Schizophrenia and Affective Bipolar Disorder Flashcards
Why does one get schizophrenia?
Cause largely remains inconclusive.
-Brain anatomy
▫ Dopamine hypotheses remains inconclusive (Healy
2009)
▫ Genetics – we inherit a certain level of risk
▫ Relationship with stress –the brain is shaped by
the environment –neuroplasticity
-there is a strong correlation with drugs and alcohol
What does schizo mean?
TWO
What does a positive symptom refer to?
Positive symptoms refer to extra/additional experiences and behaviours that people with schizophrenia have (often related to psychosis). For example- Delusions & hallucinations • Thought broadcasting • Thought insertion • Incongruent affect Agitation or excitability • Hostility • Ideas of reference • Flight of ideas • Behavioural disturbance (eg posturing) • Disinhibition and disorganisation • Disorganised speech • Loose association
What does a negative symptom refer to?
Negative symptoms refer to behaviour and experience that is lost, or diminishes for the person, in comparison with their pre-morbid selves/level of functioning- for example Social isolation • Anergia- no energy • Avolition- no motivation • Apathy • Anhedonia- no happiness, no feeling • Flattened affect • Lack of concentration • Concrete thinking • Decreased problem-solving skills • Anosognosia- convinced something is theres; like delusions
Clozapine
Clozapine is a atypical antipsychotic agent, antagonising D1, D2, D4 dopamine receptors and antagonises serotonin, histamine and adrenoreceptors.
Agranulocytosis (loss of production of white cells which are involved in infection defence) has been associated with Clozapine.
Clozapine Patient Monitoring System
▫ Screening for eligibility
▫ Weekly blood tests for the first 18 weeks
▫ Monthly blood tests thereafter
THIS IS A LAST RESULT MEDICATION
Terrible weight gain
Rispiridone and Olanzapine
Both blocks 5-HT2 and dopamine D2 receptors.
Can cause lactation.
Haloperidol can cause what?
Haloperidol may cause a condition called “orthostatic hypotension” during the early phase of treatment (first week or two).
What is the difference between typical/1st generation antipsychotic meds and atypical/2nd generation antipsychotic meds
1st generation is older agents which much worser side effects, whereas 2nd generation are newer, still have bad side effects.
Antipsycotics work by antgonising the main inhibitory central effects of dopamine. This anti-dopamine action leads to useful therapeutic effects like slower thinking, movements and antiemetic (anti-vomiting) actions.
Antipsycotics are effective against positive effects of schizophrenia.
What is Incongurrent affect?
Person says what doesn’t match in their facial expression
What does ideas of reference mean?
The person feels that they are causing bad stuff to happen
What is behavioural disturbance (i.e.posturing)
When you can place someones arm up and they don’t move it- ie. lets you position them
What is loose association?
Ideas jump from one to another
How long does a person need to have negative symptoms of schizophrenia to be diagnosed?
1 year
What is bipolar affective disorder?
Formerly known as manic depressive disorder
• A disorder of mood
What is thought insertion?
Thinks that my thought is from another person- that someone is telling me what to do
What is required to be given a diagnosis of bipolar?
To be given the diagnosis of bipolar
affective disorder the person needs to
have had at least one manic or hypomanic
episode….and one depressive episode
What is bipolar affective disorder?
Formerly known as manic depressive disorder
• A disorder of mood
Involves severe swings in mood that
can impact significantly on life roles, the
ability to make decisions and social
interactions.
• Can span from elevated and irritable to
sad, hopeless and depressed.
• Changes in mood can present rapidly
(over days) or more gradually.
What is mania?
Mania is a distinct period of abnormally persistently
elevated, expansive, irritable mood.
• Results in extreme physical and mental overactivity
and poor quality of judgment
What is hypomania?
Hypomania is a form of elevated mood less severe
than mania
What are the nursing interventions for bipolar disorder?
Lower the mood: encourage a slowing of
behaviours, thoughts and physical activity
• Medication
• Calm, clear communication conveys
support & that events are under control
• Neither reinforce, nor deny
delusions/hallucinations.
What are the nursing interventions for bipolar disorder?
Lower the mood: encourage a slowing of behaviours, thoughts and physical activity • Medication • Calm, clear communication conveys support & that events are under control • Neither reinforce, nor deny delusions/hallucinations. Encourage a decrease in physical activity • Remind the person or hand small drinks and snacks as they move around • Separate the client from others at times, to at least encourage rest • If the client is amenable teach some simple relaxation strategies, deep breathing techniques • Cut back on caffeine
What type of medications are used for bipolar disorder?
Depending on the symptoms - bipolar
affective disorder is treated with mood
stabilisers, antipsychotics, & antidepressants
What do mood stabilisers include?
Mood stabilisers include: – Lithium Carbonate – Anti-seizure medications: • Sodium Valproate, Carbamazepine, Lamotrigine – Olanzapine
What kind of nursing education needs to be given in regards to lithium?
Service users need to be informed of • the importance of continuing to take lithium even when they are feeling well • the need for regular blood tests, the adverse effects and toxicity • the need to maintain adequate fluid (2 litres) and sodium intake
