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Schizophrenia Flashcards

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1
Q

Schizophrenia probably causes more white out of all the mental illnesses

A

Lengthy hospitalizations
Chaos and family life
Cost to individual government
Fear

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2
Q

What is a major concern in risk of in about 1/3 of people with schizophrenia

A

Suicide

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3
Q

What is psychosis?

A

A severe mental condition in which there is a disorganization of the personality, deterioration and social functioning in loss of contact with distortion of reality
Hallucinations and delusional, thinking

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4
Q

What are the four phases of schizophrenia?

A

Premorbid
Prodromal
Active psychotic phase
Residual phase

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5
Q

What is the pre-morbid phase

A

Signs that occur before there is clear evidence of illness and may include distinctive, personality, traits, or behaviors
Shy withdrawn, poor peer, relationships, doing poorly in school demonstrating antisocial behavior

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6
Q

What is phase 2 the prodromal phase

A

 Individual begins to show signs of significant deterioration and function. Social withdrawn is not uncommon some have sudden onset of OCD.
Recognition of behaviors provides opportunity for early intervention
Can last for 2 to 5 years

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7
Q

What is the active psychotic phase of schizophrenia?

A

Psychotic symptoms are typically prominent
Delusions, hallucinations, disorganized, speech, behavior, decrease level of functioning, and work relationships, or self-care

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8
Q

What is the residual phase of schizophrenia?

A

Active psychotic face symptoms are either absent or no longer prominent
Positive symptoms remain
Flat affect and impairment are common

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9
Q

Can the phases of schizophrenia go through exacerbations

A

Yes, they can be exacerbations and remissions the more likely this happens the more likely they are to have residual effects
Harder to get out of the active phase

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10
Q

What are the DSM five criteria for diagnosis of schizophrenia?

A

Two or more of the following each present for a significant portion of time during one month period. At least one of these must be one two or three.
1. Delusions.
2. Hallucinations.
3. Disorganized speech.
4. Grossly disorganized or catatonic behavior.
5. Negative symptoms.

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11
Q

What is delusional disorder?

A

Presence of delusions experience for at least one month
Hallucinations are not prominent
Behavior is not bizarre
Types of delusional disorder include erotomanic grandiose, jealous, persecutory somatic, and mixed

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12
Q

What is a brief psychotic disorder?

A

Sudden onset of psychotic symptoms that may or not be proceeded by several psychosocial stressors
Symptoms less at least a day, but less than a month there is an eventual fall return to the preorbital level of functioning

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13
Q

What is substance medication induced psychotic disorder?

A

Prominent hallucinations and and illusions are directly attributed to substance and intoxication or withdrawal, or exposure to a medication or toxin

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14
Q

What is psychotic disorder due to another medical condition?

A

Prominent hallucinations and delusions that can be directly attributed to another medical condition

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15
Q

What is catatonic disorder due to another medical condition

A

Symptoms, such as super catalepsy, waxy flexibility, mutism in negativism or present catatonic disorder may be associated with with other psychotic disorders
Hepatic encephalopathy
Hypo or hyperthyroidism
Vitamin B 12 deficiency

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16
Q

What is catatonia?

A

Refers to a significant motor disturbance that may range from stupor no motor activity to excessive motor activity and agitation

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17
Q

What is schizophreniform disorder

A

Identical to schizophrenia, except that the duration, including prodromal, active and residual phrases, is at least one month, but less than six months

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18
Q

If you are diagnosed with schizophreniform can it ever be changed to schizophrenia?

A

The diagnosis has changed to schizophrenia. The clinical picture persist on six months.

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19
Q

What is schizoaffective disorder?

A

Signs and symptoms of schizophrenia, along with a strong element associated with a mood disorder

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20
Q

What is the decisive factor in the diagnosis of schizoaffective disorder?

A

The presence of hallucinations or delusions that occur for at least two weeks in the absence of a major mood episode
Prominent mood disorder symptoms must be evident for most of the time

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21
Q

A patient is admitted with a diagnosis of brief psychotic disorder with catatonic features which symptoms are sociable with the catatonic specifier
Strong, ego boundaries, and abstract thinking
Ataxia and a akinesia
Stupor Muscle rigidity and negativism
Substance abuse, and cache is

A

Stupor
Muscle rigid
Negativism

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22
Q

What are positive symptoms of schizophrenia?

A

Delusions, disturbances, and thought content
Disturbances and thought process manifested in speech
Disturbances and perceptions hallucinations

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23
Q

What is a delusion?

A

Fixed false beliefs that are irrational, and that the individual maintains are true, despite evidence to the contrary

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24
Q

What is delusions of persecution?

A

Most common type of delusion in which individual believes they are being persecuted or male violently treated in someway
The FBI bugged my room and intense to kill me

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25
What is a paranoid delusion?
Extreme suspicion of others in their actions, or perceived intentions I won’t eat this food. I know it’s been poison. Aggression and violence may occur
26
What is grandiose delusions
Individual has an exaggerated feeling of importance power, knowledge or identity I am Jesus
27
What is a delusion of reference?
Someone is trying to get a message to me through the articles in this magazine. I must break the code so I can receive the message
28
What is ideas of reference?
Less rigid than delusions of reference for example, an individual with ideas may think that other people in the room, who are giggling, must be laughing about him, but with additional information there could be other explanations for their laughter
29
What is delusions of control or influence?
Individual believes certain objects, or people have control over his or her behavior Dentist put a pill in my tooth now I received transmissions through the filling and control what I think and do Common magical, thinking
30
What is magical thinking?
Ideas that one’s thoughts or behaviors have control over specific situation I am sad so it is raining
31
What is somatic delusions?
The individual has a false idea about the functioning of his or her body The doctor says I am not pregnant, but I know I am
32
What is Nihilistic delusions
The individual has a false idea that the self, a part of the self, or others of the world are nonexistent, or has been destroyed The world no longer exist. I have no heart.
33
What is erotomanic delusions
Individuals falsely believe that someone usually a higher status is in love with them Famous people are often subjects Individuals may follow contact or otherwise try to pursue
34
What is a jealous delusion
Centers on the idea that a person sexual partner is unfaithful Irrational and without cause, but individual will search for evidence to justify the belief Individual may attack lover
35
What what does loose associations?
Speech by which idea shift from one unrelated subject to another Individual is unaware topics are unconnected We wanted to take the bus but the airport took all the traffic driving is the ticket when you want to get somewhere we have it all in our pockets
36
What is neologisms
Newly invented words that are meaningless to others, but have some ballot meaning to individual
37
What is clang association?
Choice of words is covered by sounds often form of rhyming It is very cold. I am cold and bold. The gold has been sold.
38
What is word salad
Group of words that appear to be put together randomly without any logical connection
39
What is circumstantiality?
Individual delays in reaching the point of communication because of unnecessary and tedious details Patient cannot get to the point to keep patient on track
40
What is tangentiality?
Refers to a veering away from the topic of discussion and demonstrates difficulty, maintaining focus and attention
41
What is preservation?
Persistently repeats the same word or idea in response to a different question Person gets stuck on a particular thought
42
What is echolalia
Refers to repeating words or phrases spoken by others
43
What is a hallucination?
False sensory perceptions not associated with real external stimuli involves any of the five senses
44
What is an auditory hallucination?
False perceptions of sound Most commonly these are voices, may report clicks music or other noises
45
What is a command hallucination
Voices that issues commands to the individual Potentially dangerous when commands are for violence to sell for others
46
What are visual hallucinations?
False visual perceptions that may consist of formed images, such as people or light
47
What are tactile hallucinations?
False perception of sense of touch often something under the skin
48
What is formication?
Specific, tactile hallucination with a sensation that something is crawling or under the skin
49
What is a gustatory hallucination?
False perception of taste
50
What is an olfactory hallucination?
False perception of sense of smell
51
What is an illusion?
Miss perception, or misinterpretation of real external stimuli May occur during Prodomal phase and persist in residual phase as well during active
52
What is the difference between an illusion and hallucination?
A hallucination is a monster in the corner not real An illusion is that someone turns into a monster is a real person
53
What are more dangerous illusions or hallucinations?
Illusions because they are real objects someone is seeing a different way can cause harm to themselves or others
54
What is echopraxia?
Imitates movements made by others
55
What is mutism?
Individuals, inability, or refusal to speak
56
The patient here is the word match. The patient replies, a match, I like matches they are the light of the world. God will light the world let your light shine which communication pattern does the nurse identify. Word, salad Cling association Loose association Ideas of reference
Lucas association
57
A patient diagnosed with schizophrenia experiences, identity, confusion, and communicates with the nurse using echolalia is the patient attempting to do by using this form of speech Identify with the person speaking Imitate the nurses movements Alleviate, Alogia Alleviate avolition
Identify with the person speaking
58
What are negative symptoms of schizophrenia
Disturbances in affect Lack of interest or skills in interpersonal interaction Lack of insight Lack of abstract, thinking
59
What is an inappropriate affect
Inappropriate when the individuals emotional tone is incongruent with the circumstance Young woman who laughs when told of death of mother
60
What is a bland or flat affect?
Described as bland when the emotion tone is very weak individual with flat affect, appears to void of emotional tone
61
What is apathy in a negative symptom of schizo aaron
Demonstrates and indifference to or disinterest in the environment Bland or flat effect is a manifestation of emotional apathy Negative symptom
62
What is avolition of a negative symptom of schizophrenia
Impaired volition has to do with the inability to initiate goal directed activities Neglect activities of daily living, including personal hygiene, and appearance Negative sumptom
63
What is lack of interest or skills in interpersonal interaction as a negative symptom of schizophrenia
Cling to others in intrude on the personal space of others, exhibiting behaviors that are not socially and culturally acceptable Negative symptom
64
What is asociality
Ambivalence in social relationships, or made withdrawal from relationship altogether Negative symptom
65
What is anosognosia
Individuals, lack of awareness of having an illness or disorder, even when symptoms appear obvious to others Negative symptom
66
What is the most common predictor of non-adherence to treatment which predicts higher higher relapse rates increase number of involuntary treatments, poor psychosocial functioning, aggression, and poor course of ill
Anosognosia -lack of awareness of having illness Negative symptom
67
What is anergia
Deficiency of energy Negative symptom
68
What is anhedonia
Inability to experience pleasure Distressing symptoms may increase one’s risk for suicide Negative symptom
69
What is lack of abstract, thinking ability
Concrete thinking, or literal interpretations of environment represents a regression to an earlier level of cognitive development Have a great difficulty describing abstract, meanings of saying such as it’s raining cats and dogs Negative symptom
70
What is waxy flexibility
Condition in which the client allows body parts to be placed in bizarre or uncomfortable positions Associated with catatonia Once placed in position, remains in position for long periods
71
What is posturing?
Manifested by the voluntary assumption of inappropriate or bizarre postures Negative symptom
72
What is pacing and rocking?
Slow, rhythmic back and forward swinging of the trunk from the hips usually well sitting common psychomotor behaviors Negative symptom
73
What is regression?
Retreat to earlier level of development Primary defense mechanism of schizophrenia to attempt to reduce anxiety Negative symptom
74
What does eye movement abnormalities?
Manifest in several ways, including difficulty, maintaining focus on stationary object, and difficulty with smooth pursuit of a moving object Negative
75
What are some outcomes when we had a patient with schizophrenia
Recognizes distortions of reality Has not harmed self or others Perceived self and environment realistically Anxiety, manageable Relinquishes need for delusions and hallucinations Ability to trust Perform self-care
76
What are some goals when treating disturbed sensory perception including hallucinations?
Helping patient to find and test reality verbalizing understanding that hallucinations are result of illness Attitude of acceptance accept Distracting patient from hallucinations
77
What is a short term goal for disturbed thought processes
By the end of two weeks, patient will recognize and verbalize symptoms escalate at times of increasing anxiety
78
What are some long-term goals of disturbed thought processes
By the time discharge, patient verbalize is will reflect reality based thinking with no evidence of delusional ideation Patient will be able to differentiate between delusional thinking, and reality
79
What is a short term goal for risk of violence
Patient will be able to recognize signs of increasing anxiety and agitation, and report to staff for assistance Patient will not harm himself or others
80
What is a long-term goal for risk of violence?
Patient will not harm self or others
81
What is an intervention for disturbed thought process
Convey acceptance of patients need for false belief, but indicate that you do not share the belief Do not argue or deny belief Reinforce and focus on reality
82
What are some interventions of risk for violence
Maintain low level of mental stimuli Observe patients behavior frequently Assess for presence of suicidal ideation, or command hallucinations
83
What are some short term girls for impaired verbal communication
Demonstrate ability to remain on one topic using appropriate intermittent iContact for five minutes with nurse
84
What are some long-term goals for impaired verbal communication
By discharge patient will demonstrate ability to carry verbal communication and socially acceptable manner
85
What are some interventions for? Impaired verbal communication
Facilitate trust and understanding in non-threatening manner Anticipate and fulfill patients need Orient patient to reality as required
86
To deal with a client, hallucinations therapeutically, which nursing intervention should be implemented Reinforce the perceptual distortions until the patient develops new defenses Provide an unstructured environment Avoid making connections between anxiety producing situations and hallucinations Distract the patient’s attention
Distract the patient’s attention
87
A patient is diagnosed with paranoids schizophrenia. States my roommate is plotting to have others kill me, which is the appropriate nursing response. I find that hard to believe What would make you think such such a thing? I know your roommate he would do no such thing I can see why you feel that way
I find that hard to believe
88
How can individual psychotherapy help schizophrenia?
Successful intervention may be achieved with honesty, simple, directness, and manner that respects the clients privacy and human dignity Once relationship has been establish reality, orientation is maintained throughout exploration of clients behavior Primary focus reflect efforts to decrease anxiety and increase trust
89
How was group therapy helpful in a patient with schizophrenia
Focuses on real life, plans, problems, and relationships effective in reducing social isolation in increasing sense of cohesiveness and improving reality
90
How is group therapy less productive in schizophrenic patients
Group therapy can be intensive and highly stimulating. It may be counterproductive.
91
How was behavior, therapy, helpful, and schizophrenia?
Reducing the frequency of bizarre, disturbing, and deviant behaviors in increasing appropriate behaviors
92
How is social skills training beneficial in a patient with schizophrenia?
Patient struggle with interpersonal relationships and communication, often have inability to receive response Teaches patients how to have those skills
93
I was cognitive remediation therapy, helpful, and schizophrenia
Based on behavioral training, aim to help the client mend areas of cognitive dysfunction, including attention, memory and social cognition, and executive functions
94
How is family therapy beneficial in schizophrenia?
 There is a notable impact on mental health and physical health of the family when member is sick Including family can prevent or delay, relapse and help maintain client in the community Use as resource rather than stressor
95
What is ACT?
Program of case management that takes a team approach and providing comprehensive psychiatric treatment, rehabilitation, and support to the person with serious and persistent mental illness Tailored to each patient
96
What are antipsychotic used for in schizophrenia?
Decrease agitation and psychotic symptoms of schizophrenia
97
What are some common antipsychotics?
Olanzapine Aripirazole Chlorpromazine Risperidone Asenapine Ziprasidone 
98
 what are some side effects of antipsychotics
Orthostatic, hypertension Photosensitivity We gain/loss Reduction and seizure threshold Agranulocytosis Extrapyramidal symptoms Tradive dyskinesia
99
What are the signs and symptoms of agranulocytosis?
Fever Tachycardia Tachypnea Sore throat Sores and mouth
100
What is EPS extra pyramidalsymptoms?
Pseudoparkinsonism akinesia Akathisia Dystonia Anti-Parkinsonian agents may be prescribed
101
A client who’s been taking chlorpromazine For seven months presents in the emergency department with EPS of restless, drooling and tremors. What medication will the nurse expect the physician to order? Paroxetine Carbamazepine Benztropine Lorazepam
Benztropine
102
 recent research on the raise approach to the treatment of schizophrenia incorporates which of the following elements is important to improving outcomes select Early intervention at the first episode of psychosis Support for employment or educational pursuits Rapid high dose loading with psychotic medication Court ordered sanction for treatment Recovery, focused, psychotherapy
Early intervention at the first episode of psychosis Support for employment or educational pursuits Recovery focus psychotherapy
103
Which of the following is a primary goal and working with an actively psychotic suspicious client Promote interaction with others Decreases anxiety and increased trust Improve his relationship with his parents Encourage participants and therapy activity
Decrease his anxiety and increased his trust
Psych
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