Schizophrenia

Question 1

Psychosis

Answer 1

Disorder of thinking

Question 2

Schizophrenia

Answer 2

The most frequently diagnosed psychotic disorder

Question 3

Care of pt diagnosed with schizophrenia

Answer 3

1. Assess for Command Hallucinations and provide appropriate interventions to ensure safety of patient and others
2. Ensure adequate daily fluid and calorie intake
3. Provide for personal hygiene
4. Provide for reality reinforcement
5. Provide medication and disease process education
6. ensure opportunities for intellectual stimulation
7. Decrease social isolation within the milieu
8. Administer medications as ordered

Question 4

Factors linked to acquiring schizophrenia

Answer 4

1. Genetic component
2. Viral infection of fetus brain during pregnancy
3. Low serum folic acid during pregnancy
4. High levels of dopamine in the brain
5. Decrease size of cortical volume
6. Specific gene abnormalities
7. Enlarged lateral and 3rd ventricles in the brain

Question 5

Groups of presenting symptoms

Answer 5

Positive
Negative
Cognitive

Question 6

Positive Symptoms

Answer 6

Delusions
Disorganized Speech Patterns
Hallucinations
Disorganized Behavioral Patterns
Catatonic Behavior

Question 7

Persecutory

Answer 7

Type of delusion

Belief someone is trying to harm them

Question 8

Grandiose

Answer 8

Type of delusion

Belief that one is extremely gifted or powerful

Question 9

Religious

Answer 9

Type of delusion

Over involvement in religious practices or beliefs leading to dysfunction

Question 10

Somatic

Answer 10

Type of delusion

Belief in odd sensations involving the body

Question 11

Nihilistic

Answer 11

Type of delusion

Belief that one is dead or parts of one’s body are no longer functioning

Question 12

External Control

Answer 12

Type of delusion
Belief that one is being controlled by external forces
Can also involve the sending and recieving of messages

Question 13

Reference

Answer 13

Type of delusion

Belief that external events apply to one’s self when they do not

Question 14

Looseness of Association

Answer 14

Type of disorganized speech pattern
Individual words or sentences that make sense but that are not logically connected
Eg: “I am hot.” “The dog is black.” “Why is he yelling.”

Question 15

Word Salad

Answer 15

Type of disorganized speech patterns
An odd mixing of known words within a sentence.
Eg: “Up me goes slowly hill.”

Question 16

Clang

Answer 16

Type of disorganized speech pattern

the rhyming of all sentences

Question 17

Neologism

Answer 17

Type of disorganized speech pattern
Private language
Eg: “Fal os ot.”

Question 18

Echolalia

Answer 18

Type of disorganized speech pattern

The patient repeats everything heard in the environment with little if any original speech content.

Question 19

Circumstantiality

Answer 19

Type of disorganized speech pattern
This pattern is best described as talking around the point of the conversation with too much detail.
“Talking in circles.”

Question 20

Tangentiality

Answer 20

Type of disorganized speech pattern
Content of each sentence makes sense
Sentence 1 is logically connected to sentence 2 and sentence 2 is logically connected to sentence 3.
But sentence 3 is not logically connected to sentence 2.
the content of the speech is moving away from the theme in a linear direction
Eg: “My wife was angry at me for drinking at the bar.” “That bar is owned by an Irishman.” “I was in Ireland 10 years ago.”

Question 21

Hallucinations

Answer 21

Faulty perceptions
Can involve any of the 5 senses
Most often auditory for pt with schizophrenia
Auditory messages are most often a voice or voices
Content is usually menacing or negative
Command hallucinations–a voice instructs the patient to harm himself or another person(s)

Question 22

Disorganized Behavioral Patterns

Answer 22

Disorganized Behavioral Patterns
a. Decline in overall functioning including ADL’s

b. Unpredictible or Inappropriate responses
c. behaviors that appear bizarre or without purpose
d. Lack of inhibition or impulsive

Question 23

Cause of positive symptoms

Answer 23

excessive dopamine in the brain

Question 24

Cause of negative symptoms

Answer 24

structural problems in the brain primarily in the ventral striatum

Question 25

Cause of cognitive symptoms

Answer 25

etiology is poorly understood

Question 26

Catatonic Behavior

Answer 26

Observed in patients with schizophrenia Patient can exhibit extremes of behavior Ex: patient can't speak, move or respond Patient may be overexcited or hyperactive with echolalia and echopraxia Patients may seem to have purposeless actions that are performed repetitively

Question 27

Cognitive symptoms

Answer 27

1. poor executive functioning 2. difficulty focusing or paying attention 3. difficulty with "working memory"

Question 28

Poor Executive Functioning

Answer 28

the ability to understand information and use it to make decisions

Question 29

difficulty with "working memory"

Answer 29

the ability to use information immediately after learning it

Question 30

patient experiencing delusions and/or hallucinations

Answer 30

1. Assess regularly for command hallucinations and take appropriate actions to ensure safety of patient and others 2. Offer empathetic statement: “I understand that these voices/beliefs are real to you.” 3. Offer educational statement: “These beliefs/voices are part of your illness.” 4. Provide statement of reassurance: “We are hoping that your medications will lessen these thoughts/voices.” 5. Provide statement of safety to patient: “While these thoughts/voices are disturbing to you, we will keep you safe.”

Question 31

Treatment of patient with schizophrenia

Answer 31

``` antipsychotic medications Disease Education Case management Family support community support groups ```

Question 32

Antipsychotic medications

Answer 32

Primarily for the patient with positive symtoms

Question 33

Case management

Answer 33

including family | may involve home health nursing

Question 34

Community support group

Answer 34

for both family and patient

Question 35

negative symptoms

Answer 35

1. Lack of emotional expression 2. Lack of motivation 3. Lack of interest in external world 4. Poverty of speech content

Question 36

Lack of emotional expression

Answer 36

flat voice flat affect lack of eye content

Question 37

Lack of Motivation

Answer 37

Avolition

Question 38

Lack of interest in External World

Answer 38

Anhedonia

Question 39

Poverty of Speech Content

Answer 39

Alogia Inability to carry on a conversation Short and disconnected replies Monotone speaking voice