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Behavioral Health > Chapter 12 > Flashcards

Chapter 12 Flashcards

0
Q

Usually described as odd or eccentric. Do not have hallucinations or delusions. Altered interpersonal boundaries, inappropriate expression of emotion, increased mistrust, difficulty setting goals.

A

Schizotypal Personality Disorder

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1
Q

Experiences non bizarre delusions (situations that could occur in real life: having a disease, being loved by someone, being followed).

A

Delusional disorder

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2
Q

Acute onset of psychosis (delusions, hallucinations, disorganized speech) or grossly disorganized or catatonic behavior in response to extreme stress.

A

Brief psychotic disorder (lasts less than 1 month, full recovery)

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3
Q

Psychosis induced by drugs of abuse, alcohol, medications, or toxins

A

Substance-induced psychotic disorder

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4
Q

Psychosis or catatonia caused by a medical condition (delirium, neurological/metabolic condition, hepatic/renal disease, etc.)

A

Psychosis or Catatonia associated with another medical condition

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5
Q

A person has many features of schizophrenia but has had these for a period of less than six months. May or may not develop into schizophrenia

A

Schizophreniform disorder

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6
Q

An episode of major depression, mania, or mixed depression and mania occur in the presence of symptoms of schizophrenia.

A

Schizoaffective disorder

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7
Q

Comorbidity for Schizophrenia:

A

Substance abuse (especially nicotine)
Anxiety, depression, and suicide
Physical health illnesses
Polydipsia

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8
Q

Neurotransmitters associated with schizophrenia:

A

Dopamine and Serotonin (high levels)

**Maybe also glutamate and Acetylcholine

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9
Q

First-generation anti-psychotics affect which neurotransmitter?

A

Dopamine

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10
Q

Second-generation antipsychotics affect which neurotransmitters?

A

Serotonin and dopamine

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11
Q

Brain abnormalities in patients with schizophrenia include:

A

Enlargement and asymmetry of ventricles
Reduced gray matter
Temporal and Frontal lope shrinkage

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12
Q

______ symptoms appear a month- more than a year before the first psychotic breakdown

A

Prodromal

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13
Q

Symptoms before the illness:

A 
Socially awkward
Lonliness
Depression 
Vague/odd/eccentric expression 
Anxiety, phobias, obsessions, dissociation, compulsions
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14
Q

Phase when hallucinations, delusions, apathy, and withdrawal appear. Loss of functional abilities, increased care or hospitalization may be required.

A

Acute (1)

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15
Q

Phase when symptoms diminish and there is movement towards baseline functioning. Partial hospitalization or care in a residential crisis center or supervised group home may be needed.

A

Stabilization (2)

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16
Q

Phase where patient is at or near baseline functioning. Symptoms are diminished and level of functioning allows the patient to live in the community.

A

Maintenance (3)

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17
Q

Recognizing early signs of relapse such as reduced ______ and _________ can help prevent relapse.

A

Sleep, concentration

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18
Q

True or False: Adherence to antipsychotics is more important than the risk of side effects.

A

True- Most side effects are reversible, whereas consequences of relapse are not.

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19
Q

Identify which are positive symptoms and which are negative symptoms of schizophrenia:

  1. Delusions
  2. Poor hygiene
  3. Anhedonia
  4. Hallucinations
  5. Abnormal movements
  6. Decreased motivation (avolition)
A
  1. Delusions: positive
  2. Poor hygiene: negative
  3. Anhedonia: negative
  4. Hallucinations: positive
  5. Abnormal movements: positive
  6. Decreased motivation: negative
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20
Q

Symptoms present that are not normally present.

A

Positive symptoms

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21
Q

Symptoms characterized by the absence of something that should be present.

A

Negative symptoms

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22
Q

Symptoms characterized by subtle changes in memory, attention, or thinking. An example is…

A

Cognitive symptoms, impaired executive functioning (ability to set priorities or make decisions)

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23
Q

Identify if the symptom is positive or negative:

  1. Bizarre behavior
  2. Paranoia
  3. Gross errors in thinking
  4. Associative looseness
  5. Blunted affect
  6. Poverty of thought (alogia)
A
  1. Bizarre behavior- positive
  2. Paranoia- positive
  3. Gross errors in thinking- positive
    4- Associative looseness- positive
    5- blunted affect- negative
    6- Alogia- negative
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24
Q

True or False: Negative symptoms are the first to appear in schizophrenia

A

False- Positive symptoms

25
Q

Alterations in thought might best be tested by…

A

reality testing

26
Q

True or False: The patient having a delusion should be offered reality to help diminish affects.

A

FALSE: this is counterproductive.

27
Q

What should the nurse do when a patient is having a delusion?

A

-Look for and address underlying themes or needs

28
Q

Concreteness can be assess through…

A

The patient’s interpretation of proverbs

29
Q

Positive symptoms are categorized into:

A

Alterations in thought, speech, perception, and behavior

30
Q

Alteration in speech where threads are interrupted and disjointed

A

Associative looseness

31
Q

Delusions in which the patient believes that another person, group of people, or external force controls thoughts, feelings, impulses or behavior have the underlying theme of…

32
Q

Delusions in which the patient gives personal significance to unrelated or trivial events, perceives events as relating to themselves when they do not have the underlying theme of…

A

Ideas of reference

33
Q

Believing that one is being singled out for harm by others, especially by those in positions of power are delusions with the underlying theme of

A

Persecution

34
Q

Believing that one is very powerful or important are delusions with the underlying theme of…

35
Q

Believing that the body is changing in unusual ways (such as rotting from the inside) is a delusion with the underlying theme of…

36
Q

Believing that another person desires you romantically has the underlying them of…

A

Erotomanic

37
Q

Believing that one’s mate is unfaithful has the underlying theme of…

38
Q

Choosing words based on their sound rather than their meaning. Often words rhyme or have similar beginning sound.

A

Clang association

39
Q

A jumble of words that is meaningless to the listener and possibly speaker. Extreme levels of disorganization

A

Word salad

40
Q

Made-up words that have meaning to the patient but a different or non-existent meaning to others.

A

Neologisms

41
Q

The pathological repeating of another’s words. Often seen in catatonia

42
Q

An irrational fear of others, ranging from mild (wariness, guardedness) to profound (thinking someone will kill you)

43
Q

Alterations in perception include…

A

Depersonalization
Derealization
Hallucinations
Illusions

44
Q

A feelings that one is somehow different or unreal or has lost his identity.

A

Depersonalization

45
Q

A false perception that the environment has changed (everything bigger or smaller, or familiar surroundings feeling strange)

A

Derealization

46
Q

____________ is perceiving a sensory experience for which no external stimulus exists while _________ are misperception or misinterpretation of a real experience.

A

Hallucinations, Illusions

47
Q

___________ hallucinations direct the person to take action. They are a ______________ and the nurse should assess….

A

Command, psychiatric emergency, assess what the patient heard and the patient’s ability to recognize it as not real and ability to resist

48
Q

A patient tilts his head and often stops activity and moves lips silently. The nurse should…

A

Suspect hallucinations and assess the patient for command hallucinations

49
Q

True or False: Visual hallucinations should be assessed as a sign of mental illness

A

False: Usually in organic disorders (withdrawal, dementia)

50
Q

The four affects of schizophrenia:

A

Flat
Blunted
Inappropriate
Bizarre

51
Q

Affective symptoms include those related to _______ and nurse should assess for __________.

A

Mood, depression

52
Q

True or False: The nurse should speak to coworkers about frustration felt when dealing with schizophrenic patients.

A

True- helps avoid countertransference

53
Q

An inability to realize oneself as ill.

A

Anosognosia (often caused by the illness itself)

54
Q

The overall goal for the acute phase is…

A

Patient safety and stabilization

55
Q

Outcomes for the stabilization phase:

A
  • Understand illness and treatment
  • Become stabilized on medication
  • Control or cope with symptoms
56
Q

Outcomes for the maintenance phase:

A
  • Maintain achievements
  • Adhere to treatment
  • Prevent relapse
  • Achieve independence and satisfactory quality of life
57
Q

Nursing diagnosis for positive symptoms of schizophrenia:

A

Disturbed sensory perception (auditory/visual)
Risk for self-directed/other-directed violence
Impaired verbal communication

58
Q

Nursing diagnosis for negative symptoms:

A 
Social isolation
Risk for loneliness
Chronic low self-esteem
Risk for self-directed violence
Ineffective coping
Constipation
Self-care deficit
59
Q

Effective care provides:

A

Protection and structure

60
Q

____________ may enhance the effectiveness of antipsychotics. ________ is used during acute exacerbations of psychosis to hasten response to antipsychotics. ________ may be given with clozapine to improve effects, and _______________ and __________ are very important for patients with schizoaffective disorder.

A

Mood stabilizing agents, Valporate, Lamotrigine, antidepressants, mood stabilizers

61
Q

True or False: The nurse should involve the family in care for the patient with schizophrenia

A

True (if the patient agrees)

Behavioral Health (6 decks)

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