Exam 15: Schizophrenia

When a patient diagnosed with paranoid schizophrenia was discharged from the unit 6 months ago,the plan was for him to take chlorpromazine (Thorazine),a conventional (first generation)antipsychotic medication,300 mg po daily.He tells the nurse he stopped taking his pills after a few months because they made him feel like a "zombie." What other common side effects should the nurse determine if the patient experienced?

The nurse is told that a patient with disorganized schizophrenia is being admitted to the unit.The nurse should expect the patient to demonstrate:

A patient with schizophrenia who has received chlorpromazine (Thorazine)200 mg PO four times daily for 4 weeks has symptoms of a shuffling,propulsive gait,a masklike face,and drooling.Which nursing response would be most appropriate? Select all that apply.

A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his sales.Today,he argued with several office mates and threatened to kill one of them.The police were called,and he was brought to the mental health center for evaluation.He has had previous admissions to the unit for stabilization of paranoid schizophrenia.When the nurse meets him,he points at staff in the nursing station and states loudly,"They're all plotting to destroy me.Isn't that true?" Which would be the most appropriate response?

A patient with schizophrenia has received typical (first-generation)antipsychotics for a year.His hallucinations are less intrusive,but he remains apathetic,has poverty of thought,cannot work,and is socially isolated.To address these symptoms,the nurse might consult the prescribing health care provider to suggest a change to:

The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating.He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called "volmers" hiding in the warehouse where he works and undoing his work each night.This information most likely suggests:

A patient has not come out of her room for breakfast.The nurse finds the patient moving restlessly about her room in a disorganized manner.The patient is talking to herself,and her verbal responses to the nurse are nonsensical and suggest disorientation.The nurse notices that the patient's skin is hot and dry,and her pupils are somewhat dilated.All these symptoms are significant departures from the patient's recent presentation.The patient is likely experiencing ________ ,and the nurse should ___________.

A patient with schizophrenia tells the nurse,"Everyone must listen to me.I am the redeemer.I will bring peace to the world." From this the nurse can determine that an appropriate nursing diagnosis is:

A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse,"You act like a homosexual.None of the men trust you or want to be around you." The nurse,who is heterosexual,is perplexed by the patient's statements and discusses the event with his mentor.Which explanation most likely underlies the patient's behavior?

Family members of a patient newly diagnosed with paranoid schizophrenia state that they do not understand what caused the patient's illness.The nurse's response should be predicated on the:

A newly admitted patient diagnosed with paranoid schizophrenia is hypervigilant and constantly scans the environment.He states that he saw two doctors talking in the hall and knows they were plotting to kill him.When charting,how should the nurse identify this behavior?

A patient with catatonic schizophrenia exhibits little spontaneous movement and demonstrates waxy flexibility.Which nursing intervention should receive the highest priority?

A patient with schizophrenia has been stabilized in the Crisis Center and is about to be discharged.He will be living with his family,but the family knows nothing about the patient's illness,its treatment,or the role they can play in his recovery.Which activity would be most beneficial for the family to attend?

A patient standing in the dining room screams,"You are going to kill me!" He is very agitated and seems extremely frightened.He is mumbling to himself,and his eyes are darting as if tracking an unseen person.He then says repeatedly,"No! I can't! No!" Put the nursing interventions in the order they should be undertaken. A) Send other staff to report the situation and obtain PRN medication. B) Assure the patient that staff will make sure that everyone stays safe. C) Clear the dining room of other patients and unnecessary personnel. D) Explain that the medication will stop the voices,then administer it.

A patient has schizophrenia and is troubled by negative symptoms,muscle stiffness,and motor restlessness.His Advanced Practice Nurse (APN)is considering changing the patient's antipsychotic medication,haloperidol (Haldol,a typical or first generation antipsychotic drug).For planning purposes,which medication can the nurse assume that the APN will probably choose?

The wife of a patient with schizophrenia is worried about her 17-year-old daughter and asks the nurse what symptoms mark the prodromal stage of schizophrenia.The nurse should respond by listing behaviors such as:

A patient received maintenance doses of fluphenazine decanoate (Prolixin Decanoate)25 mg IM every 2 weeks for 2 years.The clinic nurse notes the patient is grimacing and seems to be constantly smacking her lips.On the next clinic visit,the patient's neck and shoulders twist in a slow,snakelike motion.The nurse should suspect the presence of ________ and should __________.

The nurse is sitting with a patient diagnosed as having schizophrenia,disorganized type,who starts to laugh uncontrollably,although nothing funny has occurred.The nurse should say:

A patient with schizophrenia who admits to auditory hallucinations anxiously tells the nurse,"The voice is telling me to do things." Which of the following responses should the nurse make next?

The nurse spends several sessions with a patient with paranoid schizophrenia and the patient's family to help them understand the importance of antipsychotic medication in controlling his illness.The patient repeatedly states he isn't sick and the pills make him stiff,and family members say he doesn't think the medication helps him.They indicate that their efforts to promote adherence only lead to a hostile response from the patient.Which options should the nurse discuss with the patient's prescribing provider? Select all that apply.