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Schizophrenia (329 E1) Flashcards

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1
Q

schizophrenia definition

A

a psychosis characterized by abnormalities in perception, content of thought and thought process, and extensive withdrawal of one’s interest from individuals and the outside world
a disconnection to the mind

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2
Q

Psychosis definition

A

a state in which the individual is experiencing hallucinations, delusions or disorganized thoughts, speech or behavior
caused by schizophrenia and mood disorders like bipolar

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3
Q

schizophrenia interferes w/ person’s ability to

A

-think clearly
-manage emotions
-make decisions
-relate to others

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4
Q

peak onset of schizophrenia

A

men: 15-25 years of age
women: 25-35 years of age

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5
Q

etiology of schizophrenia

A

-genetics
-environmental
-brain chemistry (problems w/ neurotransmitter, dopamine & glutamate)
-substance use

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6
Q

comorbidity of schizophrenia

A

-substance use disorder
-nicotine dependence
-anxiety/depression/SI
-DM
-CVD
-obesity
-malignant neoplasm
-HIV/AIDS
-osteoporosis
-Hep C

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7
Q

schizophrenia: positive symptoms

A

can be thought of as sx that exist but should not be there
-alterations in perception (paranoia, delusions, hallucinations)
-altered speech
-alterations in behavior
-alterations in thought

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8
Q

paranoia

A

-an irrational fear, ranging from mild to profound
-a deep mistrust or suspicion of others
-may result in dangerous defensive actions
-paranoia can develop into delusional thoughts

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9
Q

delusions

A

false beliefs that are held despite a lack of evidence to support them and aren’t corrected w/ reasoning
feels very real to patient

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10
Q

delusions: persecutory

A

belief that one is being watched, plotted against, ridiculed

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11
Q

delusions: referential

A

belief that events or circumstances that have no connection to you are somehow related to you

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12
Q

delusions: grandiose

A

belief that one a powerful or important person

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13
Q

delusions: erotomanic

A

believing that another person desires you reomantically

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14
Q

delusions: nihilistic

A

the delusion of nonexistence: a fixed belief that the mind, body or the world at large - or parts thereof - no longer exists

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15
Q

delusions: somatic

A

belief that the body is changing in unusual ways

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16
Q

delusions: religious

A

belief that they have a special relationship w/ god or are on a mission for god, or that they are sinners

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17
Q

delusions: control

A

belief that another person, group or external force controls your thoughts, feelings, impulses or behavior

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18
Q

intervening w/ delusion

A

-remain calm, acknowledge and accept the patient’s experience and feelings
-encourage pt to express feelings and convey empathy about the patient’s fearfulness
-provide reassurance about intentions & present reality
-focus on helping the pt feel safe, focus on the fear and not the delusion

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19
Q

when communicating w/ the patient having a delusion

A

build rapport and trust by being open, honest and genuine
-ask pt to describe the delusion
-validate if part of the delusion is real and present reality
-never debate or argue the delusional content
-assess the intensity, frequency and duration
-what triggered

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20
Q

can you clarify a delusion for a pt

A

it is helpful to clarify misinterpretations of the environment and gently suggest, as tolerated, a more reality based perspective

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21
Q

documenting delusions

A

-type of delusion experienced, content/theme, and the characteristics
-use the patient’s own words
-the pt behavior

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22
Q

hallucinations

A

-alterations in perceptions that involve errors in how one interprets perceptions or perceives reality
-occurs when a person perceives a sensory experience for which non external source exists

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23
Q

5 senses of hallucinations

A

-auditory: hearing voices or sounds
-visual: seeing people or things
-olfactory: smelling odors
-gustatory: experiencing tastes
-tactile: feeling body sensations

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24
Q

command hallucinations

A

-auditory hallucinations in the form of commands that instruct a patient to act in a specific way
-the content of the commands can range in seriousness from innocuous (not harmful) to dangerous, including commands to cause harm to self or other

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25
intervening w/ hallucinations
-introduce self to pt to gain rapport, trust and to help develop the nurse pt relationship -approach the pt in a non threatening and calm manner -reassure the pt that they are safe -ask direct questions about type and content
26
assessment for hallucinations
-moving eyes back & forth -muttering or talking to self or object -appearing distracted -suddenly stopping conversation as if interrupted -intently watching a vacant area of the room
27
hallucination: documentation
-type experienced, content/theme, & the characteristics -use pt's own words -the pt's behavior prior to assessment for hallucinations and behaviors during the hallucination -any actions taken to help the patient during the hallucination
28
teach pt w/ hallucination to
-manage stress & stim -use other sounds to compete w/ hallucination -find out what is and isn't real -engage in activities that can take your mind off the hallucination -talk -make contact w/ others -develop a plan for how to cope w/ hallucinations
29
alterations in speech: circumstantiality
extremely detailed & lengthy conversation about a topic **but gets eventually to the point**
30
alterations in speech: tangentiality
wandering off topic or going off on tangents and **never reaching the point**
31
alterations in speech: loose associations
absence of normal connectedness of thoughts, ideas & topics ex: my friend talks about french fries but how can you trust the french
32
alterations in speech: flight of ideas
topic of conversation changes repeatefly & rapidly w/ only superficial associative connections, making it difficult for others to follow ex: a man begins talking about his business but quickly shifts to discussing the economy, the government and other countries
33
alterations in speech: echolalia
repetition of another's words, pathological repetition of another word
34
alterations in speech: clang association
choosing words based on their sound rather than their meaning; often involves a rhyme or similar beginning sounds ex: "i heard the bell. Well hell then i fell"
35
alterations in speech: symbolic speech
using words based on what they symbolize, not what they mean ex: a pt reports "demons are sticking needles in me" when what he means is he is experiencing a sharp pain
36
alterations in speech: pressured speech
urgent or intense speech; reluctance to allow comments from others
37
alterations in speech: world salad
string of words totally unconnected, jumble of words meaningless to a listener ex: agents want strength of policy on a boat reigning supreme
38
alterations in speech: neologisms
made up words, meaning for the patient only ex: "his mannerologies are poor"
39
thought blocking
a reduction or stoppage of thought ex: in the middle of talking about his childhood, the patient abruptly pauses, after which he can't remember what he was saying
40
thought insertion
the belief that someone else has inserted thoughts into the patient's brain ex: the patients repeatedly complains of having disturbingly violent thoughts, which, she claims are being sent to her by satan
41
thought deletion
a belief that thought have been taken or are missing
42
paranoia
an irrational fear, ranging from mild to profound. fear may result in dangerous defensive actions, such as harming another person before that person can harm the pt
43
catatonia
a pronounced increase or decrease in the rate and amount of movement. Excessive motor activity is purposeless
44
echopraxia
involuntary imitation of another's movements & gestures
45
motor retardation
a pronounced slowing of movement
46
motor agitation
excited behavior, such as running or pacing rapidly, often in response to internal or external stimuli
47
negativism
a tendency to resist or oppose the requests or wishes of other
48
negative symptoms
ones that should be there but aren't **harder to treat than positive symptoms** **interfere greatly with function on a daily basis**
49
negative symptoms: affective blunting
reduced or constricted affect ex: face doesn't move, lack of eye contact
50
negative symptoms: apathy
a decreased interest in activities or beliefs that would otherwise be interesting or important or little attention to them ex: no longer interested in favorite sport **results in loss of activities like personal hygiene**
51
negative symptoms: alogia
a reduction in speech ex: hard to get words out
52
negative symptoms: avolition
reduced or loss of motivation or goal directed behavior; difficulty beginning or sustaining goal directed activities ex: hard to go to school **results in loss of activities like personal hygiene**
53
negative symptoms: anhedonia
a reduced ability or inability to experience pleasure or joy
54
negative symptoms: asociality
a decreased desire for social interaction or discomfort while doing it; social withdrawal
55
cognitive symptoms: concrete thinking
impaired ability to think abstractly resulting in interpreting or perceiving things in a literal manner
56
cognitive symptoms: impaired memory
impacts short term memory and the ability to learn
57
cognitive symptoms: impaired information processing
delayed responses, misperceptions or difficulty understanding others
58
cognitive symptoms: impaired executive functioning
difficulty w/ reasoning, setting priorities, comparing options, plannings...
59
cognitive symptoms: anosognosia
inability to realize one is ill; an inability caused by the illness itself; may result in resistance to or cessation of treatment; often combined w/ paranoia so that accepting help is impossible
60
affective symptoms
involve an altered experience and expression of emotions -> mood may be unstable, erratic, labile or incongruent
61
schizoaffective disorder
a chronic mental health condition characterized primarily by symptoms of schizophrenia, such as hallucinations or delusions and symptoms of a mood disorder such as mania and depression **an uninterrupted period of illness during which at some time there is either a major depressive episode, a manic episode, or a mixed episode w/ symptoms of schizophrenia**
62
affective disorders
mental health conditions that heavily affect a person's mood and feelings
63
bipolar type schizoaffective disorder
individuals experience a combination of symptoms from both schizophrenia and bipolar disorder. typically, this means individuals experience both depressive and manic espisodes alongside their schizophrenia sx
64
depressive type schizoaffective disoder
individuals suffer form the psychotic symptoms of schizophrenia as well as depressed moods that come w/ major depressive disorder. those living w/ depressive type do not experience highs and lows but instead experience long periods of intense depression
65
depresssive sx of schizoaffective disorder
-feelings of lethargy or not wanting to do anything -no longer deriving pleasure from your favorite activities -inability to sleep or sleeping excessively -loss of appetite -a feeling that you will never be happy again
66
schizophrenia sx of schizoaffective disorder
-delusions -hallucinations -difficulty holding work or staying enrolled in school -problems w/ personal hygiene or taking care of yourself -difficulty communicating w/ individuals
67
treatments of schizoaffective disorder
-medications (antipsychotic, mood stabilizing or antidepressant) -cognitive behavioral therapy -group therapy sessions

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