116 Exam 3 schizophrenia

• Affect
• Associative Looseness
• Autism
• Ambivalence

• continuous signs for at least 6 months
• 2 or more of the following each present for a significant portion of time during a 1 month period
•      Delusions
•      Hallucinations
•      Disorganized or catatonic behavior
•      Negative symptoms (affective flattening, alogia, avolition)

• Dopamine Theory
• Serotonin

• Alterations in thinking
• Alterations in speech
• Alterations in perception
• Alterations in behavior

the extended maintenance of posture, usually seen in catatonia.

The nurse raises the arm of a patient and the patient continues to hold this position in statue like manner

• Repetitive, involuntary, purposeless movements
• usually involves the toes, neck, trunk, tongue, fingers or pelvis
• caused by dopamine blockage, usually high dose long term therapy
• Tardive continues even after drug is D/C
• Sometimes permanent
• AIMS SCALE

• Thorazine
• Mellaril
• Loxitane
• Moban
• Trilafon
• Navane
• Prolixin
• Haldol

• Saphris
• Clozaril (may cause AGRANULOCYTOSIS)
• Fanapt
• Latuda
• Zyprexa
• Invega
• Seroquel
• Risperdal
• Geodon

Abilify

2nd generation

• 1st gen treats positive
• 2nd gen treats positive and negative

1st generation

1st generation

• Acute dystonia
• Akathisia
• Pseudoparkinsonism (tremors)

most pts build up a tolerance to the side effects over months / if they don't you will have to decrease the dose or add a anticholinergis or antioarkinsonian drug (to normalize the ratio of dopamine to Ach)

• caused by too much dopamine blockage
• develops over 24-72 hrs, usually early in med therapy
• Sx; muscle rigidity, hyperthermia, altered consciousness, and autonomic dysfunction, tachycardia, HTN, dyspnea
• POSSIBILY DEATH

talking to someone that is not really there

• hallucinations involve perceiving a sensory experience for which no external stimuli exists
• (hearing voices, seeing

• Disorganized Schizophrenia
• Catatonic Schizophrenia
• Residual Schizophrenia

• onset before 25
• regressive and primitive behavior
• flat or inappropriate affect
• silliness, incongruent giggling, bizarre mannerisms
• poor personal appearance
• social impairment

False fixed beliefs that cannot be corrected by reasoning

• marked abnormalities in motor behavior
• WAXY FLEXIBILITY
• stupor and motor agitation

• AKA: Ambulatory schizophrenia
• no longer has active symptoms
• Hx of at least one previous episode of schizophrenia
• CHRONIC FORM OF SCHIZOPHRENIA
• Residual Sx include social isolation, eccentric behavior, impairment in personal hygiene and grooming, inappropriate affect, poverty of speech, illogical thinking, apathy

• Phase I/Acute: SAFETY!
• inpatient hosp or partial programs

II Stabilization and III maintenance: Medication adherence and community support

• ask about hallucinations
• watch for signs the patient is hallucinating
• do not argue about hallucinations
• focus on reality
• watch for anxiety

• be honest
• be matter of fact, but supportive
• ask for info about delusions
• do not argue
• focus on underlying feelings
• observe triggers
• set limits on time talking about delusions
• validate reality in the delusion

• FEVER
• F: Fever
• E: Encephalopathy
• V: Vitals unstable
• E: elevated enzymes
• R: Rigid Muscles

• Stop the drug
• transfer to a medial unit
• parlodel; relieve the muscle rigidity and decrease the fever
• Dantrium: reduce muscle spasms

Nursing: cardiorespiratory support, treat hyperthermia, maintain renal function, ICU

• develop slowly, interfere with ability to cope, have conversations, jobs, decision making, maintain hygiene
• (interfere with the ability to live)
• Affect
• Anergia
• Anhedonia
• Avolition
• Poverty of content of speech
• Poverty of speech
• Thought blocking (can't finish sentences)

Preoccupation with one or more systematized delusion, hallucination

patient may be guarded hostile, argumentative

• initiate and maintain conversations and relationships
• obtain and maintain employment
• Make decisions and follow through on plans
• Maintain adequate hygiene and grooming

Negative symptoms contribute to poor social functioning and social withdrawal

hallucinations and delusions

they are categorized as alterations in thought, speech, perception, and behavior