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100 Cards in this Set
- Front
- Back
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Schizophrenia
Content of Thought symptoms |
Delusions
Religiosity Paranoia Magical thinking |
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Schizophrenia
Form of Thought symptoms |
Associative looseness
Neologisms Concrete thinking Clang associations Word salad Circumstantiality Tangentiality Mutism Perserveration |
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Schizophrenia
Perception symptoms |
Hallucinations
Illusions |
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Schizophrenia
Sense of self symptoms |
Echolalia
Echopraxia Identification and imitation Depersonalization |
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Schizophrenia
Affect symptoms |
Inappropriate affect
Bland of flat affect Apathy |
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Schizophrenia
Volition symptoms |
Inability to initiate goal-directed activity
Emotional ambivalence |
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Schizophrenia
Impaired interpersonal functioning and relationship to the outside word symptoms |
Autism
Deteriorated appearance |
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Schizophrenia
Psychomotor behavior symptoms |
Anergia
Waxy flexibility Posturing Pacing and rocking |
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Schizophrenia
Associated featers symptoms |
Anhedonia
Regression |
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Schizophrenia
Positive symptom categories |
content of thought
form of thought perception sense of self |
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Schizophrenia
Negative Symptom categories |
affect
volition impaired personal functioning --and relationship to the external world psychomotor behavior associated features |
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Antipsychotic drug side effects
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anticholinergic effects / nausea
skin rash / sedation orthostatic hypotension / photosensitivity hormonal effects / ECG changes reduced seizure threshold / agranulocytosis hypersalivation / EPS tardive dyskinesia / NMS hyperglycemia / increased risk of mortality in elderly patients with dementia-related psychosis |
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Anticholinergic effects
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dry mouth
blurred vision constipation urinary retention |
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Hormonal effects
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decreased libido
amenorrhea weight gain |
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EPS effects
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pseudoparkinsonism
akinesia akathisia dystonia oculogyric crisis |
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Dry mouth interventions
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*sugarless candy, gum, ice, frequent sips of water
*strict oral hygiene |
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Blurred vision interventions
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*symptoms will most likely subside after a few weeks
*do not drive car until vision clears *clear small items from pathway |
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Constipation interventions
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*order foods high in fiber
*increased physical activity *increased fluid intake |
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Urinary retention interventions
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*report any difficulty urinating
*monitor I&O |
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Nausea interventions
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*tabs or caps may be administered /c food to minimize GI upset
*concentrates may be diluted and administered with fruit juice or other liquid; they should be mixed immediately before admin |
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Skin rash interventions
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*report appearance of any rash to physician
*avoid spilling any liquid concentrate on skin |
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Sedation interventions
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*discuss /c physician administering the drug HS
*discuss /c physician decrease in dosage or change to less sedating drug *do not drive or operate dangerous equipment while sedated |
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Orthostatic hypotension interventions
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*rise slowly from lying or sitting position
*monitor BP (lying and standing q shift) |
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Photosensitivity interventions
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*wear sunblock,protective clothing, and sunglasses while outdoors
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Hormonal Effects
Decreased libido interventions |
*explain effects
*reassure of reversibility *discuss alternate med /c physician |
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Hormonal Effects
Amenorrhea interventions |
*reassurance of reversibility
*continue use of contraception |
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Hormonal Effects
Weight gain interventions |
*weight client every other day
*order calorie controlled diet *provide opportunity for physical exercise *provide diet and exercise instruction |
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ECG changes interventions
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*monitor vital signs q shift
*observe for symptoms of dizziness, palpitations, syncope, weakness, dyspnea, and peripheral edema |
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Reduced seizure threshold interventions
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*closely observe client /c a history of seizures
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Agranulocytosis interventions
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*observe for symptoms of sore throat, fever, malaise
*usually occurs within 1st 3 months of treatment *CBC done if symptoms arise |
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For which drug is there a significant risk of agranulocytosis?
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clozapine (Clozaril)
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What are the WBC and ANC (absolute neutrophil count) thresholds for agranulocytosis?
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WBC: 3,500
ANC: 2,000 |
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Hypersalivation intervention
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*offer support (may be embarrasing)
*sugar free gum to increase swallow rate *anticholinergic admin |
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EPS
Pseudoparkinsonism characteristics |
*tremor, shuffling gait, drooling, rigidity
*may appear 1-5 days after initiation of med therapy |
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EPS
Akinesia characteristics |
*muscular weakness)
*may appear 1-5 days after initiation of med therapy |
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EPS
Akathisia characteristics |
*continuous restlessness and fidgeting
*occurs most frequently in women *symptoms may occur 50-60 days after initiation of therapy |
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EPS
Dystonia characteristics |
*spasms of the face, arms, legs, and neck
*occurs most often in men and people younger than 25 *emergency situation |
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EPS
Oculogyric crisis characteristics |
*uncontrolled rolling back of eyes
*may occur as part of dystonia *emergency situation *administer Cogentin *stay /c client *give reassurance and support |
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Tardive dyskinesia characteristics
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*bizarre facial and tongue movements, stiff neck, and difficulty swallowing
*most common with typical antipsychotics *all clients receiving long-term antipsychotics are at risk *symptoms potentially irreversible *withdraw drug at first sign *first sign is usually vermiform movements of the tongue |
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NMS characteristics
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*rare, potentially fatal
*monitor temp and for parkinsonian symptoms *onset can occur within hours or years after therapy initiation *progresses rapidly over 24-72 hours *sever rigidity, fever, tachycardia, tachypnea, fluctuating BP, diaphoresis, deterioration of mental status, stupor, coma *discontinue neuroleptic meds immediately *monitor VS, rigidity, I&O, LOC *physician may order Dantrium to counteract |
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Name 3 typical antipsychotic drugs.
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chlorpromazine (Thorazine)
haloperidol (Haldol) fluphenazine (Prolixin) |
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Name 5 atypical antipsychotic drugs.
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aripiprazole (Abilify)
clozapine (Clozaril) olanzapine (Zyprexa) risperadone (Risperdal) ziprasidone (Geodon) |
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Drug that blocks cholinergic activity in the CNS?
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benzotropine (Cogentin)
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Name 5 benzodiazepines.
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chlordiazepoxide (Librium)
alprazalom (Xanex) diazepam (Valium) lorazepam (Ativan) clonazepam (Klonopin) |
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Antidepressant with delayed effects that does not cause dependence.
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buspirone (Buspar)
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What are the 4 phases of schizophrenia?
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premorbid phase
prodromal phase schizophrenia residual phase |
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The charisteric symptoms of schizophrenia include?
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delusions
hallucinations disorganized speech grossly disorganized or catatonic behavior negative symptoms |
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What are delusions? What are some common delusions?
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false personal beliefs
persecution grandeur reference control or influence somatic nihilistic |
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What is religiosity?
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Escessive demonstration of or obsession with religious ideas and behavior.
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Describe paranoia.
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extreme suspicion of others and of their actions or perceived intentions
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What is magical thinking?
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when someone believes that their thoughts or behaviors have control over specific situations or people
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Describe associated looseness.
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thinking characterized by speech in which ideas shift from one unrelated subject to another
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What are neologisms?
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invented words that are meaningless to others but have symbolic meaning to the psychotic person
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What is concrete thinking?
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literal interpretation of the environment that represents a regression to an earlier level of cognitive development
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What are clang associations?
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word combinations that are governed by sounds, like rhyming
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Describe word salad.
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a group of words put together randomly, without any logical connection
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What is circumstantiality?
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when an individual delays in reaching the point of a communication because of tedious details, though the goal is usally met after numerous interruptions
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What is tangentiality?
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when unrelated topics are introduced into communication causing the point of the communication to never be reached
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Describe mutism.
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an individual's inability or refusal to speak
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What is perserveration?
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when someone persistently repeats the same word or idea in response to different questions
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What neurotransmitter is associated with negative symptoms? What category of antipsychotics is typically used to treat these symptoms?
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seratonin
atypical |
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What neurotransmitter is associated with positive symptoms? What category of antipsychotics is typically used to treat these symptoms?
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dopamine
typical |
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What is the difference between hallucinations and illusions?
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hallucinations are false sensory perceptions not associated with real external stimuli whereas illusions are misperceptions or mininterpretations of real esternal stimuli
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What is echolalia?
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when a client repeats words that they hear in an attempt to identify with the person speaking
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What is echopraxia?
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when a patient purposefully movements made by others
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Describe identification and imitation.
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identification occurs unconciously and imitation happens conciously
ego defense mechanisms |
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What is depersonalization?
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feelings of unreality caused by the unstable self-identity of an individual with schizophrenia
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Describe inappropriate affect.
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when a person's emotional tone is incongruent with the circumstances
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What is apathy?
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an indifference or disinterest in the environment, bland or flat affect is a manifestation of apathy.
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Describe emotional ambivalence.
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the coexistence of opposite emotions toward the same object, person, or situation.
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Describe autism as experienced by schizophrenic patient.
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the condition created by a person who focuses inward on a fantasy world while excluding or distorting the external environment
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What is anergia?
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a deficiency of energy
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Describe waxy flexibility.
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a condition in which the client allows body parts to be placed in bizarre or uncomfortable positions, the body part remains in that position for long periods regardless of discomfort
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What is posturing?
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voluntary assumption of inappropriate or bizarre postures
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Describe anhedonia.
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inability to experience pleasure
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Describe the dopamine hypothesis.
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schizophrenia or schizophrenia-like symptoms may be caused by an excess of dopamine-dependent neuronal activity in the brain
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Characteristics of catatonic schizophrenia.
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catatonic stupor: extreme psychomotor retardation, muteness, posturing
catatonic excitement: extreme psychomotor agitation, purposeless movements |
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Characteristics of paranoid schizophrenia.
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delusions of persecution or grandeur, auditory hallucinations, may be aggressive, hostile or argumentative
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When is a diagnosis of undifferentiated schizophrenia used?
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when a person has a history of at least one episode of schizophrenia that doesn't fit other classes
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Characteristics of schizoaffective disorder.
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schizophrenic symptoms accompanied by an element of mood disorders, either manic or depressive
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Characteristics of a brief psychotic disorder.
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sudden onset of psychotic symptoms following a severe psychosocial stressor
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What is schizophreniform disorder?
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duration of disorder is at least 1 month but less than 6 months, waiting to see if it's actually schizophrenia
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Characteristics of delusional schizophrenia.
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prominent non-bizarre delusions
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Delusional schizophrenia
name 5 types |
erotomanic type
grandiose jealous persecutory somatic |
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Characteristics of shared psychotic disorder.
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delusional system develops in a second person as a result of a close relationship with a person who already has
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Describe social skills training.
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use of role play to teach client appropriate eye contact, interpersonal skills, voice intonation, posture, etc., aimed at improving social functioning
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Typical antipsychotic meds act on the CNS how?
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dopamine blocking with various affinities for cholinergic, a-adrenergic, and histamine receptors
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Atypical antipsychotic usually act on the CNS how?
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weak dopamine blocker, potent serotonin blocker, some antagonism of cholinergic, histamine, and adrenergic receptors
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Stress is an?
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external pressure brought to bear on an individual
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Anxiety is an?
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emotional response to a stressor, it provides motivation for achievement, and is necessary for survival
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Fear is?
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cognitive, an alteration in thinking pattern
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Anxiety is abnormal when?
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it is out of proportion to the situation causing it, and when it interferes with social, occupational, or other areas of functioning
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Panic disorder is described as?
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recurrent, unpredictable panic attacks characterized by intense apprehension, fear, terror, feelings of impending doom, or intense physical discomfort
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A patient with panic disorder accompanied by agoraphobia will also experience?
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fear of being in places or situations from which escape may be difficult or embarassing
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Generalized Anxiety Disorder is characterized by?
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chronic, unrealistic, excessive anxiety/worry
symptoms experienced for at least 6 months restlessness, irritability, difficulty concentrating, muscle tension, sleep difficulty, dizziness, tachycardia, CP, sweating, tremor |
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Obessions are?
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unwanted, persistent ideas, thoughts, impulses or images that cause marked anxiety
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Compulsions are?
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unwanted repetitive behavior patterns or mental acts
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The 4 stages of the OCD cycle are?
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obsession
anxiety compulsion relief |
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Patient/family education for a patient with anxiety/OCD/PTSD should include?
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what the disorder is
management techniques, meds, length of recovery time, what to expect from meds stress management & relaxation techniques support services (groups, hotlines, individual therapy, cognitive therapy, behavior therapy) |
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Name two types of behavior therapy. Describe them.
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systematic desensitization: client is gradually exposed to phobic stimulus, either in a real or imagined situation
imposion therapy or flooding: client must imagine situations or participate in real-life situations that he or she finds extremely frightening for a prolonged period of time |
