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67 Cards in this Set
- Front
- Back
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Schizophrenia is a ___________ disease. It affect’s a person’s perceptions, thinking, language, emotion, volition, and behavior. It is considered a ________ disorder.
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neurological
psychotic |
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Do schizophrenic symptoms generally lessen with the elderly?
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Yes
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Can people overcome schizophrenia with out lasting side effects?
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VERY RARE
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Does schizophrenia affect motivation
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Yes, very much
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Why is schizophrenia considered a psychotic disorder?
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Because pts are often out of touch with reality due to delusions, hallucinations, or other indicators of brain disorganization
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What are command hallucinations?
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auditory hallucinations- voices telling them to kill, hurt, etc... extremely dangerous.
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Is schizophrenia found only in certain populations?
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No the disease is found world wide
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Are Male or female fore affected by schizophrenia?
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Slightly more men than women are affected
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At what age range does schizophrenia usually come on?
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adolescence through early 30s
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15-25 onset
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associated more with males who have poor pre-morbid (pre-illness) functioning, more negative symptoms, and more structural damage to the brain. They tend to have poorer outcomes from the disease. Men get it earlier.
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25-35 onset
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associated more with females who have with better pre-morbid functioning, fewer structural problems, and better outcomes.
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Why do women develop more side effects from schizophrenia medications?
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due to fat binding properties causing the drugs to have longer half-lives. Losing weight causes more medication to be released.
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Can schizophrenia be a result of bad parenting?
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No- there is a strong biological component- nature over nurture.
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What 2 neurotransmitters are involved with this disease?
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dopamine and serotonin.
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3 risk factors?
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Age of father, intrauterine (mother exposed to a virus while prego and preclampsia), and also genetics (if parent has disease more likely)
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“Two Hit” theory
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genetically vulnerable individuals who then suffer stressors develop the disease.
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Most common type of schizophrenia?
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Paranoid schizophrenia
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Schizophrenia is divided into 5 subtypes
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paranoid, catatonic, disorganized, undifferentiated, and residua
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Paranoid schizophrenia
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characterized by well developed paranoid hallucinations and delusions. No disorganized speech or behavior is noted. The client usually presents as intensely suspicious, guarded, tense, and frightened.
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Catatonic schizophrenia
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Extreme abnormal motor behaviors. Both extreme motor agitation and extreme psychomotor retardation may be seen. Limbs may have waxy flexibility
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waxy flexibility
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can position persons arm up and it will remain there until someone puts their arm down for them.
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Disorganized schizophrenia
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Most severely impaired! Disorganized speech and behavior, and odd mannerisms.
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Undifferentiated schizophrenia
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has a little bit of this and a little but of that:
This type has active positive symptoms but no single clinical presentation is apparent making classification difficult. |
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Positive symptoms
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Added symptoms. Delusions, Hallucinations, Bizarre behavior, Alterations of speech.
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neologisms
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made up words
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echolalia
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repeating other person
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clang associations
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rhyme more than meaning
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Delusions
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these are false, fixed beliefs
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Negative Symptoms
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Absence of something that should be there.
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Alogia
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poverty of speech
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Avolition
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loss of motivation
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Anhedonia
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loss of pleasure
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Anergia
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loss of energy
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Cognitive Symptoms
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Impaired memory, problem solving, decision making, attn/conc, insight/judgement
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anosognosia
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Impaired insight and judgment
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Affective symptoms
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Depression and suicide, hopelessness
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These are the symptoms that get people’s attention and often result in hospitalization.
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Positive Symptoms
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These are the symptoms which most interfere with a person’s ability to function in society.
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Negative Symptoms
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These symptoms make it difficult for clients to work and to make good choices for self-care.
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Cognitive Symptoms
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These symptoms are emotional reactions to the difficulty of leaving with schizophrenia.
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Affective Symptoms
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Water intoxication
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3-6% of hospitalized clients will experience a poly dipsia which can lead to cerebral edema, seizures, and even death. It is thought to be medication induced due to an inappropriate secretion of antidiuretic hormone
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______ are the #1 factor in recovery from an acute episode of schizophrenia.
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Drugs
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Typical antipsychotic drugs work by...
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blocking the neurotransmitter dopamine at the post-synaptic cell site.
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Do Typical antipsychotic drugs have many s/e?
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Yes- They have a very high side effect profile from dry mouth to neuroleptic malignant syndrome
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Typical anti-psychotic drugs handle the what symptoms?
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Positive
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A-typical antipsychotics handle what symptoms?
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Positive and negative
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The most common and troublesome side effects are the of typical antipsychotics are...
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anti-cholinergic and extrapyramidal side effects.
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The extrapyramidal side effects (EPS) come from...
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blocking dopamine in the parts of the brain related to movement.
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Pseudoparkinsonisms
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shuffling gait, stiff/stooped posture, drooling, tremor
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Akathisia
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inner driven restlessness – tapping foot, pacing
Acute dystonic reaction (emergency) = the client is “frozen” by acute contractions of the tongue, face, neck, and back. Benadryl or Cogentin are given IV to correct the problem |
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Tardive dykinesia
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constant movement of part of the body, often the mouth (tongue thrusting and lip smacking). Must discontinue offending drug, but it may not resolve even then.
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AIMS
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The Abnormal Involuntary Movement Scale- is designed to assess the degree of involuntary movement present in client
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What is the life threatening possible s/e of Clozaril?
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Agranulocytosis (low WBC)
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What are some s-typical antidepressants?
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ZYPREXA and Clozaril!!! also Abilify, Seroquel, Risperdal, Geodon
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A rare but potentially fatal side effect from typical antipsychotics is....
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Neuroleptic Malignant Syndrome. It is characterized by severe EPS, hyperpyrexia, and hypertension. It is considered a medical emergency, and the client needs to be monitored on a medical unit.
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Decanoate
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IM oil based version of antipsychotics that stays in system for 2-4 weeks- Haldol or Prolaxin,
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Cocktail contains...
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Haldol, Ativan, Cogentin
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what to monitor pts for when taking a-typical antipsychotics?
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Metabolic Syndrome = weight gain, dyslipidemia, and increased blood glucose.
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Geodon may cause ___ ____ ____.
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cardiac conduction changes
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Depersonalization
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nonspecific feeling that a person has lost their identity
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Dystonia
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sustained contraction of muscles usually head or neck, give Benadryl
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Echopraxia
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mimicking movements
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Grandiosity
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exaggerated belief in or claims about ones importance
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Ideas of reference
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believes things are in reference to themselves
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Latency of response
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long duration between responses
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Illusion
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misperceptions or misinterpretations of a real experience
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Paranoia
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any intense and strongly defended irrational suspicion
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