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mental health finals > schizophrenia > Flashcards

schizophrenia Flashcards

1
Q

schizophrenia

A

psychotic thinking/ behavior present for ~6 months
begins to affect their life in every aspect

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2
Q

typical age of diagnosis of schizophrenia is…

A

late teens to early 20s

has occured in young children and later adulthood

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2
Q

schizotypal personality disorder

A

impairments of personality functioning (self or interpersonal)

condition is not as severe as schizophrenia

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3
Q

delusional disorder

A

has delusional thinking for ~1 month

self/interpersonal functioning is not as impaired

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4
Q

brief psychotic disorder

A

has psychotic manifestations that may last 1 day to 1 month

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5
Q

schizophreniform disorder

A

has s/s similar to schizophrenia but may only last for 1-6 months

social/occupational dysfunction may not be as obvious

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6
Q

schizoaffective disorder

A

pt meets diagnositics for both schizophrenia and/or depression/bipolar disorder

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7
Q

substance-induced psychotic disorder

A

pt has psychosis due to substance intoxication/withdrawl

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8
Q

psychotic/catatonic disorder otherwise not specified

A

pt has psychotic features (impaired reality testing) or bizarre behavior (catatonic) or a significant change in motor activity behavior (catatonic) but doesn’t meet criteria for diagnosis w/another specific psychotic disorder

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9
Q

positive symptoms

A

manifestation of things that are not normally present
* hallucinations
* delusions
* alterations in speech
* bizarre behavior (walking backward constantly)

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10
Q

negative symptoms

A

absence of things that are normally present
(more difficult to treat than positive symptoms)
* blunted/flat affect
* alogia: poverty of thought or speech
* anergia: lack of energy
* anhedonia: lack of pleasure or joy in life
* avolition: lack of motivation in activites & hygiene

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11
Q

other common symptoms found in schizophrenia

A

cognitive s/s:
* disordered thinking
* inability to make decisions
* poor problem-solving skills
* difficulty concentrating to perform tasks
* impaired abstract thinking
* short term memory deficits

affective s/s:
* hopelessness
* suicidial ideation
* unstable or rapidly changing mood

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12
Q

alterations in thought

delusions

A

false fixed beliefs that can’t be corrected by reasoning & usually bizarre

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13
Q

ideas of reference

A

misconstrues trivial events and attaches personal significance to them

pt walking by a group of people who are talking about food, are gossiping about the pt

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14
Q

persecution

A

feels singled out for harm by others

FBI hunting pt down

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15
Q

grandeur

A

believes that they’re all powerful & important

thinks they’re a god

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16
Q

somatic delusions

A

believes that their body is changing in an unusual way

thinks they’re growing a third arm

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17
Q

jealousy

A

belives that their partner is sexually involved w/another individual even though there is not any factual basis for this belief

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18
Q

being controlled

A

believes that a force outside their body is controlling them

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19
Q

thought broadcasting

A

believes that their thoughts are heard by others

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20
Q

thought insertion

A

believes that others’ thoughts are being inserted into their mind

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21
Q

thought withdrawl

A

believes that their thoughts have been removed from their mind by an outside agency

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22
Q

religiosity

A

obsession with religion

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23
Q

magical thinking

A

believes that their actions or thoughts are able to control a situation or affect others

thinks wearing a certain hat makes them invisible to others

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24
Q

associative looseness

A

unconscious inability to concentrate on a single thought

can progress to flight of ideas (pt’s ideas move so rapidly that their speech is incoherent)

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25
Q

neologisms

A

made up words that only pt understands

“i tranged and flitted”

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26
Q

echolalia

A

pt repeats the words spoken to them

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27
Q

clang association

A

meaningless rhyming of words

“oh fox, box, and lox”

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28
Q

word salad

A

words jumbled together w/ little meaning to listener

“hip hip hooray, the flip is cast and wide sprinting in the forest”

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28
Q

alterations in perception

A

hallucinations are sensory perceptions that don’t have any external stimulus

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29
Q

auditory hallucination

A

hearing voices or sounds

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30
Q

command hallucinations

A

voice instructs pt to perform an action (usually to hurt themselves or others)

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31
Q

visual hallucinations

A

seeing persons or things

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32
Q

olfactory hallucinations

A

smelling odors

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33
Q

gustatory hallucinations

A

experiencing tastes

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34
Q

tactile hallucinations

A

feeling bodily sensations

35
Q

depersonalization

A

nonspecific feeling that pt has lost their identity; self is different or unreal

36
Q

derealization

A

perception that environment has changed

thinks objects around them are shrinking

37
Q
A
38
Q

illusions

A

misinterpretations or misperceptions of a real experience

39
Q

stereotyped behaviors

A

motor patterns that had meaning to pt but now is mechanical and lacks purpose

ex: sweeping the floor

40
Q

automatic obedience

A

responding in a robot-like manner

41
Q

wavy flexibility

A

maintaining a specific position for a long time

42
Q

stupor

A

motionless for long periods of time; coma-like

43
Q

negativism

A

doing the opposite of what is requested of them

44
Q

echopraxia

A

purposeful imitation of movements made by others

45
Q

catatonia

A

pronounced decrease or increase in amt of movement

muscle rigidity or catalepsy may be so severe that the limbs stay in the position they’re in

46
Q

motor retardation

A

pronounced slowing of movement

47
Q

impaired impulse control

A

reduced ability to resist impulses

48
Q

gesturing or posturing

A

assuming unusual & illogical expressions

49
Q

boundary impairment

A

impaired ability to see where one person’s body ends and another’s begins

50
Q

AIMS scale

Abnormal Involuntary Movement Scale

A

monitors involuntary movements esp tardive dyskinesia for pts on antipsychotics

51
Q

when a pt is experiencing hallucinations, what should the nurse ask the pt?

A

ask the pt directly about the hallucinations but avoid arguing or agreeing with their views

“I don’t hear anything, but you seem to be feeling frightened”

52
Q

what hallucinations puts the pt at higher risk of harm to self or others?

A

command hallucinations

53
Q

which hallucinations may increase risk of violence against others

A

paranoid delusions

54
Q

1st generation/conventional antipsychotics

A

used to mainly treat positive psychotic symptoms
* haloperidol
* loxapine
* chlorpromazine
* fluphenazine

nursing actions: monitor for extrapyramidal effects (EPS) esp dystonia (involuntary muscle contractions), akathisia (inability to remain still), pseudoparkinsonism, tardive dyskinesia

client education: chew sugarless gum, eat foods high in fiber, drink 2-3 L of fluid, monitor for postural hypotension and orthostatic hypotension

55
Q

2nd generation/ atypical antipsychotics

A

first line of choice for med t/x
treats both positive & negative symptoms
* risperidone
* olanzapine
* quetiapine
* ziprasidone
* clozapine

pt education: manage weight gain by following low calorie diet and exercise; pt needs to report signs of agitation, dizziness, sedation, and sleep distruption

monitor blood tests for agranulocytosis

56
Q

3rd generation antipsychotics

A

used to treat both positive & negative symptoms; improves cognitive function
* aripiprazole

nursing actions: decreased risk of EPSs or tardive dyskinesia; lower risk of weight gain & anticholinergic effects

57
Q

antidepressants

A

can be used to treat depression w/psychotic disorder
* paroxetine

nursing action: monitor for suicidal ideation esp when first taking it & notify HCP of deepened depression

PT NEEDS TO KNOW NOT TO STOP MED ABRUPTLY

58
Q

mood stabilizing agents & benzodiazepines

A

used to treat anxiety and some of the pos/neg symptoms
* valproate
* lamotrigine
* lorazepam

nursing action: use w/ caution in elderly pts

client education: educate pt about sedative effects; abstinence of alcohol & other substances; keep log of feelings/changes in behavior to help med efficacy; emphasize group, family, & individual psychoeducation

59
Q

when is the most common time a person seeks initial t/x for schizophrenia

A

during the active phase

60
Q

when pt is having delusions…

A

use distracting techniques

61
Q

alogia

A

tendency to speak little or to convey little substance of meaning (poverty of content)

negative symptom

62
Q

ambivalence

A

holding seemingly contradictory beliefs or feelings about the same person, event, or situation

positive symptom

63
Q

inattention

A

inability to concentrate or focus on a topic or activity, regardless of its importance

negative symptom

64
Q

perseveration

A

persistent adherence to a single idea or topic; verbal repetition of sentence, word, phrase

positive symptom

65
Q

ideas of reference

A

positive symptom

66
Q

echopraxia

A

imitation of movements & gestures of another person whom the client is observing

positive symptom

67
Q

asociality

A

social withdrawl, few or no relationships, lack of closeness

negative symptom

68
Q

delusions

A

fixed, false beliefs that have no basis in reality

positive symptom

69
Q

bizarre behavior

A

outlandish appearance/clothing; repetitive/stereotyped, purposeless movements, unusual social behavior

positive symptom

70
Q

flat affect

A

abscence of any facial expression that would indicate emotions or mood

negative symptom

71
Q

avolition or lack of volition

A

absence of will, ambition, drive to take action or accomplish tasks

negative symptom

72
Q

associative looseness

A

fragmented or poorly related thoughts and ideas

positive symptom

73
Q

anhedonia

A

feeling no joy or pleasure from life or any activities or relationships

negative symptom

74
Q

flight of ideas

A

continuous flow of verbalization in which person jumps rapidly from one topic to another

positive symptom

75
Q

hallucinations

A

false sensory perceptions or perceptual experiences that do not exist in reality

positive symptom

76
Q

apathy

A

feelings of indifference toward people, activities, and events

negative symptom

77
Q

blunted affect

A

restricted range of emotional feeling, tone, or mood

negative symptom

78
Q

verbigeration

A

stereotyped repetition of words or phrases that may or may not have meaning to listener

79
Q

stilted language

A

use of words or phrases that are flowery, excessive, and pompous

80
Q

perseveration

A

persistent adherence to a single idea or topic and verbal repetition of a sentence

81
Q

nihilistic

A

organ or body part are not functioning, are rotting, or is disfigured

82
Q

somatic

A

vague and unrealistic beliefs about health or bodily functions

83
Q

sexual delusion

A

client’s belief that sexual behavior is known to others; is rapist; prostitute; pedophile; is pregnant

84
Q

referential delusion

A

client’s belief that TV broadcasts, music, or newspaper articles have special meaning to him/her

85
Q

religious delusion

A

center around second coming of a significant religious figure or prophet

86
Q

persecutory delusion

A

client’s belief that others are planning to harm him/her; spying, following, ridiculing, belittling

mental health finals (10 decks)

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