for Nursing Students

1. B Y
MUHAMMAD BAQAR
D I P : C H N , P O S T R N B S C N , M S P H
Schizophrenia

2. Objectives
At the end of 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

3. Schizophrenia
 is defined as a mental disorder characterized by
disordered thoughts, hallucination, and delusions.
 is a form of psychosis involving disorders of
perception, language, thought, emotion, and
behavior.

4. Etiological Factors
• Biological factors:
• 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

5. Subtype of Schizophrenia
 Paranoid
 Disorganized
 Catatonic
 Undifferentiated
 Residual

6. 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.

7. Symptoms
 Symptoms are divided 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.

8. Positive symptoms
 Delusions
 Hallucinations
 Associative looseness
 Ideas of reference
 Flight of ideas
 Echopraxia

9. Negative symptoms
 Blunted (or flat) Affect
 Alogia
 Lack of volition
 Anhedonia
 Catatonia

10. Schizophrenia treatment
 Psychosocial
 Clinical and family support services
 rehabilitation
 Pharmacological and physical treatments
 Neuroleptic medications

11. PRIORITIZED NURSING DIAGNOSES
FOR ALL 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

12. NURSING INTERVENTIONS
 Promoting safety 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.

13. NURSING INTERVENTIONS
Interventions for hallucinations:
 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