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Schizophrenia > Chp17schizo > Flashcards

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
Q

Nursing diagnosis for schizophrenia

A

Defensive coping, disturb personal identity, social isolation, ineffective impulse control

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26
Q

What nursing diagnosis have been removed from Nanda

A

Disturbed thought processes and disturbed sensory perception

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27
Q

Determine realistic outcomes for client experiencing acute schizophrenia

A

Acute phase :overall goal is client safety and medical symptoms stabilization, medication adherence, enhance clients strengths and minimize client deficit

28
Q

Identify the main goals for clients during the maintenance and stabilization phases of treatment for schizophrenia

A

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
Q

Determine an appropriate basic level nursing interventions for clients with acute schizophrenia

A

Crisis intervention, safety, acute symptoms stabilization

30
Q

Implementation: goals of hospitalization

A

Safety is a priority, acute symptom stabilization /medication, crisis intervention

31
Q

Interventions for hallucinations

A

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
Q

Interventions for delusions

A

Don’t argue,don’t touch, offer food in closed containers,

33
Q

Standard antipsychotic

A

Are conventional traditional first generation and typical

34
Q

Examples of standards antipsychotics

A

Halodol, Thorazine and Prolixin

35
Q

Actions of standard antipsychotics

A

Target positive symptoms: block dopamine receptors also reduce the disturbing quality of delusions and hallucinations, decreases disruptive and violent behavior

36
Q

Common side effects of standard antipsychotics

A

Sedation, orthostatic hypotension, anti-cholinergic effects, photosensitivity, EPS extrapyramidal symptoms , pseudoparkinsonism, dystonias, akathasia

37
Q

Adverse effects of standard antipsychotic

A

Agranulocytosis, decreased seizure threshold, neuraleptic malignant syndrome, extrapyramidal symptoms, acute dystonic reaction, tardive dyskinesia

38
Q

Standard antipsychotic monitoring

A

Vital signs, level of sedation, white blood cell count, plus for side effects l

39
Q

Teaching for standard antipsychotic

A

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
Q

Anti-cholinergic effects

A

Impotence, dry mouth, blurred vision, urinary retention, constipation, tachycardia, esophageal reflux

41
Q

Atypical antipsychotic

A

Second generation, novel

42
Q

Examples of atypical antipsychotic

A

Clozaril, risperdal, zyprexa,seroquel, geodon,ability,saphris, latuda

43
Q

Actions of atypical antipsychotics

A

Target positive and negative symptoms, block dopamine receptors, some newer one stabilize dopamine, block serotonin receptors, allowing more dopamine to be released

44
Q

Common side effects of atypical antipsychotics

A

Increased weight gain, glucose dysregulation, hyper cholesterolemia, hypertension type two diabetes and metabolic syndrome

45
Q

Monitoring for atypical antipsychotics

A

Vital signs, level of sedation, white blood cell count, weight, blood sugar and lipid levels, plus for other side effects

46
Q

Pseudo Parkinsonism

A

Math like faces stiff and stooped posture shuffling gait drooling trimmer pill rolling phenomenon

47
Q

Pseudo parkinsonism onset

A

five hours to 30 days alert medical staff give Cogentin

48
Q

Oculogyric crisis

A

Eyes locked upwards

49
Q

Oculogyric crisis onset

A

1 to 5 days give Benadryl take patient to quiet area and stay until medicated

50
Q

Akathisia

A

Motor inner driven restlessness, tapping foot consistently, rocking forward and backward and chair, shifting weight from side to side

51
Q

Akathisia onset

A

Two hours to 60 days, give antiparkinsonian agent give Ativan or Valium or Inderal

52
Q

Tardive dyskinesia

A

Protruding and rolling tongue, blowing, smacking, licking, spastic facial distortion, smacking movement

53
Q

Tardive dyskinesia onset

A

Months to years, no known treatment discontinue drug encouraged to be screamed every three months

54
Q

Neurologic malignant syndrome

A

Severe muscle rigidity, oculogyric crisis, dysphasia, cogwheeling, elevated temp, hypertension, tachycardia, diaphoresis, incontinenace

55
Q

Neurological malignant syndrome onset and treatment

A

Can occur within the first week rapidly progressive over 2 to 3 days after initial manifestation, stop medication transfer to medical unit

56
Q

What are three major categories of symptoms for schizophrenia

A

Positive, negative, cognitive symptoms depression is almost always present

57
Q

The positive symptoms

A

Are more Florid and respond to antipsychotic therapy

58
Q

Negative symptoms

A

Are more debilitating and do not respond as well to antipsychotic therapy

59
Q

Interventions for people with schizophrenia

A

Communication guidelines, health teaching and health promotion, milia management and strategies, psychotherapy and pharmacological, biological and integrative therapies

60
Q

Halodol

A

Acute dystonic, 1-5 days, quiet area, Benadryl, cogentin

61
Q

Cogwheeling, muscle stiffness

A

Pseudoparkinsm, adedonhia, hrs-days, , cogentin round clock

62
Q

Clozaril

A

Temp, sore throat, agranulocytosis, 4-5wks give antipyretic, call dr, get WBC

63
Q

Restless jittery anxious

A

Akathesia, 2hr-60days give inderal, tell dr

64
Q

Neuroleptic syndrome

A

1st wk or longer progresses 2-3 days , stop drug, transfer

65
Q

Unusual facial grimacing , smacks lips

A

Tardive dyskinesia, months to years, discontinue drug, screen q3 month let dr know. Monitor

Schizophrenia (1 decks)

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