Psych exam 3

Delusional disorder

false thoughts or beliefs that have lasted 1 month or longer, not severe enough to impair functioning, includes delusions of grandeur, persecution, somatic, and referential themes

Brief psychotic disorder

sudden onset of at least one of the following: delusions, hallucinations, disorganized speech, and disorganized or catatonic behavior. must last longer than 1 day but less than 1 month with the expectation of a return to normal functioning

Schizophreniform disorder

symptoms exactly like schizophrenia, except symptoms lasted less than 6 months. social or occupational functioning may or may not be impaired, and no guarentee there will be a return to previous level of functioning

schizoaffective disorder

symptoms of schizophrenia AND a mood disorder

substance use psychosis

delusions or hallucinations from illicit drugs, alcohol, medications, or toxins

schizophrenia

serious mental illness characterized by psychosis - altered cognition, perception, and reality testing

what are negative symptoms of schizophrenia

social withdrawal, lack of emotion, flat affect, decrease in motivation, decrease pleasure in activities

what are positive symptoms of schizophrenia

agitation, delusions, hallucinations, disorganized speech, bizarre behavior

what are the 5 negative behavior symptoms of schizophrenia

anhedonia, avolition, asociality, apathy, alogia

anhedonia

inability to experience pleasure

avolition

loss of motivation

asociality

decreased desire for or comfort during social interaction

apathy

decreased interest in or attention to activities or beliuefs that would otherwise be interesting or important

alogia

reduction of speech

what are the 10 positive speech symptoms of schizophrenia

associative looseness/”word salad"“, clang associations, neologisms, echolalia, circumstantiality, tangentiality, cognitive retardation, pressured speech, flight of ideas, symbolic speech

associative looseness/ word salad

jumble of words meaningless to listener

clang associations

words chosen based on sound, often rhyme

neologisms

brand new word created by patient, meaningless to everyone but the patient

echolalia

pathological repetition of another’s words

circumstantiality

including unnecessary and often tedious details in conversation, off topic but reaches a point

tangentiality

wandering off topic or going on tangents, off topic but NEVER reaches a point

cognitive retardation

generalized slowing of thinking, represented by delays in responding to questions or difficulty finishing thoughts

pressured speech

urgent or intense speech; resists comments from others

flight of ideas

moving rapidly from one thought to the next, often making it difficult for others to follow the conversation

symbolic speech

using symbols instead of direct communication

what are the 5 positive thought distortion symptoms of schizophrenia

thought blocking, thought insertion, thought deletion, magical thinking, paranoia

thought blocking

a reduction or stoppage of thought, can be caused by hallucination

thought insertion

uncomfortable belief that someone else has inserted thoughts into their brain

thought deletion

a belief that thoughts have been taken or are missing

magical thinking

belief that thoughts or actions affect others’ consequences

paranoia

an irrational fear, ranging from mild (guarded) to profound

hallucination

false sensory perception, can affect any sense but is most commonly auditory

should you directly confront/ask a patient about their hallucinations?

yes

what are the 4 positive behavior symptoms of schizophrenia

echopraxia, stereotyped behaviors, boundary impairment, gesturing/posturing

echopraxia

mimicking another persons movements

stereotyped behaviors

repetitive behaviors that do not serve a logical purpose

boundary impairment

impaired ability to sense where one’s body or influence ends and another’s begins, such as standing too close

gesturing/posturing

assuming unusual and illogical expressions, postures, or positions

what are the 5 positive thinking symptoms of schizophrenia

concrete thinking, impaired memory, impaired information processing, impaired executive functioning, anosognosia

concrete thinking

impaired ability to think abstractly

impaired executive functioning

difficulty with reasoning and problem solving

anosognosia

the inability to percieve one’s own cognitive deficits

what is the med class for 1st generation antipsychotics (typical or conventional)

dopamine antagonists

what are the main 2 dopamine antagonists (1st generation antipsychotic)

chlorpromazine (thorazine) and haloperidol (haldol)

what are major side effects of 1st generation antipsychotics / dopamine antagonists / chlorpromazine and haloperidol

sedation, extrapyramidal symptoms, HTN, dyslipidemia, anticholinergic effects, severe neutropenia, liver impairment, dysrhythmias

a major risk of giving antipsychotics is a condition where the body undergoes executive dysfunction; high fever, sweating, increased vitals, severe muscle ridgitidty and fatigue, stupor, and even coma. This condition is called _________

neuroleptic malignant syndrome (NMS)

1st generation antipsychotics/dopamine antagonists have an increased risk for ____ side effects, while 2nd generation antipsychotics/dopamine and serotonin antagonists have an increased risk for ______ side effects and a decreased risk for _______ and ______ side effects,

EPS, Metabolic, EPS and anticholinergic

what is the med class given for 2nd generation antipsychotics (atypical)

dopamine and serotonin antagonists

do first generation antipsychotics treat positive or negative symptoms

positive

do second generation antipsychotics treat positive or negative symptoms

both

What are the names of the 2nd generation antipsychotic drugs / dopamine and serotonin antagonists

clozapine, risperidone, olanzepine, quetiapine, ziprasidone, aripiprazole

what are the suffixes used to differentiate 2nd genertation antipsychotics / dopamine and serotonin antagonists

pine and idone

true or false, 2nd generation antipsychotics / dopamine and serotonin antagonists have the same side effects as first generation (with differring dominant side effects)

true

oppositional defiant disorder (ODD)

recurrent patterns of antisocial behavior including: negativity, disobedience, hostility, defiant behaviors, stubborness, argumentativeness, limit testing, unwillingness to cooperate, refusal to accept responsibility for misbehavior

Conduct disorder (CD)

persistent patterns of behavior that violates the rights of others or rules and norms of society: aggression to people and animals, destruction of property, deceitfulness or theft, serious violations of rules

Intermittent explosive disorder (IED)

recurrent episodes of violent and aggressive behavior with the possibility of hurting people, property, or animals

What is the symptoms of Tobacco/nicotine withdrawal like

irritability, craving, nervousness, restlessness, anxiety, insomnia, increased appetite, angry, depressed, difficulty concentrating

what meds can be given to aid a patient going through nicotine withdrawal/smoking cessation

bupropion, nicotine replacement meds, varenicline

what are common symptoms of caffeine intoxication

tachycardia, arrhythmias, flushed face, muscle twitching, restlessness, anxiety, insomnia, GI disturbance, diuresis

what are risk factors of developing an addictive disorder

genetics, trauma, low self esteem, low tolerance for pain and frustration, poor support system, few life successes, risk taking tendencies

codependance

excessive emotional or psychological reliance on a partner, typically one who requires support because of an illness or addiction

at what dose does caffeine intoxication occur

above 250 mg

what are effects of cannabis intoxication

Chronic use: increased risk of lung cancer and respiratory disorders

cannabis use disorder may cause problems with ADL’s

in high doses can cause paranoia

what are effects of cannabis withdrawal

irritability, aggression, anxiety, insomnia, lack of appetite, restlessness, depressed mood, abdominal pain, tremors, diaphoresis, fever, and headache

what are the effects of intoxication of hallucinogens

anxiety, depression, paranoia, impaired judgement, impaired social functioning, pupil dilation, tachycardia, palpitations, diaphoresis, blurred vision, tremors, incoordination, panic attacks

what are the effects of intoxication of inhalants

Depends on the substance, usually causes behavioral or psychological changes, dizziness, nystagmus, uncoordinated movements or gait, slurred speech, drowsiness, muscle weakness, diplopia, stupor or coma, respiratory depression, and possible death

what is the intended use for caffeine

increase alertness and decrease fatigue

what is the intended use of cannabis

decrease N/V from chemotherapy, manage chronic pain, euphoria, sedation

what is the intended effect of hallucinogenics

heightened sense of self and altered perceptions

what is the intended effect of inhalants

euphoria

what is the intended effect of sedative-hypnotic, antianxiety meds

decreased anxiety, sedation

what are the effects of sedative-hypnotic, antianxiety med intoxication

inctreased drowsiness and sedation, agitation, slurred speech, uncoordinated motor activity, nystagmus, disorientation, nausea, vomiting

what are the signs of withdrawal for sedative-hypnotic, antianxiety meds

Anxiety, insomnia, diaphoresis, hypertension, possible psychotic reaction, hand tremors, nausea, vomiting, hallucinations or illusions, psychomotor agitation, and possible seizure activity

what are the intended effects of stimulants

increased energy, euphoria

what are the effects of intoxication for stimulants (amphetamines & cocaine)

amphetamines: impaired judgement, hypervigilance, extreme irritability, psychomotor agitation, HTN and tachycardia

Cocaine: dizzyt, tremors, blurry vision, irritable, hallucinations, HTN, tachycardia, fever, chest pain

is stimulant withdrawal life threatening?

no

what ethnic group has the highest prevelance of alcoholism

american indians/alaskan natives

what are the systemic effects of alcohol use disorder

peripheral neuropathy, alcoholic myopathy and cardiomyopathy, esophagitis, gastritis, pancreatitis, alcoholic hepatitis, leukopenia, thrombocytopenia, cancer

what BAC level is the legal intoxication level for US adults

0.08%

what are signs of alcohol withdrawal

Abdominal cramping, vomiting, tremors, restlessness, insomnia, hallucinations or illusions, anxiety, tonic-clonic seizures, increased temp and BP

paranoid personality disorder

distrust and suspicousness toward others based on unfounded beliefs that others want to harm, exploit, or decieve the person

how should the nurse interact with a patient who has paranoid personality disorder

be direct and straightforward, not overly friendly

schizoid personality disorder

emotional detachment, disinterest in close relationships, and indifference to praise or criticism, often uncooperative

schizotypal personality disorder

odd beliefs leading to interpersonal difficulties, an eccentric appearance, and magical thinking or perceptual distortions that are not clear delusions or hallucinations

what needs to be checked for in a patient with schizotypal personality disorder

involvement with cults

antisocial personality disorder

lack of empathy, repeated unlawful actions, deceit, failure to accept personal responsibility. Evidence of conduct disorder before age 15, sense of entitlement, manipulative, impulsive, and seductive behaviors. nonadherence to traditional morals and values. verbally charming and engaging

borderline personality disorder

instability of affect, identity, and relationships, as well as splitting behaviors, manipulation, impulsiveness, and fear of abandonment. often self-injurious and potentially suicidal.

histrionic personality disorder

emotional attention-seeking behavior, in which the person needs to be the center of attention, often seductive and flirtatious

nursing care points for a patient with histrionic personality disorder

understanding seductive behavior is a response to distress

narcissistic personality disorder

arrogance, grandiose views of self-importance, and the need for consistent admiration, and a lack of empathy for others that strains most relationships; often sensitive to criticism

what are nursing care points for a patient with narcissistic personality disorder

remain neutral in response to narcissistic behavior, avoid power struggle or becoming defensive, role model empathy

avoidant personality disorder

social inhibition and avoidance of all situiations that require interpersonal contact, despite wanting close relationships, due to extreme fear of rejection

dependent personality disorder

extreme dependency in a close relationship with an urgent search to find a replacement when one relationship ends

obsessive-compulsive personality disorder

indecisiveness and perfectionism with a focus on orderliness and control to the extent that the individual might not be able to accomplish a given task

somatic symptom disorder

characterized by a focus on somatic (physical) symptoms, such as pain or fatigue, to the point of excessive concern, preoccupation, and fear. patients suffering is authentic, and they typically experience a high level of functioning impairment

illness anxiety disorder

misinterprets physical symptoms as a serious disease process; can lead to obsessive thoughts and fears about illness

conversion disorder

exhibits neurologic manifestations in the absence of a neurologic diagnosis

facitious disorder

conscious decision to report physical or psychological symptoms, may self-inflict injury. fulfill an emotional need for attention (not done for personal gain)

malingering

not a mental illness, consciously motivated and driven by personal gain

anorexia nervosa

eating disorder characterized by abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight. commonly begins during adolescence or in young adults, more common in females.