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Psych Nursing > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

Schizophrenia

A

shattered disinegrated personality

not just a condition, but a syndrome

there is no cure but can be controlled by medications

PCP can cause schizophrenia

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2
Q

Epidemiology of schizophrenia

A

Lifetime prevalence of schizophrenia is 1% worldwide

there is not a difference in regards to:

  • race
  • socaial status
  • culture
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3
Q

Comorbidity of Schizophrenia

A
  • substance abuse
    - nicotine dependance
  • Anxiety, depression, and suicide
  • physical health or illness
  • polydipsia
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4
Q

Polydipsia-

A

drinking massive amount of water

schizophrenics can drink so much water that they pee the bed and end up causing eletrolyte imbalances

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5
Q

Etiology of Schizophrenia

A

Biological Factors
Genetics- 65-80% is genetic

Neurobiological-
- Dopamine Theory- suggests that there is a
dopamine overload in the brain.
- Other neurochemical hypothesis

Brain Structure abnormalities-
- Usually in the frontal or temporal lobe
- Now use non-invasive PET and MRI scans
- If a family member has it, chances increase
- In Identical twins- if one has it, 50%
chance the other will have it too
- In fraternal twins, 15% chance if one has
it the other will have it too

Psycological and Environmental Factors
- Prenatal Stress- drugs, eating,
environmental
- Psychologicial Stressors- increased
cortisol
- Environmental Stressors- Sexual abuse in
children causes changes in brain
chemistry and so can toxins

      -
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6
Q

Prodromal

A

Before a psycotic break

prepsychotic phase- may act weird or strange to others. My all of the sudden become withdrawn, lonely or depressed.

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7
Q

Phase 1 of schizophrenia

A

`acute phase

nervous breakdown or 1st psychotic break

this is the onset or exacerbation of symptoms

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8
Q

Phase 2 of schizophrenia

A

Stabilization phase

symptoms are diminishing, returning to a normal level of functioning

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9
Q

Phase 3 of schizophrenia

A

Maintenance phase

at or near baseline functioning

(as the disease progresses, the baseline will change with it.)

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10
Q

Assessment

A

During the prepsychotic phase- Ask them or family how they were before and after their first break

General Assessment: gain isight on
Positive symptoms
Negative symptoms
Cognitive symptoms
Affective symptoms

as well as how they are responding to medications

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11
Q

Positive Symptoms

A 
Alterations in thinking
       Delusions
       Magical Thinking
       Paranoia
       Religiosity
Alterations In speech
       Clang Associations
       Word Salad
       Neologisms
       Echolalia
       Alogia
       Thought insertion/deletion/blocking
Alterations in perception
       Depersonalization
       Derealization
       Hallucination
Alterations in Behavior
       Catatonia
       Echopraxia
       Impaired impulse control
       Gesturing/posturing
       Boundary impairment
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12
Q

circumstantiality

A

giving excessive details. More than what are needed

positive symptom

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13
Q

Tangentiality

A

frequently leaving the topic

positive symptom

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14
Q

Cognitive retardation

A

delay in responding or answering a question. Cannot finish thoughts

positive symptom

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15
Q

clang associations

A

rhyming words

positive symptom

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16
Q

Word Salad

A

jumbled speech that doesnt make sense

positive symptom

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17
Q

Neologisms

A

making up words

positive symptom

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18
Q

Echolalia

A

repeating like a parrot

positive symptom

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19
Q

Religiosity

A

preoccupied with religousness

positive symptom

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20
Q

What is best drug for suicide

A

Ssri

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21
Q

Haldol side effects

A

Muscle stiffness, tiredness

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22
Q

What is haldol used for

A

To sedate pts during acute breaks in hospital

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23
Q

Remember

A

Schizophrenia drugs make you fat except abilify

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24
Q

Chlorpromazine (Thorazine)

A

Antipsychotic : Non addictive Fast acting

Typical- 1st generation

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25
Q

Concrete Thinking

A

Alterations in thinking- positive symptom

refers to an over emphasis on specific details and impairment in the ability to use abstract concepts.

example: The nurse acts the patient what brings him to the hospital, and the patient replies “a cab” rather than explaining the reason he his seeking medical or psychiatric aid.

Nursing Intervention:
Ask the client the meaning of a proverb such as “the grass is always greener on the other side” or “people in a glass house shouldn’t throw stones”

A patient with schizophrenia might answer because the window will break.

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26
Q

Amitripyline (Elavil)

A

Antidepressant: Non Addictive - Slow Acting

Trycyclic Antidepressant

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27
Q

Seratonin

A

affects sleep appetite and libido

28
Q

Associative Looseness

A

Alterations in speech- Positive symptom

Associations are the threads that tie one thought to another and one concept to another are not working properly.

In schizophrenia these threads are missing, and connections are interrupted. This causes thinking to become haphazard, illogical, and confused.

Nurse: are you going to the picnic today?
Patient: I am not an elephant hunter, no tiger teeth for me.

If this happens it is important for the nurse to remain honest with the patient and let them know that they are not being understood, but that you want and will try harder to understand them

29
Q

Clozapine (Clozaril)

Risperidone (Resperdal)

A

Atypical Antipsychotics Second generation agents; newer, fewer side effects.

fast acting

hypotension
insomnia
sedation
sexual dysfuntion
weight gain
30
Q

Negative Symptoms

A 
Affective Flattening
     Unchanging facial expression
     Decreased spontaneous movements
     Paucity of expressive genstures
     Poor Eye contact
     Inappropriate affect
     Lack of vocal expressions
Alogia
     Poverty of speech
     Poverty of content of speech
     Blocking
Avolition, Apathy
     Impaired grooming and hygiene
     Lack of persistance in work or school
     Physical anergia
Anhedonia, Asociality
     Fewer recriational interests or activities
     Little sexual interest or activity
     Impaired intamacy or closeness
     Few relationships with friends or peers
Attention Deficits
     Social inattentiveness
31
Q

Doxepin (Adapin Sinequan)

Protriptyline (Vivactil)

Clomipramine (Anafranil)

A

Tricyclic Antidepressants

Non addicting

Slow acting

32
Q

norepinephrine

A

increases energy, pain perception, stress regulator

33
Q

Hallucinations
Delusions
Disorganized Speech
Bizarre Behavior

are all __________ symptoms of schizophrenia

A

positive

34
Q 
Inattention, easily distracted
Impaired memory
Poor Problem Solving skills
Poor decision making skills
Illogical thinking
Impaired judgement

Are all __________ symptoms of Schizophrenia

A

Cognitive, associated with negative

35
Q

Dysphoria
Sucicidality
Hoplessness

Are considered ________ and other ________ symptoms of schizophrenia

A

depressive, mood

36
Q

Buspar
Visaril
Atarax

A

Non- benzodiazepines

Buspar is safer to use that any other antianxiety meds

Non Addictive

37
Q

Blunted affect
Poverty of thought
Loss of motivation
Inability to experience pleasure or Joy

Are considered _________ symptoms of schizophrenia

A

negative

38
Q

Positive, Negative, Cognitive, depressive and other mood symptoms can alter the individuals:

A 
ability to work
interpersonal relationships
self care abilities
social functioning
quality of life
39
Q 
Citalophram (Celexa)
Fluvoxamin (luvox)
Seraline (Zoloft)
Fluxetine (Prozac)
Paroxeline ( Paxil, Pexeva)
Escitalopram (Lexapro)
A

SSRI

Slow acting

Used for depression

40
Q

Alogia

A

Loss of thought

41
Q

Avolition

A

Loss of Motivation

42
Q

Anhedonia

A

Inability to experience pleasure or Joy

43
Q

Delusions

A

Alterations in thinking : Positive symptoms

Defined as false fixed beliefs that cannot be corrected with reasoning

In schizophrenia the most common delusions are perecutory and grandiose as well as involving thoughts of religiosity and hypochondriacal ideas

44
Q

Thought of broadcasting

A

delusion- positive symptom

the belief that one’s thoughts can be heard by others

example: my brain is connected to the world mind. I can control all of the head of state through my thoughts

45
Q

Throught Insertion

A

delusion- positive symptom

the belief that thoughts of others are being inserted into ones mind.

Example- they make me think bad thoughts

46
Q

Thought Withdrawl

A

delusion- positive symptom

the belief that thoughts have been removed from ones mind by an outside agency

example- the devil takes my thoughts away and leaves me empty

47
Q

Delusion of being controlled

A

Delusion- positve symptom

the belief that ones mind or body is being controlled by an outside agency

example- There is a man from the darkness that controls my thoughts with electrical waves

48
Q

Imipramine (Tofranil)
Trimipramine (Surmontil
Desipramine (Norpramin)
Nortriplyine (Pamelor)

A

Tricyclic antidepressants

Tricyclic and tetracyclic antidepressants ease depression by affecting naturally occurring chemical messengers (neurotransmitters), which are used to communicate between brain cells.

They’re effective, but they’ve generally been replaced by antidepressants that cause fewer side effects.

49
Q

Somatic Delusion

A

Positive symptom

The false belief that one’s body is changing in an unusual way

Example- David told the doctor that his brain was rotting away

50
Q

Ideas of reference

A

Positive Symptom- Delusion

Miscontruing trivial events and remarks and giving them personal significance

example: when maria saw the doctor and nurse talking together, she believed that they were plotting against her

when she heard that there was a hurricane coming, she believed that it was really a message that harm was going to befall her.

51
Q

Personal Boundary difficulties

A

People with schizophrenia often lack a sense of where their bodies end in a relationship and where others begin.

52
Q

Phenelzine (Nardil)

Tranylcypromine (Parnate)

A

MAOI

53
Q 
Amoxapine (ascendin)
Mirtazapine (Remeron)
Trazodone (Desyrel)
Bupropion (Wellbutrin)
Nefazodone (Serzone)
Venlafaxine (Effexor)
Maprotiline (Ludiomil)
Pexeva
Cymbalta
Selegiline (Emsam, Serafem)
A

Antidepressants Non Addicting Slow acting

54
Q

Waxy flexibility

A

seen in catatonia, is evidenced by excessive maintenance of posture. Clients can hold unusual postures for long periods.

positive symptom- alteration in behavior

55
Q

Stupor

A

refers to a state in which the catatonic client is motionless for long periods and may even appear to be in a coma

postitve symptom- alteration in behavior

56
Q

Negativism

A

is the equivalent to resistance. The patient does exact opposite of what they are told.

Positive Symptom- Alteration in behavior

57
Q

anergia

A

lack of energy

58
Q

Self Assessment

A

It is important for the nurse to identify personal feelings and responses to clients with schizophrenia; otherwise, the nurse may experience helplessness and increased anxiety.

Without support and the opportunity and willingness to explore these reactions with more experienced nursing staff, the nurse may adopt defensive behaviors such as denial, withdrawl, and avoidance.

59
Q

Abilify

A

Atypical antipsychotic

Little or no weight gain or increase in glucose, HDL, LDL, or triglyceride level

60
Q

Quetiapine ( Seroquel)

A

Atypical antipsychotic

weight gain
headache
drowsiness
orthostasis

61
Q

Zyprexa

A

Atypical antipsychotic

significant weight gain
drowsiness
insomnia
agitation restlessness
parkinsinism
62
Q

Palperidone ( Invega)

A

Atypical antipsychotic

fast acting

63
Q

Haldol

A

Typical antipsychotic

used in large doses for assultive clients to avoid the severe side effect of hypotension

64
Q 
Tegretol
Depakote
Lithium
Triliptal
Lamictal
A

Mood stabilizers

Non addictive

65
Q

Depersonalization

A

non specific feeling that a person has lost their identity. That self is different or unreal

example- looking in the mirror and seeing someone different

66
Q

Derealization

A

is the false perception that something has changed

Psych Nursing (3 decks)

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