chapter 15 schizophrenia Flashcards
acute dystonia
common EPS. acute sustained contraction of muscles, usually of the head and neck
affective symptoms
symptoms involving emotions and their expression
dysphoria, suicidality, hopelessness
akathisia
common EPS. psychomotor restlessnessevident as pacing or fidgeting, sometimes pronouncedand very distressing to pts
anosognosia
many pts with schizophrenia experience anosognosia, an inability to realize they are ill that is caused by the illness itself.
associative looseness
disorganized thinking, jumbled and illogical speech and impaired reasoning
atypical antipsychotics
first line antipsychotics bcause they treat both the + and - symptoms of schizophrenia. minimal EPSs
risperdal, zyprexa, geodon, abilify
autism
thinking is not bound to reality but reflects the private perceptual world of the individual, delusions, hallucinations and neologisms are examples of autistic thinking
cognitive symptoms
abnormalities in how a person thinks
inattention, easily distracted, impaired memory, poor problem-solving skills, poor decision-making skills, illogical thinking, impaired judgment
concrete thinking
impaired ability to think abstractly
nurse: “what brought you to th hospital?” pt: “a cab”
conventional antipsychotics
traditional dopamine antagonists, also known as typical or first-generation antipsychotics
cause EPSs
effective against positive symptoms
thorazine
delusions
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.
depersonalization
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
delusions:
control
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
delusions:
ideas of reference
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
delusions:
persecution
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
delusions:
grandeur
believing that one is a very powerful or important person
sam believed he was a famous playwright and tennis pro
delusions:
somatic
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
delusions:
erotomatic
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
delusions:
jealousy
believing that one’s mate is unfatihful
harry wrongly accused his grilfriend of going out with other men.
derealization
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
echolalia
repeating of the last words spoken by another; imitation of the speech of another person
echopraxia
imitation of the movements of another person
hallucinations
perceiving a sensory experience for which no external stimulus exists
- auditory
- tactile
- olfactory
- gustatory
- visual
ideas of reference
referentiality; a pt might see a nurse talking to the psychiatrist and believe they are talking abt him
illusions
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
metabolic syndrome
includes weight gain, dyslipidemia and altered glucose metabolism; it is a significant concern in most atypical antipsychotics
negative symptoms
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)
neologisms
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
neuroleptic malignant syndrome NMS
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)
positive symptoms
presence of something that is not normally present
hallucinations, dlusions, disorganized speech(associative looseness), bizarre behavior
pseudoparkinsonism
EPS; medication induced, temporary constellation of symptoms associated with parkinson’s disease: tremor, reduce accesory movements, impaired gait, stiffening of muscles, “pill-rolling”
recovery model
it stresses hope, living a full and productive life, and eventual recovery rather than focusing on controlling symptoms and adapting to disability
negativism
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
tardive dyskinesia TD or TDK
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
word salad
jumble of words that is meaningless to the listener and perhaps to the speaker as well beacuse of an extreme level of disorganization
