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Psychiatric Nursing > Schizophrenia > Flashcards

Schizophrenia Flashcards

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1
Q

A major form of psychotic disorder that
affects a person’s thinking, language,
emotions, social behavior and ability to
perceive reality

A

Schizophrenia

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2
Q

T or F

In dx schizophrenia, it needs at least 4 of 5 types of positive and negative symptoms

A

F

At least 2 of 5 types of positive and
negative symptoms

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3
Q

T or F

Schizo has characteristic symptoms and causes ocial or occupational dysfunction
(interpersonal relationships IPR, self-care)

A

T

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4
Q

To dx schizo duration must be

A

(continuous for at least 6
months)

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5
Q

Positive symptoms

A
  • Hallucinations and Illusions Delusions
  • Abnormal thought patterns or
    perceptions
  • Bizarre behavior
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6
Q

Negative symptoms

A
  • Affective flattening
  • Anhedonia (a reduced level of interest in
    activities you used to enjoy, and a
    decline in your ability to feel pleasure)
  • Attention impairment
  • Asocial behavior (withdrawn from
    people)
  • Anergia (lack of energy)
  • Autism
  • Avolition (total lack of motivation that
    makes it hard to get anything done)
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7
Q

Delusions

A

Persecutory
Religious
Grandeur
Ideas of reference

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8
Q

persistent, troubling, false beliefs that one is about to be harmed or mistreated by others in some way.

A

Persecutory

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9
Q

pt thinks he is a messenger of God, or thinks he is God.

A

Religious

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10
Q

when you believe that you have more power, wealth, smarts, or other grand traits than is true.

A

Grandeur

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11
Q
  • the false belief that irrelevant occurrences or details in the world relate directly to oneself.
A

Ideas of reference

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12
Q

Disturbed thought processes

A

Looseness of association
Flight of ideas
Ambivalence
Magical thinking
Echolalia/echopraxia
Word salad
Clang association
Neologism
Thought blocking
Concrete association

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13
Q

Bleuler’s Four A’s of Schizophrenia

A
  • Affective Disturbances
  • Autism
  • Associative looseness
  • Ambivalence (good or bad)
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14
Q

Other A’s

A
  • Attention defects
  • Disturbances of activities
  • Auditory hallucination
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15
Q

Maybe seen when a person exhibits clinical
symptoms of illogical thinking, incoherent
speech, delusions, or disorganized behavior after psychological trauma. Less than 6 months

A

Brief Psychotic Disorder

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16
Q

Develops in the second person as a result of a
close relationship with a person who has psychosis.

A

Induced Psychotic Disorder

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17
Q

delusion of plunder, infidelity, delusions does
not change

A

Delusional Psychotic Disorder

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18
Q

Characterized by depression or elation as the
psychotic symptoms of schizophrenia and MDD
Major depressive d/o

A

Schizoaffective disorder

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19
Q

When a person exhibits features of schizophrenia for more than one week but less than 6 months.

A

Schizophreniform

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20
Q

Schizophrenia subtypes:

A

Paranoid
Disorganized
Catatonic ECT
Undifferentiated schizophrenia

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21
Q

most common form of the schizophrenia.

A

Paranoid

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22
Q

T or F

Pts with schizophrenia are suspicious and violent.

A

T

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23
Q

Interventions for pt with paranoid schizo that is suspicious

A
  • Promote trust
  • Short interaction but frequent
  • Food in containers (sealed)
  • Prepare food in front of them
  • Let them see the preparation of drugs
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24
Q

Interventions for pt with paranoid schizo that is violent

A
  • Keep door open
  • Position near the door and with distance of
    1 arm length (patient-nurse)
  • Don’t touch
  • Maintain eye contact
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25
Q

absence of systematized
delusions; presence of incoherence &
inappropriate affect.

A

Disorganized

26
Q

Symptoms of disorganized schizo

A
  • Inappropriate, flat affect
  • Hebephrenic, flight of ideas
27
Q

Catatonic ECT symptoms

A

Risk for suicide
➢ Catatonic stupor, rigidity
➢ Waxy flexibility
➢ Catatonic excitement (silent pt suddenly became aggressive w/o any provocation,
shouting, running)

28
Q

it is a posture that an
individual can stay for longer hours
without experiencing any discomfort

A

Waxy flexibility

29
Q

need to categorized, combinations of symptoms, hard to specify, lack of assessment information. (Usually in mentally challenged homeless
people)

A

Undifferentiated schizophrenia

30
Q

no more positive symptoms but withdrawn

A

Residual schizophrenia

31
Q

Residual schizophrenia

A
  • Disturbed Thought Process
  • Disturbed Sensory Process
  • Risk for self-directed violence
  • Risk for other directed violence
32
Q

Intervention of schizo

A
  • Present safety
  • Present reality
33
Q

Anti-psychotic drugs

A

Taractan
Loxitane
Stelazine
Mellaril
Thorazine
Molindone
Seroquel
Serlect
Trilafon
Haloperidol
Clozapine
Navane

34
Q

Haldol, Prolixin, decanoate, and
modecate are ______-acting psychotic drugs.

A

long-acting

35
Q

Side effects of antipsychotic

A

Decrease v/s
Constipation / dry mouth
Postural hypotension
Photophobia/photosensitivity
Drowsiness
Agranulocytosis
Extrapyramidal symptoms

36
Q

Extrapyramidal symptoms

A

Parkinson’s syndrome
➢ Akathisia
➢ Akinesia loss of voluntary muscle
control
➢ Dystonia – oculogyric crisis, torticollis,
opisthotonos
➢ Tardive dyskinesia
➢ NMS neuroleptic malignant syndrome -
lethal

37
Q

Undesirable effects of anti-psychotic drugs

A

Sedation/sunlight sensitivity/sleepiness
Tardive dyskinesia
Anticholinergic/aganulocytosis/akathisia
Neuroleptic malignant syndrome
Cardiac effects (Orthostatic hypotension)
Extrapyramidal Syndrome EPS (dystonia)

38
Q

Motor retardation or akinesia characterized by mask-like appearance, rigidity, tremors, “pill-rolling”, salivation

A

Parkinsonism

39
Q

_________ generally, occurs after 1st week of
treatment of schizo or before the second month

A

Parkinsonism

40
Q

Administer anticholinergic agent, anti-Parkinson medication

A

Akineton

41
Q

Constant state of movement,
characterized by restlessness, difficulty
sitting still, or strong urges to move
about.

A

Akathisia

42
Q

___________ generally, occurs two weeks after
treatment begins

A

Akathisia

43
Q

Irregular, involuntary spastic muscle
movement, wryneck or torticollis, facial
grimacing, abnormal eye movements,
backward rolling of eyes in the sockets

A

Acute dystonic reactions

44
Q

May occur anytime from a few minutes
to several hours after first dose of
antipsychotic drug

A

Acute dystonic reactions

45
Q

Treatment for acute dystonic reactions

A

Administer anticholinergic agent, have
respiratory support equipment available.

46
Q

Most frequent serious side effect
resulting from termination of the
drug, during reduction in dosage, or
after long term high dose therapy.
Characterized by involuntary
rhythmic, stereotyped movements,
tongue protrusion, cheek puffing,
involuntary movements of
extremities and trunk

A

Tardive dyskinesia

47
Q

Occurs in approximately 20-25% of
patients taking antipsychotics for
over two years

A

Tardive dyskinesia

48
Q

No treatment except discontinuation
of the antipsychotic agent

A

Tardive dyskinesia

49
Q

A potentially fatal syndrome

A

Neuroleptic malignant syndrome

50
Q

T or F

Neuroleptic malignant syndrome may occur anytime during therapy

A

T

51
Q

Seen during the initiation of therapy,
change of therapy. After a dosage
increase or when a combination of meds
is used

A

Neuroleptic malignant syndrome

52
Q

Early sign NMS

A

rigidity or mental status
changes

53
Q

Symptoms of NMS

A

catatonia, tachycardia, tachypnea, labile blood pressure, dysphagia, diaphoresis, incontinence, rigidity, myoclonus, tremors, low grade fevers

54
Q

What to do if NMS is present?

A

Discontinue antipsychotic agent. Have
cardiopulmonary support available;
administer skeletal muscle relaxant or central acting dopamine
agonist

55
Q

skeletal muscle relaxant

A

dantrolene

56
Q

central acting dopamine
agonist

A

bromocriptine

57
Q

Anti-parkinsonian drugs

A

Dopaminergic Drugs
Anti-cholinergic drugs

58
Q

Dopaminergic Drugs

A

Levodopa
carbidopa
Amantidine
bromocriptine
pergolide
selegiline

59
Q

Anticholinergic drugs

A

BENADRYL, ARTANE,
COGENTIN, PARSIDOL, AKINETON,
KEMADRIN

60
Q

Manifestations of schizo

A

S-social isolation
* C-catatonic behavior
* H-hallucinations
* I-Incoherence
* Z-zero/lack of interest and initiative
* O-obvious failure in development
* P-peculiar behavior
* H-hygiene and grooming impaired
* R-recurrent illusions
* E-exacerbations and remissions
* N-no organic factor account S/S
* I-inability to return to functioning
* A-affect is inappropriate

61
Q

Other treatments of schizo

A

Psychotherapy
Milieu therapy

Psychiatric Nursing (23 decks)

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