CEN Exam Review: Mental Health Emergencies – Emergency Nursing Guide to Psychiatric
Crises, Risk Assessment & Crisis Intervention
What are the 3 types of Psychosis? - ✔✔1. Schizophrenia
2. Delirium
3. Depression/Mania
Define Schizophrenia - ✔✔A long-term mental disorder of a type involving a breakdown in the
relation between thought, emotion and behavior, leading to faulty perception, inappropriate
actions and feelings, withdrawal from reality and personal relationships, fantasy and delusions,
and a sense of mental fragmentation.
Define Psychosis - ✔✔a mental disorder in which thought, and emotions are so impaired that
external reality is lost.
Define Positive symptoms of Schizophrenia. - ✔✔Symptoms that a patient with Schizophrenia
will have but are not exhibited by those without the disorder.
What are some examples of Positive Symptoms of Schitzophrenia. -
✔✔Hallucinations/delusions, thought disorders, bizarre dress/behavior, preservation (persistent
adherence to a single idea or topic), ideas of reference (false belief that external events have
special meaning), Ambivalence.
Define Negative symptoms of Schizophrenia. - ✔✔Behaviors that are likely to exist in the
patient without schizophrenia but may be absent in the patient with the disorder.
What are some examples of Negative symptoms of Schizophrenia. - ✔✔Apathy, Alogia
(speaking with min. content), Flat affect, Anhedonia (feeling no joy/pleasure), Avolition (lack of
will, ambition or drive to accomplish a task).
,Define Delirium - ✔✔A form of psychosis related to a physiological cause.
What is the mnemonic used to remember the causes of Delirium? - ✔✔I WATCH DEATH
What does I WATCH DEATH mean? - ✔✔I-infection
W-withdrawal
A-acute metabolic
T-trauma
C-CNS disease
H-hypoxia
D-deficiencies
E-environmental
A-acute vascular
T-toxins/drugs
H-heavy metals
How do Delirium and Psych Disorders vary in the following fields:
1. Onset
2. Course over 24hrs
3. Consciousness
4. Attention/Cognition
5. Hallucinations
6. Delusions
7. Movements - ✔✔DELIRIUM vs PSYCH
1. over days sudden
2.fluctuating stable
, 3.reduced/hyperalert alert
4. disordered may be disordered
5. VISUAL and or auditory nearly always auditory
6. Transient/poorly organized sustained
7. tremulous, asterixis absent
How does one interact with a psychotic patient? - ✔✔-project confidently and in a non-
threatening manner.
-keep sentences brief
-talk about things grounded in reality.
-do not deny delusional behavior but do not enforce it.
-avoid figures of speech
-explain actions in advance
What are the 3 extrapyramidal symptoms associated with antipsychotic medications? - ✔✔1.
Acute Dystonia
2. Akathisia
3. Neuroleptic Malignant Syndrome (NMS)
Define Acute Dystonia - ✔✔Intermittent, uncoordated, involuntary contractions of muscles of
the face, neck, trunk, and extremities.
Define Akathisia - ✔✔subjective sensation of motor restlessness (may mimic increased
agitation).
Define NMS - ✔✔Potentially life-threatening complication causing altered mentation, muscular
rigidity, FEVER, SNS lability.
Crises, Risk Assessment & Crisis Intervention
What are the 3 types of Psychosis? - ✔✔1. Schizophrenia
2. Delirium
3. Depression/Mania
Define Schizophrenia - ✔✔A long-term mental disorder of a type involving a breakdown in the
relation between thought, emotion and behavior, leading to faulty perception, inappropriate
actions and feelings, withdrawal from reality and personal relationships, fantasy and delusions,
and a sense of mental fragmentation.
Define Psychosis - ✔✔a mental disorder in which thought, and emotions are so impaired that
external reality is lost.
Define Positive symptoms of Schizophrenia. - ✔✔Symptoms that a patient with Schizophrenia
will have but are not exhibited by those without the disorder.
What are some examples of Positive Symptoms of Schitzophrenia. -
✔✔Hallucinations/delusions, thought disorders, bizarre dress/behavior, preservation (persistent
adherence to a single idea or topic), ideas of reference (false belief that external events have
special meaning), Ambivalence.
Define Negative symptoms of Schizophrenia. - ✔✔Behaviors that are likely to exist in the
patient without schizophrenia but may be absent in the patient with the disorder.
What are some examples of Negative symptoms of Schizophrenia. - ✔✔Apathy, Alogia
(speaking with min. content), Flat affect, Anhedonia (feeling no joy/pleasure), Avolition (lack of
will, ambition or drive to accomplish a task).
,Define Delirium - ✔✔A form of psychosis related to a physiological cause.
What is the mnemonic used to remember the causes of Delirium? - ✔✔I WATCH DEATH
What does I WATCH DEATH mean? - ✔✔I-infection
W-withdrawal
A-acute metabolic
T-trauma
C-CNS disease
H-hypoxia
D-deficiencies
E-environmental
A-acute vascular
T-toxins/drugs
H-heavy metals
How do Delirium and Psych Disorders vary in the following fields:
1. Onset
2. Course over 24hrs
3. Consciousness
4. Attention/Cognition
5. Hallucinations
6. Delusions
7. Movements - ✔✔DELIRIUM vs PSYCH
1. over days sudden
2.fluctuating stable
, 3.reduced/hyperalert alert
4. disordered may be disordered
5. VISUAL and or auditory nearly always auditory
6. Transient/poorly organized sustained
7. tremulous, asterixis absent
How does one interact with a psychotic patient? - ✔✔-project confidently and in a non-
threatening manner.
-keep sentences brief
-talk about things grounded in reality.
-do not deny delusional behavior but do not enforce it.
-avoid figures of speech
-explain actions in advance
What are the 3 extrapyramidal symptoms associated with antipsychotic medications? - ✔✔1.
Acute Dystonia
2. Akathisia
3. Neuroleptic Malignant Syndrome (NMS)
Define Acute Dystonia - ✔✔Intermittent, uncoordated, involuntary contractions of muscles of
the face, neck, trunk, and extremities.
Define Akathisia - ✔✔subjective sensation of motor restlessness (may mimic increased
agitation).
Define NMS - ✔✔Potentially life-threatening complication causing altered mentation, muscular
rigidity, FEVER, SNS lability.
