NUR 114 Schizophrenia Exam II - 2020 Flashcards
is the ability to process, learn, store, retrieve and use information.
Cognition
is how we interpret the environment around us. It utilizes the senses of hearing seeing, smell, taste
Perception
these symptoms happen when these particular patients are in psychosis:
Delusions
Depression
Hallucinations
Disorganized speech
Disorganized catatonic behavior
Psychotic symptoms more pronounced and disruptive
clinical manifestations of schizophrenia: a psychotic disorder
Late onset (female 25-35 years old) Abrupt onset good pre-morbid qualities (before the "big break") Good pre-psychotic GAF scores
indications that the outcome could potentially be better in those with schizophrenia.
Extremely early onset increase severity (before 18 y.o.)
Early onset (male)
Slow onset (over 2-3 years) poor sign
Hx of negative features (abilities that are taken away fro you)
Troubled childhood
indications that the outcome would more than likely be poor of those with schizophrenia.
What two types of personality disorders can progress to schizophrenia?
schizotypal and paranoid
- More severe in industrialization nations
- Viewed differently by different cultures
- May be considered gifted or special
- May be considered as evil or possessed
- Positive and negative symptoms influenced
- Family view
Cultural considerations in regards to schizophrenia
the symptoms that are “added” to someone’s being such as hallucinations, delusions, bizarre behavior, catatonic, formal thought disorder, concrete thinking, and etc
positive symptoms
the symptoms that are seen as a loss of function. Sypmtoms that take away aspects of someone’s ability to function in a normal state such as withdrawal, apathy, lack of motivation (anhedonia), blunted or flat affect, poverty of speech, and some cognitive symptoms.
negative sypmtoms
- Eighty- ninety percent have prodromal symptoms prior to the acute phase.
- Social withdrawal, decrease social functioning & depressed mood.
- Perceptual field disturbances such as magical thinking & peculiar behavior occur.
- One month to a year before psychotic break; there will be decreased level of functioning.
Prodromal (Early Stage of Schizophrenia) also known as pre-psychotic
- Florid symptoms (- & +symptoms). Hallucinations & delusions.
- Negative symptoms such as apathy, withdrawal, lack of motivation and some cognitive symptoms
- requires hospitalization
Acute phase of schizophrenia
Acute symptoms decrease in severity (but still present never truly go away).
The remaining symptoms are positive.
Stabilization phase of schizophrenia
Symptoms in remission but may be milder persistent symptoms
Maintenance phase of schizophrenia
there is an _______ in residual dysfunction and deterioration with each relapse.
increase
- impairment in memory
- disruption in social learning
- inability to reason, solve problems and focus attentions
cognitive problems associated with schizophrenia
a person is unable to think abstractly and takes everything literally.
example: Q: “what brought you here?”
A: “the bus”
concrete thinking
- depression
- anxiety
- demoralization
- suicidal ideations
- excitability
- agitiation
mood symptoms of schizophrenia
mimicry or imitation what you say
echolalia
jumbled up words
ex: “many humble days words grass grows
word salad
a newly coined word or expression
neologisms
sensory perceptions with no external stimulus exists. This symptom must be addressed immediately
hallucinations
disorganized thinking, manifested as jumbled and illogical speech and impaired reasoning.
associative loosness
when the environment seems bigger or smaller than it actually is.
derealization
a thing that is or is likely to be wrongly perceived or interpreted by the senses
illusion
the opposite of compliance.
negativism
psychomotor symptom of catatonia as associated with schizophrenia, bipolar disorder, or other mental disorders which leads to a decreased response to stimuli and a tendency to remain in an immobile posture. Holds one position for a really long time.
waxy flexibility
lack of motivation
avolition
- Centered around suspiciousness
- Use projection as a main defense mechanism when -feeling self-critical
- Misinterpret messages from others
- Late onset (20’s-30’s)
- Cognitive abilities intact
- Guarded, tense , reserved
- Ideas of reference
paranoid subtype of schizophrenia
- Abnormal behavior
- Agitation
- Psychomotor agitation
- Stupor or mute-ism during withdrawal phase
- Will not eat or move
Catatonic subtype of schizophrenia
- Looseness of association
- Grossly inappropriate affect
- Bizarre mannerism
- Incoherent speech
- Poorly organized delusions + hallucinations
- Odd, giggly grimacing behavior
- mumbling to themselves
- Early onset (managed typically in an institution)
- commonly homeless
disorganized subtype of schizophrenia
Serotonin-dopamine receptor antagonists
Advantages
Diminishes negative as well as positive symptoms
Less side effects encourages medication compliance
Improves symptoms of depression and anxiety
Decreases suicidal behavior
Disadvantages
Weight gain
Metabolic abnormalities (glucose, Choles, HTN)
(patients are more compliant when on this medication)
atypical anti-psychotics (the newer version)
Dopamine antagonists (D2 receptor antagonists)
Target positive symptoms of schizophrenia
Advantage
Less expensive than atypical anti-psychotics
Disadvantages
Do not treat negative symptoms
Extrapyramidal side effects (EPS)
Tardive dyskinesia
Anti-cholinergic effects (ACH)
Lower seizure threshold
(ONLY TARGETS THE POSITIVE SYMPTOMS ONLY)
Traditional anti-psychotics
Spasms of face, tong, neck
Opisthotonos-
eyes locked up
Oculogyric crisis
Inner motor restless, (foot tapping, rocking, wt shifting
Akathisia
1, Facial-Protruding, rolling tongue,
- Limbs-chorea rapid, purposeless, irreg movements, serpentine
- Trunk-Neck and shoulder movement, pelvic thrusts
Tardive dyskinesia (TD) (AIMS) test
Occur after long term use. WBC initially during therapy. Agranulocytosis Neuroleptic Severe extrapyramidal Hyperpyrexia 103. F Autonomic dysfunction HTN Tachycardia Diaphoresis incontinence
toxic effects of antipsychotics (rare) neuroleptic malignant syndrome
what medicine do you give to treat NMS?
- Cogentin ,
- Dantrolene for muscle spams
- Tylenol for headache
