MENTAL HEALTH SCHIZOPHRENIA
(EXAM 1) QUESTIONS AND ANSWERS
Hallucinations - ANSWER-Comforting: friendly hallucinations
Condemning: voices calling pt. "stupid"
Controlling
Conquering
Relapse prevention - ANSWER-Prodromal Phase: early signs and symptoms
Trigger education: if cocaine causes hallucinations, don't use cocaine
Teach patients to get help early, as soon as they feel overwhelmed
As with any disease, manage life stress
Teach families to identify recurrence
Stay on medication
The most common causes of relapse is with medication
Stages of relapse - ANSWER-1. Overextension- something doesn't feel right
2. Restricted Consciousness- decreased cognition
3. Disinhibition- 1st appearance of psychosis
4. Psychotic Disorganization- needs treatment
5. Psychotic Resolution
Community resources - ANSWER-NAMI (national alliance on mental illness)
Attend to basic needs to decrease stress
Provide support
Community education
Need for additional services; support groups
Antipsychotic medication - ANSWER-"neuroleptics" or "major tranquilizers"
Older "typical" antiphyschotics - ANSWER-Improve positive symptoms
Dopamine antagonist
Ex: thorazine
Extrapyramidal symptoms - ANSWER-EPS:
muscle rigidity
tremors
akathisia- can't stop moving, rocking in place
drooling
shuffling gait
dystonia- can't control neck movement and pain
oculogyrus- can't control where their eyes look
, EPS treatment - ANSWER-Decrease dosage
Change to different antipsychotic
Administer an anticholinergic (Cogentin or Artane)
or Antihistimeine (Benadryl)
or Dopamine Agonist (Symmetrel)
REVERSIBLE
Tardive dyskinesia - ANSWER-PERMANENT. No treatment
Symptoms:
Involuntary mouth movements, foot tapping, pill rolling
Need to assess baseline and throughout treatment
Neuroleptic malignant syndrome - ANSWER-Rare, but fatal.
High potency drugs
Symptoms:
Due to dehydration
Fever
Tremor
Discontinue meds
Tachycardia
Stupor
Increased CPK
Sweating
Muscle rigidity
Treatment:
Rehydrate
Renal Dialysis
Fever reduction
Dantrolene, Bromocriptine
Abnormal Involuntary Movements Assessment - ANSWER-• Used to identify Tardive
Dyskinesia
• Takes about 10 minutes
• A score of 2 or more indicates TD
Antipsychotic meds in general - ANSWER-• Are Not physically addicting
• No tolerance to their antipsychotic effects
• Lower abuse potential
• Relatively safe in overdose
• Some can be given IM
Newer "atypical" antiphyschotics - ANSWER-Improve positive AND negative
symptoms
Help with dopamine and serotonin
Ex: Halodol, Abilify, Latuda
Used more but cost more
(EXAM 1) QUESTIONS AND ANSWERS
Hallucinations - ANSWER-Comforting: friendly hallucinations
Condemning: voices calling pt. "stupid"
Controlling
Conquering
Relapse prevention - ANSWER-Prodromal Phase: early signs and symptoms
Trigger education: if cocaine causes hallucinations, don't use cocaine
Teach patients to get help early, as soon as they feel overwhelmed
As with any disease, manage life stress
Teach families to identify recurrence
Stay on medication
The most common causes of relapse is with medication
Stages of relapse - ANSWER-1. Overextension- something doesn't feel right
2. Restricted Consciousness- decreased cognition
3. Disinhibition- 1st appearance of psychosis
4. Psychotic Disorganization- needs treatment
5. Psychotic Resolution
Community resources - ANSWER-NAMI (national alliance on mental illness)
Attend to basic needs to decrease stress
Provide support
Community education
Need for additional services; support groups
Antipsychotic medication - ANSWER-"neuroleptics" or "major tranquilizers"
Older "typical" antiphyschotics - ANSWER-Improve positive symptoms
Dopamine antagonist
Ex: thorazine
Extrapyramidal symptoms - ANSWER-EPS:
muscle rigidity
tremors
akathisia- can't stop moving, rocking in place
drooling
shuffling gait
dystonia- can't control neck movement and pain
oculogyrus- can't control where their eyes look
, EPS treatment - ANSWER-Decrease dosage
Change to different antipsychotic
Administer an anticholinergic (Cogentin or Artane)
or Antihistimeine (Benadryl)
or Dopamine Agonist (Symmetrel)
REVERSIBLE
Tardive dyskinesia - ANSWER-PERMANENT. No treatment
Symptoms:
Involuntary mouth movements, foot tapping, pill rolling
Need to assess baseline and throughout treatment
Neuroleptic malignant syndrome - ANSWER-Rare, but fatal.
High potency drugs
Symptoms:
Due to dehydration
Fever
Tremor
Discontinue meds
Tachycardia
Stupor
Increased CPK
Sweating
Muscle rigidity
Treatment:
Rehydrate
Renal Dialysis
Fever reduction
Dantrolene, Bromocriptine
Abnormal Involuntary Movements Assessment - ANSWER-• Used to identify Tardive
Dyskinesia
• Takes about 10 minutes
• A score of 2 or more indicates TD
Antipsychotic meds in general - ANSWER-• Are Not physically addicting
• No tolerance to their antipsychotic effects
• Lower abuse potential
• Relatively safe in overdose
• Some can be given IM
Newer "atypical" antiphyschotics - ANSWER-Improve positive AND negative
symptoms
Help with dopamine and serotonin
Ex: Halodol, Abilify, Latuda
Used more but cost more
