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71 Cards in this Set
- Front
- Back
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A group of psychotic disorders that are characterized by distortions of reality, withdrawal from social interactions and disorganization of perception, thought and emotion.
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Schizophrenias
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Genetic predisposition toward schizophrenia?
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Yes
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Concordance of schizophrenia in identical twins:
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38% - 86%
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Concordance of schizophrenia in fraternal twins:
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10% - 14%
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Chance of exhibiting schizophrenia for a child of one schizophrenic parent:
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16.4%
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Chance of exhibiting schizophrenia for a child of two schizophrenic parents:
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38% - 68%
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Prenatal and perinatal influences as possible explanations for schizophrenia:
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Impaired fetal oxygen supply, and first trimester endocrine and toxic substances across the placental barrier
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Biogenic amine hypothesis for schizophrenia
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Involves decreased dopamine conversion (to norepinephrine), decreased dopamine degradation and increased dopamine receptor sites,
*all about too much dopamine |
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Psychosocial factors in schizophrenia are
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Considered passe, but include:
early trauma and increased vulnerability maladaptive parent-child and family interactions maladapitive learning and coping with stress |
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Schizophrenic affect/mood:
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Blunted, flat or incongruent with emotional content
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Schizophrenic speech:
Neologisms |
New words are formed to express an idea
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Schizophrenic speech:
Echolalia |
Repeating what someone else said
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Schizophrenic speech:
Word salad |
Sarah Palin
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Schizophrenic speech:
Loose associations |
Verbalizing a connection between unrelated ideas
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Schizophrenic thought processes:
Delusions |
Irrational beliefs
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Schizophrenic thought processes:
Persecutory delusions |
Believing that others are spying on or planning to harm you
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Schizophrenic thought processes:
Thought fragmentation |
Losing track of or blocking thoughts
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Schizophrenic thought processes:
Autistic thinking |
Impaired ability to perceive self as seperate from others or to distinguish internal stimuli form external stimuli
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Schizophrenic thought processes:
Magical thinking |
Thinking = Doing
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Schizophrenic thought processes:
Delusions of reference |
Belief that events objects or other people are significant to the individual, usually of a negative nature
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Schizophrenic thought processes:
Thought broadcasting |
Belief that ones thoughts can be heard by others
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Schizophrenic thought processes:
Thought insertion |
Belief that thoughts that are not one's own are inserted into one's mind
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Schizophrenic thought processes:
Profound ambivalance |
Mixed feelings associated with significant relationships
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Bizzare body sensations
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Somatic Hallucinations
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Schizophrenic sense of self:
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Confusion regarding sexual identity
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Schizophrenic volition:
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Disruption of goal directed activity (i.e. Hygine)
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Schizophrenic relationship to outside world
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Social withdrawal; disorganization of a previous level of functioning
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Group of psychological disorders in which the client experiences physical symptoms with no organic or pathologic basis
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Somatoform disorders
*More common in women, symptoms usually appear in adolesence |
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Primary gain of a somatoform disorder:
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Blocking of psychological conflict or anxiety from conscious awareness
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Secondary gain of a somatoform disorder:
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Keeps patients from expected responsibilities and provides a means of obtaining attention
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Altering self-awareness in order to escape an upsetting event (i.e. severe physical/sexual abuse)
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Dissociative disorders
*i.e. out-of-body experience to buffer psychological/physical pain |
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Defense mechanism of dissociative disorders:
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Dissociation
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NSG assessment for anorexia nervosa:
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25% of original body weight loss
Refusal to maintain normal weight for height/age No known physical illness to account for loss Intense fear of becoming fat Alteration in body image |
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Physical appearance of anorexia nervosa:
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Lanugo
Yellow tinge Dry hair which may fall out |
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Physiology of anorexia nervosa:
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Amenorrhea
Decreased pulse Decreased temp Constipation Loss of appetite |
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Mood of pt with anorexia nervosa:
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Anxious when discussing weight
Difficulty identifying feelings Fearful for becoming fat Quiet after eating Seperation Anxiety |
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Characteristic interaction patterns of anorexic families:
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Enmeshment
Overprotectiveness Rigidity Confilct avoidance |
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Anorexia is less frequent in males because:
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> emphasis on muscle development than slimness
Later entry into adolescence (more prone to act out than to internalize) |
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NSG Interventions for eating disorders:
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Contracting with limit setting
Support establishment of realistic ecpectations |
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Behaviors to cope with anxiety:
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Withdrawal
Acting out (anxiety discharge through agression) Psychosomatization (ulcers, headaches) Avoidance Problem solving (learing adaptive behavior) |
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Repeated disturbing thought
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Obsession
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Ritualistic behavior performed to dissipate anxiety and to avoid confilcts
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Compulsion
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The obsessive-compulsive process is an example of:
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Avoidance
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Repression, isolation, reaction formation, ritualistic undoing
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Defense mechanisms
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At least three panic attacks within a three week period in situations which are not life-threatening and do not involve physical exertion
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Panic disorder
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Fear of being alone or in public places from which escape may be difficult
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Agoraphobia
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Commonalities of anxiety disorders:
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Upsetting symptoms
Perception of symptoms as unacceptable Reality testing intact No organic basis |
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Treatment of anxiety disorders
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Explore what is happening when symptoms appear
Normalize anxiety Increase self-awareness Teach self-help skills Progressive desensitization Short-tem antianxiety agents |
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Collection of personality traits that have become fixed and rigid to the point that the client experiences mental anguish and behavioral dysfunction
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Personality disorder
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Common characteristics of personality disorders:
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Inflexible, maladaptive response to anxiety
Maladaptation within an interpersonal or social context Enraging behavior (push your buttons) Self-centered, inflexible approach to work and interpersonal relationships |
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DSM-IV-TR personality disorders manifest in two or more of these areas:
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Cognition
Affect Interpersonal behavior Impulse control |
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Distorted reference to social interactions
Little social intelligence (mechanical or artistic inclinations) Indifference to thoughts and feeling of others, rarely expresses anger Impaired social relationships, socially detached life-pattern |
Schiziod personality disorder
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Pessimistic perceptual lens
Negative mindset, indecisiveness Ambivalance Feel unappreciated, unloved, overworked, used and abused Procrastination, delay tactics, inefficiency and errors of ommission |
Passive agressive personality
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Perfectionism that interferes with ability to grasp the "big picture"
Impaired ability to express warm and tender emotions Insistance on submission to his/her way of doing Excessive devotion to work/productivity |
Compulsive personality disorder
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Overly dramatic behavior; intensely experssed emotions
Draws attn. to oneself Overreaction to minor events Dependent, helpless, constantly seeking reassurance Prone to manipulitive suicidal threats, gestures or attempts |
Histrionic personality disorder
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Hypersensitivity to potential rejection, humiliation or shame
Low self-esteem Unwilling to enter relationships unless there are strong guarantees of uncritical acceptance |
Avoidant personality
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Others are hostile and out to get them
Cunning, design schemes to outwit or punish their adversaries Hostile, punitive and vengeful Criminal behavior Conflict with authority |
Antisocial personality disorder
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Long-term characteristics of Borderline personality disorder
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Potentially self-damaging impulsivity or unpredictability (Ii.e. drug abuse, med. non-comliance, promiscuity)
Unstable/intense interpersonal relationships Identity disturbance Unstable moods Difficulty being alone/expressing genuine feelings Self-mutilation Chronic feelings of emptiness/boredom |
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NSG intervention for denial in a borderline personality
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Remain emotionally neutral (no anger of frustration)
Teach about expected outcomes of behavior and offer alternatives Allow client to make all decisions that pertain to his/her care |
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NSG interventions for devaluation in a borderline personality PT
* Devaluation - Only feels good if someone else can appear bad, tries to arouse your feelings of anger |
Ignore personal attack & piont out maladaptive behavior ("It sounds as though you want me to get mad at you")
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NSG interventions for idealization in a borderline personality PT
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Convey that you arre not the "perfect" nurse, that you have limitations
Communicate that you have strengths and weaknesses just like all human beings |
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Splitting
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Mother-child symbiosis and enmeshmant were rewarded. Independence met with withdrawal of affection (borderline PT learns that he can never be safe and seperate from the mother.
Borderline PT can not tolerate being alone |
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NSG interventions for a borderline personality PT talking about staff behind their backs
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Encourage the PT th confront the staff member and express their anger directly. Do not take sides.
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NSG interventions for a borderline personality PT exhibiting projective identification (projecting their undesirable qualities onto other people, you, for example)
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Verbalize you true thoughts, feelings and perceptions - negative ones are OK provided you don't act-out and suffer the negative consequences of your behavior)
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NSG interventions for devaluation in a borderline personality PT
* Devaluation - Only feels good if someone else can appear bad, tries to arouse your feelings of anger |
Ignore personal attack & piont out maladaptive behavior ("It sounds as though you want me to get mad at you")
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NSG interventions for idealization in a borderline personality PT
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Convey that you arre not the "perfect" nurse, that you have limitations
Communicate that you have strengths and weaknesses just like all human beings |
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Splitting
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Mother-child symbiosis and enmeshmant were rewarded. Independence met with withdrawal of affection (borderline PT learns that he can never be safe and seperate from the mother.
Borderline PT can not tolerate being alone |
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NSG interventions for a borderline personality PT talking about staff behind their backs
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Encourage the PT th confront the staff member and express their anger directly. Do not take sides.
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NSG interventions for a borderline personality PT exhibiting projective identification (projecting their undesirable qualities onto other people, you, for example)
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Verbalize you true thoughts, feelings and perceptions - negative ones are OK provided you don't act-out and suffer the negative consequences of your behavior)
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NSG interventions for a borderline personality PT unable to effectively express feelings (manipulative dramatic expressions of emotions, sabatoging positive relationships)
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Remain emotionally neutral (do not get angry) and set limits on behavior.
Do not withdraw as a means of punishment (their rage is associated with fear of abandonment) |
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NSG interventions for a borderline personality PT with impaired ability to establish effective interpersonal relationships
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Verbalize the phases of the nurse/client realtionship and emotionally prepare the client for termination in order to decrease seperation anxiety
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