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OLOL~Schizophrenia
N140 OLOL Psych ~ Schizophrenia
| Question | Answer |
|---|---|
| Schizophrenia | Considered a thought disorder. A psychotic disorder. |
| Schizophrenia | Characterized by though(cognitive), affect(emotional), & behavioral disturbances. |
| overactivity of dopamine results in the illness. | The dopamine hypothesis of schizophrenia proposes that _______. |
| Family dynamics | ___ can not cause schizophrenia, but it can affect the course of the illness. |
| Disorganized speech | A primary characteristic of schizophrenia. Clients with schizophrenia cannot process complex thoughts or express coherent sentences because of malfunctioning in their information processing abilities. |
| Loose associations | (vague, diffuse, unfocused) Ex. What brought you to the hospital? “I was home when a drum began beating. I flew too low. |
| Word Salad | using words that are totally unrelated. Ex. What would you like Lucy? “The thing that goes, the nail that made me barf”. |
| Clanging | similar sounding word. Ex. “The ghost ate my shirt” instead of “The goat ate my shirt”. |
| Echolalia | repeating everything you say. |
| Disorganized behavior | People with schizophrenia may have profound psychomotor retardation or excitement, & they may exhibit bizarre posture. |
| Catatonic | marked by episodes of bizarre behavior in which clients assume & maintain strange posture. excitement clients may show uncontrolled & aimless motor activity.They may rock back & forth for hours or grimace for no reason. |
| Waxy Flexibility | May have a peculiar rigidity. They may allow others to move their limbs but then they may hold them for hours in the position in which they are placed. |
| Incongruous affect | express themselves in a way that is not congruent with the situation or content of thought. They may smile or giggle for no apparent reason, or they may laugh uproariously while describing truly frightening or sad experiences. |
| Positive Dimension | represents an excess or deterioration of normal functioning. These symptoms would not be present if the person was healthy. Includes delusions & hallucinations. |
| Persecutory | Type of delusion: Ex. Client believes neighbors, friends or family are planning to harm him, Others are spying on him. |
| Grandiose | Type of delusion: client falsely believes that they have great wealth, talent, power or beauty; Such client may believe themselves to be a famous person. |
| Somatic | Type of delusion: concerns the body; Clients may believe that they are incredibly ugly or that certain aspects of their appearance disgust others. |
| Nihilistic | Type of delusion: Client believes they are dead, dying or that they no longer exist. |
| Religious | Type of delusion: Clients may believe that they have a special relationship with God or some other deity. In addition they may think that they are the greatest sinner that ever lived & they have a special mission from God. |
| Referential | Type of delusion: Client believes that newspaper articles,TV shows or song lyrics are directed specifically at them. |
| Negative Dimension | Represents a deficit of functioning. |
| Negative Dimensions | Alogia, Affective flattening or blunting, Avolition, Anhedonia are all considered .... |
| Alogia | Speaks very brief & concrete(minimal). |
| Avolition | Lack of motivation |
| Anhedonia | Loss of pleasure. Cannot sustain work or engage in self-care. Client may begin to withdrawal. |
| Lack of insight | A common symptom of schizophrenia; It is one of the most difficult aspects of schizophrenia to treat. |
| Paranoid schizophrenic | The client is preoccupied with delusions of persecution or grandeur, ideas of reference, or frequent auditory hallucinations. They may appear tense suspicious, guarded, reserved, hostile or aggressive. |
| Disorganized schizophrenic | Client demonstrates markedly regressed, disorganized, silly, inappropriate & uninhibited behavior; Disorganized speech; Flat or inappropriate affect; Poor reality contact; Poor grooming & social skills; Strange mannerisms |
| Catatonic schizophrenic | Client demonstrates motoric immobility or stupor, rigidity, excessive motor activity, extreme negativism, peculiarities of movement. |
| Undifferentiated schizophrenic | The clients behavior & speech clearly indicate schizophrenic Psychosis but fail to meet the criteria of paranoid, disorganized or catatonic types. |
| Residual schizophrenic | Does not have active, positive symptoms, but continues to demonstrate negative symptoms, such as withdrawal from others or flat affect. |
| Projection | The paranoid patient's defense mechanism. |
| Water intoxication | A few clients with chronic schizophrenia drink excessive amounts of water, thereby inducing a state of water intoxication, characterized by Polyuria & hyponatremia. When it comes severe, it can result in seizures, coma, cerebral edema & even death. |
| Dual diagnosis | when a client has a serious mental illness in addition to a substance abuse disorder. |
| Suicide | Client's with schizophrenia are at high risk for ___. |
| Hope | The development of ___ is essential for clients recovering from schizophrenia & for their family. |
| Safety in all settings;Stabilization on antipsychotic medications;Client and family education;Physical care of the client(assistance w/ ADL's);Psychosocial support of client and family. | Overall goals of treatment for Thought disorders: |
| Milieu Management | providing an environment rich with therapeutic possibility. |
| Cognitive-Behavioral Therapy | Aims to improve motivation, socialization & reality testing by means of goal setting& increasing coping & problem solving skills, self esteem & sense of control. |
| Vocational Rehabilitation | Involves speedy placement in a real job, coupled with assistance & coaching from a therapist or job coach. |
| Traditional & Atypical | 2 types of Antipsychotics |
| Extrapyramidal side effects | The most common & distressing side effects associated with Traditional antipsychotics are acute ____. Makes the client feel worse than they did before taking medication, contributing to nonadherence. |
| Extrapyramidal side effects | Akathisia & Dystonia |
| Tardive Dyskinesia | Can occur after several months to years of therapy; treatment usually involves discontinuing or decreasing medications; assessment made by means by AIMS. |
| Neuroleptic Malignant Syndrome | Life threatening complication;marked by elevated temperature,severe EPS(rigidity, dystonia),Autonomic dysfunction(HTN,tachycardia,diaphoresis),&an elevated creatine phosphokinase level;requires immediate medical attention,transfer to ICU&admin dantrolene. |
| Atypical antipsychotics | Relieves both positive & negative symptoms; less likely to cause EPS. |
| Clozapine | An Atypical antipsychotic has a potentially fatal SE of agranulocytosis;SE's include:lowered seizure threshold,hypotension,sedation&elevated liver enzymes.Monitor wkly hematological counts&report&document any drop in WBC counts;not used as firstline agent |
| Risperidone | An Atyical antipsychotic approved for first line treatment of thought disorders, effectively treats both positive & negative symptoms with reduced EPS & TD. |
| Olanzapine / Zyprexa | Another Atypical antipsychotic approved for first line use; lower risk for EPS than risperidone. |
| Positive symptoms | ____ are treated with dopamine blocking drugs. |
| Auditory Hallucinations | Seen in most schizophrenic patients. |
| Visual Hallucinations | Seen in most often in dementia patients. |
| Tactile Hallucinations | Seen most often in alcohol withdrawals. |
| Gustatory & Olfactory Hallucinations | Seen most in seizure disorders. |
| Command Hallucinations | Voices commanding the patient to do something. |
| Disorganization Dimension | Involves one kind of thought disturbance - Formal thought disorder. It affects the relationship & associations among the words a person uses to express thoughts. |
| Stress-Vulnerability Model | Accordingly,stress characterizes schizophrenia. Under the stress of biologic&psychosocial factors,a person may be predisposed to"nervous breakdown". The risk factors(stressors)identified,may include poverty,major life stressors,substance abuse, & others. |
| Planning | Step in the Nursing Process that starts with developing the relationship with the patient & building trust . |
| 1)The client will experience improved thought processes&fewer psychotic symptoms2)The client willnot engage in violent behavior3)The client will acquire improved social skills&engage in satisfying social interaction4)The client&family will gain knowledge. | List major goals for the care of a client with schizophrenia. |
| Negative symtpoms | ___of Atypical antipsychotics,is a non dopamine process&they do not have structural changes. Ex.Increased ventricular brain ratios&decreased cerebral blood flow.Tx w/Atypical anti-psychotics(Clozapine,Risperidone,Seroquel,Geodon);Less likely to cause EPS. |
| To build a therapeutic relationship, to improve the client's coping skills, & to help the client stay oriented to reality. | What is the focus/goals of individual therapy as a treatment for schizophrenia? |
| To focus on social skills, concentrating on appropriate interpersonal interaction. | What is the focus of Group Therapy sessions as a psychosocial intervention? |
| (ACT) Assertive Community Treatment. | Program of individualized, consistent, comprehensive, & continuous services to client's with schizophrenia. |
| (ACT) Assertive Community Treatment. | A team delivers services to help clients with symptom management, medication monitoring, housing, vocational needs, parenting skill, non-psychiatric medical care, & daily responsibilities & problems. |
| (ICM) Intensive Case Management | Involves assessment, referral, coordination, & integration of a cohesive program of services tailored to the client's needs. |
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