Mental Health Quiz 2
25 questions - 20 Multiple choice/1 Fill in/ 4 SATA
Phases Of Schizophrenia
- Phase 1:
- Prodromal(Onset)
- Social Withdrawal
-
... [Show More] Prodromal has Negative symptoms
- Acute
- Exacerbation of symptoms: Hallucination, Delusion, Bizarre
behavior
- Goal: Patient safety and medical stabilization
- Phase 2: Stabilization
- Symptoms are diminishing
- Goal: to help patients understand illness and treatment
- Phase 3: Maintenance or Residual
- At or near baseline functioning and new baseline is
established
- Goal:To maintain achievement and treatment Plan
Assessment of Schizophrenia
Positive
- Delusion: False Fixed belief
- Hallucination: Something that isn’t there
- Experience 1) Auditory 2) Command 3) Visual
- If patient is having auditory hallucinations, offer patient to sit
with them. Say I will sit with you, what are the voices telling you
- Illusion: Something there, but distorted
- Neologism
- Hitting the Nurse
- Disorganized thinking/thought
- Speech
- Flight of ideas
- Alterations in Speech
- Word salad: Jumble of words meaningless to the listener
- Clang Association: Words based on sound/rhythm; oh fox, box
and lox
- Neologism: Make up words by the client
- Echolalia: Repetition of words
- Echopraxia: Imitation of body Movement
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- Pressured Speech: Speech that has a sense of urgency and
deliver at a fast pace due to overflow of ideas
- Tangentiality: Question never fully answered. Avoid questions
- EX: Nurse: How are you” Patient: I like carrots and playing
games
- Symbolic Speech: Using symbols instead of direct speech
- Ex: The demon or devil is taking me
- Disorder or distortions of Thoughts
- Thought Blocking: A reduction or stoppage of thought caused by
hallucination
- Thought insertion: Belief that someone else has inserted
thoughts into their brain
- Thought Deletion: A belief that thoughts have been taken or are
missing
- Magical thinking: GOAL SETTING Belief that thoughts/action
affect other consequences
- EX: Wearing a certain hat makes him invisible to others
- Paranoia: Irrational fear
- Depersonalization: “I am me but i feel like someone else”
- Derealization: “I’m in space” or “I see legs but they’re not mine”
- Alterations in Thoughts
- Ideas of Reference: Misconstrues others behavior
- Ex: Believe people are talking about you when they are
discussing about something else
- Persecution/Persecutory: Being followed/watch by FBI
- Tell them “It sounds like you are concerned about your
safety”
- Grandeur: Believe that you’re superior like a god, queen or king
- Somatic Delusion: Body is changing like growing an extra arm
- Jealousy: Believe S/O is cheating with no factual basis
Negative Symptoms
- 5A’s: Affect(Outward expression), Alogia(Inability to speak),
Anergia(Lack of Energy), Anhedonia(Lack of pleasure), Avolition(Lack of
motivation)
- Disheveled appearance
- Flat affect(Diminished emotional expression)
- Social withdrawal
- Affective blunting: Slight Grim
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Bipolar(3 questions including 1 med)
- Mania Patient should be kept away from nursing station and in a quiet
low stimuli area so they are not disturbing other patients
- Possess echopraxia behavior like repetitive movement
- Administer Valproic/Lithium Carbonate
Hyperprolactinemia
- Syndrome Called “nesting”
- Monitor for
- 1)Amenorrhea(absent period)
- 2) Galactorrhea(milky nipple discharge)
- 3) Gynecomastia (enlargement of breast in males)
- May cause metabolic Syndrome
- Weight gain, Metabolic derangement, Increased Lipids, Type 2
DM
Cognitive Disorder(2 Questions)
- Make sure to do a mental health exam to rule out any medical issues
like drug
- Impaired memory, Impaired information processing, concrete thinking
and impaired executive functioning(Ability to make decisions)
Major Depressive Disorder(1 Question)
- Result in patient needing more time to respond
- Accompanied by at least 5 specific clinical findings
- Occur almost every day for a minimum of 2 weeks and last most of the
day
- Body posture is important, keep feet on the floor, keep hands on lap,
do not cross arms or put them in your pocket
Depression(1 Question)
- Patients who have depression will be complaining of interrupted sleep.
- Will tell you they wake up and can't fall back asleep
- Often suicidal
- At risk for self harm and injury
- Antidepressants will be used to treat patients
- Administer Paroxetine
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- Used temporarily to treat depression
- Monitor for self harm ideations because this medication can
increase thoughts of self harm, at least in the start
- Have patient taper medication and not stop it abruptly because
it can lead to discontinuation syndrome
- Keep these patients close to the nursing station
- Sit down with patients and talk to them as much as you can
Restraints(1 Question)
- Mechanical is last resort
- Assess every 15 minutes
- Require a one on one interaction
Medications – 10 questions
Geodon (ziprasidone) (1 question) SECOND GENERATION
- Obtain baseline EKG before Administration
- Teach pt to take pills with food to avoid nausea
- Causes weight gain
- 350-500 cal of food to help with absorption
- Can cause ECG, or Q level extensions
- Can cause heart dysrhythmias
- Monitor patients pulse, heart rate, monitor for palpitations.
Risperidone (1 question) SECOND GENERATION
- Use the AIMS scale to monitor movement
- EPS→ TD Assess AIM Scale before 1st dose
- Avoid alcohol
- Monitor blood glucose daily
- Should not be used in clients who has dementia
- Comes in oral disintegrating tablets
Haldol (Haloperidol) (4 questions) FIRST GENERATION
- Extrapyramidal side effects: Dystonia, Akathisia (inability to relax and
rest), Pseudoparkinsonism (muscle tremors), tardive
dyskinesia(uncontrolled chewing and grimacing)
- Gynecomastia in men (man boobs)
- Neuroleptic Malignant Syndrome (NMS) – High fever, high BP
- Make sure to keep hydrated, check vital signs, and test for muscle
rigidity
Clozapine (1 question) SECOND GENERATION
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