SCHIZOPRENIA

CASE SCENARIO 1
 Schizophrenia is a chronic, severe mental
disorder that affects the way a person thinks,
acts, expresses emotions, perceives reality, and
relates to others. Though schizophrenia isn’t as
common as other major mental illnesses, it can
be the most chronic and disabling. People with
schizophrenia
INTRODUCTION often have problems doing
OBJECTIVES well in society, at work, at
PATIENT’S DATA
school, and in relationships.
PAST & PRESENT MEDICAL
HISTORY
PSYCHOPATHOLOGY
DIAGNOSTIC and LAB
 Contrary to popular belief, schizophrenia is not
a split or multiple personality. Schizophrenia
involves a psychosis, a type of mental illness
in which a person can’t tell what’s real from
what’s imagined. The world may seem like a
jumble of confusing thoughts, images, and
sounds. Their behavior may be very strange
INTRODUCTION and even shocking. A sudden change in
personality and behavior, which happens when
OBJECTIVES
people who have it lose touch with reality, is
PATIENT’S DATA called a psychotic episode.
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PSYCHOPATHOLOGY
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 Anyone can get schizophrenia. It affects people
all over the world, from all races and cultures.
While it can happen at any age, schizophrenia
typically first appears in the teenage years or
early 20s. The disorder affects men and women
equally, although symptoms generally appear
earlier in men. The earlier the symptoms start,
INTRODUCTION the more severe the illness tends to be.
OBJECTIVES
Children over the age of 5 can have
schizophrenia, but it’s rare before adolescence.
PATIENT’S DATA
PAST & PRESENT MEDICAL
HISTORY
PSYCHOPATHOLOGY
DIAGNOSTIC and LAB
 The WHO estimated that 154 million Filipinos suffer from
depression, 1 million from schizophrenia, and 15.3 million from
substance use disorders, while 877,000 die due to suicide every
year (Department of Health, 2018)
Positive Symptoms of Schizophrenia
They’re sometimes called psychotic symptoms and can include:
Delusions: These are false, mixed, and sometimes strange
beliefs that aren’t based in reality and that the person refuses to
give up, even when shown the facts.
INTRODUCTION Hallucinations: These involve sensations that aren't real.
Hearing voices is the most common hallucination in people
OBJECTIVES with schizophrenia.
PATIENT’S DATA Catatonia: In this condition, the person may stop speaking, and
PAST & PRESENT MEDICAL
their body may be fixed in a single position for a very long
HISTORY time.
PSYCHOPATHOLOGY
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 Negative Symptoms of Schizophrenia
Negative symptoms of schizophrenia include:

 Lack of emotion or a limited range of emotions

 Withdrawal from family, friends, and social
activities
 Less energy
INTRODUCTION  Speaking less
 Lack of motivation
OBJECTIVES
 Loss of pleasure or interest in life
PATIENT’S DATA  Poor hygiene and grooming habits
PAST & PRESENT MEDICAL
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 What Causes Schizophrenia?
The exact cause of schizophrenia isn’t known. But
like cancer and diabetes, schizophrenia is a real
illness with a biological basis including:

Genetics (heredity): Schizophrenia can run in families,

which means a greater likelihood to have schizophrenia
INTRODUCTION may be passed on from parents to their children.

OBJECTIVES

PATIENT’S DATA Brain chemistry and circuits: People with schizophrenia

may not be able to regulate brain chemicals called
PAST & PRESENT MEDICAL
neurotransmitters that control certain pathways, or
HISTORY
"circuits," of nerve cells that affect thinking and behavior.
PSYCHOPATHOLOGY
DIAGNOSTIC and LAB
 Brain abnormality: Research has found abnormal
brain structure in people with schizophrenia.
But this doesn’t apply to all people with
schizophrenia. It can affect people without the
disease.
Environment: Things like viral infections, exposure to
INTRODUCTION toxins like marijuana, or highly stressful situations may
trigger schizophrenia in people whose genes make them
OBJECTIVES
more likely to get the disorder. Schizophrenia more often
PATIENT’S DATA surfaces when the body is having hormonal and physical
PAST & PRESENT MEDICAL
HISTORY changes, like those that happen during the teen and young
PSYCHOPATHOLOGY adult years.

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 GENERAL OBJECTIVES

At the end of this case study, students will be

INTRODUCTION able to obtain knowledgeable information
about Schizophrenia. Apply proper care about
OBJECTIVES the patient's condition and obtain a good
attitude to the patient and as well as to the
PATIENT’S DATA
family.
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NURSING CARE PLAN

 Specific Objectives
Knowledge
 Discuss the definition of Schizophrenia.
 Identify the etiology of Schizophrenia.
 Understand the various mechanisms that lead to the
INTRODUCTION
development of Schizophrenia.
Skills
OBJECTIVES • Outline the management options available for Schizophrenia.
• Apply proper care for the patient's condition.
PATIENT’S DATA
• Construct a nursing care plan related to the patient's condition.
PAST & PRESENT MEDICAL
Attitude
HISTORY
PSYCHOPATHOLOGY • Establish rapport with the patient and good communication for the family.
• Display utmost confidence in managing patient's care.
DIAGNOSTIC and LAB
• Document the client's findings honestly.
NURSING CARE PLAN
 PATIENT’S DATA

Age: 21 years old

INTRODUCTION Occupation Student

OBJECTIVES Sex: Male

Religion: Not stated in the scenario.

PATIENT’S DATA
Civil Status: Single

PSYCHO PATHOLOGY Educational Attainment: College Level

DIAGNOSTIC Informant: Family

NCP Diagnosis: Schizophrenia

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 ASSESSMENT

INTRODUCTION A. CHIEF COMPLAINT

OBJECTIVES
Patient’s professor had called and reported

PATIENT’S DATA that he walked into his classroom, accused him of

taking his tuition money and refused to leave.
PAST & PRESENT MEDICAL
HISTORY
PSYCHOPATHOLOGY
DIAGNOSTIC and LAB

NURSING CARE PLAN

DRUG STUDY
 ASSESSMENT

INTRODUCTION A. CHIEF COMPLAINT

OBJECTIVES
Patient’s professor had called and reported

PATIENT’S DATA that he walked into his classroom, accused him of

taking his tuition money and refused to leave.
PAST & PRESENT MEDICAL
HISTORY
PSYCHOPATHOLOGY
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DRUG STUDY
 HISTORY OF PRESENT ILLNESS
Although Jose had much academic success as a teenager, his behavior
had become increasingly odd during the past year. He quit seeing his
INTRODUCTION
friends and no longer seemed to care about his appearance or social
OBJECTIVES
pursuits. He began wearing the same clothes each day and seldom bathed.
PATIENT’S DATA
He lived with several family members but rarely spoke to any of them.
When he did talk to them, he said he had found clues that his college was
PAST & PRESENT just a front for an organized crime operation. He had been suspended from
MEDICAL HISTORY
college because of missing many classes. His sister said that she had often
PSYCHOPATHOLOGY seen him mumbling quietly to himself and at times he seemed to be talking

DIAGNOSTIC and LAB to people who were not there. He would emerge from his room and ask his
family to be quiet even when they were not making any noise. Jose began
NURSING CARE PLAN talking about organized crime so often that his father and sister brought
DRUG STUDY him to the emergency room.

DISCHARGE PLANNING
 PAST MEDICAL HISTORY
It is not stated in the scenario.
INTRODUCTION
PHYSICAL EXAMINATION
OBJECTIVES
 NURSING ASSESSMENT
PATIENT’S DATA
During Physical Examination, the following were noted from the
patient:
PAST & PRESENT
1. Patient was found to be a poorly groomed young man who seemed
MEDICAL HISTORY
inattentive and preoccupied.
PSYCHOPATHOLOGY 2. Patient did not want to eat the meal offered by the hospital staff and voiced

DIAGNOSTIC and LAB concern that they might be trying to hide drugs in his food.
3. Patient does not use drugs or alcohol (drug screening results were negative).
NURSING CARE PLAN
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  MEDICATIONS
INTRODUCTION 1. Biperiden 2 mg ½ tablet twice a day
2. Risperidone 2 mg twice a day
OBJECTIVES
3. Chlorpromazine 100 mg once a day at bedtime
PATIENT’S DATA
•VITAL SIGNS (ASSUMED)
VITAL SIGNS NORMAL RANGE RESULT REMARKS
PAST & PRESENT
MEDICAL HISTORY Temperature 36.5-37.2 *C 36. 6*C Normal

PSYCHOPATHOLOGY Pulse Rate 60-100 bpm 85 bpm Normal

DIAGNOSTIC and LAB Respiratory Rate 16-20 cpm 18 cpm Normal

NURSING CARE PLAN Blood Pressure 120/80 mmHg 120/80 mmHg Normal

DRUG STUDY
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 PSYCHOPATHOLOGY OF SCHIZOPHRENIA

INTRODUCTION
OBJECTIVES
PATIENT’S DATA
PAST&PRESENT MEDICAL
HISTORY

PSYCHO
PATHOLOGY
DIAGNOSTIC and LAB

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DRUG STUDY
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 INTRODUCTION
OBJECTIVES
PATIENT’S DATA
PAST&PRESENT MEDICAL
HISTORY

PSYCHO
PATHOLOGY
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 INTRODUCTION The patient's blood samples revealed that the results of his lipid
profile, complete blood count, and kidney function tests were all within
OBJECTIVES normal ranges.
PATIENT’S DATA There's no single test for schizophrenia and the condition is
usually diagnosed after assessment by a specialist in mental health.
PAST&PRESENT MEDICAL
HISTORY
PSYCOPATHOLOGY
DIAGNOSTIC
&
LABORATORY
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 INTRODUCTION
FULL BLOOD COUNT TEST:
OBJECTIVES
PATIENT’S DATA Laboratory Exam Normal Values Result Significance

PAST&PRESENT MEDICAL
HISTORY Red Blood Cell (RBC) 4.32-5.72 million cell/mcl - Normal

PSYCOPATHOLOGY
DIAGNOSTIC White Blood Cell (WBC) 3,500-10,500 cells/mcl - Normal

&
LABORATORY Platelets 150,000-450,000/mcl - Normal

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Hemoglobin 13.5-15.5 grams/dL - Normal

DRUG STUDY
DISCHARGE PLANNING Hematocrit 38.8-50.0% - Normal

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 INTRODUCTION
OBJECTIVES
PATIENT’S DATA
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 INTRODUCTION
OBJECTIVES
PATIENT’S DATA
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HISTORY
PSYCOPATHOLOGY
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 INTRODUCTION
OBJECTIVES
PATIENT’S DATA
PAST&PRESENT MEDICAL
HISTORY
EXAMPLE 1 EXAMPLE 2
PSYCOPATHOLOGY Insert short Insert short
description here. description here.
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EXAMPLE 3 EXAMPLE 4
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 OBJECTIVES
PATIENT’S DATA
RISPERIDONE
PAST&PRESENT MEDICAL
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PSYCOPATHOLOGY
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 OBJECTIVES
PATIENT’S DATA CHLORPROMAZINE
PAST&PRESENT MEDICAL
DRUG NAME CLASSIFICATION AND INDICATIONS AND CONTRAINDICATIONS SIDE EFFECTS AND ADVERSE SPECIAL PRECAUTIONS NURSING RESPONSIBILITIES
HISTORY MECHANISM OF ACTION EFFECTS

Generic Name: Classification: INDICATION: Side effects: It is important to tell your -Check the doctor's order

PSYCOPATHOLOGY Chlorpromazine Antipsychotic, antiemetic Thorazine is a prescription medicine used

to treat the symptoms of Schizophrenia,
-Dizziness, feeling unsteady, or
having trouble keeping your balance
doctor about any other
symptoms you are
experiencing, especially
-Observe 10 rights of giving
medication
Trade/ Brand Name: Pharmacological Class: Psychotic Disorders, nausea and restlessness; drowsiness;
vomiting, anxiety before surgery, -Blank facial expression confusion; aggression; -Establish baseline BP (in
DIAGNOSTIC & LAB Thorazine Phenothiazines (dopamine
D2 receptor antagonist)
intraoperative sedation, intractable
hiccups and Acute Intermittent Porphyria -Restlessness
seizures; headaches; problems
with vision, hearing, speech, or
standing and recumbent
positions), and pulse, before
Dosage: (itching and blisters of the skin) balance; stomach pain or initiating treatment.
Mechanism of Action: -Agitation cramps; or constipation.
100mg CONTRAINDICATION: -Observe for adverse
NURSING CARE PLAN
Nausea and vomiting that is
The antiemetic effect of -Nervousness experienced along with these reactions
Route: chlorpromazine stems from -Chlorpromazine should not be given if symptoms may be a sign of a
the combined blockade of there is a known hypersensitivity or -Unusual, slowed, or uncontrollable more serious condition that -Do not increase or double
Oral histamine H1, dopamine allergy to phenothiazines. movements of any part of the body the dose, follow exactly as
should not be treated with
D2, and muscarinic M1 chlorpromazine. prescribed and indicated
Frequency & Timing: receptors in the vomiting -The drug should be used cautiously in -Difficulty falling asleep or staying
center. Chlorpromazine is patients on antihypertensive medications asleep -Explain common side effects
OD at bedtime

DRUG STUDY
extensively metabolized by due to the risk of developing severe
the liver. hypotension.
-It should not be administered
concurrently with drugs that depress the
central nervous system or patients with a
poorly controlled seizure disorder.
of the drugs
-Monitor blood pressure
Adverse effects :
-Instruct patient’s family that
-Drowsiness or tiredness the drug may cause pink to
red-brown discoloration of
-Sleep disturbances or insomnia urine

DISCHARGE PLANNING -Dry mouth

-Anxiety, restlessness, or excitement

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-Changes in appetite or rapid weight
gain

-Upset stomach

-Increased skin sensitivity to

sunlight
 PATIENT’S DATA
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HISTORY
THE KEYPOINTS
PSYCOPATHOLOGY
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PSYCOPATHOLOGY
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