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Mental Health - Schizophrenia
ATI NCLEX-RN related study questions
57
Nursing
Undergraduate 2
09/12/2009

Additional Nursing Flashcards

 


 

Cards

Term
Schizophrenia is a group of _______ disorders that affect what?
Definition
  1. psychotic
  2.  affect:
    • thinking
    • behavior
    • emotions
    • ability to perceive reality
Term
Psychosis
Definition

Refers to the presence of:

  • Hallucinations
  • Delusions
  • Disorganized speech, or
  • Catatonic Behavior
Term
Typical age of onset for Schizophrenia
Definition

Type age at onset is late teens and early twenties, but schizophrenia has occurred in young children and may begin in later adulthood.

Term
Comobidities of Schizophrenia
Definition
  • Substance Abuse
  • Nicotine Dependence
  • Depression
  • Suicidal ideation
  • Anxiety Disorders
Term
Positive symptoms of Schizophrenia
Definition
  • Hallucinations
  • Delusions
  • Disorganized speech
  • Bizarre behavior
Term
Negative Symptoms of Schizophrenia
Definition
  • Affect
  • Alogia
  • Avolition
  • Anhedonia
  • Anergia
Term

Negative symptoms of Schizophrenia:

 

Affect

Definition

Usually blunted (narrow range of normal expression)

 

or

 

Flat (facial expression never change)

Term

Negative symptoms of Schizophrenia:

 

Alogia

Definition

 Poverty of thought or speech.

 

Ex:  The client may sit with a visitor but may only mumble or respond vaguely to questions.

Term

Negative symptoms of Schizophrenia:

 

Avolition

Definition

  Lack of motivation in activities and hygiene.

 

Ex:  The client completes an assigned task, such as making his bed, but is unable to start the next common chore without prompting.

Term

Negative symptoms of Schizophrenia:

 

Anhedonia

Definition

Lack of pleasure or joy.   The client is indifferent to things that often make others happy.

 

Ex:  Such as looking at beautiful scenery

Term

Negative symptoms of Schizophrenia:

 

Anergia

Definition

Lack of energy

Term
4 types of Schizophrenia symptoms
Definition
  • Positive
  • Negative
  • Cognitive
  • Depressive
Term
Cognitive symtoms of Schizophrenia
Definition
  • Disordered thinking
  • Inability to make decisions
  • Poor problem-solving ability
  • Difficulty concentrating to perform tasks
  • Memory deficits
    • Long-term
    • Working memory, such as inability to follow directions to find an address
Term
Depressive symptoms of Schizophrenia
Definition
  • Hopelessness
  • Suicidal Ideation
Term
5 recognized types of schizophrenia
Definition
  1. Paranoid
  2. Disorganized
  3. Catatonic
  4. Residual
  5. Undifferentiated
Term

Types of schizophrenia:

 

Paranoid

 

and its symptoms.

Definition
  1. Characterized by suspicion toward others
  2. symptoms:
    • Hallucinations, such as hearing threatening voices, and delusions, such as believing onself president of the US.
    • Other-directed violence may occur.
Term

Types of schizophrenia:

 

Disorganized

 

and its symptoms.

Definition
  1. Def:
    • Characterized by withdrawl from society and very inappropriate behaviors, such as poor hygiene or muttering constantly to oneself.
    • Frequently seen in the homeless population
  2. symptoms:
    • Loose associations
    • Bizarre mannerisms
    • Incoherent speech
    • Hallucinations and delusions may be present but are much less organized than those seen in the client with parania.
Term

Types of schizophrenia:

 

Catatonic

 

and its symptoms.

Definition
  1. Characterized by abnormal motor movements
  2. There are two stages:  withdrawn stage & excited stage
    • Withdrawn stage
      • Psychomotor retardation; the client may apper comatose
      • Waxy flexibility may be present
      • The client often has extreme self-care needs, such as for tube feeding due to an inability to eat.
    • Excited state
      • Constant movement, unusual posturing, incoherent speech.
      • Self-care needs may predominate
      • The client may be a danger to self or others.
Term

Types of schizophrenia:

 

Residual

 

and its symptoms.

Definition
  1. Active symptoms are no longer present, but the client has two or more "residual" symptoms.
  2. Symptoms:
    • Anergia, anhedonia, or avolition
    • Withdrawn from social activities
    • Impaired role function
    • Speech problems, such as alogia
    • Odd behaviors, such as walking in a strange way
Term

Types of schizophrenia:

 

Undifferentiated

 

and its symptoms.

Definition
  1. The client has symptoms of schizophrenia but does not meet criteria for any of the other types.
  2. Symptom:
    • Any positive or negative symptoms may be present.
Term
Schizophrenia is characterized by:
Definition
exacerbations and remissions
Term
3 phases of schizophrenia
Definition
  1. Acute phase
    • Periods of both positive and negative symptoms
  2. Maintenance phase
    • Acute symptoms decrease in severity
  3. Stabilization phase
    • Symptoms in remission
Term
When does schizophrenia become problematic?
Definition
When it interferes with interpersonal relationships, self-care, and ability to work.
Term
Delusions
Definition
False fixed beliefs that cannot be corrected by reasoning and are usually bizarre.
Term

Type of Delusion:

 

 

Ideas of reference

Definition

Misconstrues trivial events and attaches personal significance to them.

 

EX:  such as believing that others, who are discussing the next meal, are talking about him.

Term

Type of Delusion:

 

 

Persecution

Definition

Feels singled out for harm by others

 

Ex:  being hunted down by the FBI

Term

Type of Delusion:

 

 

Grandeur

Definition

Believes that he/she is all powerful and important, like a god.

Term

Type of Delusion:

 

 

Somatic delusions

Definition

Believes that his body is changing in an unsusual way.

 

Ex:  such as growing a third arm.

Term

Type of Delusion:

 

 

jealousy

Definition

May feel that his/her spouse is sexually involved with another individual.

Term

Type of Delusion:

 

 

Being controlled

Definition

Believes that a force outside his body is controlling him.

Term

Type of Delusion:

 

 

Thought broadcasting

Definition

Believes that his/her thoughts are heard by others.

Term

Type of Delusion:

 

 

Thought insertion

Definition

Believes that other's thoughts are being inserted into his mind.

Term

Type of Delusion:

 

 

Thought withdrawl

Definition

Believes that his/her thoughts have been removed from her mind by an outside agency.

Term

Type of Delusion:

 

 

Religiosity

Definition

Is obsessed with religious beliefs.

Term

Alterations in speech:

 

 

Flight of ideas

Definition
  • Associative looseness
  • The Pt may say sentence after sentence, but each sentence may relate to another topic, and the listener is unable to follow the Pt's thoughts.
Term

Alterations is speech:

 

 

Neologisms

Definition
  • Made up works that only have meaning to the Pt.

Ex:  "I tranged and flittled."

Term

Alterations is speech:

 

 

Echolalia

Definition
  • The Pt repeats the words spoken to him.
Term

Alterations is speech:

 

 

Clang association

Definition
  • Meaningless rhyming of words, often forceful.

Ex:  "Oh fox, box, and lox."

Term

Alterations is speech:

 

 

Word Salad

Definition
  • Words jumbled together with little meaning or significance to listener.

Ex:  "Hip horray, the flip is cast and wide-sprinting in the forest."

Term
Types of Alterations in perception
Definition
  • Hallucinations
  • Personal boundary difficulties
Term
Types of hallucinations:
Definition
  • Auditory
  • Visual
  • Ofactory
  • Gustatory - tastes
  • Tactile
Term

Alterations in perception:

 

 

Personal Boundary difficulties

 

and two types.

Definition
  • Disenfranchisement with one's own body, identity, and perceptions.
  • Two types: 
    • Depersonalization - nonspecific feeling that a person has lost his/her identity; self is defferent or unreal
    • Derealization - perception that environment has changed.
Term
Alterations in Behavior
Definition
  • Extreme agitiation
  • Stereotyped behaviors
  • Automatic obedience
  • Wavy flexibility
  • Stupor
  • Negativism
  • Echopraxia
Term

Alterations in Behavior:

 

 

Extreme agitiation

Definition
  • including pacing and rocking
Term

Alterations in Behavior:

 

 

Stereotyped behaviors

Definition
  • Motor patterns that had meaning to client (sweeping the floor) but now are mechanical and lack purpose
Term

Alterations in Behavior:

 

 

Automatic Obedience

Definition
  • Responding in a robot-like manner
Term

Alterations in Behavior:

 

 

Wavy flexibility

Definition
  • Excessive maintenance of position

Ex:  For instance, if one were to move the arm of someone with waxy flexibility, they would keep their arm where one moved it until it was moved again, as if it were made from wax.

Term

Alterations in Behavior:

 

 

Stupor

Definition
  • Motionless for long periods of time; coma-like
Term

Alterations in Behavior:

 

 

Negativism

Definition
  • Doing the opposite of what is requested
Term

Alterations in Behavior:

 

 

Echopraxia

Definition
  • Purposeful imitation of movements made by others
Term
How should nurse respond to hallucinations?
Definition
  • Don't lie; argue or agree with client's view
  • Ask client directly about hallucinations
Term
How should nurse respond to delusions?
Definition
  • Do not argue, but focus on Pt's feelings and possibly offer reasonable explanations.
Term
Medication classifications used to treat schizophrenia
Definition
  • Atypical antipsychotics
    • current medications of choice for psychotic disorders, and they generally treat both positive and negative symptoms
  • Typical antipsychotics
    • are used to treat mainly positive psychotic symptoms
  • Antidepressants
    • used to treat the depression seen in many clients with schizophrenia
  • Axxiolytics/benzodiazepines
    • used to treat the anxiety often found in clients with schizophrenia, as well as some of the positive and negative symptoms of schizophrenia
Term
Atypical antipsychotics
Definition
  • Risperidone (Risperdal)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Ziprasidone (Geodon)
  • Aripiprazole (Abilify)
  • Clonapine (Clozaril)
Term
Typical antipsychotics
Definition
  • Haloperidol (Haldol)
  • Loxapine (Loxitane)
  • Chlorpromazine (Thorazine)
  • Fluphenazine deconoate (Prolixin)
Term

Antidepressants

SSRI

Definition
  • Celexa
  • Lexapro
  • Paxil
  • Prozac
  • Zoloft
Term
Anxiolytics / benzodiazepines
Definition
  • Lorazepam (Ativan)
  • Clonazepam (Klonopin)
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