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Schizophrenia Flashcards

(90 cards)

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0
Q

How much of the population does schizophrenia affect

A

More than 1%

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1
Q

Schizophrenia is a _______ brain disorder

A

Chronic

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2
Q

What can symptoms of schizophrenia include

A

Delusions, hallucinations, trouble with thinking and concentration, and lack of motivation

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3
Q

Onset of schizophrenia?

A

Early 20s. Men a little younger, women a little later

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4
Q

What are the subtypes of schizophrenia?

A

Paranoid, disorganized, catatonic, undifferentiated, residual

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5
Q

What does the Diathesis-Stress Model of Mental Illness mean?

A

That a person is born with a certain predisposition and then a stressor comes alone and triggers it once the stage is set.
Diathesis: sets the stage; what you’re born with
Stress: something happens to trigger it

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6
Q

first degree biologic relatives of an individual with schizophrenia have a ____ times greater risk for schizophrenia than the general population

A

10

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7
Q

The neuro-anatomic findings with a schizophrenic are similar to those of what type of patient?

A

Dementia

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8
Q

What is the monoamine hypothesis of mental illness

A

Changes in the levels of monoamine neurotransmitters (5-HT, NE, EPI, DA) cause mental illness

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9
Q

There is too much ________ with schizophrenia

A

Dopamine

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10
Q

What are positive symptoms

A

Things added

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11
Q

What is a hallucination

A

Actually feeling SENSATION without physical stimulation. It can involve and of the five senses

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12
Q

What types are hallucinations usually

A

Visual or auditory

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13
Q

What are delusions

A

Fixed false beliefs that you cannot change

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14
Q

What are negative symptoms

A

Things taken away

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15
Q

What are examples of negative symptoms?

A

Affective flattening or blunting, ambivalence, alogia, avolition, anhedonia

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16
Q

What is the neurocognitive impairment diagnostic criteria

A

Memory short and long term, vigilance or sustained attention, verbal fluency, executive functioning, disorganized behavior, disorganized thinking

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17
Q

What are internal senses

A

Biochemical and emotional

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18
Q

What are external senses

A

Sight, sound, touch, taste, smell

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19
Q

What does treatment focus on in the acute illness period

A

Alleviation of symptoms

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20
Q

What are things that go on during the acute illness period

A

Behaviors may be both confusing and frightening, less able to care for basic needs, functioning at school and work deteriorates, dependence on family and friends increases

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21
Q

What stage is the treatment intense

A

Stabilization period

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22
Q

What goes on during the stabilization period

A

Symptoms become less acute but may be present, treatment is intense, medication regimen is established, being to adjust, socialization begins to increase and rehabilitation begins ideally

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23
Q

Ideally when does socialization begin to increase and rehabilitation begin

A

Stabilization period

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24
What is typically the trigger to a relapse
Noncompliance with medication regimen
25
What does the maintenance and recovery period focus on
Focuses on regaining the previous level of functioning and quality of life by using medication management and family support and involvement
26
What are symptoms related to problems in information processing often called
Cognitive deficits
27
What type of commands to schizophrenic patients often have difficulty with?
Multiple step commands because they use concrete instead of abstract thinking
28
What type of thinking do schizophrenic patients use? Especially in acute episodes
Concrete rather than abstract thinking
29
For a schizophrenic patient to make the appropriate decision what does the nurse need to do?
Provide information as clearly and concretely as possible with simple language in short , easily understood phrases
30
What are some thought content descriptors
Thought broadcasting, thought insertion, ideas of reference, and magical thinking
31
What is alogia
Reduced fluency and productivity of thought and speech
32
What is avolition
Withdraw and inability to initiate and persist goal-directed activity
33
What is anhedonia
Inability to experience pleasure
34
What is a grandiose delusion
The belief that one has exceptional powers, wealth, skill, influence, or destiny
35
What is a nihilistic delusion
The belief that one is dead or a calamity is impending
36
What is a persecutory delusion
The belief that one is being watched, ridiculed, harmed, or plotted against
37
What is a somatic delusion
Beliefs about abnormalities in bodily functions or structures
38
What are the different types of delusions
Grandiose, nihilistic, persucatory, somatic
39
Are auditory or visual hallucinations more common?
Auditory
40
What prevents a person with schizophrenia from enjoying activities
Anhedonia
41
Extremely detailed and lengthy discourse about a topic
Circumstantial
42
The topic of conversation changes repeatedly and rapidly, generally after just one sentence or phrase
Flight of ideas
43
Absence of the normal connectedness of thoughts, ideas, and topics; sudden shifts without apparent relationship to preceding topics
Loose associations
44
The topic of conversation is changed to an entirely different topic that is a logical progression but causes a permanent detour from the original focus
Tangentiality
45
String of words that are not connected in any way
Word salad
46
What are the first symptoms of psychosis
Abnormal perception: inaccurate identification and interpretation of stimulus
47
Is there a identifiable external or internal stimulus with hallucinations?
No
48
What can cause auditory hallucinations
Excessive noise or sensory deprivation
49
What are some environmental factors that can stimulate visual hallucinations
Reflective objects like tv screens, photos frames, fluorescent lights
50
What is affect? What are ways to describe?
Expressed emotions; describe as broad, restricted, blunted, flat, or inappropriate
51
What are some maladaptive movements with schizophrenia
Catatonia, abnormal eye movements, grimacing, apraxia/echopraxia, abnormal gait, mannerisms, extrapyramidal side effects of psychotic medications
52
what are some behaviors that cause socialization problems?
Inability to communicate coherently, loss of drive and interest, deterioration of social skills, poor personal hygiene, paranoia, stigma
53
What is neurocognitive impairment often seen as?
Disorganized symptoms
54
What are disorganized symptoms?
Confused speech and thinking patterns, disorganized behavior
55
What is echolalia
Repetition of words
56
What are examples of disorganized thinking
echolalia, circumstantial, loose associations, tangential, flight of ideas, word salad, clang association, pressured speech
57
What are examples of disorganized behavior
Aggression, agitation, catatonic excitement, echopraxia, stereotypy, hypervigilance, waxy flexibility
58
What is waxy flexibility
Posture held in odd or unusual way
59
What is hypervigilance
Sustained attention to external stimuli
60
What is echopraxia
Imitation of others movements
61
First priority is always _______
Safety
62
Why do these people have a high risk lifestyle
Sedentary, smoking, or dietary habits; obesity resulting in diabetes, hypertension, coronary artery disease
63
What do antipsychotics do
Block dopamine transmission in the brain
64
Are first generation or second generation antipsychotics more efficacious and safer?
Second generation antipsychotic drugs appear to be more efficacious and safer than conventional antipsychotics
65
How long does it take antipsychotic drugs to effect a change in symptoms
1-2 weeks. The delay in outcome is why people stay in hospital to see if they are working
66
Why would a antipsychotic be used in a emergency situation for a patient who was acting out?
Sedating effect. This is a chemical restraint and must be documented
67
What are some extrapyramidal side effects
Parkinsonism, akathisia, tardive dyskinesia, orthostatic hypotension, hyperprolactactinemia, weight gain, sedation, new onset diabetes, cardiac arrhythmias, agranulocytosis
68
Is tardive dyskinesia a early or late appearing extrapyramidal side effect for antipsychotic meds?
Late
69
What does tardive dyskinesia involve
Irregular, repetitive involuntary movements of the mouth, face, and tongue, including chewing, tongue protrusion, lip smacking, Puckering of the lips, and rapid eye blinking
70
Is tardive dyskinesia reversible?
No it is irreversible
71
What is neuroleptic malignant syndrome
A life threatening condition that can develop in reaction to antipsychotic meds. Patients develop severe muscle rigidity and an elevating temperature
72
What are recognizing symptoms of neuroleptic malignant syndrome
Elevated temperature, changes in level of consciousness, leukocytosis, elevated creatinine phosphokinase, elevated liver enzymes or myoglobinuria
73
Nursing interventions with neuroleptic malignant syndrome
Stop administration of offending medications, monitor vital signs, reduce body temperature, and safety to protect muscles
74
What are supportive measures with neuroleptic malignant syndrome
IV fluids, cardiac monitoring, and Dantrolene (dopamine agonist) to make body know there is still some dopamine
75
What are symptoms of anticholinergic crisis
Elevated temperature, dry mouth, decreased salivation, decreased bronchial, nasal secretion, widely dilated eye (hot as a hare, blind as a bat, mad as a hatter, dry as a bone, red as a bee); confusion, hallucinations
76
What is anticholinergic crisis
Potentially life threatening, anticholinergic delirium, can occur with patients who are taking several medications with anticholinergic effects
77
Does anticholinergic crisis go away?
Yes it is self limiting; 3 days
78
Treatment for anticholinergic crisis
Discontinuation of medication; Physostigmine 1-2 mg IV, an inhibitor of cholinesterase, improves in 24-36 hours; gastric lavage; charcoal, catharsis
79
What should you teach patients about delusions and hallucinations
That they are symptoms of illness and part of the disorder
80
What does inpatient care focus on
Stabilization
81
What does emergency care focus on
Crisis
82
What does community care focus on?
This is where most of the care happens
83
Absorption of antipsychotic meds
Variable 30-60 minutes
84
Where is metabolism of antipsychotic drugs?
Liver---look at liver function test!
85
Is excretion of antipsychotic drugs fast or slow?
Slow
86
What blood level does a patient with schizophrenia who is taking clozapine need to monitor weekly
WBC because agranulocytosis can develop with the use of all antipsychotic drugs but most likely to develop with clozapine use
87
A patient who has been taking clozapine for 6 weeks visits the clinic complaining of fever, sore throat, and mouth sores. What would the nurse suspect?
Agranulocytosis
88
What are the 1st gen/typical antipsychotics
Chlorpromazine Thioxanthenes Haloperidol
89
What are the 2nd gen/atypical antipsychotics
``` Clozapine Olanzapine Risperidone Ziprasidone Aripiprazole Quetiapine ```

Psychatric & Mental Health (11 decks)

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