Schizophrenia
What is Psychosis?
Severe mental condition where there is disorganization of personality, deteoriation in social functioning, loss of contact with, or distortion of reality. Can occur with or without organic impairment
How long does delusional disorder last?
experienced for at least 1 month
How long does Brief psychotic disorder last?
Lasts less than 1 month then they return to the premorbid phase
What are the 4 phases of substance abuse disorder?
-Phase 1: prealcoholic (use alcohol to relieve stress, gain tolerance)
-Phase 2: Early alcoholic (Hiding alcohol, drinking in secret, feels guilt, denial and rationalization)
-Phase 3: Crucial (Everything is falling apart, and you lost everything, binge drinking, anger and aggression, sickness, loss if consciousness)
-Phase 4: Chronic phase (Emotional and physical disintegration)
What is FASDs?
Alcohol use during pregnancy. Can cause problems with learning, memory, attention span, communication, vision and hearing
What is organic impairment?
When it is not induced by something else; medical condition, drugs, medication
Define erotomaniac
stalking, feeling someone is in love with them
What evidence of impaired reality will you see with Brief psychotic disorder
incoherent speech, delusions, hallucinations, bizarre behavior, disorientation
What are the main symptoms of alcohol withdrawal?
Nausea and vomiting
(give high end protein and easy on the stomach soup)
Define Korsakoffs psychosis
Syndrome of confusion, loss of recent memory, confabulation(vitamin B12 as well)
What are the 4 phases of schizophrenia?
1. Premorbid phase
2. Prodromal phase
3. Active psychotic phase (acute schizo episode)
4. Residua phase
Define grandiose
Irritation ideas regarding their own worth, talent, knowledge or power
What is waxy flexibility?
Slight, even resistance to positioning
If there is a family Hx of alcoholism in the family what is the likeness the pt can develop it?
40-60%
Name some substance induced disorders
Symptoms from intoxication, withdrawal, delirium, NCD, Psychosis, bipolar, depression, OCD, anxiety, sexual dysfunction, sleep disorders
What occurs in the prodromal phase?
-Social maladjustment
-Shy withdrawn, poor in school, poor peer relationships (antisocial behavior)
- Easily mistaken or previously diagnosed as OCD
Define jealous
Belief their sexual partner is unfaithful
What is catalepsy?
passive induction a posture held against gravity
What is the difference in the CIWA vs. COWs test?
CIWA is for alcohol withdrawal
COWs is for opioids
What are some predisposing factors for substance disorders?
-Genetics/hereditary, developmental influences
- CONDITIONING: pleasurable effects from substance use act as a positive reinforcement for continued use of substance
What happens in the prodromal phase?
-Deterioration in role functioning/social withdrawal (signs of significant deterioration in functioning and cognitive impairment)
-sleep disturbance, anxiety, irritability, depresses mood, poor concentration, fatigue
-Adolescents can develop OCD in this phase
What is persecutory?
Believing their being plotted against
What is mannerism?
Odd, circumstantial caricature of normal actions
What are some things you will see with detox?
-Visual disturbances
-assess blood pressure and pulse every 4 hours
What causes sedative/hypnotic use disorder?
CNS depressants- Barbituates, nonbarbituates, anti anxiety
What happens in the active psychotic phase?
-Delusions and hallucinations
- impairment in work social relations and self-care, disorganized speech
-positive and negative symptoms
What is somatic?
fixed, false beliefs that they have some type of medical condition or an alteration in a body organ or its function
What is stereotypy?
Repetitive abnormally frequent non goal directed movements
What is Wernicke's encephalopathy?
Muscle rigidity, negative motor functions, seizures
What affects on the body will you see with sedative/hypnotic use disorder?
Sleep/dreaming, respiratory depression, cardio effects, renal function, hepatic effects, body temp, sexual functioning
What happens in the residual phase?
Flat affect and impairment in road functioning are prominent
Negative symptoms may remain
Similar to prodromal stage
In mental health what is mixed mean?
Delusions are prominent, but no single theme is present
What is negativism?
opposition or no response to instruction or external stimuli
If a pt is experiencing Wernicke's encephalopathy what will the nurse do?
-Use seizure precautions
-assess for injuries
-give fluids (electrolytes)
-protein meals
-small frequent meals
-adequate sleep
What is inhalant induced disorder symptoms?
Intoxication: dizziness, ataxia, muscle weakness, euphoria, nystagmus, blurred/double vision, psychomotor retardation, hypoactive reflexes, stupor
What phase can adolescents develop OCD?
Prodromal phase
What catatonic features are associated with Brief psychotic disorder
Stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, mannerism, stereotypy, agitation, grimacing and echolalia, echopraxia
What questions will you ask an alcoholic?
-When was the last time you drank?
-How much did you drink?
-How often do you drink? (This will help determine when the withdrawal will start) (4-12 for alcohol)(12-24 for drugs)
Prevalence and signs of Chemically impaired nurses
-Prevalence of substance use 5.1%
-Signs: misses work