Schizophrenia

Demonstrate therapeutic communication with an individual expressing paranoid delusions: empathize but don’t feed into the delusion

Define the type of hallucinations that necessitates immediate nursing intervention for safety: command hallucinations

Recognize objective signs an individual is experiencing auditory or visual hallucinations:

drowning out the voices by humming, talking loudly

talking to things that don’t exist

focusing gaze on something that isn’t there

Define loose associations and word salad

illogical thinking, loose association

ex. my friends talk about french fries but how can you trust the french?

word salad: words that have no connection

ex. agents want strength of policy about boat reining supreme

Demonstrate the therapeutic response for responding to a patient demonstrating incongruent affect, loose associations, word salad, and/or clang associations

clang association- words that sound the same

  • don’t pretend to understand them

  • place the blame on you not the patient

    • ex. i am having trouble to understand what you are saying NOT you are not making any sense

  • tell pt what you do understand

  • look for recurring themes and issues

  • paraphrase what pt says

  • speak in sentences not paragraphs

Differentiate the priority nursing care focus of a patient with catatonia

physiological

at risk for blood clots, malnutrition, pneumonia, exhaustion, dehydration

Define signs of pseudo parkinsonism

tremors, reduced accessory movements, gait impairment, reduce facial expressions, bradykinesia

Distinguish appropriate medications education for a patient taking antipsychotic medications

NMS- rigid, reduced consciousness, autonomic dysfunction, seek emergency treatment

anticholinergic toxicity- dilated pupils, urinary retention, delerium, worsening psychosis - seek emergency treatment

Determine the proper pharmacological intervention to treat dystonia associated with antipsychotics

2nd gen antipsychotics

botulism

Recognize negative symptoms of psychosis

anhedonia- reduced ability to experience pleasure

avolition- reduced motivation'

asociliaty- reduced social desire

blunt affect

apathy- dc interest in activities or beliefs

alogia- reduced speech

Identify signs and symptoms of neuroleptic malignant syndrome and the appropriate immediate nursing action

  • reduced consciousness

  • rigidity

  • autonomic dysfunction

  • discontinue meds, fluid balance, temperature reduction

  • seek emergency help