Schizophrenia Flashcards Preview

Mental Health (6005) #2 > Schizophrenia > Flashcards

Flashcards in Schizophrenia Deck (56):
1

A devastating brain disease that affects a person’s thinking, language, emotions, social behavior, & ability to perceive reality.

Schizophrenia

2

Early onset of schizophrenia:
A) age
B) occurs more in

A) 18-25 y/o
B) males

3

late onset of schizophrenia:
A) age
B) occurs more in

A) 25-35 y/o
B) female

4

higher prevalence occurs in?

Males and those living in urban areas

5

Schizophrenia results from?

a combination of inherited genetic factors and extreme nongenetic birth factors.

6

Bleuler’s fundamental signs of schizophrenia (THE FOUR A’S)?

- Affect: Flat, blunted, inappropriate affect.
- Associative looseness: disorganized thinking
- Autistic thinking (delusions, hallucinations)
- Ambivalence - holding on to opposing positions on a subject or person (love & hate someone)

7

Two or more of the following symptoms during 1 month is needed for a diagnosis of schizophrenia?

- delusions
- hallucinations
- disorganized speech
- grossly disorganized or catatonic behavior
- negative symptoms (i.e. affective flattening, avolition, alogia)

8

Criteria needed for a diagnosis of schizophrenia?

- Two or more symptoms during a 1 month period
- One or more major areas are markedly below premorbid functioning
- Signs persist for at least 6 months
- R/O Mental diseases & medical conditions

9

Phases of Schizophrenia?

- Acute phase
- Maintenance
- Stabilization

10

Positive Symptoms of Schizophrenia?

Hallucinations
Delusions
Disorganized Speech
Bizarre Behavior

11

.Persecution, Grandiosity, Control, and Thought broadcasting, insertion and withdrawal are examples of ?

delusions

12

The inability to think abstractly?

concrete thinking

13

made up words that hold meaning to the patient, but not to others?

Neologisms

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pathological repeating of ones words?

Echolalia

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choice of words base on sound?

Clang association

16

meaningless repetition or imitation of the movements of others

echopraxia

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a confused or unintelligible mixture of seemingly random words and phrases

word salad

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perceiving a sensory experience when none exists (i.e. hearing voices)

hallucinations

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- person has lost their identify
- may believe a body part does not belong to them

depersonalizations

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a feeling that one's surroundings are not real

derealization

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the persistent repetition of an act, especially by an animal, for no obvious purpose.

Stereotypy

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performance of all simple commands in a robot like manner

Automatic obedience

23

patient continues to hold arm that is raised by the nurse, seen in catatonia?

Waxy Flexibility

24

Negative Symptoms of Schizoprenia?

Anhedonia
Avolition
Alogia
Blunted Affect

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poverty of speech

Alogia

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inability to experience pleasure or joy

Anhedonia

27

loss of motivation

Avolition

28

Cognitive Symptoms of Schizo?

Difficulty with attention, memory, and executive functions (i.e., decision making and problem solving

29

Nursing Assessment for Schizo?

- Determine if patient has had a medical work-up.
- Assess for co-occuring disorders such as drug abuse.
- Assess risk (suicide or harmful to others).
- Assess for positive and negative symptoms.
- Assess medications

30

Acute Phase Interventions?

Patient safety and medical stabilization

31

Goal of Phase II Interventions (Stabilization)

adhere to medication regimens, understand schizophenia, & participate in available psychoeducational activities.

32

Goal of Phase III Interventions (Maintenance )

Target negative symptoms and participation in social, vocational, and skills training

33

Strategies for communicating with patient who is hallucinating:

- Watch client for cues.
- Ask pt. directly about hallucinations.
- Focus on reality-based diversions and topics.
- Be alert for signs of anxiety.
- Thought stopping and dismissal techniques.

34

Strategies for delusional patients:

- Be open & honest; respond to suspicions calmly.
- Ask to describe delusions.
- Avoid arguing content.
- Focus on the feelings the delusions generate.
- Focus conversation on reality-based topics.

35

Conventional (First Generation) Drugs

Thorazine
Stelazine
Haldol
Mellaril
phenothiazines

36

Newer (Atypical) Drugs

Clozaril
Risperdal
Zyprexa
Seroquel
Geodon
Abilify

37

Muscarinic Cholinergic Blocker A/E?

Dry mouth
blurred vision
urinary retention
constipation
tachycardia

38

Alpha 1 blocker A/E?

orthostatic hypotension
dizziness
reflex tachycardia
sexual dysfunction

39

Alpha 2 blocker A/E?

sexual dysfunction
priaprism (persistent and painful erection)

40

Serotonin Blocker A/E?

weight gain
hypotension
sexual dysfunction

41

Histamine (H1) Blocker A/E?

sedation
weight gain
orthostatic hypotension

42

blockage of D2 dopamine receptor sites in the motor area cause?

Extrapyramidal Side Effects (EPS)

43

Acute Dystonic reaction:

Oculogyric crisis - looking up
Acute contractions of the tongue, face, neck, and back
Opisthotonos
Laryngeal dystonia

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spasm of the muscles causing backward arching of the head, neck, and spine

Opisthotonos

45

S/S of Pseudoparkinsonism?

- Rigidity all over the body.
- Masked like face.
- Tremors (Pill rolling) in hands & wrists.
- Short shuffling gait.
- Dripping of saliva.
- Monotonous and slurred speech.
- Loss of postural reflexes which leads to fall & injuries especially in the elderly.

46

Akathisia is characterized by?

- Subjective feelings of restlessness (inner restlessness).
- Inability to sit still.
- Rocking back and forth on feet.
- Crossing and uncrossing legs frequently.
- Inability to relax.

47

Tardive Dyskinesia

- It is a jerky irregular movement affecting primarily the lower face (tongue, jaw, and lips), extremities and trunk and includes:
- Protrusion of tongue.
- Chewing movement.
- Puffing of checks.
- Smacking movements.
- Limbs: Choriec, rapid, purposeless movements.
- Hip jerks.

48

General Class Side Effects: Traditional Antipsychotic

- Dry mouth, urinary retention and hesitancy.
- Constipation.
- Blurred vision.
- Dry eyes.
- Increased risk for agranulocytosis & seizures.
- Photo sensitivity.
- Inhibition of ejaculation and impotence in men.
- Neuroleptic malignant syndrome (<1%).
- Metabolic effects (i.e. weight gain and DB Type II)

49

- Produce minimal to no extrapyramidal side effects or tardive dyskinesia.
- Treat both positive and negative symptoms.
- Improve the neurocognitive defects associated with schizophrenia.
- Decrease affective symptoms and suicidal behaviors

Atypical Antipsychotics

50

Used for early detection of Tardive Dyskinesia?

Abnormal Involuntary Movement Scale (AIMS) exam

51

AIMS areas of examination are?

-facial and oral movements
- extremity movements
- trunk movement.

52

S/S of Neuroleptic Malignant Syndrome (NMS)?

- decreased LOC
- autonomic dysfunction including
- hyperpyrexia, tachycardia, diaphoresis, and drooling

53

Tx of Mild NMS?

Parlodel (Bromocriptine).

54

Tx of severe NMS?

Dantrolene (Dantrium) (IV), and ECT.

55

- Is a serious side effect and can be fatal.
- Liver impairment may also occur.
- Symptoms include sore throat, fever. malaise, and mouth sores.
- Mortality is high if the drug is not ceased.

Agranulocytosis

56

S/S of Agranulocytosis?

sore throat, fever, malaise, and mouth sores, possible liver impairment