schizo and other thought disorders

A patient's mother asks the nurse, "What caused my daughter to have schizophrenia?" What should be the nurse's best response?

"The cause of schizophrenia is related to many genetic, environmental, and psychosocial issues."

2 causes of schizophrenia

*biological-behavior associated w/ changes in brain fxn *psychological-cognitive, psycho dynamic, behavioral, sociocultural. consequence of faulty learning, due to regression stage of development

Symptoms of Schizophrenia

-positive due to high dopamine levels: abnormal thought, agitation, bizarre behavior, delusions, excitement, hallucinations, insomnia, hostility -negative: inability to speak, lethargy, lack of motivation, attention deficits, lack of affect, communication problems, poor rapport/social withdrawal

3 phases of schizophrenia

1. acute: Severe psychotic symptoms are experienced, such as hallucinations and delusions. 2. stabilizing phase: The patient's symptoms are improving. 3. stable phase: Although delusions and hallucinations are experienced, they are not as severe as seen in the acute phase. Most patients alternate between acute and stable phases.

biologic theories

1. dopamine hypothesis- extra dopamine contributes to increase synthesis and causes hallucinations/delusions 2. neurostructural theory- anatomic pathology of brain responsible for negative symptoms of schizo. medial temporal areas have diminished brain volume 3. genetic factors- play major role 4. inflammation/immune fxn- pts w/ schizo have disrupted immune system fxn. may produce too much inflammatory cytokines that alter brain fxn/ structure

The nurse is teaching a prenatal class and an expectant mother asks what events in pregnancy could put a child at risk of developing schizophrenia later in life. What is information should be included in the nurse's response?

Prenatal exposure to lead has been linked to the development of schizophrenia, Exposure to viruses from house cats has been linked to the development of schizophrenia, Malformations during the early gestation period have been linked to the development of schizophrenia

The nurse is talking with the twin brother of a patient with schizophrenia. The brother asks the nurse if schizophrenia is hereditary, related to birth defects, or caused by stress. What information should the nurse provide the patient's brother regarding the pathology of the disease?

The heritability of the disease is estimated to be 70-90%, The development of schizophrenia has been linked to the labor and delivery phase of pregnancy, There is evidence that both genetic vulnerability and stressful life events can trigger symptoms of schizophrenia

The nurse notes that the patient's affect changes from happy to sad to anger several times per day. How should the nurse document this finding in the patient's chart?

The patient has a labile affect. A labile affect is a state where the affect changes quickly from one response to another. For example, a patient may be very happy and abruptly begin to cry

The nursing assistant tells the nurse that a patient with schizophrenia is distractible and seems like he is in his own world. How should the nurse explain this behavior to the nursing assistant?

The patient is experiencing a symptom known as autism. Autistic behaviors are characteristic of schizophrenia and manifest as distractibility and being in their own world.

The nurse is caring for a patient who reports hearing a voice telling her, "You are horrible and I hope you die." How should the nurse document this assessment finding in the patient's chart?

The patient is having auditory hallucinations. Hearing voices is type of hallucination. Often patients will hear voices that are very negative towards them

subjective signs

altered perception (most common sensory perception is auditory), thought, consciousness, affect

objective signs

alternations in personal relationships, social skills, communication, activity

vulnerability-stress model

identifies that genetic and other predispositions to schizophrenia, when combined with stressful life events and situations, can trigger and accelerate the schizophrenic process

The nurse is teaching a group of patients about how schizophrenia changes the structures of the brain. Which information should the nurse include in the presentation?

lower brain volume, atrophy of cerebral cortex, decreased blood flow to brain

Schizophrenia

severe and chronic mental disorder that affects how person behaves, thinks, and feels -exact cause unknown but genetic/environmental factors may contribute