Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psych Exam 1 > Psychotic Disorders > Flashcards

Psychotic Disorders Flashcards

You may prefer our related Brainscape-certified flashcards:
Psychology 101 flashcards GRE® Psychology flashcards
1
Q

Psychosis

A

defined as an abnormal state in which thoughts, feelings and perceptions are altered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Psychosis may be due to…

A

psychiatric or neurologic disorder or secondary to physiological stressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Schizophrenia

A

disease of the brain that causes distorted and bizarre thoughts, perceptions, emotions, movements, and behavior

-syndrome or disease process vs. a single illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Two major categories of symptoms for Schizophrenia

A

positive and negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Positive Schizophrenia Symptoms

A
  • delusions
  • hallucinations
  • grossly disorganized thinking, speech, and behavior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Negative Schizophrenia Symtpoms

A
  • flatted affect
  • social withdrawal
  • lack of volition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptom rule for Schizophrenia

A

Two or more of the following, each present for a significant portion of time during a 1 month period (or less if successfully treated).

Of the symptoms, at least 1 of them has to be delusions, hallucinations, or disorganized thoughts.

  1. delusions
  2. hallucinations
  3. disorganized speech
  4. grossly disorganized or catatonic behavior
  5. negative symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Adult Schizophrenia patients…

A

demonstrate a decreased ability to function either at work, in relationships, or in ability to care for themselves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Children Schizophrenia patients….

A

fail to achieve expected level of performance in tasks related to interpersonal, academic, or occupational functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Symptoms of Schizophrenia must be present for…

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Schizoaffective disorder

A

experience hallucinations, delusions, disorganized thought and disorganized behavior

  • they suffer from at least one manic episode or period of major depression
  • must experience depressive or manic episodes at least 50 percent of the time throughout the entire course of their illness
  • must persist for 2 weeks or more
  • often misdiagnosed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Schizophreniform disorder

A

presents similarly to schizophrenia but symptoms last 1-6 months whereas a full 6 month duration is needed for schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Brief psychotic disorder

A

brief episode of typically positive psychotic behavior and lasts between 1 day and 1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

catatonia

A

unusual or lack of body movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

wavy flexibility

A

will maintain any position in which they are placed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mood and affect

A
  • variable: flat or blunted to silly and inappropriate
  • mood and affect may be incongruent
  • anhedonia (lack of pleasure)
  • euphoria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Thought context

A
  • WHAT THE CLIENT ACTUALLY SAYS

- the ideas expressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is assess under thought content?

A
  • delusions
  • suicidal or homicidal ideation
  • magical thinking
  • poverty of speech or content
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Thought Process

A

aka Form of Thought

  • HOW the thoughts are expressed
  • assessed through the client’s verbal communication–inferred–speech reflects thoughts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Circumstantiality

A

speech that takes a circuitous route before reaching its goal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tangentiality

A

speech that talks past the point and never reaches the goal of answering the questions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Echolalia

A

repetition of speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clang associations

A

individual repeatedly uses rhyming words without apparent meaning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Neologisms

A

uses meaningless words that only have meaning to them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Preservation

A

uses the same words or phrases over and over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Included in the assessment of perception are…

A

-hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hallucinations

A

sensory perception in the absence of an actual external stimulus.

they can occur in any sensory system of the body, such as…

  • auditory
  • visual
  • tactile
  • olfactory
  • gustatory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Command hallucinations

A

potentially the most dangerous

MUST ASK: “do the voices ever tell you to do thing? if so, do they ever tell you to hurt yourself or someone else?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Judgment

A

Defined in Taber’s as: the use of available evidence or facts to formulate a rational opinion or to make socially acceptable choices or decisions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Intact judgment

A

requires the ability to interpret the environment correctly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

impaired judgment

A

may result from faulty perceptions

-this may manifest in an inability to recognize dangers or potential for self neglect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Insight

A

ability to recognize that something is wrong or that they are suffering from a mental illness

33
Q

Denial

A

common with schizophrenia, making the disease particularly difficult to treat

34
Q

Self Concept

A
  • ego boundaries
  • may lack a clear sense of where their own bodies, minds, and influence end and where those of others begin
  • can be seen in depersonalization, derealization, and delusions of reference
  • may be the source of bizarre behaviors, including some that are socially unacceptable
35
Q

Roles and Relationships

A
  • difficulties with trust and intimacy
  • low self esteem
  • combined with problems in thinking, behavior, and self concept this leads to isolation and avoidance of others
  • difficulty functioning at even the most basic levels such as being a son, daughter or member of a family
36
Q

Social Adjustment

A

interactions with others:

  • observe client’s interactions with staff and family
  • does client initiate social interactions?
  • able to maintain contact?
  • take part in recreational and occupational groups?
  • active participant in therapy groups?
37
Q

Developmental

A
  • Regression: Trust vs Mistrust
  • Erickson’s first stage
  • developmental age/stage may be affected by age of onset
  • level of maturity, developmental tasks, and moral development
38
Q

concrete thinking

A

inability to think in abstract terms

39
Q

illusion

A

distorted perceptions of actual sights, sounds and other stimuli

40
Q

Occipital lobe

A

interprets visual stimuli

41
Q

Temporal lobe

A

interprets auditory and olfactory stimuli

42
Q

Therapeutic Relationship

A
  • be patient
  • short, frequent contacts
  • clear and direct explanations
  • personalize the interaction by using client’s name
  • do not touch the patient
  • maintain body posture that conveys a caring and attentive tone
  • be consistent, enhances trust
43
Q

Communication

A

be ready for clients who may have little or nothing to say

44
Q

Respond to the _________ expressed by the client

A

FEELING

45
Q

Clarify the meaning of the client’s conversation by….

A

exploring and clarifying questions, listening for themes, or recurring statements

46
Q

How can you convey your interest and their value?

A

just being with the client and accepting them at that level

47
Q

Interventions for Hallucinations

A
  • look for behavioral clues
  • ask what the patient is experiencing
  • assess the content of the hallucinations so you can act to protect the client or others
  • try and find out what the CLIENT IS FEELING
  • focus on the HERE AND NOW (what is on tv, what did the patient eat last)
  • sometimes it is useful to engage the client in an activity like cards, music, etc which is a here and now, reality based activity
  • control the environment (reduce isolation, reduce excess stimulus and stress)
  • ***communicate that you are NOT experiencing the vision or voice, but validate patient experience
  • **then provide diversion
  • ***I believe that your are hearing the voice of your brother. I do not hear a voice. Let’s go sit outside with the others.

***This is an important intervention: use cautiously if patient in crisis

48
Q

Impaired reality testing

A
  • help patient check environment for source of sound
  • help patient assess responses of others (if they are not frightened, perhaps what patient saw or heard was not real)
  • help patient identify persons they trust

**use these interventions once patient is more stable

49
Q

Interventions for Delusional Thoughts

A
  • avoid playing along or participating in the client’s delusions
  • avoid openly confronting the delusions
  • distraction from delusional thinking with playing board games, listening to music, walking
50
Q

How to avoid openly confronting the delusions

A
  • present and maintain reality such as “I’ve seen no evidence of that”
  • use statements that cast doubt such as “It doesn’t seem that way to me”
51
Q

Interventions for Disorganized Thinking

A
  • Communication
  • Assess need for assistance with self care
  • Always create trust, conduct psychosocial assessment each shift
52
Q

Communication techniques for disorganized thinkers

A
  • attempt to decode speech you do not understand
  • anticipate patient’s needs
  • use short, concrete explanations (1-6 words)
53
Q

Physiologic and Self-Care Considerations

A
  • ADL’s: Lack of interest in grooming and basic hygiene
  • Performing basic ADLs may be difficult
  • They may not recognize or attend to hunger or thirst, and may become dehydrated and undernourished
  • paranoia may keep them from eating
54
Q

Sleep issues

A

paranoid thoughts, hallucinations

-sleep cycle disruptions due to late night activity and daytime sleeping

55
Q

basic living skills

A

paying bills, cooking, grocery shopping, etc may be lacking

56
Q

To apply the concept of cognition

A

-recognize situations in which a patient’s thought processes contribute to increased risk of self harm

use nursing process to minimize risk of harm or neglect and promote progress on goals

-identify interventions that allow patients to maintain dignity

57
Q

Collaborative Care goals: Acute stage

A
  • protect safety of patient and others
  • stabilize with antipsychotics
  • develop therapeutic relationship with patient (provides foundation for more in depth assessment)
  • monitor/encourage continued progress as degree of psychosis clears
58
Q

Culture of Safety

A
  • staff practice nonviolent crisis intervention
  • use personal safety plans with patients
  • coordinated response teams
  • APNA position statement on seclusion and restraint
59
Q

APNA position statement on reduction of seclusion and restraints shows some evidence that all of the following are helpful:

A
  • maintain presence on the unit and notice early changes in patient and milieu
  • assess the patient and intervene early with less restrictive measures
  • changing aspects of the unit to promote a culture of structure, calmness, negotiation and collaboration rather than control
60
Q

Psychotropic Drugs do what…

A
  • reduce distorted thinking (delusions)
  • reduce distorted perceptions (hallucinations)
  • reduce anxiety to manageable levels
  • reduce violent/bizarre behaviors
61
Q

Nursing Diagnoses for patients exhibiting POSITIVE symptoms

A
  • risk for injury
  • acute confusion
  • impaired memory
  • personal identity disturbance
  • impaired verbal communication
  • dysfunctional family processes/altered family coping
62
Q

Nursing Diagnoses for patients exhibiting NEGATIVE symptoms

A
  • self neglect
  • impaired social isolation
  • diversional activity deficit
  • ineffective health maintenance
  • ineffective management of therapeutic regimen
  • self care deficit
63
Q

Active Intervention is required when…

A

A. When the client is in an acute stage of psychosis.

B. When the client is in emotional or physical pain.

C. When the client is a danger to him/her self or others.

D. When the client is destructive to the environment.

64
Q

Intervening with Socially Inappropriate Behaviors

A

-loss of ego boundaries can lead clients into inappropriate expression of feelings and behaviors:

  • touching others
  • intruding into the living space or personal space of others
  • taking to inanimate objects
  • inappropriate statements

**protect client from retaliation

65
Q

Inappropriate Behaviors

A
  • redirect or interrupt the unacceptable behavior to reduce intrusion on others
  • engage client in activity
  • offer some time out (client’s room or quiet area)
  • use a non-judgmental and matter of fact manner, use factual statement without scolding
  • provide explanation to other clients without violating confidentiality
66
Q

Outcome Identification: Client Goals during the acute or inpatient phase

A
  • free from injury to self or others
  • establish contact with reality
  • increase social interaction
  • express thoughts/feelings appropriately
  • participate in therapeutic activities
67
Q

Suicide Risk Stats

A

Schizophrenics: 50x higher

40 percent of patients attempt suicide once, 10 percent die

68
Q

Collaborative Discharge Planning

A

-nurse and patient will collab with:

all tx team members

physician, pharmacy, social worker, family and outpatient case manager to coordinate availability and continued adherence to medications

69
Q

followup care

A

physician, social worker, family, and outpatient case manager and outpatient provider

70
Q

The nurse can help the client understand…

A
  • nature of the illness
  • medication
  • learn social skills through education, role modeling and practice
  • self care, ADLs, proper nutrition
71
Q

Family and significant other teaching

A
  • refer to NAMI
  • identify community resources
  • create a crisis response plan
72
Q

Patient and family teaching

A
  • identify behaviors that may signal a potential relapse

- understand importance of maintaining support systems

73
Q

Community Resources

A
  • case management

- ACT (Assertive Community Treatment)

74
Q

Relapse Prevention

A
  • teach risk factors for relapse
  • drug or alcohol use
  • new diagnosis
  • stress
  • teach warning signs for relapse (hearing voices)
  • feeling suspicious
  • staying away from friends
  • losing interest
75
Q

To prevent relapse encourage patient to…

A
  • take meds
  • keep all doctor and therapy appointments
  • recognize warning signs
  • attend any weekly support group or family education
  • get to a doctor ASAP
76
Q

Role of the Family (inpatient)

A
  • involve family in patient’s care, esp ADL’s
  • involve family in unit activities when possible
  • involve family in decision making concerning patient’s treatment
  • often family need to have power of attorney, esp health care
  • refer to appropriate agencies
77
Q

Role of the Family (inpatient)

A
  • involve family in patient’s care, esp ADL’s
  • involve family in unit activities when possible
  • involve family in decision making concerning patient’s treatment
  • often family need to have power of attorney, esp health care
  • refer to appropriate agencies
78
Q

Difference between positive and negative symptoms

A

Positive: additional psychotic behaviors not commonly obsereved in adult patients that can cause them to lose touch with reality

Negative: more difficult to notice, can be confused with depression

Psych Exam 1 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions