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 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?
When providing care for a patient diagnosed with schizophrenia, which associated conditions should the nurse frequently assess for? (Select all that apply)
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What information should the nurse provide to a female patient diagnosed with schizophrenia who has been prescribed a first-generation antipsychotic medication?
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Which characteristic presents the greatest risk for injury to others by a patient diagnosed with schizophrenia?
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What is the prognosis for Gilbert, who shows early signs of schizophrenia?
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Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient's nursing diagnosis is altered thought processes?
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When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:
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What is the priority nursing intervention for a patient with schizophrenia taking haloperidol who is sitting stiffly and diaphoretic with a high blood pressure?
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What co-occurring issue is common in patients diagnosed with schizophrenia who self-medicate with excessive alcohol?
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Select the nurse's most therapeutic response to a patient who believes others are plotting against them.
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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?
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How does a patient diagnosed with schizophrenia perceive their environment if they say, 'My co-workers are out to get me'?
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What are common side effects of haloperidol (Haldol) that the nurse should validate with a patient?
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Which hallucination necessitates the nurse to implement safety measures?
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Which assessment findings suggest a patient may be experiencing auditory hallucinations?
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Which antipsychotic medication should be advocated for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social functioning?
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How should the nurse respond to a patient with disorganized speech?
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What is a priority need for a patient diagnosed with schizophrenia exhibiting little spontaneous movement and waxy flexibility?
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What would be an appropriate outcome for a patient diagnosed with schizophrenia who has severe self-care deficits?
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What is the name of the phenomenon when a patient demonstrates waxy flexibility?
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Which intervention is most likely to be acceptable to a patient with delusions of persecution about being poisoned?
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What should be the nurse's best plan for establishing a relationship with a withdrawn patient diagnosed with schizophrenia?
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What do withdrawn patients diagnosed with schizophrenia typically do?
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What should the nurse reply to a patient who claims, 'The voices are bothering me. They yell and tell me I am bad.'?
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A patient diagnosed with schizophrenia exhibits symptoms like shuffling gait and a mask-like face. What term describes these symptoms?
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What most likely occurred when a patient diagnosed with schizophrenia has a head rotated to one side and displays other symptoms after haloperidol administration?
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What intervention is indicated for a patient showing a stiffly fixed position and drooling after receiving haloperidol?
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Which medication should be administered immediately for the treatment of dystonias?
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What condition is the patient likely suffering from if they are grimacing and have lip smacking?
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What is the best response for a nurse when a patient with schizophrenia laughs uncontrollably?
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Which finding is a negative symptom of schizophrenia?
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What assessment findings indicate the prodromal stage of schizophrenia?
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What problem is evident if a patient states, 'Contagious bacteria are everywhere?'
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When starting lurasidone HCL (Latuda), what is the most important topic for the nurse to include in the teaching plan?
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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?
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Which medication change would the nurse expect for a patient with continued negative symptoms despite treatment?
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Which type of therapy is best for a family unfamiliar with schizophrenia?
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What does a patient exhibit if they say, 'My computer is sending out infected radiation beams'?
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What term describes the patient's invented word like 'macnabs'?
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What is the appropriate response of a nurse when a patient with schizophrenia says they can see their body merging with a wall?
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What is the priority assessment question for a patient with auditory hallucinations?
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What condition might a patient experience if they show symptoms like muscle stiffness and difficulty swallowing after taking risperidone?
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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'?
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What is the best goal for a psychoeducational group for adults with schizophrenia?
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What initial action should a nurse take when a client expresses fear of being detained by Homeland Security?
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Which finding is a negative symptom associated with schizophrenia?
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What indicates magical thinking in a patient?
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What describes the language of a patient saying 'Red chair out town board'?
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What are the two priority topics for psychoeducational groups for persons newly diagnosed with schizophrenia?
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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.
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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.
