How to Give a Nursing Diagnosis for Schizophrenia? (5+ Assessment Cues)

In this guide, we will discuss the nursing diagnosis for schizophrenia patients (nursing plan for schizophrenia/nursing diagnosis for someone with schizophrenia), the nursing care plan about schizophrenia or nursing care plan in schizophrenia, nursing diagnosis for patients with schizophrenia/nursing diagnosis in schizophrenia, and all the possible related terms.

Nursing Diagnosis for Schizophrenia or nursing diagnosis for schizophrenia disorder

You may be wondering, “What are some nursing diagnosis for schizophrenia?” or “what is a nursing diagnosis for schizophrenia?” well, there are several Nursing Diagnosis for Schizophrenia action plans on the internet, we will discuss some of the nursing care plan for schizophrenia patients and the goals that actually involve recognizing schizophrenia symptoms, establishing trust and rapport, maximizing the level of their daily functioning, assess positive and negative symptoms, the medical history and evaluating the support system (nurselabs.com). 

Initially, it is important to mention what is understood by schizophrenia.

This is considered part of a group of severe and disabling psychiatric disorders that are characterized by a loss of touch with reality, illogical thinking, delusions, and hallucinations and marked disturbances in emotional, behavioral and cognitive areas.

One of the most common early signs or symptoms of this mental illness is usually detected in adolescence but it can actually be rather challenging since they can overlap with the normal behavior expected for this age.

Symptoms can include depression, social withdrawal, difficulties concentrating, irritability or suspiciousness, lack of emotional expression, sleep disturbances, neglecting personal hygiene and odd beliefs. 

Nursing dx for schizophrenia: Schizophrenia subtypes (DSM-5)

Shortly, we will take a look at a nursing care plan for schizophrenia from Nurseslabs/nursing diagnosis for schizophrenia from Nurseslabs, but first, note how it is no longer appropriate to say nursing diagnosis for undifferentiated schizophrenia/nursing care plan for undifferentiated schizophrenia, nursing diagnosis for unspecified schizophrenia,nursing diagnosis for catatonic schizophrenia or a nursing diagnosis for schizophrenia paranoid type, since schizophrenia subtypes have been removed. 

We could also add nursing care plan for catatonic schizophrenia, nursing diagnosis for disorganized schizophrenia/nursing care plan for disorganized schizophrenia, nursing care plan for hebephrenic schizophrenia, nursing diagnosis for paranoid schizophrenia, nursing care plan for schizophrenia paranoid type, paranoid schizophrenia nursing care plan/ paranoid schizophrenia nursing diagnosis, nursing diagnosis for residual schizophrenia, and all the possible combinations with such categories that should no longer be used.

Moreover, let’s avoid saying things like nursing diagnosis for schizophrenia bipolar type, nursing diagnosis for schizophrenia bipolar, since bipolar disorder and schizophrenia are both psychiatric conditions that share common traits but are not the same or bipolar is not considered a subtype among schizophrenia. 

Note how saying, nursing diagnosis for chronic schizophrenia/nursing care plan for chronic schizophrenia or nursing care plan for acute schizophrenia, would not be appropriate anymore since there is no longer a distinction between Acute and Chronic schizophrenia (as it was considered a while back), now it is only considered as a chronic disorder. 

Nursing Care Plans for schizophrenia patients or nursing care plan of schizophrenia

According to nurseslabs.com, there are six nursing diagnosis for a patient with schizophrenia that can be used for the NCP or Nursing Care Plan for pt with schizophrenia and they are:

1. Impaired Verbal Communication
2. Impaired Social Interaction
3. Disturbed Sensory Perception (Auditory/visual)
4. Disturbed Thought processing
5. Defensive coping
6. Interrupted family process

We will briefly describe the first four items from the list, that we would call the nursing diagnosis list for schizophrenia, we just mentioned on how to carry out a nursing diagnosis of schizophrenia patients or how to set up a nursing care plan for schizophrenia patients.

1. Impaired Verbal Communication

Impaired verbal communication as a nursing diagnosis for schizophrenia is characterized by the assessment of the patient’s speech content and their patterns since they tend to show a poor communication function. 

The nursing diagnosis of impaired verbal communication entails decreased, reduced, delayed, or absent ability to receive, process, transmit or use a system of symbols.

Some of the related factors include:

• Altered Perceptions.
• Biochemical alterations in the brain of certain neurotransmitters.
• Psychological barriers (lack of stimuli).
• Side effects of medication.

In addition, the defining characteristics are said to include subjective and objective data, or nursing assessment cues (signs and symptoms) that could serve as evidence for your care plan such as:

• The patient experiences difficulties in verbal communication
• The patient experiences difficulties in discerning and maintaining the usual communication pattern.
• The patient shows signs of disturbances in cognitive associations such as perseverations, derailment, poverty of speech or neologism, among others. 
• Inappropriate verbalization.

Desired Outcomes

For instance, the expected outcomes or patient goals for impaired verbal communication nursing diagnosis can be:

• The patient will express thoughts and feelings in a coherent, logical, goal-directed manner.
• The patient will demonstrate reality-based thought processes in verbal communication.
• The patient will spend time with one or two other people in structured activity neutral topics.
• The patient will share observations of their environment with the nurse in a time frame of 2-3 mins, 3 days a week.  
• The patient by the time of discharge will be able to communicate in a clear and comprehensive manner, with the help of medication and attentive listening. 
• The patient will learn one or two diversionary tactics that work for him/her to decrease anxiety, hence improving the ability to think clearly and speak more logically.

2. Impaired Social Interaction

Patients with schizophrenia tend to show signs of isolation or withdrawing from social activities.

The Nursing Diagnosis for schizophrenia in terms of impaired social interaction includes observing how an individual won’t engage sufficiently or will be ineffective when interacting in social settings. 

Some of the related factors for impaired social interaction that can be as your “related to” in your nurse diagnosis for schizophrenia statement could include:

• Difficulties communicating
• Difficulties concentrating
• Easily startled or having an exaggerated response to alerting stimuli
• Feeling threatened in social situations
• Having delusions or hallucinations that impair thought processes 
• Inadequate or lack of emotional responses
• Self-concept disturbance (verbalization of negative feelings about self)

In addition, the defining characteristics are said to include subjective and objective data, or nursing assessment cues (signs and symptoms) that could serve as evidence for your care plan such as:

• When others attempt to engage him/her in an activity they appear upset, agitated, or anxious when others come too close in contact
• There is a dysfunctional interaction with other patients or other people in general
• 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

For instance, the expected outcomes or patient goals for impaired social interaction nursing diagnosis can be:

• The patient will participate in a structured group activity within 5-7 days.
• The patient seeks and engages in social exchanges
• The patient will interact socially with family, friends, and others.
• The patient will use appropriate social skills in interactions.
• The patient will engage in one activity with a nurse by the end of the day.
• The patient can maintain social interaction with other patients while doing an activity such as drawing or playing a board game. 
• The patient will demonstrate interest to start coping skills training when ready for learning.
• The patient will engage in one or two activities with little to no encouragement from a nurse or a family member.
• The patient will verbalize that he/she is comfortable in at least two structured activities that are goal-oriented.
• The patient will use adequate social skills to initiate and maintain an interaction.

3. Disturbed Sensory Perception: Auditory/Visual

Patients with schizophrenia exhibit altered sensory perception where auditory and visual hallucinations are the most common symptoms.

The nursing Diagnosis of disturbed sensory perception involves a change in the amount or patterning of incoming stimuli accompanied by a diminished, exaggerated, distorted or impaired response to such stimuli.

Some of the related factors for the disturbed sensory perception that can be as your “related to” in your nursing diagnosis Schizophrenia statement can include:

• Altered sensory perception.
• Altered sensory reception; transmission or integration.
• Biochemical factors such as manifested by an inability to concentrate.
• Chemical alterations (e.g., medications, electrolyte imbalances).
• Neurologic/biochemical changes.
• Psychological stress.

In addition, the defining characteristics are said to include subjective and objective data, or nursing assessment cues (signs and symptoms) that could serve as evidence for your care plan such as:

• Communication pattern disturbances
• Auditory hallucinations
• Problem-solving difficulties 
• Inability to orientate in time/place/person 
• Frequent blinking of the eyes and grimacing
• Inadequate responses
• Mumbling, talking or laughing on their own
• A reported or measured change in sensory acuity.
• Tilting the head as if listening to someone.

Altered Thought Process Related to Schizophrenia

Altered thought process related to schizophrenia includes delusions and other thought disorders like Formal Thought Disorders and Thought Possession. Delusions are firmly held beliefs that are common in schizophrenia, and the altered thought process of schizophrenia usually responds to medication and therapy.

Desired Outcomes

For instance, the expected outcomes or patient goals for disturbed sensory perception nursing diagnosis can be: 

• The patient will verbalize three of the symptoms they recognize when they have high-stress levels. 
• The patient will verbalize that the voices are no longer threatening, nor do they interfere with his/her life.
• The patient will verbalize, using a scale from 1 to 10, that “the voices” are less frequent and/or threatening when medication is administered
• The patient will maintain role performance.
• The patient is able to maintain social exchanges.
• The patient will monitor the intensity of their anxiety symptoms.
• The patient will identify two stressful events that trigger hallucinations.
• The patient will identify strategies that decrease or lower the intensity or frequency of hallucinations such as listening to music, wearing headphones, reading out loud, jogging, socializing.
• The patient will adopt one stress reduction technique.
• The patient will demonstrate techniques that help distract him/her from the voices.
• The patient will learn ways to refrain from interacting with the imaginary source of the hallucinations.

4. Disturbed Thought Process

Patients with schizophrenia often display disturbed thought processing through delusions and disturbed perception.

Nursing diagnosis

The nursing Diagnosis of the Disturbed Thought Process involves a disruption in cognitive operations and activities. 

Some of the related factors for the  disturbed thought process that can be as your “related to” in your schizophrenia nursing diagnosis statement can include:

• Chemical alterations (e.g., medications, electrolyte imbalances).
• Inadequate support systems.
• Stressful/traumatic life events.
• Genetic factors.
• Anxiety.
• Environmental factors.

In addition, the defining characteristics are said to include subjective and objective data, or nursing assessment cues (signs and symptoms) that could serve as evidence for your care plan such as:

• Delusions
• Inaccurate interpretation of environment
• Inappropriate non-reality-based thinking
• Memory deficit/problems
• Self-centeredness

Desired Outcomes

For instance, the expected outcomes or patient goals for disturbed thought processing of the nursing diagnosis can be:

• The patient will verbalize when he/she recognizes delusional thoughts.
• The patient will be able to perceive the environment as it is contrasted with reality.
• The patient will demonstrate social interactions with real people.
• The patient will demonstrate decreased anxious behavior.
• The patient will refrain from acting on delusional thinking.
• The patient will develop a therapeutic relationship with a staff member within 1 week.
• The patient will sustain attention and concentration when completing tasks/activities.
• The patient will state that the “thoughts” are less intense/less frequent when administering medication treatment.
• The patient will talk about concrete happenings in the environment without talking about delusions for at least 5 minutes.
• The patient will demonstrate two effective strategies/coping skills that will minimize/prevent delusional thoughts.

Why is this blog about the nursing diagnosis for schizophrenia important?

Knowing how schizophrenia is a long-life condition and how it can become disabling, affecting someone’s life, then identifying the signs and symptoms is key to understanding the condition and preventing the behavior associated.

In addition, early treatment of the symptoms can help improve the quality of life for the person that is suffering from schizophrenia. 

The assessment and intervention are key areas to elaborate on an intervention plan in the nursing diagnosis for schizophrenia.

Feel free to comment in the comments section below.

Frequently Asked Questions (FAQs) about Nursing Diagnosis for Schizophrenia

Recommended links

• Schizophrenia Care Plan Interventions For Nurses
• 6 Schizophrenia Nursing Care Plans (Example of nursing care plan for schizophrenia)
• Nursing diagnosis for schizophrenia Nanda or schizophrenia Nanda diagnosis
• Nursing diagnosis for schizophrenia Slideshare or nursing care plan for schizophrenia slideshare
• Nursing care plan of schizophrenia PDF/Nursing diagnosis of schizophrenia PDF (nursing care plan for schizophrenia Scribd)

References

Nursing.com: “Nursing Care Plan for Schizophrenia”

Nursebuff.com: “Schizophrenia Care Plan Interventions for Nurses”

Martin, P. (2019, Apr.) 6 Schizophrenia Nursing Care Plans. Retrieved from Nurselabs.com.