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
This nursing diagnosis is chosen related to the perceived lack of self-efficacy, perceived threat to self, and suspicious motives of others. This is characterized by a difficulty in reality testing of perceptions, difficulty maintaining relationships, hostility, and aggression.
- Defensive Coping
Here are the common related factors for defensive coping that can be a, your “related to” in your schizophrenia nursing diagnosis statement:
- Perceived lack of self-efficacy/vulnerability
- Perceived threat to self
- Suspicions of the motives of others
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:
- Denial of obvious problems
- Difficulty in reality testing of perceptions
- Difficulty establishing/maintaining relationships
- False beliefs about the intention of others.
- Hostile laughter or ridicule of others
- Hostility, aggression, or homicidal ideation
- Projection of blame/responsibility
- Rationalization of failures
- Superior attitude towards others
Expected outcomes or patient goals for defensive coping nursing diagnosis:
- Patient will avoid high-risk environments and situations.
- Patient will interact with others appropriately.
- Patient will maintain medical compliance.
- Patient will identify one action that helps client feel more in control of his or her life.
- Patient will demonstrate two newly learned constructive ways to deal with stress and feeling of powerlessness.
- Patient will demonstrate learn the ability to remove himself or herself from situations when anxiety begins to increase with the aid of medications and nursing interventions.
- Patient will demonstrate decreased suspicious behaviors regarding with the interaction with others.
- Patient will be able to apply a variety of stress/anxiety-reducing techniques on their own.
- Patient will acknowledge that medications will lower suspiciousness.
- Patient will state that he/she feels safe and more in control with interactions with environment/family/work/social gatherings.
Nursing Interventions and Rationale
In this section are the nursing actions or interventions and their rationale or scientific explanation for defensive coping (nursing diagnosis for schizophrenia):
|Explain to client what you are going to do before you do it.||Prepares the client beforehand and minimizes misinterpreting your intent as hostile or aggressive.|
|Assess and observe clients regularly for signs of increasing anxiety and hostility.||Intervene before client loses control.|
|Use a nonjudgemental, respectful, and neutral approach with the client.||There is less chance for a suspicious client to misinterpret intent or meaning if content is neutral and approach is respectful and non-judgemental.|
|Use clear and simple language when communicating with a suspicious client.||Minimize the opportunity for miscommunication and misconstruing the meaning of the message.|
|Diffuse angry verbal attacks with a non defensive stand.||When staff become defensive, anger escalates for both client and staff. a non-defensive and non-judgemental attitude provides an atmosphere in which feelings can be explored more easily.|
|Set limits in a clear matter-of-fact way, using a calm tone. Giving threatening remarks to Jeremy is unacceptable. We can talk more about the proper ways in dealing with your feelings.||Calm and neutral approach may diffuse escalation of anger. Offer an alternative to verbal abuse by finding appropriate ways to deal with feelings.|
|Be honest and consistent with client regarding expectations and enforcing rules.||Suspicious people are quick to discern honesty. Honesty and consistency provide an atmosphere in which trust can grow.|
|Maintain low level of stimuli and enhance a non-threatening environment (avoid groups).||Noisy environments might be perceived as threatening.|
|Be aware of client’s tendency to have ideas of reference; do not do things in front of client that can be misinterpreted:
||Suspicious clients will automatically think that they are the target of the interaction and interpret it in a negative manner (e.g., you are laughing or whispering about them).|
|Initially, provide solitary, noncompetitive activities that take some concentration. Later a game with one or more client that takes concentration (e.g., chess checkers, thoughtful card games such as ridge or rummy).||If a client is suspicious of others, solitary activities are the best. Concentrating on environmental stimuli minimizes paranoid rumination.|
|Provide verbal/physical limits when client’s hostile behavior escalates: We cannot allow you to verbally attack someone here. If you cant held/control yourself, we are here in order to help you.||Often verbal limits are effective in helping a client gain self control.|
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: