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Schiz
ALS - Exam 1
| Question | Answer |
|---|---|
| what is schiz | Chron, severe brain dis charact by psychosis, disorganization of personality, deterioration of social funct, distortion of reality, hallucinations and delusional thinking |
| criteria for schiz Ds: Two (or more) of the following, each present for a sig portion of time during a 1-month period | A: Characteristic Sx B: Social/occupational dysfunct C: Duration D: Schizoaffective and Mood Disorder exclusion E: Substance/general medical condition exclusion |
| types of schiz | Catatonic Disorganized Paranoid Undifferentiated Residual |
| catatonic schiz | unusual body positions, mute, withdrawn |
| Disorganized schiz | incoherent thoughts or speech but may not have delusions |
| what are THE positive schiz sx | delusions hallucinations catatonic behav disorg thoughts/behav disorg speech |
| types of delusions | Grandeur (famous/superhuman powers) Persecution (they are out to get me) Reference (neutral message made to be especially for you) Control (thoughts/acts of being controlled by others) |
| types of delusions contin | Somatic (false ideas about body) Nihilistic (false ideas about self, others or objects) Magical thinking |
| types of disorg speech | loose associations neologisms perseveration clang |
| define loose associations | rapidly shifting from topic to topic no connection btwn one thought and next |
| define neologisms | made-up words or phrases that only have meaning to them |
| define perseveration | repetition of words/statements saying the same thing over and over |
| define associated feats as a neg sx of schiz | anhedonia or inability to feel pleasure, regression |
| what ARE negative schiz sx | normal behavs that should be present but have been "taken away" from person's ability & usual way of interacting w/world |
| SE to typical antipsychotics | ortho⇣TN antiholinergic effects sedation EPS |
| what are EPS SE | tremor shuffling gait drooling, rigidity Akinesia Akathisia Dystonia Oculogyric crisis |
| Akinesia | muscular weakness |
| Akathisia | restlessness |
| Dystonia | spasms of face, arms, legs and neck |
| typical antipsychotic meds (dopamine blockers) | Haloperidol (Haldol) Chlopromazine (Thorazine) Thioridazine (Mellaril) *may cause severe cardiac arrhythmias Stelazine (Trifluoperazine) Fluphenazine (Prolixin) |
| what meds are used to manage EPS sx | Anticholinergic medications: Benztropine (Cogentin) Diphenhydramine (Benadryl) Antiparkinsonian drugs: Trihexyphenidyl (Artane) Vesicular Monoamine transporter 2 Inhibitors: Valbenazine (Ingrezza) Deutetrabenazine (Austedo) |
| SE to Atypical antipsychotics | wt gain ortho ⇣TN sedation EPS (less than typical) photosensitivity anticholinergic effects |
| Atypical antipsychotic 2nd gen meds (weaker dopamine blockers) | Risperidone (Risperdol) ** Gynecomastia Olanzapine (Zyprexa) Chlozapine (Clozaril) ** Must monitor WBC’s Quetiapine (Seroquel) Ziprasidone (Geodon) ** EKG- may prolong QT interval Lurasidone (Latuda) Asenapine (Saphris) |
| Atypical antipsychotic 3rd gen meds (weaker dopamine blockers) | Aripiprazole (Abilify) Brexpiprazole (Rexulti) |
| what do you assess for in a pt who shows s/s of schiz | fam hx fam as witness to mood/behav changes + sx − sx cog sx |
| what are some probs a pt with schiz may exp | Disturbed sensory perception Disturbed thought processes Social Isolation Risk for Violence: Self or other-directed Impaired verbal comm Self-care deficit Disabled family coping Ineffective health maintenance Impaired home maintenance |
| what are you indep RN interv for a pt with schiz | Obs for s/s of hallucinations Admin meds as ordered Avoid touching w/out warning Maintain calm attitude/enviro w/min stim Demo attitude of acceptance Try to distract from hallucinations, but do not challenge |
| what are you indep RN interv for a pt with schiz contin | Help pt understand connection btwn ⇡ anxiety/hallucinations Remove all dangerous objects Orient pt to reality Provide simple directions for ADL as needed |
| what are the expected outcomes of successful tx for schiz? | not harmed self/others Maintains anxiety at manageable level Performs self-care indep Demos ability to interact satisfactorily w/others |
| what are the expected outcomes of successful tx for schiz contin? | Recog distortions of reality Perceives self/enviro realistically Uses appropriate verbal comm Demos ability to trust others |
| what other therapies aide in Tx schiz alongside meds? | Psychotherapy Group therapy CBT Social/ coping skills training Family therapy Assertive community treatment |
Created by:
cberna02