Paranoid Schizophrenia

[klw27]

I need to write a care plan on a patient whom has paranoid schizophrenia and has stopped taking her meds one month ago. Now telling people they are possessed by the devil and repeating what people say. She has made no threats as to harming herself. My first thought for a diagnosis was Risk for injury. I mostly need help with a diagnosis to get me started if anyone has any input. Thanks!

[MrsBradyMom]

You really need to highlight your abnormal assessment findings and go from there. Without knowing your assessment data, here are a few that might fit:

Anxiety r/t unconcious conflict with reality

Disturbed sensory perception r/t biochemical disturbances (hallucinations)

Disturbed thought processes r/t inaccurate interpretations of enviornment

Fear r/t altered contact with reality

Ineffective coping (support systems?)

Noncompliance (not taking meds)

Risk for self/other directed violence (d/t & depending on visual/auditory hallucinations...are they command?)

Social Isolation

Sleep deprivation (?)

[sbostonRN]

The way I determine which diagnosis is the primary, is to ask myself "If I fix this, will the others go away?" Therefore, for a pt with schizophrenia, I'd probably list "Noncompliance r/t not taking medications" or something. Because the anxiety, disturbed thought processes, sleep deprivation, ineffective coping, etc will all resolve if the primary outcome is achieved.

[ImThatGuy, BSN, RN]

I'd go with noncompliance because that'd fix everything else that immediately needs attention. The only way to deal with people like your patient is to medicate it out of them, lol.