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 Thought Process

Disturbed thought process as a nursing diagnosis for schizophrenia. Patients usually exhibit disturbed perception and delusions that greatly affect their thought process.

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Nursing diagnosis

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.

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:

  • Delusions
  • Inaccurate interpretation of environment
  • Inappropriate non-reality-based thinking
  • Memory deficit/problems
  • Self-centeredness

Desired Outcomes

Expected outcomes or patient goals for disturbed thought process nursing diagnosis:

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  • 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):

Nursing InterventionsRationale
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:

  • If client believes someone is going to harm him/her, client is experiencing fear.
  • If client believes someone or something is controlling his/her thoughts, client is experiencing helplessness.
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:

  • Maintain medication regimen.
  • Maintain regular sleep pattern.
  • Maintain self-care.
  • Reduce alcohol and drug intake.
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:

  • Going to a gym.
  • Phoning a helpline.
  • Singing or Listening to a song.
  • Talking to a trusted friend.
  • Thought-stopping techniques.
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.
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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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