Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 201 Week 10 > Schizophrenia & Psychotic Disorders > Flashcards

Schizophrenia & Psychotic Disorders Flashcards

1
Q

Is a severe mental condition in which there is disorganization of the personality, deterioration in social functioning, & loss of contact w/ or distortion of reality

There may be evidence of hallucinations & delusional thinking; it can occur w/ or w/o the presence of organic impairment

A

Psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Nature of the disorder

  • Also affects social & occupational functioning
  • Causes suffering; is a threat to life & happiness; causes long hospitalization; chaos in family life; is an exorbitant cost to individuals & governments
  • Thought processes
    > Alters thought content & forming thoughts (i.e., delusions, loose associations)
  • Perception
    > Disturbances can include auditory & visual hallucinations
A
  • Affect
    > Emotional tone that’s altered; an incongruence w/situation; an affect that lacks actual emotional tone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Predisposing Factors

  • Biological & psychological factors
  • Environmental influences [i.e., poverty, stressful life events, use of cannabis]
A
  • The cause of schizophrenia remains unclear; it’s viewed as a brain disorder w/little if any emphasis on psychosocial influences
  • Having relatives versus the general population; it’s unclear if schizophrenia is inherited
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Schizophrenia or schizophrenia-like symptoms may be caused by an excess of ___; this notion is reinforced by the effectiveness of antipsychotics which work by blocking the ↑ receptors

A

dopamine

> Other neurotransmitters include norepinephrine, serotonin, glutamate, and GABA

  • The dopaminergic system has been the most widely studied
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  • Some cases of schizophrenia have been observed following infection from prenatal exposure to viral infections
  • Anatomical abnormalities like ventricular enlargement
A
  • It’s likely that schizophrenia is multifactorial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Schizophrenia spectrum and related disorders

  • Schizotypal personality disorder
  • Delusional disorder
  • Brief psychotic disorder
A
  • Substance-induced psychotic disorder
  • Psychotic disorder due to another medical condition
  • Schizophreniform disorder
  • Schizoaffective disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

This condition reflects an impairment in personality but it’s not severe enough to be called schizophrenia

A

Schizotypal personality disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

This condition has a sudden onset of psychotic symptoms that may be from a stressor

> These sx’s last at least a day but less than a month. There’s an eventual return to the level of premorbid function

A

Brief psychotic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

This is characterized by the presence of delusions experienced for at least 1 month

Hallucinations are not prominent if present at all and the behavior is not bizarre; can include subtypes

A

Delusional disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

This is from substance intoxication or withdrawal or exposure to a medication or toxin

A

Substance-induced psychotic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

This differs in terms of the timeframe

At least 1 month but is less than 6 months of symptoms

A

Schizophreniform disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Signs and symptoms of schizophrenia are present along with a strong element of a mood disorder which includes symptoms of depression, mania, or both

A

Schizoaffective disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Occurs as a result of CNS infection, like neurosyphilis, also Huntington’s, and brain abscesses

A

Psychotic disorder due to another medical condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

DSM 5 Schizophrenia

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Positive symptoms of schizophrenia

Positive symptoms are manifestations of things that are not normally present and are the most easily identified symptoms or manifestations

A
  • Disturbances in thought content
  • Disturbances in perception (take the form of hallucinations)
    > Sensory, auditory [most common], visual, tactile, olfactory, gustatory
  • Disorganized thinking
  • Grossly disorganized or abnormal motor behavior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

?

Are false, fixed beliefs
> They can be persecutory, and this is the belief that one is going to be harmed by others

A

delusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

This is the belief that cues in the environment are specifically referring to the individual

A

ideas of reference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

These are beliefs of exceptional greatness

A

grandiose delusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

This is a belief that centers on one’s own body functioning

A

somatic beliefs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Paranoia can manifest as extreme suspiciousness of others & of others’ actions or perceived intention

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

This is when a person believes that his or thoughts or behaviors have control over specific situations or people

A

magical thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

These are misperceptions or misinterpretations of real external stimuli

A

Illusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Another form of a disturbance in perception is ___, which is where the client is imitating movements made by others

A

echopraxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Disorganized thinking

  • Often manifested in speech
  • Loose association; tangential thinking; circumstantiality; incoherence
A

Grossly disorganized or abnormal motor behavior

  • Can include catatonia; hyperactivity; hypervigilance; hostility; childlike silliness
  • Sometimes repetitive movements or unusual mannerisms are also seen as well as posturing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Terms to review

  • word salad
  • circumstantiality
  • tangentiality
  • perseveration
  • loose association
A
  • neologisms
  • clang associations
  • echolalia
  • ideas of reference
  • catatonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Is a group of words that’re put together randomly without any logical connection

A

word salad

27
Q

is when the individual delays in reaching the point of communication because of unnecessary & tedious details

A

circumstantiality

28
Q

Is the person that never gets to the point during communication

A

tangentiality

29
Q

Is when someone persistently repeats the same word or idea in response to different questions

A

perseveration

30
Q

Is characterized by communication in which ideas shift from one unrelated topic to another

A

Loose association(s)

31
Q

Is when words are newly invented; they’re meaningless to others, but they have a symbolic meaning to the individual

A

neologisms

32
Q

Is when words are chosen based on the sound they make; often take the form of rhyming
> “It’s very cold. I am cold and bold. Gold has been sold.”

A

clang associations

33
Q

Refers to repeating words or phrases that are spoken by another

A

echolalia

34
Q

This is when an individual misconstrues trivial events & attaches personal significance to them such as a man seeing 2 people talking & believing they’re talking about him; even if they haven’t noticed him

A

ideas of reference

35
Q

Is a condition by which there’s change in muscle tone or activity; typically assoc w/schizophrenia
> The individual can experience a defect of motor activity or at times become motionless

A

catatonia

36
Q

Negative symptoms of schizophrenia

Are functions that are missing

Are the most difficult to treat & they respond less well to anti-psychotic rx’s

Are considered the most debilitating b/c they render the client inert & unmotivated

A
  • disturbances in affect
  • avolition
  • lack of insight
  • anhedonia
  • apathy
  • lack of interest or skills in interpersonal interaction
  • anergia
  • lack of abstract thinking ability
37
Q

Is the inability to experience pleasure
> Compels some clients to attempt suicide

A

anhedonia

38
Q

Is a deficiency of energy; a lack of sufficient energy to carry out ADLs or to interact w/one another

A

anergia

39
Q

Is impaired volition, or the inability to initiate a goal, especially a goal-directed activity

> They have a lack of interest or skills in interpersonal interaction
Become emotionally detached; lack the regard for social interaction w/others; may become socially isolated as well

A

avolition

40
Q

Is the indifference to or the disinterest in the environment

A

apathy

41
Q

Disturbances in affect

> Can include bland affect, which is a very weak emotional tone or a flat affect, which is even worse (is considered the void of emotional tone)

A
42
Q

Associated features in schizophrenia

  • Waxy flexibility
    > describes a condition in which the client w/schizophrenia allows the body parts to be placed in a bizarre or uncomfortable position; usually assoc w/catatonia
  • Posturing (manifested by voluntary assumption of inappropriate or bizarre postures)
  • Pacing & rocking
A
  • Regression (the retreat to an earlier lvl of development)
  • Eye movement abnormalities
    > Can manifest in ways like difficulty in maintaining focus on a stationary object & difficulty w/the ability to follow an object w/the eyes
43
Q

Life span development of schizophrenia

Premorbid → Prodromal → Active → Residual

A
  • Generally, sx’s of schizophrenia appear in late adolescence or early adulthood; may occur in middle or late adult life as well
  • Before 17 suggests early onset schizophrenia; sx’s <13 are very rare & suggests very early onset schizophrenia
44
Q

___ phase

  • psychotic sx’s
  • impaired social, occupational functioning
A

Active

45
Q

___ phase

  • very shy & withdrawn
  • poor peer relationships
  • doing poorly in school
  • demonstrating antisocial behavior
  • irritability
A

Premorbid

46
Q

___ phase

  • negative sx’s remain
  • flat affect
  • absence of sx’s in active stage
A

Residual

47
Q

___ phase

  • begins w/a change from premorbid functioning
  • few wks to a few yrs
  • depressive sx’s
  • social withdrawal
  • sleep disturbances
  • suspiciousness/ideas of reference
A

Prodromal

48
Q

Nursing diagnoses (& assoc behaviors)

  • Disturbed sensory perception
  • Disturbed thought processes
  • Social isolation
  • Risk for violence: self-directed or other-directed
A
  • Impaired verbal communication
  • Disabled family coping
  • Ineffective health maintenance
  • Impaired home maintenance
  • Self-care deficit (common)
49
Q

Outcomes criteria

  • Demonstrates ability to relate satisfactorily w/others
  • Recognizes distortions of reality
  • Has not harmed self or others
  • Perceives self realistically
  • Demonstrates the ability to perceive the environment correctly
A
  • Maintains anxiety at a manageable level
  • Relinquishes the need for delusions and hallucinations
  • Demonstrates the ability to trust others
  • Uses appropriate verbal communication in interactions w/others
  • Performs self-care activities independently
50
Q

Interventions

→ Observe the client for signs of hallucinations

→ Avoid physical touch

→ Convey an attitude of acceptance

→ Attempt to distract from hallucination

A

→ Reinforce reality

→ Provide routine

→ Assess for suicide risk

51
Q

Treatment Modalities

  • Individual psychotherapy
  • Group therapy [has been found promising, esp w/rx’s]
  • Behavior therapy
  • Family therapy
A
  • Social skills training
  • Assertive community treatment (ACT)
    > is an evidence-based program of case management; helps pt w/various teachings on living skills
    > Helps client work w/community agencies & also helps them develop a social support network
52
Q

→ Recovery Model

Recovery in schizophrenia is controversial
These pts still deserve instillation of hope & encouragement
What does recovery mean? That’s a fluid definition

A

→ RAISE (Recovery After an Initial Schizophrenic Episode)

  • Incorporates many elements from other treatment approaches, including community treatment, recovery model approaches, & comprehensive care models
    > It looks for early identification @ the 1st ep of psychosis & is thought to be early & comprehensive & can maybe alleviate some of the long-term debilitating consequences of schizophrenia
53
Q

Psychopharmacological Treatment

Typical & atypical [newer] antipsychotics

A
  • Thorazine was the very 1st typical antipsychotic introduced in the US in 1952
54
Q

___ antipsychotic(s)

Provide relief of psychosis, improvement in positive sx’s, improvement in negative sx’s

A

Atypical

55
Q

___ antipsychotic(s)

Provide relief of psychosis, improvement in positive sx’s, worsening of negative sx’s

A

Typical

56
Q

Typical antipsychotics

  • Chlorpromazine
  • Fluphenazine
  • Haloperidol (Haldol)
  • Perphenazine
  • Loxapine
  • Pimozide (Orap)
  • Prochlorperazine
  • Thioridazine
  • Thiothixene (Navane)
  • Trifluoperazine
A

! Anti-cholinergic effects
! Orthostatic hypotension
! EPS (extrapyramidal symptoms)
! TD (tardive dyskinesia)
! NMS (Neuroleptic Malignant Syndrome)
! Pseudo-parkinsonism
! Dystonia

57
Q

?

This is caused by the blockade of dopamine receptors
> includes dystonia, which is involuntary, purposeless muscle contraction; akathisia, which is restlessness

A

EPS (extrapyramidal symptoms)

58
Q

?

This involves involuntary facial movements including the mouth, tongue, & lips
> can be permanent & irreversible

A

TD (tardive dyskinesia)

59
Q

?

Is life-threatening
> results from rx’s that block dopamine receptors
> characterized by a fever of 103 or greater, BP lability, tachycardia, tachypnea, agitation, & diaphoresis

A

NMS (Neuroleptic Malignant Syndrome)

60
Q

AIM Scale

Abnormal Involuntary Movement Scale

A

Is a rating scale that was developed to measure involuntary movements associated w/TD

61
Q

Atypical antipsychotics

  • Aripiprazole (Abilify)
  • Asenapine (Saphris)
  • Brexpiprazole (Rexulti)
  • Cariprazine (Vraylar)
  • Clozapine (Clozaril) [pts are on a registry; routine bloodwork; excess saliva/drooling]
  • Iloperidone (Fanapt)
A
  • Lurasidone (Latuda)
  • Olanzapine (Zyprexa)
  • Paliperidone (Invega)
  • Quetiapine (Seroquel)
  • Risperidone (Risperdal)
  • Ziprasidone (Geodon)
62
Q

! Sedation
! Wt gain
! Orthostatic hypotension
! QT-interval prolongation

A

! Agranulocytosis (presents as a low ANC level)
! Metabolic syndrome
! Less EPS, TD, NMS

63
Q

Novel Developments

  • Aripiprazole (AbilifyMYCITE) w/tracking sensor
A
  • Valbenazine (Ingrezza)

Used in TD treatment
> Works by reducing the dopamine release @ the synaptic cleft
- Has demonstrated some effectiveness in reducing involuntary movements
! This rx is costly ($125,000/yr)

64
Q

Considerations

> Smoking
Body temp
Alcohol

A

NUR 201 Week 10 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions