Schizophrenia

Question 1

Positive symptoms nursing diagnosis

Answer 1

• Disturbed sensory perception: auditory
• Risk of self directed violence or other directed violence
• Disturbed thought processes
• Impaired verbal communication

Question 2

Negative symptoms nursing diagnosis

Answer 2

• Social Isolation
• Chronic low self esteem
• Ineffective coping
• Self-care deficit

Question 3

Acute phase nursing interventions

Answer 3

• Secure all potential weapons and articles from patient’s room and the unit environment that could be used to inflict injury
• Attempts should be made to use the least restrictive method of coping with aggression or violence (e.g. initially use verbal intervention, followed by medication, and lastly seclusion or restraints)

Question 4

Acute phase verbal interventions

Answer 4

• Use patient’s preferred name to show a supportive and caring disposition
• Say you want to help
• Use a calming voice, keeping sentences short, simple and clear
• Be familiar with guidelines in communicating with a patient experiencing hallucinations or delusions
• Be assertive, not aggressive
• Set limits on intrusive behavior. If patient is hostile, you can tell the patient that their behaviour is not making you comfortable
• If situation escalates, do NOT wait - get help immediately

Question 5

Acute phase non verbal interventions

Answer 5

• Maintain a calm posture
• Reduce environmental stimuli
• Give personal space and do not stand directly in front of a patient
• Do not smile or grimace overtly when someone is delusional or hallucinating as this may be misinterpreted
• Avoid making sudden movements and threatening postures, such as pointing, crossing your arms and or putting your hands on hips

Question 6

Stabilization phase nursing interventions

Answer 6

• Provide patient with education about the disease and medications to enhance adherence to treatment.
• “What do you know about the medication you are taking?” After providing information ask, “How does this information make you feel?”
• Monitor therapeutic effects and potential side effects of meds i.e. intensity and frequency of hallucinations, delusions
• Provide side-effect management to control or cope with symptoms.
• Provide support/encouragement for performing self-care activities.
• Suggest strategies to reduce stress/stimuli i.e. soft music, relaxation techniques, etc.

Question 7

Maintenance phase nursing interventions

Answer 7

• maintaining a regular sleep pattern;
• reducing alcohol, drugs, cigarettes and caffeine intake;
• keeping in touch with supportive family and friends;
• staying active;
• having a daily or weekly schedule; and
• taking medication regularly.

Question 8

Extrapyramidal Side Effects

Answer 8

1. Acute dystonia
2. Akethesia
3. Pseudoparkisonism
4. Tardive Dyskinesia

Question 9

Assessment

Answer 9

1.Self-Assessment
2Mental Status Exam

3. General Observations
   - Appearance and Behavior
4. Cognitive functions
   - Level of consciousness
   - Orientation
   - Memory
   - Intellectual function
   - Judgment
   - Comprehension

5.Thought Processes:
• Form of thought
• Content of Thought

• Affect
• Mood
• Insight