Schizophrenia
By
K. Cox
ATU
Nature of Disorder
•Premorbid personality
•Acute onset
•Premorbid behavior
–The schizoid personality
–The prodromal phase
Symptoms
•Positive
–Delusions
–Hallucinations
Negative Symptoms
•Flat affect
•Ambivalence
•Anhedonia
•Alogia
Neurocognitive Impairment
•Memory
•Vigilance
•Verbal Fluency
•Executive Functioning
•Disorganized Thinking
•Disorganized Behavior
Phases of Schizophrenia
•Initial Diagnosis
–Diagnostic criteria
•General symptoms
•Social/Occupational dysfunction
•Duration
•Schizoaffective and Mood Disorder exclusion
•Substance/general medical condition exclusion
Phases Continued
•Adaptation
•Relapse
Epidemiology
•Risk factors
•Age of onset
•Gender differences
•Ethnic and cultural differences
•Familial Differences
Comorbidity
•Substance abuse and depression
•Disordered water balance
Etiology
•Biologic Theories
–Neuroanatomic findings
–Familial patterns
–Neurodevelopment
–Neurotransmitters
Etiology Continued
•Psychological Theories
•Social Theories
Interdisciplinary Treatment
•Nursing
•Psychiatry
•Psychology
•Social Work
•Occupational and Recreational therapy
•Pastoral counselors
Suicide Assessment
Psychosis or Depression
Family Response
•Life long battle
•Shock
•Fear
•Care and concern
•Disbelief
Nursing Management
•Assessment
–Thorough history
–Physical examination
–Substance use/abuse
–Risk for self injury
–Medication history
–Positive and negative symptoms
–Cognitive impairments
–Support systems (family/friends)
–Social functioning
–Mental Status
Nursing Diagnoses/Interventions
•Biological
–Self-care deficit
–Disturbed sleep patterns
–Constipation
–Imbalanced nutrition
–Fluid volume excess
Nursing Diagnoses/Interventions
•Biologic continued
–Pharmacology – Antipsychotic drugs
•Therapeutic effect
•Newer drugs
•Monitoring
•Adherence
•Side Effects
–Extrapyramidal Symptoms (EPS)
»Parkinsonism
»Dystonic reactions
»Akathisia
»Tardive dyskinesia
Side Effects Continued
–Orthostatic hypotension
–Dry mouth
–Blurred vision
–Photosensitivity
–Constipation
–Urinary retention
–Agranulocytosis
–Neuroleptic malignant syndrome
Nursing Diagnoses/Interventions
•Psychological
–Disturbed thought processes
–Disturbed sensory perception
–Low self-esteem
–Risk for violence
–Ineffective coping
–Knowledge deficit
Nursing Diagnoses/Interventions
•Social
–Social Isolation
–Ineffective Role Performance
–Disabled Family Coping
Evaluation
•Decreased symptoms
•Support systems
•Patient education
•Relapse prevention