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Understanding Schizophrenia: Symptoms and Care

Apr 21, 2025

Schizophrenia: Key Points from Lecture

Introduction

  • Presenter: Cathy from LevelUpRN
  • Topic: Schizophrenia
  • Includes a quiz at the end

Schizophrenia Overview

  • A psychotic disorder causing disturbances in thought, behavior, and perception.

Symptoms of Schizophrenia

Positive Symptoms

  • Delusions: False beliefs (e.g., "I am the president")
  • Hallucinations: False sensory perceptions, particularly auditory (e.g., hearing voices)
  • Disorganized Speech: Altered speech patterns

Negative Symptoms

  • Anhedonia: Lack of pleasure
  • Flat Affect: Lack of expression
  • Apathy: Lack of interest
  • Anergia: Lack of energy
  • Alogia: Lack of speech
  • Avolition: Lack of motivation

Speech Alterations in Schizophrenia

  • Flight of Ideas: Rapidly changing topics
  • Pressured Speech: Rapid speech without pauses
  • Neologisms: Made-up words
  • Echolalia: Repeating others' words
  • Word Salad: Incoherent string of real words
  • Clang Association: Using rhyming words

Diagnosis

  • Two or more symptoms lasting at least six months, interfering with work or social relationships
  • Rule out physiological causes (e.g., electrolyte imbalances, hypoglycemia, substance use)

Treatment

  • Medications: First and second-generation antipsychotics
    • Slow release IM medications available for better compliance
  • Therapies: Cognitive-behavioral therapy, individual and group therapy, social skills training
  • ACT (Assertive Community Treatment): Focus on severe cases, preventing hospitalizations and incarcerations

Nursing Care

  • Prioritize safety
  • Ask directly about hallucinations (especially command hallucinations)
  • Do not validate hallucinations, but acknowledge them
    • Example: "I do not hear voices, but I believe you do."
  • Decrease environmental stimuli
  • Avoid whispering in patient’s presence
  • Warn before touching
  • Reorient to reality as needed
  • Provide distractions for hallucinations
  • Monitor for suicide ideation

Quiz Questions

  1. Delusion: "I am a spy for the Secret Service"
  2. Negative Symptom: Flat affect
  3. Priority Nursing Action: Ask patient what voices are saying
  4. Clang Association: Similar or rhyming words
  5. ACT: Multidisciplinary approach for severe schizophrenia

Conclusion

  • Encouragement to use LevelUpRN materials for further study
  • Note: Importance of safety and understanding symptoms for effective nursing care.

Full transcript