Quiz 2: Schizophrenia, Thought Disorders

Question 1

Emil Kraepelin

Answer 1

Describe as dementia praecox

Question 2

Eugen Bleuler

Answer 2

Renamed dementa praecox schizophrenia

Question 3

Kurt Schneider

Answer 3

• differentiated behaviors
• First Rank Symptoms: psychotic delusions, hallucinations
• Second Rand Symptoms: all other experiences and behaviors associated with the disorder

Question 4

First Rank Symptoms

Answer 4

psychotic delusions and hallucinations

Question 5

Second Rank Symptoms

Answer 5

All other experiences and behaviors associated with the disorder

Question 6

Clinical Course of Disease

Answer 6

Prodromal Period
Acute Illness Period
Stabilization Period
Recovery period
Relapses

Question 7

Diagnostic Criteria

Answer 7

Positive Symptoms:
-Excessive or distorted thoughts and perceptions
-Delusions and hallucinations
Negative Symptoms
-Emotions and behaviors that should be present but are diminished
Neuro-cognitive Impairment
-involving memory, vigilance, verbal fluency, and executive function

Question 8

Disorganized Symptoms/Thinking

Answer 8

Echolalia, Circumstantiality, loose associations, tangentiality, flight of ideas, word salads, neologisms, paranoia, referential thinking, autistic thinking, concrete thinking, verbigeration, metonymic speech, clang association, stilted lang., pressured speech

Question 9

Disorganized Symptoms/Behavior

Answer 9

aggression, agitation, catatonia, catatonic excitement

Question 10

Disorganized Symptoms/Behavior

Answer 10

aggression, agitation, catatonia, catatonic excitement, echopraxia, repressed behavior, stereotypy, hyper vigilance, waxy flexibility

Question 11

T/F Hallucinations are positive symptoms but delusions are negative symptoms

Answer 11

F

Question 12

T/F Hallucinations are positive symptoms but delusions are negative symptoms

Answer 12

F

Question 13

Risk Factors

Answer 13

Genetics, environment

Question 14

Age of Onset

Answer 14

Late Adolescence

Early Adulthood

Question 15

Gender differences

Answer 15

Earlier diagnoses and poorer prognoses in men

Question 16

Familial differences

Answer 16

First degree biologic relatives lead to greater risk

Question 17

Comorbidity T/F

Answer 17

substance abuse and depression

Question 18

Biologic Theories

Answer 18

• Neuroanatomic volumes:larger lateral and third ventricles. Smaller total brain volumes
• familial patterns
• genetic associations
• neurodevelopment
• brain metabolism greatly reduced
• abnormalities in frontal, temporal and cingulate regions
• dopamine hyperactivity

Question 19

Psychosocial Theories

Answer 19

• social stressors contributing to changes in brain function
• social stigma
• absence of good, affordable, and supportive housing
• fragmented mental health care delivery system

Question 20

Interdisciplinary Care

Answer 20

• Pharmacologic management
• Psychosocial interventions
• Priority care issues
• Suicide assessment
• Aggression and safety of patient, staff, others
• Antipsychotic medications

Question 21

T/F Social theories contribute to changes in brain function that result in schizophrenia

Answer 21

T: contribute to changes in brain function and add to day to day challenges of living with mental illness

Question 22

Biologic Domain:Physical Assessment

Answer 22

-current and past health status and physical examination

-

Question 23

Biologic Domain: Physical Assessment

Answer 23

• current and past health status and physical examination
• physical and nutritional assessment
• pharmacologic assessment
• medication
• abnormal motor movement: major side effects of meds

Question 24

Biologic Domain: Interventions

Answer 24

• promotion self-care
• thermoregulation interventions
• promotions of normal fluid balance and prevention H20 intoxication
• pharmacologic interventions

Question 25

Interventions: Antipsychotics

Answer 25

- Blockage of dopamine trasmission | - Second generation antipsychotic drugs effective in treating negative and positive symptoms

Question 26

Side Effects of Antipsychotics

Answer 26

-Monitoring and Administration -Extrapyramidal side effects *Parkinsonism *Dystonic rxs *Tardive dyskinesia *Akathisia -Side effects orthostatic hypotension hyperprolactinemia sedation; weight gain cardiac arrhythmias agranulocytosis -drug-drug interactions

Question 27

What would a nurse expect in a patient experiencing akathsia

Answer 27

motor restlessness

Question 28

Neuroleptic Malignant Syndrome

Answer 28

- life threatening condition - severe muscle rigidity, elevated temp., req. early recognition of symptoms - dopamine agonists; muscle relaxants - frequent vital signs monitoring, treating fever, lab testing - supportive measures and promoting safety

Question 29

Anticholinergic Crisis

Answer 29

- Life-threatening Condition: overdose or sensitivity to drugs with Anticholinergic properties - S/S hot as a hare, blind as a bat, mad as a hatter, dry as a bone - treatment: discontinuation of med, physostigmine, gastric lavage, charcoal

Question 30

Psychological Domain: Psychological Assessment

Answer 30

tools, responses to mental health problems, mental status and appearance, mood and affect, speech, thought processes, hallucinations, delusions, disorganized comm., cog. impairments, memory and orientation, insight and judgement, behavioral responses, self-concept, stress and coping patterns, social network, risk assessments

Question 31

Interventions for the psychological domain

Answer 31

- development of nurse-pt relationship: trust, acceptance, hope - management of disturbed thoughts and sensory perceptions - education about symptoms - enhancement of cognitive functioning - use of behavioral interventions - teaching and coping with stress - pt education - family education

Question 32

Social Domain: Social Assessment

Answer 32

- functional status - social systems - quality of life - family assessments