Schizophrenia Spectrum Disorder Flashcards
List some comorbid disorders with schizo.
- substance use disorders
- Anxiety
3 Depression - Suicide
- Physical Illnesses
- Polydipsia
List some RFs of schizo.
- genetics
- dopamine theory
- Brain structure abnormalities
- Psychological and Envtl factors
- Prenatal stressors
What is the chance of fraternal twins developing schizo?
15%
What is the chance of identical twins developing schizo?
50%
What is the dopamine theory?
too much dopamine which may play a role in psychosis
List the phases of schizophrenia
- Prodromal
- Acute
- Stabilization
- Maintenance or Residual
Describe the prodromal phase
mild changes in thinking, reality testing, and mood, insufficient to meet diagnostic criteria. Speech and thought may be odd. Anxiety, obsessive thoughts, and compulsive behaviors. Person may not feel right
Describe the Acute phase
Sx include hallucination, delusions, apathy, social withdrawal, diminished affect, anhedonia, disorganized behavior, impaired judgment, and cognitive regression
Describe the stabilization phase
Sx are stabilizing and diminishing and there is movement toward a previous level of fxning
Describe the maintenance or residual phase
(+) Sx are usually absent or significantly diminished, but (-) Sx and cognitive Sx continue to be a concern
List the (+) Sx
- Hallucinations
- Delusions
- Paranoia
- Disorganized speech or behavior
List (-) Sx
- Algoia
- Anhedonia
- Anergia
- Avolition
- Asociality
- Affective blunting
- Apathy
List and describe the types of delusions
- Persecutory- believing that one is being singled out for harm
- Referential- a belief that events that have no connection are related
- Grandiose- believing one is quite powerful
- Erotomaniac- believing everyone is in love with you
- Nihlistic- conviction a major catastrophe will occur
- Somatic- believing the body is changing in unusual ways
- Control- believing someone is controlling them
What are some alterations in speech?
- word salad
- clang association
- associative looseness
- Echolalia
- Neologisms
What are the 2 most common types of hallucinations?
- auditory
2. visual
Define anosognosia
an inability to realize they are ill caused by the illness itself
Which 2 meds are prescribed for waxy flexibility?
- Haldol
2. Ativan
What are some interventions for a person experiencing hallucinations?
- Ask about the content
- Do not allow the pt to believe they are real
- Focus on the hear and now
- Address any underlying emotion, needs, or theme
- Once orient regains, guide them to interpret the hallucination as Sx
What are some interventions for a pt experiencing delusions?
- build trust by being open, honest, genuine, and reliable
- Ask the pt to describe his beliefs
- Never debate the delusional content
What is a major SE of 1st gen?
EPS
What are some Sx included in EPS?
- Acute dystonia
- Akathisia
- Pseudoparkinsonism
- Tardive dyskinesia
Acute dystonia
sudden, sustained contraction of one or several muscle groups (torticollis, oculogyric crisis, larynospasm and opisthotonus)
Akathisisa
motor restlessness that causes pacing, repetitive movements or an inability to stay still or remain in one place
What is the treatment for tardive dykinesia?
Ingrezza
Does NMS occur more in 1st or 2nd gen?
1st gen and 2nd but less likely in 2nd
What is NMS?
Neuroplastic Malignant Syndrome is characterized by reduced consciousness and responsiveness, increased muscle tone and autonomic dysfxn
Si/Sx of NMS
- Fever
- tachycardia
- diaphoresis
- muscle rigidity
- tachypnea
- hypersalivation
- kidney, lung, and heart failure
Tx for NMS
- DC the drug ASAP
- Monitor
- VS
- I&O
- LOC - Obtain an order for dantrolene
Why is knowing the ANC important when administering antipsychotics?
neutropenia can be fatal and monitored via ANC
What are the normal ANC values based on culture?
Caucasians: less than or equal to 1500
Everyone else: less than or equal to 1000
What is the AIMS tool?
identify and track involuntary movements
