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CJA > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

onset

A

abrupt or insidious
most with slow, gradual development of signs and symptoms

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2
Q

immediate course of schizophrenia (2 patterns)

A
  1. ongoing psychosis, never fully recovering
  2. episodes of psychotic symptoms alternative episodes of relatively complete recover
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3
Q

long-term course of schizophrenia

A

-intensity of psychosis diminishes with age
-most with difficulty functioning
-few with ability to live fully independent lives

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4
Q

what is psychosis often replaced with as people with schizophrenia age?

A

dementia

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5
Q

positive symptoms (adding something)

A

-delusions
-hallucinations
-disorganized speech
-bizarre behavior

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6
Q

negative symptoms (lacking something)

A

-flattened affect
-reduced speech
-lack of initiative
-poverty of thought (logia)

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7
Q

cognitive symptoms

A

-inattention, easily distracted
-impaired memory
-poor problem-solving skills
-poor decision-making skills
-illogical thinking
-impaired judgement

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8
Q

biological factors that contribute to schizophrenia

A

-genetic (multiple genes)
-brain structure abnormalities (larger later and 3rd ventricles, low rate of blood flow & glucose metabolism)
-neurobiology theories

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9
Q

neurotransmitters affecting schizophrenia

A

-dopamine
-serotonin
-glutamate

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10
Q

environmental factors contributing to schizophrenia

A

-immunovirologic factors (viral exposure
-research focusing on infections in pregnant women as a possible origin

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11
Q

cultural considerations

A

-ideas considered delusional in one culture possibly commonly accepted by other cultures
-auditory or visual hallucinations as normal part of religious experiences in some cultures
-culture-bound syndromes
-ethnic differences in response to psychotropic medications

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12
Q

most common type of hallucination

A

auditory

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13
Q

command hallucination

A

tells a person to do something

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14
Q

hallucination

A

false sensory perceptions

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15
Q

delusions

A

false, fixed beliefs

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16
Q

neologisms

A

made up words

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17
Q

echolalia

A

repetition of words of another

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18
Q

echopraxia

A

mimicking movement of another

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19
Q

clang association

A

meaningless rhyming of words

20
Q

word salad

A

jumble of words together without meaning

21
Q

depersonalization

A

feeling that person is unreal

22
Q

derealization

A

feeling that environment has changed

23
Q

bizarre behaviors

A

extreme motor agitation
stereotypes behaviors
automatic obedience
waxy flexibility
stupor
negativism

24
Q

flat affect

A

no emotion displayed

25
Q

inappropriate affect

A

emotional response incongruent to situation

26
Q

blunted affect

A

minimal emotional response

27
Q

bizarre affect

A

grimacing, giggling, mumbling

28
Q

nursing process - assessment

A

-History: previous history of schizophrenia; previous suicidal ideation; current support system; patient’s perception of current situation
-General appearance, motor behavior, speech (odd, bizarre; catatonia; echopraxia, psychomotor retardation, word salad, echolalia)

29
Q

nursing process - outcome identification

A

-focus on safety of patients and others
-stabilize patient’s thought process
-reality orientation

30
Q

nursing process - interventions

A

-safety of patient, others
-therapeutic relationship, therapeutic communication
-interventions for delusional thoughts (focus on reality; no confrontation reinforcement)
-interventions for hallucinations
-management of socially inappropriate behavior

31
Q

keys that a patient might be hallucinating

A

darting eyes, tilted head, mumbling to self

32
Q

communication of client dealing with hallucinations and delusions

A

-approach client in nonthreatening and nonjudgmental manner
-identify feelings client is experiencing
-clarify reality of client’s experience
-avoid arguing/attempt to reason with client who is delusional
-interact with client about concrete reality
-distract client’s attention from hallucinations and delusions

33
Q

communication of client who is paranoid

A

-be honest and consistent
-avoid talking, laughing, whispering when client cannot hear what is being said

34
Q

communication of client who is dealing with associative looseness

A

-do not pretend to understand client’s communications when you do not
-tell client you are having difficulty understanding
-look for recurring topics or themes
-emphasize what is going on in the “here and now”

35
Q

best intervention to use with client who is having auditory hallucination

A

ask the patient, “Can you tell me what you’re hearing?”

36
Q

conventional antipsychotics

A

-targeting positive symptoms
-no observable effects on negative symptoms
-prototypes: Haloperidol & Chlorpromazine

37
Q

atypical antipsychotics

A

-diminish positive symptoms
-lessen negative symptoms
-prototype: Clozapine

38
Q

when is clozapine used?

A

in severe situations

39
Q

Chlorpromazine

A

-first modern antipsychotic

40
Q

Chlorpromazine adverse effects

A

-orthostatic hypotension
-sedation
-anticholinergic effects

41
Q

Haloperidol adverse effects

A

EPS
sedation

42
Q

medication side effects

A

-EPS (more common with conventional antipsychotics)
-acute dystonic reactions (spasms)
-akathisia (restlessness, pacing)
-pesudoparkinsonism
-tardive dyskinex=sia
seizures
-neuroleptic malignant syndrome

43
Q

neuroleptic malignant syndrome

A

-rare but serious reaction
-sweating, rigidity, sudden high fever, autonomic instability, diaphoresis, deterioration of mental status
-risk of death without treatment (stop drug)
-monitoru V/S, I/Os, Parkinsonian symptoms
-may be prescribed bromocriptine or dantrolene

44
Q

clozapine adverse effects

A

agranulocytosis (significant risk); neutropenia
-seizures
-diabetes
-weight gain
-myocarditis
-effects in older adults patients with dementia

45
Q

monitoring clozapine protocol

A

-BP & pulse
-signs of EPS & NMS
-assess FBS, lipids, & BMI
-weekly WBCs for first 6 months of treatment

CJA (31 decks)

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