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Loss of pleasure in usually pleasurable things
Example would be talking about mother's death and laughing about it
Hear something and then repeat it over and over
Making up words
- Focus is inward, they create their own world
- Echolalia - hear something and repeat it over and over
- Neologism - make up new words.
- Child like mannerisms
Treatment for Schizophrenia
- Decrease Stimuli
- Observe frequently w/o looking suspicious
- Orient frequently and keep conversations reality based.
- Make sure personal needs are met
- Always suspicious
- Can't explain away their delusions or false beliefs
- Crave recognition
- Everyone else has the problem, not them
- Life is unfair
Treatment for Paranoia
- Basis of tx is a trusting relationship
- Be reliable
- Respect personal space and be careful with touch
- Avoid whispering
- Don't mix meds and always ID them
- Bring foods sealed
- No competitive activities!
Dissociative Identity Disorder
What is it?
- Used to be called multiple personalities
- Pt uses dissociation as coping mechanism to protect self from severe physical and/or psychological trauma
- May be seen in pt with history of physical or sexual abuse
- Treatment: pt must process trauma over time
- Meds may be used to treat co-existing depression and/or anxiety
Stages of withdrawl
- Stage I - mild tremors, nervous, nausea
- Stage II - Increased tremors, hyperactive, nightmares, disorientation, hallucinations, increased HR and BP
*Stage I and II = walk and talk to them
Stage III = most dangerous, severe hallucinations (visual and kinesthetic are most common), grand mal seizures
*Stage II and III are DT's (withdrawal delirium = keep light on)
feels like things are crawling on you
Treatment for alcoholism
Detox protocol usually includes thiamine injections, multivitamins, and perhaps magnesium
Anxiolytics: don't be afraid to give. Remember, pt has tolerance to alcohol and a cross-tolerance to other CNS depressants. Can handle meds every 2 hrs. DT's should be prevented, pt very scared during episode
Complications with Alcoholism
- Chronic probs: (caused by thiamine/niacin deficiencies = which are Vit B deficiencies)
- Korsakoff's syndrome - disoriented to time; confabulate - can't remember something so they make it up.
- Weinicke's syndrome - emotions labile, moody, tire easily.
- Other s/s:
- Peripheral neuritis - which is nerve damage due to Vit B deficiency
- Liver and pancreas probs
- Mg and K loss - alcohol makes you diurese, so lose mg and k