Class notes
Nurs Schizophrenia Patient Care Notes
- Course
- MENTAL HEALTH NURS 222
- Institution
- West Coast University
Comprehensive and detailed Schizophrenia Patient Care Notes wit questions and answers for Nurs 222. *Essential!! *For you!!
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GerGerardo
ardo Pineda 3-24-21
Schizophrenia patient
Introduction
Schizophrenia is a mental health disorder characterized by positive symptoms (such as
delusions or hallucinations) and negative symptoms (such as flat affect or cognition
impairment).
The symptoms present as an inappropriate or incongruent affect (such as laughing in
the absence of an appropriate stimulus); a dysphoric mood that can take the form of
depression, anxiety, or anger; a disturbed sleep pattern (such as daytime sleeping and
nighttime activity); and a heightened interest in eating or food refusal.
Depersonalization, derealization, and somatic concerns may occur and can sometimes
reach paranoid delusional proportions. Anxiety, phobias, and cognitive deficits are
common in patients with schizophrenia. Cognitive deficits can include decreases in
memory, language, and other executive functions. The patient may have difficulty
processing sensory stimuli and may lack the ability to pay attention. Some patients with
schizophrenia also display social cognitive deficits and may interpret extraneous events
or stimuli as reality-based with delusional thinking.
Hallucinations commonly occur and can manifest as auditory (most common), visual,
somatic, or—less commonly—olfactory or gustatory.
In some cases, patients with schizophrenia lack insight or awareness of their disorder,
which may then contribute to noncompliance with therapeutic interventions. Hostility
and aggression may be associated with schizophrenia, although spontaneous or random
assault is uncommon. Aggression is more common in younger males and in patients
with a history of violence, noncompliance, substance abuse, and impulsivity. Most
patients with schizophrenia aren't aggressive and are victimized more often compared
with the general population.
Schizophrenia affects about 1% of people worldwide. Slightly more men are diagnosed
than women. Schizophrenia is known to have a genetic cause in that the most
significant risk factor is a first-degree relative with schizophrenia; however, the disorder
is thought to result from a complex interaction of genetic risk and environmental
exposure.The psychotic features of schizophrenia typically emerge between the late
teens and mid-30s; onset before adolescence or older than age 45 is rare. The peak
age of onset is in the early to mid-20s for males and in the late 20s for females. Earlier
age of onset is often associated with a relatively poor prognosis. Although onset may be
abrupt, gradual development of significant signs and symptoms is more common.
, Health-related problems associated with schizophrenia include weight gain, obesity,
metabolic abnormalities (in particular, diabetes and metabolic syndrome), prolactin
increase, sexual dysfunction, and cardiovascular disease. Other issues that may affect
patient well-being include recreational drug use, sedation or physical inactivity, adverse
effects of drugs, and poor self-care. In addition, there is a 5% risk of suicide and a 25%
to 50% risk of suicide attempt in patient's with schizophrenia throughout their
lifetime .Multidisciplinary assessment and management of psychiatric and medical
conditions is necessary to ensure optimal patient functioning and quality of life
Schizophrenia usually occurs in three phases, the prodromal phase, active phase, and
residual phase.
In the prodromal phase, the patient experiences mild forms of hallucinations and
delusions.
During the active phase, the patient exhibits frank psychotic symptoms. Psychiatric
evaluation may reveal delusions, hallucinations, loosening of associations, incoherence,
and catatonic behavior.
The residual phase follows the active phase and occurs when at least two of the
symptoms noted in the prodromal phase persist.
Treatment focuses on meeting the patient's physical and psychosocial needs and may
combine drug therapy, long-term psychosocial therapy and rehabilitation, and vocational
counseling.
Equipment
Scale
Prescribed medications
Implementation
Perform hand hygiene
Confirm the patient's identity using at least two patient identifiers.
Provide privacy.
Use therapeutic communication when talking to the patient, such as offering an
accepting, nonjudgmental approach to provide support.
If the patient is having hallucinations or delusions, don't encourage them.
Instead, promote reality
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