Brainscape's Knowledge GenomeTM

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


See full index

384 Exam 2 > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

Risk factors of schiz

A
  1. genetics: inherited factors
  2. physiological: complications in birth/preg, increased paternal age, viral infection, starvation, ACE
  3. biochemical: stress: cortisol increases dop, loss of hippocampus volume
  4. enviornmental: cannabis use, minority, immigrants, grew up in dense city, poverty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Positive symptoms of schiz

A

POSITIVE manifestations: “Added” to distort normal fx. Things that are not typically present
1. Delusions
2. Hallucinations
3. Bizzare behavior (walking backward constantly)
4. Disorganized speech (switches topis or does not make any sense (word salad/incoherence)

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

Negative symptoms of schiz

A

NEGATIVE manifestations: “Take away” or reduce a person’s experiences like lack of emotion or motivation. Absence of things that are usually present
1. Alogia: (poverty of speech)slowness in thinking that is observed by how the person speaks, in langage skills
2. Affect: no expression or flat expression doesn’t change
3. Anergia: lack of energy
4. Anhedonia: lack of pleasure or joy
5. Avolition: lack of motivation in activities and hygeine

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

Idea of reference (alt in thought/delusions)

A

believing other are talking about him when they are not

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

Persecution (alt in thought/delusions)

A

singled out for harm ex. being hunted down by FBI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Grandeur (alt in thought/delusions)

A

believes they are all powerful and important like a god

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Somatic delusions (alt in thought/delusions)

A

believes their body is changing ex. growing a third arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Thought broadcasting (alt in thought/delusions)

A

believes their thoughts are heard by others

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

Thought insertion (alt in thought/delusions)

A

believes their thoughts are heard by others

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

Thought withdrawal (alt in thought/delusions)

A

believes their thoughts have been removed from their mind by an outside source

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

Magical thinking (alt in thought/delusions)

A

believes their action or thoughts are able to control a situation ex. wearing a hat that makes them invisible to others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Automatic obedience (alt in behavior)

A

responding in a robot like manner

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

Waxy flexibility (alt in behavior)

A

being in a specific position for a long time

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

Stupor (alt in behavior)

A

motionless long periods of time, coma like

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

Negativism (alt in behavior)

A

doing the opposite of what is requested

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

Echopraxia (alt in behavior)

A

purposeful imitation of movements made by others
ex: someone yawns, you yawn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Catatonia (alt in behavior)

A

decrease or increase in the amount of movement ex. muscle rigidity can be so severe the limbs remain in that position

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

Impaired impulse control (alt in behavior)

A

reduced ability to resist impulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Gesturing or posturing (alt in behavior)

A

Unusual expressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Boundary impairment (alt in behavior)

A

ex. client drinks someone else’s drink believing it is his since its in the vicinity

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

Associative looseness (alt in speech)

A

unconscious inability to concentrate on a single thought
ex: i like to dance. my feet are wet

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

Neologisms (alt in speech)

A

made up words

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

Echolalia (alt in speech)

A

client repeats the words spoken to him

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

Clang association (alt in speech)

A

meaningless rhyme of words

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

Word salad (alt in speech)

A

words jumbled together with little meaning

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

Building a schiz Therapeutic relationship: 1. Orientation

A

builds alliance with client, fam, health care team
Establish a collaboration that fosters recovery

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

Building a schiz Therapeutic relationship: 2. Identification

A

client is aware of the issues they are facing and see the impact of the disorder
Nurse must consider the phase of psychosis, pos/neg symptoms, keep client SAFE

28
Q

Building a schiz Therapeutic relationship: 3. Exploitation

A

client explores interventions and learns how to recognize triggers and express difficulties and need for assistance
setting clear limits on what actions and behaviors are acceptable, explaining what the plan of care includes, work with the client toward recovery and learn to live with mental illness

29
Q

Building a schiz Therapeutic relationship: 4. Resolution

A

all requirements of rehab and recovery have been met

30
Q

Interventions when client is experiencing a delusion or hallucination

A
  1. acknowledge the delusion then base it on fact
  2. call the client by name, and remember not to touch the client
  3. never argue with a client
  4. nurse should address the client’s feelings about the episode, and then reorient the client, providing reassurance in an empathetic manner that the environment is safe
31
Q

Patient education for schiz

A
  1. Client and family learning about the disorder and clinical manifestations.
  2. Recognizing signs of relapse such as sleep disturbances, negative thoughts, challenges with cognitive processing and remembering, being unsure of what is real, hearing voices, and paranoia.
  3. Assist the patient in formulating an after-discharge relapse prevention plan that includes signs that they are doing worse, who they can reach out to (family, friends, health professionals), crisis line, and emergency phone numbers.
32
Q

Nursing process for schiz: 1. Assessment

A

Recognizing cues of schizophrenia spectrum disorder: mood disorder, symptoms of schiz but for a shorter duration (1 month-6 months).

33
Q

Nursing process for schiz: 2. Analysis

A

Prioritize care based on the client’s specific health needs.

34
Q

Nursing process for schiz: 3. Planning/Generate solutions

A

Establish goals and plan of care addressing most urgent needs first. SMART goals. Evidence based practices to address health concerns
Long term goal: will demonstrate improvement in expressing themselves by stating two activities they would participate in before transitioning to the mental health step-down unit

35
Q

Nursing process for schiz: 4. Implementation/Take action

A

Nurse performs interventions and monitors client for improvement. Administers medication and provides education.
Safe enviornment
Reduce noise or excessive activity
Use a calm reassuring approach
Reorient
Create schedule
Encourage socialization

36
Q

Nursing process for schiz: 5. Evaluation

A

Interventions have been completed. Assess client outcomes.

37
Q

What is SGA

A

FIRST LINE TREATMENT for SCHIZ
Risperidone, clozapine, apriprazole ~done and pine

38
Q

SGA pharm action

A

Blocks serotonin more than FGA and blocks less of dopamine, norepi, histamine, and acetylcholine

39
Q

SGA Therapeutic uses

A

Relief of pos and neg symptoms of schiz, psychosis from levodopa therapy, impulse control disorders, psychotic manifestations from bipolar disorder

40
Q

SGA Client education

A

minimize weight gain → healthy/low cal diet, monitor weight, exercise

41
Q

SGA adverse effects

A

Metabolic syndrom:
increases risk of heart disease, stroke, type 2
Symptoms: weight gain, increased BP & glucose
Monitor: daily weight, HDL, cholesterol, triglyceride levels

Agitation, dizziness, sedation, sleep disruption → report to provider
- Blood tests needed to monitor agranulocytosis

42
Q

Clozapine tablet (not first line) interventions

A

Adverse: agranulocytosis (low WBC)
Baseline & regular monitoring of WBC and RBC weekly
Notify provider of infection (fever, sore throat, mouth lesions)
Low risk of EPS

43
Q

What is FGA

A

chlorpromazine, haloperidol, fluphenazine
-Used to control positive symptoms of psychotic disorders

44
Q

FGA Pharmalogical action

A

Blocks dopamine more than SGA, acetylcholine, histamine, and norepi receptors in the brain

45
Q

FGA Contraindication

A

agranulocytosis (WBC less than 3,000) → observe for infection and notify provider if occurs

46
Q

FGA Common side effects

A

anticholinergic- blurred vision, dry mouth, photophobia, urinary retention, conspitaiton, tachycardia

47
Q

FGA Serious side effects

A

extrapyramidal adverse effects → monitor EPS
1. Acute dystonia:
severe spasm of tongue, neck, face, back
Intervention: monitor 1-5 days after first dose
Treatment: benztropine
2. Pseudoparkinsonism:
bradykinesia, rigidity, shuffling gait, drooling, tremors
Intervention: monitor first month after first dose & reduce risks of falling
Treatment: benztropine or trihexyphenidyl
3. Akthisia:
inability to sit or stand still, constant pacing and agitation
Intervention: Monitor first 2 months after first dose & increased risk for suicide
Treatment: Beta blockers, lorazepam/diazepam, or benztropine
4. Tardive dyskinesia:
Involuntary lip smacking, tongue movements, arms, legs, trunk
Intervention: lower dosage or switch to SGA & teach client purposeful muscle movement helps to control the involuntary TD
No treatment
5. Neuroendocrine effects:
gynecomastia (male breasts), weight gain, menstrual irregularities
Intervention: monitor weight & notify provider if manifestations occur
6. Neuroleptic malignant syndrome (fatal): sudden high fever, BP fluctuations, diaphoresis, tachycardia, muscle rigidity, decreased LOC, coma
Intervention: can occur within first week of treatment, stop med, monitor vitals, apply cool blanket, increase fluids,
!Immediate transfer to the ICU!
Treatment: dantrolene or bromocriptine to induce muscle relaxation, medication to treat arrhythmias, antipyretics for fever
7. Orthostatic hypotension
Interventions: monitor BP and HR, hold med until provider is notified if there is a significant decrease in BP or increase in HR, increase fluid intake
8. Sedation
Intervention: take med at bedtime to avoid daytime sleepiness, do not drive
9. Seizures
Increased risk in clients who have an existing seizure disorder
Intervention: increase in antiseizure med can be necessary & report seizure activity to provider
10. Severe dysrhythmias
Intervention: obtain baseline ECG and potassium level prior to treatment & throughout
11. Sexual dysfunction
Intervention: lower dosage, report effects to provider
12. Skin effects: photosensitivity (sunburn), contact dermatitis
Education: avoid excessive exposure to sunlight, use sunscreen, and wear protective clothing, avoid direct contact with the med

48
Q

What neurotransmitters are related to schiz

A

Increased DOPAMINE, serotonin, norepinephrine
Decreased GABA
Implicated Glutamate

49
Q

How long do symptoms for schiz must be present for to be diagnosed?

A

at least 6 months

50
Q

What do antipsychotic meds do to neurotransmitters?

A

They block dopamine to help schiz symptoms

51
Q

Why are SGA used more than FGA?

A

Less adverse side effects like EPS

52
Q

Intervention for Acute Stage (early) schiz

A

Goal: reduce psychotic thoughts and behaviors
Pt experiencing first episodes –> better response to meds so can take a lower dose

53
Q

Interventions for Stable/Maintenance stage schiz

A

Goal: prevent relapse
Therapy- improve relationships, reduce stress, minimize drug and alc, support group

54
Q

Nonpharm treatment for schiz

A

-Cognitive behavioral therapy, behavioral skills training, employment,
-Coordinated Specialty Care (CSC): recovery program for first episodes of psychosis (early stage schiz)
-Assertive Community Treatment (ACT): pt with schiz who are at risk for repeated hospitalization or homelessness

55
Q

haloperidol treats

A

schiz and tourettes

56
Q

haloperidol normal side effects

A

neck twitching, dystonia, muscle twitching –> do not report

57
Q

haloperidol adverse effects

A

Neuroleptic malignant syndrome
S&S: fever, diaphroesis, change in mental, muscle RIGIDITY, tremors
Interventions: hold med, assess client, notify provider

58
Q

Clozapine/Risperidone treats

A

schiz by controlling positive and negative symptoms

59
Q

Clozapine/Risperidone normal side effects

A

sedation, anticholinergic, decreased libido

60
Q

Clozapine/Risperidone adverse effects

A

weight GAIN & agranulcytosis
S&S: sore throat, fever, flu symptoms –> report
-Do not give to dementia clients!

61
Q

Methylphenidate/Amphetamine mix treats

A

ADHD, conduct disorder

62
Q

Methylphenidate/Amphetamine mix MOA

A

increases dop and norepi

63
Q

Methylphenidate/Amphetamine mix monitor for

A

Monitor BP and weight LOSS

64
Q

Methylphenidate/Amphetamine mix interventions

A

Give med no later than 6 pm cuz restlessness, take weekly weight
Treatment: benzo’s lorazepam and alprazolam

65
Q

Alogia

A

(poverty of speech)slowness in thinking that is observed by how the person speaks, in langage skills

66
Q

Anhedonia

A

lack of pleasure or joy

67
Q

Avolition

A

lack of motivation in activities and hygeine

384 Exam 2 (3 decks)

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