Patho/Etiology
There is a single treatment to cure schizophrenia...True or False?
False! Effective treatment requires a comprehensive multidisciplinary effort, including pharmotherapy and various forms of pyschosocial care. (Varcarolis, 2023)
Name a positive symptom seen in schizophrenia
hallucinations, delusions, bizare behavior or speech alternations
(Varcarolis, 2023)
Name a second generation (atypical) antipsychotic medication used in schizophrenia
Risperdone, clozapine, aripiprazole, olazapine, etc..
(Unbound: Davis's Drug Guide)
Name a nursing diagnosis for someone suffering from schizophrenia
Disturbed sensory perceptions, social isolation, risk for violence, impaired communication, ineffective health maintenance, disturbed thought process, etc
(Varcarolis, 2023)
Match this intervention to a nursing diagnosis: "Encourage independence in ADLs, but intervene as needed. Offer recognition and positive reinforcement of patient after accomplishing ADLs"
Nursing diagnosis: Self-care deficit- psychotic disorders often interfere with self care!
The intervention of encouraging independence in ADLs (Activities of Daily Living) and offering recognition and positive reinforcement aligns with the nursing diagnosis of:
Self-care deficit: Bathing, Dressing, Toileting, Feeding, and Grooming.
According to Varcarolis, this nursing diagnosis applies when a patient experiences difficulty performing activities of daily living independently due to a variety of reasons such as physical, cognitive, or emotional impairments.
Symptoms of schizophrenia often present at what stage or period of life?
symptoms generally appears in late adolescence and early adulthood HOWEVER they may appear later in life. Some studies indicate schizophrenia presents earlier in men! (Varcarolis, 2023)
Name a negative symptom seen in schizophrenia
affect, energy, anhedonia, avolition (lack of motivation), (alogia) lack of speech
These are harder symptoms to treat!
(Varcarolis, 2023)
Haldol, a first generation antipsychotic can cause a life- threatening syndrome as a adverse effect. What is the name of this syndrome? hint: NMS
Neuroleptic Malignant Syndrome is an idiosyncratic reaction causing irregular pulse, tachycardia, tachypnea, muscle rigidity, altered mental status, autonomic nervous system dysfunction resulting in high or low blood pressure..this is life threatening!
(Unbound: Davis's Drug Guide)
True or False: While caring for a patient living with schizophrenia and A/VH the nurse should go along with delusions and agree so they don't anger the patient.
False Providing reality-based interventions and establishing trusting communication is key. The nurse should avoid confrontation but also avoid supporting or reinforcing the delusion. Instead, the focus should be on helping the patient understand and cope with their symptoms while promoting a safe and supportive environment. (Giddens, 2025)
Discharge planning starts as soon as the patient is admitted. What are some support services a schizophrenic patient may require on discharge?
Discharge planning for a schizophrenic patient involves ensuring that the patient has access to comprehensive mental health support, community resources, and family involvement to promote recovery, maintain stability, and reduce the risk of relapse. (Giddens, 2025)
The ___________ hypothesis suggests schizophrenia may be caused by excess of what neurotransmitter?
Excess of dopamine! Antipsychotics lower brain levels of dopamine by blocking dopamine receptors. Postmortem studies show a significiant increase of dopamine receptors in 2/3 of schizophrenia patients. However, dysregulation in other neurotransmitters play a role in the etiology. (Varcarolis, 2023)
Alterations in thought (delusions) are common in schizophrenia. Define Grandeur.
The false belief that one is one is a very powerful and important person, having special abilities, or possessing great wealth or beauty.
(Varcarolis, 2023)
Second generation antipsychotics are currently the drug of choice for psychotic disorders. Name a side effect of second generation antipsychotics.
weight gain, sedation, sexual dysfunction, GI disturbance, headaches, anticholengeric effects (tachycardia, insomnia, dry mouth, constipation)(Unbound: Davis's Drug Guide)
During the RN's assessment the patient reports hearing voices that are stating "kill all of the doctors". What is the priority while caring for this patient?
According to Giddens, 4th edition, when a patient expresses violent or threatening hallucinations, safety is the top priority. The nurse should promptly assess the level of risk for harm to self or others, maintain a calm and non-confrontational approach, and implement appropriate interventions.
Your have established a nursing goal of "Disturbed Thought Process" for your patient with schizophrenia. Name two possible interventions for this diagnosis.
For the nursing diagnosis of Disturbed Thought Process in a patient with schizophrenia, Giddens, 4th edition, suggests that interventions should focus on addressing the patient's distorted thinking and promoting clear and logical thought processes:
Establish Trust and Provide a Calm Environment
Encourage Structured Activities
Monitor Medication Adherence
Provide Cognitive Behavioral Therapy (CBT)
Involve Family and Support Systems
Name one environmental and one physical risk factor for psychosis
environmental: living in a city, lower social class, using drugs (cannabis and cocaine especially), stress
physical: genetics, viruses (autoimmune), CNS diseases, intrauterine (Varcarolis, 2023)
Name this speech alteration: words jumbled together with little meaning or significance to listener (ex: hip hooray the flip is cast)
Word salad. Other alterations in speech are clang association, echolalia, neologisms and associative looseness
(Varcarolis, 2023)
EPS is another side effect of first generation/ typical antipsychotics. What would the RN monitor if they suspected EPS?
dystonia, akathisia, tardive dyskinesia and pseudoparkinsonism
(Unbound: Davis's Drug Guide)
What are two things patients should avoid consuming/buying while taking antipsychotic medications?
Alcohol and OTC medication can interact with antipsychotics. Alcohol should be avoiding completely. OTC medications should be approved by PCP (many interact with antipsychotics and can be harmful)
(Unbound: Davis's Drug Guide)
The nurse is caring for a client with medication induced psychosis when the spouse asks "what medications cause psychosis?". What are some examples the nurse could tell the family?
Parkinsons drugs, anesthesia, opioids, steroids, muscle relaxers, antihistamines, etc. Psych meds like anticonvulsants and antidepressants can also raise dopamine and cause psychosis
(Unbound: Davis's Drug Guide)
Name a disease that could cause psychosis or psychotic symptoms
brain disease (encephalopathy, migraines, epilepsy) F&E imbalances, Herpes, syphilis, CNS infection/trauma, Lupus, Deafness, Cushings/Huntington's, hypo/hyperthyroidism, substance use disorder, vitamin deficiencies, etc
(Varcarolis, 2023)
State the difference between auditory hallucinations and command hallucinations
Auditory hallucinations are "Hearing voices or sounds that do not exist in the environment but are thought to be projections of inner thoughts or feeling". Command hallucinations, "refer to hearing a voice that 'commands' the person to do something".
(Varcarolis, 2023)
Name two other medications a patient with schizophrenia may be prescribed to treat their symptoms?
antidepressants (depression), mood stablizing agents (positive/negative symptoms), benzodiazipines (anxiety) or third generation antipsychotics (positive/negative symptoms)
(Varcarolis, 2023)
Why is pregnancy planning/teaching important to a patient taking antipsychotics?
According to Giddens, 4th edition, certain antipsychotic medications, particularly first-generation antipsychotics (e.g., haloperidol) and some second-generation antipsychotics (e.g., risperidone), have been associated with teratogenic effects (harmful effects on the developing fetus) and can alter fetal development.
A client with schizophrenia has physician’s orders for haloperidol (Haldol) 5 mg. IM STAT and then 1 mg benztropine prn. Why is benztropine ordered?
to prevent and treat Extrapyramidal Symptoms (EPS) like restlessness (akathisia), trouble moving (akinesia), muscle spasms (dystonia), tardive dyskinesia and pseudoparkinsons
(Unbound: Davis's Drug Guide)