Page 2266 - Saunders Comprehensive Review For NCLEX-RN

1. Physical characteristics
a. Unkempt appearance; may neglect
hygiene, eating, sleeping, and
elimination
b. Body image distortions
c. May be preoccupied with somatic
complaints
2. Motor activity (Box 65-9)
a. Catatonic posturing: Holding bizarre
postures for long periods
b. Catatonic excitement: Moving excitedly,
with no environmental stimuli present
c. Possible total immobilization
d. Inability to respond to commands or
responding only to commands
e. Waxy flexibility
f. Repetitive or stereotyped movements
g. Motor activity that may be increased, as
evidenced by agitation, pacing,
inability to sleep, loss of appetite and
weight, and impulsiveness
h. Possible inability to initiate activity
(anergia)
3. Emotional characteristics
a. Mistrust
b. View of the world as threatening and
unsafe
c. Affect blunted, flat, or inappropriate
d. May display feelings of ambivalence,
helplessness, anxiety, anger, guilt, or
depression in response to
hallucinations or delusions or as a
result of grief related to losses imposed
by the illness
4. Compulsive rituals: Constant repetitive activity
performed as an attempt to solve conflicting feelings
5. Overcompliance: Attempt to deny responsibility for
any action by doing only what another person
instructs exactly
6. Affective disturbances
a. Flat or incongruent affect or
inappropriate affect
b. Altered thought processes
7. Abnormal thought processes (Box 65-10)
a. Impaired reality testing
b. Fragmentation of thoughts
c. Thought blocking
d. Loose associations

2266