Behaviors
This should be the nurse's priority when a client with schizophrenia develops bizarre behaviors and delusions.
What is observing for escalating behaviors?
False beliefs that usually involve a misinterpretation of perceptions or experiences. Also, people maintain these beliefs despite clear evidence that contradicts them.
delusion. For example, people with schizophrenia may have persecutory delusions, believing that they are being tormented, followed, tricked, or spied on. They may have delusions of reference, believing that passages from books, newspapers, or song lyrics are directed specifically at them. They may have delusions of thought withdrawal or thought insertion, believing that others can read their mind, that their thoughts are being transmitted to others, or that thoughts and impulses are being imposed on them by outside forces.
This important teaching is conducted in skills training for those with schizoaffective d/o.
What is how to make eye contact when communicating?
Benztropine (Cogentin) is given for this behavior.
What are EPS of antipsychotic drugs such as muscle rigidity?
Other EPS symptoms include akathisia (motor restlessness), parkinsonism (cogwheel rigidity, tremors, slower movements), and dystonia (involuntary muscle contraction). While all antipsychotics can cause EPS, they tend to be more common in FGAs.
A client with schizophrenia is newly admitted and insists on wearing his shoes to bed. He also has severe body odor due to not bathing. This would be the appropriate nursing approach.
Encourage independence but intervene when necessary.
This would be the best way to document a client who is observed with darting eyes, tilting head side to side, and mumbling to self.
What is responding to internal stimuli?
Two broad types of delusions.
What are bizarre or non bizarre? Delusions in schizophrenia may be bizarre or not. Bizarre delusions are clearly implausible and not derived from ordinary life experiences. For example, people may believe that someone removed their internal organs without leaving a scar. Delusions that are not bizarre involve situations that could happen in real life, such as being followed or having a spouse or partner who is unfaithful.
This disorder is essentially schizophrenia with manic episodes or a significant depressive component.
What is schizoaffective disorder?
Of note the validity and reliability of schizoaffective d/o remains unresolved.
This vital sign abnormality would require immediate nursing intervention in the client taking an antipsychotic?
What is a fever?
This is the approach for clients taking an antipsychotic during pregnancy.
What is continue the antipsychotic for the well-being of the mother and baby, however no safe use of antipsychotics has been established during pregnancy?
This would be the reason a client with schizophrenia likely threw away their pills.
What is lack of insight into their disease and poor judgment?
These are the classic "crazy" symptoms of schizophrenia.
What are positive symptoms? These dramatic symptoms usually appear early and capture our attention and is often what precipitates treatment. May include alterations in reality testing (person hears voices and believes they are real but the person without schizophrenia may think they hear a voice but no one is there so they are able to conclude they are mistaken). Unusual speech disorders such as word salad. Alterations in perception such as hallucinations.
This assessment finding would alert the nurse to question a diagnosis of a brief psychotic episode.
What are auditory hallucinations for three hours?
This d/o is identified by a sudden onset of psychotic symptoms that last at least 1 day but less than 1 month and there is a return to premorbid level of functioning.
This potentially fatal side effect is possible for clients taking clozapine.
What is agranulocytosis?
A patient thinks they are pregnant but they have a negative pregnancy test. What kind of delusions is this?
What is a somatic delusion?
This would be the nurse's main responsibility when caring for a client with catatonia and does not initiate bodily movements.
What is supporting physiologic needs?
These type of symptoms are serious problems for people and more difficult to treat than the other type of symptoms.
What are negative symptoms? Negative symptoms include six symptoms that all begin with the letter A.
Alogia -reduced speech
anhedonia-inability to experience pleasure
avolition-loss of motivation
asociality-lack of interest, decreased desire for or comfort during social interaction
affective blunting-reduced or constricted affect
apathy-decreased interest in activities or believes that would otherwise be interesting or important.
This historical data would be found in a client dx with substance-induced psychotic disorder?
What is an opioid disorder?
The prominent hallucinations and delusions associated with a substance-induced or medication-induced d/o are found to be directly attributable to a substance intoxication or withdrawal, like opioid use disorder.
These symptoms would indicate a fatal side effect is occurring when taking Clozapine.
What is a sore throat, fever, and malaise?
The client states "It is very cold. My shirt is bold. My gold bracelet was sold." Name this positive symptom.
What is clang associations?
This habit is common in patients with schizophrenia and can increase the metabolism of antipsychotics, requiring a dosage adjustment.
What is smoking?
These are the absence of essential human qualities.
What are negative symptoms?
This would be the least severe disorder in the gradient of psychopathology of schizophrenic disorders.
What is a delusional disorder?
(A delusional disorder would have the least impact on overall functioning when compared with schizophrenia, or substance-induced psychotic d/o, for example)
This laboratory finding would indicate a potentially fatal side effect is occuring while on clozapine.
What is a low absolute neutrophil count?
Name this positive symptom.
Client states "Most forward action grows death round light."
What is word salad?