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NURS 1446 Psych PART 2 > Chapter 12 Schizophrenia Spectrum DISORDERs > Flashcards

Chapter 12 Schizophrenia Spectrum DISORDERs Flashcards

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1
Q

This is the most Disruptive & Disabling of psychotic disorders.

Must have atleast 1 psychotic symptom
Hallucinations, Delusion, Disorganized Speech
Unable to function

A

Schizophrenia

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2
Q

Schizophreniform….

A

Short term Schizophrenia <6 months

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3
Q

Depression, mania, mixed Depression, Schizophrenia sx

Describes

A

Schizoaffective disorder

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4
Q

Schizotypical Personality disorder

Describe….

A

Eccentric / odd

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5
Q

Non- bizarre Delusions describes….

A

Delusional DO

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6
Q

Psychotic NED / NOS….

A

Schizo Sx that don’t fit into other categories

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7
Q

Schizophrenia is a biologically based illness

T ir F

A

T

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8
Q

Schizophrenia

Usually onset late teen early 20s

Early onset <15 …..

Late onset >25…..

A

Early onset <15 Males, More structural brain damage, bad outcomes

Late onset >25 Females, Less Brain Damage, better outcome

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9
Q

Smoking marijuana will help with Schizophrenia

T or F

A

F

Make it worse

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10
Q

Autoimmune disorder can cause schizophrenia …

How?

A

Inflammation

Flower blood flow

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11
Q

Why might poverty lead to schizophrenia

A

Lead in old paint / pipes

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12
Q

Father older 35 at conception
Born late winter / early spring

Risk factors for schizophrenia

T or F

A

T

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13
Q

Alogia, Avolition, anhedonia is what type of symptom in schizophrenia

Type of meds to help…

Effectiveness

A

Negative

Alogia = poverty of thought
Avolition = No motivation
Anhedonia = lack of joy

2nd generation atypical antipsychotics

Not very effective

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14
Q

Alterations in speech with schizophrenia

Associative looseness
Clang associations
Word Salad
Neologisms
Echolalia

A

Know the terms

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15
Q

Positive SS of schizophrenia

Limbs or body parts can be moved into a position by someone else, and they will maintain that position for an extended period, even if it is uncomfortable or unnatural.

A

Waxy flexibility

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16
Q

Echopraxia

A

involuntary imitation or repetition of another person’s movements or actions.

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17
Q

Anosognosia….

A

Person is unaware of their own illness or disability.

This isn’t denial, they truly don’t know

18
Q

Audio hallucinations

What do you assess….

A

What they hear
Ability to recognize that hallucination is not real
Ability to resist command

19
Q

3 phases of schizophrenia

A

Acute: Safety is concern
Stabilization:
Maintenance

20
Q

When discharging ensure that you refer them with community resources

T or F

A

F

Connect then with resources. Ensure communication is present between them

21
Q

Assess content of Delusions but quickly move to reality based topics

The focus is on feelings underlying the Delusions

A

38 $ ph to start

22
Q

How long fir full effect of antipsychotics

Atypical antipsychotics have an increased mortality rate in this population

A

2 - 6 weeks

Demented Elderly

23
Q

1st generation antipsychotics

Cheaper than 2nd

Disadvantages
Weight gain
Sex dysfunction
Endocrine distrubing

Plus, these important Sx….

A

EPS
Anticholinergic
Tardive Dyskinesia

24
Q

1st generation

Low Potency/ High Dose =

High Potency/ Low Dose =

A

Low Potency/ High Dose
Sedation
Anticholinergic
Low EPS
Thorazine

High Potency/ Low Dose =
Low Sedation
Low ACH
High EPS
Haldol

25
Q

Traditional

Fluphenazine & Haloperidol

Atypical
Risperidone, Aripiprazole, Paliperidone, Olanzapine

Have this in common

A

Long acting Antipsychotic Depot Injection LAI

Can last several weeks

26
Q

EPS

Onset of Pseudoparkisonism

Describe….

Treatment

A

Onset 5 hr - 30 days

Mask like face, stooped posture, shuffling Gait, drooling, tremor, pill rolling

Artane Trihexyphenidyl - antiparkinsons
Benadryl
Cogentin

27
Q

EPS

Acute dystonia

Onset 1 - 5 hrs

Sx….

Interventions

A

Opisthotonos Severe arching of back,head, and neck

Oculogyric crisis: Eye roll in back of head

Laryngeal Dystonia

Cogwheel rigidity:
Muscle stiffness characterized by a ratcheting or jerky resistance felt by an examiner when moving a patient’s limb passively,

Benadryl & Cogentin

28
Q

EPS

Akathisia uncontrolled racing thoughts & movements.

Risk….

Interventions…..

A

Risk Suicide

Interventions: Ativan, Inderal ( Propranolol) Benztropine ( Cogentin ) - Treats Parkinsons

29
Q

TD

SS

Chores & Athetoid ….. Describe

This screening tool…. How often

A

Choreic: Rapid purposeless irregular movement

Athetoid: Serpentine, writhing

AIMS: assesses the severity of involuntary movements in patients taking neuroleptic medications

Q3months

The AIMS is scored on a scale of 0–4, where 0 means none, 1 means minimal, 2 means mild, 3 means moderate, and 4 means severe. The total score on the AIMS is not reported to the patient

30
Q

Most serious SE of anticholinergic meds

Level of concern

Name other SE

Meds to help

A

Urinary Retention

High level of concern

Constipation, Blurred vision, photosentivuty, Sex Dysfunction, non reaction pupils, tachycardia, more psychosis, seizures, repeating motor movements

Meds: BZD / physostigmine

31
Q

Physostigmine

Use….

A

Antidote for anticholinergic effects

Also

acetylcholinesterase inhibitor which can enter and stimulate the central nervous system.

Physostigmine is used to treat glaucoma and delayed gastric emptying

Antidote for Datura & Belladonna poisoning

32
Q

Do antipsychotics cause issues with BP

When to hold…

Does this issue go away….

A

Yes, hypotension

Hold systolic <80 when standing

Subsides 1 - 2 wks

33
Q

Agranulocytosis can happen with any antipsychotics but is most likely with….

Give General parameters when to hold…

A

Clozapine

WBC < 3000
ANC < 1500

34
Q

NMS can happen due to antipsychotic use.

Whose at most risk

Which are SS

Flushing /Pallor
Drooling / dry mouth
Sweaty / Dry skin
EPS ?
Floppy muscles / Rigidity
Hypopyrexia /Hyperpyrexia
HTN / Hypotension
Tachycardia / Bradycardia
Diarrhea / Incontence
Stupor / Agitation
Coma / Seizures

A

LOL & younger males

Pallor
Drooling
Sweaty
EPS
Rigidity
Hyperpyrexia
HTN
Tachycardia
Incontence
Stupor
Coma

35
Q

Parlodel / Dantrium
Heparin
Cooling
Treat arrhythmias

Used for ….

A

NMS

36
Q

Fever
Encephalopathy (Confusion/ Disorientated)
Vital signs unstable Tachycardia/ Fluctuating BP
Enzyme elevated CPK
Rigidity

Describes

A

NMS

37
Q

Main SE of Atypical antipsychotics

Which is the exception

A

Weight gain.

Aripiprazole (abilify)

38
Q

Can antidepressants be used with antipsychotics….

A

Yes

As well as

Mood stabilizers & Antianxiety agents

39
Q

Depersonalization vs Derealization

A

Depersonalization = personal identity changed

Derealization = environment has changed

40
Q

Artane: Trihexyphenidyl

Maybe prescribed for….

A

Pseudoparkisonism

Also

Benadryl & Cogentin

41
Q

Physostigmine salicylate is ….

A

Anticholinergic toxicity reversal.

NURS 1446 Psych PART 2 (6 decks)

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