The Psychiatric-Mental Health Nurse Practitioner Certification Review Manual by Zakhari Raymond DNP EdM ANP-BC FNP-BC PMHNP-BC;

Author:Zakhari, Raymond, DNP, EdM, ANP-BC, FNP-BC, PMHNP-BC; [Raymond Zakhari]
Language: eng
Format: epub
ISBN: 9780826179432
Publisher: Springer Publishing Company
Published: 2020-03-10T00:00:00+00:00

•Prodrome: Characterized by odd beliefs, ideas of reference, unusual perceptual experiences, negative symptoms, and deterioration of function prior to the onset of active psychosis.

•Active psychosis: Symptoms include delusions, hallucinations, disorganized speech, grossly disorganized behavior, and negative symptoms.

•Residual phase: Persistent functional impairment, abnormalities in affect, impaired cognition, and impaired communication.

•Assessment:

■Behavioral and cognitive symptoms

■Impaired social and occupational functioning: Underemployed or unemployed, lower academic achievement, limited intellectual capacity

■Limited interpersonal relationships and increasing isolation

■Impaired self-care: Poor grooming and hygiene, and inappropriately dressed for the season

■Disorganized speech and behavior

■Negative symptoms occur earlier in the disease process, positive symptoms tend to decrease over time

•Mental State Exam: An oddly related individual in their mid-20s, with disorganized speech, tangential and circumstantial with ideas of reference, pressured to the point of word salad, flat or blunted affect, anxious mood, with paranoid delusions and command auditory hallucinations, disorganized thoughts, concrete thought pattern, difficulty with abstraction, oriented to person only, poor insight, and poor judgment

•No specific diagnostic tests

•Differentials include seizure disorder, toxicity, substance-induced psychosis, neurosyphilis, Wilson’s disease, Wernicke–Korsakoff syndrome, auto-immune encephalitis, thyrotoxicosis encephalitis.

•Clinical management

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