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Anhedonia
Loss of pleasure in usually pleasurable things
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Inappropriate affect
Example would be talking about mother's death and laughing about it
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Echolalia
Hear something and then repeat it over and over
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Neologism
Making up words
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Schizophrenia:
Whats involved?
- Focus is inward, they create their own world
- Echolalia - hear something and repeat it over and over
- Neologism - make up new words.
- Hallucinations
- Child like mannerisms
- Religiosity
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Treatment for Schizophrenia
- Decrease Stimuli
- Observe frequently w/o looking suspicious
- Orient frequently and keep conversations reality based.
- Make sure personal needs are met
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Paranoia
- Always suspicious
- Can't explain away their delusions or false beliefs
- Hypersensitive
- Crave recognition
- Everyone else has the problem, not them
- Life is unfair
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Treatment for Paranoia
- Basis of tx is a trusting relationship
- Be reliable
- Respect personal space and be careful with touch
- Avoid whispering
- Don't mix meds and always ID them
- Bring foods sealed
- No competitive activities!
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Dissociative Identity Disorder
What is it?
Treatment
- Used to be called multiple personalities
- Pt uses dissociation as coping mechanism to protect self from severe physical and/or psychological trauma
- May be seen in pt with history of physical or sexual abuse
- Treatment: pt must process trauma over time
- Meds may be used to treat co-existing depression and/or anxiety
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Alcoholism:
Stages of withdrawl
- Stage I - mild tremors, nervous, nausea
- Stage II - Increased tremors, hyperactive, nightmares, disorientation, hallucinations, increased HR and BP
*Stage I and II = walk and talk to them
Stage III = most dangerous, severe hallucinations (visual and kinesthetic are most common), grand mal seizures
*Stage II and III are DT's (withdrawal delirium = keep light on)
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Kinesthetic
feels like things are crawling on you
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Treatment for alcoholism
Detox protocol usually includes thiamine injections, multivitamins, and perhaps magnesium
Anxiolytics: don't be afraid to give. Remember, pt has tolerance to alcohol and a cross-tolerance to other CNS depressants. Can handle meds every 2 hrs. DT's should be prevented, pt very scared during episode
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Complications with Alcoholism
- Chronic probs: (caused by thiamine/niacin deficiencies = which are Vit B deficiencies)
- Korsakoff's syndrome - disoriented to time; confabulate - can't remember something so they make it up.
- Weinicke's syndrome - emotions labile, moody, tire easily.
- Other s/s:
- Peripheral neuritis - which is nerve damage due to Vit B deficiency
- Liver and pancreas probs
- Impotence
- Gastritis
- Mg and K loss - alcohol makes you diurese, so lose mg and k
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