Clinical Focus 2

Question 1

Definition of affect

Answer 1

The behavioral expression of emotion; may be appropriate (congruent with the situation); may be inappropriate (incongruent); constricted or blunted (diminished range and intensity); or flat (absent of emotional expression)

Question 2

Definition of catatonic schizophrenia (catatonia)

Answer 2

A type that is typified by stupor or excitement. Stupor is characterized by extreme psychomotor retardation, mutism, negativism, and posturing; excitement by psychomotor agitation, in which the movements are frenzied and purposeless

Question 3

Definition of delusions

Answer 3

False personal beliefs not consistent with a person’s intelligence or cultural background. The individual continues to have the belief in spite of obvious proof that it is false and/or irrational.

Question 4

Definition of depersonalization

Answer 4

An alteration in the perception or experience of the self so that the feeling of one’s own reality is temporarily lost.

Question 5

Definition of disorganized schizophrenia

Answer 5

Behavior is markedly regressive and primitive. Contact with reality is extremely poor. Affect is flat or grossly inappropriate, often with periods of silliness and incongruous giggling. Facial grimaces and bizarre mannerisms are common, and communication is consistently incoherent. Personal appearance is generally neglected, and social impairment is extreme.

Question 6

Definition of dopamine theory

Answer 6

The theory suggests that schizophrenia (or schizophrenia like symptoms) may be caused by an excess of dopamine dependent neuronal activity in the brain. This excess activity may be related to increased production or release of the substance at nerve terminals, increased receptor sensitivity, too many dopamine receptors, or a combination of these mechanisms.

Question 7

Definition of double-bind communication

Answer 7

?

Question 8

Definition of hallucination

Answer 8

False sensory perceptions not associated with real external stimuli. Hallucinations may involve any of the five senses.

Question 9

Definition of anger

Answer 9

An emotional response to one’s perception of a situation. Anger has both positive and negative functions.

Question 10

Definition of Neuroleptic Malignant Syndrome

Answer 10

A rare but potentially fatal complication of treatment with neuroleptic drugs. Symptoms include severe muscle rigidity, high fever, tachycardia, fluctuations in blood pressure, diaphoresis, and rapid deterioration of mental status to stupor and coma.

Question 11

Definition of low serotonin syndrome

Answer 11

384, 386

Question 12

Definition of no-harm contact

Answer 12

?

Question 13

Definition of violence

Answer 13

?

Question 14

Definition of illusion

Answer 14

A misperception of a real external stimulus.

Question 15

Definition of loose associations

Answer 15

328, 776

Question 16

Definition of magical thinking

Answer 16

A primitive form of thinking in which an individual believes that thinking about a possible occurrence can make it happen.

Question 17

Definition of National Alliance for the Mentally Ill (NAMI)

Answer 17

?

Question 18

Definition of negative symptoms

Answer 18

329

Question 19

Definition of neologisms

Answer 19

New words that an individual invents that are meaningless to others, but have symbolic meaning to the psychotic person.

Question 20

Definition of paranoid schizophrenia

Answer 20

Characterized by persecutory delusions and hallucinations of a threatening nature.

Question 21

Definition of positive symptoms

Answer 21

327

Question 22

Definition of Extrapyramidal Side Effects (EPS)

Answer 22

A variety of responses that originate outside the pyramidal tracts and in the basal ganglion of the brain. Symptoms may include tremors, chorea, dystonia, akinesia, akathisia, and others. May occur as a side effect of some antipsychotic medications.

Question 23

Definition of aggression

Answer 23

Harsh physical or verbal actions intended (either consciously or unconsciously) to harm or injure another.

Question 24

Definition of impulsivity

Answer 24

575

Question 25

Definition of chemical restraints

Answer 25

68, 190

Question 26

Definition of time out

Answer 26

An aversive stimulus or punishment during which the individual is removed from the environment where the unacceptable behavior is being exhibited.

Question 27

Identify the common features of all schizophrenic disorders

Answer 27

324

Question 28

Write an explanation of the dopamine hypothesis and identify how antipsychotic medications affect dopamine levels in the brain

Answer 28

39, 320

Question 29

Identify three specific symptoms that differentiate each of the types of schizophrenias

Answer 29

324

Question 30

Identify specific nursing interventions that can be used with clients who are experiencing altered perceptions, self-care deficit, social isolation, and risk for violence

Answer 30

Reality reinforcement, clarification of communication, intervening in hallucination and delusions, role modeling appropriate affect, promoting hope, demonstrating tolerance, promoting client safety, developing trust, encouraging self-care

Question 31

Discuss and describe what the nurse would tell the client about taking antipsychotic medications. Include the following: What is the major reason these drugs are used? How will the client benefit?

Answer 31

?

Question 32

Discuss and describe what the nurse would tell the client about taking antipsychotic medications. Include the following: What are the major side effects the client should know, and what would be the proper action if the client experiences any of these?

Answer 32

?

Question 33

Discuss and describe what the nurse would tell the client about taking antipsychotic medications. Include the following: How can the client alleviate the anticholinergic effects of these medications?

Answer 33

?

Question 34

Discuss and describe what the nurse would tell the client about taking antipsychotic medications. Include the following: What would be important about taking any other medication along with the antipsychotic?

Answer 34

?

Question 35

Discuss and describe what the nurse would tell the client about taking antipsychotic medications. Include the following: What problems would require the client to notify the prescribing health professional?

Answer 35

?

Question 36

Discuss and describe what the nurse would tell the client about taking antipsychotic medications. Include the following: How should the client handle missed doses of the medication?

Answer 36

?

Question 37

Discuss and describe what the nurse would tell the client about taking antipsychotic medications. Include the following: What special precautions are taken with Clozeril and why?

Answer 37

?

Question 38

Discuss and describe what the nurse would tell the client about taking antipsychotic medications. Include the following: What is the advantage of Haldol D and Prolixin D (Decanoate drugs)?

Answer 38

?

Question 39

Discuss the critical thinking exercise at the end of chapter 14

Answer 39

?