Podcast
Questions and Answers
Which nursing diagnoses relate to a patient diagnosed with schizophrenia who is aloof, suspicious, and believes staff members are plotting against them? (Select all that apply)
Which nursing diagnoses relate to a patient diagnosed with schizophrenia who is aloof, suspicious, and believes staff members are plotting against them? (Select all that apply)
Which characteristic in an adolescent female is sometimes associated with the prodromal phase of schizophrenia?
Which characteristic in an adolescent female is sometimes associated with the prodromal phase of schizophrenia?
Which nursing intervention is particularly well-chosen for addressing a population at high risk for developing schizophrenia?
Which nursing intervention is particularly well-chosen for addressing a population at high risk for developing schizophrenia?
When providing care for a patient diagnosed with schizophrenia, which associated conditions should the nurse frequently assess for? (Select all that apply)
When providing care for a patient diagnosed with schizophrenia, which associated conditions should the nurse frequently assess for? (Select all that apply)
Signup and view all the answers
What information should the nurse provide to a female patient diagnosed with schizophrenia who has been prescribed a first-generation antipsychotic medication?
What information should the nurse provide to a female patient diagnosed with schizophrenia who has been prescribed a first-generation antipsychotic medication?
Signup and view all the answers
Which characteristic presents the greatest risk for injury to others by a patient diagnosed with schizophrenia?
Which characteristic presents the greatest risk for injury to others by a patient diagnosed with schizophrenia?
Signup and view all the answers
What is the prognosis for Gilbert, who shows early signs of schizophrenia?
What is the prognosis for Gilbert, who shows early signs of schizophrenia?
Signup and view all the answers
Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient's nursing diagnosis is altered thought processes?
Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient's nursing diagnosis is altered thought processes?
Signup and view all the answers
When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:
When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:
Signup and view all the answers
What is the priority nursing intervention for a patient with schizophrenia taking haloperidol who is sitting stiffly and diaphoretic with a high blood pressure?
What is the priority nursing intervention for a patient with schizophrenia taking haloperidol who is sitting stiffly and diaphoretic with a high blood pressure?
Signup and view all the answers
What co-occurring issue is common in patients diagnosed with schizophrenia who self-medicate with excessive alcohol?
What co-occurring issue is common in patients diagnosed with schizophrenia who self-medicate with excessive alcohol?
Signup and view all the answers
Select the nurse's most therapeutic response to a patient who believes others are plotting against them.
Select the nurse's most therapeutic response to a patient who believes others are plotting against them.
Signup and view all the answers
A patient diagnosed with schizophrenia states, 'I saw two doctors talking in the hall. They were plotting to kill me.' How should this behavior be assessed?
A patient diagnosed with schizophrenia states, 'I saw two doctors talking in the hall. They were plotting to kill me.' How should this behavior be assessed?
Signup and view all the answers
How does a patient diagnosed with schizophrenia perceive their environment if they say, 'My co-workers are out to get me'?
How does a patient diagnosed with schizophrenia perceive their environment if they say, 'My co-workers are out to get me'?
Signup and view all the answers
What are common side effects of haloperidol (Haldol) that the nurse should validate with a patient?
What are common side effects of haloperidol (Haldol) that the nurse should validate with a patient?
Signup and view all the answers
Which hallucination necessitates the nurse to implement safety measures?
Which hallucination necessitates the nurse to implement safety measures?
Signup and view all the answers
Which assessment findings suggest a patient may be experiencing auditory hallucinations?
Which assessment findings suggest a patient may be experiencing auditory hallucinations?
Signup and view all the answers
Which antipsychotic medication should be advocated for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social functioning?
Which antipsychotic medication should be advocated for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social functioning?
Signup and view all the answers
How should the nurse respond to a patient with disorganized speech?
How should the nurse respond to a patient with disorganized speech?
Signup and view all the answers
What is a priority need for a patient diagnosed with schizophrenia exhibiting little spontaneous movement and waxy flexibility?
What is a priority need for a patient diagnosed with schizophrenia exhibiting little spontaneous movement and waxy flexibility?
Signup and view all the answers
What would be an appropriate outcome for a patient diagnosed with schizophrenia who has severe self-care deficits?
What would be an appropriate outcome for a patient diagnosed with schizophrenia who has severe self-care deficits?
Signup and view all the answers
What is the name of the phenomenon when a patient demonstrates waxy flexibility?
What is the name of the phenomenon when a patient demonstrates waxy flexibility?
Signup and view all the answers
Which intervention is most likely to be acceptable to a patient with delusions of persecution about being poisoned?
Which intervention is most likely to be acceptable to a patient with delusions of persecution about being poisoned?
Signup and view all the answers
What should be the nurse's best plan for establishing a relationship with a withdrawn patient diagnosed with schizophrenia?
What should be the nurse's best plan for establishing a relationship with a withdrawn patient diagnosed with schizophrenia?
Signup and view all the answers
What do withdrawn patients diagnosed with schizophrenia typically do?
What do withdrawn patients diagnosed with schizophrenia typically do?
Signup and view all the answers
What should the nurse reply to a patient who claims, 'The voices are bothering me. They yell and tell me I am bad.'?
What should the nurse reply to a patient who claims, 'The voices are bothering me. They yell and tell me I am bad.'?
Signup and view all the answers
A patient diagnosed with schizophrenia exhibits symptoms like shuffling gait and a mask-like face. What term describes these symptoms?
A patient diagnosed with schizophrenia exhibits symptoms like shuffling gait and a mask-like face. What term describes these symptoms?
Signup and view all the answers
What most likely occurred when a patient diagnosed with schizophrenia has a head rotated to one side and displays other symptoms after haloperidol administration?
What most likely occurred when a patient diagnosed with schizophrenia has a head rotated to one side and displays other symptoms after haloperidol administration?
Signup and view all the answers
What intervention is indicated for a patient showing a stiffly fixed position and drooling after receiving haloperidol?
What intervention is indicated for a patient showing a stiffly fixed position and drooling after receiving haloperidol?
Signup and view all the answers
Which medication should be administered immediately for the treatment of dystonias?
Which medication should be administered immediately for the treatment of dystonias?
Signup and view all the answers
What condition is the patient likely suffering from if they are grimacing and have lip smacking?
What condition is the patient likely suffering from if they are grimacing and have lip smacking?
Signup and view all the answers
What is the best response for a nurse when a patient with schizophrenia laughs uncontrollably?
What is the best response for a nurse when a patient with schizophrenia laughs uncontrollably?
Signup and view all the answers
Which finding is a negative symptom of schizophrenia?
Which finding is a negative symptom of schizophrenia?
Signup and view all the answers
What assessment findings indicate the prodromal stage of schizophrenia?
What assessment findings indicate the prodromal stage of schizophrenia?
Signup and view all the answers
What problem is evident if a patient states, 'Contagious bacteria are everywhere?'
What problem is evident if a patient states, 'Contagious bacteria are everywhere?'
Signup and view all the answers
When starting lurasidone HCL (Latuda), what is the most important topic for the nurse to include in the teaching plan?
When starting lurasidone HCL (Latuda), what is the most important topic for the nurse to include in the teaching plan?
Signup and view all the answers
A patient diagnosed with schizophrenia speaks in jumbled phrases like, 'It's beat. Time to eat. No room for the cat.' What type of verbalization is this?
A patient diagnosed with schizophrenia speaks in jumbled phrases like, 'It's beat. Time to eat. No room for the cat.' What type of verbalization is this?
Signup and view all the answers
Which medication change would the nurse expect for a patient with continued negative symptoms despite treatment?
Which medication change would the nurse expect for a patient with continued negative symptoms despite treatment?
Signup and view all the answers
Which type of therapy is best for a family unfamiliar with schizophrenia?
Which type of therapy is best for a family unfamiliar with schizophrenia?
Signup and view all the answers
What does a patient exhibit if they say, 'My computer is sending out infected radiation beams'?
What does a patient exhibit if they say, 'My computer is sending out infected radiation beams'?
Signup and view all the answers
What term describes the patient's invented word like 'macnabs'?
What term describes the patient's invented word like 'macnabs'?
Signup and view all the answers
What is the appropriate response of a nurse when a patient with schizophrenia says they can see their body merging with a wall?
What is the appropriate response of a nurse when a patient with schizophrenia says they can see their body merging with a wall?
Signup and view all the answers
What is the priority assessment question for a patient with auditory hallucinations?
What is the priority assessment question for a patient with auditory hallucinations?
Signup and view all the answers
What condition might a patient experience if they show symptoms like muscle stiffness and difficulty swallowing after taking risperidone?
What condition might a patient experience if they show symptoms like muscle stiffness and difficulty swallowing after taking risperidone?
Signup and view all the answers
What indicates concrete thinking the most from a patient with schizophrenia when asked about the saying 'You can't judge a book by looking at the cover'?
What indicates concrete thinking the most from a patient with schizophrenia when asked about the saying 'You can't judge a book by looking at the cover'?
Signup and view all the answers
What is the best goal for a psychoeducational group for adults with schizophrenia?
What is the best goal for a psychoeducational group for adults with schizophrenia?
Signup and view all the answers
What initial action should a nurse take when a client expresses fear of being detained by Homeland Security?
What initial action should a nurse take when a client expresses fear of being detained by Homeland Security?
Signup and view all the answers
Which finding is a negative symptom associated with schizophrenia?
Which finding is a negative symptom associated with schizophrenia?
Signup and view all the answers
What indicates magical thinking in a patient?
What indicates magical thinking in a patient?
Signup and view all the answers
What describes the language of a patient saying 'Red chair out town board'?
What describes the language of a patient saying 'Red chair out town board'?
Signup and view all the answers
What are the two priority topics for psychoeducational groups for persons newly diagnosed with schizophrenia?
What are the two priority topics for psychoeducational groups for persons newly diagnosed with schizophrenia?
Signup and view all the answers
Study Notes
Therapeutic Communication
- Focus on feelings instead of content when addressing delusional beliefs to reduce anxiety.
- Acknowledge the patient’s fears by validating their feelings as frightening.
Assessment of Behavior and Perception
- Hypervigilance in patients may indicate ideas of reference, where they misinterpret actions of others as personally relevant.
- Patients with schizophrenia often perceive their environment as dangerous.
Side Effects of Antipsychotics
- Common side effects of typical antipsychotics include sedation and extrapyramidal symptoms, which may feel like a "robotic" state.
- Patients may respond poorly to medications like Olanzapine due to associated weight gain.
Hallucinations and Safety Concerns
- Monitor for auditory hallucinations that indicate paranoia, necessitating safety measures for both patient and staff.
- Indicators of hallucinations include detachment, darting eyes, and mumbling to oneself.
Care Plans and Patient Needs
- Physiological needs take priority for patients with severely compromised activities of daily living (ADLs).
- For patients exhibiting waxy flexibility, maintaining basic care such as feeding is crucial.
Communication Techniques
- Acknowledge difficulties in understanding incoherent speech rather than blaming the patient.
- Offering to stay with a distressed patient experiencing auditory hallucinations creates support and safety.
Antipsychotic Medication Management
- Third-generation atypical antipsychotics like Aripiprazole are beneficial for patients with metabolic concerns, as they cause minimal weight gain.
- Recognize symptoms such as shuffling gait and mask-like face as pseudoparkinsonism resulting from antipsychotic use.
Recognizing Dystonic Reactions
- Acute dystonic reactions, evidenced by sustained muscle contractions and abnormal postures, require immediate intervention with anticholinergic medications.
- Tardive dyskinesia manifests through involuntary movements and is not typically reversible after discontinuation of neuroleptics.
Building Therapeutic Relationships
- Gradual visits to withdrawn patients help establish trust; silence acceptance and predictability are key.
- Withdrawal behavior stems from anxiety related to emotional closeness and mistrust of others.
Nursing Interventions for Schizophrenia
- Use comforting speech and empathetic responses to manage patients experiencing distressing hallucinations.
- Understand that delusional beliefs about food safety highlight the need for alternative meal strategies to reduce patient anxiety.
Clinical Observations
- Waxy flexibility indicates a specific pathological state, necessitating focused care on physical wellbeing.
- Immediate recognition of violent behavior in ahighly disturbed patient requires rapid assessment and effective intervention strategies.### Schizophrenia: Key Concepts and Nursing Considerations
- Inner stimuli in schizophrenia may elicit laughter due to hallucinations, suggesting the importance of focused assessment.
- Negative symptoms include apathy, anhedonia, and poor personal hygiene, reflecting social withdrawal and lack of motivation.
- Prodromal symptoms, such as withdrawal and poor concentration, occur before the onset of more severe psychotic symptoms.
- Paranoia is evident in patients who express unrealistic fears, and distinguishing between negative and positive symptoms is critical for proper diagnosis.
- The introduction of second-generation antipsychotics, such as Olanzapine, can address both positive and negative symptoms, while conventional medications target primarily positive symptoms.
Medication Management in Schizophrenia
- Weight management is crucial for patients on lurasidone due to risks of weight gain and metabolic disorders.
- Command hallucinations necessitate assessing what the hallucinations direct the patient to do to ensure safety.
- Neuroleptic malignant syndrome is a potential life-threatening reaction to antipsychotics, characterized by severe muscle stiffness and autonomic instability.
Patient Interaction and Assessment
- Concrete thinking can be assessed by interpreting proverbs and is marked by difficulty with abstract concepts.
- Social skills enhancement is a goal in psychoeducational sessions to aid relationship maintenance and overall management of the disorder.
- Immediate reassurance about safety is vital when addressing paranoid delusions to alleviate distress.
Special Considerations in Schizophrenia
- Screening young males for early symptoms can aid in timely intervention, potentially affecting long-term outcomes.
- Comorbid conditions like alcohol use disorder, major depressive disorder, and metabolic syndrome are prevalent and should be monitored closely.
- Patients prescribed first-generation antipsychotics should be educated about the likelihood of reduced hallucinations while being aware of potential side effects.
Risk Assessment
- Patients with schizophrenia expressing paranoia are at a heightened risk for violence and should be carefully assessed for safety.
- Early signs of schizophrenia in adolescents may include heightened suspicion and withdrawal, indicating a need for early intervention strategies.
Prognosis and Treatment Outlook
- Early and gradual onset of symptoms may suggest a less favorable prognosis, highlighting the need for comprehensive treatment plans.
- Psychoeducational approaches focusing on medication compliance and management of symptoms are crucial in promoting recovery and stabilization.### Therapeutic Communication in Altered Thought Processes
- A suitable therapeutic communication statement for patients with altered thought processes: "You say you hear voices, what are they telling you?"
- This approach validates the patient's experience and encourages expression without denying their perception.
Anosognosia in Schizophrenia
- Anosognosia often leads patients to refuse medication, believing they are not actually ill.
- This denial of illness complicates treatment and often results in non-compliance with prescribed therapies.
Priority Nursing Interventions for Dystonic Reaction
- Following the administration of haloperidol, symptoms such as rigidity, diaphoresis, and altered vital signs indicate a dystonic reaction.
- Priority interventions include:
- Holding the medication and contacting the prescriber for further direction.
- Cooling the patient with a wet washcloth to manage high temperature.
- Potentially administering an IM medication like benztropine for immediate symptom relief.
Co-occurring Conditions in Schizophrenia
- Excessive alcohol self-medication is common in individuals diagnosed with schizophrenia.
- Coinciding mental health issues in these patients typically include anxiety and depression.
- Recognizing the interconnectedness of substance use and mental illness is crucial for effective treatment.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge on schizophrenia and its spectrum disorders with these flashcards based on Varcarolis Chapter 12. Engage with scenarios that highlight therapeutic responses and understanding of patients' experiences. Perfect for nursing students and mental health professionals.
