Schizophrenia

Question 1

What is schizophrenia?

Answer 1

Has positive and negative symptoms, 3 stages, is unique/unpredictable, recovery is possible but cure is not, symptoms will differ between person to person.

Question 2

3 stages of schizophrenia?

Answer 2

1. Acute illness period- first episode of psychosis, has positive/negative symptoms, stay up all night/withdraw from social situations, they are untreated
2. Stabilization period- get initial diagnosis, treatment given, symptoms stabilize
3. Maintenance/recovery period- being able to live with condition, there can be relapses

Question 3

Positive symptoms of schizophrenia?

Answer 3

First rank. Symptoms reflect excess/distortion of normal functions. Things like hallucinations, delusions, and thought disturbances.

Question 4

Negative symptoms?

Answer 4

Second rank, reflect lessening/loss of normal functions like withdrawing from social situations, flat affect, inability to make decisions…

Question 5

Hallucinations?

Answer 5

Perceptual experiences that occur without actual external sensory stimuli. Can involve all 5 senses.

Question 6

Delusions and 4 types?

Answer 6

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

Question 7

What is alogia?

Answer 7

Ability to converse is diminished. Reduced fluency of thought/speech

Question 8

What is ambivalence?

Answer 8

Inability to make decisions

Question 9

What is avolition?

Answer 9

Inability to self motivate/persist in goal directed activity

Question 10

What is anhedonia?

Answer 10

Inability to socialize/inability to experience pleasure.

Question 11

What is blunted and flat affect?

Answer 11

B- facial expression are diminished/totally lacking
F- showing little to no emotion even when personal loss occurs

Question 12

Neurocognitive impairment in schizophrenia?

Answer 12

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).

Question 13

What are illusions?

Answer 13

When people misperceive or exaggerate stimuli that actually exists in external environments.

Question 14

Disorganized thinking in schizophrenia?

Answer 14

Disturbed speech/thinking patterns, thought blocking, word salads

Question 15

Examples of disorganized behaviour?

Answer 15

Aggression, agitation, catatonic excitements (hyperactive, purposeless activity, abnormal movements)

Question 16

Echopraxia?

Answer 16

Involuntary imitation of others movements and gestures

Question 17

Regressed behaviour?

Answer 17

childlike and immature

Question 18

Hyper vigilance?

Answer 18

Sustained attention to external stimuli

Question 19

Stereotypy?

Answer 19

repetitive purposeless movements

Question 20

Risk factors for schizophrenia?

Answer 20

Genetic, age of onset (late adolescent and early adulthood), men diagnose earlier than women, childhood trauma, social isolation, cannabis use, lower socioeconomic class,

Question 21

Biological assessment?

Answer 21

Current/pass health status, physical exam, nutrition (fluid imbalance, excessive water drinking), pharmacological assessment (meds), and physical functioning

Question 22

Biological domain of care?

Answer 22

Promote self care activities, exercise/nutrtion interventions, meds, monitor/administer meds, thermoregulation

Question 23

EPS side effects?

Answer 23

Orthostatic hypotension, gynaecomastia, weight gain, sedation, cardiac arrhythmias, agranulocystosis, NMS

Question 24

What is NMS?

Answer 24

Severe muscle rigidity, elevated temp, rapidly accelerating cascade of symptoms like HTN, tachycardia, diaphoresis, incontinence, LOC changes.

Question 25

Anticholinergic side effects?

Answer 25

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

Question 26

Psychological domain?

Answer 26

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),

Question 27

Nursing care for psychological domain?

Answer 27

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).

Question 28

Social domain?

Answer 28

Look at social support systems, quality of life, family assessment.

Question 29

Interventions for social domain?

Answer 29

Promote patient safety (set limits, administer meds, monitor for agggression), support groups, milieu therapy

Question 30

What is schizoaffective disorder?

Answer 30

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

Question 31

Treatment for schizoaffective disorder?

Answer 31

Antipsychotics, mood stabilizers, ECT, and psychotherapy

Question 32

Focus of Nursing care for schizoaffective

Answer 32

disturbed thought process/sensory perception, disturbed sleep patterns, insight, self care, hopelessness, powerlessness, coping, and social dysfunction

Question 33

What is a delusional disorder?

Answer 33

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

Question 34

Major reason for relapses?

Answer 34

Non adherence to medication

Question 35

What are the most common types of hallucinations?

Answer 35

Auditory and visual (visual is the most).

Question 36

DSM criteria for schizophrenia?

Answer 36

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

Question 37

What is an illusion?

Answer 37

Person misperceives an stimuli that actually exists

Question 38

Comorbidites of schizophrenia?

Answer 38

Depression and substance use