Schizophrenia Flashcards
What type of disorder is a chronic, severe mental disorder that affects a persona ability to think clearly (reality is abnormal)
Schizophrenia
When would subtle signs start to appear?
Sever signs?
- -A person may have a normal childhood
- -subtle signs at puberty
- -severe signs late teens, early adulthood
Schizophrenia is linked to CNS irregularities, which causes defects in which part of the brain?
corpus callosum
What risk factors are associated with schizophrenia?
- -Genetic
- -no prenatal care/birth complications
- -advanced PATERNAL age
- -no social communication
- -double bind theory
- -bidirectional influence
What is the double bind theory?
- -Two conflicting levels of communication
- -i.e. mother tells kid to be spontaneous, the kid acts spontaneously, he is not acting spontaneously because he is following his mothers direction.
What is bidirectional influence?
–parents and children mutually influence each other
–child reacts to parent, parent responds to child
“theory that bad parents, produce bad kids. and good parents produce good kids”
What are some ways to prevent Schizophrenia?
- -reduce stress
- -adequate sleep
- -Avoid illegal drug use
What are some Positive clinical manifestations with Schizophrenia?
- -hallucinations (usually auditory)
- -Delusions (false beliefs)
- -thought disorders (disorganized thinking)
- -disorganized behavior (bizarre, overreact, poor impulse control)
- -movement disorders (catatonia)
What are some negative symptoms of Schizophrenia?
- -anhedonia
- -alogia
- -avolition
What is catatonia?
state of immobility or stupor (pt. is awake but does not more or respond to stimuli)
What is anhedonia?
inability to feel pleasure
What is alogia?
cannot speak (due to mental defect, confusion)
What is Avolition?
Lack of motivation to do anything
What are 3 related disorders to schizophrenia?
- -Schizoaffective disorder
- -brief psychotic disorder
- -Schizophreniform disorder
How long does a brief psychotic disorder last?
1 day to 1 month
How long can symptoms last in Schizophreniform disorder last?
1-6 months
Early onset Schizophrenia (EOS) affects 4% of sufferers. There is risk for greater childhood maladjustment and can lead to ___ delays, more ____, and fewer _____.
- -developmental delays
- -more hallucinations
- -fewer delusions
There is no single test for Schizophrenia. What diagnostic tests can be used in a patient with Schizophrenia?
- -Psychological evaluation
- -Blood tests
- -Image studies
What is the primary goal with pharm therapy?
Reduce positive psychotic symptoms with lowest possible dosage
What are two typical antipsychotics that may be prescribed?
- -Chlorpromazine
- -Haloperidol
What are adverse effects of Chlorpromazine, and Haloperidol?
- -Hypotension
- -sudden cardiac death
- -neuroleptic malignant syndrome
- -impotence
- -dyskinesia, dystonia
How can antipsychotic side effects be counteracted?
- -stop meds
- -administer anticholinergics and benzos
what are 3 atypical antipsychotics that treat positive and negative symptoms?
- -Clozapine
- -Risperidone
- -Olanzapine
Adherence to medication regimen is a challenge for these patients they may….
relapse or have worsening symptoms
Non pharm therapy related to psychiatric/psychosocial rehabilitation are:
- -increase skill levels
- -promote success in daily living
- -assist clients to make decisions about care/treatment
Nurses contribute to Psychiatric/Psychosocial rehabilitation with the patient. The nurse should…
- -be sympathetic/empathetic
- -ensure client follows tx. regimen
- -Teaches skills
- -help pt. find support in community
What is assertive community service?
Proactive process of delivering individually tailored services for the pt.
When and why would hospitalization be required for a pt. with schizophrenia?
- -initial psychotic episode
- -give meds to bring symptoms under control
- -violence towards others/self
What are 3 kind of alternative/complimentary therapies for the pt?
- -Transcranial magnetic stimulation
- -Omega 3
- -Aromatherapy
during the health history portion of the assessment the nurse should document…
- -early behaviors
- -direct observations
- -Interview family members
- -cultural influences
During the Physical exam portion the nurse will document…
- -overall physical condition
- -malnutrition
- -drug/alcohol use
- -meds
the nurse will perform a mental status evaluation, and synthesize assessment data. The nurse will document…
- -how the pt. functions in daily life (i.e work)
- -what are skills/talents
- -Stability
- -how well client communicates
- -How well client gets along with others
What are 3 nursing Dx. that can be assigned to this patient?
- -Risk for injury
- -Imbalanced nutrition (less than)
- -Risk for imbalanced nutrition (more than)
- -ineffective health maintenance
- -self care deficit
For clients experiencing psychosis, what are 3 nursing dx. for the pt.?
- -risk for suicide
- -risk for self directed violence
- -risk for other directed violence
when implementing care the nurse should include…
- -prevent injury (SAFETY)
- -provide symptomatic tx.
- -educate client and family
- -demonstrate client advocacy
To prevent injury the nurse should…
- -administer antipsychotic meds, as ordered
- -ensure safe surroundings
- -reduce stimuli
- -use restraints, if necessary
To provide symptomatic tx. the nurse should…
- -control current symptoms
- -orient to time, place
- -remain calm
- -provide consistency
- -reduce stimuli
- -make sure to tell the client before you touch them
To educate the client and family, the nurse should…
- -evaluate current family communication
- -encourage effective coping strategies
- -healthy behaviors
- -promote social skills, job training
- -provide positive reinforcement
The nurse needs to demonstrate client advocacy, the nurse should….
encourage client develop advanced directive when schizo under control
