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43 Cards in this Set
- Front
- Back
Name four etiologies that cause schizophrenia
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- Genetic
- Neurobiological - Socio-cultural - Other theories |
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What are manifestations of CATATONIC schizophrenia?
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Non movement (motor immobility)
Excessive motor activity Extreme negativism Peculiar movements Echolalia (repeating speech) or echopraxia (repeating movements) |
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What are manifestations of PARANOID schizophrenia?
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Delusions
-Persecutory -Grandiose -Hallucinations Anger Argumentativeness Violence |
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What are manifestations of DISORGANIZED schizophrenia?
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Fragmented delusions or hallucinations
Disorganized behavior -Odd behaviors ( mannerisms) -Extreme social withdrawal Disorganized speech Flat, inappropriate, or silly affect |
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What are symptoms of UNDIFFERENTIATED schizophrenia?
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Psychotic symptoms
Mixed schizophrenic symptoms |
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What are manifestations of RESIDUAL schizophrenia?
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Absence of prominent delusions/hallucinations
-Emotional blunting -Social withdrawal -Eccentric behavior -Illogical thinking -Loose associations |
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Blunt affect
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Reduced expression (only smiles a little to a joke)
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Flat affect
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Emotional impoverishment (no smile at all to a joke)
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Inappropriate affect
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Incongruence between emotions and situation (laughs at dog running over car)
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When a schizophrenic patient who typically acts friendly to you now acts mean to you, what kind of affect is that?
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Ambivalent Affect
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What is the difference between how normal people and schizophrenic people experience illusions?
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When normal people experience an illusions, they go away.
When schizophrenic people experience illusions, the illusions persist, thus becoming delusional. |
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What characteristics should a nurse consider that may contribute to a person's schizophrenia?
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Behavioral
Perceptual (delusions, hallucinations) Cognitive Social Culture Age Physiological |
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How would a nurse assess a patient's schizophrenia?
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What exacerbates schizophrenic episodes
If patient is not stable enough, you can gather information from family members History Physical assessment - Identify functional abilities and disabilities Individualized approach Trusting relationship |
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What are negative symptoms?
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Symptoms in which a person lacks normal capacities
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Name some negative symptoms
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Social withdrawal
Apathy Lack of motivation Emotional unresponsiveness |
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What are positive symptoms?
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Symptoms that people do not normally have
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Name some positive symptoms
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Delusions
Hallucinations Disordered thinking and speech |
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Name some nursing interventions for schizophrenic patients
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Understanding the meaning of client’s words and behavior
Reinforcing reality Promoting clarification Intervening in hallucinations Recognizing and accepting affect Role modeling Tolerance Social/Behavioral interventions Trust Approaching the client Encouraging independence Dealing with hostility |
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What actions can a nurse perform to manage delusions?
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Empathize with patient
Assess triggers (stress)and remove ones that exacerbate schizophrenia Respond to feelings Provide Diversional activities |
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What is the major problem with antipsychotic drugs?
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Have physical side effects that can compromise a patients welfare
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Dystonic reactions
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Abrupt onset of frightening muscle spasms in head and neck
Oculogyric crisis – eyes roll up in head Laryngospasm – spastic closure of larynx |
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Akathasia
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Syndrome characterized by unpleasant sensations of "inner" restlessness that manifests itself with an inability to sit still or remain motionless
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Parkinsonism
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Having Parkinson's like symptoms
-pill rolling -shuffled walk |
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What are some major side effects of Neuroleptic Malignant Syndrome?
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High fever
Respiratory depression Increased heart rate Confused Delirious |
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Tardrive Dyskinesia
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Movements of the tongue, mouth, face and jaw
Puckering Chewing movements Involuntary movements |
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Other major side effects with antipsychotic drugs
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Photosensitivity
Weight gain Interference with sexual function |
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Name major ANTICHOLINERGIC side effects from antipsychotics
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Dry mouth
Constipation Urinary retention Blurry vision Memory difficulties Confusion |
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What are the ADVANTAGES of conventional antipsychotic drugs?
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Well known; proven effective for positive symptoms
Cause less weight gain and diabetes than novel drugs Some can be injected for gradual absorption (long lasting effects) |
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Name some conventional antipsychotic drugs
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Haldol Decanoate
Prolixin Decanoate |
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What are the DISADVANTAGES of antipsychotic drugs?
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Constipation
Dry mouth Blurred vision Dizziness Movement disorders (some have high incidence) Little effect on negative symptoms |
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Clozapine (Clozaril) ADVANTAGES
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May be most effective; especially for negative symptoms and cognitive deficiencies
Does not cause movement disorders May lower the risk of drug and alcohol abuse |
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Clozapine DISADVANTAGES (Side effects)
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Agranulocytosis (in at least 1% of patients)
- Problem with clozaril is that it can cause agranularcytosis causing low white blood cell count, thus increasing chances of infection, fever, etc. Drowsiness, dizziness, drooling Seizures (in 1-5% of patients) Muscle weakness Weight gain Diabetes Rapid withdrawal may lead to psychosis |
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Risperidone (Risperdal) ADVANTAGES
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Outperforms conventional drugs
No seizures or drooling Movement disorders uncommon |
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Risperidone DISADVANTAGES (Side effects)
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Dizziness
Drowsiness Dry mouth Rapid heartbeat Some movement disorders at high doses Weight gain Diabetes |
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Olanzapine (Zyprexa) ADVANTAGES
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Outperforms conventional drugs
Overall low rate of side effects No seizures or drooling Movement disorders uncommon Can be injected for gradual absorption (up to one month) |
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Olanzapine DISADVANTAGES
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Dizziness
Drowsiness Dry mouth Substantial weight gain Diabetes |
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Quetiapine (Seroquel) ADVANTAGES
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Similar to Risperidone and Olanzapine, but little risk of dry mouth or dizziness
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Quetiapine DISAVANTAGES (Side effects)
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Drowsiness
Substantial weight gain Diabetes Occasional movement disorders Cataracts reported in animals given high doses |
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Ziprasidone (Geodon) ADVANTAGES
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No movement disorders
Apparently little weight gain May be helpful for depression and anxiety |
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Ziprasidone DISADVANTAGES (Side effects)
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headaches
Nausea Drowsiness Dizziness Rash Can slow electrical conduction through the heart |
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What is the biggest side effect should a nurse watch out for with patients on Geodon?
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Cardiac issues
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What nursing implications are considered in antiparkinsonian agents?
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Safe environment
Therapeutic communication Promote socialization Reduce anxiety Teaching Disease process Medication compliance Self care |
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What medication can be used to treat dystonia reactions that come from antipsychotic drugs?
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Benadryl
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