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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.
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.
Here are six (6) nursing diagnosis for schizophrenia that you can use for your
nursing care plan (NCP):
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Nursing Diagnosis
Related Factors
Here are the common related factors for impaired verbal communication that can be as your
“related to” in your schizophrenia nursing diagnosis statement:
Altered Perceptions.
Biochemical alterations in the brain of certain neurotransmitters.
Psychological barriers (lack of stimuli).
Side effects of medication.
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 care plan:
Desired Outcomes
Expected outcomes or patient goals for impaired verbal communication nursing diagnosis:
In this section are the nursing actions or interventions and their rationale or scientific
explanation for impaired verbal communication (nursing diagnosis for schizophrenia):
Establishing a baseline
Assess if incoherence in speech facilitates the
is chronic or if it is more establishment of
sudden, as in an exacerbation realistic goals, the
of symptoms. foundation for planning
effective care.
Therapeutic levels of an
Identify the duration of the antipsychotic aids clear
psychotic medication of the thinking and diminishes
client. derailment or looseness
of association.
Minimizes
misunderstanding
Use simple, concrete, and and/or incorporating
literal explanations. those
misunderstandings into
delusional systems.
Pretending to
When you do not understand a
understand limits your
client, let him/her know you
credibility in the eyes of
are having difficulty your client and lessens
understanding. the potential for trust.
Focus on
meaningful
activities.
Learn to replace
negative thoughts
with constructive
thoughts.
Learn to replace Helping the client to use
tactics to lower anxiety
irrational thoughts can help enhance
with rational functional speech.
statements.
Perform deep
breathing exercise.
Read aloud to self.
Seek support from
a staff, family, or
other supportive
people.
Use a calming
visualization
or listen to music.
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Nursing Diagnosis
Related Factors
Here are the common related factors for impaired social interaction that can be as your
“related to” in your schizophrenia nursing diagnosis statement:
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:
Appears upset, agitated, or anxious when others come too close in contact or try
to engage him/her in an activity
Dysfunctional interaction with others/peers
Inappropriate emotional response
Observed use of unsuccessful social interactions behaviors
Spends time alone by self
Unable to make eye contact, or initiate or respond to social advances of others
Verbalized or observed discomfort in social situations
Desired Outcomes
Expected outcomes or patient goals for impaired social interaction nursing diagnosis:
Patient will attend one structured group activity within 5-7 days.
Patient will seek out supportive social contacts.
Patient will improve social interaction with family, friends, and neighbors.
Patient will use appropriate social skills in interactions.
Patient will engage in one activity with a nurse by the end of the day.
Patient will maintain an interaction with another client while doing an activity (e.g.,
simple board game, drawing).
Patient will demonstrate interest to start coping skills training when ready for
learning.
Patient will engage in one or two activities with minimal encouragement from
nurse or family members.
Patient will state that he or she is comfortable in at least three structured activities
that are goal directed.
Patient will use appropriate skills to initiate and maintain an interaction.
In this section are the nursing actions or interventions and their rationale or scientific
explanation for impaired social interaction (nursing diagnosis for schizophrenia):
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Many of the
positive symptoms
of schizophrenia
(hallucinations,
Assess if the medication has delusions, racing
reached therapeutic levels. thoughts) will
subside with
medications, which
will facilitate
interactions.
Increased anxiety
Identify with client symptoms
can intensify
he experiences when he or
agitation,
she begins to feel anxious
aggressiveness, and
around others.
suspiciousness.
Client might
respond to noises
and crowding with
Keep client in an environment
agitation, anxiety,
as free of stimuli (loud noises,
and increased
crowding) as possible.
inability to
concentrate on
outside events.
Touch by an
unknown person
can be
misinterpreted as a
Avoid touching the client. sexual or
threatening
gesture. This
particularly true for
a paranoid client.
Avoids pressure on
the client and
sense of failure on
Ensure that the goals set are
part of
realistic; whether in the
nurse/family. This
hospital or community.
sense of failure can
lead to mutual
withdrawal
Client is free to
choose his level of
If client is found to be very interaction;
paranoid, solitary or one-on- however, the
one activities that require concentration can
concentration are help minimize
appropriate. distressing
paranoid thoughts
or voice.
These are
fundamental skills
Useful coping skills that client
for dealing with the
will need include
world, which
conversational and
everyone uses daily
assertiveness skills.
with more or less
skill.
Increases client’s
Define the skill to ability to derive
social support and
be learned. decrease
Model the skill. loneliness. Clients
will not give up the
Rehearse skills in
substance
a safe of abuseunless
environment, they have
alternative means
then in the to facilitate
community. socialization they
belong.
Give corrective
feedback on the
implementation
of skills.
Eventually engage other
Client continues to
clients and significant others
feel safe and
in social interactions and
competent in a
activities with the client (card
graduated
games, ping pong, sing-a-
hierarchy of
songs, group sharing
interactions.
activities) at the client’s level.
Nursing Diagnosis
Related Factors
Here are the common related factors for disturbed sensory perception that can be as your
“related to” in your schizophrenia nursing diagnosis statement:
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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In this section are the nursing actions or interventions and their rationale or scientific
explanation for the disturbed sensory perception (nursing diagnosis for schizophrenia):
Validating that
Accept the fact that the voices
your reality does
are real to the client, but
not include voices
explain that you do not hear
can help client
the voices. Refer to the voices
cast “doubt” on
as “your voices” or “voices that
the validity of his
you hear”.
or her voices.
Might herald
hallucinatory
activity, which can
be very
Be alert for signs of frightening to
increasing fear, anxiety or client, and client
agitation. might act upon
command
hallucinations
(harm self or
others).
Exploring the
hallucinations and
sharing the
experience can
help give the
Explore how the hallucinations
person a sense of
are experienced by the client.
power that he or
she might be able
to manage the
hallucinatory
voices.
Hallucinations
Help the client to identify the might reflect
needs that might underlie the needs for anger,
hallucination. What other ways power, self-
can these needs be met? esteem, and
sexuality.
Decrease the
potential for
Decrease environmental
anxiety that might
stimuli when possible (low
trigger
noise, minimal activity).
hallucinations.
Helps calm client.
Intervene before
anxiety begins to
escalate. If the
Intervene with one-on-one,
client is already
seclusion, or PRN medication
out of control, use
(As ordered) when
chemical or
appropriate.
physical restraints
following unit
protocols.
If clients’ stress
triggers
hallucinatory
Work with the client to find activity, they
which activities help reduce might be more
anxiety and distract the client motivated to find
from a hallucinatory material. ways to remove
Practice new skills with themselves from a
the client. stressful
environment or
try distraction
techniques.
Redirecting the
client’s energies
to acceptable
Engage client in reality-based
activities can
activities such as card playing,
decrease the
writing, drawing, doing simple
possibility of
arts and crafts or listening to
acting on
music.
hallucinations and
help distract from
voices.
Nursing diagnosis
Disturbed Thought Process: Disruption in cognitive operations and activities.
Related Factors
Here are the common related factors for disturbed thought process that can be as your
“related to” in your schizophrenia nursing diagnosis statement:
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:
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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:
In this section are the nursing actions or interventions and their rationale or scientific
explanation for the disturbed thought process (nursing diagnosis for schizophrenia):
Important
clues to
underlying
Attempt to understand the fears and
significance of these beliefs to the issues can be
client at the time of their found in the
presentation. client’s
seemingly
illogical
fantasies.
Recognizing
Recognizes the client’s delusions the client’s
as the client’s perception of the perception can
environment. help you
understand the
feelings he or
she is
experiencing.
If client believes
someone is going to
harm him/her, client When people
is experiencing fear. believe that
they are
If client believes
understood,
someone or anxiety might
lessen.
something is
controlling his/her
thoughts, client is
experiencing
helplessness.
When the
client has full
Explain the procedures and try to knowledge of
be sure the client understand the procedures, he
procedures before carrying them or she is less
out. likely to feel
tricked by the
staff.
When thinking
is focused on
Interact with clients on the basis reality-based
of things in the environment. Try activities, the
to distract client from their client is free of
delusions by engaging in reality- delusional
based activities (e.g., card games, thinking during
simple arts and crafts projects that time.
etc). Helps focus
attention
externally.
Suspicious
clients might
misinterpret
touch as either
aggressive or
sexual in
nature and
Do not touch the client; use
might
gestures carefully.
interpret it as
threatening
gesture. People
who are
psychotic need
a lot of
personal space.
Arguing will
only increase
client’s
defensive
position,
Initially do not argue with the thereby
client’s beliefs or try to convince reinforcing
the client that the delusions are false beliefs.
false and unreal. This will result
in the client
feeling even
more isolated
and
misunderstood.
Maintain medication
regimen. All are vital to
Maintain help keep
the client in
regular sleep pattern. remission.
Maintain self-care.
Reduce alcohol and
drug intake.
The client’s
delusion can be
Show empathy regarding the distressing.
client’s feelings; reassure the Empathy
client of your presence and conveys your
acceptance. caring, interest
and acceptance
of the client.
Going to a gym.
Phoning a helpline. When client is
ready, teach
Singing or Listening strategies
to a song. client can do
alone.
Talking to a
trusted friend.
Thought-stopping
techniques.
During acute
phase, client’s
delusional
thinking might
Utilize safety measures to protect
dictate to them
clients or others, if the client
that they might
believe they need to protect
have to hurt
themselves against a specific
others or self in
person. Precautions are needed.
order to be
safe. External
controls might
be needed.
5. Defensive Coping
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.
Nursing diagnosis
Related Factors
Here are the common related factors for defensive coping that can be a, your “related to” in
your schizophrenia nursing diagnosis statement:
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:
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Desired Outcomes
In this section are the nursing actions or interventions and their rationale or scientific
explanation for defensive coping (nursing diagnosis for schizophrenia):
Minimize the
Use clear and simple opportunity for
language when miscommunication
communicating with a and misconstruing
suspicious client. the meaning of the
message.
Be aware of client’s
tendency to have ideas of
Suspicious clients will
reference; do not do things automatically think
in front of client that can be that they are the
misinterpreted: target of the
interaction and
interpret it in a
Laughing or negative manner
whispering. (e.g., you are
laughing or
Talking whispering about
quitely when them).
client can see
but not hear
what is being
said.
Provide verbal/physical
limits when client’s hostile
behavior escalates: We Often verbal limits
cannot allow you to verbally are effective in
attack someone here. If you helping a client gain
cant held/control yourself, self control.
we are here in order to help
you.
Nursing Diagnosis
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Related Factors
Here are the common related factors for interrupted family process that can be as your
“related to” in your schizophrenia nursing diagnosis statement:
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:
Desired Outcomes
Expected outcomes or patient goals for interrupted family process nursing diagnosis:
Family and/or significant others will recount in some detail the early signs and
symptoms of relapse in their ill family member, and know whom to contact in
case.
Family and/or significant others will state and have written information identifying
the signs of potential relapse and whom to contact before discharge.
Family and/or significant others will state that they have received needed support
from community and agency resources that offer education, support, coping skills
training, and/or social network development (psychoeducational approach).
Family and/or significant others will state what medications can do for their ill
family member, the side effects and toxic effects of the drugs, and the need for
adherence to medication at least 2 to 3 days before discharge.
Family and/or significant others will name and have a complete list of community
supports for ill family members and supports for all members of the family at least
2 days before the discharge.
Family and/or significant others will attend at least one family support group
(single family, multiple family) within 4 days from onset of acute episode.
Family and/or significant others will be included in the discharge planning along
with the client.
Family and/or significant others will meet with nurse/physician/social worker the
first day of hospitalization and begin to learn about neurologic/biochemical
disease, treatment, and community resources.
Family and/or significant others will problem-solve, with the nurse, two concrete
situations within the family that all would like to discharge.
Family and/or significant others will recount in some detail the early signs and
symptoms of relapse in their ill family member, and know whom to contact.
Family and/or significant others will demonstrate problem-solving skills for
handling tensions and misunderstanding within the family member.
Family and/or significant others will have access to family/multiple family support
groups and psychoeducational training.
Family and/or significant others will know of at least two contact people when they
suspect potential relapse.
Family and/or significant others will discuss the disease (schizophrenia)
knowledgeably:
o Know about community resources (e.g., help with self-care activities,
private respite).
o Support the ill family member in maintaining optimum health.
o Understand the need for medical adherence.
In this section are the nursing actions or interventions and their rationale or scientific
explanation for interrupted family process (nursing diagnosis for schizophrenia):
Family might
have misconceptions and
Assess the family
misinformation about
members’ current level
schizophrenia and
of knowledge about
treatment, or no
the disease and
knowledge at all. Teach
medications used to
client’s and family’s level
treat the disease.
of understanding and
readiness to learn.
Provide information on
disease and treatment
Meet family members’
strategies at the
needs for information.
family’s level of
understanding.
Provide an opportunity
for the family to Nurses and staff can best
discuss feelings related intervene when they
to ill family member understand the family’s
and identify their experience and needs.
immediate concerns.
Schizophrenia is an
Provide information on overwhelming disease for
client and family both the client and the
community resources family. Groups, support
for the client and groups, and
family after discharge: psychoeducational
day hospitals, support centers can help:
groups, organizations,
psychoeducational
Access caring
programs, community
respite centers (small Access
homes), etc. resources
Access
support
Develop
family skills
Improve
quality of life
for all family
members
Minimizes
isolation
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See Also
You may also like the following posts and care plans:
Nursing Care Plan: The Ultimate Guide and Database – the ultimate database
of nursing care plans for different diseases and conditions! Get the complete list!
Nursing Diagnosis: The Complete Guide and List – archive of different nursing
diagnoses with their definition, related factors, goals and nursing interventions
with rationale.
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TAGS
Defensive Coping
schizophrenia
Paul Martin, BSN, R.N.
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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