Quiz 3 Flashcards
What is psychosis?
delusions
hallucinations
Describe hypomania
less severe/intense form of mania
must last at least 4 days
can be missed bc pt is high functioning
Describe delirious mania
happens quickly and suddenly
disoriented
psychosis
catatonia
Describe cyclothymic disorder
alternates between hypomania and depression
adults: for at least 2 years
children: 1 year
What will a nurse do during the assessment for someone with bipolar disorders?
look for:
dehydration
- acute mania can be severely dehydrated
cardiac status
- severe exhaustion/dehydration can lead to cardiac collapse
sleep
- constant activity can lead to exhaustion
safety
- assess danger to self
What will a nurse do during the implementation stage for someone with bipolar disorders?
address physiological needs (check VS)
milieu therapy
safety measures
seclusion/restraint
What will a nurse evaluate for someone with bipolar disorders?
stable VS
self-control
well-hydrated
adequate sleep
What are the comorbidities for someone with schizophrenia?
substance use disorders
tobacco use disorder
cannabis use
attempted suicide
anxiety disorders
metabolic syndrome
HIV/AIDS
Describe positive symptoms
alteration in:
- thinking
- thought process
- perception
- behavior
- boundaries
Describe the alterations in thinking for positive symptoms
delusions
- ideas of reference
- paranoid
- grandiosity
- somatic
- jealousy
- control
- thought broadcasting/insertion/withdrawal
- concrete thinking (literal)
Describe the alterations in thought process for positive symptoms
associative looseness (illogical shift)
circumstantiality (excessive detail)
tangential (tangents)
neologisms (made up words)
word salad (no sentence/grammar structure)
echolalia (repeating)
clang associations (rhyming)
Describe the alterations in perception for positive symptoms
hallucinations (5 senses)
illusions (misinterpretation of object)
pt senses something there but it is not there
Describe the alterations in behavior for positive symptoms
bizarre demeanor
eccentric dress, grooming, rituals
impaired impulse control
Describe the alterations in boundaries for positive symptoms
depersonalization
derealization
What are the negative symptoms?
anergia (lack of energy)
avolition (lack of motivation)
anhedonia (can’t experience pleasure)
affective blunting (can’t express emotions)
poverty of speech (speech restriction)
social withdrawal
What are cognitive symptoms?
memory impairment
disruption in social learning
poor judgment and focus
impaired insight
What are affective symptoms?
depression
anxiety
demoralization
suicidality
excitability
agitation
What is the treatment for catatonia?
high levels of benzos
What will the nurse assess for someone with schizophrenia?
rule out medical or substance induced psychosis
SAFETY
insight
comorbidities
pt medication/adherence
support system
What are the outcomes for someone with schizophrenia?
pt will:
- refrain from inflicting injury
- take meds w/o prompting
- state 2 coping mechanisms to reduce anxiety
What will the nurse implement for someone with schizophrenia?
crisis intervention
acute symptom stabilization
safety
meds
community support
Describe acute dystonia
facial grimacing
involuntary eye movement
muscle spasms of tongue, face, neck, back
What is a priority for acute dystonia? What is the treatment?
monitor airway (it can close)
tx: benztropine. diphenhydramine
Describe tardive dyskinesia
protrusion or rolling of tongue
sucking/smacking lips
chewing motion
involuntary movements
irreversible
What is the priority for tardive dyskinesia? What is the treatment?
stop Rx as soon as symptoms present
tx: lower dosage or switch med
benztropine
Describe akathisia
restlessness
trouble standing still
pacing
feeting moving
What is the priority for akathisia? What is the treatment?
monitor for suicide (so restless, they can harm themselves)
tx: propranolol, benzodiazepines, relaxation techniques
Describe pseudoparkinsonism
stooped posture
shuffling gait
rigidity
tremors at rest
pill-rolling motion of hand
What is the priority for pseudoparkinsonism? What is the treatment?
risk for falls
tx: benztropine, trihexyphenidyl
Describe neuroleptic malignant syndrome
muscle rigidity
high fever
fluctuating BP
irregular/increased HR
increase RR
abnormal involuntary movement scale
