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Nursing 210: Module 1, Unit B
Psych
48
Nursing
Undergraduate 2
09/22/2009

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Cards

Term
How does a thought process disorder interfere with daily living?
Definition

impairment of:

- social relationships

- communications

- sensory and perceptual input

- development

Term
What is autism characterized by?
Definition

- pervasive and usually severe impairment in reciprocal social interaction skills and communication skills

- restricted sterotypical behavioral patterns

Term
What is the estimated incidence of autism?
Definition
b/t 1 in 10,000 and 1 in 500 of children ages 1-15 years
Term
What are some of the posisble causative factors of autism?
Definition

Genetic: many austic children have a relative with autism

 

Biological: maternal rubella, anoxia, fragile X syndrome, increased brain development in 1st years of life

 

Epigentic: dopamine overactivation, elevated serotonin

Term
How is autism clinically manifested in social relationships?
Definition
unable to establish meaningful relationships
Term
How is autism clinically manifested developmentally?
Definition

mental retardation -- savants

 

IQ is not correlated with severity of autism

Term
How is autism clinically manifested linguistically?
Definition

mutism

parrot speech

echolalia

reverse pronounds

literal use of words

Term
How is autism clinically manifested sensorily and perceptually?
Definition

sensory deficits

hallucinations

may act deaf

aversion to touch

Term
What is catatonic schizophrenia?
Definition

- marked psychomotor disturbance, motionless, or excessive motor activitiy

- extreme negativisim

- mutism

- pecularities of voluntary movement: echolalia, echopraxia

Term
What is undifferentiated schizophrenia?
Definition
- mixed schizophrenic symptoms along with disturbances of thought, affect, and behavior
Term
What is residual schizophrenia?
Definition

- at least one previous psychotic episode but not currently

- social withdrawel

- flat affect

- loose associations

Term
What are possible nursing diagnoses for a child with autistic disorder?
Definition

- risk for injury

- impaired social interactions

- disturbed thought processes

Term
How should a nurse care for a child with autism?
Definition

- maintain routine, work closely with family to determine habits and preferences

- maintain consistent staff for child

- determine way child communicates

- provide family support; sucure additional resources as needed

Term
What is schizophrenia?
Definition
Snydrome or disease process of the brain causing distorted or bizarre thoughts, perceptions, emotions, movements, and behaviors
Term
What is shizophrenia usually diagnosed?
Definition
late adolesence and early adulthood
Term
What is the prevalence of schizophrenia?
Definition
1% of total population, or 3 million in US -- similiar throughout world
Term
What is schizophreniform disorder?
Definition
- sympyoms of schizophrenia are experienced for less than the 6 months required for a dx of schizophrenia
Term
What is schizoaffective disorder?
Definition
symptoms of psychosis and thought disorder along with all the features of a mood disorder
Term
What is delusional disorder?
Definition
one or more non-bizarre delusions with no impairment in psychosocial functioning
Term
What does current etiological theories of schizophrenia focus on?
Definition

- genetic factors

-neuroanatomic theories

- neurochemical theories: overactive dopamine, and more

- immunovirolgic factors

Term
What are some cultural considerations that must be kept in mind when talking about schizophrenia?
Definition

- ideas that are delusional in one culture may be accepted by another culture

- auditory or visual hallucinations may be a normal part of religious experiences in some cultures

 

Term
How might ethnicity factor into the way a person responds to psychotropic medications?
Definition

- AA, CA, and HA appear to require comparable therapeutic doses of antipsychotic medications

 

- Asian clients need lower doses of drugs such as haloperidol (Haldol) to obtain the same effects

Term
What are the 5 types of schizophrenia?
Definition

- disorganized

-catatonic

-paranoid

-residual

-undifferentiated

Term
What does disorganized type (SCDT) of schizophrenia onset?
Definition
adolescence
Term
What are the symptoms of SCDT?
Definition

- inappropriate or silly emotions

- incoherent speech

 

severe:

- regression

- hypochondriasis

- hallucinications and delusions

- extreme social withdrawel

- chronic

Term
What type of behavior or psychomotor symptoms differentiate SCCT?
Definition

- cataonic posturing

- catatonic rigidity

- waxy flexibility

- catatonic stupor

- catatonic excitment

 

Term

When do people with SCCT go catatonic?

Is it of their own volition?

How should they be medicated?

Definition

- when they are ill

 

- no

 

- ativan/benzo when in catatonic state

Term
What is the least and most prominent type of scizophrenia?
Definition

least - catatonic

 

most - paranoid

Term
What is the main behavior and symptoms of someone with SCPT?
Definition

- suspiciousness

- overuse of projection

- delusions of persecution or grandeur

- auditory hallucinations

- unaffected IQ

- homicidal or suidical ideation is often present

Term
What are the features of the residual type of schizophrenia?
Definition

- partial remission

- no obvious psychotic symptoms

- may exhibit isolation, associate looseness, illogical thinking, or eccentric behavior

Term
What are features of SCUT?
Definition

- mixture of symptoms: delusions, hallucinations, disorganized behavior

- can't be classified elsewhere

Term

How does schizophrenia affect perceptions?

How should a nurse deal with a pt experiencing hallucinations?

Definition

- auditory hallucinations, visual hallucinations

- assure them that the pt is safe and you beleive they are experiencing these things

- ask if voices are mean/derogatory or if they are commanding anything

- tell the pt to "let me worry" and "tell me if the voices tell you to do something"

Term
What type of affect do schizophrenic patients usually have?
Definition

flat, apathetic

 

not a choice

Term
How does schizophrenia affect one's sense of self?
Definition

don't think of self as seperate, unique being

 

echolalia

 

echopraxia

Term
How does schizophrenia affect one's volition?
Definition

patient feels little motivation

 

hard to maintain hygiene and cleanliness

Term
What are the negative symptoms of schizophrenia?
Definition

apathy

lack of affect

difficulty with interpersonal interaction

avolition

social withdrawal or discomfort

apathy

alogia

Term
What are the positive symtpoms of schizophrenia?
Definition

hallucinations

delusions

disorganized thought, speech and behavior

Term
How does schizophrenia affect content of thought?
Definition

- delusions

- religiosity

- paranoia

- magical thinking

Term
How does schizophrenia affect one's form of thought?
Definition

- associative looseness

- neologisms

- concrete thinking

- clang associations

- word salad

- tangentiality

Term
What is Phase I/Schizoid phase of Schizophrenia like?
Definition

thoughts are ordered

fully functional

family may start to notice changes

 

Term
What is phase II/prodromal phase of schziophrenia?
Definition
thoughts begin to break down
Term
What is PHase III / Schizophrenia phase of Schizophrenia?
Definition
psychotic break
Term
What is the clinical course of schizophrenia?
Definition

- slow and gradual onset of symtpoms

- younger age of onset associated with poorer outcomes

- first years after diagnosis, client may have relatively symptom free periods between psychotic episodes or fairly continuous psychosis with some shift in severity of symptoms

- most clients have difficulty functioning in the community and few lead fully indepedent lives

- early detection and aggressive treatment of the first psychotic episode improves outcomes

Term
If psychotic symptoms appear in later life, what are they usually associated with?
Definition
depression or dementia, not schizophrenia
Term
What are some possible outcomes for a elderly schizophrenic?
Definition

- 20 to 30 % experience dementia resulting in steady, deteriorating decline in health

 

- 20 to 30 % experience a reduction in positive symtpoms, somewhat like a remission

 

- 40 to 60 % remain mostly unchanges

Term
What are some things that should be assessed when assessing a pt concerning schizophrenia?
Definition

- previous hx with schizophrenia

- previous suicidal ideation

- current support system

- client's perception of current situation

- general appearance, motor behavior, speech

- mood and affect

- though processes and content

- delusions

- sensorium and intellectual processes: hallucinations, disorienation, concrete or literal thinking

- judgement and insight

-self concept

- roles and relationships

- physiologic and self care considerations

Term
What are common nursing diagnoses for positive symptoms of schizophrenia?
Definition

- risk for other directed violence

- risk for suicide

- disturbed thought processes

- disturbed sensory perception

- disturbed personal identity

- impaired verbal communication

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