Unit 12 - Schizophrenia and Dementia Flashcards
Define Dementia
D- The degrading of neurocognitive function.
E- Genetic. Drugs. Trauma to brain. Stress
A - Take Mini Mental State examination.
T- PET, or CT. Family education and respite care. ***Home health. Nursing home for Mod/Severe stage. Meals on wheels. Transportation service.
Define Delirium
an acute loss of neurocogntive function related to an underlying cause. 50% of hospital patients experience this.
S/S of Delirium
-Confusion, disorganized thinking *
-Irritability, or agitation
-Poor recall
-Moments of lucidity*
-Can’t follow through with stuff
-Inattention*
-Potential hallucinations or delusions. Ex. DT
-ALOC**
Safety always priority. Least to most restriction.
AD Cardinal Symptoms
-Memory loss
-Inability to do ADLs, problem solving
-Aphasia: loss of language
-Apraxia
-Agnosia: inability to recognize objects.
Mild Dementia
able to complete ADLs. Forget items. Have long term memory, but short term impaired
Moderate Dementia
persons has loss of short term and long term function. Dresses inappropriately for weather. Perseverance: repeats statements.
Severe Dementia
Unable to do ADLs. Safety risk for aspiration***.
Types of Dementia
- Alzheimer’s
- Lewy body: Lewy buildup in brain
- Vascular: stroke accumulation
- Mixed dementia
-Frontotemporal: idiopathic shrinking of brain.
R/t..
-Trauma
-HIV
-Substance abuse
-Parkinsons
-Huntington
Alzheimer’s
Most common type of Alzheimer’s. Patho: demyelination of neurons combined with overabundance of proteins?
Positive Speech alterations
Positive Symptom
-Clang associations
-Associative looseness***:
-Echolia: like myth abt Echo
-Neologism: make new words
-Tangential speech:, or “tangents”. Person keeps digressing from original topic.
-Pressured speech
-Cognitive retardation: slow speech
-Flight of ideas: jump from one thought to another. Like flight pit stops.
Positive Alteration in behavior
Positive symptoms
-Catatonia
-Motor retardation: slow movement
-Posturing, gesturing: faces and posture that don’t match situation.
-Echopraxia: copy person’s movements.
-Motor agitation: increased response to external stimuli, irritability
-Stereotyped behaviors: antsy, pacing
-Impaired impulse control
-Negativism: resistance to requests.
-Boundary impairment: everything near person is theirs.
Alteration in perception
Positive symptom
-Hallucination
-Delusion
-Derealization
-Depersonalization: out of body experience
Positive Cognitive Distortion
Positive symptom
-Thought blocking: thinking someone is blocking thoughts
-Thought insertion: Belief someone put thought in your head.
-Thought deletion
-Magical thinking: belief that an action with ex. guarantee another will happen.
-Paranoia
Negative symptoms (General)
-Apraxia: lack of purposeful movement
-Alogia: lack of speech
-Ahedonia: lacks pleasure from life. “Hed” will to live.
-Avolition: volition, decision. Can’t make decisions
- Asociality
-Affective blunting. **Beware! depression w negative affect.
-Apathy
Affective blunting
flat, blunted (minimum/reduced expression), inappropriate (to scenario), bizarre, constrict (to ex. 2 emotions)
Anosognosia
pt can’t comprehend they are ill.
Negative Cognitive Symptoms for
-Concrete thinking
-Impaired memory, info processing, executive function (thinking, problem solving)
Define psychosis
altered 1) reality 2) cognition 3) perception (sight, hearing, touch)
Define Schizophrenia
-Definition: two or more of the below for 1+month
Delusions: false beliefs that they can’t be convinced out of.
Hallucination: sense something not there. Tactile, hear, touch.
Wacky speech
Gross (*movement) disorganization
Negative symptoms
Functional impairment: ADLs? Cognitive impairment
-Etiology:
onset preteen to young adult. Genetic, prenatal.
Comorbidity of nicotine, substance abuse. Anxi and Depr.
Polydipsia r/t dopamine
-Appearance/asses: depends on if they have positive or negative symptoms. Positive similar to mania. Negative similar to depression. NOT THE SAME.
Assess affect, cognitive, and for pos/neg symptoms.
-Treatment: Limit outside stimuli. Promote safety. Supervision. antipsychotics: 1st and 2nd Gen.
-Highlights: safety priority.
Phases of Schizophrenia
-Promodal Phase: baseline. onset; not guaranteed to have break, but possible.
-Phase I, or Acute: safety priority. Med admin to bring back to earth.
-Phase II, or Stabilization: symptoms subside.
-Phase III, or Maintenance: new basline. Education: TAKE THE MEDDDDS
Assess what with Schizophrenia?
For:
-Hallucinations, delusions
-Suicidal Ideation
-Meds
-Functional impairment level
-Family/pt knowledge of issue
Define Schizoaffective Disorder
??????
Meds
Antipsychs:
First Gen: Haloperidol. Chlorpromazine. Solely Dopamine agonist. Tx positive effects.
Second Gen: Clozapine. Dopamine and serotonin. Treat negative and positive symptoms.
Third Gen: Abilify. Subset of second Gen.
Mood Stabilizers: Lithium, Valroaic Acid
Secondary:
Antidepressants: SSRIs, SNRIs, TCA, MAOIs, Atypical
***Phenelzine easy toxicity.
Anxiolytics: Benzo, Barbituates,
LITHIUM
Therapeutic range: 0.6 - 1.2
Interventions: watch fluid and Na balance
Admin: encourage normal fluid and food consumption
***S/S of lithium toxicity: confusion, fever.
