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Psychatric & Mental Health > Schizophrenia > Flashcards

Schizophrenia Flashcards

0
Q

How much of the population does schizophrenia affect

A

More than 1%

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1
Q

Schizophrenia is a _______ brain disorder

A

Chronic

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2
Q

What can symptoms of schizophrenia include

A

Delusions, hallucinations, trouble with thinking and concentration, and lack of motivation

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3
Q

Onset of schizophrenia?

A

Early 20s. Men a little younger, women a little later

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4
Q

What are the subtypes of schizophrenia?

A

Paranoid, disorganized, catatonic, undifferentiated, residual

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5
Q

What does the Diathesis-Stress Model of Mental Illness mean?

A

That a person is born with a certain predisposition and then a stressor comes alone and triggers it once the stage is set.
Diathesis: sets the stage; what you’re born with
Stress: something happens to trigger it

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6
Q

first degree biologic relatives of an individual with schizophrenia have a ____ times greater risk for schizophrenia than the general population

A

10

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7
Q

The neuro-anatomic findings with a schizophrenic are similar to those of what type of patient?

A

Dementia

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8
Q

What is the monoamine hypothesis of mental illness

A

Changes in the levels of monoamine neurotransmitters (5-HT, NE, EPI, DA) cause mental illness

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9
Q

There is too much ________ with schizophrenia

A

Dopamine

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10
Q

What are positive symptoms

A

Things added

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11
Q

What is a hallucination

A

Actually feeling SENSATION without physical stimulation. It can involve and of the five senses

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12
Q

What types are hallucinations usually

A

Visual or auditory

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13
Q

What are delusions

A

Fixed false beliefs that you cannot change

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14
Q

What are negative symptoms

A

Things taken away

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15
Q

What are examples of negative symptoms?

A

Affective flattening or blunting, ambivalence, alogia, avolition, anhedonia

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16
Q

What is the neurocognitive impairment diagnostic criteria

A

Memory short and long term, vigilance or sustained attention, verbal fluency, executive functioning, disorganized behavior, disorganized thinking

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17
Q

What are internal senses

A

Biochemical and emotional

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18
Q

What are external senses

A

Sight, sound, touch, taste, smell

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19
Q

What does treatment focus on in the acute illness period

A

Alleviation of symptoms

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20
Q

What are things that go on during the acute illness period

A

Behaviors may be both confusing and frightening, less able to care for basic needs, functioning at school and work deteriorates, dependence on family and friends increases

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21
Q

What stage is the treatment intense

A

Stabilization period

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22
Q

What goes on during the stabilization period

A

Symptoms become less acute but may be present, treatment is intense, medication regimen is established, being to adjust, socialization begins to increase and rehabilitation begins ideally

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23
Q

Ideally when does socialization begin to increase and rehabilitation begin

A

Stabilization period

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24
Q

What is typically the trigger to a relapse

A

Noncompliance with medication regimen

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25
Q

What does the maintenance and recovery period focus on

A

Focuses on regaining the previous level of functioning and quality of life by using medication management and family support and involvement

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26
Q

What are symptoms related to problems in information processing often called

A

Cognitive deficits

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27
Q

What type of commands to schizophrenic patients often have difficulty with?

A

Multiple step commands because they use concrete instead of abstract thinking

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28
Q

What type of thinking do schizophrenic patients use? Especially in acute episodes

A

Concrete rather than abstract thinking

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29
Q

For a schizophrenic patient to make the appropriate decision what does the nurse need to do?

A

Provide information as clearly and concretely as possible with simple language in short , easily understood phrases

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30
Q

What are some thought content descriptors

A

Thought broadcasting, thought insertion, ideas of reference, and magical thinking

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31
Q

What is alogia

A

Reduced fluency and productivity of thought and speech

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32
Q

What is avolition

A

Withdraw and inability to initiate and persist goal-directed activity

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33
Q

What is anhedonia

A

Inability to experience pleasure

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34
Q

What is a grandiose delusion

A

The belief that one has exceptional powers, wealth, skill, influence, or destiny

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35
Q

What is a nihilistic delusion

A

The belief that one is dead or a calamity is impending

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36
Q

What is a persecutory delusion

A

The belief that one is being watched, ridiculed, harmed, or plotted against

37
Q

What is a somatic delusion

A

Beliefs about abnormalities in bodily functions or structures

38
Q

What are the different types of delusions

A

Grandiose, nihilistic, persucatory, somatic

39
Q

Are auditory or visual hallucinations more common?

A

Auditory

40
Q

What prevents a person with schizophrenia from enjoying activities

A

Anhedonia

41
Q

Extremely detailed and lengthy discourse about a topic

A

Circumstantial

42
Q

The topic of conversation changes repeatedly and rapidly, generally after just one sentence or phrase

A

Flight of ideas

43
Q

Absence of the normal connectedness of thoughts, ideas, and topics; sudden shifts without apparent relationship to preceding topics

A

Loose associations

44
Q

The topic of conversation is changed to an entirely different topic that is a logical progression but causes a permanent detour from the original focus

A

Tangentiality

45
Q

String of words that are not connected in any way

A

Word salad

46
Q

What are the first symptoms of psychosis

A

Abnormal perception: inaccurate identification and interpretation of stimulus

47
Q

Is there a identifiable external or internal stimulus with hallucinations?

A

No

48
Q

What can cause auditory hallucinations

A

Excessive noise or sensory deprivation

49
Q

What are some environmental factors that can stimulate visual hallucinations

A

Reflective objects like tv screens, photos frames, fluorescent lights

50
Q

What is affect? What are ways to describe?

A

Expressed emotions; describe as broad, restricted, blunted, flat, or inappropriate

51
Q

What are some maladaptive movements with schizophrenia

A

Catatonia, abnormal eye movements, grimacing, apraxia/echopraxia, abnormal gait, mannerisms, extrapyramidal side effects of psychotic medications

52
Q

what are some behaviors that cause socialization problems?

A

Inability to communicate coherently, loss of drive and interest, deterioration of social skills, poor personal hygiene, paranoia, stigma

53
Q

What is neurocognitive impairment often seen as?

A

Disorganized symptoms

54
Q

What are disorganized symptoms?

A

Confused speech and thinking patterns, disorganized behavior

55
Q

What is echolalia

A

Repetition of words

56
Q

What are examples of disorganized thinking

A

echolalia, circumstantial, loose associations, tangential, flight of ideas, word salad, clang association, pressured speech

57
Q

What are examples of disorganized behavior

A

Aggression, agitation, catatonic excitement, echopraxia, stereotypy, hypervigilance, waxy flexibility

58
Q

What is waxy flexibility

A

Posture held in odd or unusual way

59
Q

What is hypervigilance

A

Sustained attention to external stimuli

60
Q

What is echopraxia

A

Imitation of others movements

61
Q

First priority is always _______

A

Safety

62
Q

Why do these people have a high risk lifestyle

A

Sedentary, smoking, or dietary habits; obesity resulting in diabetes, hypertension, coronary artery disease

63
Q

What do antipsychotics do

A

Block dopamine transmission in the brain

64
Q

Are first generation or second generation antipsychotics more efficacious and safer?

A

Second generation antipsychotic drugs appear to be more efficacious and safer than conventional antipsychotics

65
Q

How long does it take antipsychotic drugs to effect a change in symptoms

A

1-2 weeks. The delay in outcome is why people stay in hospital to see if they are working

66
Q

Why would a antipsychotic be used in a emergency situation for a patient who was acting out?

A

Sedating effect. This is a chemical restraint and must be documented

67
Q

What are some extrapyramidal side effects

A

Parkinsonism, akathisia, tardive dyskinesia, orthostatic hypotension, hyperprolactactinemia, weight gain, sedation, new onset diabetes, cardiac arrhythmias, agranulocytosis

68
Q

Is tardive dyskinesia a early or late appearing extrapyramidal side effect for antipsychotic meds?

A

Late

69
Q

What does tardive dyskinesia involve

A

Irregular, repetitive involuntary movements of the mouth, face, and tongue, including chewing, tongue protrusion, lip smacking, Puckering of the lips, and rapid eye blinking

70
Q

Is tardive dyskinesia reversible?

A

No it is irreversible

71
Q

What is neuroleptic malignant syndrome

A

A life threatening condition that can develop in reaction to antipsychotic meds. Patients develop severe muscle rigidity and an elevating temperature

72
Q

What are recognizing symptoms of neuroleptic malignant syndrome

A

Elevated temperature, changes in level of consciousness, leukocytosis, elevated creatinine phosphokinase, elevated liver enzymes or myoglobinuria

73
Q

Nursing interventions with neuroleptic malignant syndrome

A

Stop administration of offending medications, monitor vital signs, reduce body temperature, and safety to protect muscles

74
Q

What are supportive measures with neuroleptic malignant syndrome

A

IV fluids, cardiac monitoring, and Dantrolene (dopamine agonist) to make body know there is still some dopamine

75
Q

What are symptoms of anticholinergic crisis

A

Elevated temperature, dry mouth, decreased salivation, decreased bronchial, nasal secretion, widely dilated eye (hot as a hare, blind as a bat, mad as a hatter, dry as a bone, red as a bee); confusion, hallucinations

76
Q

What is anticholinergic crisis

A

Potentially life threatening, anticholinergic delirium, can occur with patients who are taking several medications with anticholinergic effects

77
Q

Does anticholinergic crisis go away?

A

Yes it is self limiting; 3 days

78
Q

Treatment for anticholinergic crisis

A

Discontinuation of medication; Physostigmine 1-2 mg IV, an inhibitor of cholinesterase, improves in 24-36 hours; gastric lavage; charcoal, catharsis

79
Q

What should you teach patients about delusions and hallucinations

A

That they are symptoms of illness and part of the disorder

80
Q

What does inpatient care focus on

A

Stabilization

81
Q

What does emergency care focus on

A

Crisis

82
Q

What does community care focus on?

A

This is where most of the care happens

83
Q

Absorption of antipsychotic meds

A

Variable 30-60 minutes

84
Q

Where is metabolism of antipsychotic drugs?

A

Liver—look at liver function test!

85
Q

Is excretion of antipsychotic drugs fast or slow?

A

Slow

86
Q

What blood level does a patient with schizophrenia who is taking clozapine need to monitor weekly

A

WBC because agranulocytosis can develop with the use of all antipsychotic drugs but most likely to develop with clozapine use

87
Q

A patient who has been taking clozapine for 6 weeks visits the clinic complaining of fever, sore throat, and mouth sores. What would the nurse suspect?

A

Agranulocytosis

88
Q

What are the 1st gen/typical antipsychotics

A

Chlorpromazine
Thioxanthenes
Haloperidol

89
Q

What are the 2nd gen/atypical antipsychotics

A 
Clozapine
Olanzapine
Risperidone
Ziprasidone
Aripiprazole
Quetiapine

Psychatric & Mental Health (11 decks)

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