Schizophrenia

Question 1

client with schizophrenia may need what type of training

Answer 1

social skills

Question 2

social skills training falls under what level of prevention

Answer 2

tertiary

Question 3

may need to refer client for what kind of program

Answer 3

exercise program to improve cognition/brain function, quality of life, overall long term health

Question 4

Age of onset for males and females

Answer 4

males 18-25 yo
females 25-35 yo

Question 5

when do symptoms normally appear for schizophrenia

Answer 5

mid to late 20s but an be up to mid 30s

Question 6

Hallmark of schizophrenia

Answer 6

impaired proverb interpretation (abstraction)
have difficulty interpreting a problem

Question 7

what intrauterine insults can contribute to the etiological picture of schizophrenia (4)

Answer 7

prenatal exposure to toxins, viral agents
oxygen deprivation
maternal malnutrition, substance use

Question 8

Schizophrenia is associated with what disorders (3)

Answer 8

lipid, HDL and increased triglycerides

Question 9

patients with schizophrenia have a low tolerability to __________

Answer 9

alpha 2 adrenergic agonists like Guanfacine and clonidine

neuro protective effects of these medications can be limited

Question 10

Should you give a client with schizophrenia stimulants

Answer 10

no due to risk of exacerbating the symptoms of d/o such as psychosis
and stimulants potentiate dopamine in the brain

Question 11

positive symptoms are caused by and what do stimulants do to them

Answer 11

excess dopamine
stimulants increase dopamine creating more positive symptoms

Question 12

neurobiological defects associated with schizophrenia (6)

Answer 12

Enlarged ventricles *** (everything else is smaller)
cerebral cortex atrophy
smaller frontal and temporal lobes
reduced symmetry in temporal, frontal, and occipital lobes
decreased cerebral blood flow
hippocampus and amygdala reduction

Question 13

aggression, impulsivity, and abstract thinking problems in schizophrenia are caused by what abnormalities in the brain?

Answer 13

prefrontal cortex
amygdala
basal ganglia
hippocampus
limbic regions

Question 14

how to switch a patient who is not compliant with their oral Haldol to IM Haldol

Answer 14

Monthly first month: 10-15 x daily oral dose for stabilized client on low daily oral dose (up to 10mg/day)

for high dose and risk of relapse***
20x daily oral dose

exp: 5mg/BID
is 20 x 10mg =200mg
max of 100mg in one administration and in 5-7 days or 14 days later administer remaining (100mg) (due to Haldol having risk of adverse effects)

Question 15

non pharmacological managment

Answer 15

group therapy**
Assertive community treatment

Question 16

Assertive community treatment (ACT)

Answer 16

services are not provided during hospitalization, but done in a community setting for people experiencing severe mental illness

Question 17

Schizoaffective disorder

Answer 17

symptoms of psychosis and also mood symptoms

Question 18

Schizophreniform is different from schizophrenia because

Answer 18

symptoms must persist for at least one month but LESS than 6 months

Question 19

difference between schizoaffective disorder and bipolar disorder with psychotic features

Answer 19

schizoaffective d/o has psychotic symptoms persist even when mood symptoms are not present, lasting for at least 2 weeks without major mood episodes

Bipolar with psychotic features occur during mood episodes and may resolve once mood episode subsides

Question 20

hypnagogic hallucinations (3)

Answer 20

occurs when falling asleep
during the transition from wakefulness to sleep
(hear someone calling names or seeing patterns as someone is about to go to sleep)

Question 21

hypnopompic hallucinations

Answer 21

occur as one is waking up during the transition from sleep to full wakefulness

Question 22

If a patient is delusional what do you not do?

Answer 22

You do not try to challenge their delusion or bring them to reality, you also must take all delusions seriously (threats)

Question 23

Delusion

Answer 23

false belief firmly maintained despite evidence to the contrary