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Chp17schizo Flashcards

1
Q

Schizophrenia

A

Person is ilL for at least six months with at least two of these five symptoms hallucinations delusions disorganized behavior disorganized speech and negative symptoms person does not have a significant manic or depressive symptoms and both substance use and general medical conditions have been ruled out

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2
Q

Schizo affective disorder

A

For at least one month these clients have had symptoms of schizophrenia at the same time they have prominent symptoms of mania or depression or both

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3
Q

Differentiate between schizophrenia and schizoaffective disorder and schizophrenia

A

And schizophrenia they do not have significant manic or depressive symptoms and schizoaffective disorder they do

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4
Q

Prodromal signs and symptoms

A

Maybe seen one month for one year before the onset of an acute psychotic break

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5
Q

Early signs of prodromal

A

social withdrawal deterioration in function depressed mode and strange ideas or believe increased stress anxiety sleep disturbance and eccentric behavior

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6
Q

Acute phase

A

Positive symptoms as well as negative symptoms and cognitive symptoms

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7
Q

Positive symptoms

A

Get our attention delusions hallucinations alterations in speech and bizarre behavior

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8
Q

Delusions

A

False fixed believes that cannot be corrected by reasoning ideas of reference persecution grandiosity somatic sensations jealousy

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9
Q

Hallucinations

A

Sensory perceptions for which no external stimulus exist auditory visual factory gustatory tactile

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10
Q

Command hallucinations

A

often command the person to herself or others and may signal a psychiatric emergency

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11
Q

Alterations in speech

A

Associative looseness, neologism, echolalia, clanging, word salad

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12
Q

Neologism

A

Are made up words that have special meaning for the person

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13
Q

Ecolalia

A

Pathological repeating of another word my imitation and often seen in Catalonia

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14
Q

Bizarre behavior

A

Eccentric dress grooming and rituals catatonia and agitation

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15
Q

Catalonia

A

Extreme abnormal motor behavior or psychomotor retardation

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16
Q

Distinguish between positive and negative symptoms of schizophrenia

A

Positive are delusions hallucinations disorganized speech or associative looseness or bizarre behavior, negative symptoms are blunted affect Alogia-poverty of thought avolution-loss of motivation or anhedonia-inability to experience pleasure on joy

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17
Q

Negative symptoms

A

Do not get our attention something taken away from the person

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18
Q

Negative symptoms

A

Affect flattening or blunting alogia, avolution ,anhedonia or associality

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19
Q

Affect flattening or bunting

A

I’m changing facial expressions poor eye contact lack of vocal inflections

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20
Q

Alogia

A

Property of thought content in speech thought blocking

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21
Q

avolition

A

Apathy, anergia , impaired grooming, lack of persistence at work or school

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22
Q

Anhedonia

A

Do you interests, impaired intimacy, a few relationships, social and attentiveness

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23
Q

Cognitive symptoms

A

A better predictor of the clients ability to function

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24
Q

Signs of cognitive symptoms

A

Inattention, poor judgment, easily distracted, poor problem-solving, impaired memory, impaired judgment

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25
Nursing diagnosis for schizophrenia
Defensive coping, disturb personal identity, social isolation, ineffective impulse control
26
What nursing diagnosis have been removed from Nanda
Disturbed thought processes and disturbed sensory perception
27
Determine realistic outcomes for client experiencing acute schizophrenia
Acute phase :overall goal is client safety and medical symptoms stabilization, medication adherence, enhance clients strengths and minimize client deficit
28
Identify the main goals for clients during the maintenance and stabilization phases of treatment for schizophrenia
Medication adherence/compliance, psycho education for client and family, relapse prevention skills/recognition, social interpersonal coping and vocational skills training, community supports, enhance clients strengths and minimize client deficit
29
Determine an appropriate basic level nursing interventions for clients with acute schizophrenia
Crisis intervention, safety, acute symptoms stabilization
30
Implementation: goals of hospitalization
Safety is a priority, acute symptom stabilization /medication, crisis intervention
31
Interventions for hallucinations
Head tilting watch for staring sideways changes in facial expressions ask if they are hallucinating document what they say, tell the voices to go away, help patient focus on reality-based topics
32
Interventions for delusions
Don't argue,don't touch, offer food in closed containers,
33
Standard antipsychotic
Are conventional traditional first generation and typical
34
Examples of standards antipsychotics
Halodol, Thorazine and Prolixin
35
Actions of standard antipsychotics
Target positive symptoms: block dopamine receptors also reduce the disturbing quality of delusions and hallucinations, decreases disruptive and violent behavior
36
Common side effects of standard antipsychotics
Sedation, orthostatic hypotension, anti-cholinergic effects, photosensitivity, EPS extrapyramidal symptoms , pseudoparkinsonism, dystonias, akathasia
37
Adverse effects of standard antipsychotic
Agranulocytosis, decreased seizure threshold, neuraleptic malignant syndrome, extrapyramidal symptoms, acute dystonic reaction, tardive dyskinesia
38
Standard antipsychotic monitoring
Vital signs, level of sedation, white blood cell count, plus for side effects l
39
Teaching for standard antipsychotic
Acute dystonia give Benadryl for muscle oculargyric dystonia are:eyes move up, acute: eyes don't move back, don't give round clock, prn
40
Anti-cholinergic effects
Impotence, dry mouth, blurred vision, urinary retention, constipation, tachycardia, esophageal reflux
41
Atypical antipsychotic
Second generation, novel
42
Examples of atypical antipsychotic
Clozaril, risperdal, zyprexa,seroquel, geodon,ability,saphris, latuda
43
Actions of atypical antipsychotics
Target positive and negative symptoms, block dopamine receptors, some newer one stabilize dopamine, block serotonin receptors, allowing more dopamine to be released
44
Common side effects of atypical antipsychotics
Increased weight gain, glucose dysregulation, hyper cholesterolemia, hypertension type two diabetes and metabolic syndrome
45
Monitoring for atypical antipsychotics
Vital signs, level of sedation, white blood cell count, weight, blood sugar and lipid levels, plus for other side effects
46
Pseudo Parkinsonism
Math like faces stiff and stooped posture shuffling gait drooling trimmer pill rolling phenomenon
47
Pseudo parkinsonism onset
five hours to 30 days alert medical staff give Cogentin
48
Oculogyric crisis
Eyes locked upwards
49
Oculogyric crisis onset
1 to 5 days give Benadryl take patient to quiet area and stay until medicated
50
Akathisia
Motor inner driven restlessness, tapping foot consistently, rocking forward and backward and chair, shifting weight from side to side
51
Akathisia onset
Two hours to 60 days, give antiparkinsonian agent give Ativan or Valium or Inderal
52
Tardive dyskinesia
Protruding and rolling tongue, blowing, smacking, licking, spastic facial distortion, smacking movement
53
Tardive dyskinesia onset
Months to years, no known treatment discontinue drug encouraged to be screamed every three months
54
Neurologic malignant syndrome
Severe muscle rigidity, oculogyric crisis, dysphasia, cogwheeling, elevated temp, hypertension, tachycardia, diaphoresis, incontinenace
55
Neurological malignant syndrome onset and treatment
Can occur within the first week rapidly progressive over 2 to 3 days after initial manifestation, stop medication transfer to medical unit
56
What are three major categories of symptoms for schizophrenia
Positive, negative, cognitive symptoms depression is almost always present
57
The positive symptoms
Are more Florid and respond to antipsychotic therapy
58
Negative symptoms
Are more debilitating and do not respond as well to antipsychotic therapy
59
Interventions for people with schizophrenia
Communication guidelines, health teaching and health promotion, milia management and strategies, psychotherapy and pharmacological, biological and integrative therapies
60
Halodol
Acute dystonic, 1-5 days, quiet area, Benadryl, cogentin
61
Cogwheeling, muscle stiffness
Pseudoparkinsm, adedonhia, hrs-days, , cogentin round clock
62
Clozaril
Temp, sore throat, agranulocytosis, 4-5wks give antipyretic, call dr, get WBC
63
Restless jittery anxious
Akathesia, 2hr-60days give inderal, tell dr
64
Neuroleptic syndrome
1st wk or longer progresses 2-3 days , stop drug, transfer
65
Unusual facial grimacing , smacks lips
Tardive dyskinesia, months to years, discontinue drug, screen q3 month let dr know. Monitor

Schizophrenia (1 decks)

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