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Psychology NUR 172 > Schizophrenia > Flashcards

Schizophrenia Flashcards

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1
Q

What is schizophrenia?

A

Combination of delusional ideations, hallucinations, disorganized speech/thinking, and bizzare behaviors

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2
Q

DSM-V criteria for schizophrenia

A

1: 2 of the following– (delusions, hallucinations, disturbed speech, disturbed behavior/catatonic, negative symptoms) ONE must be: delusions, hallucinations, or disturbed speech
2: ongoing for at least 6 months and ACTIVE sx for 1 month
3: not attributed to another condition

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3
Q

brain structure abnormalities associated with schizophrenia

A

large brain ventricles

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4
Q

What neurotransmitter plays a part in schizophrenia?

A

excess dopamine

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5
Q

Overactivity of what pathway causes positive sx?

A

mesolimbic pathway

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6
Q

Dysfunction of what pathway causes negative and cognitive sx?

A

mesocortical pathway

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7
Q

3 phases of schizophrenia

A

Prodromal
Active
Residual

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8
Q

What happens in the prodromal phase of schizophrenia?

A

social withdrawal and isolation
inappropriate affect
poor communication patterns
neglect of personal grooming

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9
Q

What happens in the active phase of schizophrenia?

A

full blown sx
psychotic break: delusions, hallucinations….
high risk of suicide
usually hospitalized

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10
Q

What happens in the residual phase of schizophrenia?

A

sx are no longer prominent, but haven’t gone away

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11
Q

5 types of schizophrenia

A 
Catatonic
Paranoid
Residual
Disorganized
Undifferentiated
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12
Q

Catatonic schizophrenia

A 
will usually need help with all ADLs
no speech
slow motor movement (statue like)
stupor
excessive negativism
inappropriate/bizarre posture
waxy flexibility
echolalia
echopraxia
don't respond to antipsychotics
respond better to benzos like lorazepam
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13
Q

echolalia

A

involuntary parrot like repetition of words spoken by others

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14
Q

echoprazia

A

meaningless imitation of motions made by others

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15
Q

Paranoid schizophrenia

A 
auditory hallucinations
preoccupied with one or more delusion usually of persecutory nature
appear hostile, angry, scared, nervous
increased risk of violence
respond well to antipsycotics
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16
Q

Disorganized schizophrenia

A 
inappropriate or flat affect
disorganized behavior
disorganized speech (word salad)
usually look unkept, dirty, and primitive
severe cognitive impairment
looseness of associations
extreme social withdrawal
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17
Q

Residual schizophrenia

A

past hx of at least 1 episode of psychosis
eccentric behavior
absence of prominent positive sx
social withdrawal and inappropriate affect (neg sx)

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18
Q

Undifferentiated schizophrenia

A 
usually a mix of all other types of schizophrenia
disorganized behavior
positive sx (delusions and hallucinations)
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19
Q

4 sx groups of schizophrenia

A

positive
negative
cognitive
affective

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20
Q

positive sx of schizophrenia

A

adding something that normally isn’t there
hallucinations
delusions
illusions
disorganized speech (associative looseness)
bizarre behavior

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21
Q

negative sx of schizophrenia

A 
take away something (harder to tx)
blunted affect
alogia (povery of thought)
avolition (loss of motivation)
anhedonia
anergia
social withdrawal
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22
Q

cognitive sx of schizophrenia

A 
easily distracted
impaired memory
poor problem-solving skills
poor decision-making skills
illogical thinking
impaired judgment
word salad
inability to think abstractly
23
Q

affective sx of schizophrenia

A

dysphoria
suicidality
hopelessness

24
Q

assessment for schizophrenia

A

alterations in thinking (delusions…)
alterations in speech (word salad…)
alterations in perception (hallucinations…)
alterations in behavior

25
Q

Why is it important to assess a patient for command hallucinations?

A

DTO

DTS

26
Q

nursing dx for positvie sx of schizophrenia

A

disturbed sensory perception
risk for self-directed violence
disturbed thought process

27
Q

nursing dx for negative sx of schizophrenia

A 
social isolation
impaired social interaction
risk for loneliness
chronic low self-esteem
ineffective coping
28
Q

interventions for phase one (acute) of schizophrenia

A 
focus on :crisis interventions, acute sx stabilization (meds), safety
limit setting
supportive and directive care
psych, medical, neuro evaluations
meet with family
psychopharmacological tx
29
Q

interventions for phase two (stabilization) of schizophrenia

A

focus on: understanding/accepting illness
support and teaching
med teaching; side effect management
id phases (prodromal, acute, residual)

30
Q

interventions for phase three (maintenance) of schizophrenia

A

focus on: social, vocational, self-care, learning, adaptations
cognitive and social skill enhancement
med compliance!!
encourage outpatient support
attention to details of self-care, social, and work
encourage family interaction

31
Q

therapeutic communication for schizophrenic patients

A

lower anxiety
decrease defensive patterns
raise self-worth
increase med compliance

32
Q

EPS

A

extrapyramidal symptoms

  • akathisia
  • dystonia
  • parkinsonism
  • tardive dyskinesia
33
Q

akathisia

A

EPS
pacing, motor restlessness, rocking, foot tapping
fidgeting

34
Q

dystonia

A

EPS

muscle cramps of head and neck

35
Q

torticolis

A

EPS

neck muscle contraction; pulls head to the side

36
Q

Parkinsonism sx

A 
EPS
tremors
shuffling gait
pill-rolling
drooling
stooped posture
masked face
37
Q

tardive dyskinesia

A 
EPS
late occuring; usually irreversible
usually involves mouth
constant lip smacking or sucking
uncontrollable biting, chewing, or sucking motions
38
Q

Neuroleptic malignant syndrome (NMS)

A 
dangerous response to antipsychotics
decreased LOC
increased muscle tone
autonomic dysfunction
increased temp, BP, CPK
delirium
dehydration
39
Q

tx of EPS and NMS

A

alert medical staff
anticholinergic agent may be used
usually dipenhydramine (Benadryl)
benztropine (Congentin)

40
Q

What is schizophreiform disorder?

A

total duration of illness at least 1 month but less than 6 months

41
Q

What is brief psychotic disorder?

A

sudden onset of psychosis lasts at least one day but less than a month

42
Q

What is schizoaffective disorder?

A

MDD + schizophrenia

43
Q

What is delusional disorder?

A

non bizarre delusions for at least one month; functioning
not impaired
ex: woman convinced a man is in love with her although they’ve never met

44
Q

What is induced or secondary psychosis?

A

induced by drugs (like bath salts/huffing) or caused by medical condition (infection)

45
Q

Anger

A

an emotional response to frustration of desires, threat to one’s needs (emotional or physical), or a challenge

46
Q

Aggression

A

action or behavior that results in verbal or physical attack

acting out anger

47
Q

Why is there more violence in the health care setting?

A

stress
fear
threat to needs
lack of control

48
Q

assessment of anger

A 
rate of speech, tone, volume
red face
clenched fists
clapping
hx of violence
coping skills
triggers
49
Q

nursing dx for anger

A

ineffective coping
stress overload
risk for self-directed violence
risk for other-directed violence

50
Q

interventions for anger

A 
teach coping mechanisms
figure out triggers
anger management
anxiolytics
antipsychotics
51
Q

cycle of violence

A

tension building
acute battering (explosion)
honeymoon

52
Q

interventions for abuse

A 
educate pt
show video about domestic violence
safety plan
report of abuse
community resources
53
Q

crisis

A

mentally healthy people experiencing disequilibrium
loss of balance in life
not pathological
usually 4-6 wks

Psychology NUR 172 (12 decks)

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