Thought Disorders
List positive and negative symptoms
Positive: hallucinations, delusions, disorganized thinking and speech, agitation, aggression, unusual mannerisms
Negative: blunted affect, avolition, alogia, concrete thinking, withdrawn
S: sleep disturbance, I: interest decreased, G: guilt, E: energy, C: concentration decreased, A: appetite, P: psychomotor retardation/ agitation, S: suicide
How is each cluster described?
Cluster A: odd or eccentric
Cluster B: dramatic and emotional
Cluster C: anxious and fearful
risk factors (marital status, gender, age, religion, socioeconomic status, ethnicity)
- more women attempt, more men complete
- male rates increase with age
- less likely if their religion looks down on it
- highest and lowest social classes
- white
Describe Autism Spectrum Disorder and indications
withdrawal of a child into their self and into a fantasy world of their own creation
impaired social interaction, impaired communication and imaginative activity, and restricted activities and interests
agitation, waxy flexibility (stay in odd stance for long period), stupor (motionless for long periods), negativism (opposite of what they are told), echopraxia, motor movements lacking purpose, reduced impulse control, gesturing/ posturing, catatonia (decreased or no response to stimuli)
What is an assessment that qualifies someone of having major depressive disorder?
persistently depressed mood lasting a minimum of two weeks
What is the difference between schizoid personality disorder and avoidant personality disorder?
schizoid does not have interest in making connections and relationships with people
avoidant desires relationships and connections but have a fear of rejection and feelings of inadequacy so they are scared to reach out
warning signs
I: ideation, S: substance use, P: purposelessness, A: anger, T: trapped, H: hopelessness, W: withdrawal, A: anxiety, R: recklessness, M: mood
Characteristics of a resilient child
- problem solving skills
- social and emotional intelligence
- adaptive temperament
- shows respect to authority figures
- proud of own accomplishments
Nursing interventions
client safety, limit setting, ask about delusions and hallucinations, adherence to medical regimen, target negative symptoms, anxiety control, relapse prevention
Indications of a patient experiencing a manic episode
D: distractibility, I: insomnia, G: grandiosity, F: flight of ideas, A: activity increased, S: speech pressured, T: talkative
What is schizotypal personality disorder and how would it present in a patient?
- Magical thinking: believe in superstitions or past lives
- discomfort with close relationships and social interaction
Nursing interventions for patient at risk
- safe environment
- close observation
- encourage to express feelings
- make a safety plan
What is the main difference between Oppositional Defiant Disorder and Conduct Disorder?
a patient with conduct disorder is physically violent towards others
Differences between schizophrenia, schizoaffective, brief psychotic, and psychotic or catatonic
schizophrenia: psychotic symptoms for 6 months
schizoaffective: schizophrenic and mood disorder
brief psychotic: only lasts one day to one month, acute onset of psychosis
psychotic or catatonic: showing symptoms but not meeting criteria
What is the difference between Bipolar I, Bipolar II, and Cyclothymia?
Bipolar I: mania and major depression (both extremes)
Bipolar II: hypomania and major depression
Cyclothymia: hypomania and minor depression
Indications of borderline personality disorder
- frantic efforts to avoid abandonment
- inappropriate intense anger (trouble controlling it)
- will threaten to kill themselves if you leave
- may cut themselves and have suicidal behaviors but will not actually do it
Suicidal precautions in the hospital
- assess risk every 8 hours
- environmental check twice a day
- removes shoelaces or belts
- make sure patient swallows meds
- only plastic silverware
Factors that can cause intellectual disability
- genetics
- disruptions in embryonic development (drugs or alcohol, illness, or infections during pregnancy)
- perinatal factors
- illness in infancy (infections: meningitis and encephalitis, poison: insecticides, meds, and lead, physical trauma: head injury, asphyxiation)
- socioeconomic factors (pollution, lack of nutrition)
Typical vs Atypical Antipsychotics
Typical: target positive symptoms, side effects: EPS, tardive dyskinesia, medications: chlorpromazine, fluphenazine, haloperidol
Atypical: decrease positive and negative symptoms, side effects: neutropenia, cardiac concerns, neuroleptic malignant syndrome (sudden high fever, BP fluctuations, muscle rigidity, tachy, decreased LOC/ coma), medications: arirpiprazole, clozapine, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone
Patient education on MAOI's and SSRI's
MAOI's: avoid tyramine (aged cheese, chocolate, salami, fermented foods, pickles
SSRI's: sexual dysfunction (patient will want to stop and that will harm patient), serotonin syndrome (fever, sweating, diarrhea, abdominal pain, increased BP and HR, irritability, could have seizures and die), suicide (when patient is most vulnerable and will start to get more energy)
Nursing interventions for personality disorders
- be consistent
- set limits (do not change rules)
- maintain professional boundaries
- do not let them manipulate to get what they want
- listen to patient
- explain importance of patient in their life
- restrict methods
- find resources
- play close attention to signs of suicide and take them all seriously
Interventions for patient with ADHD
- give rewards
- give small tasks to complete one full one
- CNS stimulants (methylphenidate, dextroamphetamine/amphetamine)