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):
- Impaired Verbal Communication
- Impaired Social Interaction
- Disturbed Sensory Perception: Auditory/Visual
- Disturbed Thought Process
- Defensive Coping
- Interrupted Family Process
Disturbed Thought Process
Disturbed thought process as a nursing diagnosis for schizophrenia. Patients usually exhibit disturbed perception and delusions that greatly affect their thought process.
Disturbed Thought Process
Here are the common related factors for disturbed thought process that can be as your “related to” in your schizophrenia nursing diagnosis statement:
- Chemical alterations (e.g., medications, electrolyte imbalances).
- Inadequate support systems.
- Overwhelming stressful life events.
- Possibility of a hereditary factor.
- Panic level of anxiety.
- Repressed fears.
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:
- Inaccurate interpretation of environment
- Inappropriate non-reality-based thinking
- Memory deficit/problems
Expected outcomes or patient goals for disturbed thought process nursing diagnosis:
- Patient will verbalize recognition of delusional thoughts if they persist.
- Patient will perceive the environment correctly.
- Patient will demonstrate satisfying relationships with real people.
- Patient will demonstrate decrease anxiety level.
- Patient will refrain from acting on delusional thinking.
- Patient will develop trust in at least one staff member within 1 week.
- Patient will sustain attention and concentration to complete task or activities.
- Patient will state that the “thoughts” are less intense and less frequent with the help of the medications and nursing interventions.
- Patient will talk about concrete happenings in the environment without talking about delusions for 5 minutes.
- Patient will demonstrate two effective coping skills that minimize delusional thoughts.
- Patient will be free from delusions or demonstrate the ability to function without responding to persistent delusional thoughts.
Nursing Interventions and Rationale
In this section are the nursing actions or interventions and their rationale or scientific explanation for the disturbed thought process (nursing diagnosis for schizophrenia):
|Attempt to understand the significance of these beliefs to the client at the time of their presentation.||Important clues to underlying fears and issues can be found in the client’s seemingly illogical fantasies.|
|Recognizes the client’s delusions as the client’s perception of the environment.||Recognizing the client’s perception can help you understand the feelings he or she is experiencing.|
|Identify feelings related to delusions. For example:
||When people believe that they are understood, anxiety might lessen.|
|Explain the procedures and try to be sure the client understand the procedures before carrying them out.||When the client has full knowledge of procedures, he or she is less likely to feel tricked by the staff.|
|Interact with clients on the basis of things in the environment. Try to distract client from their delusions by engaging in reality-based activities (e.g., card games, simple arts and crafts projects etc).||When thinking is focused on reality-based activities, the client is free of delusional thinking during that time. Helps focus attention externally.|
|Do not touch the client; use gestures carefully.||Suspicious clients might misinterpret touch as either aggressive or sexual in nature and might interpret it as threatening gesture. People who are psychotic need a lot of personal space.|
|Initially do not argue with the client’s beliefs or try to convince the client that the delusions are false and unreal.||Arguing will only increase client’s defensive position, thereby reinforcing false beliefs. This will result in the client feeling even more isolated and misunderstood.|
|Encourage healthy habits to optimize functioning:
||All are vital to help keep the client in remission.|
|Show empathy regarding the client’s feelings; reassure the client of your presence and acceptance.||The client’s delusion can be distressing. Empathy conveys your caring, interest and acceptance of the client.|
|Teach client coping skills that minimize “worrying” thoughts. Coping skills include:
||When client is ready, teach strategies client can do alone.|
|Utilize safety measures to protect clients or others, if the client believe they need to protect themselves against a specific person. Precautions are needed.||During acute phase, client’s delusional thinking might dictate to them that they might have to hurt others or self in order to be safe. External controls might be needed.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans for mental health and psychiatric nursing:
- Alcohol Withdrawal | 5 Care Plans
- Anxiety and Panic Disorders | 7 Care Plans
- Bipolar Disorders | 6 Care Plans
- Major Depression | 9 Care Plans
- Personality Disorders | 4 Care Plans
- Schizophrenia | 6 Care Plans
- Sexual Assault | 1 Care Plan
- Substance Dependence and Abuse | 8 Care Plans
- Suicide Behaviors | 3 Care Plans
References and Sources
Here are references and sources for schizophrenia: