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3-Third semester > DONE-mental health lp5- schizophrenia > Flashcards

DONE-mental health lp5- schizophrenia Flashcards

(93 cards)

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1
Q

Schizophrenia- Biological/Neurological causes

g

too much d/s

g

a

A

Genetic-

Too much dopamine or serotonin

Glutamate (PCP induces similar symptoms)

Acetylocholin

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2
Q

Schizophrenia cause- brain structure

disruptions in

might be differences in

A

Disruptions of communication w/ pathways

There might be structural differences with the brain

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3
Q

Schizophrenia cause
Psychological and Environmental

complications

i

what stress

older

hx of

toxins->

A

Prenatal complications (Folate and hypoxia)

Infections

Psychological stress to mother during pregnancy

Older father

Hx of sexual abuse, social adversity, trauma or social defeat

Toxins (Tetrachloroethylene)

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4
Q

Comorbidities

a

abuse
d
possible

health illnesses-5

p ()behaviors

A

Anxiety

substance abuse

Depression

Possible suicide

Health illnesses – HTN, obesity, CVD, DM, COPD

Polydipsia -constant thirst from meds— obsessive behaviors over water- can kill pt because of water intoxication and hyponatramia

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5
Q

schizo
course of disorder-common in

prognosis

prepare

A

course- starts usually 15-25 in males

prognosis- will always have disease and most likely relapses

prepare family for relapses

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6
Q

prodromal phase of schizo

alterations

person

well before

A

mild alterations in though and mood

person may not feel right or like something is wrong

wellbefore actual attacks

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7
Q

actue phase of schizo

what is it

may need

coping/ others

A

onset of s/s,

may need hospitalization

difficulty coping and symptoms become apparent to others

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8
Q

stabalization phase of schizo

symtoms

tx where

A

Symptoms diminishing- previous level of functioning

outpatient tx

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9
Q

maintenance phase of schizo

A

near baseline

positive symptoms are diminihsed

negative continue to be a concern

will be able to live independently

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10
Q

assessment in prodromal phase

what’s key

what can reduce risk

A

early assessment is key

reducing risk factors like stress or abuse can reduce risk of developing schizo

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11
Q

Schizophrenia- 4 a s

A

affect

associative looseness

autism

ambivalence

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12
Q

4-a’s affect
schizo classic signs

__or__ affect

this is

A

inappropriate or bizarre affect

This is the outward manifestations of a person’s feelings

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13
Q

4-a’s associative looseness
schizo classic signs

what kind of thinking

what kind of reasoning

A

Disorganized thinking

Jumbled, illogical and impaired reasoning

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14
Q

4-a’s autism
schizo classic signs

thinking

ANd

A

thinking is not reality

hallucinations and delusions

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15
Q

4-a’s ambivence
schizo classic signs

two

A

Two opposing emotions toward someone

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16
Q

positive symptoms definition in schizo

A

project very early and are usually very dramatic so they will be caught right away

what most people associate with mental illness

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17
Q

concrete thinking

Schizophrenia – 1st - Positive symptoms

A

very black or white

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18
Q

reality testing

positive symptoms

A

lose ability to determine what is real and what is fake

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19
Q

delusions

positive symptoms

A

false beliefs that are held despite a lack of evidence to support them.

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20
Q

Neologisms-Alterations in speech
words that
or create

Schizophrenia –1st - Positive symptoms

A

words that have different meaning to pt then to you

or create a new words that doesn’t make. sense

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21
Q

Echolalia-Alterations in speech

Schizophrenia –1st - Positive symptoms

A

Repeating words that the nurse says

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22
Q

Echopraxia Alterations in speech

Schizophrenia –1st - Positive symptoms

A

mimicking of movements

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23
Q

Clang association

chooses words

usually

A

chooses words based on sounds rather then what they mean

usually the beginning or end the same

“on track big mac”

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24
Q

Word salad

A

(Jumble of words that makes no sense

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25
depersonalization alterations in perception Schizophrenia –Positive symptoms
- Their body is not their own
26
Derealization positive symptoms
- Surrounding have changed
27
illusions Schizophrenia Assessment – Positive symptoms alterations in perception
- Misinterpretations of realty
28
hallucinations -types visual- boundary Schizophrenia Assessment – Positive symptoms alterations in perception
types all 5 senses -Visual- see things that do not exist/ are not real -Boundary (don’t know where body end
29
command hallucinations
tell the person to take action like pee in public or kill nurse
30
motor retardation Alterations in Behavior Schizophrenia – Positive symptoms
pronounced slowing of movement
31
catatonia positive symptoms-alterations in thought
pronounced increase or decrease in rate of movement most common is when person moves little to no
32
motor agitation Alterations in Behavior Schizophrenia – Positive symptoms
excited behavior like running to pacing in response to stimuli
33
negatism- a/p Alterations in Behavior Schizophrenia – Positive symptoms
-Active (doing opposite) - Passive (not doing)
34
impaired impulse control positive
- Reduced ability to resist one’s impulses
35
schizo assess 2nd negative symptoms defintion
develop slowly and are life altering
36
Anhedonia negative symtoms
reduced ability to expeircne pleasure
37
Avolition negative symtpms
reduced motivation
38
Asociality negative symtpms
decreased desire for social interaction
39
Affective blunting: negative symtpms
reduced affect
40
Apathy negative symtpms.
decreased interests in activities
41
Alogia negative symtpms
reduction in speech
42
--Interfere most with person’s ability to cope-- c e d/f h/g schizo negative symptoms
Conversations- cant really talk to people Employment- cant hold a job Decisions and follow-through Hygiene and grooming- might have to do everything for them
43
flat affect schizo negative symptoms
(Blank)
44
Blunted affect schizo negative symptoms
(minimal emotional response)
45
Inappropriate affect schizo negative symptoms
(doesn’t match the situation)
46
Bizarre affect tell them schizo negative symptoms
(odd, illogical) tell them what is reality- tell the voices to go away
47
3rd- cognitive concrete thinking-only memory-has/ needs lots information processing has//reduce dm, j, p Schizophrenia –cognitive symptoms
concrete thinking-only thinks in black and white Memory- have short term memory- needs lots of repetition Information processing-has delayed responses- reduce stimuli Decision making, judgment and planning- not really functional
48
4th - Affective d s a risk Schizophrenia affective symptoms
Depression Substance abuse Risk for suicide
49
Schizophrenia Self Assessment strong n
Strong emotional reactions in healthcare workers Negativism-might bring out anxiety and fear in nurses
50
assessment guidline ensure a full asses for anything __ assess what disorders complete a assess assess risk of assess prescribed
ensure a full medical workup assess for medical problem that might mimic assess fir substance or alc disorders complete mental status examination assess hallucinations and delusions assess suicide risk assess prescribed meds assess family knowledge
51
acute phase goal how to want them to
Goal is patient safety and stabilization how to keep patient safe and away from harm want them to recognize hallucinations are not real
52
Stabilization goal
Goal is to adhere to tx and meds
53
Maintenance goal goal is to will happen #1 risk factor
Goal is preventing relapse relapses will happen and be aware of it to catch it before it gets out of control noncompliance is #1 risk factor for relapse
54
partial residential houses day looking for Schizophrenia implementation acute settings
Partial hospitalization Residential crisis centers Halfway houses Day treatment programs looking for activities and safety
55
p t s l s e Schizophrenia implementation Interventions
Pharmacological treatments Supervision Limit setting Evaluations
56
Stabilization and Maintenance Phases provided through types Schizophrenia implementation
provided through community health centers med support, monitoring, activités,
57
Milieu Management a therapeutic environment that
a therapeutic milieu provides structure and boundaries environment that maximizes safety and opputrinity for practicing skills
58
therapeutic communication lowers build encourages enchases Counseling and Communication
Lower anxiety Building trust Encouraging interactions Enhancing self-esteem
59
understand what do not/offer focus on also need to//call/speak/convey how do you help with pt experiencing hallucinations
understand what they are seeing to know severity do not negate expierence- offer your perspective and empathy focus on here/now- conversations also needs to call pt by name and speak simple and convey support
60
how do you help with pt experiencing delusions get do not build focus on use
get pt to describe beliefs do not debate build trust focus on the feelings of the delusions use reality based interventions
61
nurse needs tell sum speak how do you help with pt expeircne associative looseness
nurse needs to be the one having trouble understanding, not the patient tell the patient what you do understand summarize pts communications speak clearly
62
family and pt teaching regular take minimize maintain keep
regular contact with supportive individuals take care of ones health minimize tobacco maintain a stable weight keep active
63
First generation/ conventional /typical Antipsychotic agents what type of med treats used less why cost
Dopamine receptor antagonists-haloperidol Treat positive symptoms- delusions and hallucinations Used less because of failure to treat negative symptoms Less $
64
low potency first generations c t
Chlorpromazine Thioridazine
65
medium potency first generations l p
loxapine Perphenazine
66
high potency first generations h f p t t
haloperidol Fluphenazine Pimozide Thiothixene Trifluoperazine
67
2nd Generation/atypical (serotonin-dopamine antagonists) why first line takes little to no Antipsychotic agents
First line due to treating positive and negative symptoms Take 2-6 weeks to work Little or no EPS
68
examples of second generation antipshycitocs 3 types of meds
'one' "prazole" "ine"
69
dry mouth encourage also give what dont want to take is it Lethal side effects of antipsychotic medications
encourage ingestion of ice chips/water sugarless candy/gum dont want any caffeine, alcohol nonlethal
70
urinary retention and hesitancy what scan/ possible what what schedule running what is it lethal side effects of antipsychotic medications
bladder scan// posible catheter bathroom schedule running water and a warm moist towel nonlethal
71
constipation ensure promote consider is it lethal side effects of antipsychotic medications
ensure adequate fluid/fiber intake promote physical activity consider laxitives nonlethal
72
blurred vision lasts use if intolerable is it lethal side effects of antipsychotic medications
lasts 1-2 weeks use reading or magnifying glasses if intolerable may cause med change nonlethal
73
sexual dysfunction consult for artificial is it lethal side effects of antipsychotic medications
consult prescriber for alterative medicine to help for ed artificial lubricants for dryness nonlethal
74
anticholinergic toxicity s/s reduced urinary hyper d cardia unstable
reduced peristalsis urinary retention hyperpyrexia-hot skin delerium tachycardia unstable vital signs
75
anticholinergic toxicity is it life threatening meds emergency if needed adminster what is the reversal agent side effects of antipsychotic medications
life threatening hold all meds emergency cooling measures urinary Cath if needed admisnter benzos phygostimine -reversal
76
pseuodparkinism s/s
pill rolling posture tremors stiff and stooped posture
77
Pseudoparkinsonism administer if intolerable provide is it lethal side effects of antipsychotic medications
adminster antiparkisnons if intolerable consult about dosage change provide towel or handkerchief nonlethal
78
acute dystonic reactions s/s
eyes roll back laryngeal dystonia-airway spams causing backwards arching painful contractions
79
acute dystonic reactions monitor for reassure admisnter stay assist pt side effects of antipsychotic medications
monitor for open airway reassure that they are non life threatening adminster antiparkinsons stay with pts assist pt to keep up with meds
80
akathisia s/s
motor restlessness
81
akathisia consult give whaat meds help in severa cases usually subsides when side effects of antipsychotic medications
consult about med chnage give antiparksinons agent propranolol, lorazepam, diazepam in severe cases may contribute to suicidality usually subsudes when med is discontinued
82
tardive dyskinesia s/s tongue movements movements movements
protruding tongue and licking irregular movemtns slow movements neck/shoulder movements
83
tardive dyskenisa discontinuing adminster screen how often side effects of antipsychotic medications
discontinuing rarely relieves symptoms administer nazines as order screen every 3 months
84
orthostatic hypotension monitor hold rise ensure subsides when side effects of antipsychotic medications
monitor lying/standing bp hold dose when bp under 80 rise slowly ensure hydration subsided 1-2 weeks
85
severe neutropenia s/s check labs -first 6months/next 6 months drug observe for side effects of antipsychotic medications
s/s are increased infections check labs weekly for 6 months check labs monthly for 6 hold drug and potential new med observe for s/s of an infection
86
cholesatic jaundice s.s first week then what
fever malaise nausea ab pain fist week jaundice 1 week later
87
cholestatic jaundice consult tests diet side effects of antipsychotic medications
consult about med change liver function tests every 6 months high protein high carb diet
88
NMS s/s severe hyper d tension/cardia dys
severe muscle rigidity hyperreprexia- fever over 103- always assess them first delirium hypertension, tachycardia dysphagia
89
NMS is it life threatening reversal agents what to temp maintain what to antipshyotics side effects of antipsychotic medications
life threatening medical emergency bromoctripine and dantrolene are reversal agents cool body to reduce fever maintain hydration hold all antisphyotics
90
metabolic syndrome s/s wt dys increased
wt gain dyslipedemia increased insulin resistance
91
metabolic syndrome minimize what's used for diabetes teach about. side effects of antisphyoctocs
minimize wt gain through nutrition and activity metformin is used to reduce diabetes teach the pt and family about importance of regular medical evaluation to correct anything necessary
92
When to change regimen
no improvement dangerous/intolerable side effects
93
Complementary and alternative medicine
Family Therapy * Psycho-educational Approach * Community Programs * Exercise * Nutrition * Animal Therapy * Transcranial Magnetic Stimulation * Music Therapy

3-Third semester (19 decks)

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