Psychosis Flashcards
what are the steps to answering a question dealing with psychosis
1) ask: is it non-psychotic or psychosis
2) determine the type of psychosis
what are characteristics of non-psychosis
- pt will have insight and is reality based
- may be emotionally distressed, but know that they have a problem
- what they see, hear, feel, etc. is the same as us
what is the treatment for non-psychosis
- good therapeutic communication
what are characteristics of psychosis
- no insight
- not reality based
- think everyone else has the problem, not them
delusions, hallucinations, and illusions are ______ symptoms
- psychotic (only pt’s with psychosis get these, non-psychotic DO NOT)
define: delusion
- false, fixed (doesn’t change) idea or belief
- no sensory component, all has to do with thoughts
what are 3 types of delusions
- paranoid
- grandoise
- somatic
what is a paranoid delusion
- false, fixed belief that people are out to harm them
what is a grandoise delusion
- false, fixed belief that you are superior
what is a somatic delusion
- false, fixed belief about your body
ex. body is hollow
define: hallucination
- false, fixed sensory experience
- hear, feel, taste, smell things
what are 5 types of hallucination
- auditory (voices, etc.)
- visual
- tactile (feeling things)
- gustatory (tasting)
- olfactory (smelling)
define: illusion
- misinterpretation of reality
- sensory experience
how can you tell the difference between hallucination and an illusion
- both are sensory experience
- illusion has a referrant in reality –> something to which a person refers to when they say something, something is actually there, it’s just misinterpreted
ex. the pt says “listen, i hear demon voices”. hallucination or illusion?
- hallucination
ex. pt hears doctors and nurses laughing. says “listen, i hear demon voices”
hallucination or illusion?
- illusion
what are the 3 types of psychosis
- functional
- psychosis of dementia
- psychotic delirium
those with functional psychosis are…
- functional in daily life
what 4 diseases make up functional psychosis
- schizophrenia
- schizophrenia effective disorder
- major depression
- manic
(“schizo, schizo, major, manic”)
what are the 4 steps of care for functional psychosis (in order)
1) acknowledge feelings (answer should either say “feel” or specify a feeling)
2) present reality (“i know ___ is real to you but I don’t ___”)
3) set limits (“this topic is off limits in our convo”)
4) enforce boundaries (end the convo, do not take away privileges/punish them)
what is psychosis of dementia
- psychosis due to brain damage
- not functional
what are examples of diseases that cause psychosis of dementia
- dementia
- alzheimers
- organic brain damage
- post-stroke
- may say “senile”
what is care for a pt with psychosis of dementia
1) acknowledge feelings
2) re-direct (do not present reality, they cannot learn it, channel from something they can’t do to something they can)
what is psychotic delirium
- temporary, sudden, dramatic, 2ndary loss of reality
- often due to chemical imbalance in the body
what are examples of causes of psychotic delirium
- drug rxn
- OD on upper drug
- WD on downer drug
- post-op
- UTI in older adults
- thyroid storm
- adrenal crisis
what is the care for a pt with psychotic delirium
- remove underlying cause
- acknowledge feeling
- reassure that it’s temporary and that they will be kept safe
what is involved in care for personality disorders
- good therapeutic communication
define: loosening of association
- thoughts aren’t wrapped too tight = thoughts all over the place
what are 3 types of loosening of association
- flight of ideas
- word salad
- neologism
define: flight of ideas
- each individual phrase is coherent, but incoherent when phrases put together
define: word salad
- incoherent phrase with random words
define: neologism
- make up imaginary words
what is a narrowed self concept
- when a psychotic refuses to leave their room or change their clothes
- often functional
why does narrowed self concept occur?
- because they define who they are based on where and who they are = don’t know who they are unless they’re wearing these clothes in that room
what is care for someone with narrowed self concept
- do not force them to change their clothes or leave their room
define: ideas of reference
- think everyone is talking about you
