Schizophrenia Flashcards
What is schizophrenia?
Has positive and negative symptoms, 3 stages, is unique/unpredictable, recovery is possible but cure is not, symptoms will differ between person to person.
3 stages of schizophrenia?
- Acute illness period- first episode of psychosis, has positive/negative symptoms, stay up all night/withdraw from social situations, they are untreated
- Stabilization period- get initial diagnosis, treatment given, symptoms stabilize
- Maintenance/recovery period- being able to live with condition, there can be relapses
Positive symptoms of schizophrenia?
First rank. Symptoms reflect excess/distortion of normal functions. Things like hallucinations, delusions, and thought disturbances.
Negative symptoms?
Second rank, reflect lessening/loss of normal functions like withdrawing from social situations, flat affect, inability to make decisions…
Hallucinations?
Perceptual experiences that occur without actual external sensory stimuli. Can involve all 5 senses.
Delusions and 4 types?
Fixed/false belief that involves misinterpretation of experience.
grandiose- belief that one has exceptional powers
nihilistic- belief that one is dead or smothering is impending, impending doom
persecutory- belief that someone is watching them/going to hurt them
somatic- belief that something is wrong with the body
What is alogia?
Ability to converse is diminished. Reduced fluency of thought/speech
What is ambivalence?
Inability to make decisions
What is avolition?
Inability to self motivate/persist in goal directed activity
What is anhedonia?
Inability to socialize/inability to experience pleasure.
What is blunted and flat affect?
B- facial expression are diminished/totally lacking
F- showing little to no emotion even when personal loss occurs
Neurocognitive impairment in schizophrenia?
Problems with memory, viligance, verbal learning, and executive functioning. Includes disorganized symptoms- disorganized speech, thinking, and behaviour (make it difficult to understand/respond to ordinary sounds/sights of daily living).
What are illusions?
When people misperceive or exaggerate stimuli that actually exists in external environments.
Disorganized thinking in schizophrenia?
Disturbed speech/thinking patterns, thought blocking, word salads
Examples of disorganized behaviour?
Aggression, agitation, catatonic excitements (hyperactive, purposeless activity, abnormal movements)
Echopraxia?
Involuntary imitation of others movements and gestures
Regressed behaviour?
childlike and immature
Hyper vigilance?
Sustained attention to external stimuli
Stereotypy?
repetitive purposeless movements
Risk factors for schizophrenia?
Genetic, age of onset (late adolescent and early adulthood), men diagnose earlier than women, childhood trauma, social isolation, cannabis use, lower socioeconomic class,
Biological assessment?
Current/pass health status, physical exam, nutrition (fluid imbalance, excessive water drinking), pharmacological assessment (meds), and physical functioning
Biological domain of care?
Promote self care activities, exercise/nutrtion interventions, meds, monitor/administer meds, thermoregulation
EPS side effects?
Orthostatic hypotension, gynaecomastia, weight gain, sedation, cardiac arrhythmias, agranulocystosis, NMS
What is NMS?
Severe muscle rigidity, elevated temp, rapidly accelerating cascade of symptoms like HTN, tachycardia, diaphoresis, incontinence, LOC changes.
Anticholinergic side effects?
Confusion, recent memory loss, agitation, dysarthria, delusions, ataxia, blurred vision, flush skin, dry membranes, difficulty swallowing, nausea, vomit. Can have hallucinations that are accompanied by picking/plucking/gasping motions
Psychological domain?
Assess mental status/appearance, mood/affect, speech, thought process, disorganized communication (word salad, flight of ideas), memory, behavioural response, self concept, risk assessment (self farm, suicide),
Nursing care for psychological domain?
Manage disturbed thoughts/sensory perceptions, recognize symptoms of disorders, teach pt. that hallucination/delusion are symptoms of illness, self monitor/prevent relapse, improve attention/help memory, reinforce positive behaviours, help with stress, family support, educate patients (minimal distractions, skill training).
Social domain?
Look at social support systems, quality of life, family assessment.
Interventions for social domain?
Promote patient safety (set limits, administer meds, monitor for agggression), support groups, milieu therapy
What is schizoaffective disorder?
Combo of a mood disorder and schizophrenia. Un-Interrupted period of illness where there’s major depressive/manic/mixed episode along with symptoms of schizophrenia. More common in women
Treatment for schizoaffective disorder?
Antipsychotics, mood stabilizers, ECT, and psychotherapy
Focus of Nursing care for schizoaffective
disturbed thought process/sensory perception, disturbed sleep patterns, insight, self care, hopelessness, powerlessness, coping, and social dysfunction
What is a delusional disorder?
psychotic disorder characterized by nonbizarre, logical, stable, and well-systemized delusions that occur in the absence of other psychiatric symptoms. many types of delusional disorders
Major reason for relapses?
Non adherence to medication
What are the most common types of hallucinations?
Auditory and visual (visual is the most).
DSM criteria for schizophrenia?
2/more symptoms present during 1 month period, and one of those symptoms must be 1/2/3.
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Catatonic behaviour
5. Negative symptoms…
These can decrease level of functioning
What is an illusion?
Person misperceives an stimuli that actually exists
Comorbidites of schizophrenia?
Depression and substance use
