Schizophrenia

[wsustudent]

I had a pt that was schizophrenic and acting out violently who I need to do a care plan on. I wanted to use risk for violence others directed but my instructor said that the pt's aggravation factors were more important because it is pt centered leaning towards Maslow's ideas. I cannot decide what to do with this. I see that Disturbed thought processes kind of fits this but I just can't seem to grasp what other diagnosis might work. Any suggestions? This is really frustrating because I have not had any psy in lecture yet since this is my first semester. This pt was your text book (from what I had to read on my own) schizophrenic that was off her medications and VERY non-compliant. thanks to all that may be able to help.

[cardiacRN2006, ADN, RN]

What about Risk for Injury R/T pt's self destructive behaviors?

[SuesquatchRN, BSN, RN]

Fear

Anxiety

Ineffective Therapeutic Regimen Maintenance

[smk1, LPN]

non-compliance (regarding medication usage)

risk for self directed violence (if you have evidence to back this up)

[pawashrn]

just from reading you question. I would guess that your instructor wanted you to do more research into Schizo-behavior. Violence is a factor, but the cause of the violence is the patients confusion of reality. Slip violence into your care-plan, but focus on more psych issues. That's my 2 cents. Good luck

[CT Pixie, BSN, RN]

Non-complience

Risk for Injury

Disturbed Thought Process

Ineffective Coping

Impaired Adjustment

Impaired Social Interaction

Knoweldge Deficit

[Bocephus71RN-BSN, BSN, RN]

I feel from what you wrote your instructor wants you not only to direct your plan of care at the illness of schizophrenia itself (including agitation, paranoia, delusions ect.) as perhaps the effects these behaviors may have according to maslows hierarchy of needs. For instance, self care deficit with ADL's or is the Patient taking in the proper nutrition related to the fact that they may be paranoid the food is poisoned, or how is the pt.'s hygeine ect. Whatever the case might be. But more directed at knowledge deficit and self care deficits possibly. Just an idea.

[Daytonite, BSN, RN]

what your instructor is asking you to do is to relook and maybe rethink your assessment of the patient. to help you do this you want to read some references on schizophrenia and what the symptoms and behavior of it are. you might have missed something in doing your assessment of the patient. you see, your patients problems (nursing diagnoses) are based upon your assessment information. i think that disturbed thought processes would probably be a very good nursing diagnosis to use. did you look at the defining characteristics of this diagnosis? does you patient have any of them? [color=#3366ff]disturbed thought processes

in doing your care plan, don't get too hung up on a nursing diagnosis. the nursing diagnosis is merely a label that gets attached to a group of symptoms. what is important is that you nail down the symptoms that the patient has. and i think that is what your instructor was trying to tell you. those symptoms form the foundation for the nursing diagnoses you eventually choose, the goals you pick and all the nursing interventions you use.

let me drive this point home a little further. a doctor doesn't just treat "the flu". he's very interested in the symptoms. he treats the symptoms. he also treats the underlying cause if he is able.