chapter 15 schizophrenia

Question 1

acute dystonia

Answer 1

common EPS. acute sustained contraction of muscles, usually of the head and neck

Question 2

affective symptoms

Answer 2

symptoms involving emotions and their expression

dysphoria, suicidality, hopelessness

Question 3

akathisia

Answer 3

common EPS. psychomotor restlessnessevident as pacing or fidgeting, sometimes pronouncedand very distressing to pts

Question 4

anosognosia

Answer 4

many pts with schizophrenia experience anosognosia, an inability to realize they are ill that is caused by the illness itself.

Question 5

associative looseness

Answer 5

disorganized thinking, jumbled and illogical speech and impaired reasoning

Question 6

atypical antipsychotics

Answer 6

first line antipsychotics bcause they treat both the + and - symptoms of schizophrenia. minimal EPSs

risperdal, zyprexa, geodon, abilify

Question 7

autism

Answer 7

thinking is not bound to reality but reflects the private perceptual world of the individual, delusions, hallucinations and neologisms are examples of autistic thinking

Question 8

cognitive symptoms

Answer 8

abnormalities in how a person thinks

inattention, easily distracted, impaired memory, poor problem-solving skills, poor decision-making skills, illogical thinking, impaired judgment

Question 9

concrete thinking

Answer 9

impaired ability to think abstractly

nurse: “what brought you to th hospital?” pt: “a cab”

Question 10

conventional antipsychotics

Answer 10

traditional dopamine antagonists, also known as typical or first-generation antipsychotics

cause EPSs

effective against positive symptoms

thorazine

Question 11

delusions

Answer 11

false fixed beliefs that cannot be corrected by reasoning. a person experiencing delusions is convinced that what he/she believes to be real IS real.

Question 12

depersonalization

Answer 12

a nonspecific feeling that a person has lost his/her identity and that the self is different or unreal.

a pt may see her fingers as snakes or her arms as rotting wood

Question 13

delusions:

control

Answer 13

believing that another person, group of people, or external force controls thoughts , feelings, impulses or behaviors

brian always wears a hat so that aliens don’t insert thoughts into his brain

Question 14

delusions:
ideas of reference

Answer 14

giving personal significance to trivial events; perceiving events as relating to you when they are not

when maria saw staff talking together, she believed they were plotting against her

Question 15

delusions:

persecution

Answer 15

believing that one is being singled out for harm by others, this belief often takes the form of a plot by pople in power

peter believed that the secret service was planning to kill him by poisoning his food. therefore, he would only eat food he bought from machines

Question 16

delusions:

grandeur

Answer 16

believing that one is a very powerful or important person

sam believed he was a famous playwright and tennis pro

Question 17

delusions:

somatic

Answer 17

believing that the body is changing in an unusual way, e.g. rotting inside

david told the doctor that his heart had stopped and his insides were rotting away

Question 18

delusions:

erotomatic

Answer 18

believing that another person desires you romantically

although he barely knew her, mary insisted that sam would marry her if only his current wife would stop interfering

Question 19

delusions:

jealousy

Answer 19

believing that one’s mate is unfatihful

harry wrongly accused his grilfriend of going out with other men.

Question 20

derealization

Answer 20

a false perception that the environment has changed.

everything seems bigger or smaller, or familiar surroundings have become somehow strange and unfamiliar

both depersonalization and derealization can be interpreted as loss of ego boundaries

Question 21

echolalia

Answer 21

repeating of the last words spoken by another; imitation of the speech of another person

Question 22

echopraxia

Answer 22

imitation of the movements of another person

Question 23

hallucinations

Answer 23

perceiving a sensory experience for which no external stimulus exists

• auditory
• tactile
• olfactory
• gustatory
• visual

Question 24

ideas of reference

Answer 24

referentiality; a pt might see a nurse talking to the psychiatrist and believe they are talking abt him

Question 25

illusions

Answer 25

misperceptions or misinterpretations of a real experience

a man sees his coat on a coar rack and believes it is a bear abt to attack. he does sees something real but misinterprets what it is

Question 26

metabolic syndrome

Answer 26

includes weight gain, dyslipidemia and altered glucose metabolism; it is a significant concern in most atypical antipsychotics

Question 27

negative symptoms

Answer 27

absence of something that should be present but is not

blunted affect, povery of thought(alogia), loss of motivation(avolition), inability to experience pleasure or joy(anhedonia)

Question 28

neologisms

Answer 28

made-up wordsthat have meaning for the pt but a different or nonexistent meaning to others

i was going to tell him the mannerologies of his hospitality won’t do

it represents disorganized thinking and interferes with communication

Question 29

neuroleptic malignant syndrome NMS

Answer 29

acute reduction in brain dopamine acitvity plays a role in its development. NMS is a life-threatening medical emergency

reduced consciousness, increased muscle tone(muscular rigidity), autonomic dysfunction(hyperpyrexia, hypertension, tachycardia, tachypnea, diaphoresis, drooling

discontinue antipsychotic med, transfer stat to medical unit, cooling blankets, alcohol/cool water/ ice bath, maintain hydration, administer parlodel(for muscle rigidity) and dantrium(for muscle spams)

Question 30

positive symptoms

Answer 30

presence of something that is not normally present

hallucinations, dlusions, disorganized speech(associative looseness), bizarre behavior

Question 31

pseudoparkinsonism

Answer 31

EPS; medication induced, temporary constellation of symptoms associated with parkinson’s disease: tremor, reduce accesory movements, impaired gait, stiffening of muscles, “pill-rolling”

Question 32

recovery model

Answer 32

it stresses hope, living a full and productive life, and eventual recovery rather than focusing on controlling symptoms and adapting to disability

Question 33

negativism

Answer 33

akin toreistance but may not be intentional. in active negativism the pt does the opposite or what he/she is told to do. passive negativism is a failure to do what is requested

Question 34

tardive dyskinesia TD or TDK

Answer 34

persistent EPS that usually appears after prolonged treatment and persists even after medication has been discontinued

involuntary tonic muscular contraction that involve the ongue, fingers, toes, neck trunk or pelvis.

no known treatment, pts should be screened q 3 months

Question 35

word salad

Answer 35

jumble of words that is meaningless to the listener and perhaps to the speaker as well beacuse of an extreme level of disorganization