When a patient has Schizophrenia, they have a _____-_____ need for medication.
When a patient has Schizophrenia, they have a LIFE-LONG need for medication.
What does schizophrenia affect?
Ability to perceive reality accurately
At what age is the onset of schizophrenia in male and females?
75-85% of patients with schizophrenia ______ and they usually ______ 2-3 times more than the general population.
75-85% of patients with schizophrenia SMOKE and they usually SMOKE 2-3 times more than the general population.
What is the leading cause of death in schizophrenics?
What causes schizophrenia?
Combined inherited genetic factors and extreme nongenetic factors
Serotonin may play a role
Lack of Oxygen at birth
Doesn't cause but can trigger mental break
What are some assessments for Schizophrenia?
Intense irrational suspicion
Defense mechanism of projection is common
Unable to trust actions of others
May adopt a superior, hostile and sarcastic attitude
Have a good outcome or recovery
Prevention of _______ is more important than side effects, with each relapse there is an increase in residual __________.
Prevention of RELAPSE is more important than side effects, with each relapse there is an increase in residual DYSFUNTION.
There are 3 types of Schizophrenia, they are Paranoid, Catatonic and Disorganized, What is the common defense mechanism and what do they do?
Common Defense: Projection
Unable to trust actions of others
May act superior, hostile w/ sarcastic attitude
Dwell on short comings of others
What do Catatonic Schizophrenics do?
Extreme abnormal motor behavior
Motor agitation to EXTREME psychomotor retardation
Echolalia - Repeating words
Echopraxia - mimmicking movement
What do disorganized schizo's do?
Grossly inappropriate affect
Incoherence of speech
May be giggling or gimacing in response to internal stimuli
Found in State hospitals - HOMELESS
What are some interventions for halluci9nations?
Watch for cues: eyes darting, muttering, staring sideways, changes in facial expressions
Ask if they are hallucinating
Ask if voices are telling them to harm self
Document what pt says
accept that voices are real
Present calm demeanor
Keep focused on basic simple reality based topics
Help pt identify times and situations these happen
Assess for signs of inc anxiety, fear, agitation and intervene ASAP
What are some interventions for delusions?
Assess if external controls are needed
Be aware that pts delusions represent they way they are experiencing reality
Do not argue or try to correct
Do not touch pt
Offer food in closed containers
They think someone is trying to poison them
Reality based activities
Observe events for triggers
Use least restrictive intervention
One on One, PRN meds, seclusion
What are some pt and family teachings for Hallucinations and Delusions?
Learn all they can about illness
Develop relapse plan
S&S of Relapse: social withdrawal, trouble sleeping, Inc bizarre or magical thinking
Relapse is part of illness not a sign of failure
Family and Group Therapy
Learn new behavior and Coping skills
Comply with treatment
Avoid alcohol & drugs
Keep in touch with supportive people
Get plenty of sleep
Give pt and family #'s to support groups
How to deal with client?
Try lowering anxiety
Encourage participation in therapeutic & social events
Increase their feeling of self worth
Increase meditation compliance
If you don't understand, Say so
What are some common DX for schizophrenia?
Disturbed thought process
Disturbed Sensory Perception
Risk for Self directed violence
What are some priority outcomes for schizo?
Safety & Stabilization
Reduction in symptoms
What are some interventions for schizo?
Provide safe useful activities
Resources to solve conflicts
Opportunities for learning social and vocational skills = Inc socialization
Day treatment programs
Programs for assertive community treatment
Conventional 1st generation anti-psychotic meds target ________ symptoms.
Atypical 2nd generation anti-psychotic meds target ________ symptoms.
Conventional 1st generation anti-psychotic meds target POSITIVE symptoms.
Atypical 2nd generation anti-psychotic meds target NEGATIVE symptoms.
Why are 1st generation meds less widely used?
B/c of side effects
Extrapyramidal symptoms consist of:
What is Tardive Dyskinesia?
Involuntary tonic muscular spasms that include:
tongue, fingers, toes, neck and pelvis
Not always REVERSIBLE
Abnormal involuntary movement scale (AIMS) is used for screening
What are some 2nd generation meds?
What are POSITIVE symptoms?
Florid psychotic symptoms
ADDS to personality
Leads to hospitalization
What are NEGATIVE symptoms?
Takes away from personality
Flat (Blank Look)
Blunted (minimal response)
Inappropriate affect (response doesn't fit situation)
Bizarre affect (grimacing, gigling, mumbling to self)
What are some cognitive signs and symptoms?
Beliefs that can't be corrected by reasoning
Types: Persecutory, grandiose, religious, hypochondriacol
They feel what they think is REAL
Thought Broadcastings - Their thoughts can be heard
Thought Insertion - Thought of others inserted in mind
Thought Withdrawal - Thought have been removed
Delusion of being controlled (mind or body) by others
sensory perceptions for whick no EXTERNAL stimuli exists
Types: Auditory, Visual, Olfactory, Gustatory, Tactile
Unable to manage health care, job, social system, LIVE ALONE
Depression is COMMON, watch for suicidal tendencies
What are some speech signs and symptoms?
Linkage of one thought to another, thinking becomes illogical and confused
Words have special meanings
Repeating words of others
Jumble of words that are meaningless
What are some behavior signs and symptoms?
Extreme motor agitation
Stereotype: patterns that once having meaning lose purpose
Stupor: motionless for long periods
Negativism - Does opposite of what told to do
Wrapping your head around Schizo