CHAPTER 12:
POSITIVE S/S OF SCHIZOPHRENIA:
● Add-on behaviors that should not be there
○ Alterations in reality: delusions (false, fixed beliefs). Common: persecutory
(being plotted against), grandiose, referential, and somatic
○ Alterations in speech: associative looseness (disorganized thinking), word
salad, clang associations (rhyming), & neologisms (made-up words)
○ Alterations in perception: most common are hallucinations (auditory,
visual, olfactory, gustatory, tactile, or command) and illusions
(misperception of real external stimuli)
○ Alterations in behavior: catatonia, motor agitation, retardation, and waxy
flexibility)
NEGATIVE S/S OF SCHIZOPHRENIA:
● Absence of essential human qualities; impair quality of life and ability to function
○ “A” symptoms: apathy (lack of interest), avolition (loss of motivation),
anhedonia (inability to feel pleasure), asociality, and affective flattening
(decreased emotion expression)
PLANNING NURSING CARE:
● Phases of schizophrenia:
○ Prodromal: subtle S/S (anxiety, distressing thoughts, and concentration
issues)
○ Acute: focus on pt and medical stabilization
○ stabilization/maintenance: help pt understand the illness, adhere to the
treatment, prevent relapse, and become independent
● Safety: regularly assess risks for suicide/violence and monitor fluid intake
(polydipsia is a S/E of most meds)
● Med adherence:
○ Address anosognosia: brain-based inability to realize one is ill. Leads to
treatment resistance
○ Educate: family and pt on antipsychotic meds; long-acting injections for
those with adherence issues
● Psychological support: provide psychoeducation for family and pt on relapse
prevention, coping skills, and community resources (NAMI)
NURSING INTERVENTIONS FOR PSYCHOSIS:
POSITIVE S/S OF SCHIZOPHRENIA:
● Add-on behaviors that should not be there
○ Alterations in reality: delusions (false, fixed beliefs). Common: persecutory
(being plotted against), grandiose, referential, and somatic
○ Alterations in speech: associative looseness (disorganized thinking), word
salad, clang associations (rhyming), & neologisms (made-up words)
○ Alterations in perception: most common are hallucinations (auditory,
visual, olfactory, gustatory, tactile, or command) and illusions
(misperception of real external stimuli)
○ Alterations in behavior: catatonia, motor agitation, retardation, and waxy
flexibility)
NEGATIVE S/S OF SCHIZOPHRENIA:
● Absence of essential human qualities; impair quality of life and ability to function
○ “A” symptoms: apathy (lack of interest), avolition (loss of motivation),
anhedonia (inability to feel pleasure), asociality, and affective flattening
(decreased emotion expression)
PLANNING NURSING CARE:
● Phases of schizophrenia:
○ Prodromal: subtle S/S (anxiety, distressing thoughts, and concentration
issues)
○ Acute: focus on pt and medical stabilization
○ stabilization/maintenance: help pt understand the illness, adhere to the
treatment, prevent relapse, and become independent
● Safety: regularly assess risks for suicide/violence and monitor fluid intake
(polydipsia is a S/E of most meds)
● Med adherence:
○ Address anosognosia: brain-based inability to realize one is ill. Leads to
treatment resistance
○ Educate: family and pt on antipsychotic meds; long-acting injections for
those with adherence issues
● Psychological support: provide psychoeducation for family and pt on relapse
prevention, coping skills, and community resources (NAMI)
NURSING INTERVENTIONS FOR PSYCHOSIS:
