module 9 schizophrenia

delusions

false beliefs

ex: paranoid of government planting cameras in your house

disordered thinking

confused thoughts that do not link up

hallucinations

sensing things that feel real to that person but does not exist in reality

psychosis

a syndrome of neurocognitive symptoms that impair cognitive capacity, leading to deficits of perception, functioning, and social relatedness

schizophrenia assessment findings

at least one psychotic symptom (delusion, disordered thinking, hallucinations)

disrupt normal activities

often fail to achieve age-appropriate milestones

hygiene/nutrition neglect

dsm v criteria

delusions

hallucinations

disorganized speech

disorganized OR catatonic behavior

negative symptoms

*AT LEAST TWO OR MORE PRESENT, 1 OF FIRST 3 MUST BE PRESENT

positive symptoms

something that should NOT be present

positive symptom examples

delusions

hallucinations

disorganized speech

grossly disorganized / catatonic behavior

negative symptoms

something that should be present but is missing

six a's (negative)

alogia (speak less)

anhedonia

apathy (lack of interest/enthusiasm)

asociality (not social)

avolition (lack of motivation)

affective blunting OR flat affect

delusions interventions

avoid confronting the delusion

show empathy

DONT "play along"

establish and maintain reality

hallucinations interventions

describe the hallucination

understand they are experiencing something

DONT "play along"

present reality

first gen antipsychotics

chlorpromazine

haloperidol

first gen antipsychotics action

blocks dopamine

target positive symptoms

first gen antipsychotic EPS

higher risk for EPS

acute dystonia

akathisia

pseudoparkinsonism

tardive dyskinesia

pseudoparkinsonism

stooped posture

shuffling gait

rigidity

tremors (pill-rolling)

acute dystonia

facial grimacing

severe spasms of tongue, neck, face

akathisia

restless

trouble standing still

paces (feet in constant motion)

tardive dyskinesia

protrusion of the tongue

sucking and smacking movement of lips

chewing motion

facial dyskinesia

involuntary movement of the body

benztropine

antiparkinsonian agent

used for pseudopark, acute dystonia, akathisia

second gen antipsychotics

clozapine

olanzapine

risperidone

second gen antipsychotic actions

blocks dopamine and bind to serotonin

target positive and negative symptoms

low risk of EPS

antipsychotic effects

anticholinergic effects

sedation

orthostatic hypotension

weight gain

sexual dysfunction

first gen antipsychotic adverse effects

EPS

QT prolongation

hyperprolactinemia

second gen antipsychotic adverse effects

metabolic syndrome

QT prolongation

agranulocytosis

associated with clonzapine

neutropenia may develop (FATAL)

assess for infection

STOP medication

neuroleptic malignant syndrome

fever (potentially fatal and life threatening)

STOP medication and notify provider immediately

prepare to transfer to critical unit

cool body

types of hallucinations

auditory

visual

gustatory (taste)

tactile (touch)

olfactory (smell)

command