What is schizophrenia?
Mental health disorders characterized by problems with perception and thoughts (problems distinguishing reality).
Symptoms are characterized as positive and negative symptoms.
May also have neurocognitive impairment (memory, attention, executive function).
What are positive symptoms of schizophrenia?
- delusions
- hallucinations
- disorganized speech and behaviour
What are negative symptoms of schizophrenia?
- flat affect, difficulty expressing emotion
- anhedonia (loss of enjoyment/pleasure)
- ambivalence (can’t make decisions)
When is schizophrenia most often diagnosed?
adolescence or early adulthood
What are risk factors for schizophrenia?
congenital?
- parental age
- low birth weight
- obstetric complications
- stresses during perinatal period (starvation, infection)
What is a unique problem in schizophrenia the nurse must watch for?
disordered water balance
- abnormally high water intake/compulsive drinking of water
- causes hyponatremia
- life threatening
What are problems in patients with schizophrenia? (not related to medications)
- safety (suicide risk)
- self-care deficit
- nutritional deficits
- fluid imbalance
- disturbed sleep
- thermoregulation (can be oblivious to cold in winter)
What are causes of schizophrenia?
- changes in brain structure, decreased blood flow to different areas
- genetic?
- dopamine changes (hyperactivity)?
What are nursing interventions for schizophrenia?
- encourage exercise
- promote healthy nutrition (often not able to focus on eating, meds can change appetite)
- promote self-care
- thermoregulation
- sleep hygiene
- monitor fluid balance
What are adverse effects to watch for with all antipsychotic and antidepressant medications?
- changes in behaviour
- suicidal thoughts
What are two specific adverse effects to watch for with patients taking antipsychotic medications?
- neuroleptic malignant syndrome
- extrapyramidal side effects
What is neuroleptic malignant syndrome?
- caused by dopamine depletion (risk with drugs that block dopamine)
- severe muscle rigidity and elevated temperature
- also hypertension, tachycardia, tachypnea, diaphoresis, leukocytosis, changes in LOC, muscle injury (CK)
- life threatening
What are extrapyramidal effects?
- from lower dopamine levels
- Parkinson’s-like symptoms:
- rigidity
- bradykinesia
- tremors
- akathisia (motor restlessness)
- dystonia (spasms and contractions)
Can schizophrenia be cured?
no, patient may need to take medication for rest of life
What medications are used to treat schizophrenia?
1) typical antipsychotics, “neuroleptics”
2) atypical antipsychotics
What are typical antipsychotics?
- ex. loxapine
- block dopamine and serotonin receptors in particular areas of brain
- may take a few weeks to work
- helps to block positive symptoms of schizophrenia
What are atypical antipsychotics?
- ex. quetiapine, risperidone
- used to help with positive and negative symptoms
- less extrapyramidal symptoms
What are some common side effects to antipsychotics?
- weight gain
- sedation
- hypotension
- dry mouth
- EPS
- NMS
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Patients with Cancer23
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Mental Health - Assessment and Mental Health Act14
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Postpartum Depression11
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Mood Disorders (Depression)18
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Bipolar Disorder8
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Schizophrenia18
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Suicide5
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Acute Renal Injury12
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Chronic Kidney Disease11
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COPD9
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Asthma, Bronchiolitis and RSV9
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Pneumonia4
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Respiratory and Metabolic Acidosis and Alkalosis4
