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3-Third semester > DONE-mental health lp5- schizophrenia > Flashcards

DONE-mental health lp5- schizophrenia Flashcards

1
Q

Schizophrenia- Biological/Neurological causes

g

too much d/s

g

a

A

Genetic-

Too much dopamine or serotonin

Glutamate (PCP induces similar symptoms)

Acetylocholin

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2
Q

Schizophrenia cause- brain structure

disruptions in

might be differences in

A

Disruptions of communication w/ pathways

There might be structural differences with the brain

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3
Q

Schizophrenia cause
Psychological and Environmental

complications

i

what stress

older

hx of

toxins->

A

Prenatal complications (Folate and hypoxia)

Infections

Psychological stress to mother during pregnancy

Older father

Hx of sexual abuse, social adversity, trauma or social defeat

Toxins (Tetrachloroethylene)

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4
Q

Comorbidities

a

abuse
d
possible

health illnesses-5

p ()behaviors

A

Anxiety

substance abuse

Depression

Possible suicide

Health illnesses – HTN, obesity, CVD, DM, COPD

Polydipsia -constant thirst from meds— obsessive behaviors over water- can kill pt because of water intoxication and hyponatramia

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5
Q

schizo
course of disorder-common in

prognosis

prepare

A

course- starts usually 15-25 in males

prognosis- will always have disease and most likely relapses

prepare family for relapses

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6
Q

prodromal phase of schizo

alterations

person

well before

A

mild alterations in though and mood

person may not feel right or like something is wrong

wellbefore actual attacks

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7
Q

actue phase of schizo

what is it

may need

coping/ others

A

onset of s/s,

may need hospitalization

difficulty coping and symptoms become apparent to others

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8
Q

stabalization phase of schizo

symtoms

tx where

A

Symptoms diminishing- previous level of functioning

outpatient tx

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9
Q

maintenance phase of schizo

A

near baseline

positive symptoms are diminihsed

negative continue to be a concern

will be able to live independently

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10
Q

assessment in prodromal phase

what’s key

what can reduce risk

A

early assessment is key

reducing risk factors like stress or abuse can reduce risk of developing schizo

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11
Q

Schizophrenia- 4 a s

A

affect

associative looseness

autism

ambivalence

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12
Q

4-a’s affect
schizo classic signs

__or__ affect

this is

A

inappropriate or bizarre affect

This is the outward manifestations of a person’s feelings

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13
Q

4-a’s associative looseness
schizo classic signs

what kind of thinking

what kind of reasoning

A

Disorganized thinking

Jumbled, illogical and impaired reasoning

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14
Q

4-a’s autism
schizo classic signs

thinking

ANd

A

thinking is not reality

hallucinations and delusions

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15
Q

4-a’s ambivence
schizo classic signs

two

A

Two opposing emotions toward someone

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16
Q

positive symptoms definition in schizo

A

project very early and are usually very dramatic so they will be caught right away

what most people associate with mental illness

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17
Q

concrete thinking

Schizophrenia – 1st - Positive symptoms

A

very black or white

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18
Q

reality testing

positive symptoms

A

lose ability to determine what is real and what is fake

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19
Q

delusions

positive symptoms

A

false beliefs that are held despite a lack of evidence to support them.

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20
Q

Neologisms-Alterations in speech
words that
or create

Schizophrenia –1st - Positive symptoms

A

words that have different meaning to pt then to you

or create a new words that doesn’t make. sense

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21
Q

Echolalia-Alterations in speech

Schizophrenia –1st - Positive symptoms

A

Repeating words that the nurse says

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22
Q

Echopraxia Alterations in speech

Schizophrenia –1st - Positive symptoms

A

mimicking of movements

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23
Q

Clang association

chooses words

usually

A

chooses words based on sounds rather then what they mean

usually the beginning or end the same

“on track big mac”

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24
Q

Word salad

A

(Jumble of words that makes no sense

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25
Q

depersonalization

alterations in perception
Schizophrenia –Positive symptoms

A
  • Their body is not their own
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26
Q

Derealization

positive symptoms

A
  • Surrounding have changed
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27
Q

illusions

Schizophrenia Assessment –
Positive symptoms
alterations in perception

A
  • Misinterpretations of realty
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28
Q

hallucinations

-types

visual-

boundary

Schizophrenia Assessment –
Positive symptoms
alterations in perception

A

types all 5 senses

-Visual- see things that do not exist/ are not real

-Boundary (don’t know where body end

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29
Q

command hallucinations

A

tell the person to take action

like pee in public or kill nurse

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30
Q

motor retardation

Alterations in Behavior
Schizophrenia – Positive symptoms

A

pronounced slowing of movement

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31
Q

catatonia

positive symptoms-alterations in thought

A

pronounced increase or decrease in rate of movement

most common is when person moves little to no

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32
Q

motor agitation

Alterations in Behavior
Schizophrenia – Positive symptoms

A

excited behavior like running to pacing in response to stimuli

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33
Q

negatism- a/p

Alterations in Behavior
Schizophrenia – Positive symptoms

A

-Active (doing opposite)
- Passive (not doing)

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34
Q

impaired impulse control

positive

A
  • Reduced ability to resist one’s impulses
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35
Q

schizo assess 2nd

negative symptoms defintion

A

develop slowly and are life altering

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36
Q

Anhedonia

negative symtoms

A

reduced ability to expeircne pleasure

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37
Q

Avolition

negative symtpms

A

reduced motivation

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38
Q

Asociality

negative symtpms

A

decreased desire for social interaction

39
Q

Affective blunting:

negative symtpms

A

reduced affect

40
Q

Apathy

negative symtpms.

A

decreased interests in activities

41
Q

Alogia

negative symtpms

A

reduction in speech

42
Q

–Interfere most with person’s ability to cope–

c
e
d/f
h/g

schizo negative symptoms

A

Conversations- cant really talk to people

Employment- cant hold a job

Decisions and follow-through

Hygiene and grooming- might have to do everything for them

43
Q

flat affect
schizo negative symptoms

A

(Blank)

44
Q

Blunted affect

schizo negative symptoms

A

(minimal emotional response)

45
Q

Inappropriate affect

schizo negative symptoms

A

(doesn’t match the situation)

46
Q

Bizarre affect

tell them

schizo negative symptoms

A

(odd, illogical)

tell them what is reality- tell the voices to go away

47
Q

3rd- cognitive

concrete thinking-only

memory-has/ needs lots

information processing has//reduce

dm, j, p

Schizophrenia –cognitive symptoms

A

concrete thinking-only thinks in black and white

Memory- have short term memory- needs lots of repetition

Information processing-has delayed responses- reduce stimuli

Decision making, judgment and planning- not really functional

48
Q

4th - Affective

d
s a
risk

Schizophrenia affective symptoms

A

Depression

Substance abuse

Risk for suicide

49
Q

Schizophrenia Self Assessment

strong
n

A

Strong emotional reactions in healthcare workers

Negativism-might bring out anxiety and fear in nurses

50
Q

assessment guidline

ensure a full

asses for anything __

assess what disorders

complete a

assess

assess risk of

assess prescribed

A

ensure a full medical workup

assess for medical problem that might mimic

assess fir substance or alc disorders

complete mental status examination

assess hallucinations and delusions

assess suicide risk

assess prescribed meds

assess family knowledge

51
Q

acute phase goal

how to

want them to

A

Goal is patient safety and stabilization

how to keep patient safe and away from harm

want them to recognize hallucinations are not real

52
Q

Stabilization

goal

A

Goal is to adhere to tx and meds

53
Q

1 risk factor

Maintenance goal

goal is to

will happen

A

Goal is preventing relapse

relapses will happen and be aware of it to catch it before it gets out of control

noncompliance is #1 risk factor for relapse

54
Q

partial
residential
houses
day
looking for

Schizophrenia implementation acute settings

A

Partial hospitalization

Residential crisis centers

Halfway houses

Day treatment programs

looking for activities and safety

55
Q

p t
s
l s
e

Schizophrenia implementation Interventions

A

Pharmacological treatments

Supervision

Limit setting

Evaluations

56
Q

Stabilization and Maintenance Phases

provided through

types

Schizophrenia implementation

A

provided through community health centers

med support, monitoring, activités,

57
Q

Milieu Management

a therapeutic

environment that

A

a therapeutic milieu provides structure and boundaries

environment that maximizes safety and opputrinity for practicing skills

58
Q

therapeutic communication

lowers
build
encourages
enchases

Counseling and Communication

A

Lower anxiety

Building trust

Encouraging interactions

Enhancing self-esteem

59
Q

understand what

do not/offer

focus on

also need to//call/speak/convey

how do you help with pt experiencing hallucinations

A

understand what they are seeing to know severity

do not negate expierence- offer your perspective and empathy

focus on here/now- conversations

also needs to call pt by name and speak simple and convey support

60
Q

how do you help with pt experiencing delusions

get
do not
build
focus on
use

A

get pt to describe beliefs

do not debate

build trust

focus on the feelings of the delusions

use reality based interventions

61
Q

nurse needs
tell
sum
speak

how do you help with pt expeircne associative looseness

A

nurse needs to be the one having trouble understanding, not the patient

tell the patient what you do understand

summarize pts communications

speak clearly

62
Q

family and pt teaching

regular
take
minimize
maintain
keep

A

regular contact with supportive individuals

take care of ones health

minimize tobacco

maintain a stable weight

keep active

63
Q

First generation/ conventional /typical Antipsychotic agents

what type of med
treats
used less why
cost

A

Dopamine receptor antagonists-haloperidol

Treat positive symptoms- delusions and hallucinations

Used less because of failure to treat negative symptoms

Less $

64
Q

low potency first generations

c
t

A

Chlorpromazine

Thioridazine

65
Q

medium potency first generations

l
p

A

loxapine

Perphenazine

66
Q

high potency first generations

h
f
p
t
t

A

haloperidol

Fluphenazine

Pimozide

Thiothixene

Trifluoperazine

67
Q

2nd Generation/atypical (serotonin-dopamine antagonists)

why first line
takes
little to no

Antipsychotic agents

A

First line due to treating positive and negative symptoms

Take 2-6 weeks to work

Little or no EPS

68
Q

examples of second generation antipshycitocs

3 types of meds

A

‘one’

“prazole”

“ine”

69
Q

dry mouth

encourage
also give what
dont want to take
is it Lethal

side effects of antipsychotic medications

A

encourage ingestion of ice chips/water

sugarless candy/gum

dont want any caffeine, alcohol

nonlethal

70
Q

urinary retention and hesitancy

what scan/ possible what
what schedule
running what
is it lethal

side effects of antipsychotic medications

A

bladder scan// posible catheter

bathroom schedule

running water and a warm moist towel

nonlethal

71
Q

constipation

ensure
promote
consider
is it lethal

side effects of antipsychotic medications

A

ensure adequate fluid/fiber intake

promote physical activity

consider laxitives

nonlethal

72
Q

blurred vision

lasts
use
if intolerable
is it lethal

side effects of antipsychotic medications

A

lasts 1-2 weeks

use reading or magnifying glasses

if intolerable may cause med change

nonlethal

73
Q

sexual dysfunction

consult for

artificial

is it lethal

side effects of antipsychotic medications

A

consult prescriber for alterative medicine to help for ed

artificial lubricants for dryness

nonlethal

74
Q

anticholinergic toxicity s/s

reduced
urinary
hyper
d
cardia
unstable

A

reduced peristalsis

urinary retention

hyperpyrexia-hot skin

delerium

tachycardia

unstable vital signs

75
Q

anticholinergic toxicity

is it life threatening
meds
emergency
if needed
adminster
what is the reversal agent

side effects of antipsychotic medications

A

life threatening

hold all meds

emergency cooling measures

urinary Cath if needed

admisnter benzos

phygostimine -reversal

76
Q

pseuodparkinism s/s

A

pill rolling posture

tremors

stiff and stooped posture

77
Q

Pseudoparkinsonism

administer
if intolerable
provide
is it lethal

side effects of antipsychotic medications

A

adminster antiparkisnons

if intolerable consult about dosage change

provide towel or handkerchief

nonlethal

78
Q

acute dystonic reactions s/s

A

eyes roll back

laryngeal dystonia-airway

spams causing backwards arching

painful contractions

79
Q

acute dystonic reactions

monitor for
reassure
admisnter
stay
assist pt

side effects of antipsychotic medications

A

monitor for open airway

reassure that they are non life threatening

adminster antiparkinsons

stay with pts

assist pt to keep up with meds

80
Q

akathisia s/s

A

motor restlessness

81
Q

akathisia

consult
give
whaat meds help
in severa cases
usually subsides when

side effects of antipsychotic medications

A

consult about med chnage

give antiparksinons agent

propranolol, lorazepam, diazepam

in severe cases may contribute to suicidality

usually subsudes when med is discontinued

82
Q

tardive dyskinesia s/s

tongue
movements
movements
movements

A

protruding tongue and licking

irregular movemtns

slow movements

neck/shoulder movements

83
Q

tardive dyskenisa

discontinuing
adminster
screen how often

side effects of antipsychotic medications

A

discontinuing rarely relieves symptoms

administer nazines as order

screen every 3 months

84
Q

orthostatic hypotension

monitor
hold
rise
ensure
subsides when

side effects of antipsychotic medications

A

monitor lying/standing bp

hold dose when bp under 80

rise slowly

ensure hydration

subsided 1-2 weeks

85
Q

severe neutropenia

s/s

check labs -first 6months/next 6 months
drug
observe for

side effects of antipsychotic medications

A

s/s are increased infections

check labs weekly for 6 months
check labs monthly for 6

hold drug and potential new med

observe for s/s of an infection

86
Q

cholesatic jaundice s.s

first week

then what

A

fever malaise nausea ab pain fist week

jaundice 1 week later

87
Q

cholestatic jaundice

consult
tests
diet

side effects of antipsychotic medications

A

consult about med change

liver function tests every 6 months

high protein high carb diet

88
Q

NMS s/s

severe
hyper
d
tension/cardia
dys

A

severe muscle rigidity

hyperreprexia- fever over 103- always assess them first

delirium

hypertension, tachycardia

dysphagia

89
Q

NMS
is it life threatening
reversal agents
what to temp
maintain
what to antipshyotics

side effects of antipsychotic medications

A

life threatening medical emergency

bromoctripine and dantrolene are reversal agents

cool body to reduce fever

maintain hydration

hold all antisphyotics

90
Q

metabolic syndrome s/s

wt
dys
increased

A

wt gain

dyslipedemia

increased insulin resistance

91
Q

metabolic syndrome

minimize
what’s used for diabetes
teach about.

side effects of antisphyoctocs

A

minimize wt gain through nutrition and activity

metformin is used to reduce diabetes

teach the pt and family about importance of regular medical evaluation to correct anything necessary

92
Q

When to change regimen

A

no improvement

dangerous/intolerable side effects

93
Q

Complementary and alternative medicine

A

Family Therapy
* Psycho-educational Approach
* Community Programs
* Exercise
* Nutrition
* Animal Therapy
* Transcranial Magnetic Stimulation
* Music Therapy

3-Third semester (13 decks)

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