Schizophrenia: Causes, Signs And Symptoms, Risk Factors, Treatment Options, And Nursing Considerations.

By Peter Jumba

 Schizophrenia: Causes, Signs And Symptoms, Risk Factors, Treatment Options, And Nursing Considerations.

Source: Google Images 

Schizophrenia is a severe and chronic mental illness that alters how a person thinks, feels, and behaves. It is characterized by a "break" with reality, or psychosis, which can be distressing for both the individual and their loved ones. With consistent, lifelong treatment, however, most symptoms can be managed effectively. 

Signs and Symptoms of Schizophrenia


Symptoms:

Symptoms of schizophrenia usually appear between the late teens and mid-30s and are categorized into positive, negative, and cognitive symptoms. 

Positive symptoms

These are psychotic behaviors not seen in healthy people. 

  • Hallucinations: Experiencing sensations that aren't real, such as hearing voices (most common), seeing things, or feeling phantom touches.


  • Delusions: Strong, fixed false beliefs, such as the idea that one is being harassed or is a person of great fame.



  • Disorganized or abnormal motor behavior: Movement that is not goal-directed, ranging from childlike silliness to catatonia (lack of movement or responsiveness). 


Negative symptoms

These refer to a decrease in normal behaviors and emotions. 

  • Reduced emotion: Lack of emotional expression, speaking in a flat tone, or poor eye contact.


  • Avolition: Decreased motivation to engage in purposeful, self-directed activities.


  • Social withdrawal: Avoiding social interaction and a reduced interest in everyday activities.


  • Poverty of speech (alogia): Speaking less than usual. 


Cognitive symptoms

These affect thinking and can interfere with day-to-day life. 

  • Difficulty with attention, concentration, and memory.



  • A lack of insight into one's own illness, making treatment more challenging. 


Causes and risk factors:

The exact cause of schizophrenia is not known, but research suggests a combination of factors may contribute to the condition. 

  • Genetics: Schizophrenia often runs in families. While no single gene is responsible, a combination of genetic factors can increase a person's vulnerability.



  • Brain development: Differences in brain structure and tissues during brain development before birth have been observed in people with schizophrenia.


  • Environmental factors: Stressful life events, exposure to viruses, complications during pregnancy and birth, and childhood trauma have been linked to a higher risk of developing schizophrenia.


  • Drug use: The use of certain psychoactive drugs, particularly strong cannabis, during teenage and young adult years is associated with an increased risk, though it is unclear if it directly causes the illness. 


Diagnosis

There is no single medical or psychological test for schizophrenia. A diagnosis is made by a mental health professional, such as a psychiatrist, who will conduct a mental health evaluation and rule out other potential causes. 

  • Diagnostic criteria: The evaluation checks for the presence of at least two of the primary symptoms (delusions, hallucinations, disorganized speech) for at least one month, with continuous signs of disturbance for at least six months.


  • Rule out other conditions: A physical exam and other tests, such as blood work or a brain scan (MRI or CT), may be used to exclude other issues that could cause similar symptoms, including other mental health disorders, substance use, or medical conditions. 


Treatment:

While there is no cure, a personalized treatment plan can help manage symptoms and improve quality of life. A multidisciplinary team often provides care, which can include a psychiatrist, therapist, social worker, and case manager. 

Medication:

  • Antipsychotics: These are the primary medications used to manage symptoms, particularly positive symptoms like hallucinations and delusions. They are thought to work by affecting neurotransmitters in the brain.



  • Other medications: Antidepressants or mood stabilizers may be used alongside antipsychotics. 


Psychosocial interventions

  • Psychotherapy: Individual therapy, such as cognitive-behavioral therapy (CBT), can help individuals cope with their symptoms.


  • Family therapy: This helps the family learn about schizophrenia and develop better coping strategies.




Other treatments:

  • Hospitalization: During a crisis or times of severe symptoms, a short hospital stay may be necessary to ensure the person's safety.


  • Electroconvulsive therapy (ECT): In adults with treatment-resistant schizophrenia, ECT may be considered. 


Schizophrenia Nursing Care and Management:

Nurses play a vital, multifaceted role in managing the complex needs of individuals with schizophrenia. Care considers a patient's symptoms, safety risks, and overall well-being, focusing on building trust and promoting the highest possible level of functioning. 

Key nursing considerations

Safety and stabilization

During acute episodes of psychosis, a patient's priority is safety. Nurses are responsible for creating a safe and low-stimulus environment to prevent self-harm or harm to others. 

  • Constant assessment: Nurses must continuously assess for suicidal or homicidal ideations, especially if the patient is experiencing command hallucinations.


  • Risk mitigation: Take precautions by removing potentially harmful objects from the patient's environment.


  • De-escalation: Use calm, straightforward communication to de-escalate agitation. Physical or chemical restraints are a last resort and must be used according to hospital protocol.


  • Reduce stimuli: Decrease environmental overstimulation, which can worsen hallucinations. 


Therapeutic relationship and communication:

  • Establishing rapport and trust is fundamental, as many patients with schizophrenia experience paranoia and mistrust. 


  • Consistent approach: Use a consistent, accepting approach and maintain consistency in assigned staff whenever possible to provide a sense of stability.


  • Honest communication: Communicate in a clear, sincere, and honest manner. Avoid vague or evasive remarks and do not make promises you cannot keep.


  • Empathy and validation: Acknowledge the patient's feelings and reassure them of your acceptance. You can validate their feelings without validating their delusions or hallucinations.


  • Reality orientation: Gently remind the patient of reality without arguing about their delusions or sensory experiences. For example, say, "I understand that the voices are real to you, but I do not hear them". 


Medication management:

  • Ensuring medication adherence is a core nursing responsibility, as it is crucial for preventing symptom relapse. 


  • Administer medication: Ensure patients take their prescribed antipsychotic medications. Nurses may observe the patient taking their medication to ensure adherence.


  • Monitor side effects: Systematically monitor patients for adverse effects, including metabolic issues (weight gain, diabetes) and movement disorders (e.g., tardive dyskinesia), using tools like the Abnormal Involuntary Movement Scale (AIMS).


  • Patient education: Provide comprehensive education to patients and families on the purpose, benefits, risks, and potential side effects of medications.


  • Promote follow-through: Work with the patient to identify and address obstacles to medication adherence, such as unpleasant side effects or difficulty affording medications. 


Psychosocial and functional support

Nurses provide essential support to help patients regain skills and function effectively within the community. 

  • Daily living assistance: Help patients with basic hygiene and daily living activities. Use concise and simple instructions, and praise their efforts.


  • Social skills training: Encourage participation in structured, non-threatening group activities to help improve social interactions. Start with one-on-one interactions and gradually expand to small groups.


  • Coping strategies: Teach coping mechanisms for managing symptoms. This can include distraction techniques like listening to music, exercise, or journaling.


  • Family involvement: Educate the family on schizophrenia and empower them to recognize signs of impending relapse. Involve them in the patient's care plan to foster a supportive home environment.


  • Healthy habits: Promote healthy lifestyle choices, including diet, exercise, and avoiding substance use, which is a common comorbidity. 


Evaluation and collaboration:

Effective nursing care includes continuous evaluation of the patient's progress and collaboration with other healthcare professionals. 

  • Evaluate outcomes: Regularly assess the patient's mental status, functional level, and adherence to the treatment plan. Adjust interventions as needed.


  • Interdisciplinary team: Collaborate with the patient's multidisciplinary care team, which may include psychiatrists, social workers, and therapists, to ensure a holistic approach to recovery. 

This is for informational purposes only. For medical advice or a diagnosis, consult a professional.



Comments

Post a Comment

Popular posts from this blog

The Ultimate Guide to the Liver and Pancreas: Comparing Anatomy and Vital Functions.

By Peter Jumba
Image
 The Ultimate Guide to the Liver and Pancreas: Comparing Anatomy and Vital Functions. This image illustrates the accessory organs of the digestive system in the upper abdomen of a human body, specifically highlighting the: Liver Gallbladder Pancreas It shows their relative positions to each other and surrounding digestive structures ( intestines ) The liver and pancreas are both essential organs located in the upper abdomen that play key roles in digestion and metabolism , but they have distinct functions, locations, and structures. The liver primarily produces bile and processes nutrients, while the pancreas produces digestive enzymes and hormones like insulin .  Key Differences and Comparisons: Feature Liver Pancreas. Location:  Upper right abdomen, below the diaphragm. Behind the stomach, in the C- shaped curve of the duodenum. Size/Shape:  The largest internal organ, wedge-shaped. A smaller, long, flat, pear-shaped gland (about 6 inches). Primary Secretion (E...
Let's go

The Silent Heroes: What You Need to Know About Your Kidneys Right Now.

By Peter Jumba
Image
The Silent Heroes: What You Need to Know About Your Kidneys Right Now. A diagram illustrating the anatomy of the human urinary system. The image shows the two bean-shaped Kidneys located toward the back of the abdomen. Leading down from each kidney is a tube called the Ureter , which carries urine to the central Bladder . The bladder is situated in the lower pelvis, and below it, the Urethra is shown as the tube through which urine exits the body. The human body is an engineering marvel, and its purification system—your two fist-sized kidneys—are the unsung heroes working 24/7. Their primary function is a life-or-death job: filtering your blood, removing toxic waste products, balancing fluids, and regulating vital minerals. In an era of increased awareness and new medical breakthroughs, people are asking more questions than ever ab...
Let's go

BP Measurements: Easy Step-by-Step Guide for Learner Nurses.

By Peter Jumba
Image
BP Measurements: Easy Step-by-Step Guide for Learner Nurses. Struggling with BP measurements ? This easy-to-follow guide breaks down blood pressure technique into simple steps for learner nurses . Master the skill and boost your confidence now! Mastering Manual Blood Pressure: A Definitive Step-by-Step Guide for Learner Nurses. Accurate vital sign measurement is the bedrock of clinical practice . For learner nurses, mastering the manual auscultatory blood pressure (BP) technique is essential, as it often serves as the most accurate method for assessing cardiovascular status . This guide breaks down the process into four clear stages, ensuring accuracy and confidence every time. Part 1: Preparation and Patient Readiness. Before even touching the equipment, proper setup is crucial. Errors at this stage are the most common cause of inaccurate readings. Step Action Clinical Rationale (Expand). ...
Let's go

The Basics of First Aid: Essential Skills for Emergency Response.

By Peter Jumba
Image
The Basics of First Aid: Essential Skills for Emergency Response. Everyone should know basic first aid. This comprehensive lecture covers essential life-saving techniques, emergency procedures, and how to act quickly when it matters most. Start learning today. Mastering First Aid Basics: Slide 1: What is First Aid? Definition:  First aid is immediate care given to a person who is injured or ill to preserve life, prevent the condition from worsening, or promote recovery until professional medical help arrives. Goal: Your primary objective is to preserve life, prevent further injury, and promote recovery. Importance: First aid is a vital skill that everyone must learn; you have the power to make a significant difference in any emergency. Slide 2: Key Principles of First Aid Safety First: Always prioritize your safety, as well as that of the injured person and onlookers. Identify and eliminate any potential hazards. A...
Let's go

Cancer in Women: Early Detection, Screening, and Awareness.

By Peter Jumba
Image
Cancer in Women: Early Detection, Screening, and Awareness. Stay informed about the cancers that commonly affect women. Learn about critical early detection methods, essential screening guidelines, and what you need to know for prevention and peace of mind. Introduction: Hey there! Let's talk about an important topic— cancer . It's a group of diseases where abnormal cells grow and spread uncontrollably in the body. While cancer can impact anyone, women are particularly at risk for certain types. Common Types of Cancer in Women. 1. Breast Cancer: This is the most common cancer for women around the world. It typically starts in the breast tissue , especially in the ducts or lobules . 2. Cervical Cancer: This type begins in the cervix , the low...
Let's go

Master Critical Thinking in Nursing: A Beginner's Guide.

By Peter Jumba
Image
Master Critical Thinking in Nursing: A Beginner's Guide .  Learn the 11 key steps to critical thinking in nursing, from patient observation to sound clinical judgment. Build the confidence to deliver safe, effective care. Critical thinking in general nursing refers to the ability of nurses to actively and skillfully analyze, interpret, evaluate, and synthesize information to make sound clinical judgments and provide safe and effective patient care. This process goes beyond simply following protocols; it involves a thoughtful and reasoned approach to problem-solving and decision-making.  Key Aspects of Critical Thinking in Nursing: 1. Observation:  Paying close attention to both verbal and nonverbal patient cues and recognizing changes in their condition.    2. Interpretation:  Understanding the meaning of assessment data , lab results , and other relevant i...
Let's go

Medication Management for Learner Nurses: 8 Essential Pillars.

By Peter Jumba
Image
 Medication Management for Learner Nurses: 8 Essential Pillars. source: Google Images  Master the 8 core principles of medication administration, including pharmacokinetics, dosage calculations, and the Rights of Administration. Essential reading for Learner Nurses. As a Learner Nurse, your journey into patient care is exciting, and few responsibilities are as critical as medication administration. It's more than just following a doctor's order; it's about truly understanding the science behind the medications we administer, and acting as knowledgeable advocates for our patients. Mastering medication management is a cornerstone of competent nursing practice. To do this effectively, you must understand eight key pillars. Eight Essential Pillars of Medication Knowledge 1. Pharmacokinetics: What the Body Does to the Drug This refers to how the body absorbs, distributes, metabolizes, and excretes drugs (ADME). Understanding pharmacokinetics helps you predict how a medication w...
Let's go

Mastering Patient Care: Holistic Skills for Nurses.

By Peter Jumba
Image
Mastering Patient Care: Holistic Skills for Nurses. Source: Google Images   Elevate your nursing practice! Discover the foundations of patient-centered care, essential communication skills, ethical principles (Autonomy, Justice), and teamwork needed for compassionate, quality care.  Understanding Patient Care : A Guide for Nurses and Healthcare Professionals" is a comprehensive topic that encompasses a variety of principles, skills, and practices. At its core, patient care is about a holistic, patient-centered approach that prioritizes the individual's well-being, preferences, and needs. Here is a guide to understanding patient care, broken down into key components: 1. The Foundation:   Patient-Centered Care : Patient-centered care is the cornerstone of modern healthcare. It moves beyond simply treating a patient's illness to considering ...
Let's go

The Definitive Guide to Nursing Tasks: Roles, Duties, and Settings (CNA, LPN, RN, APRN).

By Peter Jumba
Image
The Definitive Guide to Nursing Tasks: Roles, Duties, and Settings (CNA, LPN, RN, APRN). Explore the definitive guide to nursing tasks! Understand the core duties of CNAs, LPNs, RNs, and APRNs across hospitals, clinics, and home health settings. Hierarchy of nursing tasks and roles (CNA, LPN, RN, APRN) showing duties like medication administration, patient education, and care planning in diverse settings. Introduction: What Do Nurses Really Do? Nursing is a multifaceted profession, encompassing far more than just taking vitals. Nurses are the backbone of patient care, delivering holistic support from the bedside to advanced clinical practice. The specific duties performed depend heavily on the nurse's level of certification (e.g., CNA , LPN , RN , APRN ) and their unique work environment. This guide breaks down the core responsibilities that define the nursing profession across all specialties and settings. Core Nursing Responsibilities: The Pillars of Patient Care. The foundationa...
Let's go