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Schizophrenia is a mental state in which the individual struggles to distinguish the __________ from his/her __________.
- external world
__________ is a brain disease that disrupts perceptions, thinking, feelings, and behaviors.
Bleuler's 4 A's:
- affective disturbance: inappropriate, blunted or flat affect
- autism: preoccupation with the self with little concern for external reality
- associative looseness: the stringing together of unrelated topics
- ambivalence: simultaneous opposite feelings
Schizophrenia is an axis __ diagnosis.
Type 1 schizophrenia: (positive)
- Acute onset
- high dopamine levels
- illusions and insomnia
Type 2 schizophrenia: (negative)
- chronic onset
- low dopamine levels
- brain changes: brain smaller/vesicles larger
- attention deficits
- passive social withdrawal
- asocial behavior
- paranoid: suspicious/mistrustful
- disorganized: alterations in thoughts, speech, behaviors
- catatonic: immobility
- residual: chronic, lesser symptoms
Some theories about the cause of schizophrenia:
- biochemical: dopamine level alterations
- neurostructural: brain atrophy, decreased cerebral blood flow
- perinatal: maternal flu, birth during late winter/early spring, prenatal exposure to lead...
- developmental/family: lack of care/nurturing by or severe conflicts with the mothering one
What is psychosis-induced polydipsia?
- compulsion to drink excess of water (4-10 L/day)
- major concern is hyponatremia
- NI: strict I&O w/ possible fluid restrictions, monitor wts, monitor labs r/t F&E balance, esp Na & K
Haldol, Navane, Thorazine are __________.
An adverse effect of this group is:
- neuroleptic malignant syndrome
AIMS assessment to evaluate neuroleptic malignant syndrome:
- akathisia: restlessness
- akinesiea/bradykinesia: absent/slowed movement
- parkinsonism: temors, shuffling gait, regidity, pill rolling
- tardive dyskinesia: starts around mouth: tongue protrusion, lip smacking, puckering, teeth grinding, movement stops with sleep
- pisa syndrome: leaning to one side
Tx for EPSE (extrapyramidal s/e):
- cogentin, benadryl
- decanote form is long acting by injection; can be given at 2-4 week intervals or longer
__________ is the most frequently prescribed atypical antipsychotic.
- decrease risk of EPSE with newer drugs