Thought Disorders (psychosis, schizophrenia), Situational Crisis (terminal dx, job loss, relationship issues, unexpected death), Intentional Overdose & Ingestions Flashcards
(50 cards)
a mental disorder in which thought and emotions are so impaired that contact w external reality is lost
psychosis
a long-term mental disorder of a type involving a breakdown in the relation btwn thought, emotion, and behavior, leading to a faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships, fantasy and delusion, and a sense of mental fragmentation
schizophrenia
symptoms that a patient w schizophrenia will exhibit but are not exhibited by those w/o the disorder
hallucination/delusions, thought disorganization, bizarre dress or behavior, perseveration, ideas of reference, ambivalence
positive symptoms of schizophrenia
persistent adherence to a single idea or topic
perseveration
false belief that external events have a special meaning
ideas of reference
behaviors that are likely to exist in the patient w/o schizophrenia but may be absent in the patient w the disorder
apathy, alogia, flat affect, anhedonia, avolition
negative symptoms of schizophrenia
speaking w minimal content
alogia
feeling no joy or pleasure
anhedonia
lack of will, ambition or drive to accomplish a task
avolition
form of psychosis related to a physiological cause
delirium
false personal beliefs about oneself
delusions
intermittent, uncoordinated, involuntary contractions of muscled of the face, neck, trunk, extremities
place patient in quiet room w/ minimal stimulation, diphenhydramine or benztropine
acute dystonia
subjective sensation of motor restlessness (may mimic increased agitation/anxiety)
place patient in quiet room w/ minimal stimulation, diphenhydramine or benztropine
akathisia
potentially life-threatening complication causing altered mental status, muscular rigidity, fever, sympathetic nervous system lability
withdraw offending medications, cooling measures, airway protection, stabilize BP and pulse, reduce muscular rigidity (dantrolene, bromocriptine, amantadine)
neuroleptic malignant syndrome
ineffective coping due to stressors (leaving the individual to solve problems and deal w internal or external stressors)
exacerbation of chronic illness, change in employment, move to a new geographical area, demands of school or job, maturational crisis (birth, marriage, retirement), and/or reliance of ineffective or inappropriate coping strategies, natural disaster, unexpected death, terminal dx
situational crisis
mimics or stimulates the sympathetic nervous system
illegal street drugs (cocaine, amphetamines, methamphetamines, ecstasy, LSD) certain rx drugs (albuterol, dopamine, TCAs, MAOIs)
increased BP, HR, RR, diaphoresis, agitation, temperature and pupil size
sympathomimetics toxidrome
suppresses the parasympathetic nervous system
atropine, antihistamines, TCAs, cyclobenzaprine, drugs to treat Parkinson’s, anti-spasmodic, certain plants (jimsonweed, nightshade, leaves of the potato plant)
increased BP, HR, temperature, pupil size, confused/seizures, hallucinations
decreased diaphoresis, bowel sounds
blind as a bat, red as a beet, dry as a bone, mad as a hatter, hotter than hades
anticholinergics toxidrome
refers to parasympathetic nervous system (stimulates or mimics)
insecticides, organophosphorus, warfare agents (sarin, soman, tuban), physostigimine, certain mushrooms, pilocarpine, nicotine
Diarrhea/diaphoresis Urination Miosis Bradycardia/bronchorrhea Emesis Lacrimation Salivation
cholinergics toxidrome
heroin, morphine, dilaudid
decreased BP, HR, RR, mental status, temperature, pupil size, bowel sounds
triad of respiratory depression, CNS depression, mitosis
opiate toxidrome
brief intense withdrawal which begins 4-6 hrs after the last dose, peaks in 48-72 hours, lasts 5-10 days
yawning, lacrimation, rhinorrhea, diaphoresis, mydriasis, myalgia, tremors, n/v, diarrhea, abd cramps, fever, chills, tachycardia, hypertension, piloerection, muscle cramping, involuntary leg movements
short acting opiate withdrawal (heroin, morphine)
milder withdrawal which begins 24-48 hrs after last dose but may last for weeks
yawning, lacrimation, rhinorrhea, diaphoresis, mydriasis, myalgia, tremors, n/v, diarrhea, abd cramps, fever, chills, tachycardia, hypertension, piloerection, muscle cramping, involuntary leg movements
long acting opiates withdrawal (methadone)
barbiturates (end in tal) benzos (end in pam), antihistamines, alcohol
decreased BP, HR, RR, mental status, temperature, bowel sounds
sedative/hypnotic toxidrome
benzo antidote
may cause seizures in patients w dependence on benzos or @ high risk for seizures - should be avoided or used w extreme caution in these patients
flumazenil (romazicon)
alcoholic beverages
hypoglycemia (esp in children), AMS, hypomag (chronic alcoholism), wernicke-korsakoff syndrome
tx - airway protection, glucose and mag PRN, 100 mg IV thiamine
ethanol
