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Schizophrenia Flashcards

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
thought withdrawal example
a man continually blames his poor memory on "government agents" who he claims can steal his thoughts
26
thought insertion example
patient repeatedly complains of having disturbingly violent thoughts, which, she claims, are being sent to her by Satan
27
paranoia
--an irrational fear, ranging from mild to profound --suspiciousness that is unrealistic
28
circumstantiality
extremely detailed and lengthy talk about a topic but gets eventually to the point
29
tangentiality
extremely detailed and lengthy talk about a topic, but usually doesn't get to the point
30
loose associations
absence of normal connectedness of thoughts, ideas, and topics
31
flight of ideas
topic of conversation changes repeatedly and rapidly with only superficial associative connections
32
echolalia
repetition of another's words, pathological repetition of another's word
33
clang association
repetition of words that are similar in sound, but in no other way
34
stilted language
overly and artificial formal language
35
pressured speech
as if words are being forced out
36
word salad
--string of words totally unconnected --jumble of words meaningless to a listener
37
neologisms
--made up words --meaning for patient only
38
illogicality
conclusions are reached that do not follow logically
39
aggression
behaviors or attitudes that reflect rage
40
agitation
--inability to sit still or attend to others --pacing
41
catatonic excitement
hyperactivity characterized by purposeless activity and abnormal movements
42
echopraxia
involuntary imitation of another's movements and gestures
43
regressed behavior
childlike/immature
44
stereotype
repetitive purposeless movements that are peculiar to the person
45
hypervigilence
sustained attention to external stimuli
46
waxy flexibility
posture held in fixed position
47
negative symptoms
symptoms that should be there but aren't
48
affective flattening or blunting
flat or blunted emotion
49
ambivalence
presence of two opposing forces, leading to inaction/can't decide/stuck
50
alogia
--brief and lack of content verbal responses --not able to elaborate
51
avolition
inability to complete projects, assignments, or work
52
anhedonia
--inability to gain pleasure --hijacks joy
53
asociality
decreased desire for, or comfort during, social interactions
54
concrete thinking
inability to think abstractly
55
impaired memory
impacts short-term memory and the ability to learn
56
impaired information processing
--delayed responses --misperceptions or difficulty understanding others
57
impaired executive functioning
difficulty with reasoning, setting priorities, comparing options, planning, etc.
58
treatment for schizophrenia
--psychopharmalogical interventions --psychosocial interventions --support
59
what do antipsychotic medications treat?
severe thought disorders (schizophrenia and BPD)
60
when are antipsychotic medications used?
used for acute and chronic confusion that commonly accompanies psychoses, extreme aggression, and dementia
61
target symptoms of antipsychotic medications
--disorganized thinking, speech, and behavior --flat or inappropriate affect --delusions --hallucinations --catatonia
62
overall goals of treatment for schizophrenia
--safety --stabilization --education --physical care --psychosocial support
63
anosognosia
--inability to realize they are ill --often combined with paranoia so that accepting help is impossible
64
target of typical antipsychotics (1st gen)
positive symptoms of schizophrenia
65
disadvantages of typical antipsychotics (1st gen)
--extrapyramidal side effects --anticholinergic side effects --tardive dyskinesia --weight gain, sexual dysfunction, endocrine disturbances
66
side effects of chlorpromazine and haloperidol
--anticholinergic --sedation --EPS --hypotension --seizure --photosensitivity --GI upset --EKG changes --neuromalignant syndrome --tardive dyskinesia
67
examples of anticholinergic side effects
--dry mouth --urinary retention/hesitancy --constipation --blurred vision --dry eyes --sexual dysfunction --hypotension
68
extrapyramidal side effects
--acute dystonia --akathisia --pseudoparkinsonism --tardive dyskinesia
69
treatment of pseudoparkinsonism
dosage reduction or the addition of oral anticholinergic agents
70
akathisia
a feeling of inner restlessness that can be manifested as excessive pacing or inability to remain still for any length of time
71
treatment of akathisia
--dosage reduction --addition of low-dose BB
72
torticollis
spasmodic and painful spasm of muscles (head pulled to one side)
73
oculogyric crisis
eyes roll back toward the head
74
opisthotonus
a type of spasm in which the head and heels arch backward in extreme hyperextension and the body forms a reverse bow
75
laryngospasm
spasm of throat impairing breathing and swallowing
76
oral-facial maxillary spasms
treat emergently as they may progress
77
treatment for mild side effects of medication
--reduce dosage --D/C med --switch to another med in same class --add anticholinergic agent
78
tardive dyskinesia
involuntary movement disorder that can occur with long-term antipsychotic treatment and may not be reversible even if meds are discontinued
79
what is the body part most commonly involved with tardive dyskinesia?
orofacial region
80
risk factors for developing tardive dyskinesia
--long-term therapy with FGAs --older age --females --concurrent affective disorders
81
what medication is used to treat tardive dyskinesia?
clozapine
82
neuroleptic malignant syndrome
--associated with antipsychotics --dehydration is predisposing factor --more common in warm climates
83
signs/symptoms of NMS
--fever 103-105 F --diaphoresis --muscle rigidity --tachycardia --tachypnea --agitation --AMS
84
interventions for NMS
--stop all antipsychotics --supportive treatment --hospitalization --history is critical
85
drugs used to treat NMS
--dantrolene --bromocriptine --levodopa --lorazepam
86
what are atypical antipsychotics (2nd gen.) used for?
treating both positive and negative symptoms
87
disadvantage to atypical antipsychotics (2nd gen.)
--tendency to cause significant weight gain --risk of metabolic syndrome
88
side effects of atypical antipsychotics
--sedation --N/V --weight gain/changes in metabolism --potential for cardiac dysrhythmias --rhinitis --sexual dysfunction
89
clozapine use
--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
fatal side effect of clozapine
agranulocytosis
91
when are long-acting depot medications used?
--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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