Schizophrenia Spectrum Disorders

Overview

Schizophrenia spectrum disorders are characterized by psychosis, where the patient loses touch with reality. Symptoms are categorized as positive (excesses like hallucinations) or negative (deficits like social withdrawal). Nursing management focuses on symptom stabilization using antipsychotics and ensuring safety during acute psychotic episodes.

Key nursing concepts

• Schizophrenia involves disturbances in thought, perception, and behavior.
• Positive symptoms include hallucinations, delusions, and disorganized speech.
• Negative symptoms include flat affect, social withdrawal, and lack of motivation.
• Typical antipsychotics primarily target positive symptoms.
• Atypical antipsychotics treat both positive and negative symptoms with fewer EPS.
• Safety is paramount when a patient is experiencing command hallucinations.

Important nursing considerations

• Administer antipsychotics as ordered and monitor for efficacy.
• Assess for extrapyramidal symptoms (EPS) and tardive dyskinesia.
• Observe for Neuroleptic Malignant Syndrome (NMS): high fever and rigidity.
• Do not argue with or challenge the patient's delusions.
• Provide a reality-based perspective without dismissing the patient's experience.
• Monitor for commands in auditory hallucinations that may direct harm.

Patient teaching

• Explain the importance of medication adherence to prevent relapse.
• Teach the patient to report sore throat or fever if taking Clozapine.
• Instruct the patient on techniques to manage "voices," like listening to music.

Related practice questions

Real questions from the NursGuru bank, each with the answer and rationale.

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