Unit 13 Flashcards
What are the types of schizophrenia spectrum disorders?
Delusional - false beliefs or thoughts that have lasted more than 1 month
Brief psychotic - sudden onset of delusions, hallucinations, disorganized speech, or disorganized/catatonic behavior lasting from days to a month
Schizophreniform - same as schizophrenia, but less than 6 months
Schizoaffective - major depressive, mania, or mixed episode concurrent with symptoms of schizophrenia (not caused by meds or condition)
Substandard-induced - may have delusions or hallucinations
Psychotic due to another medical condition
What are the four main symptom categories?
Negative
Positive
Cognitive - subtle or obvious impairment in memory, attention, and thinking; impaired executive functioning (judgment, control, prioritization, or problem-solving); THINK CONCRETE THINKING
Affective - altered experience and expression of emotions, ASSESS FOR DEPRESSION
What are positive symptoms of schizophrenia?
The presence of s/s that should be absent
Hallucinations, delusions, paranoia, or disorganized/bizarre thoughts, behaviors, or speech
What are negative symptoms of schizophrenia?
Absence of essential human qualities
Anhedonia (absence of pleasure), avolition (lack of motivation), asociality, affective blunting, apathy, alogia (decrease in speech)
How can a nurse deal with their personal reactions while working with a schizophrenia patient?
Think about stereotypes and take time to step away from the situation if needed.
What teaching should be given with schizophrenia and importance of medications?
Give support (milieu)
Monitor fluid intake - WATER INTOXICATION
Make sure to take medications
Try therapeutic services
Teamwork - encourage family involvement
What are the basic ideas of how to care for patients with symptoms of psychosis?
Medications
Build trust
Provide safety
Take care of basic needs.
What are genetic risk factors for schizophrenia?
Commonly runs in family
What are neurobiological risk factors for schizophrenia?
Dopamine theory - too much uptake or not enough uptake of dopamine and other chemicals in the brain
What are brain structure abnormalities for schizophrenia?
Grey matter deficits
Decrease in insulation and hippocampus
Increased in age-related decline in cortical thickness
What are environmental risk factors for schizophrenia?
Development and family stress
Tetrachloroethylene (chemical in drinking water)
Childhood sexual abuse
Social adversity
What are prenatal risk factors for schizophrenia?
Increase risk after pregnancy
Born in the winter/spring
Father is over 35 years old
What are the types of delusions?
Persecutory - believing one is being singled out for harm or prevented from progressing
Referential - believing that events or circumstance that have no personal connection are related to you
Grandiose - believing one is a powerful or important person
Erotomanic - believing that another person desires you romantically
Nihilistic - conviction that a major catastrophe will occur
Somatic - believing that the body is changing in unusual ways
Control - believing that another person/group/external force controls your thoughts, feelings, impulses, or behavior
What are alterations in perception in relation to schizophrenia?
Auditory: hearing voices or sounds
Visual: seeing people or things
Olfactory: smelling odors
Gustatory: experiencing tastes
Tactile: feeling bodily sensations
What does anosognosia mean?
Inability to realize one is ill
What are EPS effects?
Acute dystopia - sudden, sustained contraction of muscle(s)
Akathisia (restlessness)
Pseudoparkinsonism (temporary Parkinson’s symptoms)
Tardive dyskinesia: involuntary rhythmic movements, usually doesn’t go away
What is word salad vs clang association?
Clang: choosing words that sound similar
Word Salad: jumble of words that are meaningless to the listener
What are alterations in speech with schizophrenia?
Associate looseness: concentration is poor and thoughts are loosely connected
Neologism: words have meaning for the patient, but not the same meaning or no meaning for others
Echolalia: repetition of words
Magical thinking: believing that reality can change by thoughts or unrelated actions
Paranoia: irrational fear (suspicious)
What are command hallucinations?
Person is directed to take an action
ESSENTIAL TO ASSESS WHAT THEY HEAR
What is concrete thinking?
Impaired ability to think abstractly
What is echopraxia?
Mimicking movements of others
What is affect?
External expression of a persons emotional state
Flat - immobile or blank
Blunted - reduced or minimal response
Constricted - reduced in range
Inappropriate - incongruent with the actual emotional state
Bizarre - odd, illogical, inappropriate, or unfounded
What is the prodromal phase?
Onset, mild changes
May have decreased function in school, social engagement, and have disorganized speech/thought.
What are therapeutic communication techniques when working with aggressive patients?
Reduce stimuli
Explore patient’s feelings
Promote verbal expression
