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schizophrenia Flashcards

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1
Q

What are some risk factors for developing schizophrenia

A

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

children born from father 60 yrs or older have higher risk

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2
Q

What are the pathophys hypothesis for schizo

A

dopamine hypo

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3
Q

What is the dopamine pathway

A

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

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4
Q

What is an abnormal anatomy finding of schizo pats

A

larger brain ventricles than normal

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5
Q

What are some physiological/physical factors could contribute to schizophrenia

A 
epilepsy 
huntingtons dis
birth trauma 
head injury in adulthood 
alc abuse 
cerebral tumor or accident
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6
Q

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

A

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

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7
Q

What is schizoprenia

A

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

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8
Q

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

A 
positive symptoms dont have a physiological counterpart like a heart beat to tachycardia 
ex:
delusions
hallucinations
disorganized speech 
disorganized behavior 
catatonic behavior
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9
Q

What are delusions and give example

A

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

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10
Q

What are hallucinations and give example

A

any sensation that isnt there

like hearing voices

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11
Q

What is catatonic behavior

A

abnormal movements, posture or responsiveness to stimuli

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

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12
Q

What are negative symptoms

A

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

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13
Q

What are 6 negative symptoms and give examples

A

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

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14
Q

What are cognitive symptoms

A

difficulty with cognitive funcitons like learning, memory, and understanding

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15
Q

What is required to diagnose schizophrenia

A 
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
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16
Q

What are the phases of schizophrenia

A

premorbid
prodromal
schizophrenic (active) episode
residual

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17
Q

What types of symptoms are seen in premorbid phase

A

antisocial behavior like
shyness
withdrawn
poor relationships

18
Q

What symptoms are seen in predromal phase

A

isolation
anx
poor acedemic performance

19
Q

what symps are seen in the residual phases

A

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

20
Q

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

A 
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
21
Q

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

A

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

22
Q

What are some thought processes of positive symps and give ex

A

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

23
Q

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

A

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

24
Q

What are some psychomotor behavior descriptors

A

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

25
Q

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

A 
extreme supiciousness
panic anx 
catatonic excitement 
rage rx's 
command hallucinations
26
Q

What might the diagnosis of impaired verbal comm be related to

A

panic anx
withdrawal
disordered unrealistic thinking

27
Q

What might the diagnosis of self care deficit be related to

A

withdrawal
regression
panic anx
inability to trust

28
Q

What screening tool is used in DSM 4

A

global assessment function (GAF)

29
Q

What screening tool is used in DSM 5

A

WHODAS

30
Q

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

A

abnormal involuntary movement scale

for tardive dyskinesia

31
Q

What are the steps of the AIM scale

A
  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
32
Q

is there any symptom that is unique to schizo

A

no

33
Q

Care for schizo pats

A

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

34
Q

What type of route for med admin is helping with compliance

A

injection

35
Q

What is a common addiction that schizo pats have and why

A

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

36
Q

What are some discharge teaching for schizo’s

A

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

37
Q

What are some guidelines for responding to a pats delusions

A

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.”

38
Q

What was the first med to treat schizo

A

chlorpromazine

39
Q

When is a schizo pat more likely to commit suicide

A

residual phase after the hallucinations go away

40
Q

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

A

ev 8 hours

41
Q

What is the difference between mood and affect

A

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

Psych (14 decks)

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