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Schizophrenia nursi
Schizophrenia flash cards
| Question | Answer |
|---|---|
| Age at onset | late adolescence, early adulthood |
| Commons symptoms of psychosis | hallucinations delusions difficulty with thought organization |
| Most common cause of psychosis | Schizophrenia |
| Schizophrenia is not characterized by a changing personality, it characterized by... | a deteriorating personality |
| Perceptual disturbance | hallucinations |
| Thought process disturbance | thought derailment |
| Reality testing disturbance | delusions |
| Feeling disturbance | flat or inappropriate affect |
| Behavior disturbance | social withdrawal |
| Attention disturbance | inability to concentrate |
| Motivation disturbance | cannot initiate or persist in goal-directed activities |
| Bleuler's Four A's of Schizophrenia | Affective disturbance: inappropriate, blunted, flat affect Autism: preoccupation with self, with little concern for external reality Associative looseness: stringing together of unrelated topics Ambivalence: Simultaneous opposite feelings |
| Stages of Schizophrenia | Acute phase Stabilizing phase Stable phase |
| DSM-IV Subtypes of Schizophrenia | Paranoid Disorganized Catatonic Undifferentiated Residual |
| DSM-IV Criteria: Paranoid Schizophrenia | Preoccupation with one or more delusions or frequent auditory hallucinations (content frequently persecutory and/or grandiose) |
| DSM-IV Criteria: Disorganized Schizophrenia | * worst prognosis All of the following are prominent: disorganized speech, disorganized behavior, flat or inappropriate affect |
| DSM-IV Criteria: Catatonic Schizophrenia | * best prognosis At least two of the following: 1. motoric immobility, wavy flexibility, or stupor 2. excessive motor activity (purposeless) 3. extreme negativism or mutism 4. peculiar movements, stereotype of movements, prominent mannerisms, or prom |
| DSM-IV Criteria: Undifferentiated Schizophrenia | Characteristic symptoms (motoric immobility, wavy flexibility, or stupor) are present but criteria unmet for paranoid, catatonic, or disorganized subtypes not met |
| DSM-IV Criteria: Residual Schizophrenia | A. Characteristic symptoms (motoric immobility, wavy flexibility, or stupor) are no longer present; criteria are unmet for paranoid, catatonic, or disorganized subtypes B. Continuing evidence of disturbance, such as presence of negative symptoms or chara |
| Echolalia | the automatic repetition of vocalizations made by another person |
| Echopraxia | the automatic repetition of movements made by another person |
| Positive Symptoms are | the embellishment of normal cognition and perception |
| Negative Symptoms are | an absence or diminution of that which should be |
| Pathoanatomy | decreased cerebral blood flow (CBF) increased ventricular brain ratios (VBR)s (use MRI and CT) cerebral atrophy |
| Objective Signs | Alterations in Personal Relationships Alterations of Activity |
| Objective Signs- Alterations in personal relationships | decreased attention to appearance and social amenities R/T introspection and autism Inadequate of inappropriate communication Hostility Withdrawal |
| Objective Signs- Alterations of activity | psychomotor agitation catatonic rigidity echopraxia sterotypy (repetitive acts or words) anergia (- energy) |
| Subjective Symptoms | Altered perceptions Alterations of thought Altered Consciousness Alterations of affect |
| Subjective Symptoms- Altered perception | hallucinations (auditory most common *visual could indicate toxicity) illusions paranoid thinking |
| Subjective Symptoms- Alterations of thought | loose associations retardation blocking autism ambivalence delusions poverty of speech ideas of reference mutism concrete thinking |
| Subjective Symptoms- Altered Consciousness | confusion incoherent speech clouding sense of "going crazy" |
| Subjective Symptoms- Alterations of affect | inappropriate, blunted, flattened, or labile affect apathy ambivalence overreaction anhedonia (apathy) |
| Paranoid personality disorder vs. Paranoid delusions | Personality- can be corrected with facts |
| Somatic delusion | After medical tests confirm otherwise, a patient still insists, "I have cancer in my stomach." |
| Grandiose delusion | "I am the president." |
| Religious delusion | "The devil told me to kill my children." |
| Nihilistic delusion | "I am dead." "If you are dead, how can you talk?" "I don't know, but I am dead." |
| Delusion of reference | "The TV is talking about me. The guests on Oprah are making fun of me." |
| Delusions of influence | "I can control her with my thoughts." |
| Paranoid delusion | "They all think I'm a homosexual." |
| Schizophrenic overreact to normal events because | they have to in order to overcome mental and social inertia |
| Key objectives for Tx Schizophrenia | work with the family treat depression (75%) minimize stressful interactions treat substance abuse avoid lengthy, intense verbal interactions |
| Leading cause of premature death for Schizophrenic pts | Suicide |
| Psychosis-Induced Polydipsia | between 4-10 L/day -hyponatremia S/S: lightheadedness, weakness, lethargy, muscle cramps, N/V, confusion, convulsions, coma I: frequent weigh-in restrict fluid intake sodium replacement positive reinforcement |
| Psychotherapeutic management is aimed at helping | patients becoming stronger than their symptoms |
| Nurse-Patient Relationship | -be calm when talking -accept patients as they are, but do not accept all behaviors -keep promises -be consistent -be honest -do not reinforce hallucinations/ delusions -orient x3 -do not touch w/o warning -avoid whispering/laughing when pt cannot |
| Milieu Mgmt- Disruptive Patients | -set limits -decrease environmental stimuli -observation -take away objects that are possible weapons -restraints-> evaluate for hydration, nutrition, elimination, circulation |
| Milieu Mgmt- Withdrawn Patients | -nonthreatening, physical activities -arrange furniture to facilitate conversation -assist decision making -reinforce grooming/ hygiene -psychosocial rehab (social skills, community living, health care skills) |
| Milieu Mgmt- Suspicious Patients | -matter-of-fact -laughter/ whispering -no touch w/o warning -consistent -maintain eye contact |
| Milieu Mgmt- Impaired Communication | -be patient -dont pressure them to make sense -provide opportunities for purposeful psychomotor activity |
| Milieu Mgmt- Hallucinations | -provide distracting activities -discourage conversation about hallucinations with other patients -monitor tv selection -monitor for command hallucinations -have staff available for listening |
| Milieu Mgmt- Disorganized Patients | -less stimulation -calm environment -safe, simple activities |
Created by:
rkasiejka27
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