Schizophrenia has affected countless individuals throughout history. It is a severe, chronic and disabling brain disorder. There are 3 forms of schizophrenia: paranoid, catatonic and disorganized. Treated properly, this illness can be managed and even cured. People with this illness are often scared by their own distorted thoughts and actions. Often, they hear voices or noises others do not hear. Paranoia can set in, making them think someone else is controlling their minds or are about to harm them. At present, the specific cause of this disorder is still unknown. But you have a better chance of getting the treatment you need if you are aware of the nursing diagnosis for schizophrenia.
What Are the Nursing Diagnosis for Schizophrenia?
It is important to be familiar with schizophrenia’s nursing diagnosis because the illness causes a wide range of symptoms that differ from one individual to the next. Individuals suffering from this disorder have a hard time telling the difference between real and unreal events, maintaining sociability, thinking in a rational manner and upholding normal emotions.
1. Nursing Diagnosis for Schizophrenia: Risk for Violence
- Panic or anger
- Rigid posture, clenched fists
- Limited attention span
- Tormenting of others
- Irritability or restlessness
- Aggressive in verbal and non-verbal communication
- Keep surrounding area free of high level stimuli.
- Routinely observe patient at regular intervals.
- Give the patient something to reflect its aggressive actions.
- Administer appropriate medications and monitor for effectiveness and side effects.
- Do not acknowledge rude comments or behavior.
- Have staff with the ability to restrain patient if needed and create a safe environment.
- Maintain a calm demeanor towards the patient and set boundaries for unacceptable actions.
2. Nursing Diagnosis for Schizophrenia: Altered Thought Processes
- Delusional thinking
- Shifting from one topic to another
- Unable to stay focused
- Escalated reaction to normal stimuli
- Inconsistent communication
- Difficulties in problem solving
- Speak clearly and directly to patient in a simple and professional manner.
- Explain all treatments, tests and medications to patient before using them.
- Let patient have as much control as possible within therapy limits.
- Maintain consistent expectations and rules for acceptable and non-disruptive behavior.
- Teach patients how to use thought-stopping and focus techniques.
- Discuss patients’ feelings when they are experiencing disturbing and delusional thoughts.
- Give alternative ways to express feelings in acceptable, non-threatening ways.
3. Nursing Diagnosis for Schizophrenia: Social Isolation
- Limited or no interaction with others
- Sad facial expressions
- Limited or no eye contact with others
- Dependent use of non-verbal communication
- Avoidance of social situations
- Establish schedule for frequent, yet brief patient meetings.
- Maintain distance from patient until trust established.
- Avoid touching patient unless appropriate and necessary.
- Teach social skills and how to interact with others.
- Assist patient in choosing and attending social activities.
- Provide words of encouragement and praise for all social interaction attempts.
4. Nursing Diagnosis for Schizophrenia: Sensory and Perceptual Alterations Related to Hallucinations
- Strange body sensations
- Little or no interaction with nurse or others
- Unable to concentrate
- Unsuitable reactions and responses to reality
- Encourage patient to speak about their hallucinations and communicate with patient during event but do not counsel until episode has ended.
- Do not argue with patients, but explain others don’t share their sensory perceptions.
- Monitor for symptoms and signs of hallucinating, such as looking around or talking to themselves.
- Help identify and deal with triggers and feelings that bring on hallucinations or illusions.
- Place patient in quiet environment and encourage tasked-based activities.
- Teach patient distraction techniques and involve them in concrete activities so as to bring them back to reality.
5. Nursing Diagnosis for Schizophrenia: Impaired Verbal Communication
- Lack of emotion in verbal communication
- Inability to think abstractly
- Little use of speech
- Unable to express cause of agitation
- Incongruent non-verbal communication
- Allow time for consistent one-on-one interaction with patient.
- Inform patient when you are unable to understand what they are trying to convey.
- Verbalize feelings and model expressions of feelings for patients.
- Speak with patient about personal interests, favorite activities and hobbies.
- Look out for open communication on topics that are meaningful and important to patient.
6. Nursing Diagnosis for Schizophrenia: Ineffective Individual Coping
- Feelings of loneliness and rejection
- Avoidance of interaction and people
- Regression and projection defenses
- Unable to perform daily self-care tasks
- Physical and emotional withdrawal
- Teach patient to verbalize feelings.
- Only touch patient when appropriate and assistance is needed.
- Assist patient in identifying bizarre or impulsive actions and how to control them.
- Teach and practice daily living skills with patient.
- Evaluate patient’s reactions to unexpected events and situations in clinical environment.
7. Nursing Diagnosis for Schizophrenia: Ineffective Individual Coping
- Facial expressions of anger
- Increased psychomotor activity while self-absorbed
- Abundance of pacing
- Lack of control
- Speaking previous incidents of violence
- Verbal and non-verbal threats
- Create a quiet, non-stimulating setting.
- Teach patient techniques to control agitation.
- Give patient appropriate medications and monitor side effects and effectiveness.
- Use physical restraints as a last resort.
- Assist patient in identifying stressors and triggers of agitation.
- Discuss negative feels and how to keep these emotions from escalating.
- Teach patient how to depart from situations that will trigger agitation.
- Reinforce positive behaviors.