Week 3 and 4 Powerpoint Flashcards
(39 cards)
Review:
What are the 5 categories of the MSE?
- General appearance
- Emotional State (mood/affect)
- Perception/sensory experience
- Thinking (thought content and form)
- Sensorium/Cognitive processes
What are three examples of mental disorders or situations whereby a patient might exhibit/experience psychosis?
- Schizophrenia
- Schizoaffective disorder
- Bipolar disorder
- Major depression
- Brief reactive psychosis
- ICU psychosis
- Post partum psychosis
- Drug/substance induced
What are three examples of problems/behaviours that a person with psychosis might be experiencing?
- Anxiety
- Agitation
- Difficulty processing information
- Difficulty communicating needs
- Disturbances in sensory experiences
- Many others!
What are the goals of care associated with a psychotic/schizophrenic patient?
- establish safety, security, and trust
- orient towards reality
- alleviate high levels of anxiety and agitation
- Promote action towards: appearance, hygiene, biological needs, social behaviour (appropriate)
- Increase/maintain self esteem
What are the 5 types of schizophrenia?
- Paranoid
- Disorganized
- Catatonic
- Undifferentiated
- Residual
What is specific to paranoid schizophrenia?
Presence of auditory hallucinations or prominent delusional thoughts about persecution or conspiracy
What is specific to disorganized schizophrenia?
Disorganization of the thought processes
What is specific to catatonic schizophrenia?
Disturbances in movement
What is specific to undifferentiated schizophrenia?
Symptoms that are NOT sufficiently formed or specific
What is specific to residual schizophrenia?
No longer displays prominent symptoms
What are the 5 negative symptoms of schizophrenia?
- Affective flattening
- Alogia
- Avolition/apathy
- Anhedonia
- Attention problems
Define alogia Is it (+) or (-)?
Inability to speak
- b/c of mental defect, mental confusion or aphasia
- NEGATIVE symptom
Define avolition/apathy Is it (+) or (-)?
Severe lack of initiative or motivation
- NEGATIVE symptom
Define Anhedonia Is it (+) or (-)?
Inability to feel pleasure
- NEGATIVE symptom
What are 6 positive symptoms of schizophrenia?
- Delusion
- Hallucinations
- Thought form disorders
- Disorganized speech
- Bizarre behaviour
- Inappropriate affect
What is the main neurotransmitter than is related to schizophrenia?
Dopamine
If a person is schizophrenic/psychotic, do they too much dopamine or not enough dopamine?
Too MUCH dopamine
What can happen if you have too little dopamine?
Unwanted motor side effects
What are the 4 EPS (extrapyramidal side effects) of antipsychotic drug use?
- Acute dystonia
- Akathisia
- Pseudoparkinsonism
- Tardive dyskinesia
Explain what acute dystonia would look like and what it is
Severe muscle spasms, difficulty swallowing, stiff neck, rotation of eyes upwards, PROTRUSION of tongue
- It’s an extrapyramidal side effect (EPS)
What medication can be given if acute dystonia is suspected?
Benztropine (Cogentin) (IM)
- extremely powerful muscle relaxant
Explain what akathisia would look like and what it is.
Extreme restlessness, pacing, jittery, discomfort alleviated with pacing/moving
- It’s an extrapyramidal side effect
When does akathisia commonly appear?
After the first few days of treatment
- important to recognize, b/c if not, the antipsychotic drug dosage may be INCREASED to relieve agitiation
- This would only make it WORSE - it’s a SIDE EFFECT!
What are three features of pseudo parkinsonism?
- Repetitive “pill rolling” movement
- Persistent tremors
- Shuffling gait/taking small steps
