Mental Health- Test 2 - Ch 15 2 (Schizophrenia)

Front 1

schizophrenia:

-what kind of disorder?

-schizophrenia is a psychotic disorder, meaning that:

Back 1

thought disorder (cognitive problems)

-delusions, hallucinations, and disorganized thinking, speech, and behavior are prominent elements of the disorder

Front 2

-fundamental signs of schizophrenia are the 4 A’s

Back 2

-Affect: may be flat, blunted, inappropriate, or bizarre affect
-Associative looseness: disorganized thinking, jumped and illogical speech, impaired reasoning
-Autism: thinking is not bound to reality but reflects the private perceptual world (delusions, hallucinations, and neologisms are examples)
-Ambivalence: holding 2 opposite emotions, attitudes, ideas, or wishes toward the same person, situation, or object.

Front 3

-to have schizophrenia you have to have some kind of _______ going on

Back 3

psychosis

(psychosis diff. discerning your external and internal world)

Front 4

-schizoaffective (type of schizophrenia who have what)

-what is it characterized by:

what are symptoms not due to:

Back 4

who have psychosis in addition to a mood disorder (mania and depression mood swings)

-characterized by MDD, manic, or mixed mood episode presenting concurrently with the symptoms of schizophrenia:

-symptoms are not due to substance use or to a medical condition

Front 5

*neuroleptic is interchangeable with

Back 5

antipsychotic

Front 6

-high incidence of depression with __________

Back 6

schizophrenia

Front 7

*neuroleptic is interchangeable with _____________

Back 7

antipsychotic

Front 8

(what 3 things) co-occur frequently in schizophrenia

Back 8

-anxiety, depression, suicide

Front 9

comorbidity schizophrenia

-in relation to "water"

-can lead to:

Back 9

-polydipsia (insatiable thirst that results in a dangerous intake of water)

-can lead to fetal water intoxication, indicated by hyponatremia, confusion, worsening of psychotic symptoms, and ultimately coma)

Front 10

schizophrenia

Etiology
-when does it usually develop?

Back 10

-usually develops during the late teens and early 20s

Front 11

schizophrenia

what does the diathesis stress model say about the etiology of this MI?

Back 11

-occurs when multiple inherited gene abnormalities combine with nongenetic factors (viral infections, birth injuries, prenatal malnutrition), altering the structures of the brain, affecting the brains neurotransmitter systems and/or injury the brain directly

Front 12

schizophrenia

-the younger the person is, the ______ the prognosis

Back 12

poorer the prognosis,


(the younger the person is, the worse off they are)

Front 13

schizophrenia


(the younger the person is, the ______ off they are)

Back 13

worse

Front 14

schizophrenia

negative vs positive symtpoms (which is the worst one to start off with)

Back 14

-negative symptoms is poorer than if they started out with positive symptoms (if they have negative symptoms, they worse off they are)

Front 15

schizophrenia

dopamine theory
-what do conventional antipsychotics block??

-what do atypical antipsychotics black??

Back 15

-conventional antipsychotics block the activity of dopamine receptors in the brain, limiting the activity of dopamine and reducing some of the symptoms of schizophrenia

-atypical antipsychotics block serotonin and dopamine

Front 16

schizophrenia (acute, stablization, maintenance)

disruptive symptoms (hallucinations, delusions)

Back 16

acute

Front 17

schizophrenia (acute, stablization, maintenance)

apathy

Back 17

acute

Front 18

schizophrenia (acute, stablization, maintenance)

withdrawal,

Back 18

acute

Front 19

schizophrenia (acute, stabilization, maintenance)

- interventions for acute: (3)

Back 19

keep them safe and medically stable and target negative symptoms

Front 20

schizophrenia (acute, stabilization, maintenance)

-overall goal: pt safety and medical stabilization

Back 20

acute

Front 21

schizophrenia (acute, stabilization, maintenance)

-examples of outcomes: pt refrains from self injury, pt consistently labels hallucinations as “not real –a symptom of an illness”

Back 21

acute

Front 22

schizophrenia (acute, stabilization, maintenance)

-hospitalization if the pt is considered a danger to self or others, or too disorganized to function in the community w/o supervision

Back 22

acute

Front 23

schizophrenia (acute, stabilization, maintenance)

symptoms are diminishing and there is movement toward one’s previous level of functioning (baseline),

Back 23

stabilization

Front 24

schizophrenia (acute, stabilization, maintenance)

day hospitalization or care in a residential crisis center or group home may be needed

Back 24

stabilization

Front 25

schizophrenia (acute, stabilization, maintenance)

- more about psychoeducation (involve family and caregivers).

Back 25

stabilization

Front 26

schizophrenia (acute, stabilization, maintenance)

adhere to medication regimen

Back 26

stabilization

Front 27

schizophrenia (acute, stabilization, maintenance)

relapse prevention ( going off medications, invites symptoms) – prevent relapse

Back 27

stabilization

Front 28

schizophrenia (acute, stabilization, maintenance)

-overall goal: focus on helping the pt adhere to treatment, become stabilized on meds, and control or cope with symptoms

Back 28

stabilization

Front 29

schizophrenia (acute, stabilization, maintenance)

-outcomes target the negative symptoms and may include ability to succeed in social or self care activities

Back 29

stabilization

Front 30

schizophrenia (acute, stabilization, maintenance)

-focuses on providing pt and family education and skills training (psysosocial education).

Back 30

stabilization

Front 31

schizophrenia (acute, stabilization, maintenance)

relapse prevention skills are vital. planning identifies interpersonal, coping, health care, and vocational needs and addresses how and where these needs can be met within the community

Back 31

stabilization

Front 32

schizophrenia (acute, stabilization, maintenance)

psychoeducation, a key role of the nurse,

Back 32

stabilization

Front 33

schizophrenia (acute, stabilization, maintenance)

-patient is at or near baseline (premorbid) functioning

Back 33

maintenance

Front 34

schizophrenia (acute, stabilization, maintenance)

-symptoms are absent or diminished

Back 34

maintenance

Front 35

schizophrenia (acute, stabilization, maintenance)

-level of functioning allows the pt to live in the community

Back 35

maintenance

Front 36

schizophrenia (acute, stabilization, maintenance)

-most live in their own residences

Back 36

maintenance

Front 37

schizophrenia (acute, stabilization, maintenance)

-getting back to normal level of functioning

Back 37

maintenance

Front 38

schizophrenia (acute, stabilization, maintenance)

–interventions: education that is needed and continue to take meds

Back 38

maintenance

Front 39

schizophrenia (acute, stabilization, maintenance)

goal/focus: maintaining achievement, preventing relapse, achieving independence and satisfactory quality of life

Back 39

maintenance

Front 40

schizophrenia (acute, stabilization, maintenance)

--focuses on providing pt and family education and skills training (psysosocial education).

Back 40

maintenance

Front 41

prepsychotic phase:
-how long does it last?

Back 41

month to a year

Front 42

assessment / schizophrenia
-what do we reduce?
-what do we monitor? ex?
-what do we enhance?


what do we build?

Back 42

-reduce stress
-monitor high risk people (children of parents who have schizophrenia)
-enhance social and coping skills

(build resiliency)

Front 43

symptom groups of schizophrenia

-the presence of something that is not normally present

Back 43

*positive symptoms:

Front 44

symptom groups of schizophrenia

hallucinations, delusions, bizarre behavior,

Back 44

*positive symptoms:

Front 45

symptom groups of schizophrenia

paranoia

Back 45

*positive symptoms:

Front 46

symptom groups of schizophrenia

disorganized speech(associative looseness)

Back 46

*positive symptoms:

Front 47

symptom groups of schizophrenia

-something that is added to what already exists

Back 47

*positive symptoms:

Front 48

symptom groups of schizophrenia

ex: we all hear and see but when you have hallucinations that’s an added sense of hearing or seeing,

Back 48

*positive symptoms:

Front 49

symptom groups of schizophrenia

hallucinations
-what is the most common type?

Back 49

*positive symptoms:

AH: can hear a single voice, many voices, assign name, can hear people in background but can’t hear what they are saying. AH is the most common)

Front 50

symptom groups of schizophrenia

hallucinations is:

Back 50

*positive symptoms:


-hallucinations: perceiving something in the envt that is not there

Front 51

symptom groups of schizophrenia

sensory stimuli that is not real to us, but it is real to the pt

Back 51

hallucinations

+ symptom

Front 52

symptom groups of schizophrenia

perceiving a sensory experience for which no external stimulus exists

Back 52

hallucinations

+ symptom

Front 53

symptom groups of schizophrenia

-types of hallucinations are:
-auditory:
-visual:
-olfactory:
-gustatory:
-tactile:

Back 53

-types of hallucinations are:
-auditory: hearing voices or sounds
-visual: seeing persons or things
-olfactory: smelling odors
-gustatory: experiencing tastes
-tactile: feeling bodily sensations

Front 54

symptom groups of schizophrenia

based on something that’s real in the envt

Back 54

illusion:

positive symptom

Front 55

symptom groups of schizophrenia

-misperceptions or misinterpretations of a real experience

Back 55

illusion:

positive symptom

Front 56

symptom groups of schizophrenia

ex: man see’s his coat on a coat rack and believers it is a bear about to attack (see’s something real but misinterprets what it is)

Back 56

illusion:

positive symptom

Front 57

symptom groups of schizophrenia

-reality testing:
---people with impaired reality testing maintain the error which contributes to ____

Back 57

delusions

Front 58

symptom groups of schizophrenia

what are false fixed beliefs that cannot be correct by reasoning

Back 58

delusions

Front 59

symptom groups of schizophrenia

-most common delusions are

Back 59

persecutory, grandiose, or those involving religious or hypochondriacal ideas

Front 60

symptom groups of schizophrenia

-delusion may be a response to

Back 60

anxiety or reflect areas of concern for a person

Front 61

symptom groups of schizophrenia

-concrete thinking: impaired ability to

Back 61

think abstractly

+

Front 62

symptom groups of schizophrenia

concreteness is often assessed through the pts interpretation of:

Back 62

proverbs “the grass is always
greener on the other side of the fence”

+

Front 63

symptom groups of schizophrenia

-alternations in speech:

Back 63

interruption or illogical, thinking becomes haphazard and illogical, difficult to
follow


+

Front 64

symptom groups of schizophrenia

-Neologisms:

Back 64

made up words that have meaning for the pt but a different or nonexistent meaning to
others

+

Front 65

symptom groups of schizophrenia

-echolalia:

Back 65

repeating of another’s words, often seen in catatonia

+

Front 66

symptom groups of schizophrenia

-echopraxia:

Back 66

mimicking of movements of another, seen in catatonia

+

Front 67

symptom groups of schizophrenia

-clang association:

Back 67

choice of words based on their sound rather than their meaning, often rhyming

+

Front 68

symptom groups of schizophrenia

-word salad:

Back 68

jumble of words that is meaningless to the listener, extreme level of disorganization

+

Front 69

symptom groups of schizophrenia

-depersonalization:

Back 69

nonspecific feeling that a person has lost his or her identity that the self is
different or unreal. people may feel that body parts do not belong to them or may suddenly sense that their body has drastically changed (ex: a pt may see his or her fingers as snakes or her arms as rotting wood)


+

Front 70

symptom groups of schizophrenia

-derealization:

Back 70

false perception that the envt has changed. (ex: everything seems bigger or smaller, or
familiar surroundings are now strange and unfamiliar.

+

Front 71

symptom groups of schizophrenia

-catatonia:

Back 71

pronounced increase or decrease in the rate and amount of movement


+

Front 72

symptom groups of schizophrenia

most common cataonia is:

Back 72

-most common form is stuporous behavior in which the person moves little or not at all


+

Front 73

symptom groups of schizophrenia

-what functioning is less than the norm. if the norm is to have pleasure doing something, the symptom is

Back 73

*negative symptoms- think subtraction

anhedonia

Front 74

symptom groups of schizophrenia

negative symptoms
-develop (fast or slow)
-interfere with a persons (2)

Back 74

*negative symptoms- think subtraction

-develop slowly and interferer with a persons adjustment and ability to cope

Front 75

symptom groups of schizophrenia

-impedes one’s ability to initiate and maintain convos and relationships, maintain a job, make decisions and follow through on plans, maintain adequate hygiene and grooming

Back 75

*negative symptoms- think subtraction

Front 76

symptom groups of schizophrenia

-contribute to poor social functioning and social withdrawal

Back 76

*negative symptoms- think subtraction

Front 77

symptom groups of schizophrenia

apathy

Back 77

*negative symptoms- think subtraction

, lack of motivation

Front 78

symptom groups of schizophrenia

avolition

Back 78

*negative symptoms- think subtraction

reduced motivation, which can lead to inability to initiate ADLS

Front 79

symptom groups of schizophrenia

anhedonia

Back 79

*negative symptoms- think subtraction

inability to experience pleasure or joy (

Front 80

symptom groups of schizophrenia

alogia

Back 80

*negative symptoms- think subtraction

poor/poverty thought processes

Front 81

symptom groups of schizophrenia

blunted affect

Back 81

negative affect

Front 82

symptom groups of schizophrenia

-affective blunting: reduction in the (3)

-in flat affect:
-blunted:
-inappropriate:

Back 82

-affective blunting: reduction in the expression, range, and intensity of affect. in flat affect, no facial expression is present).. blunted-minimal emotional response, inappropriate-man laughs when told his father died,

Front 83

symptom groups of schizophrenia

-anergia:

Back 83

lack of energy, passivity, lack of persistence at work/school

NEGATIVE

Front 84

symptom groups of schizophrenia

which is worse:
positive or negative symptoms??

Back 84

-negative symptoms are worse than positive because they render the person inert and can cause them to be unmotivated (positive symptoms can be treated with antipsychotics)

Front 85

symptom groups of schizophrenia

-abnormalities in how a person thinks

Back 85

Cognitive symptoms:

Front 86

symptom groups of schizophrenia

-involve difficulty with attention and memory

Back 86

Cognitive symptoms:

Front 87

symptom groups of schizophrenia

difficulty with information processing

Back 87

Cognitive symptoms:

Front 88

symptom groups of schizophrenia

difficuulty with executive functions (decision making, judgement, planning, problem solving)

Back 88

Cognitive symptoms:

Front 89

symptom groups of schizophrenia

-symptoms involving emotions and their expression

Back 89

affective symptoms:

Front 90

symptom groups of schizophrenia

-ex: inattention, easily distracted, impaired memory

Back 90

Cognitive symptoms:

Front 91

symptom groups of schizophrenia


ex: poor problem-solving skills, poor-decision making skills

Back 91

Cognitive symptoms:

Front 92

symptom groups of schizophrenia

ex: illogical thinking, impaired judgment

Back 92

Cognitive symptoms:

Front 93

symptom groups of schizophrenia

-symptoms involving emotions and their expression

Back 93

Affective symptoms

Front 94

symptom groups of schizophrenia

ex: dysphoria

Back 94

Affective symptoms

Front 95

symptom groups of schizophrenia

ex: suicidality

Back 95

Affective symptoms

Front 96

symptom groups of schizophrenia


ex: hopelessness

Back 96

Affective symptoms

Front 97

symptom groups of schizophrenia

ex: increased substance abuse, impending relapse

Back 97

Affective symptoms

Front 98

schizophrenia

outcomes should focus on what:

what should the outcomes be consistent with?

Back 98

focus on enhancing strengths and minimizing the effects of the pts deficits and symptoms

- the recovery model, which stresses hope, living a full and productive life

Front 99

schizophrenia

-what is a good coping technique

Back 99

distraction
(listening to music, reading, watching TV)

(keeps mind off voices) –know interventions and teachings

Front 100

delusions
-come from what?
-correlated with?

Back 100

-come from a real lived experienced
-correlation with anxiety (keep anxiety low)

Front 101

Delusions
-may be the pts attempt to understand (2)

Back 101

confusion and distorted experience.

Front 102

Delusions
-what should the nurse do (intervention)

what do they rely on?
what should they focus on?

Back 102

-rely on empathy


focus on what the pt is feeling

Front 103

Delusions
-do not focus on:

Back 103

-do not focus on content, don’t argue,

Front 104

-Delusions
-whatshould the nurse do (interevention)

Back 104

-distract them with reality based activities (noncompetitive exercise)

Front 105

communication with pts w/ delusions

-focus on what?

Back 105

-focus on feelings that the delusions cause and convey empathy about the pts fearfulness, labels the pts feelings so they can be explored as tolerated

Front 106

communication with pts w/ delusions

-what is their thinking level?

Back 106

-concrete thinking/level

Front 107

Speech:
-many different kinds of alternations in speech with schizophrenia

-how they speak is reflective of what?

Back 107

what’s going on in their mind/thought process

Front 108

schizophrenia

-most common speech patterns are (2)

Back 108

associative looseness (ideas / thoughts are not related)

flight of ideas (jumping from topic to topic)

Front 109

schizophrenia

an increase in associative looseness indicates that

Back 109

the pt is feeling increased anxiety or overwhelmed by internal and external stimuli

Front 110

associative looseness / flight of ideas

-do not pretend you understand the pts words or meaning, instead:

Back 110

tell the pt u r having difficulty understanding

-place the difficulty in understand n yourself NOT on the pt “im having trouble following what you are saying” do not say “your not making sense”

Front 111

associative looseness / flight of ideas

-look for (2)

Back 111

recurring topics and themes in the pts communications and tie these to events and timelines

Front 112

*negative symptoms*

-all words begin with :

Back 112

a and a means “without”

Front 113

*negative symptoms*
-responds to which type of antipsychotics?

Back 113

-traditionally , poor response to old fashion or conventional antipsychotics (they do respond to the newer antipsychotics)

Front 114

*negative or positive symptoms*

-hardest to reat

Back 114

negative

Front 115

*negative or positive symptoms*


-cause most decline in functioning

Back 115

negative

Front 116

*negative or positive symptoms*

-cause a lot of suffering for pt

Back 116

negative

Front 117

Milieu and schizophrenia

-provides what 2 things

Back 117

provides
1) protection from stressful or disruptive envts
2) structure –shows greater improvements


-structure structure structure –the better they function (happens through programs and activities)

Front 118

Counseling and communication techniques (schizophrenia)

-what is the aim??

-what do you want to build?
-encourage what?
-decrease what?
-encourage what?
-enhance?
-reinforce what kind of skills? (2)

Back 118

-aim to lower the pts anxiety,

-build trust
-encourage clear communication by the pt,
-decrease defensiveness,
-encourage interaction,
-enhance self-esteem,
-and reinforce skills (reality testing and assertiveness)

Front 119

Counseling and communication techniques (schizophrenia)

(long or frequent interactions)

Back 119

-shorter but more frequent interactions may be more therapeutic

Front 120

Health teaching and health promotion (schizophrenia)

-teach family what (2)

Back 120

how stress and medication effect the illness

Front 121

Health teaching and health promotion (schizophrenia)

-key thing:

Back 121

teach signs of impending relapse and the fact that going off medication invites relapse and how to manage those symptoms (what you should do if relapse is starting to occur—Call dr)


impending relapse:
-feeling tense
-difficulity concentration
-difficulty sleeping
-increased withdrawal
-increased bizzare though or magical behavior

Front 122

Health teaching and health promotion (schizophrenia)


-talking about the enviornment where the pt can function the highest

Back 122

(it’s a structured envt with a routine schedule, it’s also a low stimuli envt ---the more expressed emotion in the home the worse the person does (the more conflict, yelling, even if it’s positive emotion)

Front 123

people with schizophrenia will have repeated hospitalization over the course –

goal:

Back 123

people live in the community

Front 124

Pharmacological

-antipsychotic medications: take effect when?

Back 124

2-6 weeks after the regimen is strated

Front 125

Pharmacological -antipsychotic medications

-3 serious and potentially fatal effects of antipsychotic drugs?

Back 125

neuroleptic malignant syndrome

agranulocytosis ((immune system is compromised and you develop symptoms of infections –sore throat or fever)

liver impairment

Front 126

Pharmacological/antipsychotic

(the newer ones)

Back 126

-atypical/second generation antipsychotics

Front 127

Pharmacological/antipsychotic

-second generation

Back 127

atypical/

Front 128

Pharmacological/antipsychotic

atypical/second generation
-what 2 neurotransmitters are affected?

Back 128

-serotonin and dopamine antagonists

Front 129

Pharmacological/antipsychotic

-considered 1st line treatment b/c they have a lower side effect profile

Back 129

atypical

Front 130

Pharmacological/antipsychotic

they treat the positive and the negative symptoms

Back 130

atypical

Front 131

why do atypical antipsychotics treat negative symptoms?

Back 131

they treat the negative symptoms is b/c they affect serotonin (serotonin is related to depression) asociality, blunted affect, lack of motivation

Front 132

antipsychotics

-have minimal EPS or tardive dyskinesia so there is better compliance and adherence

Back 132

atypical

Front 133

antipsychotics

-main problem: Clozapine

-pts education, what do they have to have done??

-what does it increase the risk for:

Back 133

atypical

agranulocytosis

– pts must have weekly white blood cell counts for the first 6 months and then frequent monitoring thereafter, to obtain the medication)

increases risk for seizures

Front 134

antipsychotics

-disadvantage?

-increased risk for (3)

Back 134

disadvantage : metabolic syndrome (weight gain, altered lipid levels, and altered glucose levels)

so you have an increase risk for diabetes, hypertension, and cardiovascular disease

-more expensive (hundreds of $)

Front 135

antipsychotics

conventional
-what neurotransmitter is affected

Back 135

-traditional dopamine antagonists

Front 136

antipsychotics

-effective against positive symptoms only

Back 136

conventional

-they don’t affect serotonin at all and that’s why they don’t help the negative symptoms

Front 137

antipsychotics

-very effective for positive symptoms (hallucinations, delusions, disordered thinking)

Back 137

conventional

Front 138

antipsychotics

-se of conventional: antichoinergic

Back 138

conventional


blurred vision,
urinary retention,
reduced peristalsis = constipation,
dilated pupils,
dry mucous membranes,

leading to........cognitive impairment

Front 139

antipsychotics

-directly affect BP (hypotension, orthostatic), lower seizure threshold

Back 139

conventional

Front 140

antipsychotics

-chlorpromazine (Thorazine)

Back 140

conventional

is the most sedating agent and has fewer EPSs than do other antipsychotic agents but it causes significant hypotension

Front 141

antipsychotics

Haloperidol (Haldol)

Back 141

-conventional

is less sedating and induces less hypotension but has a high incidence of EPS(good for positive symptoms)

Front 142

common EPS are:

sustained contraction of muscles, usually of head and neck

Back 142

acute dystonia

Front 143

-3 common EPS are:

-akathisia

Back 143

(psychomotor restlessness evident as pacing or fidgeting

Front 144

-3 common EPS are:

pseudoparkinsonism
-what is this caused by?
-characteristics?

Back 144

- medication induced, tremor,


reduced accessory movements,
impaired gait,
stiffening of muscles

Front 145

-tardive dyskinesia

when does it appear?

what are the characteristics?

Back 145

is a persistent EPS that appears after prolonged treatment and persists after medication has been discontinued

-involves tonic muscular contractions of the tongue, fingers, toes, neck, trunk, or pelvis

Front 146

EPS
-can be minimized by

Back 146

lowering dosages and/or adding antiparkinsonian drugs anticholinergic drugs

Benztropine (Cogentin) and Diphenhydramine hydrochloride (Benadryl)

Front 147

-lorazepam (Benzodiazepine) may be helpful in reducing what EPS symptom?

Back 147

akathisia

Front 148

EPS

contraction of discrete muscle groups (spasms), very frightening experience for pt (eyes rolling back, airway is compromised)

Back 148

acute dystonia

Front 149

EPS

acute dystonia
-what culture group is at risk?

Back 149

-young asian males are at higher risk

Front 150

EPS

acute dystonia
-treatment:

Back 150

take person to quiet area, then give them medication (Benadryl is 1st choice IM route, you want immediate effect to get them out) Benztropine

Front 151

EPS

internal restless that is so severe that a person can’t sit still, they feel like their inside is jumping out,

Back 151

akathisia

Front 152

EPS

main cause of people going off medication

Back 152

akathisia

Front 153

EPS

akathisia
-treatment:

Back 153

-treatment: decrease antipsychotic (give benztropine, benzodiazepines might help)

Front 154

EPS

-shuffling gait
-pill rolling
-mask like face

Back 154

pseudoparkinsonism

Front 155

EPS

pseudoparkinsonism
-treatment:

Back 155

treatment: medication, antichoinergic *Benztropine (Cogentin)

Front 156

EPS

late appearing problem

Back 156

Tardive dyskinesia

Front 157

EPS

-irreversible
-involuntary movements
-bigger than a tick

Back 157

Tardive dyskinesia

Front 158

EPS

-caused by all antipsychotic but more pronounced with conventional

Back 158

Tardive dyskinesia

Front 159

EPS

the AIMS scale
-what does it stand for?
-what is it a test for?
-what does it examine?

Back 159

Abnormal Involuntary Movement Scale
- which is a brief test for the detection or tardive dyskinesia and other involuntary movements.

it examines facial, oral, extremity, and trunk movement

Front 160

cardinal symptoms of neuroleptic malignant syndrome

Back 160

severe EPS, muscle rigidity, fever over 103 (hyperpyrexia) , autonomic dysfunction (all your vitals are elevated, sweating, HR and RR are up)

Front 161

neuroleptic malignant syndrome

-treatment:

Back 161

stop neuroleptic (don’t give anymore antipsychotic)

and

then treat symptoms (dehydration or electrolyte imbalance)

Front 162

neuroleptic malignant syndrome

-occurs if people take what kind of drugs?

-what neurotransmitter plays a role in the development?

Back 162

conventional and atypical antipsychotics


acute reduction in brain dopamine activity plays a role in it’s development

Front 163

neuroleptic malignant syndrome

-characterized by:

Back 163

reduced consciousness

increased muscle tone (muscular rigitidity)

autonomtic dysfunction (hyperpyrexia, labile hypertension, tachycardia, diaphoresis, drooling)


"AIR"

Front 164

neuroleptic malignant syndrome

-treatment:

Back 164

-treatment: early detection, discontinuation of the antipsychotic, management of fluid balance, temp reduction
-can be treated with bromocriptine (Parlodel) for mild cases and severe cases can be treated with dantrolene (Dantrium) and even with ECT

Front 165

3 adjuncts to antipsychotics

antimanic (mood stabilizing) agents
-what have they been found to enhance?

-what are they used to treat?

Back 165

- have been found to enhance the effectiveness of antipsychotics

-mood stabilizers to treat mood swings (esp in schizoaffective)

Front 166

3 adjuncts to antipsychotics

-anti depressants--- are recommended along with antipsychotic agents for the treatment of:

Back 166

depression which is common in schizophrenia

Front 167

3 adjuncts to antipsychotics

-benzodiazepines help people

Back 167

sleep but mainly to reduce agitation (calm you) , reduce anxiety and agitation and contribute to improvement in + and – symptoms

Front 168

-paranoia

most common defense mechanism used is:

Back 168

-projection

Front 169

paranoia

-the paranoia is often a defense against

Back 169

painful feelings of loneliness, despair, helplessness, and fear of abandonment

Front 170

paranoia

-focus on

Back 170

reducing the pts anxiety and fear and not be defensive or make reactions or rejections towards the patient

Front 171

paranoia
-what can they nurse do to help decrease anxiety?

-what should the nures do to establish trust?

Back 171

-activities that distract the pt from ruminating on paranoid themes helps decrease anxiety
- regular brief contact to help establish trust

Front 172

-catatonia in withdrawn phase

-essential feature is

-when providing care, the nurse can assume that what needs will take priority?

Back 172

abnormal levels of motor behavior (either extreme agitation or retardation)

–think of someone in vegatative state (physical needs take priority including skin care)

Front 173

-catatonia excited phasse-

-person is in a stage of

Back 173

greatly increase motor activity

Front 174

-catatonia excited phase-

during heightened physical activity, the pt requires stimulation reduction and additional

Back 174

fluids, calories, and rest


- physical needs take priority (Nutrition and rest)

Front 175

-disorganized schizophrenia

they need help with day to day living, ADLs, and need to be in structured envt

Back 175

disorganized schizophrenia

Front 176

-disorganized schizophrenia

-major communication problems, so repeated refocusing may be needed to help keep the pt on topic or to allow task completion

Back 176

disorganized schizophrenia

Front 177

-cognition, memory, and executive function are grossly impaired, the pt is frequently too
-disorganized to carry out simple activities of daily living

Back 177

disorganized schizophrenia

Front 178

-grooming is neglected
-hair is often dirty and matted
-cloths are unclean and often inappropriate for the weather

examples of what kind of schizophrenia???

Back 178

disorganized schizophrenia