David has been admitted in the Behavioral Health Center with a diagnosis of paranoid schizophrenia. He has had previous admissions to the unit for stabilization of the symptoms associated with paranoid schizophrenia.

David has been admitted in the Behavioral Health Center with a diagnosis of paranoid schizophrenia. He has had previous admissions to the unit for stabilization of the symptoms associated with paranoid schizophrenia. When the nurse meets David, he tells her that he saw two of the other nurses standing in the hallway looking at him. He said that he was sure they were talking about him. He says that he wants to kill thembefore they get a chance to harm him.

1. What two nursing diagnoses would be appropriate for the nurse to consider based on this nurse-patient interaction?

2. What would be considered an effective nursing intervention based on the assessment? (Please list 3 nursing interventions for each nursing diagnoses).

ANSWER

Nursing Interventions for Paranoid Schizophrenia: Ensuring Safety and Promoting Recovery

Introduction

When caring for individuals with paranoid schizophrenia, nurses play a vital role in assessing and addressing their needs. This essay discusses two appropriate nursing diagnoses for a patient diagnosed with paranoid schizophrenia and provides effective nursing interventions for each diagnosis to optimize patient care.

Nursing Diagnosis 1: Disturbed Thought Processes

Disturbed Thought Processes is a crucial nursing diagnosis for individuals with paranoid schizophrenia. Delusions and paranoid ideation are common symptoms that can significantly impact the patient’s perception of reality. To address this diagnosis effectively, nurses can implement the following interventions:

Establish a therapeutic relationship: Building trust and rapport with the patient is essential. Nurses should actively listen, demonstrate empathy, and validate the patient’s feelings (Nursing, 2022). By creating a safe and non-judgmental environment, the nurse encourages open communication and the sharing of thoughts and concerns.

Reality orientation and education: Helping the patient differentiate between reality and their delusions is vital. Nurses can gently provide factual information and evidence to challenge their distorted thoughts. Using simple and concrete language, the nurse can explain that their perceptions may be influenced by their illness. Collaborating with the treatment team, the nurse can provide psychoeducation about paranoid schizophrenia, its symptoms, and available treatment options.

Medication management: Collaborating closely with the healthcare provider, nurses should ensure that the patient receives appropriate antipsychotic medications. Monitoring medication adherence and assessing for any side effects or changes in symptoms is crucial (Van Dulmen et al., 2007). Educating the patient about the importance of taking medication as prescribed, as well as the potential benefits and risks associated with it, promotes informed decision-making and enhances treatment outcomes.

Nursing Diagnosis 2: Risk for Violence

Patients with paranoid schizophrenia may experience heightened fear and exhibit a risk of violence towards themselves or others. Prompt interventions are essential to ensure the safety of the patient and those around them. The following nursing interventions can effectively address this diagnosis:

Safety assessment and monitoring: Thoroughly assessing the patient’s environment for potential risks is crucial. Identifying and removing any objects that could be used for harm is a priority (Vaismoradi et al., 2020). Implementing appropriate safety measures, such as close observation and regular check-ins, helps monitor the patient’s behavior and prevent violent episodes.

Crisis prevention and de-escalation techniques: Nurses should be trained in crisis prevention and de-escalation techniques. These skills enable them to recognize early signs of agitation or aggression and intervene appropriately. Techniques like verbal de-escalation, distraction, and relaxation techniques can help redirect the patient’s focus and diffuse potential violent situations.

Collaborative care planning: Engaging the patient, their family, and the interdisciplinary team in care planning is essential. The nurse can facilitate discussions to develop a comprehensive plan that addresses the patient’s unique needs, risk factors, and potential triggers. Collaborative care planning promotes a holistic approach and enhances the effectiveness of interventions.

Conclusion

Caring for individuals with paranoid schizophrenia requires a comprehensive approach that addresses their unique needs and challenges. By prioritizing nursing diagnoses such as Disturbed Thought Processes and Risk for Violence, nurses can implement effective interventions to promote patient safety, support their recovery, and optimize overall well-being. By establishing therapeutic relationships, providing education, and ensuring a safe environment, nurses play a vital role in enhancing the lives of individuals living with paranoid schizophrenia.

References

Nursing, O. R. F. (2022). Chapter 2 Therapeutic Communication and the Nurse-Client Relationship. Nursing: Mental Health and Community Concepts – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK590036/ 

Vaismoradi, M., Tella, S., Logan, P., Khakurel, J., & Vizcaya-Moreno, M. F. (2020). Nurses’ Adherence to Patient Safety Principles: A Systematic Review. International Journal of Environmental Research and Public Health, 17(6), 2028. https://doi.org/10.3390/ijerph17062028 

Van Dulmen, S., Sluijs, E., Van Dijk, L., De Ridder, D. T. D., Heerdink, R., & Bensing, J. M. (2007). Patient adherence to medical treatment: a review of reviews. BMC Health Services Research, 7(1). https://doi.org/10.1186/1472-6963-7-55