Schizophrenia Lecture - LevelUpRN

Introduction

• Presenter: Cathy with LevelUpRN
• Topics: Overview of schizophrenia, symptoms, diagnosis, treatment, and nursing care.
• Includes a quiz at the end to test knowledge.

Schizophrenia Overview

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

Symptoms

• Positive Symptoms: Additions to behaviors that shouldn’t be there.
  • Delusions: False beliefs (e.g., "I am the president.")
  • Hallucinations: False sensory perceptions (e.g., hearing voices)
  • Disorganized speech
• Negative Symptoms: Absence of behaviors that should be present (hint: "Six A's")
  • 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 shifting from one topic to another.
• Pressured Speech: Talking very rapidly without pauses.
• Neologisms: Made-up words (e.g., "coopa dupa")
• Echolalia: Repeating back words heard.
• Word Salad: Incoherent combination of real words.
• Clang Association: Rhyming words together (e.g., "Dan ran to get his can.")

Diagnosis

• Criteria: Two or more symptoms lasting at least six months.
• Must interfere 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 for severe, persistent cases.
    • Focuses on caring for high-risk individuals in the community.

Nursing Care

• Priority: Ensure safety.
  • Directly ask about hallucinations: "Are you hearing voices? What are they saying?"
  • Acknowledge but do not validate hallucinations.
  • Decrease stimuli in the environment.
  • Warn before touching the patient.
  • Reorient to reality as needed.
  • Monitor for suicide ideation.

Quiz Questions

1. Delusion example: "I am a spy for the Secret Service."
2. Flat affect is a negative symptom.
3. Priority nursing action for command hallucinations: Ask what the voices are saying.
4. Clang association: Combination of similar or rhyming words.
5. ACT: Multidisciplinary team approach for severe, persistent schizophrenia in the community.

Conclusion

• Encouragement for further study and review.
• Reminder to use LevelUpRN flashcards.