Schizophrenia Flashcards
schizophrenia spectrum disorders
psychosis with altered cognition, perception and reality testing
delusional disorder
false thoughts or beliefs that have lasted 1 mon or more but not impair functioning
grandiose delusions
grand, over the top (i am president)
persecutory delusions
accusing someone (stole my pen when there was none)
somatic delusions
pain or injury that has never been there
referential delusions
people out to get you
brief psychotic disorder
delusions, hallucinations, disorganized speech, catatonia lasting less than 1 mon w return to norm function
schizophreniform disorder
schiz symptoms lasting less than 6 months
schizoaffective disorder
depressive, mic or mixed episodes w schiz symptoms not caused by substance/condition
substance induced or medical condition psychotic disorder
delusions/hallucinations from illicit drugs, alc, meds or delirium, neuro disease
schizophrenia
psychosis w altered cognition, perception, reality testing that is highly hereditary from 15-25
DSM-V criteria
at least 2 every mon for 6 mon…delusions, hallucinations, disorganized speech, catatonia, neg symptoms, functional impairment
comorbidity of schiz
substance use disorders, anxiety, depression, suicide, physical illness, polydipsia
risk factors of schiz
genetics w abnl in brain, prenatal stressors, neurobio w glutamate, dopamine, serotonin, environment
prodromal phase of schiz
prior to diagnosis with odd speech and thoughts, decreased concentration but able to maintain functioning
acute phase of schiz
acute symptoms from few/mild to many/severe with poor coping, functional impairment, hallucinations, delusions, apathy
stabilization phase of schiz
stabilized/diminished symptoms w prodromal functioning, medicated
maintenance of residual schizophrenia
stable condition w neg and cognitive symptoms
general assessment
pos, neg, cognitive, affective symptoms
positive symptoms
adding symtpoms like delusions, altered speech, concrete thinking, altered reality testing
associative looseness (alter speech)
word salad: jumble of words meaningless to listener
illogical thinking w poor concentration
clang association (alter speech)
words chosen based on sound w no correlation
neologisms (alter speech)
words that are put together that have meaning towards pt
echolalia (alter speech)
pathological repetition of another
circumstantiality (abnl speech)
unnecessary details in convo but soon getting to the point
tangentiality (abnl speech)
continuing to wander off topic but never reaching point of convo
cognitive retardation (abnl speech)
slowing cognition delaying thinking and responding
pressured speech (abnl speech)
urgent or intense speech and reluctance to allow comments from others
flight of ideas (abnl speech)
moving rapidly from one thought to the next making it difficult for people to follow
symbolic speech (abnl speech)
using words based on what they symbolize not what they mean
thought blocking (distorted thoughts)
reduction or stoppage of thought
thought insertion (distorted thoughts
often uncomfortable belief that someone has inserted into a pt brain
thought deletion (distorted thoughts)
belief that thoughts have been taken or missing
magical thinking (distorted thoughts)
believing that reality can be changed by thinking or unrelated actions
paranoia (distorted thoughts)
irrational fear ranging from mild to profound
mild: suspicious/guarded
profound: believing person will kill you
hallucinations (alter perceptions)
auditory:hearing voices/sounds
visual: seeing things
olfactory: smelling things
gustatory: tasting things
tactile: feeling body sensations
command: something telling you to do something
illusions (alter perceptions)
something morphing into something else
depersonalization (alter perceptions)
dissociation aka out of body experience
derealization (alter perceptions)
person saying they feel like they are in simulation
catatonia (alter behavior)
pronounced increase of decrease movement, useless motor activity
motor retardation(alter behavior)
pronounced slowing of movement
motor agitation (alter behavior)
excited behavior such as running/pacing
stereotyped behaviors (alter behavior)
repetitive behaviors that dont have logical purpose
waxy flexibility
wont move at all and trying to move but unable to
echopraxia (alter behavior)
mimicking of movements of another person
negativism (alter behavior)
tendency to risk or repose others
impaired impulse control (alter behavior)
reduced ability to resist impulses
gesturing or posturing (alter behavior)
assuming unusual and illogical expression, posture, positions
boundary impairment
impaired ability to sense one’s body or influence ends and other begins
negative symptoms
absence of symptoms/qualities
anhedonia (neg symptom)
reduced ability to experience pleasure and inability to enjoy things
avolition (neg symptom)
reduced motivation or goal directed behavior
asociality (neg symptom)
decreased desire for social interaction
affective blunting (neg symptom)
reduced or constricted affect
apathy (neg symptom)
decreased interest in activities
alogia (neg symptom)
reduction in speech
affect
outward expression of a person’s internal emotional state
flat affect
expressionless, unreadable
blunted affect
reduced or minimal emotional response
constricted affect
reduced in range
inappropriate affect
incongruent w actual emotion/situation
bizarre affect
odd, illogical and inappropriate and unfounded
concrete thinking (cog)
impaired ability to think abstractly (literal)
impaired memory (cog)
effect short term memory and ability to learn
impaired info processing (cog)
delayed responses, misperceptions and cant understand others
impaired executive functioning (cog)
difficulty w reasoning, priorities, comparing options
anosognosia
inability to realize you are ill, often refuse treatment
affective symtpoms
assess for depression with increase substance use/suicide, further impair functioning
self assessment
anxiety, fear, frustration
assessment guidelines
med problems, psychosis symptoms, drug/alc use, MSE, reality test
nursing diagnoses
hallucinations, delusions, risk for violence, distorted thinking, anosognosia, risk for suicide
outcomes acute phase 1
pt safety and stabilize
outcomes stabilization phase 2
understand illness/treatment, stabilize meds, cope w symptoms
outcomes maintenance phase 3
prevent relapse, independence
planning acute phase 1
strategies for pt safety and symptom stabilization
planning maintenance phase 3
pt/fam ed, relapse prevention
acute implementation
psych/med/neuro eval, psychopharmaco, psychoed, work w aggression, limit setting
stabilization/maintenance implementation
meds, relationships, safety, groups
evaluation
adjust treatment, communication, small goals
anticholinergic toxicity
no peristalsis, urinary retention, hallucinations, seizures, unstable vitals, delirium, agitation
neuroleptic malignant syndrome
excessive dopamine receptor blocking causing severe muscle rigidity, no speech, low consciousness, delirium, coma, resp failure
severe neutropenia
reduced neutrophil count and increased severe infections causing infection S/S
prolonged QT interval
delay of ventricular depolarization causing tachycardia, fainting, seizures, death
liver impairment
in first wks of therapy or clozapine causing jaundice, edema, ascities, vomit, pain
metabolic syndrome
wt gain, high blood glucose, risk of diabetes/cancer/cardio disease
acute dystonia (EPS)
sudden, sustained contraction
akathisia (EPS)
motor restlessness w inability to stay still
pseudoparkinsonism (EPS)
temporary symptoms resembling parkinsons
tardive dyskinesia (EPS)
involuntary rhythmic movements
psychological therapies
individual/group, psychoed, med prescription, health assess, fam therapy
