Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Community Mental Health Nursing > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Psychosis

A

Alterations in mental state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Schizophrenia Clinical Picture

A

Affects 1% of adults

Characterized by psychosis

Develops gradually, presenting at 15 to 25 years

Child-onset and late-onset are more rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

DSM-V Criteria for Schizophrenia

A

Two or more of the following for a significant portion of time in one month:
Delusions, hallucinations, disorganized speech, gross disorganization or catatonia, negative symptoms (not showing emotions)

Continuous disturbance for at least 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Epidemiology of Schizophrenia

A

1 in 40,000 children

No difference related to race, social status, culture

More frequently diagnosed among males and in urban areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Comorbidities of Schizophrenia

A

Substance abuse disorders

Anxiety, depression, risk for suicide

Physical health or illness

Polydipsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Etiology of Schizophrenia

A

Biological factors: Genetics

Neurobiological: dopamine therapy, neurochemical hypotheses

Brain structure abnormalities

Prenatal stressors, psychological stressors, environmental stressors, prognostic considerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Phases of Schizophrenia

A

Prodromal: onset, mild changes

Acute: exacerbation of psychotic symptoms

Stabilization: symptoms diminishing, movement toward previous level of functioning

Maintenance or Residual: new baseline is established

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Assessment During Prodromal Phase of Schizophrenia

A

Positive symptoms: present but not actually present

Negative symptoms: absence of something that should be there

Cognitive symptoms: symptoms that impair thinking or memory

Affective symptoms: involve our emotions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Positive Symptoms of Schizophrenia

A

Alterations in reality testing

Delusions, alterations in speech, concrete thinking (inability to think abstractly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Alterations in Speech with Schizophrenia

A

Associative looseness (word salad, jumble of words meaningless to listener)

Clang association (words chosen based on sound)

Neologisms (meaning for the patient only)

Echolalia (pathological repetition of another’s words)

Circumstantiality, tangentiality, cognitive retardation, pressured speech, flight of ideas, symbolic speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Distortions of Thought with Schizophrenia

A

Thought blocking: reduction or stoppage of thought; hallucinations may cause this

Thought insertion: belief that someone else has inserted thoughts into their brains

Thought deletion: belief that thoughts have been taken or are missing

Magical thinking: believing that thoughts affect others’ consequences

Paranoia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Alterations in Perception with Schizophrenia

A

Depersonalization: feeling of being unreal or having lost identity

Derealization: feeling that the environment has changed

Hallucinations

Illusions: misperceptions or misinterpretations of a real experience

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Alterations in Behavior with Schizophrenia

A 
Catatonia
Motor retardation
Motor agitation
Stereotyped behaviors
Waxy flexibility
Echopraxia
Negativism
Impaired impulse control
Gesturing or posturing
Boundary impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Negative Symptoms with Schizophrenia

A

Absence of essential human qualities

Anhedonia: lack of pleasure

Avolition: lack of motivation

Asociality: don’t want to interact with anyone

Affective blunting: no affect, no expressions, monotone

Apathy: lack of interest

Alogia: poverty of speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cognitive Symptoms of Schizophrenia

A

Concrete thinking

Impaired memory

Impaired information processing

Impaired executive functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Affective Symptoms of Schizophrenia

A

Assessment for depression is crucial (may herald impending relapse, increases substance abuse, increases suicide risk, further impairs functioning)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Self-Assessment with Schizophrenia

A

Anosognosia: inability to recognize illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Assessment Guidelines with Schizophrenia

A

Any medical problems

Drug/alcohol use disorders

Mental status examination

Cognitive assessment

Assess for hallucinations, delusions, suicide risk

Assess ability to ensure personal safety

Assess prescribed meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Potential Nursing Diagnoses for Schizophrenia

A

Positive Symptoms: disturbed sensory perception, risk for self-directed or other-directed violence, impaired verbal communication

Negative Symptoms: social isolation, chronic low self-esteem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Outcomes Identification for Schizophrenia

A

Phase I-Acute: patient safety and medical stabilization

Phase II-Stabilization: help patient understand illness/treatment, stabilize medications, control/cope with symptoms

Phase III-Maintenance: maintain achievement, prevent relapse, achieve independence, satisfactory quality of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Planning for Schizophrenia

A

Phase I-Acute: best strategies to ensure patient safety and provide symptom stabilization

Phase III-Maintenance: provide patient and family education, relapse prevention skills are vital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Implementation during Acute Phase of Schizophrenia

A

Psychiatric, medical, and neurological evaluation

Psycopharmalogical treatment

Support, psychoeducation, and guidance

Supervision and limit setting in the milieu

Monitor fluid intake

Working with aggression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Interventions for Stabilization and Maintenance Phases of Schizophrenia

A

Medication administration/adherence

Relationships with trusted care providers

Community-based therapeutic services

Teamwork and safety

Activities and groups

Counseling and communication techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Psychobiological Interventions for Schizophrenia

A

Antipsychotic medications (1st, 2nd, and 3rd generation)

Injectable antipsychotics (short- and long-acting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
First-Generation Antipsychotics
Dopamine antagonists Target positive symptoms of schizophrenia Advantage: less expensive Disadvantages: extrapyramidal side effects (dystonia, akathisia, pseudoparkinsonism), ACh side effects (dry mouth), tardive dyskinesia (repetitive movements), weight gain, sexual dysfunction, endocrine disturbances
26
Second-Generation Antipsychotics
Serotonin and dopamine antagonists (clozapine) Treat both positive and negative symptoms Minimal to no EPS or tardive dyskinesia Disadvantage: tendency to cause significant weight gain, risk of metabolic syndrome (increased risk for diabetes)
27
Third-Generation Antipsychotics
Really a subset of the SGAs Ariprazole, brexpiprazole, calprazine Dopamine system stabilizers May improve positive and negative symptoms and cognitive function Little risk of EPS or tardive dyskinesia
28
Potentially Dangerous Responses to Antipsychotics
ACh toxicity Neuroleptic malignant syndrome Agranulocytosis Prolongation of QT interval Liver impairment
29
Advanced Practice Interventions for Schizophrenia
Individual and group therapy Psychoeducation Medication prescription and monitoring Basic health assessment Cognitive remediation Family therapy
30
Anxiety
Apprehension, uneasiness, uncertainty, or dread from real or perceived threat Normal anxiety is necessary for survival
31
Fear
Reaction to a specific danger
32
Mild Anxiety
Everyday problem-solving leverage Grasps more information effectively
33
Moderate Anxiety
Selective inattention Clear thinking hampered Problem-solving not optimal Sympathetic nervous system symptoms begin
34
Severe Anxiety
Perceptual field greatly reduced Difficulty concentrating on environment Confused and automatic behavior Somatic symptoms increase
35
Panic
Markedly disturbed behavior--running, shouting, screaming, pacing Unable to process reality; impulsivity
36
Defense Against Anxiety
Automatic coping styles Protect people from anxiety Maintain self-image by blocking feelings, conflicts, memories Can be healthy or unhealthy
37
Separation Anxiety Disorder
Developmentally inappropriate levels of concern over being away from a significant other
38
Panic Disorder
Panic attacks Unpredictable, self-limiting Typically last 10min or longer May have palpitations, tremors, SOB, feeling of smothering, chest pain, nausea, abdominal pain, dizziness, paresthesia All other medical issues have been ruled out if given this diagnosis
39
Agoraphobia
Excessive anxiety or fear about being in places or situations from which escape might be difficult or embarrassing
40
Social Anxiety Disorder
Severe anxiety or fear provoked by exposure to a social or a performance situation that will be evaluated negatively by others
41
Generalized Anxiety Disorder
Excessive worry that lasts for months Easily fatigued, difficulty concentrating, muscle tension, sleep disturbance, difficulty functioning due to worry
42
Other Anxiety Disorders
Substance-induced anxiety disorders Anxiety due to medical condition (COPD)
43
Obsessions
Thoughts, impulses, or images that persist and recur, so that they cannot be dismissed from the mind
44
Compulsions
Ritualistic behaviors an individual feels driven to perform in an attempt to reduce anxiety
45
Obsessive-Compulsive Disorders
Obsessive-compulsive disorder Body dysmorphic disorder Hoarding disorder Hair pulling and skin picking disorders
46
Epidemiology of Anxiety Disorders
Decreased levels of serotonin and dopamine
47
Assessment of Anxiety Disorders
Sound physical and neurological exam Determine source of anxiety (primary vs. secondary) Determine current level of anxiety Assess for potential self-harm Complete psychosocial assessment (ask patent about causes they can identify) Self-assessment
48
Nursing Diagnoses and Outcome Identification for Anxiety
Anxiety (self-monitors intensity, uses reduction techniques) Ineffective coping (identifies ineffective and effective patterns)
49
Planning with Anxiety
Patients do not usually require inpatient admission Planning involves selecting community-based interventions Encourage active participation in planning to increase positive outcomes Patient experiencing severe levels may not be able to participate in planning
50
Implementation for Anxiety
Identify their anxiety Counseling Teamwork and safety Promotion of self-care activities Pharmacological interventions (antidepressants, anti-anxiety drugs, other classes) Psychobiological interventions Integrative therapy Health teaching
51
Concepts Central to Addictive Use Disorders
Addiction Intoxication Tolerance Withdrawal
52
Comorbidities with Substance Abuse Disorders
Psychiatric comorbidities (schizophrenia, anxiety) Medical comorbidities (diabetes, hepatitis C, psoriasis)
53
Etiology of Substance Abuse Disorders
Neurobiological factors Psychological factors Sociocultural factors
54
Caffeine
Most widely used psychoactive substance in the world Can result in intoxication and withdrawal
55
Cannabis
Most widely used illicit drug in the world Fourth most commonly used psychoactive drug in the United States after caffeine, alcohol, and nicotine
56
Hallucinogens
Cause a profound disturbance in reality
57
Inhalants
Solvents for glues and adhesives Propellants Thinners Fuels
58
Opioids
Heroin and prescription drugs Pharmacologic treatment: methadone, buprenorphine, and naltrexone Withdrawal symptoms start within 6-8 hours and peak within 2-3 days Withdrawal symptoms: bone pain, insomnia, hostility, aggression, vomiting, diarrhea
59
Sedative, Hypnotic, and Antianxiety Medications
Benzodiazepines, benzodiazepine-like drugs, carbamates, barbiturates, barbiturate-like hypnotics CNS depressants--drowsiness, low BP, slow breathing Withdrawal symptoms include insomnia, anxiety, tremors, sweating, increased HR and BP, seizures NG tube and gastric lavage for overdose
60
Stimulants
Amphetamine-type, cocaine, or other stimulants Second only to cannabis as the most widely used illicit substances in the United States
61
Systemic Effects of Alcoholism
Peripheral neuropathy Alcoholic myopathy and cardiomyopathy Esophagitis, gastritis, and pancreatitis Alcoholic hepatitis Cirrhosis of the liver Leukopenia Thrombocytopenia Cancer of the head and neck
62
Screening Tools
SBIRT: Screening, Brief Intervention, Referral to Treatment AUDIT: Alcohol Use Disorders Identification Test CAGE: 4 questions to identify alcohol abuse CAGE-AID: same questions as CAGE but adds drug use to alcohol T-ACE: Tolerance, Annoyance, Cut down, Eye opener
63
Implementation for Substance Abuse Disorders
Promote safety and sleep (first-line interventions) Reintroduce good nutrition and hydration Support for self-care Explore harmful thoughts and spiritual distress
64
Care Continuum for Substance Abuse
``` Detoxification Rehabilitation Halfway houses Other housing Partial hospitalization Intensive outpatient treatment Outpatient treatment Alcoholics Anonymous Relapse Prevention ```

Community Mental Health Nursing (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions