Nursing Care Plan



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Nursing Care Plan Multiple Setting Nursing Care Plan for a Patient With Schizophrenia JB is a 19-year-old African American man exhibiting symptoms of schizophrenia for the first time.. Associated Psychiatric Diagnosis Medications Axis I Schizophrenia, catatonic type Axis II None Axis III None Axis IV Educational problems (failing) Social problems (withdrawn from social contacts) Axis V GAF Current = 25 Potential = Risperidone (Risperdal) 2 mg bid then titrate to 3 mg bid if needed Lorazepam (Activan) 2 mg PO or IM PRN IM for agitation Nursing Diagnosis 1: Disturbed Thought Processes Defining Characteristics Related Factors Inaccurate interpretation of stimuli (people thinking his thoughts, trying to take information from his brain).. Nursing Diagnosis 2: Risk for Violence Defining Characteristics Related Factors Assaultive toward others, self, and environment Presence of pathophysiologic risk factors: delusional thinking Frightened, secondary to auditory hallucination and delusional thinking Excessive activity and explosive agitated comments (catatonic excitement) Poor impulse control Dysfunctional communication patterns Outcomes Initial Discharge 1.. Nursing Diagnosis 1: Disturbed Sleep Pattern Defining Characteristics Related Factors Difficulty falling or remaining asleep Dozing during the day Excessive hyperactivity secondary to catatonic excitement Excessive daytime sleeping Inadequate daytime activities Outcomes Initial Discharge 1.. Nursing Diagnosis 2: Impaired Social Interactions Defining Characteristics Related Factors Inability to establish and maintain stable relationship Dissatisfied with social network Avoidance of others Interpersonal difficulties Social isolation Embarrassment about mental illness Communication barriers secondary to schizophrenia Alienation from others secondary to hallucinations, delusions, disorganized thinking Lack of social skills Outcomes Initial Discharge 1..




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