Schizophrenia Flashcards
What are the effects that might occur when a family member has been given the diagnosis of schizophrenia?
Individuals with schizophrenia may be emotionally unavailable due to mental stress therefore the family may feel rejected and lonely.
The symptoms can also be very disabling and can be life long which may have a severe burden on the family if they choose to support and care for the patient (Causing fatigue, emotional, and financial stress).
What is schizophrenia?
A disorder characterised by a major disturbance in thought, perception, cognition, and psychosocial functioning. This is one of the most severe mental disorders.
What is the Aetiology of schizophrenic disorders?
Research has identified a complex combination of genetic and environmental factors that suggest an interference with normal brain development and function that can lead to the development of schizophrenia.
How long must a person have experiences a mixture of positive and negative symptoms of schizophrenia to be diagnosed?
6 months
What are the most common signs and symptoms of schizophrenia?
Delusions, thought disorder, and hallucinations
What is the diathesis-stress model?
This theory has the assumption that individuals are exposed to stressful situations during their life and these events may cause symptoms in some people that may be predisposition to mental illness
What does genetic predisposition mean?
Where an individuals genetics leaves them vulnerable to the development of the illness.
What is involved in nursing assessment?
Risk assessment, functional assessment, and a mental state examination
Define delusions.
Delusions are characterized as fixed and false beliefs that contradict reality.
Define hallucinations
a hallucination includes seeing, hearing, tasting, smelling, or feeling something that isn’t there.
Define disorganised speech
People with disorganized speech might speak incoherently, respond to questions with unrelated answers, say illogical things, or shift topics frequently.
Define disorganised behaviour
Disorganised behaviour includes bizarre or inappropriate behaviour, actions or gestures.
What are negative symptoms?
“Negative” symptoms are things that are “taken away” or reduced (e.g., reduced motivation or reduced intensity of emotion).
What are positive symptoms?
“Positive’ symptoms are changes in thoughts and feelings that are “added on” to a person’s experiences (e.g., paranoia or hearing voices).
Define anhedonia.
inability to feel pleasure in normally pleasurable activities.
Define avolition.
a total lack of motivation that makes it hard to get anything done
Define Aphasia
inability (or impaired ability) to understand or produce speech, as a result of brain damage.
Define anergia
abnormal lack of energy.
Define alogia
difficulty with speaking or the tendency to speak little due to brain impairment.
Why is cognitive behavioural therapy (CBT) considered an appropriate intervention?
Because it has no adverse effects and has a potential to improve the quality of an individuals life
Why is non-adherence to medication a significant concern in management of schizophrenia?
To ensure the person does no experience a relapse of the illness it is important that the medication that is prescribed is maintained for at least a year.
Why do nurses need to assess levels of personal hygiene and nutritional intake?
Nurses need to monitor the personal hygiene and nutritional intake to prevent infections and also to ensure the person is eating a healthy diet.
What does the nurse do regarding psychopharmacology is they cant prescribe?
They are involved in managing adherence and the understanding around medications for patients
The primary goal of antipsychotic drug administration is to what?
Control positive symptoms of schizophrenia such as delusions and hallucinations although they can make negative symptoms worse such as loss of emotions and social withdrawl
What are the two main typical antipsychotics?
Chlorpromazine and haloperidol
What are the 5 main types of Atypical antipsychotics
Olanzapine, Clozapine, Respiridone, Zuclopenthixol, and quetiapine
What are the 4 depot preparations? (slow release medications by injection)
Flupenthixol, Zuclopenthixol, Paliperidone, and Olanzapine
What does NMS stand for?
Neuroleptic malignant syndrome
What is neuroleptic malignant syndrome?
A rare disorder with symptoms that can last longer than a week and cause death. It is shown to be caused by antipsychotic medications
What is agranulocytosis?
A blood disorder characterised by severe depletion of white blood cells rendering the body almost defenceless against infection (Has flu-like symptoms)
Constipation is a serious side affect of which medication
Clozapine
When a patient is on clozapine and we suspect constipation what are we assessing for?
Regular bowel movements, current diet and exercise, and other medications,
When a patient is on clozapine and we suspect constipation what should we advise the patient to do?
Drink 6-8 glasses of water per day, increase fibre in diet, increase exercise, and use pharmacological products as needed
What is medication adherence
The maintenance of a prescribed medication regimmen
What would be the nursing management for an adverse effect of weight gain?
Education around diet and exercise
What would be the nursing management for an adverse effect of parkinsonian effects (blank mask like expression, salivary drooling, noticeable tremor in the limbs, and muscle rigidly/shuffling)?
Reassure the patient that these symptoms will subside with time, monitor effects and administer anticholinergics as prescribed
What would be the nursing management for an adverse effect of akathisia?
Report to doctor who may need to review medication
What is akathisia?
Akathisia is a movement disorder that makes it hard for you to stay still. It causes an urge to move that you can’t control.
What would be the nursing management for an adverse effect of neuroleptic malignant syndrome?
This is an emergency. Nursing care includes hyper vigilance for symptoms, monitoring and reducing temp if it occurs.
What does ISBAR stand for?
Introduction/Identify Situation Background Assessment Request / Recommendation
What the the 5 characteristic symptoms of schizophrenia?
Delusions, hallucinations, disorganised speech, grossly disorganised or catonic behaviour, and negative symptoms
What is involved in the MSE (Mental state examination)?
Behaviour/Appearance, Mood/Affect, thought form, thought content, perception, cognition/orientation, judgement, and insight
What is involved in the functional inquiry?
Sleep, appetite, motivation/activity, anxiety, enjoyment, + alcohol/other drugs, psychosocial inquiry, and physical health
What are 3 nursing interventions for an objective of: “Nigel will remain safe and continue to resist the impulse of suicide”
- Develop trust
Name 5 sensory experiences that can be associated with hallucinations?
Auditory (hearing voices), visual (seeing things), olfactory (smelling things), tactile (feeling things), and gustatory (tasting things)
“I am jesus and I am a millionaire” is an example of what?
Grandiose delusion
What is grandiose delusion?
Delusions of grandeur are one of the more common ones. It’s when you believe that you have more power, wealth, smarts, or other grand traits than is true.
“The newsreader on the TV is talking about me” is an example of what?
Ideas of reference
What is ideas of reference
An idea of reference—sometimes called a delusion of reference—is the false belief that irrelevant occurrences or details in the world relate directly to oneself.
Name some negative symptoms associated with schizophrenia?
Anhedonia, affective blunting, avolition. Alogia, asociality, poverty of ideas, loss of living skills
What are some examples of how symptoms can impact upon recovery ?
Loss of motivation, poor communication, limited social interactions, personal hygiene, poor nutrition, and loss of hope
What are 6 words that contribute to stigmatisation of schizophrenia?
Crazy, dangerous, schizo, stupic, psycho, and unpredictable
What are some aspects of life that can be affected by discrimination?
Social, relationships, employment, education, sport, inclusion, community, housing, physical health, self perception/esteem, and coping
What are some strategies that a nurse can do to reduce stigma?
Use of language, health promotion, focus on strengths not deficts, education, positive regard, respect, and hope
What are the major side effects/risks associated with atypical antipsychotic medications?
Weight gain, metabolic syndrome (diabetes), sedation, and gastrointestinal upset
What is the primary neurotransmitter target for atypical medicaiton?
Dopamine
What are some depot antipsychotic medications?
Flupenthixol, Olanzapine, Zuclopenthixol, Risperidone, Paliperisone, and Aripiprazole
What are some reasons why someone would stop taking their medication?
To feel good, due to side effects, stigma, from poor memory, and influence from other substance use
What tests need to be conducted regularly for people prescribed clozapine and why?
Blood tests, blood pressure, ECG, and bowel monitoring. Because of angranulocytosis, postural hypotenstion, QT prolonged interval, myocarditis, cardiomyopathy (for Long-t use) and constipation
Why is it important to ask about mood on the MSE?
Many people who develop schizophrenia have a co-morbid mood disorder
What question could we ask regarding perception?
Do you hear any voices other than mine now or at any time?
Do you ever hear or see things that you think other people may not be seeing?
What negative symptom would affect assessment of affect?
Affect dysregulation (inability to regukate emotional states), blunted affect, and maybe some medications.
“Ive been playing cards with the devil and he cheated me” would be assessed under what in the MSE?
Thought content
Why would it be important to find out how long symptoms have been present during the MSE ?
Psychosis can occur at any time and be of a short duration (at least 1 day but less than a month) symptoms that are present for a significant portion of time may indicate something more serious
The biological theory of schizophrenia suggests an excess of what neurotransmitter?
Dopamine
The diathesis theory suggests that ….. and …. Can contribute to the development of schizophrenia
Exposure to stressful events and vulnerability
What is the difference between psychosis and schizophrenia?
Psychosis is a term describing a set of synptoms and can be linked to many things wheras schizophrenia is a specific diagnosis where specific psychotic symptoms, delusions and/or hallucinations and/or thought disorder have to be present for 1 month or more
Can schizophrenia run in families?
This is inconclusive, the theory is that there is a generic vulnerability and a person can inherit a risk that may be enhanced with the presence of other factors (i.e environment, stress, attachment, and trauma for example)
What are 7 things that are commonly present with schizophrenia?
Drugs, alcohol, anxiety, mood disorder, hopelessness, poor self-esteem, and social isolation
