What are the 4 A’s ofschizophrenia? Affect, associative looseness, autism, & ambivalence What are the different types ofsymptoms ofschizophrenia? Positive, negative, cognitive, and mood Describe positive symptoms ofschizophrenia. Alteration in thinking or behavior that was not present before patient became ill What are examples of positive symptoms? Delusions, ideas of reference, thought broadcasting, word salad, hallucinations, wavy flexibility Describe negative symptoms ofschizophrenia. Normal thoughts or behavior that the patient had is no longer present due to illness What are examples of negative symptoms? Anergia (lethargy), anhedonia (inability to express pleasure), thought blocking, flat affect What are examples of cognitive symptoms? Inattention, impaired memory, poor decision making, poor problem solving, illogical thinking What are the mood symptoms ofschizophrenia? Dysphoria, suicidal ideation, and hopelessness What are the phases of schizophrenia? Acute,stabilization, and maintenance What nursing interventions are needed during the acute phase ofschizophrenia? Supervision and limit setting in the milieu What is milieu therapy? Group psychotherapy in which individuals are placed in large groups and asked to take responsibility for their actions and the actions of other patients as well Whatsafety considerations are needed during milieu therapy? Risk for physical violence due to hallucinations or delusions What is appropriate plan of action for a patient being physically violent in milieu therapy? Least restrictive intervention possible; verbal warning, medication,seclusion or restraints What nursing actions are needed for a patient experiencing hallucinations? Approach in nonthreatening manner, assessif messages are suicidal or homicidal, patientsafety What nursing actions are needed for a patient experiencing delusions? Be honest & matter of fact, have client describe delusion, avoid arguing, validate any truth What nursing actions are needed for a patient experiencing associative looseness? Do not pretend you understand, look for recurring themes, involve client in simple activities What patient and family education is needed for schizophrenia? Learn about illness, develop relapse plan, avoid alcohol & drugs, address fears and losses What are atypical antipsychoticsindicated for? Treatment of positive and negative symptoms What isthe main disadvantage of atypical antipsychotics? Significant weight gain What are examples of atypical antipsychotics? Clozapine, olanzapine, quetiapine (-apines) Rispieridone, ziprasidone (-idones) What are the side effects of atypical antipsychotics? Anticholinergic symptoms: photosensitivity, dry mouth, urine retention, blurred vision What atypical antipsychotic causes agranulocytosis? Clozapine What are conventional/typical antipsychoticsindicated for? Treatment of positive symptoms What are the disadvantages of conventional/typical antipsychotics? Do not treat negative symptoms, EPS effects, tardive dyskinesia, gait issues, & sedation What are examples of conventional/typical antipsychotics? (-azines) and haloperidol Whatshould be monitored for patientstaking typical antipsychotics? Involuntary movements using the AIMS test What is a serious adverse effect from antipsychotic use? Neuroleptic malignantsyndrome which causes hyperpyrexia and autonomic dysfunction A patient taking haloperidol is observed to have their head rotate to one side in a stiff position, the lower jaw thrust forward, and drooling. What does the nurse suspect is occurring? Acute dystonic reaction to typical antipsychotics What other extrapyramidalside effects may occur while taking antipsychotics? Pseudoparkinsonism, opithotonos, oculogyric crisis, akthisia, and tardive dyskinesia A patient on thorazine has decreased hallucinations but consistent complaints of apathy, poverty of thought, & social isolation. What medication would the nurse expect to switch to? Olanzapine, or another atypical antipsychotic, that will treat the patient’s negative symptoms Brain Injury What are the different types of head injuries? Diffuse & focal What is a diffuse head injury? Concussion; damage to brain cannot be localized to one area What are the characteristics of a diffuse head injury? Brief disruption in LOC, retrograde amnesia, headache,short time frame Whatsyndrome can a diffuse head injury lead to? Post-concussion syndrome What is post-concussion syndrome? Persistent headache, lethargy, and behavioral changes occur 2 weeks-2 months after injury