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Mental Health > Mental Health Exam 3 - Schizophrenia > Flashcards

Mental Health Exam 3 - Schizophrenia Flashcards

1
Q

Schizophrenia

A

Is a syndrome
Is a disabling psychotic disorder
Age of onset typically late teens early twenties

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2
Q

Types of schizophrenia

A 
Paranoid
Disorganized
Catatonic
Residual
Undifferentiated
Other: schizoaffective, brief psychotic disorder, schizophreniform disorder, shared psychotic disorder, secondary (induced) psychosis
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3
Q

Schizoaffective disorder

A

Mood disorder along with schizophrenia

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4
Q

Brief psychotic disorder

A

Sudden onset of psychotic symptoms that last less than 1 month

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5
Q

Schizophreniform disorder

A

Similar to schizophrenia but lasts less than 6 months & impairments less noticeable

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6
Q

Shared psychotic disorder

A

Folie a delux

Shared delusion between two people who have a close relationship
Cult phenomenon

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7
Q

Secondary (induced) psychosis

A

Related to substance ingestion, toxins, or medical condition

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8
Q

Phases of Schizophrenia

A

Prodomal
Phase I - Acute Phase
Phase II - Stabilization Phase
Phase III - Maintenance Phase

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9
Q

Prodomal Symptoms

A

Occur 1 month to 1 year prior to psychotic symptoms

Appear as deterioration in function

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10
Q

Acute Phase

A

Florid psychotic symptoms present
Safety & medical stabilization are PRIMARY interventions
Interventions include: meds, limit setting directive care, crisis intervention, work with family

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11
Q

Stabilization phase

A

Symptoms diminishing
Adherence to Tx
Cope with symptoms
Skills training

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12
Q

Maintenance Phase

A

Maintains gains - at or nearing baseline functioning
Relapse prevention
Independence- live in community
Utilize case management

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13
Q

ASSESSMENT of Schizophrenia

What are the four characteristic dimensions?

A

Positive symptoms
Negative symptoms
Cognitive symptoms
Depressive symptoms

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14
Q

*Positive signs of schizophrenia

A

Hallucinations
Delusions
Disorganized speech
Bizarre behavior , motor agitation

better prognosis if only have positive symptoms

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15
Q

*Negative signs of schizophrenia

A 
Blunted or flat affect
Poverty of speech (alogia)
Loss of motivation (avolition)
Lack of pleasure (Anhedonia)
Lack of physical energy (Anergia)

neg symptoms indicate a poorer prognosis, bc positive symptoms are easier to treat

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16
Q

Blunted affect

A

Narrow range of normal expression

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17
Q

Alogia

A

Poverty of speech

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18
Q

Avolition

A

Loss of motivation

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19
Q

*Anhedonia

A

Lack of pleasure

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20
Q

Anergia

A

Lack of energy

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21
Q

Cognitive symptoms

A 
Disordered thinking
Inability to make decisions 
Poor problem-solving ability
Difficulty concentrating
Memory deficits
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22
Q

Depressive symptoms

A

Hopelessness

Suicidal ideation

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23
Q

DELUSIONS - Alterations in Thought/Thinking

A

False fixed beliefs that cannot be corrected by reasoning and are usually bizarre.

Ideas of reference
Persecution
Grandeur
Somatic delusions
Jealousy
Being controlled
Thought broadcasting
Thought insertion
Thought withdrawal
Religiosity
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24
Q

Ideas of reference

A

Misconstrues trivial events and attaches personal meaning to them.

Paranoia

25
Q

Persecution

A

Feels as if others might harm him

26
Q

Grandiosity

A

All powerful god-like qualities

27
Q

Somatic sensations (somatic delusions)

A

Delusions that body is changing in an unusual way

Ex-growing a third arm

28
Q

Thought broadcasting

A

Believes one’s thoughts can be heard by others

29
Q

Thought insertion

A

Believes that other’s thoughts are being inserted into his mind

30
Q

Thought withdrawal

A

Believes that her thoughts have been removed from her mind by an outside agency.

31
Q

Alterations in speech

A 
Loose associations (connections between thoughts are absent, haphazard, or illogical)
Flight of ideas
Neologisms
Echolalia
Clang association
Word salad

*Need to let the pt know if you do not follow or understand them

32
Q

Neologisms

A

Made up words that only have meaning to the client

33
Q

Echolalia

A

Client repeats words spoken to them

34
Q

*Alterations in perception

A

Hallucinations: auditory, visual, olfactory, gustatory, tactile

  • Personal boundary difficulties:
  • Depersonalization
  • Derealization
Alterations in behavior:
Stereotyped behaviors
Automatic disobedience
Waxy flexibility
Stupor
Negativism
Echopraxia
35
Q

*Command hallucinations

A

*Ask pt what voices are telling them to do

36
Q

*Depersonalization

A

Nonspecific feeling that a person has lost their identity; self is different or unreal

37
Q

*Derealization

A

Perception that environment has changed

38
Q

Alterations in Behavior

A 
Extreme agitation, including pacing and rocking
Stereotyped behaviors
Automatic obedience
Waxy flexibility
Stupor 
Negativism 
Echo praxis
39
Q

Stereotypical behaviors

A

Motor patterns that once had meaning to the pt, but now are mechanical and lack purpose.

“hammering, sweeping”

40
Q

Automatic obedience

A

Responding in a robot-like manner

Seen in catatonia

41
Q

Waxy flexibility

A

Excessive maintenance of position.

Seen in catatonia

42
Q

Stupor

A

Motionless for long periods of time

43
Q

*Echopraxia

A

Purposeful imitation of movements made by others

44
Q

*Neuroleptic Malignant syndrome (NMS)

A

Caused by reduction in brain dopamine activity
Occurs in 1% or less of pts
Fatal in 10% medical emergency

*Know that it is emergent

45
Q

**Symptoms of NMS

A 
Decreased LOC 
Muscle rigidity
*Hyperpyrexia (fever)
*Tachycardia 
Tachypnea
Autonomic instability
*HTN
46
Q

*Tardive Dyskinesia

A

Involuntary muscle movements of the trunk, face, and extremities
Usually not reversible
Women are more prone

AIMS test is used to screen baseline & routinely

47
Q

What is the purpose of the AIMS exam?

A

Used to screen for Tardive dyskinesia

Observing for muscle twitching/movement to indicate positive response

48
Q

Polydipsia

A

Excessive thirst

49
Q

Autism

A

Thinking is not bound to reality but reflects the private perceptual world of the individual.

Ex-delusions, hallucinations, neologisms

50
Q

Ambivalence

A

Simultaneously holding two opposing emotions, attitudes, ideas, or wishes towards the same person, situation, or object.

Occurs in all relationships but becomes pathological and paralyzing when a person vacillates between opposing positions.

51
Q

What are significant findings of the AIMS exam

A

.

52
Q

*Appropriate interventions for an pt that is hallucitating / delusions

A

Ask client directly about hallucinations
**Do not argue with client about hallucinations/delusions but FOCUS ON FEELINGS
Provide safety if experiencing command hallucinations
Focus conversation on reality based subjects
Identify symptoms & triggers
Be genuine & empathetic

53
Q

*Akathisia

A

Regular rhythmic movements, usually of the lower limbs; constant pacing may also be seen; often noticed in people taking antipsychotic medication.

54
Q

*Akinesia

A

Absence or diminution of voluntary motion. Akinesia is usually accompanied by a parallel reduction in mental activity.

55
Q

*Eps symptoms

A

Dystonia
Parkinsonisms
Akinesia
Akathesia

56
Q

*Institutionalization

A

The provision of psychiatric care in a custodial setting, typically viewed as a restrictive environment. When overused or used inappropriately it can result in apathy, dependency, and stagnation and impede a person’s ability to function normally outside the institution.

57
Q

Transinstutionalization

A

The shifting of a person or population from on form of institution to another, such as from state hospitals to jails, prisons, nursing homes, or shelters.

58
Q

Dystonic episode.? And antidote

A

Abnormal muscle tonicity resulting in impaired voluntary movement. May occur as an acute side effect of neuroleptic (antipsychotic) medication, in which it manifests as muscle spasms of the face, head neck and back.

59
Q

First priority

A

Establish relation ship with pt = establish rapport

Mental Health (13 decks)

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