Schizophrenia Spectrum Disorder PDF

**Schizophrenia Spectrum Disorder(read ATI chapt. on psychotic disorders)** - Schizophrenia Spectrum Disorders and Psychosis - Range of disorders with psychotic symptoms - Schizophrenia - schizoaffective disorder- more symptoms associated with depression...

**Schizophrenia Spectrum Disorder(read ATI chapt. on psychotic disorders)** - Schizophrenia Spectrum Disorders and Psychosis - Range of disorders with psychotic symptoms - Schizophrenia - schizoaffective disorder- more symptoms associated with depression - schizophreniform disorder, brief psychotic disorder, delusional disorder, shared psychotic disorder, substance-induced psychotic disorder, late-onset schizophrenia - No cure - Treatment focuses on managing symptoms and maintaining or improving daily functioning - Nursing responsibilities - Liaison for clients, other interprofessional team members, and community organizations - Initiate referrals to primary care or specialized mental health services - **Psychosis (symptom where you cannot tell the difference in real or nonreal)** - Hallmark characteristic of a psychotic-related disorder - Disconnection with reality caused by disturbances in a client's thoughts and perceptions - Hallucinations( hearing or seeing things that others cannot) - Troubling thoughts or beliefs - Emotional Changes - Withdrawal - Lack of self-care - Diagnosis - Eliminate other medically related causes - Gradual onset - Family history - Tx - Antipsychotic medications - Most pts. are one and off meds because of the side effects - psychotherapy, cognitive behavioral therapy, support, and education for both the client and family - Diagnosed (DSM-5-TR Criteria or Schizophrenia) - Schizophrenia is typically [diagnosed when a client is between 16 and 30 years old] - More common in males - Common Facts about Schizophrenia - Productive lives when treatment and support are available. - Stigma leads to limited health care access, underdiagnosis, and undertreatment - *[14 times more likely to be victims of crime or violence]* than the greater population. - One-half of persons who have a diagnosis of schizophrenia have a co-occurring mental health disorder - Risk Factors and Etiology - Genetics - Physiological(neurodevelopment, infections, hypoxia) - Biochemical(long exposure to cortisol) - Environmental( cannabis use) - Clinical Manifestations - Positive symptoms(adds symptoms)- it is an active function - Hallucinations - Delusions - Disorganized speech - Motor agitation - Negative symptoms(Something being taken away) - Alogia (speaks on little words) - Anergia (lack of energy) - Anhedonia (inability to feel pleasure) - Cognitive symptoms - Poor concentration - Slow thinking - Poor memory - Nurse's Role - Creating and maintaining a safe therapeutic relationship - Ensuring a safe, calm, therapeutic environment - Advocating and supporting early detection of psychosis - Ensuring assessment, including mental status examination is complete and thorough - Providing interventions that focus on stabilizing - Providing support to the client toward recovery, self-management, and engagement - **Phases of a Therapeutic Relationship** - Orientation - Client does not recognize the need for assistance and blocks alliance - Family or friends are unable or unwilling due to client history or symptoms - Manifestations of psychosis (positive or negative symptoms) - Health care team's feelings or bias - Cognitive deficit of client - Identification - Poor insight - May have a hard time with reporting self-symptoms - They believe nothing is wrong with them - Challenges with communication and daily functioning - Monitor positive and negative manifestations - Assist client in understanding their condition - Prioritize safety - Exploitation - Explore interventions - Medications - Cognitive therapies - Recognize triggers - Express difficulties and seek assistance when needed - Progress toward recovery - Resolution - Rehabilitation and recovery - Supportive housing - Able to function without live in support or supervision - Continue therapeutic relationship with client to improve daily functioning - Treatment - Recovery-oriented approach - Medications - Antipsychotics - Cognitive behavioral therapy - Family education and support - Assertive community treatment(ACT team) - treatment assists individuals who have repeated hospitalizations or who are without housing - Interventions - Assess if they are taking meds or if they are being truthful - Recognize medical and psychological symptoms - Extrapyramidal Symptoms - Acute dystonia - Akathisia - Pseudoparkinsonism - Tardive Dyskinesia - Increase anxiety and sometimes pain - Establish a therapeutic milieu environment - Evaluate there response - Evaluate their medication adhere - Social Problems - Jail/prison - Stigma - Isolation and loneliness - Victimization - Economic Challenges - Unemployment - Homelessness - Caregiver burden - Tx issues - Nonadherence - Tx inadequacies - Anosognosia- believes nothing is wrong with them