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Nurs 327 > Week 3- psychosis/crisis intervention > Flashcards

Week 3- psychosis/crisis intervention Flashcards

1
Q

psychosis

definition

A

disruptions to a persons thoughts and perceptions that make it difficult to recognize what is real and what isnt

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2
Q

psychosis DSM-5 definition

abnormalities in 5 different symptomatic domains

A
  • delusions
  • hallucinations
  • disorganized thoughts/speech
  • disorganized behavior
  • negative symptoms
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3
Q

psychosis physiology

A

no one cause but thought to deal with lack of dopamine which leads to positive symptoms
- can be due to environment, toxins, genetics
- usually develops early to late 20’s due to amount of stress during this time

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4
Q

schizophreniform disorder

duration

A

1- 6 months

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5
Q

schizophrenia

duration

A

symptoms last longer than 6 months

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6
Q

schizoaffective disorder

A

psychosis with a mood disorder
- there will be psychosis at all times

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7
Q

disorders that may manifest psychosis

A

bipolar disorder I, major depressive disorder, alcohol use disorder, substance use disorder

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8
Q

secondary psychosis

A

product of underlying medical problems

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9
Q

schizophrenia diagnostic criteria

A

2 or more of the following;
- delusions
- hallucinations
- disorganized speech
- disorganized behavior
- negative symptoms

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10
Q

delusions

A

false, fixed beliefs that are unlikely to change despite contradictory evidence

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11
Q

hallucinations

A

perceptions that occur without an external stimulus
- auditory is most common

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12
Q

positive symptoms

A
  • hallucinations
  • delusions
  • disorganized speech
  • thought disorder
  • disorganized behavior
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13
Q

negative symptoms

A
  • alogia (no speech)
  • flat affect
  • poor attention
  • avolition (no motivation)
  • anhedonia (no pleasure)
  • loss of social interest
  • attention defecits
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14
Q

1st phase of psychosis

A
  • subtle early signs
  • vague changes in thoughts/feelings/perceptions
  • able to maintain some level of functioning
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15
Q

2nd phase of psychosis

A
  • clear psychotic signs
  • functioning deteriorates
  • substance abuse for coping is common
  • high risk of suicide due to lots of frustration
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16
Q

3rd phase of psychosis

A
  • treatment/recovery
  • medication
  • social supports and resources
  • relapse is common
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17
Q

consequences of psychosis

A
  • problems with functional ability
  • dementia
  • long term problems related to pharmacological treatment
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18
Q

grandiose delusions

A

belief of special powers or of being greatly significant

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19
Q

paranoid delusions

A

reflect profound fear and anxiety

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20
Q

control delusions

A

do not feel in control of their movement

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21
Q

somatic delusions

A

deals with feelings in body
- eg. parasites

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22
Q

nihilistic delusions

A

believes they are dead

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23
Q

magical thinking

A

believes that specific thoughts/words have special influence on world around them

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24
Q

command halluciantions

A

voice telling you to do something

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25
Q

circumstantial thought

A

gives excessive and non-essential detail but returns to point or answers question

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26
Q

tangential thought

A

never returns to topic

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27
Q

loose associations

A

lack of logical relationship betwen thoughts

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28
Q

flight of ideas

A

rapid change from one topic to another

29
Q

thought blocking

A

sudden pause in train of thought and then cannot recall

30
Q

preservation

A

persisting on topic even when stimulus has changed

31
Q

clang association

A

similar sounds but incoherent meaning

32
Q

echolalia

A

repetition of things said by others

33
Q

neologisms

A

making up words

34
Q

word salad

A

incoherent mixture of words

35
Q

waxy flexibility

A

body showing resistance to being moved
- specific symptom of catatonia

36
Q

stereotypy

A

repetitive or ritualistic movement or posture

37
Q

echopraxia

A

involuntary repetition or imitation of another persons actions

38
Q

alogia

A

poverty of speech

39
Q

avolition

A

decreased motivation

40
Q

anhedonia

A

inability to feel pleasure

41
Q

ambivalence

A

strong opposing feelings

42
Q

acute phase interventions

psychosis

A

safety, establish trust, do not confirm delusions or hallucinations

43
Q

recovery phase interventions

psychosis

A

show positive regard for experience, focus on goal oriented activity, model appropriate skills

44
Q

first generation antipsychotics

A

most common is haldol; least expensive
- treats positive symptoms
- not for long term
- side effects are parkonsinism, NMS, dystonia, akathisia

45
Q

neuroleptic malignant syndrome

A

mental status change with muscle rigidity and fever

46
Q

dystonia

A

involuntary muscle contraction

47
Q

akathisia

A

inability to remain still

48
Q

2nd generation antipsychotics

A

clozapine, olanzapine, risperidone, palperidone
- treats positive and negative symptoms but much more expensive
- very potent
- can cause side effects but lesser degree than 1st gen
* can cause agranulocytosis

49
Q

3rd generation antipsychotics

A

aripiprazole (abilify)
- treat mood disorders and schizophrenia
- can cause side effects but lesser degree than 1st or 2nd gen
- expensive

50
Q

meds to manage side effects for antipsychotics

A

benztropine and clonazepam

51
Q

purpose of crisis intervention

A

goal is rapid resolution to prevent further deterioration

52
Q

stages of a crisis

A

precipitant –> early escalation –> meet needs –> cope

53
Q

initial threat

stage of crisis

A

problem where patient has to cope

54
Q

escalation

stage of crisis

A

problem persists and usual defensive coping skills fails

55
Q

crisis

stage of crisis

A

fight or flight response and may attempt to find helpful resources

56
Q

personal disorganization

stage of crisis

A

if problem is unresolved from 2nd or 3rd stage then there will be serious disorganization

57
Q

situational crisis

A

things related to immediate life circumstances

58
Q

maturational crisis

A

related to stages of life

59
Q

adventitious crisis

A

related to natural disasters, acts of terrorism, interpersonal disaster

60
Q

key to crisis intervention

3

A

empowerment, empathy, interdisciplinary

61
Q

stage 1 crisis intervention

crisis assessment

A
  • level of functioning and current safety
  • suicide risk assessment
62
Q

stage 2 crisis intervention

establish rapport

A
  • may need to use de-escelation techniques
  • active listening
  • empathy
  • role clarity
  • boundaries
63
Q

stage 3 crisis intervention

identify major problems

A
  • identify major problems
  • client perspective on the situation
64
Q

stage 4 crisis intervention

feelings and emotions

A
  • education
  • empower
  • positive reframing
65
Q

stage 5 crisis intervention

explore alternatives

A
  • avoid probing in depth
  • ask what strategies work for them
  • offer choice
66
Q

stage 6 crisis intervention

develop plan

A
  • collaborative agreement on a plan
  • focus on basic needs
  • implement the plan
67
Q

illusion

A

misperception of a real experience or stimulus

68
Q
A

Nurs 327 (8 decks)

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