exam 3 Flashcards
what are delusions? how are they different from hallucinations?
a false fixed belief that has no evidence to support it; however, the person cannot be
persuaded that the belief is incorrect, they are different because hallucinations are sensory experiences and delusions are saying something that is not true and believing it
what are the types of hallucinations?
auditory hallucinations are the most common in schizophrenia,
types:
-visual, olfactory, tactile, gustatory, auditory
hallucinations occur when the person is fully conscious and appear to them to come from an outside source.
therapeutic communication with client experiencing delusions or hallucinations
assess and intervene to maintain safety – suicide, violence, physiological stability
establish trusting relationship with patient and family, recognize suspicious and paranoid behaviors by the client as part of the illness, fear of the hostile or aggressive patient, frustration with client for not adhering to medication regimen,
you are not expected to have all of
the answers and solutions
types of delusion:
-persecutory Delusions: The person feels he or she is being plotted or discriminated against, spied on, threatened, attacked or
deliberately victimized. This is the most common form of psychotic delusion.
-grandiose Delusions: The person believes he or she has enormously superior characteristics or is a person of great power or fame.
-delusions of reference: Also common, these symptoms occur when a person attaches special personal meaning to television broadcasts, music, or newspaper articles- they may believe
television sets are talking to them or that people are sending thoughts to them.
-somatic delusions: unrealistic beliefs about their own health or
bodily functions.
what are disordered speech patterns?
disorganized thinking resulting in someone having schizophrenia
tangential:
the person’s ideas are only loosely connected to the topic, i.e. there are “loose associations” between expressed ideas and one thought or statement does not logically follow the other
neologisms:
the person makes up new words that have meaning only to them
circumstansial:
provides unnecessary detail but does return to the point
perseveration:
adherence to a single idea or topic, and verbal repetition of the sentence phrase or word even when attempts are made to change the topic
word salad:
the person’s language can become so disordered as to be incomprehensible, a senseless jumble of words
flight of ideas:
the person’s ideas rapidly shift from one subject to another and are not related at all, however he or she believes the incoherent statements make perfect sense
Antipsychotic medication side effects
electrocardiogram (ECG) changes-
prolong QT interval
neuroleptic malignant syndrome (NMS)
agranulocytosis-severe low white blood
count
extrapyramidal symptoms (EPS)
-pseudoparkinsonism
-akathisia-state of agitation, distress
and restlessness
-dystonia-muscles contract
involuntarily
-tardive dyskinesia-movements appear in the eyes, lips, tongue and jaw
weight gain
positive (add to) symptoms of schizophrenia
delusions, hallucinations, grossly disorganized thinking, speech, and behavior
negative (take away) symptoms of schizophrenia
flat affect, lack of volition (making a decision), social withdrawal, low energy, anhedonia (lack of interest)
bipolar 1 disorder (manic
depressive disorder)
will experience a full manic episode
excessive cheerfulness or elevation in mood, extreme mood fluctuations from mania to depression, manic episodes begin suddenly, last from a few weeks to several months, manic episodes-pressured speech, sleeplessness, impulsiveness, grandiose
bipolar 2 disorder
will experience only a hypomanic episode (a period that’s less severe than a full manic episode), the “up” moods never reach full blown mania
-hypomania: period of milder expansive or irritable mood, milder symptom of mania
nursing interventions for client experiencing mania
provide a safe environment, meet physiological needs, therapeutic
communication, promote appropriate behaviors, manage medications, educate client and family
anorexia nervosa characteristics and difference between bulimia
refusal or inability to maintain minimal normal body weight, intense fear of gaining weight or becoming fat, significantly disturbed perception of body shape or size, steadfast inability or refusal to acknowledge seriousness of problem or even that one exists, anorexia starves on purpose, very thin, some may use laxatives
bulimia nervosa characteristics and differences between anorexia
recurrent episodes of binge eating (secretive); compensatory behaviors to
avoid weight gain (purging, use of laxatives, diuretics, enemas, emetics,
fasting, excessive exercise), recognition of behavior as pathologic; feelings of guilt, shame, remorse, contempt, usually normal weigh, bulimia binge eating followed by purging, average weight, heavy meals followed by purging, guilt
be familiar with terms in chapter 20 for eating disorders
purging: making self throw up
anorexia: eat too little
bulimia: eat too chaotically
obesity: eat too much
symptoms of major depressive disorder
changes in eating habits → weight gain or loss, hypersomnia or insomnia, impaired concentration, decision making, or
problem solving, worthlessness, hopelessness, despair, guilt, thoughts of death/suicide, overwhelming fatigue, negative thinking, anhedonia, at least 2 weeks
suicide risk factors
deliberate non-suicidal behaviors
intended to cause self-harm, family history, may be seen as an acceptable behavior, previous attempts Feelings of
hopelessness, isolation, barriers to
accessing mental health treatment, history of alcohol or substance use disorders
cluster a personality disorders: odd or eccentric behaviors “accusatory”
-paranoid personality
disorder
-schizoid personality
disorder
-schizotypal personality
disorder
may have trouble forming close relationships and may have odd or cold traits that can lead to criticism from others
cluster b personality disorder: erratic or dramatic behaviors “wild”
-antisocial personality
disorder
-borderline personality
disorder
-histrionic personality disorder
-narcissistic personality
disorder
dramatic, impulsive, and emotional behaviors and thoughts
cluster c personality disorder: anxious or fearful behaviors “worried”
-obsessive personality
disorder: compulsive
-avoidant personality disorder: cowardly
-dependent personality
disorder: clingy
cause persistent and harmful patterns of behavior and thinking, affecting how individuals perceive themselves and interact with others
nursing interventions for personality disorders
be cautious and avoid patient attempts to use manipulation or splitting
techniques, use clear communication, set limits, boundaries, and realistic goals, deal with frustration: patients change slowly yet “look” like they are capable
of better behavior, work effectively as part of team; consistency is essential
the following four slides are what type of disorder?
somatic symptom illnesses
conversion disorder:
involves unexplained, usually sudden deficits in sensory or motor
function (blindness, paralysis), client is usually indifferent or shows a lack of distress to the functional loss
pain disorder:
client complaints of physical pain that is not relieved by pain medications, greatly affected by psychological factors in terms of onset, severity, exacerbation, and maintenance
hyperchondriasis
defined as the preoccupation with the fear that one has or will contract a serious and possibility life threatening disease, clients often misinterpret bodily sensations or functions
somatic symptom disorder
when a person has a significant focus on physical symptoms, such as pain, weakness or shortness of breath, to a level that results in major distress and/or problems functioning
nursing Interventions for clients with somatic disorders
psychoeducation, cognitive behavioral therapy, medications, symptomatic measures, encourage functional behaviors, goals, help express emotions
and validate feelings; journaling; limiting
time spent on physical complaints
be familiar with factitious disorder
characterized by physical symptoms that are feigned or self inflicted for the sole purpose of drawing attention to oneself and gaining emotional benefits of assuming the sick role
Munchausen Syndrome and Munchausen Syndrome by Proxy (imposed on someone else so they can be a hero or get sympathy from people)
what is malingering?
feigning (or pretending to be affected by) physical symptoms for some external gain such as avoiding work
Review Professor Coates Power Point on Community Health
https://learn.radford.edu/d2l/le/content/247888/viewContent/4023233/View
somatization
is the transference of mental experiences and states into bodily symptoms
hysteria
multiple physical complaints with no organic basis
psychosomatic
connection between mind (psyche) and body (soma)
