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Mental Health (6005) #2 > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

A devastating brain disease that affects a person’s thinking, language, emotions, social behavior, & ability to perceive reality.

A

Schizophrenia

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2
Q

Early onset of schizophrenia:
A) age
B) occurs more in

A

A) 18-25 y/o

B) males

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3
Q

late onset of schizophrenia:
A) age
B) occurs more in

A

A) 25-35 y/o

B) female

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4
Q

higher prevalence occurs in?

A

Males and those living in urban areas

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5
Q

Schizophrenia results from?

A

a combination of inherited genetic factors and extreme nongenetic birth factors.

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6
Q

Bleuler’s fundamental signs of schizophrenia (THE FOUR A’S)?

A
  • Affect: Flat, blunted, inappropriate affect.
  • Associative looseness: disorganized thinking
  • Autistic thinking (delusions, hallucinations)
  • Ambivalence - holding on to opposing positions on a subject or person (love & hate someone)
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7
Q

Two or more of the following symptoms during 1 month is needed for a diagnosis of schizophrenia?

A
  • delusions
  • hallucinations
  • disorganized speech
  • grossly disorganized or catatonic behavior
  • negative symptoms (i.e. affective flattening, avolition, alogia)
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8
Q

Criteria needed for a diagnosis of schizophrenia?

A
  • Two or more symptoms during a 1 month period
  • One or more major areas are markedly below premorbid functioning
  • Signs persist for at least 6 months
  • R/O Mental diseases & medical conditions
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9
Q

Phases of Schizophrenia?

A
  • Acute phase
  • Maintenance
  • Stabilization
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10
Q

Positive Symptoms of Schizophrenia?

A

Hallucinations
Delusions
Disorganized Speech
Bizarre Behavior

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11
Q

.Persecution, Grandiosity, Control, and Thought broadcasting, insertion and withdrawal are examples of ?

A

delusions

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12
Q

The inability to think abstractly?

A

concrete thinking

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13
Q

made up words that hold meaning to the patient, but not to others?

A

Neologisms

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14
Q

pathological repeating of ones words?

A

Echolalia

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15
Q

choice of words base on sound?

A

Clang association

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16
Q

meaningless repetition or imitation of the movements of others

A

echopraxia

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17
Q

a confused or unintelligible mixture of seemingly random words and phrases

A

word salad

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18
Q

perceiving a sensory experience when none exists (i.e. hearing voices)

A

hallucinations

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19
Q
  • person has lost their identify

- may believe a body part does not belong to them

A

depersonalizations

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20
Q

a feeling that one’s surroundings are not real

A

derealization

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21
Q

the persistent repetition of an act, especially by an animal, for no obvious purpose.

A

Stereotypy

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22
Q

performance of all simple commands in a robot like manner

A

Automatic obedience

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23
Q

patient continues to hold arm that is raised by the nurse, seen in catatonia?

A

Waxy Flexibility

24
Q

Negative Symptoms of Schizoprenia?

A

Anhedonia
Avolition
Alogia
Blunted Affect

25
Q

poverty of speech

A

Alogia

26
Q

inability to experience pleasure or joy

A

Anhedonia

27
Q

loss of motivation

A

Avolition

28
Q

Cognitive Symptoms of Schizo?

A

Difficulty with attention, memory, and executive functions (i.e., decision making and problem solving

29
Q

Nursing Assessment for Schizo?

A
  • Determine if patient has had a medical work-up.
  • Assess for co-occuring disorders such as drug abuse.
  • Assess risk (suicide or harmful to others).
  • Assess for positive and negative symptoms.
  • Assess medications
30
Q

Acute Phase Interventions?

A

Patient safety and medical stabilization

31
Q

Goal of Phase II Interventions (Stabilization)

A

adhere to medication regimens, understand schizophenia, & participate in available psychoeducational activities.

32
Q

Goal of Phase III Interventions (Maintenance )

A

Target negative symptoms and participation in social, vocational, and skills training

33
Q

Strategies for communicating with patient who is hallucinating:

A
  • Watch client for cues.
  • Ask pt. directly about hallucinations.
  • Focus on reality-based diversions and topics.
  • Be alert for signs of anxiety.
  • Thought stopping and dismissal techniques.
34
Q

Strategies for delusional patients:

A
  • Be open & honest; respond to suspicions calmly.
  • Ask to describe delusions.
  • Avoid arguing content.
  • Focus on the feelings the delusions generate.
  • Focus conversation on reality-based topics.
35
Q

Conventional (First Generation) Drugs

A 
Thorazine
Stelazine
Haldol
Mellaril
phenothiazines
36
Q

Newer (Atypical) Drugs

A 
Clozaril
Risperdal
Zyprexa 
Seroquel
Geodon 
Abilify
37
Q

Muscarinic Cholinergic Blocker A/E?

A 
Dry mouth
blurred vision
urinary retention
constipation
tachycardia
38
Q

Alpha 1 blocker A/E?

A

orthostatic hypotension
dizziness
reflex tachycardia
sexual dysfunction

39
Q

Alpha 2 blocker A/E?

A

sexual dysfunction

priaprism (persistent and painful erection)

40
Q

Serotonin Blocker A/E?

A

weight gain
hypotension
sexual dysfunction

41
Q

Histamine (H1) Blocker A/E?

A

sedation
weight gain
orthostatic hypotension

42
Q

blockage of D2 dopamine receptor sites in the motor area cause?

A

Extrapyramidal Side Effects (EPS)

43
Q

Acute Dystonic reaction:

A

Oculogyric crisis - looking up
Acute contractions of the tongue, face, neck, and back
Opisthotonos
Laryngeal dystonia

44
Q

spasm of the muscles causing backward arching of the head, neck, and spine

A

Opisthotonos

45
Q

S/S of Pseudoparkinsonism?

A
  • Rigidity all over the body.
  • Masked like face.
  • Tremors (Pill rolling) in hands & wrists.
  • Short shuffling gait.
  • Dripping of saliva.
  • Monotonous and slurred speech.
  • Loss of postural reflexes which leads to fall & injuries especially in the elderly.
46
Q

Akathisia is characterized by?

A
  • Subjective feelings of restlessness (inner restlessness).
  • Inability to sit still.
  • Rocking back and forth on feet.
  • Crossing and uncrossing legs frequently.
  • Inability to relax.
47
Q

Tardive Dyskinesia

A
  • It is a jerky irregular movement affecting primarily the lower face (tongue, jaw, and lips), extremities and trunk and includes:
  • Protrusion of tongue.
  • Chewing movement.
  • Puffing of checks.
  • Smacking movements.
  • Limbs: Choriec, rapid, purposeless movements.
  • Hip jerks.
48
Q

General Class Side Effects: Traditional Antipsychotic

A
  • Dry mouth, urinary retention and hesitancy.
  • Constipation.
  • Blurred vision.
  • Dry eyes.
  • Increased risk for agranulocytosis & seizures.
  • Photo sensitivity.
  • Inhibition of ejaculation and impotence in men.
  • Neuroleptic malignant syndrome (<1%).
  • Metabolic effects (i.e. weight gain and DB Type II)
49
Q
  • Produce minimal to no extrapyramidal side effects or tardive dyskinesia.
  • Treat both positive and negative symptoms.
  • Improve the neurocognitive defects associated with schizophrenia.
  • Decrease affective symptoms and suicidal behaviors
A

Atypical Antipsychotics

50
Q

Used for early detection of Tardive Dyskinesia?

A

Abnormal Involuntary Movement Scale (AIMS) exam

51
Q

AIMS areas of examination are?

A
  • facial and oral movements
  • extremity movements
  • trunk movement.
52
Q

S/S of Neuroleptic Malignant Syndrome (NMS)?

A
  • decreased LOC
  • autonomic dysfunction including
    • hyperpyrexia, tachycardia, diaphoresis, and drooling
53
Q

Tx of Mild NMS?

A

Parlodel (Bromocriptine).

54
Q

Tx of severe NMS?

A

Dantrolene (Dantrium) (IV), and ECT.

55
Q
  • Is a serious side effect and can be fatal.
  • Liver impairment may also occur.
  • Symptoms include sore throat, fever. malaise, and mouth sores.
  • Mortality is high if the drug is not ceased.
A

Agranulocytosis

56
Q

S/S of Agranulocytosis?

A

sore throat, fever, malaise, and mouth sores, possible liver impairment

Mental Health (6005) #2 (5 decks)

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