Etiology & Risk Factors
Schizophrenia affects approximately this percentage of the population.
What is 1% of the population?
False sensory perceptions such as hearing voices or seeing things that are not there.
What are hallucinations?
When communicating with a patient experiencing disorganized thinking, the nurse should use this communication style.
What is short, clear, simple communication?
This medication class is the primary treatment for schizophrenia.
What are antipsychotics?
Patients with schizophrenia should avoid these substances because they worsen symptoms.
What are alcohol and drugs?
This neurotransmitter is most commonly associated with schizophrenia when it becomes overactive.
What is dopamine?
Fixed false beliefs that are not based in reality.
What are delusions?
Instead of arguing with a patient’s delusion, the nurse should use this therapeutic communication technique.
What is reinforcing or presenting reality?
These medications block dopamine receptors and primarily treat positive symptoms.
What are first-generation (typical) antipsychotics?
Haloperidol (Haldol), Chlorpromazine, Perphenazine, Fluphenazine, Loxapine, and Thioridazine
The most important factor in preventing relapse.
What is medication adherence?
Name two biological risk factors associated with schizophrenia.
Genetics
Brain structure abnormalities
Neurotransmitter imbalance (dopamine, serotonin, glutamate)
This speech pattern involves jumping rapidly from one thought to another.
What is flight of ideas?
When assessing hallucinations, the nurse should ask this safety question.
“What are the voices telling you to do?”
These movement-related side effects include tremors, rigidity, and restlessness.
What are extrapyramidal symptoms (EPS)?
A written strategy to identify early warning signs and manage stress is called this.
What is a relapse prevention plan?
Schizophrenia most commonly develops during this stage of life.
What is late adolescence to early adulthood?
Symptoms such as apathy, avolition, and social withdrawal belong to this category.
What are negative symptoms?
Name one reality-based coping strategy nurses can teach patients experiencing hallucinations.
Listening to music
Talking with others
Exercise
Relaxation techniques
This medication treats resistant schizophrenia but requires monitoring for agranulocytosis.
What is clozapine?
Name one support organization for individuals with schizophrenia.
NAMI
Schizophrenia and Related Disorders Alliance of America
A 19-year-old college student with a family history of schizophrenia reports increasing paranoia and disorganized thinking. The nurse is teaching about risk factors.
Which factors increase the risk of schizophrenia?
(Select all that apply)
A. Family history of schizophrenia
B. Cannabis use during adolescence
C. Prenatal stress exposure
D. High protein diet
E. Brain structure abnormalities
A. Family history of schizophrenia
B. Cannabis use during adolescence
C. Prenatal stress exposure
E. Brain structure abnormalities
Rationale: Biological and environmental risk factors include genetics, prenatal stress, cannabis use, and neurobiological abnormalities.
A nurse assesses a client with schizophrenia who reports hearing voices and believing others are plotting against them. Select the correct condition, two nursing actions, and two parameters to monitor.
Type of symptom: Positive, Negative, Cognitive, Affective
Nursing Actions: Reinforce reality using calm communication, Assess hallucination content, Ensure patient safety
Parameters to monitor: Command hallucinations, Ability to perform abstract thinking, Level of paranoia
Condition:
✔ Positive symptoms of schizophrenia
Actions:
✔ Assess hallucination content
✔ Ensure patient safety
Parameters to monitor:
✔ Command hallucinations
✔ Level of paranoia
A patient with schizophrenia reports hearing voices that say they are worthless.
Place the nursing interventions in the correct order.
Reinforce reality
Encourage distraction techniques
Assess what the voices are saying
Determine if voices are commanding harm
1 → Assess what the voices are saying
2 → Determine if voices are commanding harm (safety risk!!)
3 → Reinforce reality
4 → Teach coping strategies & distraction techniques
A patient with schizophrenia is taking an antipsychotic medication. The nurse observes high fever, muscle rigidity, altered mental status, and autonomic instability. The nurse suspects Neuroleptic Malignant Syndrome (NMS).
Which nursing actions should the nurse take?
Select all that apply.
A. Stop the antipsychotic medication and notify the provider
B. Initiate cooling measures for hyperthermia
C. Monitor vital signs frequently
D. Administer PRN antipsychotic medication
E. Prepare to administer medications such as dantrolene or bromocriptine
A. Stop the antipsychotic medication and notify the provider
B. Initiate cooling measures for hyperthermia
C. Monitor vital signs frequently
E. Prepare to administer medications such as dantrolene or bromocriptine
A nurse is providing discharge education to a patient with schizophrenia.
Which teaching points are appropriate? Which teaching points are inappropriate?
- Avoid alcohol and drugs
- Stop medication when symptoms improve
- Maintain sleep and stress management
- Participate in therapy and support groups
Appropriate:
- Avoid alcohol and drugs
- Maintain sleep and stress management
- Participate in therapy and support groups
Inappropriate:
- Stop medication when symptoms improve