation in the hospital bed), and the list of possible causes of delirium is virtually 5. Any factor which disturbs the metabolism of Organic (Including Symptomatic) Mental Disorders 21 brain suf ciently can cause delirium. The aetiology of One of the important causes of delirium, namely delirium demonstrates a threshold phenomenon, with post-cardiac surgery delirium, is discussed in Chapter a combination of factors adding up to cross a threshold 12. In cases where a cause is not obvious (or other contributory causes are suspected), a battery of Table 3. Pre-existing brain damage or dementia complete blood count, urinalysis, blood glucose, 2. Extremes of age (very old or very young) blood urea, serum electrolytes, liver and renal 3. Previous history of delirium function tests, thyroid function tests, serum B and 12 4. Stroke (acute phase), Hypertensive encephalo Drugs (Both ingestion and withdrawal can cause pathy delirium) and Poisons vi. There is impairment of agitated, emergency psychiatric treatment may judgement and impulse control, and also impairment be needed. There is however usually no im zepam or diazepam) or antipsychotics (haloperi pairment of consciousness (unlike in delirium; Table dol or risperidone) may be given either orally or 3. Maintenance treatment can continue though some forms of dementia can be reversible. These There is an increased risk of stroke in elderly include: patients with dementia with prescription of 1. Emotional lability (marked variation in emotional atypical antipsychotics such as olanzapine and expression). Disorientation in time; disorientation in place and memory, especially in early stages), person may also develop in later stages.
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Brown formula adjusts the correlation calcu Accordingly, individuals will construct dif lations to estimate what the reliability would ferent spontaneous self-concepts in different be if each half of the test had been the length social contexts. A disorder characterized by the presence recruited to defne who one is in response of two or more distinct personalities or iden to different features of the social situation. If you strongly with one side of the emotional expe see a student kick a puppy out of his way in his rience only. For example, an individual may rush across campus, it is hard to escape the unconsciously feel frustration at his father as impression that the student is cruel. For example, if and interactions, even (or particularly) when you were thinking about honesty (rather than people do not realize they have made them. For example, authoritar inferences intentionally, we know what they ian perceivers spontaneously interpret many refer to, because we have intentions to make behaviors differently than nonauthoritarians them about something. Those with repressive coping they are about actors (in addition, perhaps, to styles differ from others in their likelihood of being about behaviors). Traits are not the only things about other There are also cultural and social class people that are inferred spont aneously. We a study of Latino and Anglo college students spontaneously infer the causes of natural and in Texas, using the lexical decision procedure human-caused events and aspects of other described earlier. And we sponta See also priming neously develop expectancies and emotions about others, often based on their unrecog spoonerism nized similarity to signifcant others. This are unintentionally transposed in a way to latter phenomenon, called social cognitive give a different meaning to the utterance, transference, has been studied extensively which is sometimes humorous as in saying by Susan Andersen. An archaic form of psychology that concep applies the fndings of psychology to the feld tualizes behavior in terms of the relationship of sports, usually with the aim of enhancing between a stimulus and a response. In instrumental conditioning, it is tion of one neuron spreads to other neurons, between a discriminative stimulus and the either increasing or decreasing their likeli response.
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Those with an egalitarian gender 217 gender schema (theory) general intelligence role ideology believe that men and women gene expression should be treated equally. The appearance underlying natures of women and men, but of the characteristics associated with a gene they believe that neither women nor men in the phenotype or actual organism. Many should be discriminated for or against on the genes are not expressed or only partially basis of their sex. Both women and men may expressed because of the presence of a more hold egalitarian gender ideology, but women dominant gene controlling the same feature are more likely to do so than men. The idea that children learn what it means gene frequency to be male and female from the culture in n. The frequency of a particular version of a which they are raised; it is stored in the mind gene or allele in a population relative to the as mental models and these mental models frequency of other versions or alleles. The total number of genes and their varia expectations of men and women within the tions present in an interbreeding population culture. The beliefs about differences between men and women and differences in what is appro general adaptation syndrome priate for each that are generally held within n. Some cultures hold these beliefs chronic stress in three stages: alarm, resis more rigidly than others and tend to be puni tance, and exhaustion. In the frst stage of tive toward those who do not conform to the response to stress, the body frst goes into stereotypes while other cultures are neither shock, in which body temperature, blood rigid nor punitive toward nonconformists. The process of forming or applying expec nervous system into its fight-or-fght stance. These changes can posed of a promoter region which controls lead to organ damage if arousal continues the action of a gene and a coding sequence chronically. Genes control the form of the body by concentration, becoming easily startled, dis controlling which proteins are produced and turbed coordination, and tremor. Based on lower frequency or intensity than will the factor analysis, the general intelligence (g) original stimulus. A disorder characterized by excessive anx are then attributed to the existence of a larger iety and worry more days than not for at least factor, general intelligence, which is primar 6 months. Despite tends to feel restless, keyed up, and on edge a large body of evidence supporting biologi and is easily fatigued, has diffculty in con cal and social correlates of the general intel centrating and has a tendency for the mind to ligence factor, the existence of the g factor is go blank, is irritable, and experiences muscle quite controversial. This depends on the similarity of the present situation to the situation(s) in which general intelligence factor See general the habit was originally conditioned as well as intelligence the habit strength in the original situation. The study of basic principles of human ple which is held to be true in all or at least mental functioning and behavioral con most circumstances. A name for an introductory or survey ing an idea or practice derived from specifc course in psychology, which usually includes cases to all cases in general.
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