Schizophrenia Flashcards
assessing the schizophrenic pt
medical workup to rule out drug abuse/medical cause suicidal/homicidal thoughts clients belief system substance use command hallucinations psych/med comorbidities medication use/compliance family response to pt/symptoms social supports level of functioning
which assessment tools would we use for schizo pt
positive and negative syndrome scale
abnormal involuntary movement scale
positive symptoms r/t schizophrenia
violence (self/other) impaired verbal communication disturbed thought processes impaired environmental interpretation disturbed sensory perception
negative symptoms r/t schizophrenia
risk for loneliness/suicide self-care deficit risk for violence impaired social interaction ineffective coping
goal for acute schizophrenic phase
SAFETY and medical stabilization
goal for maintenance and stabilization r/t schizo.
adhere to meds
prevent relapse
improved quality of life
understanding of disease
A patient with catatonic schizophrenia is semistuporous, demonstrates little spontaneous movement, and has waxy
flexibility. The patient’s activities of daily living are severely
compromised. An appropriate outcome is that the patient will:
B.perform self-care activities with coaching by the
end of day 3.
planning and implementation r/t schizophrenia
planning dependent on phase of illness
implementation is geared to pt. strengths (education and support are key to effective trt)
planing phases for schizo
acute phase - ensure safety/stabilize symptoms
maintenance phase - client/family education
stabilization phase - prevent relapse
A community mental health nurse wants to establish a relationship with a very withdrawn patient diagnosed with schizophrenia. The patient lives at home with a supportive family. Select the nurse’s best plan.
A.Visit daily for 4 days, then visit every other day for 1
week; stay with the patient for 20 minutes; accept silence; state when the nurse will return.
communication guidelines for schizophrenia
approach non-threatening and non-judgmental
identify feelings client is experiencing
clarify with concrete reality
avoid arguing/attempting to reason while delusional
distract attention from hallucinations/delusions
how to deal w/paranoid schizophrenia
be honest/consistent
avoid talking, laughing, whispering when client can’t hear what is being said
how to deal with associative looseness r/t schizo
do not pretend to understand when you don’t - tell client you are having trouble understanding
emphasis on the here and now
look for recurring topics/themes
A newly admitted patient with schizophrenia says, “The voices are bothering me. They yell and tell me I’m bad. I have got to get away from them.” Select the nurse’s most helpful reply.
C. I’ll stay with you. Focus on what we are talking about, not the voices. (Attend to them, distract them)
milieu therapy for schizo pt. can take place where
hospital - partial hospital - halfway house - day trt prog
