Nursing Management of Schizophrenia (v.8) Lecture Outline Dosette Bush Jones, MSN, RN-BC, CNS I. Definition: classified as a psychotic (not connected to reality) (split mind- split off fromwhat is real, evident, accurate or concrete) disorder -about 1% of US population-impairment in reality -psychiatric disorder in brain functioning (brain enables humans to reason, express, personality and interact with the environment)-pathological disorder of normal thought processing -brain chemistry reveals bio-cellular dysfunction of neurotransmitters-there is no cure, only treatment (multi-disciplinary)Sometimes called a thought disorderCharacteristics: Distortions of reality (what’s real vs what is not)Withdrawal from social interactionsPervasive nature affecting the entire person*Symptoms occur on a continuum (mild, severe, acute)II. Predisposition for schizophrenia (etiologies) Biologic influences -genetics (occurs in family, most frequently in males, inherited genetic transmission)-excessive dopamine found in the limbic and meso-limbic pathways (sexuality, emotions, flight-fight, personality etc) includes hippocampus and amygdala-physical conditions -abnormal fetal brain development-birth complications, viral infections-brain injuries-mental retardation-substance use (LSD, PCP)Neurostructural influences -ventricle to brain ratio is disproportional-frontal lobe atrophy (thought processing, impulse control, comprehension)-decrease in cerebral blood flow/hypofrontality Positive and Negative symptoms Positive - Type 1 -hyper-dopaminergic -hallucinations, delusions, abnormal thought forms, bizarre behavior (embellishment of normal thought processes)negative –Type 2
-structural changes -flat affect, anhedonia (inability to feel pleasure), alogia (lack of normal speech), avolition, anergia *Occurs over a period of times-Usually diagnosed in late adolescence through the mid-30’sProdromal Signs -lifelong hx of marginal functioning -increasing isolation -withdrawal -loss of interest -poor hygiene/grooming -verbal expressions of unusual beliefs/experiences-un-provoked anger -onset precipitated by a major stressor III. Effects of Schizophrenia on Thought Process and Content loose associations -poorly related, illogical, unrelatedautism -retreats into private inner world, introspective, distracted from external eventsslow thought processing -difficulty in expression of full thoughts **silence by nurse is importantrapid thinking -poor concentrationconcrete thinking -inability to separate, differentiate or comparethought blocking -inability to complete thoughtsthought insertion -belief that others are controlling or inserting thoughtsperseveration -repetitive statements, behaviors or soundscircumstantial -excessive and irrelevant detailtangential IV. Sensory and Perceptual Disturbances Delusions: fixed false beliefs; not validated in reality exaggerated defense mechanism as compensation for anxiety, fear, low self-esteem; maladaptive process in which individual alters what is unacceptable usually for protection
You've reached the end of your free preview.
Want to read all 12 pages?
- Fall '19
- Schizophrenia, Antipsychotic, hallucinations