Psychosis

Question 1

what are the steps to answering a question dealing with psychosis

Answer 1

1) ask: is it non-psychotic or psychosis
2) determine the type of psychosis

Question 2

what are characteristics of non-psychosis

Answer 2

• pt will have insight and is reality based
• may be emotionally distressed, but know that they have a problem
• what they see, hear, feel, etc. is the same as us

Question 3

what is the treatment for non-psychosis

Answer 3

• good therapeutic communication

Question 4

what are characteristics of psychosis

Answer 4

• no insight
• not reality based
• think everyone else has the problem, not them

Question 5

delusions, hallucinations, and illusions are ______ symptoms

Answer 5

• psychotic (only pt’s with psychosis get these, non-psychotic DO NOT)

Question 6

define: delusion

Answer 6

• false, fixed (doesn’t change) idea or belief
• no sensory component, all has to do with thoughts

Question 7

what are 3 types of delusions

Answer 7

1. paranoid
2. grandoise
3. somatic

Question 8

what is a paranoid delusion

Answer 8

• false, fixed belief that people are out to harm them

Question 9

what is a grandoise delusion

Answer 9

• false, fixed belief that you are superior

Question 10

what is a somatic delusion

Answer 10

• false, fixed belief about your body

ex. body is hollow

Question 11

define: hallucination

Answer 11

• false, fixed sensory experience
• hear, feel, taste, smell things

Question 12

what are 5 types of hallucination

Answer 12

• auditory (voices, etc.)
• visual
• tactile (feeling things)
• gustatory (tasting)
• olfactory (smelling)

Question 13

define: illusion

Answer 13

• misinterpretation of reality
• sensory experience

Question 14

how can you tell the difference between hallucination and an illusion

Answer 14

• both are sensory experience
• illusion has a referrant in reality –> something to which a person refers to when they say something, something is actually there, it’s just misinterpreted

Question 15

ex. the pt says “listen, i hear demon voices”. hallucination or illusion?

Answer 15

• hallucination

Question 16

ex. pt hears doctors and nurses laughing. says “listen, i hear demon voices”

hallucination or illusion?

Answer 16

• illusion

Question 17

what are the 3 types of psychosis

Answer 17

• functional
• psychosis of dementia
• psychotic delirium

Question 18

those with functional psychosis are…

Answer 18

• functional in daily life

Question 19

what 4 diseases make up functional psychosis

Answer 19

• schizophrenia
• schizophrenia effective disorder
• major depression
• manic

(“schizo, schizo, major, manic”)

Question 20

what are the 4 steps of care for functional psychosis (in order)

Answer 20

1) acknowledge feelings (answer should either say “feel” or specify a feeling)
2) present reality (“i know ___ is real to you but I don’t ___”)
3) set limits (“this topic is off limits in our convo”)
4) enforce boundaries (end the convo, do not take away privileges/punish them)

Question 21

what is psychosis of dementia

Answer 21

• psychosis due to brain damage
• not functional

Question 22

what are examples of diseases that cause psychosis of dementia

Answer 22

• dementia
• alzheimers
• organic brain damage
• post-stroke
• may say “senile”

Question 23

what is care for a pt with psychosis of dementia

Answer 23

1) acknowledge feelings
2) re-direct (do not present reality, they cannot learn it, channel from something they can’t do to something they can)

Question 24

what is psychotic delirium

Answer 24

• temporary, sudden, dramatic, 2ndary loss of reality
• often due to chemical imbalance in the body

Question 25

what are examples of causes of psychotic delirium

Answer 25

• drug rxn
• OD on upper drug
• WD on downer drug
• post-op
• UTI in older adults
• thyroid storm
• adrenal crisis

Question 26

what is the care for a pt with psychotic delirium

Answer 26

• remove underlying cause
• acknowledge feeling
• reassure that it’s temporary and that they will be kept safe

Question 27

what is involved in care for personality disorders

Answer 27

• good therapeutic communication

Question 28

define: loosening of association

Answer 28

• thoughts aren’t wrapped too tight = thoughts all over the place

Question 29

what are 3 types of loosening of association

Answer 29

1. flight of ideas
2. word salad
3. neologism

Question 30

define: flight of ideas

Answer 30

• each individual phrase is coherent, but incoherent when phrases put together

Question 31

define: word salad

Answer 31

• incoherent phrase with random words

Question 32

define: neologism

Answer 32

• make up imaginary words

Question 33

what is a narrowed self concept

Answer 33

• when a psychotic refuses to leave their room or change their clothes
• often functional

Question 34

why does narrowed self concept occur?

Answer 34

• because they define who they are based on where and who they are = don’t know who they are unless they’re wearing these clothes in that room

Question 35

what is care for someone with narrowed self concept

Answer 35

• do not force them to change their clothes or leave their room

Question 36

define: ideas of reference

Answer 36

• think everyone is talking about you