Podcast
Questions and Answers
A patient with schizophrenia is exhibiting a flat affect, social withdrawal, and a lack of motivation. Which category of symptoms do these behaviors fall under?
A patient with schizophrenia is exhibiting a flat affect, social withdrawal, and a lack of motivation. Which category of symptoms do these behaviors fall under?
- Negative symptoms (correct)
- Positive symptoms
- Cognitive symptoms
- Disorganized symptoms
A client with schizophrenia is prescribed haloperidol. What potential side effect is most important for the nurse to monitor?
A client with schizophrenia is prescribed haloperidol. What potential side effect is most important for the nurse to monitor?
- Weight gain
- Photosensitivity
- Excessive movement (correct)
- Agranulocytosis
When communicating with a client experiencing delusions, which intervention is most therapeutic?
When communicating with a client experiencing delusions, which intervention is most therapeutic?
- Encouraging detailed descriptions of delusional experiences
- Shifting the focus to reality-based topics (correct)
- Presenting logical explanations to disprove the delusions
- Arguing against the delusional beliefs
A client with schizophrenia is non-adherent to their medication regimen. Which pharmacological intervention might be considered to improve adherence and outcomes?
A client with schizophrenia is non-adherent to their medication regimen. Which pharmacological intervention might be considered to improve adherence and outcomes?
A client experiencing catatonia is exhibiting rigid posture, is unresponsive to stimuli, and is refusing to eat or drink. What is the priority nursing intervention?
A client experiencing catatonia is exhibiting rigid posture, is unresponsive to stimuli, and is refusing to eat or drink. What is the priority nursing intervention?
A client with schizophrenia states, "The TV is sending messages directly to my brain." Which type of delusion is the client experiencing?
A client with schizophrenia states, "The TV is sending messages directly to my brain." Which type of delusion is the client experiencing?
A client with schizophrenia is exhibiting disorganized speech, including inventing new words that have no meaning. This is an example of what?
A client with schizophrenia is exhibiting disorganized speech, including inventing new words that have no meaning. This is an example of what?
Which nursing intervention is most likely to promote trust with a newly admitted client with schizophrenia?
Which nursing intervention is most likely to promote trust with a newly admitted client with schizophrenia?
A client with schizophrenia is prescribed risperidone. What potential side effect is most important for the nurse to monitor?
A client with schizophrenia is prescribed risperidone. What potential side effect is most important for the nurse to monitor?
A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is most appropriate?
A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is most appropriate?
A client with schizophrenia is pacing and agitated. What is the first nursing action?
A client with schizophrenia is pacing and agitated. What is the first nursing action?
A client diagnosed with schizophrenia is speaking incoherently. They are jumping from one unrelated topic to another. Which term describes this?
A client diagnosed with schizophrenia is speaking incoherently. They are jumping from one unrelated topic to another. Which term describes this?
Which of the following principles should guide the nurse's approach when caring for a client experiencing delusions?
Which of the following principles should guide the nurse's approach when caring for a client experiencing delusions?
A client with schizophrenia displays minimal emotional expression. The client's face appears immobile, and his voice lacks inflection. How should the nurse document this?
A client with schizophrenia displays minimal emotional expression. The client's face appears immobile, and his voice lacks inflection. How should the nurse document this?
A client’s chart indicates treatment with a first-generation antipsychotic medication. Which side effect is more commonly associated with first-generation antipsychotics compared to second-generation?
A client’s chart indicates treatment with a first-generation antipsychotic medication. Which side effect is more commonly associated with first-generation antipsychotics compared to second-generation?
Which of the following outcomes indicates effective social skills training for a client diagnosed with schizophrenia and negative symptoms?
Which of the following outcomes indicates effective social skills training for a client diagnosed with schizophrenia and negative symptoms?
A client with schizophrenia refuses to eat or drink, stating, “The food is poisoned.” What is the most appropriate intervention?
A client with schizophrenia refuses to eat or drink, stating, “The food is poisoned.” What is the most appropriate intervention?
During an assessment, a client with schizophrenia reports tactile hallucinations. Which question is most appropriate?
During an assessment, a client with schizophrenia reports tactile hallucinations. Which question is most appropriate?
Which statement reflects the current understanding of the etiology of schizophrenia?
Which statement reflects the current understanding of the etiology of schizophrenia?
A client says 'The bread is buttered, I need a ladder to go to the moon after noon!" Which of the following does this symptom represent?
A client says 'The bread is buttered, I need a ladder to go to the moon after noon!" Which of the following does this symptom represent?
A client states, "I am the president of the United States, and I have the power to control the world." Which type of delusion is the client experiencing?
A client states, "I am the president of the United States, and I have the power to control the world." Which type of delusion is the client experiencing?
Which of the following interventions demonstrates appropriate nursing care for a client diagnosed with schizophrenia exhibiting disorganized behavior?
Which of the following interventions demonstrates appropriate nursing care for a client diagnosed with schizophrenia exhibiting disorganized behavior?
A client states says a new word that they made up, such as "flurries" which of the following terms describes this?
A client states says a new word that they made up, such as "flurries" which of the following terms describes this?
What would be the priority nursing intervention for a client with schizophrenia experiencing command hallucinations?
What would be the priority nursing intervention for a client with schizophrenia experiencing command hallucinations?
A client taking a first-generation antipsychotic begins to display facial grimacing and repetitive movements. Which medication should the nurse prepare to administer?
A client taking a first-generation antipsychotic begins to display facial grimacing and repetitive movements. Which medication should the nurse prepare to administer?
Which of the following distinguishes schizophrenia from other psychotic disorders?
Which of the following distinguishes schizophrenia from other psychotic disorders?
A client receiving antipsychotic medication develops muscle rigidity, fever, and altered mental status. Which of the following should the nurse suspect?
A client receiving antipsychotic medication develops muscle rigidity, fever, and altered mental status. Which of the following should the nurse suspect?
Why is it important to use canned foods?
Why is it important to use canned foods?
A client diagnosed with schizophrenia is prescribed clozapine. Which potential adverse effect requires regular monitoring?
A client diagnosed with schizophrenia is prescribed clozapine. Which potential adverse effect requires regular monitoring?
During a home visit, the nurse observes that a client with schizophrenia is withdrawn, neglects personal hygiene, and reports feeling empty. Which aspects of care should the nurse prioritize?
During a home visit, the nurse observes that a client with schizophrenia is withdrawn, neglects personal hygiene, and reports feeling empty. Which aspects of care should the nurse prioritize?
A client with schizophrenia states, "I can’t take medications because the government is tracking me with the pills." How should the nurse respond?
A client with schizophrenia states, "I can’t take medications because the government is tracking me with the pills." How should the nurse respond?
A client who has been on antipsychotic medications for several years begins exhibiting involuntary, repetitive movements of the tongue and face. What is the appropriate term for this?
A client who has been on antipsychotic medications for several years begins exhibiting involuntary, repetitive movements of the tongue and face. What is the appropriate term for this?
A client reports that they are unable to feel pleasure from activities that they used to enjoy, such as hobbies and spending time with loved ones. Which symptom is the client experiencing?
A client reports that they are unable to feel pleasure from activities that they used to enjoy, such as hobbies and spending time with loved ones. Which symptom is the client experiencing?
A client recently diagnosed with schizophrenia is overwhelmed and asks their nurse, "What caused this disease?". Which is the best response?
A client recently diagnosed with schizophrenia is overwhelmed and asks their nurse, "What caused this disease?". Which is the best response?
What is meant by balance neutral?
What is meant by balance neutral?
Which of the following is true?
Which of the following is true?
Which of the following is NOT a nursing intervention that can be utilized for hallucinations?
Which of the following is NOT a nursing intervention that can be utilized for hallucinations?
Flashcards
Schizophrenia
Schizophrenia
Complex psychiatric disorder affecting interpretation of reality.
Hallucinations
Hallucinations
False sensory experiences (tactile, visual, auditory, olfactory)
Delusions
Delusions
Irrational beliefs
Neologism
Neologism
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Tangentiality
Tangentiality
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Word Salad
Word Salad
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Echolalia
Echolalia
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Catatonia
Catatonia
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Apathy
Apathy
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Avolition
Avolition
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Asociality
Asociality
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Affective Flattening
Affective Flattening
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Anhedonia
Anhedonia
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Alogia
Alogia
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Treatment for Schizophrenia
Treatment for Schizophrenia
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Side effect of 1st Generation Antipsychotics
Side effect of 1st Generation Antipsychotics
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Side effect of 2nd Generation Antipsychotics
Side effect of 2nd Generation Antipsychotics
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Study Notes
- Schizophrenia is a complex psychiatric disorder where the client is unable to interpret and interact with reality.
- Schizophrenia can arise from a combination of genetics, the environment, and brain chemistry.
- Dopamine plays a significant role in schizophrenia.
- Too much dopamine can lead to positive symptoms in the limbic part of the brain.
- Too little dopamine can lead to negative emotions in the prefrontal cortex.
Clinical Features - Positive Symptoms
- Hallucinations involve false senses, including tactile, visual, auditory, and olfactory.
- Delusions are irrational beliefs, such as grandiose delusions, delusions of reference, and delusions of control.
- Disorganized thoughts/incoherent speech lack a logical flow and can manifest as:
- Neologisms: made-up words.
- Tangentiality: diverging from the main topic.
- Word Salad: jumbling words without meaning.
- Echolalia: repeating phrases or words.
- Disorganized/Agitated behavior e.g. catatonia, which includes immobile, peculiar postures and unresponsiveness.
- Psychomotor slowing or agitation can be present.
Clinical Features - Negative Symptoms
- Apathy is a lack of interest, such as poor hygiene or poor eating habits.
- Avolition is a lack of motivation.
- Asociality is social withdrawal, where the person is comfortable when alone.
- Affective Flattening involves empty, monotone speech.
- Anhedonia is the inability to experience pleasure.
- Alogia is a lack of speech.
Treatment
- Antipsychotics can manage positive symptoms.
- 1st Generation/Typical antipsychotics (e.g., haloperidol) can cause excessive movement as a side effect.
- 2nd Generation/Atypical antipsychotics (e.g., risperidone, olanzapine, aripiprazole) can cause weight gain as a side effect.
- Long-acting injectables improve adherence and outcomes.
Nursing Interventions
- Priority: Establish trust by being honest and consistent.
- Use frequent and short interaction times.
- Sit calmly in the client's room if needed.
- Avoid touching the client without informing them.
- Maintain a balanced, neutral approach, avoiding being overly warm.
- Explain procedures step by step.
- Initiate activities on a one-on-one basis, progressing to small groups.
Nursing Interventions - Hallucinations:
- Monitor cues.
- Ask directly about the content of the hallucination.
- Monitor for worsening anxiety and agitation.
- Decrease stimuli or assist the client to another area.
- Provide distraction, such as music with headphones.
- Explain what is real and unreal verbally.
- Check for suicidal/homicidal ideation.
Nursing Interventions - Delusions:
- Use therapeutic communication.
- Refrain from arguing or trying to convince the client.
- Shift the conversation to reality-based topics rather than focusing on the delusion.
- Use canned or prepackaged foods.
- Open medication in front of the client.
- Check the mouth and palms after medication administration.
- Use positive reinforcement.
Nursing Interventions - Negative Symptoms:
- Use social skills training.
- Measure the client's readiness to engage with others.
- If the client is in a catatonic state, prioritize fluid and nutrition.
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