SYMPTOMS
Inability to distinguish between reality and what they see or hear
Psychosis
What are the four phases of schizophrenia?
Premorbid, Prodromal, Active, and Residual
Interventions for Hallucinations
Observe for hallucinations; Do not touch client until you warn the client first; Do not reinforce hallucinations; Distract from hallucination
This class of medication has a higher likelihood for development of EPS
1st Gen Antipsychotics
Screening tool for EPS
Abnormal Involuntary Movement Scale (AIMS)
Alogia, Anergia, Anhedonia, and Avolition are examples of
Negative symptoms
In which phase would the patient present with active psychotic symptoms?
Active phase
Interventions for Risk of Injury
Remain calm; Decrease stimuli; Observe behavior; Create a safe environment; Intervene at signs of increased anxiety/agitation/aggression; Deescalate >> medication >> restraints; If in restraints, assess q15mins
This medication can be used to treat positive and negative symptoms, as well as improve cognitive function
Aripiprazole(Abilify)
Symptoms of schizophrenia + Symptoms of a mood disorder =
Schizoaffective Disorder
Hallucinations, Delusions, Alterations in speech, and Bizarre behavior are examples of
Positive symptoms
Signs that occur before there’s clear evidence of the illness present during what phase?
Premorbid phase
“Is it that you mean ____?” or “I don’t understand what you mean by that. Can you explain it to me?” are examples of?
Decoding
Complications of Atypical Antipsychotics
Metabolic syndrome; Orthostatic Hypotension; Anticholinergic effects; Agitation, dizziness, sedation, sleep disruption; Mild EPS; Increased Prolactin Levels; Sexual dysfunction
Promoting therapeutic communication works to
lower anxiety, decrease defensive patterns, and encourage participation in the milieu
The process of thinking about physical things from the surface level
Concrete thinking
In what phase would symptoms no longer be present or no longer prominent?
Residual phase
Interventions for Disturbed Thought Process
Convey acceptance of client’s need for false belief but indicate you do not share it; Do not argue with client; Reinforce and focus on reality
Sudden high fever, blood pressure fluctuations, diaphoresis, tachycardia, muscle rigidity, decreased LOC, and coma are manifestations of what?
Neuroleptic Malignant Syndrome
Nursing interventions for 'Suspicious' or 'Distrustful' patients
Continuity of care; Matter-of-fact, assertive, genuine approach; Avoid physical touch; Avoid laughing, whispering where client can see but cannot hear; Mouth checks with medication administration
Disordered thinking, Inability to make decisions, Poor problem solving, Difficulty concentrating to perform tasks, Short term memory deficits, and Impaired abstract thinking are examples of
Cognitive symptoms
A patient presenting with clear signs of illness, including deterioration of function, social withdrawal, and cognitive impairment would be in what phase?
Prodromal phase
Desired Outcomes for Patients with schizophrenia
Reduction of symptoms; Preventing reoccurrences of episodes and functional decline; Meeting their needs(Psychosocial, Developmental, Cultural, Spiritual); Function at highest level possible
This medication requires frequent lab monitoring for indications of agranulocytosis or leukopenia.
Clozapine(Clozaril)
Intensive case management and interprofessional team approach to assist clients with community living needs
Program of Assertive Community Treatment (PACT)