question

What is affect?

answer

The outward manifestation of a person's feelings and emotions; flat, blunted, inappropriate or bizarre

question

What is associative looseness?

answer

Disorganized thinking, manifested as jumbled and illogical speech, and impaired reasoning is displayed.

question

What is autism?

answer

Thinking is not bound to reality but reflects the private perceptual world of the individual: delusions, hallucinations, and neologisms.

question

What is ambivalence?

answer

Simutaneously holding two emotions, attitudes, ideas, or wishes towards the same person, situation, or object.

question

Schizophreniform

answer

Duration at least 1 month but less than 6 months.

question

Brief Psychotic

answer

Lasts atleast 1 day but less than 1 month.

question

Schizoaffective

answer

6 months and more (major depressive, manic, or mixed episodes)

question

Delusional

answer

Atleast 1 months duration, non-bizarre delusion (no bizarre behavior)

question

Shared Psychotic

answer

Someone who believes in the schizophrenic person's delusions.

question

Anergia

answer

Lack of energy

question

How are brain structure abnormalities detected?

answer

CT, MRI, PET Scans.

question

Neologisms

answer

Made up words that have meaning for the patient but different or nonexistent meaning to others.

question

Echolalia

answer

Repeating of anothers words (cataonia)

question

Echopraxia

answer

mimicking movements of another (catatonia)

question

Clang Association

answer

choice of words based upon their sounds (rap,tap,fap) often rhyming

question

Word Salad

answer

A jumble of words that is meaningless (extreme level of disorganization)

question

What axis is schizophrenia on?

answer

Axis 1 (Diagnosis)

question

What causes schizophrenia?

answer

high dopamine

question

Positive symptom

answer

presence of something that is not normally there (hallucinations,delusions)

question

Negative

answer

absence of something that should be present like emotion (attention deficits, avolition, alogia)

question

Cognitive Symptoms

answer

Abnormalities in how a person thinks (difficulty with attention, memory, info processing)

question

Conventional typical Meds treat:

answer

Positive symptoms (block dopamine receptors)

question

TMSPNH

answer

Today Many Schizos Probably Need Homes (Thorazine,Mellaril, Stelazine, Prolixin,Navone, Haldol)

question

Prolixin:

answer

Decanoate, med that can also be given in an injection form for those people who can not comply with meds (block dopamine receptors)

question

Side effects of typical/conventional meds:

answer

extrapyramidal effects

question

What are some EPS effects?

answer

akathisia (restless movement), dystonia (contraction of the neck), pseudoparkinsonism (tremors), tardive dyskenesia (involuntary muslces movement with tongue, fingers, toes, trunk, pelvis [woman])

question

How do you treat EPS effects?

answer

Cogentin (takes thirty minutes to take effect) give ASAP if symptoms occur.

question

What is the AIMS test?

answer

Scale that tells you how severe TD is

question

Is TD permanent?

answer

Yes! No treatment. All you can do is stop the medication.

question

What is NMS?

answer

key manifestation is temperature (hyperpyrexia), sweating, decrease LOC

question

What happens with an untreated NMS patient?

answer

result in seizure -> coma -> death

question

Acronym for Atypicals

answer

ISRGZAC

question

What are two atypical medications?

answer

Respierdone and Consta (R-Consta)

question

GZAC

answer

Causes side effects or have contraindictions (Geodon)

question

Geodon

answer

Do not give to patient with cardiac issues

question

Zyprexa

answer

increases weight

question

Abilify

answer

Do not give to anyone with DM (diabetus mellitus)

question

Clozaril

answer

causes agranulocytosis (WBC will be less than 3000) before giving medication, assess for their BP before and after med, also seizure precaution. DO NOT give to anyone who is immunocompromised.

question

What is phase 1 in Schizo?

answer

acute. Goal is safety and stabilization

question

Phase 2:

answer

stabilize. Help adhere to treatment, get them on meds, help them cope with diagnosis and symptoms

question

Phase 3:

answer

maintenance. maintain achievement, prevent relapse, they're getting discharged and being sent out into the world.

question

What do you treat a mild case of NMS with?

answer

Parlodel (Pardon their NMS)

question

Severe case of NMS?

answer

Dantrium (Pardon their NMS)

question

What is Narcan used for?

answer

higher dose Opiods overdose (Methadone for lower dose, and to titrate alcohol withdrawal)

question

What is used for alcohol withdrawal?

answer

Ativan and Revia

question

What is used to treat akathesia?

answer

propanolol, lorazepam, diazepam

question

What do zyprexia and abilify have in common?

answer

Do not give to patients with diabetes.

question

Do not give Geodon to:

answer

cardiovascular patients

question

What does clozaril cause?

answer

agranulocytosis

question

What are the some deconoates?

answer

RisperdalConsta, Haldol, Prolixin

question

Side effects of atypical medications:

answer

metabolic syndrome, agranulocytosis-clozaril.(all meds except abilify, geodon, )

question

How are deconoates given?

answer

IM & Injection

question

What are the atypical medications?

answer

Invega, Seroquel, Risperdal, Geodon, Zyprexa, Abilify, Clozaril (ISRGZAC) In Schizophrenia Reality Gets Zapped and Crazy

question

Alogia:

answer

lack of speech

question

Avolition

answer

Lack of motivation

question

Anhedonia

answer

Lack of pleasure

question

What are the four types of opiods?

answer

Heroine, Morphine, Codeine, Methadone

question

Types of Hallucinogens?

answer

Mescalin, peyote, mushrooms, angel trumpet, LSD, MDMA, PCP

question

Types of inhalants?

answer

Hairspray, gas, whiteout, solvents, anesthetics

question

Types of OTC drugs:

answer

Antihistamines, cough syrup, nyquil, mouthwash, vanilla favoring, sleep AIDs

question

Types of CNS stimulants:

answer

amphetamines, non-amphetamines, methamphetamines, cocaine (most potent), caffieine, nicotine

question

Types of CNS depressants:

answer

alcohol, barbituates, benzodiazepines, hypnotic sedatives

question

Physical Effects of Opioids:

answer

Pupil constriction; respiratory depression; tolerance Intervention: Methadone Tapering

question

Physical Effects of Hallucinogens:

answer

Pupil dilation, increased temperature/pulse/respiration Intervention: Low sitmuli, 1:1, diazepam for anxiety

question

Physical Effects of Inhalants:

answer

Euphoria, CNS depression, hallucinations Intervention: B12, Oxygen, Methylene Blue

question

Physical Effects of OTC:

answer

Alcohol effects, antihistamine effects Intervention: treats symptoms related to use.

question

Physical Effects of CNS Stimulants:

answer

Dilated pupils, tachycardia, elevated BP, paranoia Intervention: Antidepressants, dopamine agonists (bromocriptine)

question

Physical Effects of CNS Depressants

answer

Slurred speech, ataxia, decreased BP, drowsiness, impaired memory Intervention: carefully titrated detoxification with similar drug; abrupt withdrawal is deadly

question

A client diagnosed with schizophrenia, paranoid type, is admited to an acute care psychiatric hospital unit. Which nursing diagnosis should be given highest priority in the initial nursing plan?

answer

Risk for Violence; safety is always the highest priority when caring for any client, this is particularly true when the client has paranoid schizophrenia, they are at high risk for aggression and/or violence.

question

1. The client diagnosed with schizophrenia says "Everyone here is part of the secret police and wants to torture me" and refuses to be weighed by a member of the nursing staff. What is the most appropriate response by the nurse?

answer

"That must be a frightening thought; we are nurses who work at this hospital" The nurse should show awareness of the feelings of the client and present reality about the role of the nursing staff

question

2. A male client is taking a second generation antipsychotic drug. The clients spouse tells the nurse that she read that the drug is effective to treat negative symptoms of schizophrenia and asks the nurse to explain what these are. What should the nurse include in a response to the spouse?

answer

Diminished pleasure, blunted affect, and difficulty making decisions all represent a loss or lack of normal skills and functioning of the individual.

question

3. The nurse is assessing a client who recently began taking a typical antipsychotic medication. The client says "All of a sudden I can't breathe right." The nurse observes generalized body rigidity and diaphoresis. The body temp is 103 and the pulse is 130. What should the nurse do next?

answer

*Begin preparing the client for immediate transfer to an emergency department.* The client is exhibiting signs and symptoms of possible NMS which is potentially lethal side effect that requires immediate medical care. It can not be delayed.

question

While the nurse is meeting with the family of a client with schizophrenia, a family member asks the nurse to explain what causes the disorder. What is the nurse's best response?

answer

"The exact cause of schizophrenia is unclear at this time." The precise cause if schizophrenia is unknown, the general consensus results from interaction between a variety of biological and psychosocial factors.

question

The client has catatonic schizophrenia and demonstrates rigidity, waxy, flexibility, and extreme psychomotor retardation. The nurse anticipates that this client is at risk for which of the following?

answer

Aggressive outbursts, constipation, and nutritional deficiency.

question

A client diagnosed with schizophrenia says "I want to go home to tome in a dome." When documenting, the nurse will refer to this as which of the following?

answer

Clang associations; These association disturbances in which schizophrenic clients rhyme words in a sentence that seems nonsensical to the listener.

question

The client is to begin taking olanzepine (Zyprexa). The nurse makes it priority to asses which of the following before administering the first dose?

answer

Body weight; Increase in body weight and BMI can occur very quickly when clients take Zyprexa. Baseline data about these should be obtained before the client begins to take this drug.

question

A client diagnosed with schizophrenia tells the nurse that another client is "creating negative thoughts in me against my will." The nurse documents that the client is exhibiting which of the following features of schizophrenia?

answer

Thought insertion; the client believes that others are putting thoughts in his or her mind against the client's will.

question

Symptoms of schizophrenia typically include:

answer

delusional ideation, hallucinations, disorganized speech patterns, disorganized or catatonic behaviors, negative symptoms (Atleast two of these symptoms must be present for atleast 1 month)

question

Symptoms of paranoid schizo:

answer

auditory hallucinations, preoccupation with one or more delusions usually of persecutory nature, hostile or angry, no affect or catatonic symptoms are present

question

Catatonic type:

answer

Stupor (state of daze); motor immobility, excessive negativism or inability to speak, inappropriate or bizarre body postures, *echolalia*, *echopraxia*

question

Residual type:

answer

absence of prominent psychotic symptoms; social withdrawal; eccentric behavior; lack of interest; past history of atleast 1 schizo episode

question

Disorganized type:

answer

disorganized speech, behavior, and inappropriate or flat affect, oddities of behavior (grimacing)

question

Undifferentiate type:

answer

disorganized behaviors, psychotic symptoms (including delusions and hallucinations)

question

Somatic positive symptoms

answer

individual has delusions that are fixed on irrational belief about his or her body

question

Akathisia

answer

motor restlessness; inability to remain still

question

Akinesia

answer

absence of movement or difficulty with movement

question

Dystonia

answer

muscle spasm, spastic movements of neck and back, can be painful and frightening for the client

question

Pseudoparkinsonism

answer

Shuffling and slow gait, masklike facial expression, tremors, pill rolling

question

Tardive dyskinesia

answer

Involuntary and abnormal movement of the mouth, tongue, face, and jaw

question

Neuroleptic malignant syndrome

answer

A potential lethal side effect of antipsychotic medication that requires *emergency treatment*

question

Benefits of atypical antipsychotics:

answer

treats positive and negative symptoms, minimal to no risk of EPS or TD, often first line of treatment, can cause weight gain and metabolic abnormalities that increase

question

Treat parkinsonism with:

answer

Dopamine agonist

question

Treat acute dystonia with:

answer

antihistamine

question

Treat akathisia with:

answer

beta blockers or benzodiazepine

question

Prevent or manage EPS of antipsychotic medications:

answer

anticholinergics (cause dry mouth, blurred vision, constipation)

question

Individual interventions:

answer

express to the client that you understand that he or she believes the delusion or hallucination but you do not share in the delusional belief or hallucination

question

Schizoaffective disorder:

answer

clinical manifestations characteristic of both schizophrenia and a mood disorder (often have difficulty maintain a job or functioning in school)

question

Schizophreniform disorder:

answer

essential features of schizophrenia are present with the exception that the duration is at least 1 month but less than 6

question

1. While talking with a female client diagnosed with schizophrenia, the nurse notices the client look away from the nurse and stare at the wall while making facial grimaces. What is the most appropriate intervention by the nurse?

answer

Ask the client if she sees something on the wall; The client is most likely experiencing visual hallucination, it is important for nurses to know the content of the hallucination so they can assist the client to process the experience and prevent any aggressive behavior.

question

2. A client taking antipsychotic medications for treatment of schizophrenia reports feeling nervous. The nurse notices that the client is pacing the long hallway and is unable to remain still, even when in conversation with other clients. What term should the nurse use to document this occurrence?

answer

Akathisia; this is an EPS effect of antipsychotic meds.

question

3. The client who is schizoaffective disorder takes both haldol and depakote. When the client asks the nurse to explain with this particular combination of drugs is expected to do, what would be the best response by the nurse?

answer

"Haldol improves your thinking and valproic acid (depakote) stabilizes your moods." Haldol is a traditional anti psychotic and Depakote is a traditional anticonvulsant that is also used for the nontraditional purpose of mood stabilization.

question

4. A client is admitted to an inpatient unit has a diagnosis of paranoid type schizophrenia. The new mental health care work on this unit approaches the nurse and asks about the best way to work with this client. How should the nurse respond?

answer

"When possible, remain at arm's length from this client."; Paranoid schizophrenic clients are very suspicious and potential dangerous. It is best to avoid any physical contact.

question

5. The client has schizophrenia, residual type. A nursing care plan should give priority to which nursing diagnosis?

answer

Social isolation; residual type manifests with socially withdrawn behavior, an innappropriate affect, and an absence of prominent psychotic symptoms.

question

6. The nurse observes that the client with paranoid schizophrenia appears very preoccupid. The client is pacing back and forth in the hall, periodically looking to the side, clenching the fist, and saying, "I told you to go away." At this time, the nurse should plan to do which of the following?

answer

Reduce proximity to others, avoid touching the client during conversation, refrain from using non-verbal hand gestures; The client is actively responding to internal stimuli and could easily react aggressively to others.

question

7. The nurse is to complete an AIMs assessment of the client. When explaining this test to the client, the nurse should say that this test will help to identify if the client is beginning to have which of the following?

answer

Uncontrollable motions in the body. (Abnormal Involuntary Movement Scale)

question

8. A client reports having blurred vision that began after beginning drug therapy with a traditional antipsychotic. What would be the best response by the nurse?

answer

"Blurred vision is a temporary side effect of your medication that usually resolves within a few weeks."; Blurred vision is an anticholinergic symptom/side effect that usually resolves in a few weeks.

question

9. A client is planning to be discharged from the hospital. It is the nurse's responsibility to educate this client regarding prescribed medications. This client is taking Clozaril. The nurse makes it a priority to teach the client to notify the physical immediately for which of the following?

answer

Indications of any sort of infection; Agranulocytosis is the most dangerous common side effect of clozapine and can lead to death if not detected and treated early; Need weekly analysis of WBCs must be complete before clozapine can be reordered.

question

10. A client with chronic schizophrenia has been recieving an atypical antipsychotic for three months. The nurse concludes that the client is experiencing a reduction in negative symptoms of schizophrenia if a family member says which of the following?

answer

"For the past week, he has gotten up, dressed and taken a walk early each morning", "We went to a musical concert, and he smiled and applauded the musicians"

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