Patient/family teaching guidelines about psychosis
A therapeutic interpersonal relationship
What is educating about individual psychotherapy?
Rationale: Education about identifying sources of real or perceived danger and ways of acting appropriately. P.486
Fixed false beliefs that are irritational and that the individual maintains are true.
What are hallucinations-Positive symptom
Rationale – These beliefs are not explainable as part of the person’s usual religious or cultural precepts (Morgan, 2024, p.474)
This type of antipsychotics is considered weaker than the other dopamine antagonists but more useful as serotonin type 2A receptor antagonists.
What is an Atypical Antipsychotic medication.
Rational "Atypical antipsychotics are weaker dopamine receptor antagonists then conventional antipsychotics but more potent antagonists of the serotonin (5-hydroxytryptamine) type 2A (5HT2A) receptor" (Morgan, 2024 Pg. 490).
A patient who is taking an antipsychotic agent develops extrapyramidal symptoms.
What is tongue protrusions, neck torsions, shuffling gait, and seizures.
(Willihnganz et al., 2022, P. 275)
Stopping mid-sentence and cocking her head to the side as if listening.
What are signs of hallucinations?
Rationale: Early intervention may prevent aggressive response to command hallucinations. P.479
Groups offer a supportive environment.
What is educating about group therapy?
Rationale: Group therapy has been most useful over the long-term course of the illness. P.487
The most common type of hallucinations
What is auditory hallucinations- Positive symptom
Rationale– Auditory hallucinations are false perceptions of sound (Morgan, 2024, p.474)
This type of antipsychotic blocks post synaptic dopamine receptors
What is a typical antipsychotic medication.
Rational: "Typical antipsychotics work by blocking postsynaptic dopamine receptors in the basal ganglia, hypothalamus, limbic system, brainstem, and medulla"(Morgan, 2024 Pg. 490).
Adverse effects a patient should be monitored for.
What are seizures, dyslipidemia, and hyperglycemia?
(Willihnganz et al., 2022, P.275)
"Every student has been told to keep an eye on me"
What is assess the patient's anxiety level?
Rationale: If the patient can learn to interrupt anxiety, episodes may be prevented. P.482
Topics related to schizophrenia
What is educating about nautre of the illness, management of the illness, and support services?
Rationale: The role of patient teacher is important in the psychiatric area, as it is in all areas of nursing. P.486
Retreat to an earlier level of development
What is Regression-Negative symptom
Rationale- Regression is a primary defense mechanism of schizophrenia (Morgan, 2024, p.475)
Do not stop taking the medications because symptoms can return in the absence.
What is a piece of teaching that is important for Caroline to know about compliancy?
"Continue to take the medication, even if feeling well and as tough it is not needed. Symptoms may return if medication is discontinued" (Morgan, 2024 Pg. 493).
Part of the nurse’s ongoing assessment of the client taking antipsychotic medications is to observe for extrapyramidal symptoms.
What are muscular weakness, rigidity, tremors, facial spasms?
(Morgan & Townsend, 2021, P. 84)
"They are so jealous". "I am the chosen one"!
What is should you not argue or deny belief?
Rationale: A trusting relationship may be impeded. P.482
Groups offer a supportive environment.
What is educating about group therapy?
Rationale: Group therapy has been most useful over the long-term course of the illness. P.487
Withdrawing from others or social relationships
What is social isolation- Negative symptom
Rationale – Some may experience ambivalence in social relationships or may withdraw from relationships altogether (Morgan, 2024, p.475)
Also called antipsychotic agents.
What is neuroleptics?
"Antipsychotics agents are also called neuroleptics"(Morgan, 2024 Pg. 73).
Extrapyramidal side effects
What is pseudo parkinsonism, akathisia, dystonia?
(Morgan & Townsend, 2021, P. 70-71)
"I'm an expert chemist that's why everyone is out to get me"!
What is maintain an assertive, genuine, matter-of-fact approach?
Rationale: Approaches that are overly cheerful may increase a patient's suspiciousness. P. 482
Behavior modification
What is behavior therapy?
Rationale: Behavior therapy is a powerful tool for helping patient change undesirable behavior. P. 484
Deficiency of energy
What is anergia?
Rationale: The individual with schizophrenia may lack sufficient energy to carry out activities of daily living or to interact with others (Morgan, 2024, p.475)
Why should the patient be careful operating or driving machinery?
What is drowsiness and dizziness
Rational: "Use cation when driving or operation dangerous machinery. Drowsiness and dizziness can occur"(Morgan, 2024 Pg. 491)
When a patient is experiencing the extrapyramidal side effect of acute dystonia, this drug class should be administered as ordered and immediately.
What are Antiparkinsonian Agents?
"Her thought process was loose and vague, and often circumstantial.
What is use an attitude of acceptance?
Rationale: This question is important to prevent injury to the patient and others from command hallucinations. P. 482