schizophrenia

Question 1

What are some risk factors for developing schizophrenia

Answer 1

ID twins with one having it the other has 50% chance

children born from father 60 yrs or older have higher risk

Question 2

What are the pathophys hypothesis for schizo

Answer 2

dopamine hypo

Question 3

What is the dopamine pathway

Answer 3

too much dopamine in the mesolimbic, mesocortical, tubero-hypophyseal or nigrostriatal pathway

Question 4

What is an abnormal anatomy finding of schizo pats

Answer 4

larger brain ventricles than normal

Question 5

What are some physiological/physical factors could contribute to schizophrenia

Answer 5

epilepsy 
huntingtons dis
birth trauma 
head injury in adulthood 
alc abuse 
cerebral tumor or accident

Question 6

What are some of the psychosocial factors that could contribute to schizophrenia

Answer 6

poor brain dev from poor nutrition of pregnant mothers
prenatal viral infection
Toxoplasmosis Gondii exposure to prego

Question 7

What is schizoprenia

Answer 7

a syndrome that causes abnormal thinking with possible positive, negative or cognitive symptoms

Question 8

What are examples of positive symptoms and what is positive symptom def

Answer 8

positive symptoms dont have a physiological counterpart like a heart beat to tachycardia 
ex:
delusions
hallucinations
disorganized speech 
disorganized behavior 
catatonic behavior

Question 9

What are delusions and give example

Answer 9

false beliefs that the person feels very strongly about and are inconsistent with their culture like thinking someone is controlling them, trying to harm them or talking to them when they clearly arent like seeing only their first name in the newpaper

Question 10

What are hallucinations and give example

Answer 10

any sensation that isnt there

like hearing voices

Question 11

What is catatonic behavior

Answer 11

abnormal movements, posture or responsiveness to stimuli

like refusing to move, or being in a stupor, negativism

Question 12

What are negative symptoms

Answer 12

the loss or reduction of a normal process like a decrease in the ability to convey emotions or a loss of interest in things that they would normally find interesting

Question 13

What are 6 negative symptoms and give examples

Answer 13

avolition- decrease motivaiton to accomplish goals
Affect or Flat affect- inappropriate reaction to something like being calm when you see an aligator in the house
Alogia- lack in content in their speech like responding with just a “yes” to a question that would normal start a full conversation
attention - poor
anhedonia - absense of pleasure
Apathy- emotionless

Question 14

What are cognitive symptoms

Answer 14

difficulty with cognitive funcitons like learning, memory, and understanding

Question 15

What is required to diagnose schizophrenia

Answer 15

must have two of the following and one of them must be one of the first three, must have these symptoms for at least 6mo, and other health probs cant be the cause 
hallucinations
delusions
disorganized speech 
disorganized behavior 
catatonic behavior 
negative symptoms

Question 16

What are the phases of schizophrenia

Answer 16

premorbid
prodromal
schizophrenic (active) episode
residual

Question 17

What types of symptoms are seen in premorbid phase

Answer 17

antisocial behavior like
shyness
withdrawn
poor relationships

Question 18

What symptoms are seen in predromal phase

Answer 18

isolation
anx
poor acedemic performance

Question 19

what symps are seen in the residual phases

Answer 19

negative symptoms of the active phase or signs of premorbid/predromal
rarely psychosis

Question 20

What are some factors that are assoc. with good prognosis with schizo

Answer 20

caught during the premorbid 
onset later in life 
female gender 
caused by abrupt stress rather than disease 
short active phase/min residual symps
not structural abnormalities

Question 21

What are some conditions/delusions that are used to describe a pats thought content of positive symps

Answer 21

delusions like
persecution
ideas of reference- believes things that are referring to them when they aren’t
grandeur thoughts
somantic delusions like believing they have a third leg
paranoia
magical thinking
being controlled
thought broadcasting- think others can hear their thoughts
religiosity- obsessed w/ religion
thought insertion- thinking their thoughts have been extracted forcefully

Question 22

What are some thought processes of positive symps and give ex

Answer 22

associative looseness- shifting from unrelated topics
neologism- making up words that only mean something to them
concrete thinking- literal interpretations like asking them to write a sentence on the paper and they write “a sentence” on it
clang association- chooses based on sound and rhyme
mutism- inability or refusal to talk
echolalia - repeating words that was
echopraxia - copying movements

Question 23

What are some conditions to describe the appearance/mood/affect of a schizo pat

Answer 23

inappropriate affect- incongruent with the circumstances
bland affect- weak emotional tone
flat affect- void of emotions
apathy- disinterested

Question 24

What are some psychomotor behavior descriptors

Answer 24

anergia- energy deficiency
waxy flexibility- resistant to all movements
posturing- voluntary inappropriate or bizzare postures
pacing and rocking- like it soulnd s

Question 25

What are some things that are related to self violence and schizo pats

Answer 25

``` extreme supiciousness panic anx catatonic excitement rage rx's command hallucinations ```

Question 26

What might the diagnosis of impaired verbal comm be related to

Answer 26

panic anx withdrawal disordered unrealistic thinking

Question 27

What might the diagnosis of self care deficit be related to

Answer 27

withdrawal regression panic anx inability to trust

Question 28

What screening tool is used in DSM 4

Answer 28

global assessment function (GAF)

Question 29

What screening tool is used in DSM 5

Answer 29

WHODAS

Question 30

What scale is used on pats taking first gen antipsychs and what does it test for

Answer 30

abnormal involuntary movement scale | for tardive dyskinesia

Question 31

What are the steps of the AIM scale

Answer 31

1. ask pat if they have anything in mouth and remove if they do 2. ask pat about the condition of their teeth, and if dentures or something is bothering them now 3. ask pat if they have any movement of face, mouth, hands, or feet- have them describe them if so and how much it bothers them 4. Have pat sit with hands on knee's, legs slightly apart and feet flat on ground then observe the entire body for any invol movements 5. Ask pat to sit with hands hanging between legs, observe for invol moves 6. ask pat to open mouth and observe tongue for invol movements, repeat twice 7. ask pat to protrude tongue, mon for invol tongue moves, repeat twice 8. ask pat to tap thumb to other fingers as rapidily as poss for 10-15 secs, first right hand then left, observe invol movements in face and legs 9. flex and extend arms one at a time 10. have pat stand, observe entire bod for invol moves 11. ask pat to extend both arms in front of them palm down, observe trunk, legs, and mouth 12. have pat walk a few paces turn and walk back to chair, observe hands and gait, repeat twice

Question 32

is there any symptom that is unique to schizo

Answer 32

no

Question 33

Care for schizo pats

Answer 33

ask directly about hallucinations if they have command halluc's, provide safety for dangerous commands assess for paranoid delusions focus conversations on reality based subjects ID triggers like loud noises assess abilities to do ADL and teach them if struggling encourage med compliance

Question 34

What type of route for med admin is helping with compliance

Answer 34

injection

Question 35

What is a common addiction that schizo pats have and why

Answer 35

smoking bec the nicotine increases acetylcholine which helps they relax and counteract the effects of antipsych's

Question 36

What are some discharge teaching for schizo's

Answer 36

teach about disease they have teach to see doctor ev 3mo bec meds can cause probs like diabetes get organizer for pills need to support groups and refrain from using abusive substances log feelings and changes in behavior

Question 37

What are some guidelines for responding to a pats delusions

Answer 37

don't argue against or agree to them focus on pats feelings try to offer a reasonable explanation like ‘I can’t imagine that the president of US would have a reason to kill a citizen, but it must be frightening for you to believe that.”

Question 38

What was the first med to treat schizo

Answer 38

chlorpromazine

Question 39

When is a schizo pat more likely to commit suicide

Answer 39

residual phase after the hallucinations go away

Question 40

How often does a mental health asssessment need to be done in psych nursing

Answer 40

ev 8 hours

Question 41

What is the difference between mood and affect

Answer 41

mood is what you ask them and what they respond with, scaling them is a good idea affect is the outward expression of their emotional state