6 Schizophrenia Nursing Care Plans

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In this guide are nursing care plans for schizophrenia including six nursing diagnosis. Nursing care plan goals for schizophrenia involves recognizing schizophrenia, establishing trust and rapport, maximizing the level of functioning, assessing positive and negative symptoms, assessing medical history and evaluating support system.

Schizophrenia refers to a group of severe, disabling psychiatric disorders marked by withdrawal from reality, illogical thinking, possible delusions and hallucinations, and emotional, behavioral, or intellectual disturbance.

The most common early warning signs of schizophrenia are usually detected until adolescence. These include depression, social withdrawal, unable to concentrate, hostility or suspiciousness, poor expressions of emotions, insomnia, lack of personal hygiene, or odd beliefs.

Nursing Care Plans

Here are six (6) nursing diagnosis for schizophrenia that you can use for your nursing care plan (NCP):

  1. Impaired Verbal Communication
  2. Impaired Social Interaction
  3. Disturbed Sensory Perception: Auditory/Visual
  4. Disturbed Thought Process
  5. Defensive Coping
  6. Interrupted Family Process
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Disturbed Sensory Perception: Auditory/Visual

This nursing diagnosis is chosen related to altered sensory perception experienced by the patient. Auditory and visual hallucinations are the most common in schizophrenia.

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Nursing Diagnosis

Disturbed Sensory Perception

Here are the common related factors for disturbed sensory perception that can be as your “related to” in your schizophrenia nursing diagnosis statement:

  • Altered sensory perception.
  • Altered sensory reception; transmission or integration.
  • Biochemical factors such as manifested by inability to concentrate.
  • Chemical alterations (e.g., medications, electrolyte imbalances).
  • Neurologic/biochemical changes.
  • Psychologic stress.

Defining Characteristics

The commonly used subjective and objective data or nursing assessment cues (signs and symptoms) that could serve as your “as evidenced by” for this nursing care plan for schizophrenia:

  • Altered communication pattern.
  • Auditory distortions.
  • Change in a problem-solving pattern.
  • Disorientation to person/place/time.
  • Frequent blinking of the eyes and grimacing.
  • Hallucinations.
  • Inappropriate responses.
  • Mumbling to self, talking or laughing to self.
  • Reported or measured change in sensory acuity.
  • Tilting the head as if listening to someone.

Desired Outcomes

Expected outcomes or patient goals for disturbed sensory perception nursing diagnosis:

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  • Patient will learn ways to refrain from responding to hallucinations.
  • Patient will state three symptoms they recognize when their stress levels are high.
  • Patient will state that the voices are no longer threatening, nor do they interfere with his or her life.
  • Patient will state, using a scale from 1 to 10, that “the voices” are less frequent and threatening when aided by medication and nursing intervention.
  • Patient will maintain role performance.
  • Patient will maintain social relationships.
  • Patient will monitor intensity of anxiety.
  • Patient will identify two stressful events that trigger hallucinations..
  • Patient will identify to personal interventions that decrease or lower the intensity or frequency of hallucinations (e.g, listening to music, wearing headphones, reading out loud, jogging, socializing).
  • Patient will demonstrate one stress reduction technique.
  • Patient will demonstrate techniques that help distract him or her from the voices.

Nursing Interventions and Rationale

In this section are the nursing actions or interventions and their rationale or scientific explanation for the disturbed sensory perception (nursing diagnosis for schizophrenia):

Nursing InterventionsRationale
Accept the fact that the voices are real to the client, but explain that you do not hear the voices. Refer to the voices as “your voices” or “voices that you hear”.Validating that your reality does not include voices can help client cast “doubt” on the validity of his or her voices.
Be alert for signs of increasing fear, anxiety or agitation.Might herald hallucinatory activity, which can be very frightening to client, and client might act upon command hallucinations (harm self or others).
Explore how the hallucinations are experienced by the client.Exploring the hallucinations and sharing the experience can help give the person a sense of power that he or she might be able to manage the hallucinatory voices.
Help the client to identify the needs that might underlie the hallucination. What other ways can these needs be met?Hallucinations might reflect needs for anger, power, self-esteem, and sexuality.
Help client to identify times that the hallucinations are most prevalent and frightening.Helps both nurse and client identify situations and times that might be most anxiety-producing and threatening to the client.
If voices are telling the client to harm self or others, take necessary environmental precautions.

  • Notify others and police, physician, and administration according to unit protocol.
  • If in the hospital, use unit protocols for suicidal or threats of violence if client plans to act on commands.
  • If in the community, evaluate the  need for hospitalization.

Clearly, document what the client says and if he/she is a threat to others, document who was contacted and notified (use agency protocol as a guide).

People often obey hallucinatory commands to kill self or others. Early assessment and intervention might save lives.
Stay with clients when they are starting to hallucinate, and direct them to tell the “voices they hear” to go away. Repeat often in a matter-of-fact manner.The client can sometimes learn to push voices aside when given repeated instructions. especially within the framework of a trusting relationship.
Decrease environmental stimuli when possible (low noise, minimal activity).Decrease the potential for anxiety that might trigger hallucinations. Helps calm client.
Intervene with one-on-one, seclusion, or PRN medication (As ordered) when appropriate.Intervene before anxiety begins to escalate. If the client is already out of control, use chemical or physical restraints following unit protocols.
Keep to simple, basic, reality-based topics of conversation. Help the client focus on one idea at a time.Client’ thinking might be confused and disorganized; this intervention helps the client focus and comprehend reality-based issues.
Work with the client to find which activities help reduce anxiety and distract the client from a hallucinatory material. Practice new skills with the client.If clients’ stress triggers hallucinatory activity, they might be more motivated to find ways to remove themselves from a stressful environment or try distraction techniques.
Engage client in reality-based activities such as card playing, writing, drawing, doing simple arts and crafts or listening to music.Redirecting the client’s energies to acceptable activities can decrease the possibility of acting on hallucinations and help distract from voices.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

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Other care plans for mental health and psychiatric nursing:

References and Sources

Here are references and sources for schizophrenia:

  • Bartels, S. J., Mueser, K. T., & Miles, K. M. (1997). A comparative study of elderly patients with schizophrenia and bipolar disorder in nursing homes and the community. Schizophrenia Research27(2-3), 181-190. [Link]
Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
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