Schizophrenia

Sanjay Reddy is a 60 year old male who came to the hospital because of acute psychosis related to his schizophrenia. He was brought to the hospital for a psychiatric evaluation and monitoring for his safety.

Inpatient Hospital Room

1. Recognize common symptoms of schizophrenia, including hallucinations, delusions, disorganized thought, and social withdrawal.
2. Establish a therapeutic nurse-patient relationship using non-threatening, empathetic communication strategies.
3. Apply therapeutic communication techniques such as active listening, reality orientation, and validation to de-escalate fear or mistrust.
4. Assess for barriers to medication adherence, including paranoia, delusional beliefs, or side effects.
5. Administer antipsychotic medications safely, and monitor for extrapyramidal symptoms or adverse effects.
6. Collaborate with the behavioral health team to report changes in mental status or refusal of medication.
7. Educate the patient (when appropriate) on the purpose and importance of medication adherence in managing schizophrenia.

1. Identify symptoms of schizophrenia and assess the patient’s current mental status and level of insight.
2. Use therapeutic communication to reduce anxiety, build trust, and promote cooperation.
3. Attempt medication administration using patient-centered, non-coercive language.
4. Appropriately manage refusal of medication or resistance by using de-escalation and referral to team support.
5. Document medication administration or refusal, communication strategies used, and the patient’s response.
6. Collaborate with psychiatric and interprofessional teams to ensure safe, ethical, and therapeutic care.