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86 Cards in this Set

  • Front
  • Back
what is the average age of onset for schizophrenia?
16-26 years old
what are the different types of schizophrenia?
Catatonic, paranoid, disorganized, undifferentiated and residual
What are the negative symptoms of schizophrenia?
social withdrawal, apathy, lack of motivation, emotional unresponsiveness
What are the positive symptoms of schizophrenia?
delusions, hallucinations, disordered thinking and speech
As the nurse, what is the best way to manage your schizophrenic patients delusions?
show empathy, assess the triggers (stress, stimuli in the environment, etc), respond to their feelings and attempt diversional activities
What are some therapeutic approaches for schizophrenia?
individual therapy, group therapy, family therapy, milieu therapy, rehabilitation and psychotropic medications
What are some extra pyramidal effects of antipsychotic drugs?
dystonic reactions (muscle spasms), akathisia (muscle restlessness), parkinsonism, and neuroleptic malignant syndrome
What is Tardive dyskinesia?
movements of the tongue, mouth, face and jaw, puckering, chewing movements and involuntary movement of the extremities
What are some anticholinergic effects of anitpsychotic drugs?
dry mouth, constipation, urinary retention, blurry vision, memory difficulties, confusion
What are some advantages of Clozapine (clozaril)?
may be most effective; does not cause movement disorders and may lovwer the risk of drug and alcohol abuse
What are some of the side effects of Clozapine?
agranulocytosis, drowsiness, dizziness, drooling, seizures, muscle weakness, weight gain, diabetes, rapid withdrawal may lead to psychosis
what are some advantages of Resperidone (risperdal)?
outperforms conventional drugs, no seizures or drooling, movement disorders uncommon
What are the side effects of resperidone?
dizziness, drowsiness, dry mouth, rapid HB, weight gain, diabetes
What are the advantages of Olanzapine (zyprexa)?
outperforms conventional drugs, overall low rate of side effects, no seizures or drooling, movement disorders uncommon and cona be injected for gradual absorption
What are the side effects of Olanzapine (zyprexa)?
dizziness drowsiness, dry mouth, substantial weight gain, diabetes
What are the advantages of Quetiapine (seroquel)?
similar to risperidone an olanzapine
What are the side effects of serquel (quetiapine)?
drowsiness, substantial weight gain, diabetes, occassional movement disorders, cataract reported in animal given high doses.
What are the advantages of Ziprasidone (geodon)?
no movement disorders, apparently little weight gain and may be helpful for depression and anxiety
What are the side effects of Ziprasidone (geodon)?
headaches, nausea, drowsiness, dizziness, rash and can slow electrical conduction through the heart
List the antipsychotic drugs?
Clozapine (clozaril), Risperidone (risperdal), Olanzapine (zyprexa), Quetiapine (serquel), Ziprasidone (geodon)
What are some nursing implications regarding schizophrenia?
safe environment, therapeutic communication, pro,ote socialization, reduce anxiety, teaching
What are some symptoms of residual schizo?
absence of prominent delusion/halluc., emotional blunting, social withdrawal, eccentric behavior, illogical thinking, loose associations
What are some symptoms of undiferentiated schizo?
psychotic symptoms, mixed schizo symptoms
Whate are some symptoms of Disorganized schizo?
fragmented delusions or halluc., disorganized behaviors, extreme social withdrawal, disorganized speech, falt, inappropriate or silly affect
What are some symptoms of paranoid schizo?
delusions (organized around a theme, persecutory, grandiose), halluc., anger, argumentativeness, violence
What are the symptoms of catatonic schizo?
non movement, excessive motor activity, extreme negativism, peculiar movements, echolalia(imitates what you say) or echopraxia ( imitates what you do)
What type of assessments should the nurse do for a schizophrenic patient?
nurses attitude and role, history, physical assessment, individualized approach, trusting relationship
What are some cognitive characteristics of substance abuse?
low self-esteem, grandiose thoughts, balckouts, confabulation, paranoid thinking, general decline in cognitive ability, use of defense mechanisms
What are the defense mechanisms related to subst. abuse?
denial, projection (blaming other people), minimalization, rationalization
What are some CNS depressants?
alcohol, anxiolytics, sedative hypnotics, opiods
What are some of the family roles when is comes to subst. abuse?
co-dependent, hero, scapegoat, clown,lost child
What does co-dependency mean?
a relationship in which a non-subst. abusing partner remains with a subst. abuser
What are some examples of enabling?
rescuing, taking over, attempting to control, covering up, denying, justifying, avoiding, enduring, blaming
What are some signs of alcohol intoxication and overdose?
slurred speech, incoordination, unsteady gait, nystagmus, impairment in memory and attention, stupor, coma, respiratory depression, aspiration
What are some priority interventions re: alcohol overdose?
maintain airway, monitor breathing pattern, iv line patent, blood alcohol levels, assess and monitor LOC, obtain history r/t abuse and recent intake
describe Alcohol Withdrawal Delerium
usually occurs on day 2 or 3 bu may be as late at day 14, confusion, disorientation, halluc., tachycardia, hypertension or hypotension, extreme tremors, agitation, diaphoresis, fever, death may result from cariovascular collapse or hyperthermia
*more serious than normal withdrawal
What are the preferred drugs to use in alcohol withdrawal?
Why?
benzodiazapines, they decrease symptoms and prevent seizures
What is the most common benzodiazapine?
chlordiazepoxide (librium)
List the benzodiazapine drugs
Chlordiazepoxide (librium, Diazepam (valium), ozazepam (serax), lorazepam (ativan)
What should be monitored in regards to AWS?
BP, tremors, state of anxiety.agitation
What drugs are used to maintain abstinence from alcohol?
disulfiram (antabuse), naltrexone (reVia), acamprosate (campral)
What reaction may occur if someone on disufiram (antabuse) consumes alcohol?
nausea, copious vomiting, flushing, palpitations, headache, sweating, thirst, chest pain, hypotension, weakness, blurred vision
What does Naltrexone (ReVia) do?
decreases craving, decreases pleasurable effects
What does Acamprosate (campril) do?
reduces unpleasant feelings brought on by abstinence
What are some anianxiety agents?
Barbituates and benzodiazapines
What are some of the effects of sedatives/hypnotics/antianxiety agents?
drowsiness, sedated appearance, lack of coordination, euphoria, labile emotions, irritability, anxiety, impaired attention, working memory loss
List 2 antidotes for benzodiazapines
Anexate, Romanzicon (flumazenil)
List 2 designer drugs and their street names
Rohypnol (roofies, date rape drug)
GHB (g-riffic, Liquid G)
List the different opiods
morphine, heroine, codeine, dilaudid, percodan, demerol, methadone, oxycodone, percocet, vicodin
What kind of effect do opiods have?
Brief, intense sensation, followed by longer-lasting high, calmness, sedated appearance, motor retardation, slurred speech decreased awareness, etc
What are some complications of opiods?
liver problems, malignant hypertension, strokes, kidney failure, poisoning from heroine, risk for hep/HIV/aids
What are some symptoms of an opiod overdose?
clammy skin, shallow respriations, pinpoint pupils, death from respiratory depression or irreversable pulmonary edema
What drugs are used to assist in opiate withdrawal?
Methadone, buprenorphine, clonidine
What does Methadone do?
modifies drug using behaviors, prevents the reinforcing pleasurable effects of street drugs, highly addicting
What opiate withdrawal medication cannot be prescribed by all doctors?
Buprenorphine
What does Buprenorphine do?
alleviates craving, reduces use of illicit drugs, low abuse potential, safer than medadone, can prevent opioid-induced euphoria, withdrawal is milder
What does Naltrexone do?
opioid analgesic, prevents pleasurable effects of opioids, patient must go through withdrawal before taking this drug
What are some of the effects of cocaine?
uniquely addicting, euphoria, increased energy, mental alertness, increased self-confidence, sexual arousal, tension/fatigue/shyness disappear, talkative, playful, judgment may be impaired, may become aggressive/violent, paranoia
What are some of the negative effects of cocaine?
rebound dysphoria (crash), progressive tolerance of positive effects, intensified negative effects
What are some of the complications of cocaine?
vasoconstriction - severe hypertension, elevated heart rate, stroke, MI, dysrrythmia

Seizures - hypertension, stroke, MI
What are the withdrawal symptoms of cocaine?
severe craving, depression, fatigue, irritability, vivid and unpleasant dreams
What are some signs that a person has overdosed on cocaine?
tachycardia, cardiac arrythmias, elevated BP, nausea, vomiting, seizures, respiratory depression, hyperpyrexia, death
What are some elements of recovery?
abstinence, detox, diet, exercise, overcome denial, face/explore feelings. learn about the illness of addiction , learn new behavior patterns, learn new ways of communicating and relating, relapse prevention and support
How long does it take for an addict to adjust to no drugs?
9 - 15 months
What are the four levels of anxiety?
mild, moderate, severe, panic
Describe MILD anxiety
agreeable, even pleasant increase in tension, helps to deal constructively with stress, motivates learning, produces creativity
Descibe MODERATE anxiety
Person alert, narrowing of perceptual field, focus on present, selective inattention, twitching eyelid, trembling lips, mild GI symptoms
Describe SEVERE anxiety
Fight or flight response begins,SNS and endocrine systems react, HR/BP/SOB increase, pupils dilate, sweats, cold, clammy hands, body trembles, fearful expression, tense, exaggerated startle response, increase in blood glucose level, diarrhea, dry mouth, upset stomach, headache, urinary urgency, sexual dysfunction
Describe PANIC anxiety
body can not adapt or organize for fight or flight, helpless to care for or defend self, pale, hypotension may occur, voice quivers, agitated, poor motor control, involuntary movements, trembles, expression of terror with dilated pupils, dizziness, lightheadedness, nausea, chest pain, pressure, palpitations, SOB, choking or smothering sensation, fear of immediate death
What are some effective coping mechanisms when it comes to anxiety?
physical activity, making short and long term goals, reviewing strengths and limitations, formulating a plan of action to confront the anxiety-producing situation, expressing emotions, seeking support
What are some stress reduction techniques?
meditation, progressive relaxation, visualization, biofeedback
What is the single largest mental health problem in the US?
anxiety disorders
What are some characteristics of dissociative disorders?
amnesia, derealization, depersonalization, identity confusion, identity alteration
List 2 antiolytic medications
benzodiazepines, buspirone
Describe Benzodiazipines
dangerous in overdose-respiratory depression, synergistic effect with alcohol and other CNS depressants, may develop tolerance, become dependent, withdrawal can occur
Describe Buspirone
May take several weeks for maximum benefit, not a prn med., can be used long term
What are the principles of community mental health care?
normalization, contextualization, self-advocacy
What are the goals of normalization?
integration into mainstream community, destigmatization, independence
What are the goals of Contextualization?
Maintaining clients in their context
What are some examples of outpatient services?
day treatment programs, medication clinics, psychosocial clubhouses
What are psychosocial clubhouses?
therapeutic communities, staff are coaches, encourage decision-making and socialization, transitional
What are the four levels of family cohesion?
disengaged, seperated, connected, enmeshed
What two signs of cohesion represent a "balanced" family?
separated, connected
What percent of acute care clients are discharged to families?
60%
What percentage of psychiatrically disabled clients live with families regularly?
40-50%
What are some of the goals of family therapy?
help families cope, improve communication skills, develop better parenting skills, establish or reinstate boundaries, assist adults to be involved with each other, decrease family reactions to symptoms, moderate family cohesion and flexibility, help them to maintain balance and harmony, adapt to change