1. Anhedonia
    Loss of pleasure in usually pleasurable things
  2. Inappropriate affect
    Example would be talking about mother's death and laughing about it
  3. Echolalia
    Hear something and then repeat it over and over
  4. Neologism
    Making up words
  5. 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
  6. Treatment for Schizophrenia
    • Decrease Stimuli
    • Observe frequently w/o looking suspicious
    • Orient frequently and keep conversations reality based. 
    • Make sure personal needs are met
  7. 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
  8. 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!
  9. Dissociative Identity Disorder
    What is it?
    • 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
  10. 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)
  11. Kinesthetic
    feels like things are crawling on you
  12. 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
  13. 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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