Mental Health Ch 49 Flashcards
Know the most common thought disorder
schizophrenia
include hallucinations, delusions, and disorganized speech and/or behavior
Psychotic features
hearing, seeing, smelling, tasting, or feeling something that is not there
Hallucinations
false fixed ideas
Delusions
misinterpretation of something that really exists
Illusions
those that should not be there. Examples include hallucinations, delusions, disordered thinking or loose associations between thoughts, and hearing voices that tell the person what to do
positive symptoms
abilities or personal characteristics that are absent or lost to the patient with schizophrenia. Apathy, social withdrawal, psychomotor retardation, flat affect, poverty of thoughts, lack of motivation, and inability to experience pleasure or joy
negative symptoms
Know percentage of the population that is affected by schizophrenia pg1127
1.1% which represents 3.5 million americans
Know the neurotransmitter related to schizophrenia
dopamine, low is negative and high is positive
Know the brain structure abnormalities related to schizophrenia pg 1128
Enlargement of the lateral cerebral ventricles; reduced cortical, frontal lobe, and hippocampus volume; and increased fissure size on the surface of the brain
Know the environmental factors related to schizophrenia pg1128
Exposure to chronic poverty or a high-crime environment have an effect with schizophrenia development
Know about diet in schizophrenia pg1128
omega 3
Age when schizophrenia usually shows pg 1128
15-25
Know the types of delusions and their definitions pg 1128
grandeur and persecution
Know ideas of reference pg 1128
The individual believes that events or situations are occurring because of-or specifically for-them
poverty of thoughts
Alogia
lack of motivation
Avolition
inability to experience pleasure or joy
Anhedonia
Greatest predictor of potential violence with schizophrenia
drugs
maintains a limb in one position for a long time
Waxy flexibility
imitating the motions of others
Echopraxia
involuntary repetition of words spoken by others
Echolalia
First generation antipsychotics what do they treat
positive symptoms
Know why you want to use atypicals
less side effects and has benefit for negative symptoms
Know about considerations with first generation in old people pg 1131
dry up, cant eat, cant spit, cant poop
stooped posture. Shuffling gait. Rigidity. Bradykinesia. Tremors at rest. Pill rolling motion of the hand.Treatment requires lowering the dosage of the first generation antipsychotic or change the medication and give benztropine (cogentin)
Pseudoparkinsonism
restlessness. Trouble standing still. Paces the floor. Feet in constant motion, rocking back and forth.Treatment requires lowering the dosage of the first generation antipsychotic or change the medication and give benztropine (cogentin)
Akathisia
facial grimacing. Involuntary upward eye movement. Muscle spasms of tongue, face, neck, and back. Laryngeal spasms.Treatment requires lowering the dosage of the first generation antipsychotic or change the medication and give benztropine (cogentin) or benadryl.
Acute dystonia
protrusion and rolling the tongue. Sucking and smacking movements of the lips. Chewing motion. Facial dyskinesia. Involuntary movements of the body and extremities. Treatment requires lowering the dosage of the first generation antipsychotic or change the medication and give benztropine (cogentin) or benadryl.
Tardive dyskinesia
(know) Tardive dyskinesia is a primary concern because symptoms are irreversible once they have developed if not caught early
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Look for tardive dyskinesia in what type of people pg 1130
the people who have been on 1st generation medications for 6-12 months
Know about neuroleptic malignant syndrome, what the symptoms are and what you are going to do for them pg 1131
high fever, increased pulse, muscle rigidity, stupor, incontinence, elevated white blood cell count, hyperkalemia, and renal failure
Know what a benefit of olanzapine (zyprexa) is pg 1131
Comes in a quickly dissolving oral form that is a potential alternative to an injection. This form is more expensive; however, it eliminates the risk of a needle-stick injury if they patient is combative, and it discourages “cheeking”.
Know how you are going to treat the negative symptoms pg 1131
Are treated with medication, a therapeutic environment that includes therapeutic relationships with nurses, and education about basic living skills. Dialogue therapy has been proven to help. Programs such as PACT and ACT have proven to help.
Know the rights of the psych patient pg 1131
Have the right to refuse medication and other therapies, in emergency situations you can order administration of involuntary medications and/or place the patient on an involuntary hold if proven they are a harm to themselves or others
making up new words
Neologisms
disorganized mix of words, phrases, and fragments
Word salad
expression of ideas that do not logically connect
Loose associations
Know about command hallucinations, also, know that they are a priority pg 1132
Are voices that the patient hears that direct them to harm self or others
(know) Clozapine (clozaril) can cause agranulocytosis pg 1131
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Know why you need to watch how you dress pg 1133
Monitor your professional appearance and clothing when working with patients who have thought disorders. Be a role model who wears clean, matching, and appropriate clothing. Avoid flashy and dangling jewelry because patients are easily distracted by such objects. Do not place items like necklaces, lanyards, scares, ties, or stethoscopes around your neck, as patients who are agitated can easily grab these and induce choking
(know) Know not to drink with antipsychotic medications
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Know the national patient safety goals involving patient identifiers pg 1133
Two forms of identity must be checked before giving medication or blood products or taking blood samples. When patients are not able to state their correct legal name, an alternative method is to have two health care providers verify the patient’s identity
Know how to approach/touch patients with schizophrenia
get the patient’s attention first and if agitated do not touch
(know) Therapeutic relationships are built on trust so you need to stay consistent and offer self
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Pg 1134 how are you going to determine medication effectiveness
Adherence to the treatment plan, should decrease hallucinations and delusions, and improve sleep
(know) Medications usually work for positive symptoms as opposed to negative systems ESPECIALLY the first generation medications
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Personality disorder, know about diagnosing it pg 1134
an ongoing, inflexible pattern of behavior that is markedly different from others within the individual’s culture
Know the four characteristics of personality disorder pg 1134
1 inflexible and maladaptive response to life events
2 serious difficulty in areas of personal and work relationships
3 tendency to evoke interpersonal conflict
4 tendency to evoke a negative empathic response from others
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How old do you have to be before being diagnosed with a personality disorder
18
Know the main features of Borderline personality disorder is pg 1138
Marked emotional and mood instability, self image distortion, impulsivity and difficulty in interpersonal relationships
(know) Self mutilation may occur with patients with BPD when they feel abandoned
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A primitive defense mechanism is the inability to see both the positive and the negative aspects of others. The patient with BPD sees people as either entirely good or entirely bad
splitting
Know what gynecomastia is
man boob