Schizophrenia & Meds Flashcards
What term is used to describe irrational ideas regarding their own worth, talent, knowledge, or power and may believe they have a special relationship w/ a famous person or assume identity of one?
Grandiose type
Which phase of schizophrenia is a social maladjustment where it’s before the illness and kids aren’t getting along w/ others?
Phase I: Premorbid Phase
Which type of schizophrenia includes these types: erotomanic, grandiose, jealous, persecutory, somatic, and mixed and just have delusions for at least 1 month?
Delusional disorder
What is the term used to describe a belief that a person is being persecuted, plotted against, cheated, poisoned, drugged, or spied on?
Persecutory type
What term is used to describe a stalker in love, where the person believes someone usually of higher status is in love w/ them?
Erotomanic type
What is the term used to describe a believe that a person has a general medical condition or a false idea of their body?
Somatic type
Name this phase of schizophrenia: Antagonistic thoughts/behavior, shy & withdrawn, poor peer relationships, doing poorly in school, antisocial behavior; common to ADHD & usually presents in children?
Phase I: Premorbid phase
When a pt. says “I am Jesus Christ” what type of delusion is this?
Grandiose type
What is the term used to describe stalkers or constantly believe their partner is unfaithful & is later confronted or attacked by the pt. bc of that belief?
Jealous type
Which type of delusion is it when a person constantly thinks someone is going to harm them & may say something like “The FBI has bugged my room & are trying to kill me.”
Persecutory type
A pt says “I’m 70 years old & the oldest person to give birth. The doctor says I’m not pregnant, but I know I am.” Which type of delusion is this?
Somatic type
Which type of delusion has no single theme that is predominant, & the disorder is mixed?
Mixed type
Which psychotic disorder is when someone experiences or sees something horrific & have emotional turmoil or overwhelming perplexity or confusion?
Brief Psychotic Disorder
Which phase of schizophrenia has positive & negative symptoms that usually appears in teens & is determined on how well lives were beforehand?
Phase II: Prodromal Phase
Which disorder has the presence of prominent hallucinations & delusions that are judged to be directly attributed to substance intoxication or withdrawal, but the s/s are more excessive than withdrawal or intoxication? (Bath salt “zombies”)
Substance-Induced Psychotic Disorder
Which disorder has prominent hallucinations & delusions that are directly attributed to a general medical condition like Thyroid stroke, Wilson’s disease, Huntington’s, Renal/Hepatic disease or systemic lupus?
Psychotic disorder associated w/ another medical condition
What can’t make the brain do what the body wants, but is very dangerous bc they are aware of whats happening around them?
Catatonic features
Which disorder may or may not be preceded by a severe psychosocial stressor & lasts less than 1 month then returns back to premorbid level of functioning?
Brief Psychotic Disorder
Name this phase of schizophrenia: lasts from a few weeks-few years (2-5yrs.) deterioration in role functioning & social withdrawal, substantial functional impairment?
Phase II: Prodromal Phase
What may be associated w/ other psychotic disorders, such as brief psychotic disorder, schizophreniform, schizophrenia, schizoaffective disorder, & substance-induced psychotic disorder?
Catatonic feature specifier
What disorder include these symptoms: mannerism, agitation, grimacing, stereotypy, mutism, posturing, stupor, muscle rigidity or excessive purposeless motor activity, waxy flexibility, negativism, echolalia, echopraxia, catalepsy?
Catatonic disorder
Which disorder has a sudden onset of psychotic symptoms & catatonic like features (stupor, mutism, negativism, agitation) & incoherent speech, delusions, disorientation, hallucinations, & bizarre behavior?
Brief Psychotic Disorder
What term is used to describe limbs that remain in whatever position placed in & where they have a loss of voluntary motion?
Catalepsy
What compares to catalepsy?
Waxy flexibility
Name this phase of schizophrenia: sleep disturbances, anxiety, irritability, depressed mood, poor concentration, fatigue, & perceptual abnormalities, ideas of reference & suspiciousness herald onset of psychosis
Phase II: Prodromal Phase
Which symptoms tend to reflect an alteration or distortion of normal mental functions has normal brain structures, & good responses to treatment?
Positive symptoms
What disorder diagnosis is made when the catatonic symptoms are directly attributed to the physiological consequences of a general medical condition like metabolic disorders & neurological conditions?
Catatonic Disorder associated with another medical condition
What type of disorder has the same symptoms as schizophrenia w/ exception that the duration of the disorder has been at least 1 month but less than 6 months?
Schizophreniform disorder
Which phase of schizophrenia is in the active phase of the disorder & where psychotic symptoms are prominent?
Phase III: Schizophrenia
A pt. is admitted w/ a diagnosis of brief psychotic disorder, w/ catatonic features. Which symptoms are associated w/ catatonic specifier?
A. strong ego boundaries & abstract thinking
B. Ataxia & akinesia
C. Stupor, muscle rigidity, & negativism
D. Substance abuse & cachexia
C. Stupor, muscle rigidity, & negativism
Which symptoms include: delusions, religiosity, paranoia, & magical thinking?
Positive symptoms: content of thought
What are delusions?
false personal beliefs
Name this phase of schizophrenia: Delusions, hallucinations, impairment in work, social relationships & self-care & persists at least 6 months?
Phase III: Schizophrenia
What term is used to describe excessive demonstration of obsession w/ religious ideas & behavior, are really in tune w/ the bible & believe they can hear God?
Religiosity
What disorder has a good prediction if the individual’s affect isn’t blunted or flat, has a rapid onset of psychotic symptoms or if premorbid social & occupational function is satisfactory?
Schizophreniform Disorder
What are extreme suspiciousness of others?
Paranoia
If a pt says “I won’t eat this food, I know it’s poisoned” what are they experiencing?
Paranoia
Name this phase of schizophrenia: remission & exacerbation that follows active phase of illness, has similar symptoms of prodromal phase, is flat affect & impairment in role functioning are prominent?
Phase IV: Residual Phase
Which disorder has presence of hallucinations & or delusions that occur for at least 2 weeks in absence of a major mood episode & is mostly present w/ schizophrenia & bipolar?
Schizoaffective disorder
What is the term used to describe ideas that one’s thoughts or behaviors have control over specific situations & think they can control things w/ their thoughts?
Magical thinking
What symptoms include: associative looseness (loose association), neologisms, concrete thinking, clang associations, word salad, circumstantiality, tangentiality, mutism, & perseveration?
Positive symptoms: form of thought
What is the term used to describe shift of ideas from one unrelated topic to another; making connections that have no meaning?
Associative looseness or loose association
Name this phase of schizophrenia: Disorganized speech, grossly disorganized or catatonic behavior & has negative symptoms w/ a diminished emotional expression?
Phase III: Schizophrenia
Which disorder appears depressed with psychomotor retardation & suicidal ideation or symptoms may include euphoria, grandiosity & hyperactivity?
Schizoaffective disorder
What is the term used to describe made-up words that have meaning only to the person who invents the words?
Neologisms
What is the term used to describe literal interpretations of the environment
Concrete thinking
What is the term used to describe choice of words is governed by sound (often rhyming) For example, it is very cold. I am cold & bold. The gold has been sold.
Clang associations
What is the term used to describe a delay in reaching the point of a communication bc of unnecessary & tedious details; takes forever to make a point?
Circumstantiality
Which phase of schizophrenia has continuous signs that persist for at least 6 months, that must include at least 1 month of symptoms w/ periods of prodromal phase?
Phase IV: Residual phase
What is the term used to describe inability to get to the point of communication due to introduction of many new topics; NEVER make the point?
Tangentiality
What is the term used to describe a group of words put together in a random fashion?
Word salad
What is mutism?
Inability or refusal to speak
What is the term used to describe persistent repetition of the same word or idea in response to different questions?
Perseveration
What symptoms include: perceptions, hallucinations, & illusions through auditory, visual, tactile, gustatory, & olfactory?
Positive symptoms
Which disorder has schizophrenic symptoms accompanied by a strong element of symptomatology associated w/ mood disorders, either mania or depression?
Schizoaffective disorder
What is the term used to describe interpretation of stimuli through the senses?
Perception
What is the term used to describe false sensory perceptions not associated w/ real external stimuli?
Hallucinations
What is the term used to describe misperceptions of real external stimuli?
Illusions
What symptoms include: sense of self, echolalia, echopraxia, identification & imitation, & depersonalization?
Positive symptoms
What is the term used to describe repeating words that are heard maybe more than once? For example, the nurse says “medication time” and the pt. says “medication time, medication time, medication time.”
Echolalia
What is the term used to describe repeating movements that are observed?
Echopraxia
What symptoms are the most destructive & difficult to treat but are so much like depression & unmotivation?
Negative symptoms
What is the term used to describe taking on the form of behavior one observes in another
Identification and imitation
What is the term used to describe feelings of unreality?
Depersonalization
What symptoms include: inappropriate affect, bland, flat, & apathy?
Negative symptom affect
What is the term used to describe emotions are incongruent w/ the circumstances? For example, laughs at death of mother.
Inappropriate affect
What symptoms reflect a reduction or loss of normal functions & respond less to antipsychotics?
Negative symptoms
What is the term used to describe disinterest in the environment?
Apathy
What symptoms include emotional ambivalence & deterioration in appearance?
Negative symptoms volition
What is the term used to describe coexistence of opposite emotions toward the same object, person or situation; emotions may interfere w/ persons ability to make a very simple decision like to have coffee or tea w/ lunch?
Emotional ambivalence
What is the term used to describe impaired personal grooming & selfl-care activities?
Deterioration in appearance
What is the term used to describe the feeling state or emotional tone?
Affect
What is the term used to describe impairment in the ability to initiate goal-directed activity?
Volition
What is the term used to describe weak emotional tone?
Bland
What is the term used to describe appearing to be invalid of emotional tone?
Flat
What symptoms include: impaired social interaction & social isolation?
Negative symptoms: impaired interpersonal functioning & relationship to the external world
What is the term used to describe clinging & intruding on the personal space of others, exhibiting behaviors that aren’t culturally & socially acceptable?
Impaired social interaction
What is the term used to describe a focus inward on the self to the exclusion of the external environment
Social isolation
What symptoms include: anergia, waxy flexibility, posturing, & pacing and rocking?
Negative symptoms: Psychomotor behavior
What is the term used to describe passive yielding of all movable parts of the body to any effort made at placing them in certain positions; allows body parts to be placed in uncomfortable/bizarre positions & stay like that for a while?
Waxy flexibility
What is the term used to describe voluntary assumption of inappropriate or bizarre postures?
Posturing
What is the term used to describe deficiency of energy?
Anergia
What is pacing & rocking?
Pacing back & forth & rocking the body
What symptoms include anhedonia & regression?
Negative symptoms: Associated features
What is the term used to describe inability to experience pleasure?
Anhedonia
What is the term used to describe retreat to an earlier level of development; child-like?
Regression
What is the term used to describe all events w/in the environment are referred by the psychotic person to themselves; assuming when in presence of others they’re the object of discussion? For example the pt. says “Someone is trying to send me a message through the articles in this magazine, I must break the code so I can receive it.”
Delusion of reference
What is the term used to describe certain objects or persons have control over their behavior? For example the pt. says “The dentist put a filling in my tooth, I now receive transmissions through the filling that control what I do/think.”
Delusion of control or influence
What is the term used to describe false idea that the self, part of self, others, or world is nonexistent? For example the pt. says “I have no heart” or “The world no longer exists”
Nihilistic delusion
What is the abnormalities of the brain that may cause schizophrenia?
enlargement in cerebral ventricular size & decrease in temporal lobe size
What is the neurotransmitter hypothesis that may cause schizophrenia?
excess of dopamine-dependent neuronal activity
What is the possible endocrine correlation that may cause schizophrenia?
decrease in levels of prolactin hormones
How do antidepressants work?
blocking reuptake of serotonin & norepinephrine
What is the term used to describe the process of neurotransmitter inactivation where neurotransmitter is reabsorbed into a pre-synaptic neuron from which it had been released?
Reuptake
How do “atypical” (novel) antipsychotics work?
Block a specific serotonin receptor
How do benzodiazepines work?
enable transmission of inhibiting neurotrans GABA
How do antipsychotics work?
Block dopamine receptors
How do psychostimulants work?
increase norepinephrine, serotonin, & dopamine relase
What is the term used to describe a severe mental condition where there’s disorganization of the personality, deterioration in social function & loss of contact w/ or distortion of reality & can occur w/ or w/o presence of organic impairment?
Psychosis
What physiological influence may cause schizo?
Viral infection like the flu or birth complications
What psychological influence may cause schizo?
poor parent-child relationships or dysfunctional families
What treatment focuses on problem solving, reality testing, psychoeducation, & supportive/cognitive behavioral techniques?
Individual psychotherapy
What treatment focuses on real life plans, problems, & relationships, & decrease social isolation?
Group therapy
What treatment decreases the frequency of bizarre, disturbing, & deviant behaviors?
Behavior therapy
What treatment focuses on complex interpersonal skills involving smooth integration of a combo of simpler behaviors?
Social skills training
What treatment focuses on family education/contact to decrease overt manifestations of conflict?
Family therapy
What treatment takes a team approach in providing comprehensive, community-based psychiatric treatment?
Program of Assertive Community Treatment (PACT)
What treatment emphasizes group & social interaction?
Milieu therapy
What treatment focuses on level of functioning in relationships, work, independent living, & other life functions?
The recovery model
How do “typical” antipsychotics work?
Block postsynaptic dopamine receptors
What drugs have these side effects: dry mouth, blurred vision, constipation, urinary retention, nausea/GI upset, skin rash, sedation, orthostatic hypotension, photosensitivity, hormonal effects, weight gain, ECG changes, hyper-salivation, akinesia, akathisia, dystonia, oculogyric crisis, or tardive dyskinesia?
Antipsychotics
Which classification includes these drugs: Chlorpromazine (thorazine), fluphenazine, Haloperidol/butyrophenone (Haldol), Loxapine, Perphenazine, Pimozide (Orap), Prochlorperazine, Thioridazine, Thiothixene (Navane) & Trifluoperazine?
typical antipsychotics
What is the term used to describe muscle weakness?
Akinesia
What is the term used to describe continuous restlessness/fidgeting?
Akathisia
Which drugs are 1st generation, cause movement disorders, may worsen negative symptoms & psychotic agitation is reduced in hours?
Typical antipsychotics
What is the term used to describe bizarre facial & tongue movements?
Tardive dyskinesia
Which drugs have higher potency & more EPS?
Haldol & Prolixin (lower dosages)
Which drugs block dopamine pathways, reduce positive symptoms in 2-8 wks, & fixed hallucinations & delusions may respond minimally?
Typical antipsychotics
Which drugs have lower potency, more anticholinergic, postural hypotension, & sedation?
Thorazine (higher dosages)
Which classification include these drugs: Aripiprazole (Abilify), Asenapine (Saphris), Clozapine (Clozaril), Iloperidone (Latuda), Olanzapine (Zyprexa), Paliperdone (Invega), Quetiapine (Seroquel), Risperidone (Risperdal) & Ziprasidone (Geodon)?
Atypical antipsychotics
Which drugs have no anticholinergic effects & used for pt’s w/ delirium & include Chlorpromazine (Thorazine) & Butyrophenone (Haldol)?
Typical- dopamine 2 receptor antagonists
Which drugs block 5-HT serotonin receptors, decrease negative symptoms & EPS?
5-HT serotonin receptors
Which drugs have dopamine-serotonin system stabilizers (DSS) & include Aripiprazole (Abilify)?
3rd generation antipsychotics
Which drugs are second generation, bind less strongly to dopamine, reduce EPS (funny voice), & improve cognitive & mood symptoms (negative) & have less side effects?
Atypical antipsychotics
Which drugs include these side effects that are not a problem: EPS, weight gain, prolactin elevation, glucose & lipid & cardiac abnormalities, prolongation of QT interval, but do include insomnia, nausea, & vomiting for less than 14 days?
3rd generation Aripiprazole (Abilify)
Which drugs include: Aripiprazole extended release (Abilify), fluphenazine decanoate (fluphenazine-LAI) 4 wks, Haloperidol decanoate (LAI)-4 wks, Olanzapine Pamoate (Zyprexa Relprevv) 3 wks, Paliperidone palmitate (Invega Sustenna) 4 wks, & Risperidone microspheres (Risperdol Consta) 2 wks.
Long acting medications (shots)
What do long acting medications (shots) need to hold blood levels stable?
an oral dose in b/t &/or more than 1 loading dose
A pt. who has disorganized thinking associated w/ schizophrenia. Which area of the brain is to blame for this dysfunction? A. Hippocampus B. Cerebellum C. Frontal lobe D. Brainstem
C. Frontal Lobe
Typical antipsychotics exert their influence primarily over what neurotransmitter to achieve effect? A. Dopamine B. Serotonin C. GABA D. Acetylcholine
A. Dopamine
Pt. taking the atypical antipsychotic Clozaril (Clozapine), must have which blood test completed each week? A. Clozapine level B. Sodium level C. CBC D. BUN
C. CBC
A pt. taking an antipsychotic develops restlessness & an uncontrollable urge to move the bottom half of their body. This extrapyramidal side effect is called: A. Tardive dyskinesia B. Parkinsonism C. Occulogyric Crisis D. Akathisia
D. Akathisia
A pt. taking an antipsychotic develops restlessness & an uncontrollable urge to move the bottom half of their body. What is the cause of the EPS? A. Dopamine blocking effects B. Anticholinergic effects C. Endocrine stimulating effects D. Ability to stimulate spinal nerves
A. Dopamine blocking effects
A nurse administering antipsychotic meds should monitor for additional adverse effects if the pt. also has which of the following health problems? Select all that apply. A. Diabetes B. Parkinson's Disease C. Osteoarthritis D. Epilepsy E. Grave's Disease
A, B, D, E
A pt. is receiving the atypical antipsychotic Risperdal (Risperidone) reports severe muscle stiffness midmorning. During lunch he has a difficulty time swallowing food & speaking, & when VS are taken 30 min later he is found stuporous & diaphoretic. T-38.8, P-110, BP-159/90. The nurse should suspect ___ & should ____.
A. Neuroleptic malignant syndrome & initiate measures to decrease fever & notify MD.
B. Anticholinergic toxicity & check VS again
C. Relapse of psychosis & give PRN antipsychotic
D. Agranulocytosis & hold meds & call for CBC
A. Neuroleptic malignant syndrome & initiate measures to decrease fever & notify MD.
This med blocks dopamine, is considered an “old” med, & should be watched out for EPS & ticks?
Typical antipsychotic
What scale is used to measure EPS?
AIMS
What anticholinergic med is given to help w/ EPS?
Cogentin or Benadryl
What anticholinergic med is given to help w/ anti-Parkinsonism?
Cinimat
This med is considered a “new” med, & should be assessed for skin rash, & neuroleptic malignant syndrome (NMS)
Atypical antipsychotic
What is a life-threatening neurological disorder most often caused by an adverse reaction to antipsychotic drugs (prescribed for Tx of schizophrenia) & include symptoms such as: high fever, sweating, unstable blood pressure, stupor, muscular rigidity, & autonomic dysfunction?
Neuroleptic Malignant Syndrome (NMS)
D/C of the antipsychotic med, monitoring VS, degree of muscle riigidity, I&O, level of consciousness, & an order from physician for Perlodel or Datrium is used to treat what?
Neuroleptic malignant syndrome
What kind of medication is Depakote?
mood stabilizer
What should you assess for if a pt. is taking Depakote?
liver function, can cause severe liver damage
Vistaril is what kind of medication?
Anti-anxiety
Which med blocks & inhibits reuptake of serotonin & may be used for sleep in adults, but for mood in the elderly?
Trazadone
What type of neuroleptic-induced movement disorder is characterized by the following: frightening, painful muscle spasms in back, neck, or eyes w/in hours/days of starting antipsychotic meds?
Dystonia
What type of neuroleptic-induced movement disorder is characterized by the following: symptoms like Parkinson’s w/o destruction of dopaminergic cells. Has triad rigidity, slowed movements, & tremor begins w/in 1st months?
Parkinsonism
What type of neuroleptic-induced movement disorder is characterized by the following: most common, occurs after wks of high doses of antipsychotics & can’t sit still w/o moving & is associated w/ increased suicides?
Akathisia
What type of neuroleptic-induced movement disorder is characterized by the following: irreversible form of EPS, is most serious, may persist despite D/C of med, has no effective treatment & anticholinergics worsen?
Tradive dyskinesia
What type of neuroleptic-induced movement disorder has these symptoms: Thick tongue, tight jaw, stiff neck, laryngopharyngeal constriction, neck spasms (torticollis) head forced to side, fixed tongue protrusion, Occulogyric crisis, upward deviation of eyes?
Dystonia
What type of neuroleptic-induced movement disorder has these symptoms: reduced arm swing, “zombie-like” walk, mask-like face, slow, regular muscular jerks, postural instability, hunched posturing, stooped posture, unsteady shuffling gait, drooling?
Parkinsonism
What type of neuroleptic-induced movement disorder has these symptoms: Inward sensation of restlessness, motor restlessness, unable to sit still, paces, shifts weight from foot to foot, taps feet?
Akathisia
What type of neuroleptic-induced movement disorder has these symptoms: Involuntary/repetitive/rhythmic movements of tongue, face, mouth, or jaw. Lip smacking, chewing movements, facial grimacing, cheek puffing, puckering of lips, tongue protrusion, grunts & vocal utterances, movements of trunk & extremities that lessen w/ relaxation & during sleep?
Tardive dyskinesia
