Schizophrenia Spectrum Disorders, Ch. 12 (Ver) Flashcards
- Delusional Disorder
- Brief Psychotic Disorder
- Schizophreniform Disorder
- Schizoaffective Disorder
- Substance-Induced or Medical Condition Psychotic Disorder
- Schizophrenia
Schizophrenia Spectrum Disorders
False thoughts and beliefs that last > 1 mnth
DELUSIONS: Grandiose, Persecutory, Somatic, And Referential themes
“believes everyone on the bus is talking about them”
-Does not impair fxn
Delusional Disorder
Sudden Onset of at least 1 =
Delusions, hallucinations, disorganized speech, and disorganized/ catatonic behavior
DURATION: >1day but <1mnth; then return to normal fxn
Brief Psychotic Episode
have sx of schizophrenia that last <6mnth
- May not return to normal fxn, & develop recurrent or persistent psychosis
Schizophreniform Disorder
MAJOR depressive, manic, or mixed episodes that meet the criteria for schizophrenia
-NOT caused by a substance or medical condition.
Schizoaffective Disorder
-Delusions or hallucinations from illicit drugs, alcohol, meds, or toxins
- “” from delirium, neurological dz, hepatic or renal dz, and many more
Psychotic Disorder that is Substance-Induced or Dur to Medical condition
Affects <1% of pop.
- Altered cognition, perception, and reality testing for >6mnth
- Presents at age 15-25, Hereditary
- S/SX: Delusions, hallucinations, disorganized speech-frequent derailment, gross disorganization or catatonia, decrease in rate or motor movement, Negative sx, fxn impairment
Schizophrenia
- Prodromal
- Mnth-Yrs before full disorder manifests = mile sx = less social, diminished cognitive ability, suspicions, disorganized thoughts - Acute
-Hallucinations, withdrawal, anhedonia, impaired judgment, and cognition - Stabilization
-SX: stabilized/ diminished (move towards prior behavior) - Maintenance or Residual
- SX: Stable but negative SX continue
Phases of Schizophrenia
Alterations in reality testing
-Delusions
-Altered Speech
- Concrete Thinking
Positive SX
-Associative Looseness
(word salad)
-Clang Association = words that rhyme or are based on sounds ( like bells and whistle noises)
- Neologisms = word meaning only for pt. (calling a fork a dinglehopper)
- Echolalia = mimics what others say to them
Alterations in Speech
Positive SX
-Circumstantially - unnecessary details in conversation
- Tangentiality - wandering off-topic
- Cognitive Retardation - slow thinking
- Pressured speech
- Flight of Ideas- rapid movement from one topic to another
- Symbolic speech - uses words based on what they symbolize (“Demons are sticking needles in me”)
Abnormal Speech Patterns
Positive SX
-Thought blocking- thoughts interrupted by hallucinations
- Thought insertion- Someone else put thoughts in the head (ex: alien)
- Thought deletion - Thoughts have been taken away
- Magical thinking- believing thoughts or actions affect other’s consequences (“b/c I hate my nurse, she had an accident)
- Paranoia- irrational fear
Distortions of Thought
Positive SX
-Hallucinations- perceives a sensory for which there are no external stimuli; effects all senses
ASK PT: Who’s voice they are hearing?
- Illusions- misperceptions or misinterpretations
- Depersonalization-a feeling of being unreal. Body parts don’t belong (“this is not my arm”)
- Derealization- a feeling the environment changed (believe things are missing or moved when they are not)
Alterations of Perception
Positive SX
-Catatonia- unresponsive
- Motor Retardation
- Stereotyped behavior: mimic gestures, grimace
- Waxy flexibility
- Echopraxia- mimic
- Negativism
- Impaired impulse control
- Gesturing or posturing- illogical expressions
- Boundary impairment- believes that whatever is near to them belongs to them
Alterations in Behavior
Positive SX
The absence of essential human qualities
-Anhedonia- lack of pleasure
- Avolition- lack of Motivation
- Asociality- dec. desire for social interaction
- Affective Blunting-reduced affect
-Apathy-lack of interest
-Alogia-lack of speech
Negative SX
The outward expression of a person’s internal emotional state
-Flat, Blunted, Constricted, inappropriate, bizarre
Affect
Negative SX
-Concrete thinking- very literal
-Impaired memory
-Impaired information processing
- Impaired executive fxn- difficulty with reasoning or placing things in logical order
-Anosognosia- inability to realize one is ill
Cognitive
Negative SX
Phase 1. ACUTE
-Pt. safety and medical stabilization
Phase 2. STABILIZATION
-help pt. understand illness and tx
-Stabilize meds
-Control or cope w/ sx
Phase 3. MAINTENANCE
-maintain achievement
-prevent relapse
-achieve independence, satisfactory quality of life
NURSING OUTCOMES IDENTIFICATION
Antipsychotics
1st Generation
-Haloperidol, Fluphenazine, Decanoate
2nd Generation: Risk of Metabolic Syndrome
-Olanzapine, Pamoate, Paliperidone, Palmitate, Clozapine
3rd Generation
-Aripiprazole, Brexpiprazole, Cariprazine
MEDICATION
—ACh toxicity= reduced or absent peristalsis could lead to obstruction, urinary retention.
—Neuroleptic Malignant Syndrome (NMS)=severe muscle rigidity, decreased responsiveness, high temp ^103, ^BP, ^HR, delirium
—Agranulocytosis= lowered immune system
—Prolonged QT intervals= dysrhythmia
—Liver Impairment
Dangers of Antipsychotics
