Schizophrenia Discharge Care Plan
Type a discharge care plan for the patient with schizophrenia. I’ve provided his previous care plan to which you can copy and paste the obvious such as pathophysiology and age etc.. I’ve attached his current labs, a page of MSE and Patient Introductions, his current medications’ that should be all you need 🙂 You can choose the interventions, etc that you have to fill out, and don’t forget that this is discharge planning. It’s pretty straight forward and shouldn’t take too long! Please use the Care Plan Template I’m attaching here.
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Solution
| SEATTLE CENTRAL COLLEGE REGISTERED NURSE PROGRAM
NURS 142 BEHAVIORAL HEALTH CARE PLAN FORM |
DATE: | STUDENT: XXX | Page 1 | ||||||
| RELEVANT LABORATORY VALUES | |||||||||
| PATIENT DATA | DIAGNOSES | Date | Test | Result | Normal/
Abnormal: |
Significance | |||
| Pt Initials: DC
Age: 28
Gender: Male
Admit Date: 02/16/2022
Precautions : Fall Risk, Risk for Others-Directed Violence
Level/Privileges: 3
Ethnicity: unknown Reason for Admission: Police brought David into the hospital after becoming aggressive and throwing a table at his mother.
Psychiatric History: 10-year history of schizophrenia and was previously stable on his medications until discontinuation. |
Schizophrenia | FEB 23
FEB 23 FEB 23 FEB 23 FEB 23 |
WBC
HCO3- Na+ K+ Creatinine |
7
24 140 3.9 0.7 |
Normal
Normal Normal Normal Normal |
Infection status; neuroleptic malignant syndrome signs
GI irritation and acidity Hydration status, risks of constipation or impaction, risks of Na deficiency Risk of Hypokalemia due to possible nutritional deficiency Kidney functioning |
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| PATHOPHYSIOLOGY OF DIAGNOSES
Schizophrenia is a mental disorder that affects how a person thinks, feels and behaves. Patients often have difficulty distinguishing between reality and imagination and have difficulty communicating with others. Schizophrenia tends to run in families but most frequently appears to be related to an imbalance of neurotransmitters (dopamine, glutamate and serotonin) that change the brain’s reactions to stimuli. Patients are not normally violent but may react defensively to even the most well-intended gestures or stimuli. |
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| STUDENT PLAN FOR DAY | |||||||||
| Instruct the patient and family about schizophrenia, including the genetic and environmental links to the disorder. Teach them how to deal with hallucinations and delusions. Educate them about the need for the patient to continue taking prescribed medications, even if the patient feels better. Ensure that the patient and family have contact information for the patient’s health care team, including the psychiatric practitioner.
Document the patient’s behaviors, including hallucinations or delusions. Record medication given and any adverse reactions. Document teaching provided to the patient and family (if applicable), their understanding of that teaching, and any need for follow-up teaching. |
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| NURS 142 BEHAVIORAL HEALTH CARE PLAN FORM | Page 2 | ||||
| NURSING DIAGNOSIS #1
Impaired thought process Related to: paranoid delusions.
As evidenced by: the perception that he needs to check if his food at home is poisoned
|
EXPECTED OUTCOME/PLAN (SMART)
(List only 1 )
Patient maintains reality orientation and recognizes changes in thinking or behavior pattern. Patient demonstrate decreased anxiety level and satisfying relationships with real people. |
NURSING INTERVENTIONS
1. Attempt to understand the significance of the patient’s delusional belief. 2. Recognize the patient’s delusions as to his perception of the intention of people around him.
3. Identify feelings related to delusions, such as fear of harm or thought control. |
RATIONALE/SOURCE
(for each intervention) 1. Nurse can identify important cues to underlying fears or issues from the illogical delusions.
2. Nurse can recognize the patient’s perception, which can help understand his feelings and experience around other people.
3. Patient will feel understood, lessening his anxiety level.
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| NURSING DIAGNOSIS #2
Impaired verbal communication Related to: trouble conversing, altered perception, and disturbance in cognitive associations
As evidenced by: vacillated between being withdrawn and agitated, showing difficulty communicating thoughts verbally
|
EXPECTED OUTCOME/PLAN (SMART)
(List only 1 )
Patient communicates clearly with others. Patient will express thoughts and feelings coherently, logically, and in a goal-directed manner. Patient will demonstrate reality-based thought processes in verbal communication. Patient will differentiate between withdrawal and agitation feelings verbally and more logically. |
NURSING INTERVENTIONS
1. Keep the environment as calm, quiet, and free of stimuli as possible.
2. Use clear or simple words, and keep directions simple.
3. Use simple, concrete, and literal explanations.
|
RATIONALE/SOURCE
(for each intervention)
1. Prevents anxiety from escalating and heightening confusion and delusions.
2. Patient has difficulty processing information, including simple sentences.
3. They minimize misunderstandings and integrate the misunderstandings into delusional systems. |
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| NURSING DIAGNOSIS #1 | NURSING DIAGNOSIS #2 | RATIONALE/SOURCE | |||
| Evaluation: | Evaluation: | ||||
| In the process, the patient eats comfortably at the hospital, showing the trustworthiness of his caregivers. The patient shows decreased anxiety and a satisfying relationship with real people. However, the patient still expresses delusional thoughts regarding being poisoned at home.
(Describe if and how expected outcome/goal was met or not met, and which interventions were effective in meeting the goal) Goal Met Yes:___ No:___ In process:____ |
Was met, the patient communicates clearly with other people can express thoughts verbally and coherently. The patient can also differentiate withdrawal and agitation, and he apologized for his aggressive behavior towards his mother.
(Describe if and how expected outcome/goal was met or not met, and which interventions were effective in meeting the goal) Goal Met Yes:___ No:___ In process:____ |
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| NURS142 BEHAVIORAL HEALTH CLINICAL NURSING PROCESS FORM | Page 3 | ||||||
| MEDICATION LIST | |||||||
| TIME DUE | MEDICATION, DOSE,
ROUTE, FREQUENCY |
NORMAL DOSE | DRUG ACTION | SPECIFIC RATIONALE FOR PT | ADVERSE REACTIONS/
SIDE EFFECTS |
NURSING RESPONSIBILITIES | |
| 09:00 | Sertraline orally once daily | 150g | Selective serotonin reuptake inhibitor | To restore the balance of serotonin (a natural substance) in the brain. | Nausea, diarrhea, constipation, vomiting, difficulty falling or staying asleep, dry mouth, heartburn, loss of appetite, fatigue, increased sweating, feeling emotionally numb | Assess medication history to avoid drug interaction, hypersensitivity to sertraline, serotonin syndrome, and autonomic instability. | |
| 21:00 | Fluphenazine orally once daily | 10mg | Blocks postsynaptic dopamine D2 receptors in limbic, cortical system, and basal ganglia. | Works to prevent actions of dopamine, hence minimizing hallucinations and delusions associated with schizophrenia. | Upset stomach, weakness, tiredness, excitement or anxiety, insomnia, nightmares, dry mouth, skin more sensitive to sunlight than usual, appetite or weight changes | Monitor signs of agranulocytosis and leukemia, such as fever, sore throat, mucosal lesions, and signs of infection. Monitor signs of thrombocytopenia and assess motor function, and pay attention to extrapyramidal symptoms | |
| Benztropine orally every 12 hours PRN | 2mg | Blocks acetylcholine (a natural substance) to help decrease symptoms. | Decreases muscle stiffness, sweating, and saliva production and can improve mobility. | Difficulty or pain when urinating, vomiting, nausea, loss of appetite, constipation, and dry mouth | Assess balance problems and functional limitations. Monitor confusion, depression, hallucination, hypotension, palpitations, and arrhythmias | ||