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Family Concepts II - 2130 > Exam II > Flashcards

Exam II Flashcards

1
Q

_____ is refusing to admit reality or what is really occurring

A

Denial

I.e. Alcoholic denies having a problem because they can still function or man puts plate at table for dead spouse

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2
Q

_____ is attributing one’s own unacceptable qualities or feelings and attributing them to another

A

Projection

I.e. Spouse angry at SI for not listening when they are the one not listening

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3
Q

_____ is the inability to integrate the positive and negative qualities of oneself or others into a cohesive image (can’t view positive/negative as a whole)

A

Splitting

I.e. Pitting two people against one another

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4
Q

_____ is avoiding conscious experience of the emotion through impulse action

A

Acting out

I.e. Instead of feeling sad or angry a person gets drunk

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5
Q

_____ is the transformation of emotion into bodily symptoms

A

Somatization

I.e. Woman feels body aches and pains when husband goes out of town

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6
Q

_____ is reverting to an earlier more primitive and childlike pattern or behavior that may or may not have been previously exhibited.

A

Regression

Child wets bed after parents divorce

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7
Q

_____ _____ is taking up the opposite feeling, impulse, or behavior in order to reduce anxiety

A

Reaction formation

I.e. Treating someone you don’t like in a friendly manner to hide true feelings

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8
Q

_____ is the process in which the focus is on the intellectual component rather than the emotional or stressful emotion

A

Intellectualization

I.e. Person given terminal diagnosis, instead of expressing sadness they focus on all possible fruitless medical procedures

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9
Q

_____ is the unconscious exclusion of unpleasant or unwanted experiences, emotions, or ideas from conscious awareness.

A

Repression

I.e. Child can’t remember abuse from parents

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10
Q

_____ is transference of emotions associated with a particular person, object, or situation to another non-threatening person, object, or situation

A

Displacement

I.e. Man gets angry at work and comes home and kicks dog

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11
Q

_____ is explaining an unacceptable behavior or feeling in a rational or logical manner

A

Rationalization

I.e. Didn’t get job because boss was playing favorites

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12
Q

_____ is avoiding emotional distress through an altered state of consciousness

A

Dissociation

I.e. Person can’t remember a block of time and doesn’t remember what happened

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13
Q

_____ is an attempt o take back an unconscious behavior or thought that is unacceptable or hurtful

A

Undoing

I.e. Send flowers after fight

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14
Q

_____ is a dedication to meeting the needs of others and gratification from the response of others

A

Altruism

I.e. Woman gives money to charity to help the homeless

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15
Q

_____ is counterbalance perceived deficiencies by emphasizing strengths

A

Compensation

I.e. Person who can’t cook but instead is very organized

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16
Q

_____ is pointing out funny or ironic aspects of a situation to express feelings

A

Humor

I.e. Uses self-deprecating humor to put others at ease

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17
Q

_____ converts unacceptable impulses into more acceptable impulses

A

Sublimation

I.e. A person with extreme anger goes t gym to box

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18
Q

_____ is the conscious removal of unwanted information out of awareness

A

Suppression

I.e. Elderly man caring for a dying spouse who feels chest pain ignores it so he can take care of her

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19
Q

_____ is the unconscious modeling of one’s self upon another persons character and behavior

A

Identification

I.e. 15 year old thinks she needs to act like her 21 year old sister by engaging in drinking and partying like her

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20
Q

What are the five principles of motivational interviewing?

A 
Express empathy,
Develop discrepancy,
Avoid argumentation,
Roll with resistance,
Support self-efficacy
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21
Q

What are the signs of resistance?

A

Arguing,
Interrupting,
Ignoring,
Denying

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22
Q

Challenging, discounting and hostility are considered _____

A

Arguing

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23
Q

Talking over or cutting off are signs of _____

A

Interrupting

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24
Q

Inattention, not answering, not responding, and sidetracking are considered _____

A

Ignoring

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25
Q

Blaming, disagreeing, making excuses, claiming impunity, minimizing, being pessimistic, reluctance, and unwillingness to change are _____

A

Denying

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26
Q

What is CAGE and what does it stand for?

A

Screening for alcoholism

Has anyone asked you to Cut down on your drinking?
Have people Annoyed you by criticizing your drinking?
Have you ever felt bad or Guilty about your drinking?
Have you ever had a drink first thing in the morning to get rid of hangover or steady your nerves (Eye opener)?

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27
Q

Stages of change

A 
Precontemplation,
Contemplation,
Preparation,
Action,
Maintenance,
Relapse
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28
Q

In _____ there is no intention of changing behavior

A

Precontemplation

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29
Q

In _____ a person is aware a problem exists but has no commitment to action

A

Contemplation

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30
Q

In ______ there is an intent to take action

A

Preparation

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31
Q

In the _____ stage a person is active in modifying their behavior

A

Action

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32
Q

In the _____ stage change is sustained and new behaviors replace old behaviors

A

Maintenance

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33
Q

In the ______ stage a person falls back into old patterns of behavior

A

Relapse

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34
Q

Intrusive thoughts, apprehension, uncertainty, dread and autonomic responses relating to the future is _____

A

Anxiety

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35
Q

_____ is a function of worry or thoughts about the past

A

Depression

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36
Q

Anxiety is most prevalent among which age group?

A

30-44

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37
Q

Which race and gender have higher prevalence of anxiety?

A

Non-Hispanic whites,

Female

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38
Q

What are the risk factors for anxiety?

A

Medical conditions,
Environment (culture, trauma),
Genetics (twins)

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39
Q

What are the brain structures affected by anxiety?

A

Amygdala, GABA

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40
Q

_____ occurs when a person feels anxiety about a situation such as the marketplace, bus station, or crowds, whereby the person perceives escape could cause embarrassment and/or be difficult

A

Agoraphobia

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41
Q

_____ is a problem that manifest with an abrupt, unexpected feeling of discomfort whereby cognitive and/or autonomic responses manifest

A

Panic

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42
Q

_____ is a persistent, recurrent thought, impulse, or image that causes distress or anxiety. A _____ is a repetitive behavior (handwashing, checking) and/or thought that a person uses to diminish, neutralize, or word off an obsession

A

Obsession,

Compulsion

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43
Q

This group of conditions is characterized by excessive worry and anxiety that occurs more days than not for a minimum of six months. The problem is chronic, symptoms may fluctuate and are exacerbated by stress.

A

Generalized anxiety disorder

This disorder causes problems with concentration, irritability, restlessness, sleep disturbances, and/or muscle tension may occur

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44
Q

What are medical conditions associated with anxiety?

A

Cancer, COPD, dysrhythmias, encephalitis, heart failure, hyperthyroidism, hypoglycemia, pneumonia, vestibular dysfunction, vitamin B 12 deficiency, Pheochromocytoma

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45
Q

What are the three phases of stress response?

A

Alarm (reaction to stress),
Resistance (organism performs self repair and stores energy),
Exhaustion

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46
Q

What are the benzodiazepine medications used for panic disorder, GAD, and social anxiety disorder?

A

Alprazolam (Xanax),
Lorazepam (Ativan),
Clonazepam (Klonapin)

Side effects include dizziness and sedation, alcohol is contradicted, potential for abuse

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47
Q

What are the SSRI medication is used for anxiety, OCD, panic attacks, GAD, PTSD, and social anxiety?

A 
Sertraline (Zoloft),
Citalopram (Celexa),
Paroxetine (Paxil),
Fluvoxamine (Luvox),
Escitalopram (Lexapro)

Side effects are nausea, diarrhea, lightheadedness, sexual dysfunction

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48
Q

Which SNRI medications are used for performance anxiety, GAD, and social anxiety disorder?

A

Venlafaxine (Effexor)

Side effects include hypertension, nausea, diarrhea, lightheadedness, and sexual dysfunction

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49
Q

Which tricyclic medications are used for panic attacks, panic disorder, and GAD?

A

Imipramine (Tofranil)

Potential side effect is being jittery

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50
Q

Which MAOI medication is used to treat phobic disorder, GAD and social anxiety disorder?

A

Phenelzine (Nardil),
Tranylcypromine (Parnate),
Isocarboxazid (Marplan),
Selegiline (Eldepryl)-patch

Cancel side effects include insomnia, hypotension, and weight gain. A diet low in Tyramine reduces the risk for hypertensive crisis.

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51
Q

Which anticonvulsants are used for the treatment of social anxiety disorder, resistant panic disorders, and PTSD?

A

Gabapentin (Neurontin)-social anxiety disorder,
Divalproex (Depakote)-resistant panic disorders,
Topiramate (Topamax)-PTSD,
Lamotrigine (Lamictal)-PTSD,
Levetiracetam (Keppra)

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52
Q

Cognitive behavioral therapy is effective for which anxiety disorders?

A

In children/teens-
Separation anxiety disorder, OCD, phobias, and PTSD,
In adults-
Panic disorder, agoraphobia, social phobia, OCD, and PTSD

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53
Q

heightened senses, mild restlessness, sleeplessness, feelings of increased alertness and arousal are common in which level of anxiety?

A

Mild

Deep breathing, reassurance, relaxation techniques are good interventions

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54
Q

Voice tremors appear, Pitch changes, muscle tremors, facial twitches, shakiness, increase muscle tension, narrowed focus of attention, selective attentiveness, butterflies in stomach, slight increase in heart and respiratory rate (respirations mid 20s, heart rate low 100s) are present in which level of anxiety?

A

Moderate

Interventions include coaching, refocusing, and teaching; use
simple directions; deep breathing exercises

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55
Q

Communication difficult to understand, inability to relax, increased motor activity, fearful look, inability to focus, Rochen concentration, severely impaired learning, impaired judgment, easily distracted, tachycardia, hyperventilation, headache, dizziness, nausea, markedly increased vital signs (tachycardia 110-120s) are evident in which level of anxiety?

A

Severe

Interventions include firm redirection and consideration of medication

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56
Q

Pounding headache, trembling, loss of coordination, inability to learn, feeling of impending doom, hallucinations, delusions, palpitations, choking, chest pain, parasthesia, diaphoresis, dilated pupils, and loss of control are signs of which level of anxiety?

A

Panic

Interventions are primarily medication

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57
Q

St. John’s wort is helpful in treating _____ and _____

A

Depression, anxiety

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58
Q

_____ disorder is indicated with exaggerated and rigid traits that cause dysfunction with relationships.

A

Personality

Personality disorders associated with emotional, social, and occupational disability. It is often occurring with other psychiatric disorders.

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59
Q

Personality disorder traits are present from infancy but emerge during ____ ?

A

Adolescence

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60
Q

What are the risk factors for personality disorder?

A

Genetics, environment, childhood neglect, childhood trauma (harsh, erratic discipline; alcoholic parents; physical and sexual abuse)

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61
Q

Which cultural groups are more at risk for personality disorder?

A

Native and African-Americans, young adults, low socioeconomic status, divorced, separated, widowed, never married

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62
Q

What are the common traits with personality disorder?

A

Self identity and self direction, lack of empathy and intimacy, perception of nothing wrong, issues with interpersonal relationships and socialization (fear of rejection, lack of trust, fault finding)

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63
Q

What are the primitive/immature defenses for personality disorder ?

A 
Attempt to control inner chaos, 
ambivalence and poor impulse control, 
Blurred personal boundaries, 
needs are experienced as rage, 
sexuality and dependency confused with aggression
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64
Q

What are the characteristics of borderline personality disorder?

A 
Emotionally labile, 
fear of separation/rejection,
impulsive and self-destructive, 
interpersonal difficulties, 
antagonistic, 
inability to forgive, no guilt,
Engages in splitting behavior
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65
Q

What is the treatment plan for borderline personality disorder?

A

Work on affect/ behavior,
Mindfulness,
Medication (anticonvulsants for mood),
Low dose antipsychotics and omega 3

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66
Q

What are the characteristics of antisocial personality disorder?

A 
Antagonistic (deceitful, manipulative for personal gain),
Impulsive,
Risk taking, 
Takes no responsibility,
Not capable of intimacy,
Lack of empathy
67
Q

_____ personality disorder usually coexists with other mental illness, is associated with self-mutilization, and is a disruption from normal separation

A

Borderline

68
Q

Those with _____ personality disorder are often referred to as sociopaths. They are associated with criminal activity and have lowered levels of serotonin and dopamine.

A

Antisocial

69
Q

What is the treatment plan for antisocial personality disorder?

A

Typically involuntary admission for risk-taking behaviors, setting boundaries and realistic choices,
support,
off label meds for mood

70
Q

What are the risk factors for antisocial personality disorder?

A

Inconsistent parenting/discipline,
Abuse/neglect
Higher incidence in African-American,
Environment

71
Q

What are typical manipulative behaviors used by those with personality disorders?

A 
Arguing or begging,
Using flattery or seductiveness,
Instilling guilt and clinging,
Constant attention seeking,
Pitting one person against another, 
Frequent disregard for rules,
Constant engagement in power struggles,
Exhibiting angry, demanding behaviors
72
Q

What are the interventions for impulsive behavior for those with personality disorder?

A

Identify and discuss what proceeds impulsive acts,
Explore effects on self and others,
Recognize cues,
Identify triggers,
Discuss alternative behaviors,
Teach or refer the patient for coping skills training (i.e. Anger management, assertiveness skills)

73
Q

What assessments are necessary for personality disorders?

A
  • Assess for suicidal and homicidal thoughts,
  • Determine whether the patient has a medical disorder or another psychiatric disorder,
  • Consider ethical, cultural, social backgrounds,
  • Assess for recent and important losses,
  • Evaluate for strong negative emotions,
  • Assess for substance-abuse
74
Q

_____ is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences

A

Addiction

75
Q

What are the acute effects of cannabinoids such as marijuana and hashish?

A

Euphoria, relaxation, slow reaction time, distorted sensory perception, impaired balance and coordination, increased heart rate an appetite, impaired learning and memory

76
Q

What are the health risks of cannabinoids such as marijuana and hashish?

A

Anxiety, panic attacks, psychosis, cough, frequent respiratory infections, possible mental health decline, addiction

77
Q

What are the acute effects of opioids such as heroin and opium?

A

Euphoria, drowsiness, impaired coordination, dizziness, confusion, nausea, sedation, feeling of heaviness in the body, slowed or arrested breathing

78
Q

What are the health risks of opioids such as heroin and opium?

A

Constipation, endocarditis, hepatitis, HIV, addiction, fatal overdose

79
Q

What are the acute effects of stimulants such as cocaine, amphetamines, methamphetamine?

A

Increased heart rate, blood pressure, body temperature, metabolism, feelings of exhilaration, increased energy, mental alertness, tremors, reduced appetite, irritability, anxiety, panic, paranoia, violent behavior, psychosis

80
Q

What are the health risks of stimulants such as cocaine, amphetamines, methamphetamine?

A

Weight loss, insomnia, cardiac or cardiovascular complications, stroke, seizures, addiction

For cocaine: nasal damage from snorting
For methamphetamine: severe dental problems

81
Q

What are the acute effects of the club drug MDMA (Ecstacy)?

A

Mild hallucinogenic effects, increased tactile sensitivity, empathetic feelings, lowered inhibition, anxiety, chills, sweating, teeth clenching, muscle cramping

82
Q

What are the health risks of the club drug MDMA (Ecstacy)?

A

Sleep disturbances, depression, impaired memory, hypothermia, addiction

83
Q

What are the acute effects of the club drug Flunitrazepam (roofies)?

A

Sedation, muscle relaxation, confusion, memory loss, dizziness, impaired coordination

Health risk: addiction

84
Q

What are the acute effects of the club drug GHB (liquid Ecstacy, liquid X)?

A

Drowsiness, nausea, headache, disorientation, loss of coordination, memory loss

Health risks: unconsciousness, seizures, coma

85
Q

What are the acute effects of dissociative drugs (Ketamine-Special K)?

A

Feelings of being separated from one’s body and environment, impaired motor function, analgesia, impaired memory, delirium, respiratory depression and arrest, death

Health risks: anxiety, tremors, numbness, memory loss, nausea

86
Q

What are the acute effects of dissociative drugs (PCP-Angel Dust)?

A

Feelings of being separated from one’s body and environment, impaired motor function, analgesia, psychosis, aggression, violence, slurred speech, loss of coordination, hallucinations

Health risks: anxiety, tremors, numbness, memory loss, nausea

87
Q

What are the acute effects of hallucinogens (LSD)?

A

Altered states of perception and feeling, hallucinations, nausea, increased body temperature, increased heart rate, increase blood pressure, loss of appetite, sweating, sleeplessness, numbness, dizziness, weakness, tremors, impulsive behavior, rapid shifts in emotion

88
Q

What are the Health risks of hallucinogens (LSD)?

A

Flashbacks, hallucinogen persisting perception disorder

89
Q

What are the acute effects of anabolic steroids?

A

None

90
Q

What are the Health risks of anabolic steroids?

A

Hypertension, blood clotting and cholesterol changes, liver cysts, hostility and aggression, acne,

  • in adolescents: premature stoppage of growth,
  • in males: prostate cancer, sperm production, shrunken testicles, breast enlargement
  • in females: menstrual regularities, development of beard and other masculine characteristics
91
Q

What are the acute effects of inhalants?

A

Stimulation, loss of inhibition, headache, nausea or vomiting, slurred speech, loss of motor coordination, wheezing

92
Q

What are the health risks for inhalants?

A

Cramps, muscle weakness, depression, memory impairment, damage to cardiovascular and nervous systems, and consciousness, sudden death

93
Q

What neurotransmitter is craved buy those with addiction?

A

Dopamine

94
Q

What are the signs and symptoms of uncomplicated or mild to moderate alcohol withdrawal?

A 
Restlessness, 
irritability, 
lack of appetite, 
tremor, 
insomnia, 
impaired cognitive functions, 
mild perceptual changes
95
Q

What are the signs and symptoms of severe alcohol withdrawal?

A

Obvious trembling of the hands and arms, sweating, elevated pulse (above 100), elevated blood pressure (greater than 140/90), nausea (sometimes with vomiting), hypersensitivity to noises and light, brief periods of hearing and seeing things that are not present, fever greater than 101°F

96
Q

What are the medical complications of alcohol withdrawal?

A

Infections, hypoglycemia, G.I. bleeding, undetected trauma, hepatic failure, cardiomyopathy with an effective pumping, pancreatitis, encephalopathy

97
Q

What are the signs and symptoms of opioid withdrawal?

A

Tachycardia, hypertension, hyperthermia, insomnia, Mydriasis (enlarged pupils), Hyperreflexia, diaphoresis, piloerection (goosebumps), increased respiratory rate, lacrimation (tearing), yawning, rhinorrhea, muscle spasms, abdominal cramps, nausea, vomiting, diarrhea, bone and muscle pain, anxiety

98
Q

What are the signs and symptoms of short term stimulant intoxication?

A

Increased energy, decreased appetite, mental alertness, increased heart rate/pressure, dilated pupils

99
Q

What are the signs and symptoms of long term stimulant intoxication?

A

Irregular heartbeat, chest pains, increased risk of heart attack, panic attacks, depression, delusions/hallucinations, skin sensation (cocaine bugs)

100
Q

What are the signs and symptoms of stimulant withdrawal?

A

Depression, hypersomnia (or insomnia), fatigue, anxiety, irritability, poor concentration, psychomotor retardation, increased appetite, paranoia, drug craving

101
Q

What are the five As for alcohol abuse intervention?

A
  • Assess alcohol consumption with a brief screening tool,
  • Advise clearly and specifically about effects of alcohol consumption,
  • Agree on goals for reducing use or abstinence
  • Assist in developing motivation, self-help skills, and supports
  • Arrange follow-up, repeat counseling, or specialty referral
102
Q

What does the acronym FRAMES stand for?

A 
Feedback,
Responsibility,
Advice,
Menu,
Empathic,
Self efficacy
103
Q

Which medications are used for alcohol withdrawal?

A

Carbamazepine (Atretol, Tegretol), phenobarbital, diazepam (Valium), naltrexone (vivitrol)

104
Q

Which neurotransmitter regulates reward and feelings of pleasure?

A

Dopamine

105
Q

Which neurotransmitter signals craving after a dopamine crash

A

Glutamate

106
Q

Which neurotransmitter regulates motor, emotion, motivation, and cognition?

A

Acetylcholine

107
Q

Which neurotransmitter regulates arousal, attention, mood, and stress response?

A

Norepinephrine

108
Q

Red flags to identifying addiction…

A 
Appearance older than stated age,
Undernourished,
Failure of standard doses of sedatives to have therapeutic effect,
Cognitive deficits,
Withdrawal symptoms
109
Q

What is the emergency management for opiate overdose?

A

Naloxone

Restores respiratory function by blocking opiate receptors

110
Q

What are the nursing considerations when administering naloxone during potential opiate overdose?

A

Potential for violence attributable to panic and fear as consciousness is restored

111
Q

When do signs of delirium tremens typically occur with acute alcohol withdrawal?

A

6-9 hours after last drink

112
Q

What medications are administered for alcohol withdrawal?

A

Naltrexone (Vivitrol)-also reduces cravings,
Nalmefene (Selincro),
Acamprosate (Campral)

Disulfiram (Antabuse)-aversion therapy, makes sick when combined with alcohol

113
Q

Which medications are administered to treat opiate withdrawal?

A

Methadone (Dolophine),
Buprenorphine (Butrans)-higher dosage, less side effects,
Clonidine (Catapres)-antihypertensive,
Suboxone (Buprenorphine/Naloxone)-combination drug, reduces potential abuse of Buprenorphine

114
Q

Which medications are administered for nicotine withdrawal?

A

Nicotine (Habitrol, Nicoderm, Nicotrol)-gum or patch,

Bupropion (Aplenzin)-non-nicotine replacement, reduces cravings

115
Q

What are the primitive/narcissistic defense mechanisms?

A

Denial,
Projection,
Splitting

116
Q

What are the immature defense mechanisms?

A

Somatization,
Acting out,
Regression

117
Q

What are the neurotic defense mechanisms?

A 
Reaction formation,
Intellectualization,
Repression,
Displacement,
Rationalization,
Dissociation,
Undoing
118
Q

What are the mature defense mechanisms?

A 
Altruism,
Compensation,
Humor,
Sublimation,
Suppression,
Identification
119
Q

_____ is a medically managed inpatient program with 24 hour medical coverage while the patient’s body clears itself of drugs.

A

Detox

120
Q

_____ programs are available as medically managed and medically monitored inpatient programs. The have 24 hour staff and can be for short or long term recovery of biomedical or psychiatric conditions.

A

Rehabilitation

121
Q

These facilities offer residential treatment in a substance free communal or family environment. Residents typically live here but work outside the home.

A

Halfway houses

122
Q

This intensive form of outpatient programming is for patients who do not require 24 hour care. Treatment in psychotherapy and educational groups on at least 3 days per week for a minimum of 10 hours per week is typical.

A

Partial hospitalization

123
Q

This type of care is highly structured with scheduled treatment groups and at least one individual session regularly. Participants attend at least 3 days per week from 5-10 hours per week

A

Intensive outpatient

124
Q

This type of care is highly structured with a mix of individual and group therapy consisting of not more than 5 hours per week.

A

Outpatient treatment

125
Q

_____ is the total inability to recognize reality

A

Psychosis

126
Q

_____ are fixed, false beliefs. Such as ‘you’re all army men coming to get me’.

A

Delusions

127
Q

______ is seeing (visual) or hearing (auditory) things that are not there. Such as ‘look at all those bugs crawling up the wall’ or ‘grandpa (deceased) said we can’t go there’

A

Hallucinations

128
Q

_____ schizophrenia is a result of a major stressor and lasts about a month followed by full recovery.

A

Brief

129
Q

_____ is the form of schizophrenia that lasts less than 6 months

A

Schizophreniform

130
Q

______ disorder is a form of schizophrenia that is most common and co-exists with a mood/affect disorder

A

Schizoeffective

131
Q

What is the primary biological factor of schizophrenia ?

A

Heredity

132
Q

Which neurotransmitters are effected in schizophrenia ?

A

Increased dopamine and glutamate

133
Q

What are the brain abnormalities associated with schizophrenia?

A

Enlarged ventricles/fissures,
Reduced connectivity,
Low rate blood flow

134
Q

What are the psychological and environmental factors relating to schizophrenia ?

A

Prenatal stressors/birth complications,
Increased cortisol (impedes hypothalamic development),
Trauma/abuse,
Environment (toxinx, poverty, crime)

135
Q

What are the phases of schizophrenia ?

A

Prodromal/Pre-psychotic,
Phase I - Acute,
Phase II - Stabilization,
Phase III - Maintenance

136
Q

A person presents as socially awkward, lonely, depressed, with anxiety, phobias, obsessions, dissociation and compulsions in which phase of schizophrenia ?

A

Prodromal/Pre-psychotic

May appear for a month or more than a year before first psychotic break

137
Q

This phase of schizophrenia presents with disruptive symptoms (hallucinations, delusions, apathy, withdrawal) and results is loss of functional abilities.

A

Phase I - Acute

Increased care or hospitalization may be required.

138
Q

This phase of schizophrenia has symptoms diminishing and the level of functioning is returning to baseline.

A

Phase II - Stabilization

May require partial hospitalization or care in a residential crisis center or group home

139
Q

This phase of schizophrenia has the patient returned to baseline (or nearing) functioning. Symptoms are diminished or absent and the level of functioning is good enough for the patient to live in the community.

A

Phase III - Maintenance

140
Q

_____ schizophrenia symptoms include hallucinations, delusions, bizarre behavior, paranoia, abnormal movements, gross errors in thinking.

A

Positive

141
Q

_____ schizophrenia symptoms include the absence of something that should be present. Such as hygiene, motivation, ability to experience pleasure.

A

Negative

142
Q

_____ symptoms of schizophrenia include subtle changes in memory, attention or thinking. There is an inability to set priorities and make decisions (executive functioning)

A

Cognitive

143
Q

_____ symptoms of schizophrenia involve emotions and their expressions. Such as suicidality, hopelessness, dysphoria, depression, or hostility.

A

Affective

144
Q

Alterations in speech such as clang associations, word salad, neologisms, and echolalia are ______ symptoms of schizophrenia

A

Positive

145
Q

Thought blocking, thought insertion, thought deletion, religiosity, paranoia, flight of ideas and magical thinking are all ______ symptoms of schizophrenia

A

Positive

146
Q

Perceptual changes such as depersonalization, derealization, delusions, and hallucinations are _____ symptoms of schizophrenia

A

Positive

Hallucinations can be visual, command or auditory (auditory being the most common)

147
Q

Movement/Behavior alterations such as catatonia, echopraxia (mimicking movements), negativism (failing to do what’s asked of them), impaired impulse control, repeated movements, gesturing/posturing, and boundary impairment are all _____ symptoms of schizophrenia

A

Positive

148
Q

Flat/Blank affect, lack of emotion, labile mood (fluctuating), and restricted/constricted affect are all ______ symptoms of schizophrenia

A

Negative

149
Q

Difficulty with executive functioning such as attention, memory, information processing and cognitive flexibility are _____ symptoms of schizophrenia

A

Cognitive

150
Q

Nursing considerations for Phase I - Acute schizophrenia

A

Patient safety,
Medical stabilization,
Safety/stabilization strategies

151
Q

Nursing considerations for Phase II - Stabilization schizophrenia

A

Help patient understand illness and treatment,
Stabilize medications,
Control/cope with symptoms

152
Q

Nursing considerations for Phase III - Maintenance schizophrenia

A

Maintain achievements/relapse prevention,
Achieve independence,
Skills training,
Monitoring

153
Q

_____ generation antipsychotics target positive symptoms of schizophrenia

A

First

They are cheaper

Side effects include anticholinergic side effects, extra pyramidal side effects, tardive dyskinesia (involuntary movements), Weight gain, sexual dysfunction, endocrine disturbances

154
Q

_____ generation antipsychotics target positive and negative symptoms of schizophrenia and is a 5HT2A/D2 agtagonist (targets serotonin/dopamine)

A

Second

Requires blood monitoring for one year

Caution: CVD, lipademia, diabetes, metabolic syndrome

155
Q

_____ is the most used high potency first generation antipsychotic

A

Haloperidol (Haldol)

156
Q

_____ is the most used low potency first generation antipsychotic

A

Chlorpromazine (Thorazine)

157
Q

___, ___, ____, are common second generation antipsychotics

A

Quetiapine (Seroquel),
Risperidone (Risperdal),
Aripiprazole (Abilify)

158
Q

_____ is the most used medium potency antipsychotic

A

Ioxaine (Loxitane)

159
Q

What are the adverse reactions to first generation (conventional/typical) antipsychotics?

A 
Extra pyramidal symptoms (EPSs):  
     Akathisia (restlessness of body)
     Acute dystonia (involuntary repetitive muscle contractions)
     Pseudoparkinsons (reactions that mimic Parkinson's, depleted 
     dopamine)
Tardive Dyskinesia (TD):  involuntary movement
Neuroleptic Malignant Syndrome (NMS): 
     FARM - Fever greater 103, 
     Autonamic instability, 
     Rigidity of muscles, 
     Mental status change (delirium)
Agranulocytosis:  dangerous leukopenia
Anticholinergic effects
Orthostasis
Lowered seizure threshold
Weight gain
Sexual dysfunction
Endocrine disturbances
     autonomic instability, delirium
160
Q

What are the adverse reactions to second generation (atypical) antipsychotics?

A

More expensive
Minimal (less than 1st gen) extra pyramidal side effects (EPSs)
Tardive Dyskinesia
Metabolic syndrome (weight gain, dyslipidemia, altered glucose
metabolism
Increased risk for diabetes, HTN, CVD
Agranulocytosis (specifically with Clozapine, required 1yr blood
Monitoring)

161
Q

What are the treatments for Extra Pyramidal Symptoms (EPSs)?

A 
Lower dosage of antipsychotics,
Antiparkinson drugs (Cogentin, Benadryl)
162
Q

What are the third generation antipsychotics?

A

Aripiprazole (Abilify) - often still considered 2nd gen

Little risk of EPS or TDK, Unlikely to have significant metabolic effects, hypotension, little anticholinergic effects

Safer but less effective (hit or miss)

163
Q

What are the adjunct therapies for antipsychotic medications for co-morbidity?

A

Antidepressants,
Lithium,
Benzodiazepines,
Clonazepam

164
Q

What is the timeframe for antipsychotic medications to have full effect ?

A

2-4 Weeks

Family Concepts II - 2130 (3 decks)

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