Schizophrenia - Mercer University



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. Diagnostic Criteria

1. Positive Symptoms of Schizophrenia

2. Negative Symptoms of Schizophrenia

3. Neurocognitive Impairment

2. Phases of Schizophrenia

1. Phase I: Initial Diagnosis and Early Schizophrenia

2. Phase II: Adaptation

3. Phase III: Relapse

3. Schizophrenia in Special Populations

1. Children

2. Elderly People

4. Epidemiology

1. Risk Factors

2. Age of Onset

3. Gender Differences

4. Ethnic and Cultural Differences

5. Familial Differences

5. Comorbidity

1. Substance Abuse and Depression

2. Diabetes Mellitus

1. Disordered Water Balance

2. Prevalence

3. Etiology of Disordered Water Balance

6. Clinical Characteristics

1. Etiology

2. Biologic Theories

3. Neuroanatomic Findings

7. Familial Patterns

8. Neurodevelopment

1. Neurotransmitters, Pathways, and Receptors

2. Positive Symptoms: Hyperactivity of Mesolimbic Tract

3. Negative Symptoms and Cognitive Impairment: Hyperactivity of the

4. Mesocortical Tract

5. Role of Other Dopamine Pathways

6. Role of Other Receptors

9. Psychological Theories

10. Social Theories

11. Interdisciplinary Treatment

1. Priority Care Issues

12. Family Response to Disorder

13. Nursing Management: Human Response to Disorder

1. Biologic Domain

2. Biologic Assessment

1. Present and Past Health Status and Physical Examination

3. Physical Functioning

4. Nutritional Assessment

5. Fluid Imbalance Assessment

6. Pharmacologic Assessment

7. Nursing Diagnosis Related to Biologic Domain

14. Biologic Interventions

1. Promotion of Self-Care Activities

2. Activity, Exercise, and Nutritional Interventions

3. Thermoregulation Interventions

4. Promotion of Normal Fluid Balance and Prevention of Water

5. Intoxication

15. Pharmacologic Interventions

1. Monitoring and Administering Medications

2. Monitoring Side Effects

3. Medication Emergencies

16. Psychological Domain

1. Psychological Assessment

2. Responses to Mental Health Problems

3. Speech

4. Thought Process

5. Behavioral Responses

6. Self-Concept

7. Stress and Coping Patterns

8. Risk Assessment

17. Nursing Diagnoses Related to Psychological Domain

1. Psychological Interventions

18. Special Issues in the Development of the Nurse-Patient Relationship

1. Management of Disturbed Thoughts and Sensory Perceptions

2. Self-Monitoring and Relapse Prevention

3. Enhancement of Cognitive Functioning

19. Behavioral Interventions

1. Stress and Coping Skills

20. Patient Education

21. Family Education

22. Social Domain

1. Social Assessment

1. Functional Status

2. Social Systems

3. Quality of Life

2. Family Assessment

3. Nursing Diagnoses Related to Social Domain

23. Social Interventions

1. Promotion of Patient Safety on Psychiatric Units

2. Support Groups

3. Milieu Therapy

4. Psychiatric Rehabilitation

5. Family Interventions

24. Evaluation and Treatment Outcomes

25. Continuum of Care

1. Inpatient-Focused Care

2. Emergency Care

3. Community Care

4. 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:

This is the website of the National Alliance for the Mentally Ill.

The National Institute of Mental Health website presents all aspects of the diagnosis and treatment of schizophrenia.

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.

This is the site of the Schizophrenia Society of Canada, an organization committed to alleviating suffering caused by schizophrenia.

This is a not-for-profit information, support, and education center.

This site of the Mental Health Network provides extensive information on schizophrenia.

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