Row 1
Ch. 12
Ch. 12
(1) What is impaired reality testing?
(2) What are the ages of pts that are usually dx with schizophrenia?
(200 more points added if correct)!
(1) The belief that their perception is real
(2) 15-25 years of age
Assessment: Cognitive (mind) symptoms
(1) what is impaired executive functioning?
(2) What is anosognosia?
(300 points added)
(1) poor decision making and reasoning
(2) inability to realize that they are ill...."lack of insight"
(Delusions)
(1) what does Persecutory mean?
(2) What does Referential mean?
(3) What does Grandiose mean?'
(300 more points added)!
(1) belief that they are a victim, being singled out
(2) Belief that events, or situations are connected to you
(3) Belief that you are powerful or inflated self-importance
Hallucinations and delusions are which type of symptom of schizophrenia?
A. unbalanced
B. positive
C. negative
B.
Delusions are?
A. confabulations
B. false beliefs
C. distorted thinking
B
(1) We must have at least 3 psychotic symptoms present for diagnosis of schizophrenia.
True or False
(2)
Name a few psychotic symptoms for dx of schizophrenia.
(If you get these correct, 200 more points added)!
(1) False (Must have at lease one psychotic symptom present for dx).
(2) hallucinations, delusions, and/or disorganized speech/thoughts (Remember we are looking at their symptoms. Behaviors).
Assessment: cognitive (mind) symptoms
(1) what is concreate thinking?
(2) what is memory impairment?
(3) What is impaired information processing?
(300 points added)!
(1) unable to understand abstractly, decreased ability to understand abstract concepts such as love and humor "early bird catches the worm..."
(2) Repetition and reminders may be necessary
(3) delayed responses, may be overstimulated and distracted easily.
(Delusions)
(1) What does Erotomanic mean?
(2) What does Nihilistic mean?
(3) What does Somatic mean?
(4) What does Control mean?
(400 points added)!
(1) belief that another person romantically desires you
(2) belief that a major catastrophe will happen
(3) belief that your body is changing in unusual ways
(4) belief that another person or external force controls your thoughts and behaviors
Which type of delusion carries the belief that the person is being singled out or a victim?
A. erotomanic
B. grandiose
C. persecutory
(1) High EPS risk is a concerned s/e for 1st generation antipsychotics (True or false)?
(2) High metabolic syndrome risk is a concerned s/e for 2nd generation antipsychotics (True or False)?
(3) How long does it take for antipsychotics to be effective?
(4) What should we teach pts who are on antipsychotics?
(200 points added)!
(1) true
(2) true
(3) 2-6 weeks
(4) Do not drink alcohol, ways to manage orthostatic hypotension
What are some comorbidities when it comes to poor physical health with schizophrenia?
-- substance use
-- tobacco (60%)
-- anxiety
-- depression
-- heart disease
-- diabetes
-- polydipsia
Name positive symptoms of schizophrenia.
-- Delusions
-- Alterations in speech
-- Hallucinations
-- Illusions
(Negative symptoms)
(1) what is apathy?
(2) what is Alogia?
(3) what is affective blunting?
(300 points added)!
(1) decreased interest in activities "no care"
(2) poverty of thought, less speaking often, fewer words, takes longer to talk.
(3) Flat, constrictive, inappropriate or bizarre. "No facial expressions"
(1) What types of symptoms (positive, negative, or both) does 1st generation (typical) antipsychotics tx?
(2) What types of symptoms (positive, negative, or both) does 2nd generation (a-typical) antipsychotics tx?
(1) positive (and negative but not often)
(2) Positive and negative symptoms (typically 1st line medication.
What are the basic s/es of antipsychotics?
-- Urinary retention
-- sexual dysfunction
-- Anticholinergic toxicity (delirium, unstable vs's, absent peristalsis, agitation, disorientation, worsening psychotic).
--Severe neutropenia (Clozapine (clozeril)) (Signs: increased infections, decreased neutrophil count) (Interventions: POTENTIALLY FATAL, HOLD MED, CALL MD).
Name at least 3 risk factors involved with Schizophrenia.
-- Biological (Genetic and neurobiological)
-- Brain structure abnormalities (Atrophy causes disruption)
-- Prenatal stressors-- Infection during/after pregnancy
-- Environmental factors (Social, Psychological, and physical stressors).
What are the two command hallucinations we should ask about?
--Auditory (most common), visual, olfactory, gustatory, tactile
--Visual (second most common)
(Negative symptoms)
(1) What is anhedonia?
(2) What is avolition?
(3) what is Asociality?
(If correct, 200 points added)!
(1) lack of interest, enjoyment or pleasure from life's experiences (not want to spend time with others or activities that made you happy).
(2) A total lack of motivation that makes it hard to get anything done "no motivation"
(3) decreased desire of social interaction
Name the 1st generation antipsychotics.
(100 points added)
-- Haloperidol (Haldol)
-- Loxapine
-- Fluphenazine (Prolixin)
-- Thioridazine (Mellaril)
-- Molindone (Moban)
Acute dystonia reaction, Akathisia, pseudoparkinsonism, and tardive dyskinesia are s/e's of EPS (Antipsychotics).
What are the signs and interventions for each one?
(200 points added)!
-- Acute dystonia reaction: signs: acute painful contractions or muscle spasms (head and jaw) Interventions: Assure pt airway, Administer Benztropine (Cogentin) or diphenhydramine asap, STOP ANTIPSYCHOTIC.
-- Akathisia: Signs: motor restlessness, rocking back and forth. Interventions: Give Benztropine (Cogentin), stop antipsychotic, may give benzos.
-- Pseudoparkinsonism: Signs: Shuffled gait, drooling, pill rolling finger movements. Interventions: Give benztropine (Cogentin), fall precautions
-- Tardive dyskinesia: Signs: Protruding tongue, irregular or purposeful movement. Interventions: Give Valbenazine. Remember, Tardive dyskinesia is very difficult to reverse.
(1) What are the phases of Schizophrenia in order?
(2) What does each phase entail?
-- Prodromal (mild changes in thinking, reality testing, odd or obsessive thoughts.
-- Acute (Hallucinations, delusions, apathy, social withdrawal, anhedonia, diminished affect, impaired coping; usually hospitalized).
-- Stabilization (symptoms improving, moving to previous level of functioning)
-- Maintenance (condition has stabilized and new normal is present, focus to prevent relapse).
What is the differences between delusions, hallucinations, and illusions?
--A hallucination involves the senses and feels real but is not
-- A delusion is a false belief persists in spite of evidence.
-- An illusion is a misinterpretation of a real experience (from a stimulus in the environment, ex; pile of clothes in the corner...sees that it is a person).
What are the Negative symptoms of schizophrenia that we assess?
-- Anhedonia
-- Avolition
-- Asociality
-- Apathy
-- Alogia
-- Affective blunting
Name the 2nd generation antipsychotics.
-- Olanzapine (Zyprexa)
-- Quetiapine (Seroquel)
-- Risperidone (Risperadal)
-- Ziprasidone (Geodone)
-- Aripiprazole (Abilify)
-- Paliperidone (Invega)
-- Larasidone (Latuda)
-- Clozapine (Clozeril)
Neuroleptic malignant syndrome (NMS), metabolic syndrome, and cholestatic jaundice and s/e's from antipsychotics.
What are the signs and interventions of each on of these s/e's?
(200 points added)
-- NMS: Muscle rigidity, hyperpyrexia (high fever)!! Interventions: POTENTIALLY FATAL!--Hold med and contact provider, give fluids, cooling blankets, DANTROLENE.
-- Metabolic syndrome: Signs: weight gain, dyslipidemia, increased risk for DM, and CV disease. Interventions: Teach management of weight gain, may be prescribed Metformin.
-- Cholestatic Jaundice: Signs: fever, malaise, nausea, abd pain, jaundice. Interventions: LFT's to be monitored twice a year, bedrest, consult provider.