schizophrenia Flashcards
what are the five different symptomatic domains?
delusions, hallucinations, disorganized thoughts, disorganized or abnormal motor behavior, and negative symptoms
what is secondary psychosis?
secondary causes of psychosis include brain tumors, dementia, late-stage neurological diseases, drug-associated, environmental toxins
what is the prodromal phase?
the prodromal phase is the signs and symptoms that precede the acute, fully manifested s/s of the disease
what is the acute phase?
the acute phase is well-developed symptoms grouped into 4 categories:
1) positive symptoms
2) negative symptoms
3) cognitive symptoms
4) mood symptoms
what is the stabalization phase?
a period in which acute symptoms, particularly the positive symptoms decrease in severity
what is the maintenance phase?
a period in which symptoms are in remission, although there might be milder persistent symptoms (residual symptoms)
what are positive symptoms?
symptoms added to a person such as hallucinations, delusions, bizarre behavior, paranoia
what are negative symptoms?
things that are taken away such as apathy, lack of motivation, and anhedonia (lack of interest)
cognitive symptoms
impairment in memory, disruption in social learning, decreased ability to reason and solve problems, or focus attention
mood symptoms
depression, anxiety, dysphoria, and suicidality
how to diagnose schizophrenia?
first, assess pt to rule out any medical or substance-induced psychosis. then, specify impaired perceptions and hallucinations, anxiety level, risk of suicide, impaired coping, social isolation, loneliness, self-esteem is low
planning for phase 1
brief hospitalization is frequently identified for acute phase 1. if the patient refuses to eat or drink, is considered harmful to self or others, is too disorganized to provide self-care
planning for phase 2-3
identify the social, interpersonal, coping, and vocational skills needed. teaching relapse prevention strategies is highlighted. determining how and where these needs can be best met within the community
intervention for phase 1
crisis intervention, acute symptom stabilization, medical adherence, safety
intervention for phases 2 and 3
meds, nursing intervention, community support, pt and family psychoeducational, health promotion, and health maintenance
communication guidelines
wait longer to give the pt time to think and process questions, repeat and redirect shorter phrases
hallucination communication
ask pts directly if they are hallucinating, determine if the voices are telling pt to self-harm or harm others, document what pt say, accept voices are real but explain you do not hear, present calm demeanor and stay with pt and you can tell pt at times to tell the voices to go away
delusion communication
assess if external controls are needed, be aware that pts delusions represent the way that person is experiencing reality, identify feelings, engage the individual in yoga, do not argue with the beliefs, do not touch pt use gestures carefully
paranoia communication
place self beside pt not face to face, avoid eye contact, use a business-like approach, engage in reality-based activities, and engage the pt in intellectually taxing non-competitive activities, if pt loses control use the least restricted intervention
associated looseness interventions
do not pretend to understand, tell pt if you’re having a hard time understanding, verbalize the implied, place the difficulty in understanding on yourself not the pt, look for recurring topics and themes, emphasize what is going on in the pts immediately environment and involve the pt in simple reality-based activities
what is milieu therapy?
it provides emotional and physical safety, useful activities, resources for resolving conflicts, opportunities for learning social and vocational skills
what safety measures to taken during the acute phase?
verbal de-escalation efforts, sedative meds, physical restraints and seclusions (last resort)
antipsychotic meds
first-generation (conventional antipsychotics) or second-generation (atypical antipsychotics)
side effects of antipsychotic meds
extrapyramidal symptoms (EPS), neuroleptic malignant syndrome, drug-induced liver problems
