schizophrenia

Question 1

what are the five different symptomatic domains?

Answer 1

delusions, hallucinations, disorganized thoughts, disorganized or abnormal motor behavior, and negative symptoms

Question 2

what is secondary psychosis?

Answer 2

secondary causes of psychosis include brain tumors, dementia, late-stage neurological diseases, drug-associated, environmental toxins

Question 3

what is the prodromal phase?

Answer 3

the prodromal phase is the signs and symptoms that precede the acute, fully manifested s/s of the disease

Question 4

what is the acute phase?

Answer 4

the acute phase is well-developed symptoms grouped into 4 categories:
1) positive symptoms
2) negative symptoms
3) cognitive symptoms
4) mood symptoms

Question 5

what is the stabalization phase?

Answer 5

a period in which acute symptoms, particularly the positive symptoms decrease in severity

Question 6

what is the maintenance phase?

Answer 6

a period in which symptoms are in remission, although there might be milder persistent symptoms (residual symptoms)

Question 7

what are positive symptoms?

Answer 7

symptoms added to a person such as hallucinations, delusions, bizarre behavior, paranoia

Question 8

what are negative symptoms?

Answer 8

things that are taken away such as apathy, lack of motivation, and anhedonia (lack of interest)

Question 9

cognitive symptoms

Answer 9

impairment in memory, disruption in social learning, decreased ability to reason and solve problems, or focus attention

Question 10

mood symptoms

Answer 10

depression, anxiety, dysphoria, and suicidality

Question 11

how to diagnose schizophrenia?

Answer 11

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

Question 12

planning for phase 1

Answer 12

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

Question 13

planning for phase 2-3

Answer 13

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

Question 14

intervention for phase 1

Answer 14

crisis intervention, acute symptom stabilization, medical adherence, safety

Question 15

intervention for phases 2 and 3

Answer 15

meds, nursing intervention, community support, pt and family psychoeducational, health promotion, and health maintenance

Question 16

communication guidelines

Answer 16

wait longer to give the pt time to think and process questions, repeat and redirect shorter phrases

Question 17

hallucination communication

Answer 17

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

Question 18

delusion communication

Answer 18

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

Question 19

paranoia communication

Answer 19

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

Question 20

associated looseness interventions

Answer 20

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

Question 21

what is milieu therapy?

Answer 21

it provides emotional and physical safety, useful activities, resources for resolving conflicts, opportunities for learning social and vocational skills

Question 22

what safety measures to taken during the acute phase?

Answer 22

verbal de-escalation efforts, sedative meds, physical restraints and seclusions (last resort)

Question 23

antipsychotic meds

Answer 23

first-generation (conventional antipsychotics) or second-generation (atypical antipsychotics)

Question 24

side effects of antipsychotic meds

Answer 24

extrapyramidal symptoms (EPS), neuroleptic malignant syndrome, drug-induced liver problems

Question 25

Extrapyramidal symptoms (EPS)

Answer 25

Tardive dyskinesia
Acute dystonia
Akathisia
Pseudoparkinsodim

Question 26

neuroleptic malignant syndrome

Answer 26

a life-threatening neurologic emergency associated with the use of antipsychotic agents characterized by a distinctive clinical syndrome of mental status change, rigidity, fever, and dysautonomia.

Question 27

Adjuncts to antipsychotic drug therapy

Answer 27

Antidepressants and Benzodiazepines

Question 28

First-generation antipsychotics

Answer 28

low potency includes
Chlorpromazine
Prochlorperazine
Thioridazine
high potency includes
Fluphenazine
Haloperidol
Pimozide
Thiothixene

Question 29

second-generation antipsychotic

Answer 29

Aripiprazole
Asenapine
Clozapine
Iloperidone
Lurasidone
Olanzapine
Quetiapine
Risperidone
Ziprasidone