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ATI Mental Health > Mod. 5 ATI ch. 15 & 24 > Flashcards

Mod. 5 ATI ch. 15 & 24 Flashcards

1
Q

Interventions schizophrenia

A
  • assess safety
  • reduce stimuli
  • SME
  • suicide assessment
  • assess command hallucinations and if plan to follow them
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2
Q

How will nurse be able to recognize and assess signs and symptoms of a psychotic disorder?

A

!!! recognize social withdrawal
!!! notice positive or negative signs
!!! cognitive findings
!!! Affective findings

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3
Q

DSM Review

A

used for every mental dx

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4
Q

Positive Symptoms

A

manifestations of things that are not normally present.

  • hallucinations
  • delusions
  • alterations in speech
  • bizarre behavior (walking backward constantly)
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5
Q

Negative symptoms (anergia)

A

absence of things that are normally present. More difficult to treat successfully than positive ones.

  • Affect- usually blunted or flat
  • Alogia- poverty of thought or speech. May mumble
  • Anergia- lack of energy
  • Anhedonia- lack of pleasure or joy
  • Avolition- lack of motivation
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6
Q

Psychotic Disorders recognized by DSM-5

8

A
  • Schizophrenia
  • Schizotypal personality disorder
  • Delusional disorder
  • Brief psychotic disorder
  • Schizophreniform disorder
  • Schizoaffective disorder
  • Substance- induced psychotic disorder
  • Psychotic or catatonic disorder not otherwise specified
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7
Q

Phases of care

A

Phase 1
Phase 2
Phase 3

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8
Q

Some labs to consider

A

RPR: r/o for syphillus
HIV
Tox. screen

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9
Q

Halol

A

tarditive dyskenesia is the big side effect we look out for

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10
Q

Congentin

A

should be given with halol. to control the EPS

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11
Q

What causes schizophrenia?

A

possibly results from a combination of;

  • genetic
  • neurobiological
  • non-genetic (injury at birth, viral infection, nutritional factors)
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12
Q

Typical age of onset of Schizophrenia

A

late teens and early 20s

  • can occur in young children
  • can occur in late adulthood
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13
Q

Schizophrenia

A

client has psychotic thinking/ behavior for at least 6 months

significantly impaired areas of functioning; school, work, self-care, relationships

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14
Q

Schizotypal personality disorder

A

impairments of personality functioning (self and interpersonal)

impairment not as severe as with schizophrenia

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15
Q

Delusional Disorder

A

experiences delusional thinking for at least 1 month

self or interpersonal functioning is NOT markedly impaired

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16
Q

Brief Psychotic Disorder

A

psychotic manifestations that last 1 day to 1 month in duration

17
Q

schizophreniform disorder

A

manifestations similar to schizophrenia, but duration is 1-6 months and social/ occupational dysfunction might not be apparent.

18
Q

schizoaffective disorder

A

disorder meets criteria for both schizophrenia AND depressive OR bipolar disorder.

19
Q

substance-induced psychotic disorder

A

experiences psychosis due to substance intoxication or withdrawal

however, psychotic manifestations are more severe than typically expected.

20
Q

psychotic or catatonic disorder not otherwise specified

A

PSYCHOTIC features (impaired reality testing) or BIZARRE behavior (psychotic) or a significant change in MOTOR ACTIVITY behavior (catatonic) but does not meet criteria for diagnosis with another specific psychotic disorder.

21
Q

Assessment: Cognitive Findings for psychotic disorders

A
  • disordered thinking
  • inability to make decisions
  • poor problem-solving ability
  • difficulty concentrating to perform tasks
  • short term memory deficits
  • impaired abstract thinking
22
Q

Assessment: Affective findings for psychotic disorders

A

involving emotions

  • hopelessness
  • suicidal ideation
  • unstable or rapidly changing mood
23
Q

Assessment: alterations in thought (delusions) for psychotic disorders

A
  • ideas of reference: misconstrutes trivial events and attaches personal significance to them. ex. thinking others are talking about them when they’re just discussing the next meal
  • persecution
  • Grandeur
  • somatic delusions: believes that their body is changing unusually
  • jealousy
  • being controlled: believes someone outside their body is controlling
  • thought broadcasting: believes their thoughts are being heard by others
  • thought insertion: believes that others’ thoughts are being inserted into their mind
  • thought withdrawal: believes their thoughts have been removed
  • religiosity: obsessed w/ religious beliefs
  • magical thinking: beliefs their thoughts/ actions can control others or situations
24
Q

Assessment: psychotic disorders

Alterations in speech

A
  • associative looseness: unconscious inability to concentrate on a single thought. Can progress to a flight of ideas (one thought to another, incoherent)
  • neologisms: made-up words w/ meaning only to the client
  • echolalia: client repeats words spoken to him
  • clang association: meaningless rhyming of words, often forceful
  • word salad: words jumbled together with little meaning or significance to listener
25
Q

Assessment: psychotic disorders

Alterations in Perception

A

hallucinations are sensory perceptions that don’t have any apparent external stimulus:

  • auditory: command:
  • visual
  • olfactory
  • gustatory: experiencing tastes
  • tactile: feeling bodily sensations
26
Q

Assessment: psychotic disorders

Personal boundary difficulties

A

disenfranchisement w/ one’s own body, identity, and perceptions

  • depersonalization- nonspecific feeling that the client has lost their identity. Self is different or unreal
  • derealization- perception that the environment has changed, such as client believing that objects in their environment are shrinking
  • illusions- misperceptions or misinterpretations of a real experience
27
Q

Assessment: psychotic disorders

alterations in behavior

A

> extreme agitation&raquo_space;> pacing and rocking
stereotypical behaviors&raquo_space;> motor patterns that had meaning, are now mechanical and lack purpose
automatic obedience&raquo_space;> responding in a robotic manner
waxy flexibility&raquo_space;> maintaining specific position for a long time
stupor&raquo_space;> coma-like, motionless
negativism&raquo_space;> doing opposite of what’s requested
echopraxia&raquo_space;> purposeful imitation of movements from others
catatonia&raquo_space;> increase/ decrease in amount of movement. Muscular rigidity, catalepsy
motor retardation&raquo_space;>
impaired impulse control&raquo_space;> reduced ability to resist impulse
gesturing or posturing&raquo_space;> assuming unusual/ illogical expressions
boundary impairment&raquo_space;> impaired ability to see where one person’s body ends and another’s begins

28
Q

Standardized screening tools for psychotic disorders

A

Abnormal Involuntary Movement Scale (AIMS)- used to monitor involuntary movement and tardive dyskinesia in clients taking antipsychotic medication

World Health Organization Disability Assessment Schedule (WHODAS)-
helps determine client’s level of global functioning.

29
Q

Nursing Care: psychotic disorders

Milieu therapy

A

Milieu Therapy: in acute mental health facilities and in community facilities. It is a social environment controlled to help client.

  • provide a structured, safe environment (milieu)
  • Program of assertive community treatment (PACT): intensive case management and interprofessional team approach to assist clients w/ community-living needs.
30
Q

Medications for psychotic disorders

A
  • First- generation/ conventional antipsychotics
  • Second- generation/ atypical antipsychotics
  • Third- generation antipsychotics
  • Antidepressants
  • Mood stabilizing agents and benzodiazepines

ATI Mental Health (8 decks)

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