The Schizophrenias Part 2
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| For the acute phase of schizophrenia, the overall goal is | client safety and medical stabilization
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| In the maintenance and stabilization phases the focus is on | Helping the client to adhere to medication regimens, to understand schizophrenia, and to participate in available psychoeducation activities for both the client and the clients family.
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| During the stabilization phase the outcomes target the | negative symptoms
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| What kind of outcomes would reduce the patient's vulnerability to psychosis? | Maintain a regular sleep pattern, reduce alchohol, drug, and caffeine intake; keep in touch with supportive friends and family; stay active; have a routine daily and weekly schedulte including enjoyable activities; take meds regulary.
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| Planning during the maintenance and stabilization phases identifies what ______, ______, ________, and ________ skills are needed as well as how and where these needs can best be met within the community. | social, interersonal, coping, and vocational skills
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| A key component of long term card of an individual with schizophrenia relies on what three things? | medications, nursing interventions, and community support
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| _____ ____ which is a part of nursing inteventions as well as community support is a key component of effective treatment of schizophrenia. | family psyhoeducation
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| Interventions for the schizophrenic patient are always geared toward the client's strengths and healthy functioning as well as to areas of | deficiency
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| During the acute phase of schizophrenia, the nurse should maintain ____ ______ call the client by name, and speak simply but in a louder voice thatn usual. | eye contact
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| When the nurse attempts to see the world as it appears through the eyes of the client, it is easier to understand the client's | delusional experience
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| When clients sleep at home and attend treatment sessions during the day or evening. | partial hospitalization
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| clients live in the community with a group of other clients, sharing expenses and responsibilities. | halfway houses
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| Patients live in a halfway house or on their own, sometimes with home visits, or in residentioal programs. Patients attend a structured program during the day. | day treatment programs
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| The single most important factor in the prevention of relapse in a person suffering from schizophrenia. | medication maintenance
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| This improves the level of social activity, foster new social contacts, improve quality of life, and help lower anxiety. | Social skills training (SST)
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| This appears to improve cognitive dysfunction, helping individuals better cope with symptoms, the disorder itself, and everyday problems. | cognitive remediation
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| a novel technique aimed at improving adaptive functioning and compensating for the cognitive impairment associated with schizophrenia. | cognitive adaption training (CAT)
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| This aims to change abnormal thoughts or responses to hallucinations through coping strategies such as listening to music. | cognitive-behavioral therapy (CBT)
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| The conventional (traditional) antipsychotics target | the positive symptoms of schizophrenia such as hallucinations, delusions, disordered thinking, and paranoia.
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| Atypical (novel) antipsychotics diminish the | negative symptoms of schizophrenia
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| _______ antipsychotics have fewer side effects and thus are better tolerated. | atypical
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| Antipsychotic agents usually take effect __________ after the regimen is started. | 3 to 6 weeeks
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| This atypical antipsychotic increases the risk for agranulocytosis and seizures. | clozapine (Clozaril)
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| These drugs permit control of the most alarming symptoms of schizophrenia and they also allow for improbement in the quality of life of people with schizophrenia. | atypical antipsychotics
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| Because of the risk for agranulocytosis and seizures, patients taking clozapine (Clozaril) are required to to have what kind of testing? | Weekly WBC for the first 6 months, then frequent monitoring thereafter.
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| What are the disadvantages of AAP's? | They have a tendency to cause significant weight gain in clients and they are more expensive than traditional antipsychotics.
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| What kind of a drug is Risperidone? | AAP
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| What are the two advantages of conventional antipsychotics? | Cost, and they come in depot forms
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| These antipsychotic medications are D2 antagonists. | conventional antipsychotics
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| Akathisia, dystonia, parkinsonism, and tardive dyskinesia are __________ side effects. | Extrapyramida Side Effects
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| Other side effects of conventional antipsychotics besides EPS's are | anticholinergenic effeccts, orthostasis, and lowered seizure threshold.
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| Low Potency Conventional Antipsychotic drugs= | high sedation, high ACh and low EPS's
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| High Potency Conventional Antipsychotic Drugs = | low sedation, low ACh and high EPS's
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| All conventional antipsychotic drugs can cause | tardive dyskinesia
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| Conventional antipsychotic drugs can lower the | seizure threshold
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| muscle cramps of the head and neck | acute dystonia
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| internal restlessness and extenal restless pacing or fidgetting | akathisia
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| stiffening of the muscular activity in the face, body, arms, and legs | pseudoparkinsonism
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| Commonly used drugs to lower the occurance of EPS's are the antiparkinsonian drugs: | Artane, Cogentin, Benedryl, Akineton, Kemadrin, Parlodel, and Symmetrel
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| Blurred vision caused by traditional antipsychotics usually abates in | 1 to 2 weeks
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| Tetanic heightening of entire body, head and belly up | opisthotonos
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| eyes locked upward | oculogyric crisis
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| A serious and irreversible side effect of the phenothiazines and related drugs that consists of involuntary tonic muscle spasms typically involving the tongue, fingers, toes, neck, trunk or pelvis. | tardive dyskinesia
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| Symptoms of this rare toxic effect of traditional antipsychotics include sore throat, fever, malaise, and mouth sores. Flulike symptoms. | agranulocytosis
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| The prodromal symptoms of ______ ____ are fever, malaise, nausea, and abdominal pain; jaundice appears 1 week later. | cholestatic jaundie
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| Sever extrapyramindal effects, hyperpyrexia and autonomic dysfunction are indicative of what somewhat rare, but potentially fatal effect of traditional antipsychotics? | Neuroleptic malignant syndrome(NMS)
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| An EPS that usually appears after prolonged treatment and is more serious and is not always reversible. | tardive dyskinesia (TD)
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| Tardive dyskinesia is most frequently seen in | women and older patients
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| Early symptoms of tardive dyskinesia are | constant smacking of the lips
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| It is believed that the acute reduction in brain dopamine activity plays a role in the development of | neuroleptic malignant syndrome
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| A decreased level of consciousness, greatly increased muscle tone, and autonomic dysfunction, including hyperpyrexia, labile hypertension, tachycardia, tachypnea, diaphoresis, and drooling. | neuroleptic malignant syndrome
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| Use of benzodiazepines with antipsychotic medications can improve | positive and negative symptoms by about 50%.
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| Use of _________ adjunct to antipsychotics may diminish anxiety, agitation, and possibly psychosis. | Clonazapam (benzodiazepine)
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| Any intense and strongly defended irrational suspicion can be regarded as | paranoia
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| The most common defense mechanism used by people who are paranoid. | Projection
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| ______ _______ is one of the primary paranoid disorders. | paranoid schizophrenia
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| When the patient frequently misinterprets the messages of others or gives private meaning to the communications of others. | ideas of reference
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| Abnormal motor behivior. Clients show either extreme motor agitation or extreme psychomotor retardation. | catatonia: withdrawn phase
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| The onset of catatonia is usually | abrupt
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| Posturing, waxy flexibility, sterotyped behavior, extreme negativism or automatic obedience, echolalia and echopraxia are some behaviors associated with | catatonia: withdrawn phase
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| The ability to hold distorted postures for extensive periods. | waxy flexibility
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| If someone raises the patients arm over his head, the patient maintaining that position for hours or longer is called | waxy flexibility
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| During this stage of catatonia, the person talks or shouts continually, and verbalizations may be incoherrent. | catatonia: excited phase (acute phase)
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| The most regressed and socially impaired of all the schizophrenias. | Disorganized schizophrenia
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| A person diagnosed with this type of schizophrenia may have marked looseness of associatins, grossly inappropriate affect, bizarre mannerisms, and incoherence of speech and may display extreme social withdrawl. | disorganized schizophrenia
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| This type of schizophrenia has an earlier age of onset and often develops insidiously. | disorganized schizophrenia
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| Often patients diagnosed with this type of schizophrenia are either homeless or live in state hospitals. | disorganized schizophrenia
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| a sudden cessation in the train of thought. | Blocking
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| When active signs of the the disorder of schizophrenia (positive or negative) are present, but the individual does not meet the criteria for paranoia, catatonia, or disorganized type. | undifferentiated schizophrenia
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| When active phase symptoms are no longer present, but evidence of two or more residual symptoms persists. | residual type of schizophrenia
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| To plan appropriate interventions the nurse must know that depersonalization and derealization are examples of | personal boundary difficulties
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| What symptomsof schizophrenia are most amenable to treatment with both low and high potency antipsychotic medications? | hallucinations and delusions
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| A nursing diagnosis that is universally applicable to clients with schizophrenia during the prodromal and acute phases is | Disturbed Thought Process
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| _______ symptoms include the crippling symptoms of affective blunting, anergia, anhedonia avolition, poverty of content of speech, poverty of speech, and thought blocking. | Negative
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| What is the most common course of schizophrenia? Initial episode followed by | recurrent acute exacerbations and deterioration
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| The causation of schizophrenia is currently understood to be | a combination of inherited and nongenetic factors
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| ________ symptoms are the attention-getting symptoms such as hallucinations, delusions, bizarre behavior, and paranoia. | Positive
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| What side effect of antipsychotic medication has no known treatment? | tardive dyskinesia
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| A client with paranoid schizophrenia refuses food. He states the voices are telling him the food is contaminated and will change him from a male to a female. A therapeutic response for the nurse would be | "I understand that the voices are very real to you, but I do not hear them."
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| A client with paranoid schizophrenia tells the nurse "I have to get away. The volmers are coming to execute me." The term "volmers" can be assessed as | neologism
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| When a client with paranoid schizophrenia tells the nurse "I have to get away. The volmers are coming to execute me," an appropriate response for the nurse would be | "It must be frightening to think something is going to harm you."
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| A desired outcome for a client with schizophrenia who has a nursing diagnosis of Disturbed sensory perception: auditory hallucinations related to neurobiological dysfunction would be that the client will | Begin to question his or her own altered perceptions by seeking input from staff
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| Antipsychotic medications may cause _______________, the first manifestation of which may be a sore throat and flulike symptoms. | agranulocytosis
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