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mental health/psych > schizophrenia (halter ch 12, [3]) > Flashcards

schizophrenia (halter ch 12, [3]) Flashcards

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1
Q

what % of schizophrenic cases begin between ages of 15-35 yo (stressful time of life)

A

75%

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2
Q

what is DSM 5 classification for schizophrenia (presence of 2 symptoms for atleast 1 month) (5)

A
  • delusions
  • prominent hallucinations
  • incoherent speech, loose associations
  • catatonic, disorganized behavior
  • negative symptoms
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3
Q

positive symptoms (added to someone) of schizophrenia (4)

A
  • delusions
  • hallucinations
  • thought disorders
  • bizarre behaviors
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4
Q

negative symptoms (taken away from someone) of schizophrenia (5)

A
  • flat affect
  • anhedonia (unable to enjoy things)
  • alogia (unclear speech)
  • avolition (unmotivated to do things)
  • attention impairment
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5
Q

predisposing factors of schizophrenia (3)

A
  • family h/o
  • neurobiology (brain structure, neurotransmitters dopamine and serotonin, neurodevelopment)
  • viral
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6
Q

cognitive assessment findings schizophrenia (6)

A
  • short attention span
  • poor decision making
  • thought disorder
  • non-reality-based thought content
  • poor insight
  • concrete thinking
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7
Q

5 types delusions

A
  • paranoid (/persecutory)
  • grandiose (feeling really important/special abilities)
  • religious
  • somatic (about their body)
  • nihilistic (end of world/everything is horrible)
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8
Q

5 types hallucinations

A
  • auditory
  • olfactory
  • visual
  • gustatory (taste)
  • tactile
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9
Q

emotional assessment findings schizophrenia (5)

A
  • usually “hypoexpressive”
  • broad
  • restricted
  • flat
  • blunt
  • inappropriate
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10
Q

behavioral assessment findings schizophrenia (6)

A
  • decreased ADLs
  • poor health
  • agitation/aggression
  • catatonia
  • “waxy” flexibility (holding position they’re put in)
  • apraxia (lack of movement), echopraxia (copying movements)
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11
Q

socialization assessment findings schizophrenia (3)

A
  • inappropriateness
  • poor communication
  • disinterest
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12
Q

physical assessment findings schizophrenia

A

thorough H&P needed!

-have higher pain threshold

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13
Q

symptoms of altered mental status (7)

A
  • loose associations
  • clang associations
  • neologisms
  • echolalia
  • thought insertion
  • magical thinking
  • ideas of reference
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14
Q

symptom of altered mental status: thoughts seem unrelated

A

loose association

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15
Q

symptom of altered mental status: rhyming/alliterative

A

clang associations

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16
Q

symptom of altered mental status: create their own words

A

neologism

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17
Q

symptom of altered mental status: repeating back your words

A

echolalia

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18
Q

symptom of altered mental status: thoughts from external source

A

thought insertion

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19
Q

symptom of altered mental status: thoughts make things happen

A

magical thinking

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20
Q

symptom of altered mental status: special meaning/importance of unrelated events

A

ideas of reference

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21
Q

other psychotic disorders besides schizophrenia (5)

A
  • schizophreniform disorder
  • schizoaffective disorder
  • delusional disorder
  • brief psychotic disorder
  • folie a deux
22
Q

psychotic disorder: similar to schizophrenia but lasts 1-6 months. rapid onset

A

schizophreniform disorder

23
Q

psychotic disorder: psychosis and mood disorder

A

schizoaffective disorder

24
Q

psychotic disorder: non-bizzare delusions, no hallucinations, no thought disorders; cling to a belief

A

delusional disorder

25
Q

psychotic disorder: short duration less than one month

A

brief psychotic disorder

26
Q

psychotic disorder: two people have same delusional system

A

folie a deux

27
Q

what is term for when pt doesn’t realize they have a problem

A

anosognosia

28
Q

nursing interventions for delusions

A
  • develop trust**
  • assess characteristics of delusions
  • promote distraction
  • reorient, refer to them by name
  • acknowledge what they believe and what you believe
  • avoid trying to “prove them wrong”
  • validate real part of delusion
  • meet the need/emotion the delusion does
  • teach reality testing
29
Q

4 categories hallucinations

A
  • comforting
  • condemning
  • controlling/commanding
  • conquering
30
Q

nursing interventions for hallucinations

A
  • confirm reality
  • help pt distinguish bw reality and hallucinations
  • identify pattern and triggers
  • teach distractions
  • teach them to request corrective feedback
  • teach socially appropriate behaviors
  • cognitive responses to hallucinations
31
Q

pt teaching relapse prevention for schizophrenia (4)

A
  • teach pts to get help early (prodromal phase)
  • teach families to identify recurrence
  • stay on meds
  • manage life stress
32
Q

what do 1st gen antipsychotic meds help manage

A

positive symptoms

33
Q

what do 2nd gen antipsychotic meds help manage

A

positive and negative symptoms

34
Q

are 1st or 2nd gen antipsychotic meds used more

A

2nd gen, newer but more costly

35
Q

2nd gen antipsychotic med side effects (6)

A
  • weight gain (especially w/ olanzapine and clozapine)
  • sedation
  • dizziness
  • constipation
  • prolactin elevation (especially w/ risperidone and paliperidone)
  • metabolic syndrome (weight gain, diabetes, hyperlipidemia, CV problems)
36
Q

rare but serious 2nd gen antipsychotic med side effects (4)

A
  • agranulocytosis (w/ clozaril)
  • extrapyramidal symptoms
  • tardive dyskinesia
  • neuroleptic malignant syndrome (NMS)
37
Q

what are the down sides to 1st gen antipsychotic meds

A
  • more side effects

- more monitoring needed

38
Q

S+S neuroleptic malignant syndrome

A
  • hyperthermia
  • hyperreflexia
  • tremor
  • clonus
  • often hypertensive
  • tachycardia
  • diaphoresis
  • agitation
  • increased bowel sounds, maybe diarrhea
39
Q

what causes NMS

A

decreased dopamine

can be caused by antipsychotics

40
Q

how to treat NMS (4)

A
  • reduce temp
  • give fluids
  • discontinue antipsychotic
  • give bromocriptine or dantrolene
41
Q

action of 1st gen antipsychotics

A

decrease dopamine

42
Q

action of 2nd gen antipsychotics

A

decrease dopamine

increase serotonin

43
Q

anticholinergic side effects of antipsychotics

A
  • constipation
  • dry mouth
  • blurred vision
  • memory impairment
  • confusion
  • dizziness
  • urinary retention
  • nasal congestion
44
Q

Tx mild symptoms of anticholinergic side effects with antipsychotic meds (3)

A
  • hard candy
  • sips of water
  • stool softeners
45
Q

S+S toxicity of antipsychotic meds (4)

A
  • hyperthermia
  • delirium
  • unstable VS
  • musculoskeletal changes
46
Q

extrapyramidal symptoms (pseudo-parkinsonism) of antipsychotic meds (6)

A
  • muscle rigidity
  • tremors
  • akathisia (constant movement)
  • drooling
  • shuffling gait
  • acute dystonia and oculogyrus (involuntary movements)
47
Q

Tx extrapyramidal S+S of antipsychotic meds (3)

A
  • decrease dosage
  • change to diff antipsychotic
  • administer anticholinergic (benztropine), antihistamine (benadryl), or dopamine agonist (symmetrel)
48
Q

S+S tardive dyskinesia (3)

A
  • involuntary mouth movements
  • foot tapping
  • pill rolling
49
Q

Tx tardive dyskinesia

A

valbenazine (ingrezza)

50
Q

test for tardive dyskinesia

what is considered positive score

A

test: AIMS (abnormal involuntary movements)
positive: 2+

51
Q

2nd gen antipsychotic meds

A 
Olanzapine (zyprexa)
Quetiapine (seroquel)
Clozapine (clozaril)
Asenipine (saphris)
Paliperidone (invega)
Risperidone (risperidal)
Ziprasidone (geodon)
Iloperidone (fanapt)
Lurasidone (latuda)
Aripiprazole (abilify)
Brexpiprazole (rexulti)
Capriprazine (vraylar)
52
Q

1st gen antipsychotic meds

A

Chlorpromazine (thorazine)
Fluphenazine (prolixin)
Haloperidol (haldol)

mental health/psych (14 decks)

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