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Psych Exam 1 > Schizophrenia > Flashcards

Schizophrenia Flashcards

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1
Q

examples of typical antipsychotics

A

–chlorpromazine
–haloperidol

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2
Q

examples of antipsychotic depot injections

A

–haloperidol
–risperidone
–paliperidone

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3
Q

examples of anticholinergic medications

A

–benztropine
–diphenhydramine
–trihexyphenidyl

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4
Q

examples of atypical medications

A

–clozapine
–olanzapine
–risperidone
–paliperidone
–iloperidone
–Respiradol Consta

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5
Q

schizophrenia definition

A

a mental illness which interferes with the person’s ability to:
–think clearly
–manage emotions
–make decisions
–relate to others

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6
Q

psychosis definition

A

a state in which the individual is experiencing hallucinations, delusions, or disorganized thoughts, speech, or behavior

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7
Q

comorbidities of schizophrenia

A

–substance use disorders
–nicotine dependence
–diabetes
–obesity
–CV disease
–HIV/AIDS
–Hep C

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8
Q

positive symptoms

A

symptoms that exist but should not be there

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9
Q

positive symptoms include…

A

–hallucinations
–delusions
–disorganized behavior
–disorganized speech

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10
Q

hallucinations

A

perceptual experiences that occur without actual external sensory stimuli

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11
Q

types of hallucinations

A

–auditory (most common)
–visual
–tactile
–olfactory
–gustatory

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12
Q

command hallucinations

A

auditory hallucinations in the form of commands; careful monitoring required

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13
Q

signs associated with individuals having hallucinations

A

–eyes tracking
–muttering or talking to oneself
–appearing distracted
–suddenly stopping conversation as if interrupted
–intently watching a vacant area of the room

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14
Q

treating hallucinations

A

–ask about content of hallucination
–do not refer to hallucinations as if they are real
–be alert for signs of anxiety (may be intensifying)
–do not negate patient’s hallucinations
–focus on reality-based here and now activities
–promote and guide reality testing

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15
Q

teaching for patients with hallucinations

A

–manage stress
–use other sounds to compete with hallucinations
–find out what is and isn’t real
–engage in activities that can take your mind off the hallucinations
–talk (tell voices to go away, aren’t real, etc.)
–develop a plan for how to cope with hallucinations

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16
Q

grandiose delusions

A

belief that one has exceptional powers, wealth, skills, influence, destiny

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17
Q

nihilistic delusions

A

belief that one is dead or disaster is impending

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18
Q

persecutory delusions

A

belief that one is being watched, plotted against, ridiculed

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19
Q

somatic delusions

A

belief about abnormalities in body function or structure

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20
Q

religious delusions

A

believe they have a special relationship with God or are on a mission from God, or that they are sinners

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21
Q

referential delusions

A

believe that newspaper articles, TV shows or song lyrics are directed specifically at them

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22
Q

treating patients with delusions

A

–establish therapeutic relationship
–respond in matter-of-fact, empathic, supportive, and calm manner
–ask patient to describe beliefs
–never debate delusional content; supportively convey doubt where appropriate
–validate if part of the delusion is real
–focus on feelings or themes of the delusion
–reality-based interventions
–do not dwell excessively on delusion

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23
Q

thought blocking example

A

in middle of talking about childhood, patient pauses abruptly and then can’t remember what he was saying

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24
Q

thought broadcasting example

A

“I know you know what I’m thinking. Everybody hears what I’m thinking.”

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25
Q

thought withdrawal example

A

a man continually blames his poor memory on “government agents” who he claims can steal his thoughts

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26
Q

thought insertion example

A

patient repeatedly complains of having disturbingly violent thoughts, which, she claims, are being sent to her by Satan

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27
Q

paranoia

A

–an irrational fear, ranging from mild to profound
–suspiciousness that is unrealistic

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28
Q

circumstantiality

A

extremely detailed and lengthy talk about a topic but gets eventually to the point

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29
Q

tangentiality

A

extremely detailed and lengthy talk about a topic, but usually doesn’t get to the point

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30
Q

loose associations

A

absence of normal connectedness of thoughts, ideas, and topics

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31
Q

flight of ideas

A

topic of conversation changes repeatedly and rapidly with only superficial associative connections

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32
Q

echolalia

A

repetition of another’s words, pathological repetition of another’s word

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33
Q

clang association

A

repetition of words that are similar in sound, but in no other way

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34
Q

stilted language

A

overly and artificial formal language

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35
Q

pressured speech

A

as if words are being forced out

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36
Q

word salad

A

–string of words totally unconnected
–jumble of words meaningless to a listener

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37
Q

neologisms

A

–made up words
–meaning for patient only

38
Q

illogicality

A

conclusions are reached that do not follow logically

39
Q

aggression

A

behaviors or attitudes that reflect rage

40
Q

agitation

A

–inability to sit still or attend to others
–pacing

41
Q

catatonic excitement

A

hyperactivity characterized by purposeless activity and abnormal movements

42
Q

echopraxia

A

involuntary imitation of another’s movements and gestures

43
Q

regressed behavior

A

childlike/immature

44
Q

stereotype

A

repetitive purposeless movements that are peculiar to the person

45
Q

hypervigilence

A

sustained attention to external stimuli

46
Q

waxy flexibility

A

posture held in fixed position

47
Q

negative symptoms

A

symptoms that should be there but aren’t

48
Q

affective flattening or blunting

A

flat or blunted emotion

49
Q

ambivalence

A

presence of two opposing forces, leading to inaction/can’t decide/stuck

50
Q

alogia

A

–brief and lack of content verbal responses
–not able to elaborate

51
Q

avolition

A

inability to complete projects, assignments, or work

52
Q

anhedonia

A

–inability to gain pleasure
–hijacks joy

53
Q

asociality

A

decreased desire for, or comfort during, social interactions

54
Q

concrete thinking

A

inability to think abstractly

55
Q

impaired memory

A

impacts short-term memory and the ability to learn

56
Q

impaired information processing

A

–delayed responses
–misperceptions or difficulty understanding others

57
Q

impaired executive functioning

A

difficulty with reasoning, setting priorities, comparing options, planning, etc.

58
Q

treatment for schizophrenia

A

–psychopharmalogical interventions
–psychosocial interventions
–support

59
Q

what do antipsychotic medications treat?

A

severe thought disorders (schizophrenia and BPD)

60
Q

when are antipsychotic medications used?

A

used for acute and chronic confusion that commonly accompanies psychoses, extreme aggression, and dementia

61
Q

target symptoms of antipsychotic medications

A

–disorganized thinking, speech, and behavior
–flat or inappropriate affect
–delusions
–hallucinations
–catatonia

62
Q

overall goals of treatment for schizophrenia

A

–safety
–stabilization
–education
–physical care
–psychosocial support

63
Q

anosognosia

A

–inability to realize they are ill
–often combined with paranoia so that accepting help is impossible

64
Q

target of typical antipsychotics (1st gen)

A

positive symptoms of schizophrenia

65
Q

disadvantages of typical antipsychotics (1st gen)

A

–extrapyramidal side effects
–anticholinergic side effects
–tardive dyskinesia
–weight gain, sexual dysfunction, endocrine disturbances

66
Q

side effects of chlorpromazine and haloperidol

A

–anticholinergic
–sedation
–EPS
–hypotension
–seizure
–photosensitivity
–GI upset
–EKG changes
–neuromalignant syndrome
–tardive dyskinesia

67
Q

examples of anticholinergic side effects

A

–dry mouth
–urinary retention/hesitancy
–constipation
–blurred vision
–dry eyes
–sexual dysfunction
–hypotension

68
Q

extrapyramidal side effects

A

–acute dystonia
–akathisia
–pseudoparkinsonism
–tardive dyskinesia

69
Q

treatment of pseudoparkinsonism

A

dosage reduction or the addition of oral anticholinergic agents

70
Q

akathisia

A

a feeling of inner restlessness that can be manifested as excessive pacing or inability to remain still for any length of time

71
Q

treatment of akathisia

A

–dosage reduction
–addition of low-dose BB

72
Q

torticollis

A

spasmodic and painful spasm of muscles (head pulled to one side)

73
Q

oculogyric crisis

A

eyes roll back toward the head

74
Q

opisthotonus

A

a type of spasm in which the head and heels arch backward in extreme hyperextension and the body forms a reverse bow

75
Q

laryngospasm

A

spasm of throat impairing breathing and swallowing

76
Q

oral-facial maxillary spasms

A

treat emergently as they may progress

77
Q

treatment for mild side effects of medication

A

–reduce dosage
–D/C med
–switch to another med in same class
–add anticholinergic agent

78
Q

tardive dyskinesia

A

involuntary movement disorder that can occur with long-term antipsychotic treatment and may not be reversible even if meds are discontinued

79
Q

what is the body part most commonly involved with tardive dyskinesia?

A

orofacial region

80
Q

risk factors for developing tardive dyskinesia

A

–long-term therapy with FGAs
–older age
–females
–concurrent affective disorders

81
Q

what medication is used to treat tardive dyskinesia?

A

clozapine

82
Q

neuroleptic malignant syndrome

A

–associated with antipsychotics
–dehydration is predisposing factor
–more common in warm climates

83
Q

signs/symptoms of NMS

A

–fever 103-105 F
–diaphoresis
–muscle rigidity
–tachycardia
–tachypnea
–agitation
–AMS

84
Q

interventions for NMS

A

–stop all antipsychotics
–supportive treatment
–hospitalization
–history is critical

85
Q

drugs used to treat NMS

A

–dantrolene
–bromocriptine
–levodopa
–lorazepam

86
Q

what are atypical antipsychotics (2nd gen.) used for?

A

treating both positive and negative symptoms

87
Q

disadvantage to atypical antipsychotics (2nd gen.)

A

–tendency to cause significant weight gain
–risk of metabolic syndrome

88
Q

side effects of atypical antipsychotics

A

–sedation
–N/V
–weight gain/changes in metabolism
–potential for cardiac dysrhythmias
–rhinitis
–sexual dysfunction

89
Q

clozapine use

A

–treats refractory schizophrenia (doesn’t respond to normal treatment)
–decreased negative symptoms, increased impulse control, reduced violence to self and others, and improved quality of life

90
Q

fatal side effect of clozapine

A

agranulocytosis

91
Q

when are long-acting depot medications used?

A

–patients with schizophrenia and BPD
–those unable to adhere to treatment regimen
–cognitive deficits
–lack of social support

Psych Exam 1 (3 decks)

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