Schizophrenia

Schizophrenia

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  B Y MUHAMMAD BAQAR DI P : C H N , P O S T R N B S C N , M S P H Schizophrenia
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  Objectives At the endof this lesson you will be able to:  define schizophrenia  Describe the etiological Factors of schizophrenia  list the types of schizophrenia  State the clinical features of schizophrenia  Explain the nursing interventions of schizophrenia
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  Schizophrenia  is definedas a mental disorder characterized by disordered thoughts, hallucination, and delusions.  is a form of psychosis involving disorders of perception, language, thought, emotion, and behavior.
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  Etiological Factors • Biologicalfactors: • age, virus, Chemical imbalance & physical abnormalities-neurotransmitters, brain structures Dopamine activity is excessive in the schizophrenic brain  Psychological factors: Traumatic experiences: Abuse Damage to body image , Fear of death, Frustration with memory loss , Role transitions • Environmental factors: Life stressors, changes • Social factors: Loneliness, isolation ,Recent sadness ,Lack of a supportive social network , Decreased mobility Due to illness or loss of driving privileges
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  Subtype of Schizophrenia Paranoid  Disorganized  Catatonic  Undifferentiated  Residual
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  Subtype of Schizophrenia Paranoid: Preoccupation with delusion or hallucinations, often with themes of persecution or grandiosity.  Disorganized: Disorganized speech or behavior, flat or inappropriate emotion.  Catatonic: Immobility ( or excessive , purposeless movement) extreme negativism and /or parrot like repeating of another’s speech or movements.  Undifferentiated: Many and varied symptoms.  Residual: Withdrawal, after hallucination and delusions have disappeared.
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  Symptoms  Symptoms aredivided into Positive and Negative symptoms.  Positive Symptoms: Positive symptoms are characterized by abnormal thoughts, perceptions, language and behavior  Negative Symptoms: Negative symptoms are characterized by restrictions in range and intensity of emotional expression, communication, body language and interest in normal activities.
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  Positive symptoms  Delusions Hallucinations  Associative looseness  Ideas of reference  Flight of ideas  Echopraxia
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  Negative symptoms  Blunted(or flat) Affect  Alogia  Lack of volition  Anhedonia  Catatonia
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  Schizophrenia treatment  Psychosocial Clinical and family support services  rehabilitation  Pharmacological and physical treatments  Neuroleptic medications
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  PRIORITIZED NURSING DIAGNOSES FORALL TYPES OF SCHIZOPHRENIA  Risk for violence: Directed toward self or other (priority!!!)  Self-care deficit  Thought process, altered  Sensory/perceptual alterations (related to illusion, delusion & hallucination)  Social isolation
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  NURSING INTERVENTIONS  Promotingsafety of client and others and right to Privacy and dignity  Establishing therapeutic relationship by establishing trust  Using therapeutic communication (clarifying feelings and statements when speech and thoughts are disorganized or confused) Interventions for delusions:  Do not openly confront the delusion or argue with the client.  Establish and maintain reality for the client.  Teach the client positive self-talk, positive thinking,  and to ignore delusional beliefs.
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  NURSING INTERVENTIONS Interventions forhallucinations:  Help present and maintain reality by frequent contact and communication with client.  Engage client in reality-based activities such as card playing, occupational therapy, or listening to music. Coping with socially inappropriate behaviors  Redirect client away from problem situations  Reassure others that the client’s inappropriate  behaviors or comments are not his or her fault (without violating client confidentiality).  Do not make the client feel punished or shunned for inappropriate behaviors  Teach social skills through education, role modeling, and practice.  Client and family teaching  Establishing community support systems and care