Schizophrenia Flashcards
Onset of schizophrenia
Abrupt or insidious, most with slow, gradual development of s/s
Symptoms of schizophrenia
Positive: Delusions, hallucinations, disorganized speech, bizarre behavior
Negative: Flattened affect, reduced speech, lack of initiative
Environmental factors
Viral exposure, cytokines
Infection in pregnant women is a possible origin
Psychosis
Symptom, not a diagnosis
Inability to recognize reality
What assessment findings suggest a patient may be hallucinating?
Darting eyes, tilted head, mumbling to self
Best intervention when you assess a patient is responding to an auditory hallucination
“Can you tell me what you are hearing?”
Considerations for older adults
Psychotic symptoms later in life usually associated with depression or dementia
Conventional antipsychotics
Target positive symptoms, no observable effect on negative symptoms
Haldol (Haloperidol), Thorazine (Chlorpromazine)
Atypical antipsychotics
Diminish positive symptoms, lessen negative symptoms
Clozapine, concern for neutropenia
Agranulocytosis (significant risk), seizures, diabetes, weight gain, myocarditis. Do not give if WBC is less than 3,500
Neuroleptic Malignant Syndrome
Rare but serious reaction
Sweating, rigidity, sudden high fever, autonomic instability, diaphoresis, deterioration of mental status
Risk of death without treatment (stop drug!)
Monitor vital signs, I&Os, LOC, Parkinsonian symptoms
May be prescribed bromocriptine or dantrolene
Goal of psychiatric rehabilitation
Patient recovery, accurate identification of those at risk, early intervention
