Hallucinogenic substances are capable of distorting an individual’s perception of reality. They have the ability to alter sensory perception and induce hallucinations. Substance induced hallucinations are usually visual.
This slide contains information regarding Psychiatric Emergencies (Anger, Aggression and violence, Stupor and Catatonia) . This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Schizophrenia is a metal disorder characterized by disruptions in thought processes, perceptions, emotional responsiveness and social interaction. Here the etiology, epidemiology, types, signs and symptoms, pathophysiology, complications, diagnosis as well as management of schizophrenia is explained.
Hallucinogenic substances are capable of distorting an individual’s perception of reality. They have the ability to alter sensory perception and induce hallucinations. Substance induced hallucinations are usually visual.
This slide contains information regarding Psychiatric Emergencies (Anger, Aggression and violence, Stupor and Catatonia) . This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Schizophrenia is a metal disorder characterized by disruptions in thought processes, perceptions, emotional responsiveness and social interaction. Here the etiology, epidemiology, types, signs and symptoms, pathophysiology, complications, diagnosis as well as management of schizophrenia is explained.
Behavior therapy is a type of psychotherapy which is based on theories of learning and aims at changing maladaptive behavior and substituting it with adaptive behavior.
In this presentation I have tried to discuss in brief about obsessive compulsive disorder and its treatment both pharmacological and non pharmacological.
hii guys this is my ongoing presentation from my speciality class i hope u guys lije that please so i hope it is been useful for u in ur specialities by getting little help with that
Psychiatric emergency is a condition where in the patient has disturbances of thought, affect and psychomotor activity leading to a threat to his existence (suicide), or threat to the people in the environment (homicide).
Medically unexplained symptoms are ‘persistent bodily complaints for which adequate examination does not reveal sufficient explanatory structural or other specified pathology’.
These patients are challenge to medical professionals
Behavior therapy is a type of psychotherapy which is based on theories of learning and aims at changing maladaptive behavior and substituting it with adaptive behavior.
In this presentation I have tried to discuss in brief about obsessive compulsive disorder and its treatment both pharmacological and non pharmacological.
hii guys this is my ongoing presentation from my speciality class i hope u guys lije that please so i hope it is been useful for u in ur specialities by getting little help with that
Psychiatric emergency is a condition where in the patient has disturbances of thought, affect and psychomotor activity leading to a threat to his existence (suicide), or threat to the people in the environment (homicide).
Medically unexplained symptoms are ‘persistent bodily complaints for which adequate examination does not reveal sufficient explanatory structural or other specified pathology’.
These patients are challenge to medical professionals
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
optics at visible wavelengths.
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
What is greenhouse gasses and how many gasses are there to affect the Earth.moosaasad1975
What are greenhouse gasses how they affect the earth and its environment what is the future of the environment and earth how the weather and the climate effects.
Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
(May 29th, 2024) Advancements in Intravital Microscopy- Insights for Preclini...Scintica Instrumentation
Intravital microscopy (IVM) is a powerful tool utilized to study cellular behavior over time and space in vivo. Much of our understanding of cell biology has been accomplished using various in vitro and ex vivo methods; however, these studies do not necessarily reflect the natural dynamics of biological processes. Unlike traditional cell culture or fixed tissue imaging, IVM allows for the ultra-fast high-resolution imaging of cellular processes over time and space and were studied in its natural environment. Real-time visualization of biological processes in the context of an intact organism helps maintain physiological relevance and provide insights into the progression of disease, response to treatments or developmental processes.
In this webinar we give an overview of advanced applications of the IVM system in preclinical research. IVIM technology is a provider of all-in-one intravital microscopy systems and solutions optimized for in vivo imaging of live animal models at sub-micron resolution. The system’s unique features and user-friendly software enables researchers to probe fast dynamic biological processes such as immune cell tracking, cell-cell interaction as well as vascularization and tumor metastasis with exceptional detail. This webinar will also give an overview of IVM being utilized in drug development, offering a view into the intricate interaction between drugs/nanoparticles and tissues in vivo and allows for the evaluation of therapeutic intervention in a variety of tissues and organs. This interdisciplinary collaboration continues to drive the advancements of novel therapeutic strategies.
Seminar of U.V. Spectroscopy by SAMIR PANDASAMIR PANDA
Spectroscopy is a branch of science dealing the study of interaction of electromagnetic radiation with matter.
Ultraviolet-visible spectroscopy refers to absorption spectroscopy or reflect spectroscopy in the UV-VIS spectral region.
Ultraviolet-visible spectroscopy is an analytical method that can measure the amount of light received by the analyte.
1. Plan of care should include, but is not limited to, the following components:
1. Signs and Symptoms.
2. Theory of what causes this mental illness (from your book).
3. Treatment options, including 2 medications your client might be receiving & pertinent lab tests.
For medications that might be used, you should know classification, mechanism of action, side effects and nursing implications.
4. At least 2 possible nursing diagnoses with expected client outcome.
5. Nursing interventions (with rationale) you may perform with this prototype.
Disorganized Schizophrenia
• Is marked by incoherent, disorganized speech and behaviors and by blunted or inappropriate affect.
• May have fragmented hallucinations and delusions with no coherent theme.
• Usually includes extreme social impairment.
• This type of schizophrenia may start early and insidiously, with no significant remissions.
Signs and Symptoms
• Incoherent, disorganized speech, with markedly loose associations.
• Grossly disorganized behavior.
• Blunted, silly, superficial, or inappropriate affect.
• Grimacing
• Hypochondriacal complaints.
• Extreme social withdrawal.
Nursing Interventions
• Spend time with the patient even if he’s mute and unresponsive, to promote reassurance and support.
• Remember that, despite appearances, the patient is acutely aware of his environment, assume the patient can hear – speak to him
directly and don’t talk about him in his presence.
• Emphasize reality during all patient contacts, to reduce distorted perceptions (for example, say, “The leaves on the trees are turning
colors and the air is cooler, It’s fall”)
• Verbalize for the patient the message that his behavior seems to convey, encourage him to do the same.
• Tell the patient directly, specifically, and concisely what needs to be done; don’t give him choice (for example, say, “It’s time to go for a
walk, lets go.”)
• Assess for signs and symptoms of physical illness; keep in mind that if he’s mute he won’t complain of pain or physical symptoms.
• Remember that if he’s in bizarre posture, he may be at risk for pressure ulcers or decreased circulation.
• Provide range-of-motion exercises.
• Encourage to ambulate every 2 hours.
• During periods of hyperactivity, try to prevent him from experiencing physical exhaustion and injury.
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2. • As appropriate, meet his needs for adequate food, fluid, exercise, and elimination; follow orders with respect to nutrition, urinary
catheterization, and enema use.
• Stay alert for violent outbursts; if these occur, get help promptly to intervene safely for yourself, the patient, and others.
1. Nursing Diagnosis for Schizophrenia: Risk for Violence
• Panic or anger
• Rigid posture, clenched fists
• Limited attention span
• Tormenting of others
• Irritability or restlessness
• Aggressive in verbal and non-verbal communication
Interventions
• Keep surrounding area free of high level stimuli.
• Routinely observe patient at regular intervals.
• Give the patient something to reflect its aggressive actions.
• Administer appropriate medications and monitor for effectiveness and side effects.
• Do not acknowledge rude comments or behavior.
• Have staff with the ability to restrain patient if needed and create a safe environment.
• Maintain a calm demeanor towards the patient and set boundaries for unacceptable actions.
2. Nursing Diagnosis for Schizophrenia: Altered Thought Processes
• Delusional thinking
• Shifting from one topic to another
• Unable to stay focused
• Escalated reaction to normal stimuli
• Inconsistent communication
• Hallucinations
• Difficulties in problem solving
Interventions
• Speak clearly and directly to patient in a simple and professional manner.
• Explain all treatments, tests and medications to patient before using them.
• Let patient have as much control as possible within therapy limits.
• Maintain consistent expectations and rules for acceptable and non-disruptive behavior.
• Teach patients how to use thought-stopping and focus techniques.
• Discuss patients' feelings when they are experiencing disturbing and delusional thoughts.
• Give alternative ways to express feelings in acceptable, non-threatening ways.
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3. 3. Nursing Diagnosis for Schizophrenia: Social Isolation
• Depression
• Limited or no interaction with others
• Sad facial expressions
• Limited or no eye contact with others
• Dependent use of non-verbal communication
• Avoidance of social situations
Interventions
• Establish schedule for frequent, yet brief patient meetings.
• Maintain distance from patient until trust established.
• Avoid touching patient unless appropriate and necessary.
• Teach social skills and how to interact with others.
• Assist patient in choosing and attending social activities.
• Provide words of encouragement and praise for all social interaction attempts.
4. Nursing Diagnosis for Schizophrenia: Sensory and Perceptual Alterations Related to Hallucinations
• Strange body sensations
• Little or no interaction with nurse or others
• Unable to concentrate
• Unsuitable reactions and responses to reality
Interventions
• Encourage patient to speak about their hallucinations and communicate with patient during event but do not counsel until
episode has ended.
• Do not argue with patients, but explain others don't share their sensory perceptions.
• Monitor for symptoms and signs of hallucinating, such as looking around or talking to themselves.
• Help identify and deal with triggers and feelings that bring on hallucinations or illusions.
• Place patient in quiet environment and encourage tasked-based activities.
• Teach patient distraction techniques and involve them in concrete activities so as to bring them back to reality.
5. Nursing Diagnosis for Schizophrenia: Impaired Verbal Communication
• Lack of emotion in verbal communication
• Inability to think abstractly
• Little use of speech
• Unable to express cause of agitation
• Incongruent non-verbal communication
Interventions
• Allow time for consistent one-on-one interaction with patient.
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4. • Inform patient when you are unable to understand what they are trying to convey.
• Verbalize feelings and model expressions of feelings for patients.
• Speak with patient about personal interests, favorite activities and hobbies.
• Look out for open communication on topics that are meaningful and important to patient.
6. Nursing Diagnosis for Schizophrenia: Ineffective Individual Coping
• Feelings of loneliness and rejection
• Avoidance of interaction and people
• Regression and projection defenses
• Unable to perform daily self-care tasks
• Physical and emotional withdrawal
Interventions
• Teach patient to verbalize feelings.
• Only touch patient when appropriate and assistance is needed.
• Assist patient in identifying bizarre or impulsive actions and how to control them.
• Teach and practice daily living skills with patient.
• Evaluate patient's reactions to unexpected events and situations in clinical environment.
7. Nursing Diagnosis for Schizophrenia: Ineffective Individual Coping
• Facial expressions of anger
• Increased psychomotor activity while self-absorbed
• Abundance of pacing
• Lack of control
• Speaking previous incidents of violence
• Verbal and non-verbal threats
Interventions
• Create a quiet, non-stimulating setting.
• Teach patient techniques to control agitation.
• Give patient appropriate medications and monitor side effects and effectiveness.
• Use physical restraints as a last resort.
• Assist patient in identifying stressors and triggers of agitation.
• Discuss negative feels and how to keep these emotions from escalating.
• Teach patient how to depart from situations that will trigger agitation.
• Reinforce positive behaviors.
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5. Diagnostic Test
• Clinical diagnosis is developed on historical information and thorough mental status examination.
• No laboratory findings have been identified that are diagnostic of schizophrenia.
• Routine battery of laboratory test may be useful in ruling out possible organic etiologies, including CBC, urinalysis, liver function
tests, thyroid function test, RPR, HIV test, serum ceruloplasmin ( rules out an inherited disease, wilson’s disease, in which the body
retains excessive amounts of copper), PET scan, CT scan, and MRI.
• Rating scale assessment:
◦ Scale for the assessment of negative symptoms.
◦ Scale for the assessment of positive symptoms.
◦ Brief psychiatric rating scale
Treatments and Medications
Currently, there is no method for preventing schizophrenia and there is no cure. Minimizing the impact of disease depends mainly on early
diagnosis and, appropriate pharmacological and psychosocial treatments. Hospitalization may be required to stabilize ill persons during an
acute episode. The need for hospitalization will depend on the severity of the episode. Mild or moderate episodes may be appropriately
addressed by intense outpatient treatment. A person with schizophrenia should leave the hospital or outpatient facility with a treatment
plan that will minimize symptoms and maximize quality of life.
A comprehensive treatment program can include:
• Antipsychotic medication
• Education & support, for both ill individuals and families
• Social skills training
• Rehabilitation to improve activities of daily living
• Vocational and recreational support
• Cognitive therapy
Medication is one of the cornerstones of treatment. Once the acute stage of a psychotic episode has passed, most people with
schizophrenia will need to take medicine indefinitely. This is because vulnerability to psychosis doesn’t go away, even though some or all
of the symptoms do. In North America, atypical or second generation antipsychotic medications are the most widely used. However, there
are many first-generation antipsychotic medications available that may still be prescribed. A doctor will prescribe the medication that is the
most effective for the ill individual
Another important part of treatment is psychosocial programs and initiatives. Combined with medication, they can help ill individuals
effectively manage their disorder. Talking with your treatment team will ensure you are aware of all available programs and medications.
In addition, persons living with schizophrenia may have access to or qualify for income support programs/initiatives, supportive housing,
and/or skills development programs, designed to promote integration and recovery.
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6. SCHIZOPHRENIA
CONCEPT
• Schizophrenia is a group of psychotic disorders that affect thinking, behavior, emotions, and the ability to perceive reality.
• The term “Psychosis” refers to the presence of hallucinations, delusions, or disorganized speech or catatonic behavior.
• The typical age at onset is late teens and early twenties, but schizophrenia has occurred in young children and may begin in later adulthood.
TYPES/
SUBTYPES
PARANOID DISORGANIZED CATATONIC RESIDUAL UNDIFFERENTIATED
(MIXED TYPE)
FEATURES
• Characterized by
suspicion
toward others
• Dominant:
Hallucinations
and Delusions
(positive
symptoms)
• NO
Disorganized
speech,
disorganized
behavior,
catatonia or
inappropriate
affect present.
(No negative
symptoms)
• Characterized by
withdrawal from
society and very
inappropriate
behaviors, such as
poor hygiene, or
muttering constantly to
self.
• Frequently seen in the
homeless population
• Dominant:
Disorganized speech,
disorganized behavior,
and inappropriate
affect.
• Marked regression
• Poor Reality Testing
• Poor social skills
• Inappropriate
emotional responses
• Outbursts of laughter
• Silly behavior
• Characterized by abnormal motor
movements.
• There are two stages: the
withdrawn stage and the excited
stage.
• WITHDRAWN STAGE:
o Psychomotor retardation;
client may appear
comatose.
o Waxy Flexibility or stupor
o Echolalia and/or
Echopraxia
o Client often has extreme
self-care needs, such as for
tube feeding due to inability
to eat
• EXCITED STAGE:
o Peculiar voluntary
movement: Unusual
posturing, Stereotyped
movements, Prominent
mannerisms, Prominent
Grimaces
o Excessive purposeless
motor activity (agitation)
o Self-care needs may
predominate
o Client may be a danger to
self or others
• Active-phase (positive)
symptoms are not
longer present
(Delusions,
hallucinations,
disorganized speech and
behaviors)
• However, the client has
two or more “residual
symptoms” (some
negative symptoms) such
as:
o Marked social
isolation or
withdrawal
o Impaired role
function (wage
earner, student,
homemaker)
o Anergia,
Anhedonia, or
Avolition
o Alogia (speech
problems)
o Odd behavior, such
as walking in a
strange way
o Impaired personal
hygiene
o Lack of initiative,
interest or energy
o Blunted or
inappropriate affect
• Client has symptoms for
schizophrenia, but does
not meet criteria for any
of the other types (no one
clinical presentation
dominates (e.g. paranoid,
disorganized, catatonic)
• Any positive or negative
symptoms may be
present (has active-
phase symptoms (does
have hallucinations,
delusions, and bizarre
behaviors)
• Eccentric
• Psychotic features are
extreme:
o Fragmented
delusions
o Vague
hallucinations
o Bizarre,
disorganized
behavior
o Disorientation,
Incoherence
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7. ASSESSMENT
Diagnostic criteria: The four “A”s:
1. Affect: Refers to the outward manifestation of a person’s feelings or emotions. In Schizophrenia, clients may display flat, blunted affect.
2. Associative Looseness: Refers to haphazard and confused thinking that is manifested in jumbled and illogical speech and reasoning. The term
“looseness of association” is also used
3. Autism: Refers to thinking that is not bound to reality, but reflects the private perceptual world of the individual. Delusions, hallucinations, and
neologisms are examples of autistic thinking in persons with schizophrenia. (Also termed as “response to internal stimuli”)
4. Ambivalence: Refers to simultaneously holding two opposite emotions, attitudes, ideas, or wishes toward the same person, situation, or object.
DISEASE
PROGRESSION
:
Schizophrenia is characterized by periods of exacerbations and remissions. Has three phases:
o ACUTE PHASE: Periods of both positive and Negative symptoms
o MAINTENANCE PHASE: Acute symptoms decrease in severity
o STABILIZATION PHASE: Symptoms in remission
CHARACTERIS
TIC
DIMENSIONS
OF
SCHIZOPHREN
IA
(No single
symptom is
always present in
all cases)
POSITIVE SYMPTOMS:
These are the most easily identified symptoms
o Alterations in perception: Hallucinations: Sensory perceptions for which no external
stimulus exists (auditory, visual, olfactory, tactile), Personal Boundary Difficulties,
Depersonalization, Derealization
o Alterations in thinking:: Delusions: A false belief held and maintained as true, even with
evidence to the contrary, concrete thinking, thought broadcasting, thought insertion, thought
withdrawal, delusions of being controlled)
o Alterations in speech: Associative looseness (Disorganized Speech), Neologisms, Echolalia,
Clang Association, Word Salad.
o Alterations in behavior (Bizarre behavior): Extreme motor agitation, stereotyped
behaviors, Automatic obedience, waxy flexibility, stupor, negativism)
NEGATIVE SYMPTOMS (THE FIVE “A”s):
These symptoms are more difficult to treat
successfully than positive symptoms
o AFFECT: usually Blunted (narrow range of normal expression) or Flat (Facial expression
never changes).
o ALOGIA: Poverty of thought or speech; client may sit with a visitor but may only mumble
or respond vaguely to questions
o AVOLITION: Lack of motivation in activities and hygiene
o ANHEDONIA: Inability to find pleasure in life; the client is indifferent to things that often
make others happy
o ANERGIA: Lack of energy, chronic fatigue
COGNITIVE SYMPTOMS:
Problems with thinking make it very difficult for the
client to live independently
o Disordered thinking
o Poor problem-solving skills
o Poor decision-making skills
o Inattention; easily distracted (Difficulty concentrating to perform tasks)
o Impaired judgment
o Impaired memory
▪ Long-term memory loss
▪ Working Memory loss (such as inability to follow directions to find an address)
DEPRESSIVE SYMPTOMS:
o Hopelessness
o Suicidal Ideation
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8. EXPECTED
OUTCOMES
ACTIVE PHASE:
-Client safety and medical stabilization
MAINTENANCE PHASE:
-Adherence to medication regimen
-Understanding schizophrenia
-Participation of client and family in psycho
educational activities
STABILIZATION PHASE:
-Target negative symptoms
-Anxiety Control
-Relapse prevention
INTERVENTIO
NS
ACUTE PHASE: (Hospitalization, Client Safety,
Stabilization Of Symptoms)
1. Administer antipsychotic medication as prescribed
2. Observe client behavior closely
3. Set limits on inappropriate behavior
4. Increase reality testing when delusional or hallucinating
5. Do not touch without warning
6. Offer foods that are not easily contaminated
7. Assist with ADLs as needed
8. Supportive counseling
9. Milieu Therapy
10. Family psycho education
MAINTENANCE AND STABILIZATION PHASES:
-Psychosocial education
-Relapse prevention skills
MEDICATIONS
TYPICAL (CLASSIC) ANTISYCHOTICS (Treatment of
positive symptoms)
o HALDOL (Haloperidol)
o THORAZINE (Chlorpromazine)
o PROLIXIN (Fluphenazine)
o SERENTIL (Mesoridazine)
o TRILAFON (Pherphenazine)
o MELLARIL (Thioridazine)
ATYPICAL ANTIPSYCHOTICS (Treatment of both positive and negative symptoms)
o ZYPREXA (Olanzapine)
o RISPERDAL (Risperidone)
o SEROQUEL (Quetiapine)
o GEODONE (Ziprasidone)
o CLORAZIL (Clozpine)
o ABILIFY (Aripriprazole)
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