116 Exam 3 schizophrenia

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116 Exam 3 schizophrenia
2014-04-24 00:14:30
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  1. What are the 4 A's of Schizophrenia?
    • Affect
    • Associative Looseness
    • Autism
    • Ambivalence
  2. Diagnoses criteria for schizophrenia
    • 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)
  3. Biochemical Influences of Schizophrenia
    • Dopamine Theory
    • Serotonin
  4. what are positive symptoms of Schizophrenia?
    • Alterations in thinking
    • Alterations in speech
    • Alterations in perception
    • Alterations in behavior
  5. what is waxy flexibility?
    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
  6. Tardive Dyskinesia
    • 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
  7. examples of
    1st generation antipsychotics
    • Thorazine
    • Mellaril
    • Loxitane
    • Moban
    • Trilafon
    • Navane
    • Prolixin
    • Haldol
  8. Examples of 2nd generation antipsychotics
    • Saphris
    • Clozaril (may cause AGRANULOCYTOSIS)
    • Fanapt
    • Latuda
    • Zyprexa
    • Invega
    • Seroquel
    • Risperdal
    • Geodon
  9. examples of 3rd Generation antipsychotics
  10. which category of antipsychotics causes weight gain
    2nd generation
  11. which generation of antipsychotic treats which symptoms?
    • 1st gen treats positive
    • 2nd gen treats positive and negative
  12. which category of antipsychotics lowers the seizure threshold
    1st generation
  13. which category of antipsychotic cause the most motor side effects?
    1st generation
  14. what are some common Extrapyramidal side effects caused by  antipsychotics
    • 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)
  15. What is Neuroleptic Malignant Syndrome?
    • 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
  16. what are indications that patients are having hallucinations?
    talking to someone that is not really there

    • hallucinations involve perceiving a sensory experience for which no external stimuli exists
    • (hearing voices, seeing
  17. types of Schizophrenia include
    • Disorganized Schizophrenia
    • Catatonic Schizophrenia
    • Residual Schizophrenia
  18. Disorganized Schizophrenia
    • onset before 25
    • regressive and primitive behavior
    • flat or inappropriate affect
    • silliness, incongruent giggling, bizarre mannerisms
    • poor personal appearance
    • social impairment
  19. what are delusions?
    False fixed beliefs that cannot be corrected by reasoning
  20. catatonic schizophrenia
    • marked abnormalities in motor behavior
    • stupor and motor agitation
  21. Residual Schizophrenia
    • AKA: Ambulatory schizophrenia
    • no longer has active symptoms
    • Hx of at least one previous episode of schizophrenia
    • Residual Sx include social isolation, eccentric behavior, impairment in personal hygiene and grooming, inappropriate affect, poverty of speech, illogical thinking, apathy
  22. Treatment for schizophrenia
    • Phase I/Acute: SAFETY!
    • inpatient hosp or partial programs

    II Stabilization and III maintenance: Medication adherence and community support
  23. how to communicate with person having hallucinations
    • ask about hallucinations
    • watch for signs the patient is hallucinating
    • do not argue about hallucinations
    • focus on reality
    • watch for anxiety
  24. communicate with delusional patient
    • 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
  25. Mnemonic  for NMS
    • FEVER
    • F: Fever
    • E: Encephalopathy
    • V: Vitals unstable
    • E: elevated enzymes
    • R: Rigid Muscles
  26. what is the treatment for NMS
    • 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
  27. negative symptoms of schizophrenia
    • 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)
  28. Paranoid Schizophrenia
    Preoccupation with one or more systematized delusion, hallucination

    patient may be guarded hostile, argumentative
  29. negative symptoms develops slowly and are those that interfere with a person's adjustment and ability to cope.
    Negative symptoms impede one's ability to ___
    • 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
  30. Positive symptoms of schizophrenia include
    hallucinations and delusions

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