Basics
What is the etiology behind schizophrenia?
Neurotransmitter dysregulation: Dopamine, GABA, Glutomate, acetylcholine
What are some risk factors for schizophrenia?
Genetics (bio parent w/ it puts you at 30% higher risk)
Father being 60 or older when having child = 2x risk
Advanced maternal age
Stress during development
Early life adversity
Poverty, violence, trauma
Developmental issues
Emotional, cognitive, language, motor development
What are delusions of reference?
Belief that certain events occur for THEIR benefit
"Everything relates to me and belongs to me"
What medication is used for auditory hallucinations?
Risperidone (Risperdal)
What type of communication strategy should be used?
Use “I” language to express feelings and to avoid blame
“I am happy when you join us for dinner”
What is psychosis?
Loss of reality
What are positive symptoms and examples?
Positive sx: added behaviors
EX: Hallucinations, delusions, thought disorders, disorganized speech (word salad), bizarre behavior (like only walking backwards), echolalia
What are delusions of grandiose?
Belief they have special powers
"I am GOD"
What is the goal for pharmacological treatment?
To reduce sx w/ the lowest dose possible
Which strategies would promote effective communication with someone with schizophrenia?
Practicing what you say
Minimizing stimuli
What is something you should avoid doing when it comes to hallucinations or delusions?
What are negative symptoms and examples?
Negative sx: loss of function
EX: anhedonia, flat affect, alogia (decreased speech), avolition (decreased motivation), poor personal hygiene, social withdrawal, poor problem solving
What are delusions of persecution?
Belief someone is out to harm them
"The FBI is coming for me!!!!"
What are the First Gen (typical) Antipsychotics used for?
To treat positive sx
EX: Haloperidol, Chlorpromazine
Proper nursing care during a hallucination?
Validate their fears or emotions
Do not feed into the hallucination
What are some indications of reduction in psychotic symptoms
-demonstrates appropriate affect
-adheres to the medication regimen
-demonstrates appropriate self-care
-reports improvement in sleep quality and quantity
-remains safe and free of injury
-refrains from use of nicotine, alcohol, and illicit drugs
-demonstrates improved coping skills
-reports increased social interactions with others
-has an emergency plan in place
What are examples of cognitive symptoms?
Memory deficits, poor facial recognition, poor attention/concentration, limited insight, prone to sensory overload, difficulty w/nonverbal cues
Auditory hallucinations that instruct a patient to act in specific ways
NOT GOOD!!
What are the Second Gen (Atypical) Antipsychotics used for?
Tx positive and negative sx
EX: Risperidone, Olanzapine, Clozapine
What type of therapeutic procedures are used?
Psychotherapy (CBT)
Social skills training
ECT (for affective sx)
Cognitive remediation
What are s/s of relapse in mania?
Social withdrawal, sleep disturbances, increased paranoia
What are examples of affective symptoms?
Depression, mania, increased suicide risk
Complementary health examples for schizophrenia
vit B, vit D, omega-3 fatty acids
How long must sx be present before a diagnosis is made?
At least 6 months
or 1 month of active sx
Should you use consistent staff and routine care for a patient with schizophrenia?
Yes