Download Schizophrenia

Schizophrenia
LESSON OBJECTIVES:
1. Distinguish key symptoms of schizophrenia.
2. Analyze the prevailing biologic, psychological, and social theories that are the basis for
understanding schizophrenia.
3. Analyze human responses to schizophrenia with emphasis on hallucinations, delusions, and
social isolation.
4. Formulate nursing diagnoses based on a biopsychosocial assessment of persons with
schizophrenia.
5. Formulate nursing interventions that address specific diagnoses based on a continuum of
care.
6. Identify expected outcomes and their evaluation.
7. Analyze special concerns within the nurse-patient relationship common to treating those with
schizophrenia.
CONTENT OUTLINE
1. Clinical Course
1.1. Diagnostic Criteria
1.1.1. Positive Symptoms of Schizophrenia
1.1.2. Negative Symptoms of Schizophrenia
1.1.3. Neurocognitive Impairment
2. Phases of Schizophrenia
2.1. Phase I: Initial Diagnosis and Early Schizophrenia
2.2. Phase II: Adaptation
2.3. Phase III: Relapse
3. Schizophrenia in Special Populations
3.1. Children
3.2. Elderly People
4. Epidemiology
4.1. Risk Factors
4.2. Age of Onset
4.3. Gender Differences
4.4. Ethnic and Cultural Differences
4.5. Familial Differences
5. Comorbidity
5.1. Substance Abuse and Depression
5.2. Diabetes Mellitus
5.2.1. Disordered Water Balance
5.2.2. Prevalence
5.2.3. Etiology of Disordered Water Balance
6. Clinical Characteristics
6.1. Etiology
6.2. Biologic Theories
6.3. Neuroanatomic Findings
7. Familial Patterns
8. Neurodevelopment
8.1. Neurotransmitters, Pathways, and Receptors
8.2. Positive Symptoms: Hyperactivity of Mesolimbic Tract
8.3. Negative Symptoms and Cognitive Impairment: Hyperactivity of the
8.4. Mesocortical Tract
8.5. Role of Other Dopamine Pathways
8.6. Role of Other Receptors
9. Psychological Theories
10. Social Theories
11. Interdisciplinary Treatment
11.1.
Priority Care Issues
12. Family Response to Disorder
13. Nursing Management: Human Response to Disorder
13.1.
Biologic Domain
13.2.
Biologic Assessment
13.2.1. Present and Past Health Status and Physical Examination
13.3.
Physical Functioning
13.4.
Nutritional Assessment
13.5.
Fluid Imbalance Assessment
13.6.
Pharmacologic Assessment
13.7.
Nursing Diagnosis Related to Biologic Domain
14. Biologic Interventions
14.1.
Promotion of Self-Care Activities
14.2.
Activity, Exercise, and Nutritional Interventions
14.3.
Thermoregulation Interventions
14.4.
Promotion of Normal Fluid Balance and Prevention of Water
14.5.
Intoxication
15. Pharmacologic Interventions
15.1.
Monitoring and Administering Medications
15.2.
Monitoring Side Effects
15.3.
Medication Emergencies
16. Psychological Domain
16.1.
Psychological Assessment
16.2.
Responses to Mental Health Problems
16.3.
Speech
16.4.
Thought Process
16.5.
Behavioral Responses
16.6.
Self-Concept
16.7.
Stress and Coping Patterns
16.8.
Risk Assessment
17. Nursing Diagnoses Related to Psychological Domain
17.1.
Psychological Interventions
18. Special Issues in the Development of the Nurse-Patient Relationship
18.1.
Management of Disturbed Thoughts and Sensory Perceptions
18.2.
Self-Monitoring and Relapse Prevention
18.3.
Enhancement of Cognitive Functioning
19. Behavioral Interventions
19.1.
Stress and Coping Skills
20. Patient Education
21. Family Education
22. Social Domain
22.1.
Social Assessment
22.1.1. Functional Status
22.1.2. Social Systems
22.1.3. Quality of Life
22.2.
Family Assessment
22.3.
Nursing Diagnoses Related to Social Domain
23. Social Interventions
23.1.
Promotion of Patient Safety on Psychiatric Units
23.2.
Support Groups
23.3.
Milieu Therapy
23.4.
Psychiatric Rehabilitation
23.5.
Family Interventions
24. Evaluation and Treatment Outcomes
25. Continuum of Care
25.1.
25.2.
25.3.
25.4.
Inpatient-Focused Care
Emergency Care
Community Care
Mental Health Promotion
LEARNING ACTIVITIES:
1.
Study Guide: Chapter 18: Pages79-84
2.
Participation in Critical Thinking Exercises in Class
3.
Quiz
CRITICAL THINKING FOCUS:
The mental health nurse's response to individuals exhibiting symptoms of schizophrenia, having a
diagnosis of schizophrenia, and/or prescribed anti-psychotic medications.
REQUIRED READING:
Boyd, M. A. (2002). Psychiatric Nursing: Contemporary Practice.(2nd. Ed., pp. 332-383).
Philadelphia: Lippincott.
WEB LINKS:
http://www.nami.org This is the website of the National Alliance for the Mentally Ill.
http://www.nimh.nih.gov/publicat/schizmenu.cfm The National Institute of Mental Health website
presents all aspects of the diagnosis and treatment of schizophrenia.
http://www.narsad.org This is the site of the National Alliance for Research on Schizophrenia and
Depression, which is a national organization that raises and distributes money for research.
http://www.schizophrenia.ca This is the site of the Schizophrenia Society of Canada, an
organization committed to alleviating suffering caused by schizophrenia.
http://www.schizophrenia.com This is a not-for-profit information, support, and education center.
http://www.mentalhealth.com This site of the Mental Health Network provides extensive
information on schizophrenia.