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Schizophrenia Flashcards

1
Q

Schizophrenia

A

shattered disinegrated personality

not just a condition, but a syndrome

there is no cure but can be controlled by medications

PCP can cause schizophrenia

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2
Q

Epidemiology of schizophrenia

A

Lifetime prevalence of schizophrenia is 1% worldwide

there is not a difference in regards to:

  • race
  • socaial status
  • culture
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3
Q

Comorbidity of Schizophrenia

A
  • substance abuse
    - nicotine dependance
  • Anxiety, depression, and suicide
  • physical health or illness
  • polydipsia
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4
Q

Polydipsia-

A

drinking massive amount of water

schizophrenics can drink so much water that they pee the bed and end up causing eletrolyte imbalances

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5
Q

Etiology of Schizophrenia

A

Biological Factors
Genetics- 65-80% is genetic

Neurobiological-
- Dopamine Theory- suggests that there is a
dopamine overload in the brain.
- Other neurochemical hypothesis

Brain Structure abnormalities-
- Usually in the frontal or temporal lobe
- Now use non-invasive PET and MRI scans
- If a family member has it, chances increase
- In Identical twins- if one has it, 50%
chance the other will have it too
- In fraternal twins, 15% chance if one has
it the other will have it too

Psycological and Environmental Factors
- Prenatal Stress- drugs, eating,
environmental
- Psychologicial Stressors- increased
cortisol
- Environmental Stressors- Sexual abuse in
children causes changes in brain
chemistry and so can toxins

      -
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6
Q

Prodromal

A

Before a psycotic break

prepsychotic phase- may act weird or strange to others. My all of the sudden become withdrawn, lonely or depressed.

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7
Q

Phase 1 of schizophrenia

A

`acute phase

nervous breakdown or 1st psychotic break

this is the onset or exacerbation of symptoms

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8
Q

Phase 2 of schizophrenia

A

Stabilization phase

symptoms are diminishing, returning to a normal level of functioning

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9
Q

Phase 3 of schizophrenia

A

Maintenance phase

at or near baseline functioning

(as the disease progresses, the baseline will change with it.)

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10
Q

Assessment

A

During the prepsychotic phase- Ask them or family how they were before and after their first break

General Assessment: gain isight on
Positive symptoms
Negative symptoms
Cognitive symptoms
Affective symptoms

as well as how they are responding to medications

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11
Q

Positive Symptoms

A 
Alterations in thinking
       Delusions
       Magical Thinking
       Paranoia
       Religiosity
Alterations In speech
       Clang Associations
       Word Salad
       Neologisms
       Echolalia
       Alogia
       Thought insertion/deletion/blocking
Alterations in perception
       Depersonalization
       Derealization
       Hallucination
Alterations in Behavior
       Catatonia
       Echopraxia
       Impaired impulse control
       Gesturing/posturing
       Boundary impairment
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12
Q

circumstantiality

A

giving excessive details. More than what are needed

positive symptom

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13
Q

Tangentiality

A

frequently leaving the topic

positive symptom

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14
Q

Cognitive retardation

A

delay in responding or answering a question. Cannot finish thoughts

positive symptom

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15
Q

clang associations

A

rhyming words

positive symptom

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16
Q

Word Salad

A

jumbled speech that doesnt make sense

positive symptom

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17
Q

Neologisms

A

making up words

positive symptom

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18
Q

Echolalia

A

repeating like a parrot

positive symptom

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19
Q

Religiosity

A

preoccupied with religousness

positive symptom

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20
Q

What is best drug for suicide

A

Ssri

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21
Q

Haldol side effects

A

Muscle stiffness, tiredness

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22
Q

What is haldol used for

A

To sedate pts during acute breaks in hospital

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23
Q

Remember

A

Schizophrenia drugs make you fat except abilify

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24
Q

Chlorpromazine (Thorazine)

A

Antipsychotic : Non addictive Fast acting

Typical- 1st generation

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25
Concrete Thinking
Alterations in thinking- positive symptom refers to an over emphasis on specific details and impairment in the ability to use abstract concepts. example: The nurse acts the patient what brings him to the hospital, and the patient replies "a cab" rather than explaining the reason he his seeking medical or psychiatric aid. Nursing Intervention: Ask the client the meaning of a proverb such as "the grass is always greener on the other side" or "people in a glass house shouldn't throw stones" A patient with schizophrenia might answer because the window will break.
26
Amitripyline (Elavil)
Antidepressant: Non Addictive - Slow Acting Trycyclic Antidepressant
27
Seratonin
affects sleep appetite and libido
28
Associative Looseness
Alterations in speech- Positive symptom Associations are the threads that tie one thought to another and one concept to another are not working properly. In schizophrenia these threads are missing, and connections are interrupted. This causes thinking to become haphazard, illogical, and confused. Nurse: are you going to the picnic today? Patient: I am not an elephant hunter, no tiger teeth for me. If this happens it is important for the nurse to remain honest with the patient and let them know that they are not being understood, but that you want and will try harder to understand them
29
Clozapine (Clozaril) Risperidone (Resperdal)
Atypical Antipsychotics Second generation agents; newer, fewer side effects. fast acting ``` hypotension insomnia sedation sexual dysfuntion weight gain ```
30
Negative Symptoms
``` Affective Flattening Unchanging facial expression Decreased spontaneous movements Paucity of expressive genstures Poor Eye contact Inappropriate affect Lack of vocal expressions Alogia Poverty of speech Poverty of content of speech Blocking Avolition, Apathy Impaired grooming and hygiene Lack of persistance in work or school Physical anergia Anhedonia, Asociality Fewer recriational interests or activities Little sexual interest or activity Impaired intamacy or closeness Few relationships with friends or peers Attention Deficits Social inattentiveness ```
31
Doxepin (Adapin Sinequan) Protriptyline (Vivactil) Clomipramine (Anafranil)
Tricyclic Antidepressants Non addicting Slow acting
32
norepinephrine
increases energy, pain perception, stress regulator
33
Hallucinations Delusions Disorganized Speech Bizarre Behavior are all __________ symptoms of schizophrenia
positive
34
``` Inattention, easily distracted Impaired memory Poor Problem Solving skills Poor decision making skills Illogical thinking Impaired judgement ``` Are all __________ symptoms of Schizophrenia
Cognitive, associated with negative
35
Dysphoria Sucicidality Hoplessness Are considered ________ and other ________ symptoms of schizophrenia
depressive, mood
36
Buspar Visaril Atarax
Non- benzodiazepines Buspar is safer to use that any other antianxiety meds Non Addictive
37
Blunted affect Poverty of thought Loss of motivation Inability to experience pleasure or Joy Are considered _________ symptoms of schizophrenia
negative
38
Positive, Negative, Cognitive, depressive and other mood symptoms can alter the individuals:
``` ability to work interpersonal relationships self care abilities social functioning quality of life ```
39
``` Citalophram (Celexa) Fluvoxamin (luvox) Seraline (Zoloft) Fluxetine (Prozac) Paroxeline ( Paxil, Pexeva) Escitalopram (Lexapro) ```
SSRI Slow acting Used for depression
40
Alogia
Loss of thought
41
Avolition
Loss of Motivation
42
Anhedonia
Inability to experience pleasure or Joy
43
Delusions
Alterations in thinking : Positive symptoms Defined as false fixed beliefs that cannot be corrected with reasoning In schizophrenia the most common delusions are perecutory and grandiose as well as involving thoughts of religiosity and hypochondriacal ideas
44
Thought of broadcasting
delusion- positive symptom the belief that one's thoughts can be heard by others example: my brain is connected to the world mind. I can control all of the head of state through my thoughts
45
Throught Insertion
delusion- positive symptom the belief that thoughts of others are being inserted into ones mind. Example- they make me think bad thoughts
46
Thought Withdrawl
delusion- positive symptom the belief that thoughts have been removed from ones mind by an outside agency example- the devil takes my thoughts away and leaves me empty
47
Delusion of being controlled
Delusion- positve symptom the belief that ones mind or body is being controlled by an outside agency example- There is a man from the darkness that controls my thoughts with electrical waves
48
Imipramine (Tofranil) Trimipramine (Surmontil Desipramine (Norpramin) Nortriplyine (Pamelor)
Tricyclic antidepressants Tricyclic and tetracyclic antidepressants ease depression by affecting naturally occurring chemical messengers (neurotransmitters), which are used to communicate between brain cells. They're effective, but they've generally been replaced by antidepressants that cause fewer side effects.
49
Somatic Delusion
Positive symptom The false belief that one's body is changing in an unusual way Example- David told the doctor that his brain was rotting away
50
Ideas of reference
Positive Symptom- Delusion Miscontruing trivial events and remarks and giving them personal significance example: when maria saw the doctor and nurse talking together, she believed that they were plotting against her when she heard that there was a hurricane coming, she believed that it was really a message that harm was going to befall her.
51
Personal Boundary difficulties
People with schizophrenia often lack a sense of where their bodies end in a relationship and where others begin.
52
Phenelzine (Nardil) | Tranylcypromine (Parnate)
MAOI
53
``` Amoxapine (ascendin) Mirtazapine (Remeron) Trazodone (Desyrel) Bupropion (Wellbutrin) Nefazodone (Serzone) Venlafaxine (Effexor) Maprotiline (Ludiomil) Pexeva Cymbalta Selegiline (Emsam, Serafem) ```
Antidepressants Non Addicting Slow acting
54
Waxy flexibility
seen in catatonia, is evidenced by excessive maintenance of posture. Clients can hold unusual postures for long periods. positive symptom- alteration in behavior
55
Stupor
refers to a state in which the catatonic client is motionless for long periods and may even appear to be in a coma postitve symptom- alteration in behavior
56
Negativism
is the equivalent to resistance. The patient does exact opposite of what they are told. Positive Symptom- Alteration in behavior
57
anergia
lack of energy
58
Self Assessment
It is important for the nurse to identify personal feelings and responses to clients with schizophrenia; otherwise, the nurse may experience helplessness and increased anxiety. Without support and the opportunity and willingness to explore these reactions with more experienced nursing staff, the nurse may adopt defensive behaviors such as denial, withdrawl, and avoidance.
59
Abilify
Atypical antipsychotic Little or no weight gain or increase in glucose, HDL, LDL, or triglyceride level
60
Quetiapine ( Seroquel)
Atypical antipsychotic weight gain headache drowsiness orthostasis
61
Zyprexa
Atypical antipsychotic ``` significant weight gain drowsiness insomnia agitation restlessness parkinsinism ```
62
Palperidone ( Invega)
Atypical antipsychotic | fast acting
63
Haldol
Typical antipsychotic used in large doses for assultive clients to avoid the severe side effect of hypotension
64
``` Tegretol Depakote Lithium Triliptal Lamictal ```
Mood stabilizers Non addictive
65
Depersonalization
non specific feeling that a person has lost their identity. That self is different or unreal example- looking in the mirror and seeing someone different
66
Derealization
is the false perception that something has changed

Psych Nursing (3 decks)

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