RNSG 1125 Unit 4 A

Explain the 3 phases of schizophrenia:

Prodromal: early period between the appearance of initial manifestations Active: the episodes get more severe and noticeable Residual: manifestations of hallucinations and delusions are less severe

a reaction to medication that imitates the symptoms of Parkinson's disease and can be treated by stopping the medication that caused the reaction:

Pseudo Parkinsonism

An inability to sit still, and it can be a side effect of antipsychotic or antidepressant medication:

akathisia

This is a side effect of anticholinergic toxicity, and it can cause dry mouth and constipation

anticholinergic toxicity

Unconscious inability to concentrate on a single thought. Can progress to flight of ideas in which the client's speech moves so rapidly from one thought to another that is incoherent.

associative looseness

When is schizophrenia usually diagnosed?

late adolescence or early adulthood from ages 16 to 30

a group of symptoms that can occur in people taking antipsychotic medications: ex: an inability to sit still, involuntary muscle contraction, tremors, stiff muscles, and involuntary facial movements.

extrapyramidal side effect

What is the best therapeutic technique for delusions?

gravitate the patient towards reality in a therapeutic way

What are the 3 positive symptoms of schizophrenia?

hallucinations, delusions, organized speech

What are 3 cognitive symptoms of schizophrenia?

poor concentration, slow thinking, poor memory

What are the 3 phases of schizophrenia?

prodromal, active, residual

What is the best therapeutic technique for tactile and auditory hallucinations?

provide earphones and music (audio simulations)

These are medical doctors that can diagnose and prescribe medical procedures, tests, and medications:

psychiatrist

These are not medical doctors and cannot prescribe tests such as an MRI. They can conduct clinical interviewing, evaluate a clinical psychologically, ad perform individual and group therapy.

psychologist

This is a clinical manifestation rather than an illness or disorder:

psychosis

What is acute dystonia?

spasm of muscles of tongue, face, neck and back, side effect of antipsychotic medication.

this is caused by long term use of neuroleptic drugs which are used to treat psychiatric conditions. This can cause repetitive involuntary movements, grimacing, eye blinking lip smacking:

tardive dyskinesia

What are the 2 important factors of the resolution phase?

1) Able to function without live in support or supervision 2) rehabilitation and recovery

What are the 2 important factors of the orientation phase ?

1) Client does not recognize the need for assistance and blocks alliance 2) Manifestations of psychosis (positive or negative symptoms)

What are the 2 important factors of the exploitation phase?

1) Explore interventions: medication and cognitive therapies 2) Recognize triggers

What are the 2 important factors of the identification phase?

1) Monitor positive and negative manifestations 2) Challenges with communication and daily functioning

A nurse is discussing responsibilities in milieu therapy with a group of newly hired nurses. Which of the following should the nurse include? A: Explain unit rules, including expectations and client rights B: Provide orientation, including a tour of the unit, rules, and expectations C: Select activities based on preferences of available staff D: Ensure that culturally sensitive care is provided E: Use a trauma-informed approach to client care

A: Explain unit rules, including a tour of the unit, rules, and expectations. B: Provide orientation, including a tour of the unit, rules, and expectations D: Ensure that culturally sensitive care is provided E: Use a trauma-informed approach to client care

A nurse is completing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse document as positive symptoms? A: Auditory hallucination B: Lack of motivation C: Use of clang associations D: Delusion of persecution E: Constantly waving arms F: Flat affect

A: Hallucinations C: Use of clang associations (alterations in speech) D: Delusion of persecution E: Constantly waving arms (bizarre motor movements)

A nurse is caring for a client who is in physical restraints. The nurse should identify that which of the following complications can result from inadequate monitoring of the client? A: Positional asphyxia B: Food aspiration C: Cardiac arrest D: Infection E: Somnolence

A: Positional asphyxia, B: Food aspiration, C: Cardiac arrest

This is a 12 item clinician rate scale to asses severity dyskinesias (oral facial movement) in clients who take antipsychotic medication

AIMS scale 0-4 1 minimal-4 severe

This act mandates mental health parity. Parity is equal coverage for physical and mental healthcare which is guaranteed under this act.

Affordable Care Act of 2010

A nurse is discussing milieu therapy with a group of newly licensed nurses. Which of the following statements should the nurse make? A: "Create an environment where structure is prompted over autonomy B: "Create and environment that is safe and beneficial for recovery C: The mental health provider is responsible for the structure and maintenance of the therapeutic milieu D: Ensure spontaneous changes in activities throughout the client's daily schedule.

B: Create and environment that lis safe and beneficial for recovery.

A nurse is caring for a client who is agitated and requires chemical restraints. Which of the following types of medications should the nurse expect the provider to prescribe? A: Antidepressants B: Sedative C: Steroid D: N-methyl D-aspartate receptor (NMDA) inhibitor

B: Sedative- Sedatives are frequently used to calm clients who are agitated. They act fast and are usually well tolerated.

A nurse is discussing false imprisonment with a group of newly hired staff members. Which of the following information should the nurse include? A: A client cannot claim false imprisonment if they were restrained by use of an injectable antipsychotic medication B: Claims of false imprisonment can be made if a nurse verbally threatens to place a client in seclusion. C: Claims of false imprisonment are most often made in reference to the use of seclusion or restraints. D: A client cannot claim false imprisonment if they are voluntarily admitted without being assessed by a provider.

C: Claims of false imprisonment are most often made in reference to the use of seclusion or restraints.

In patients with schizophrenia this type of scan shows an enlargement of the third ventricle:

CT scan

The meaningless rhyming of words, often in a forceful manner. ex: "Oh fox, box, and lox

Clang association

This types of antipsychotic medications produce minimal extrapyramidal side effects and treats both negative and positive symptoms of schizophrenia: Provide examples as well.

Clozapine, Risperidone, Olanzapine, Zaprasidone

A patient who has been involuntarily committed does not have the right to refuse treatment. True or False?

False, even patient's who have been involuntary admitted have the right to refuse procedures or medications.

This test is a 30 point questionnaire used extensively in clinical research settings to measure cognitive impairment:

Mini mental status exam

Made up words that have meaning only to the client such as "I tranged and flitted"

Neologisms

a life threatening neurological emergency associated with the use of antipsychotic (neuroleptic) agents and characterized by a distinctive and clinical syndrome of mental status change, rigidity, fever, and dysautonemia

Neuroleptic malignant syndrome

The act requires provider's to inform clients of the cost of the treatment and whether the provider is covered by their insurance:

No Surprises Act

This is the organization that is tasks with ensuring worker safety, including providing oversight for workplace violence

OSHA

What are the 4 phases of a therapeutic relationship?

Orientation, Identification, Exploitation, Resolution

This type of diagnostic can compare brain activity during periods of depression with normal brain activity:

PET (positron emission tomography) scan

These people work to figure out what stimulus is paired with specific behaviors our reaction:

behavior therapist

What are 3 negative symptoms of schizophrenia?

blunted affect, alogia, avolition

What is an exception of HIPPA ?

duty-to-warn

The client repeats the words spoken to him

echolalia

What qualifies a person to be diagnosed with schizophrenia?

two or more symptoms must be present for a period of 1 month or longer with signs of continuous disturbance for at least 6 months.

What are the 3 different types of admission for patients?

voluntary- they come in on their own and sign themselves in. involuntary-someone else brings the patient in. emergency admission- patients requires emergency admission because they are a threat to themselves or someone.

Words jumbled together with little meaning or significance to the listener ex: "Hip hooray, the flip is cast and wide-sprinting in the forest"

word salad