Schizophrenia
What are the causes of schizophrenia?
- brain structure
- genetics
- inflammation
- immune system
- decrease in neurotransmitters
What are the three types of advanced directives?
- living will
- power of attorney
- DNR
What should we know about PAIN?
- start low go slow
- Morphine gold standard
- prevent constipation
- apply heat/ cold
- breathing exercises
What are some things that taking antipsychotic medication can cause?
- extrapyramidal symptoms
- neuroleptic malignant syndrome
- metabolic syndrome
What are the meds will be give for n/v?
- promethazine
- ondansetron
- prochlorperazine
- anti anxiolytics
What are the positive signs and symptoms of schizophrenia?
- hallucinations
- delusions
- formal thought disorder
- abnormal movements
What is palliative care?
- provide comfort/ help manage disease
What should be known about gastrointestinal changes?
What are the extrapyramidal symptoms?
- akathisia > restlessness
- dystonia > bent neck, salvation
- psuedoparkinism > tremors
- tardive dyskinesia > bulging/ chewing of tough
What med is given for decreased appetite?
- Megestrol
What are the negative sign and symptoms of schizophrenia?
- avolition
- affect flat
- anhedonia
- antisocial
- alogia
What is hospice care?
- provide comfort when the end is near
- regulated by Medicare
What are the BREATHING PATTERN CHANGES towards end of life?
- Cheyne Stokes > changes between shallow and rapid breathing with periods of apnea
- Kussmaul > deep labored breathing
- Agonal > gasping at the end of life
What are the signs and symptoms of neuroleptic malignant syndrome?
- high fever
- severe muscle rigidity
- increased creatine
What is the time frame for impending death? What are the signs and symptoms of impending death?
last 4-48 hrs of life
- change in LOC
- sensory changes
- increased pain
- decreased Bp, Hr, RR
- Cheyne Stokes RR
- terminal secretions
- mottling/ cool extremities
- decreased urinary output
What are typical antipsychotics? Which signs and symptoms do they treat and what are the names of the typical meds?
- typical are older antipsychotic meds that are used in emergency situations
- they treat positive signs and symptoms
- Chlorpromazine, Haloperidol, Fluphenazine
What are the 4 levels of hospice care?
- routine > care occurs in pt home
- respite > inpatient temporary relief for caregivers
- general inpatient > short term, to manage symptoms
- continuous > nursing care at home that is continuous
What are the circulatory changes are experienced towards the end of life?
- cold hands and feet
- diminished/absent pulses
- increased wounds
- mottling feet/ knees
What are the signs and symptoms of metabolic syndrome?
- increased Bp
- increased triglycerides
- increased HDL
- insulin resistance
What is trauma informed care?
- shifting mindset from what's wrong with you to what happened to you
What are atypical antipsychotics? Which signs and symptoms do they treat and what are the names of the typical meds?
atypical antipsychotics are the newer meds and are for long term use
- they treat positive and negative symptoms
- Clozapine, resperidone, olanzapine, quetiapine, ziprasidone, paliperdone, aripiprazole
What MENTAL STATUS CHANGES may a person at the end of life might experience?
- restlessness/ repetitive motions
- increased sleep
- confusion/ delirium
- agitation > treat with haloperidol/ benzodiapines
What are the other side effects of metabolic syndrome?
- agranulocytosis
- sexual dysfunction
- hyperglycemia
- gynecomastia
Who is more likely to experience abuse?
- children and old adults