 Care Plans

o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
 Exams
o
o
o
o
o
 Mnemonics
 Notes
o
o
o
o
o
o

o
o
o
o
 Career
 Lifestyle
 Videos
 News

ADVERTISEMENT

 Nursing Care Plans

 Mental Health and Psychiatric Care Plans

6 Schizophrenia Nursing Care Plans

By

Paul Martin, BSN, R.N.

Updated on March 20, 2019

1
ADVERTISEMENT
In this guide are nursing care plans for schizophrenia including six nursing diagnosis.
Nursing care plan goals for schizophrenia involves recognizing schizophrenia, establishing
trust and rapport, maximizing the level of functioning, assessing positive and negative
symptoms, assessing medical history and evaluating support system.

Schizophrenia refers to a group of severe, disabling psychiatric disorders marked by

withdrawal from reality, illogical thinking, possible delusions and hallucinations, and
emotional, behavioral, or intellectual disturbance.

The most common early warning signs of schizophrenia are usually detected until
adolescence. These include depression, social withdrawal, unable to concentrate, hostility
or suspiciousness, poor expressions of emotions, insomnia, lack of personal hygiene, or
odd beliefs.

Here are six (6) nursing diagnosis for schizophrenia that you can use for your
nursing care plan (NCP):

1. Impaired Verbal Communication

2. Impaired Social Interaction
3. Disturbed Sensory Perception: Auditory/Visual
4. Disturbed Thought Process
5. Defensive Coping
6. Interrupted Family Process

1. Impaired Verbal Communication

Impaired verbal communication as a nursing diagnosis for schizophrenia. The patient’s
speech content and patterns are being assessed because they usually exhibit poor
communication function.

ADVERTISEMENT
Nursing Diagnosis

 Impaired Verbal Communication: decreased, reduced, delayed, or absent

ability to receive, process, transmit or use a system of symbols.

Related Factors

Here are the common related factors for impaired verbal communication that can be as your
“related to” in your schizophrenia nursing diagnosis statement:

 Altered Perceptions.
 Biochemical alterations in the brain of certain neurotransmitters.
 Psychological barriers (lack of stimuli).
 Side effects of medication.

Defining Characteristics

The commonly used subjective and objective data or nursing assessment cues (signs and
symptoms) that could serve as your “as evidenced by” for this care plan:

 Difficulty communicating thoughts verbally.

 Difficulty in discerning and maintaining the usual communication pattern.
 Disturbances in cognitive associations (e.g., perseveration, derailment, poverty of
speech, tangentiality, illogicality, neologism, and thought blocking).
 Inappropriate verbalization.

Desired Outcomes

Expected outcomes or patient goals for impaired verbal communication nursing diagnosis:

 Patient will express thoughts and feelings in a coherent, logical, goal-directed

manner.
  Patient will demonstrate reality-based thought processes in verbal
communication.
 Patient will spend time with one or two other people in structured activity neutral
topics.
 Patient will spend two to three 5-minute sessions with nurse sharing observations
in the environment within 3 days.
 Patient will be able to communicate in a manner that can be understood by others
with the help of medication and attentive listening by the time of discharge.
 Patient will learn one or two diversionary tactics that work for him/her to
decrease anxiety, hence improving the ability to think clearly and speak more
logically.

Nursing Interventions and Rationale

In this section are the nursing actions or interventions and their rationale or scientific
explanation for impaired verbal communication (nursing diagnosis for schizophrenia):

Nursing Interventions Rationale

Assess if incoherence in speech
is chronic or if it is more
sudden, as in an exacerbation
of symptoms.
Establishing a baseline
facilitates the
establishment of
realistic goals, the
foundation for planning
effective care.

Identify the duration of the
psychotic medication of the
client.
Therapeutic levels of an
antipsychotic aids clear
thinking and diminishes
derailment or looseness
of association.

Keep voice in a low manner

and speak slowly as much as A high-pitched/loud
possible. tone of voice can
elevate anxiety levels

Keep environment calm, quiet
and as free of stimuli as
possible.
Plan short, frequent periods
with a client throughout the
day.
Use clear or simple words, and
keep directions simple as well.
Use simple, concrete, and
literal explanations.
Focus on and direct client’s
attention to concrete things in
the environment.
Look for themes in what is
said, even though spoken
words appear incoherent (e.g.,
fearful, sadness, guilt).
When you do not understand a
client, let him/her know you
while slow speaking aids
understanding.
Keep anxiety from
escalating and
increasing confusion and
hallucinations/delusions.
Short periods are less
stressful, and periodic
meetings give a client a
chance to develop
familiarity and safety.
Client might have
difficulty processing
even simple sentences.
Minimizes
misunderstanding
and/or incorporating
those
misunderstandings into
delusional systems.
Helps draw focus away
from delusions and
focus on reality-based
things.
Often client’s choice of
words is symbolic of
feelings.
Pretending to
understand limits your
credibility in the eyes of
are having difficulty your client and lessens
understanding. the potential for trust.

When client is ready, introduce

strategies that can minimize
anxiety and lower voices and
“worrying” thoughts, teach
client to do the following:

 Focus on
meaningful
activities.
 Learn to replace
negative thoughts
with constructive
thoughts.
 Learn to replace Helping the client to use
tactics to lower anxiety
irrational thoughts can help enhance
with rational functional speech.
statements.
 Perform deep
breathing exercise.
 Read aloud to self.
 Seek support from
a staff, family, or
other supportive
people.
 Use a calming
visualization
or listen to music.

Even if the words are

Use therapeutic techniques hard to understand,
(clarifying feelings when try getting to the
speech and thoughts are feelings behind them.
 disorganized) to try to
understand client’s concerns.

2. Impaired Social Interaction

Patients with a progressive form of the disease are increasingly socially isolated.

ADVERTISEMENT

Nursing Diagnosis

Impaired Social Interaction: The state in which an individual participates in an insufficient

or excessive quantity or ineffective quality of social exchange.

Related Factors

Here are the common related factors for impaired social interaction that can be as your
“related to” in your schizophrenia nursing diagnosis statement:

 Difficulty with communication

 Difficulty with concentration
 Exaggerated response to alerting stimuli
 Feeling threatened in social situations
 Impaired thought processes (delusions or hallucinations)
 Inadequate emotional responses
 Self concept disturbance (verbalization of negative feelings about self)

Defining Characteristics

The commonly used subjective and objective data or nursing assessment cues (signs and
symptoms) that could serve as your “as evidenced by” for this nursing care plan for
schizophrenia:
  Appears upset, agitated, or anxious when others come too close in contact or try
to engage him/her in an activity
 Dysfunctional interaction with others/peers
 Inappropriate emotional response
 Observed use of unsuccessful social interactions behaviors
 Spends time alone by self
 Unable to make eye contact, or initiate or respond to social advances of others
 Verbalized or observed discomfort in social situations

Desired Outcomes

Expected outcomes or patient goals for impaired social interaction nursing diagnosis:

 Patient will attend one structured group activity within 5-7 days.
 Patient will seek out supportive social contacts.
 Patient will improve social interaction with family, friends, and neighbors.
 Patient will use appropriate social skills in interactions.
 Patient will engage in one activity with a nurse by the end of the day.
 Patient will maintain an interaction with another client while doing an activity (e.g.,
simple board game, drawing).
 Patient will demonstrate interest to start coping skills training when ready for
learning.
 Patient will engage in one or two activities with minimal encouragement from
nurse or family members.
 Patient will state that he or she is comfortable in at least three structured activities
that are goal directed.
 Patient will use appropriate skills to initiate and maintain an interaction.

Nursing Interventions and Rationale

In this section are the nursing actions or interventions and their rationale or scientific
explanation for impaired social interaction (nursing diagnosis for schizophrenia):
 ADVERTISEMENT

Nursing Interventions Rationale

Many of the
positive symptoms
of schizophrenia
(hallucinations,
Assess if the medication has delusions, racing
reached therapeutic levels. thoughts) will
subside with
medications, which
will facilitate
interactions.

Increased anxiety
Identify with client symptoms
can intensify
he experiences when he or
agitation,
she begins to feel anxious
aggressiveness, and
around others.
suspiciousness.

Client might
respond to noises
and crowding with
Keep client in an environment
agitation, anxiety,
as free of stimuli (loud noises,
and increased
crowding) as possible.
inability to
concentrate on
outside events.

Touch by an
unknown person
can be
misinterpreted as a
Avoid touching the client. sexual or
threatening
gesture. This
particularly true for
a paranoid client.
 Avoids pressure on
the client and
sense of failure on
Ensure that the goals set are
part of
realistic; whether in the
nurse/family. This
hospital or community.
sense of failure can
lead to mutual
withdrawal

Client can lose

interest in activities
Structure activities that work
that are too
at the client’s pace and
ambitious, which
activity.
can increase a
sense of failure.

Structure times each day to Helps client to

include planned times for develop a sense of
brief interactions and safety in a non-
activities with the client on threatening
one-on-one basis environment.

If client is unable to respond An interested

verbally or in a coherent presence can
manner, spend frequent, provide a sense of
short period with clients. being worthwhile.

Client is free to
choose his level of
If client is found to be very interaction;
paranoid, solitary or one-on- however, the
one activities that require concentration can
concentration are help minimize
appropriate. distressing
paranoid thoughts
or voice.

If client is Even simple

delusional/hallucinating or is activities help draw
having trouble concentrating client away from
at this time, provide very delusional thinking
simple concrete activities into reality in the
with client (e.g., looking at a environment.
picture or do a painting).

Learn to feel safe

If client is very withdrawn, with one person,
one-on-one activities with a then gradually
“safe” person initially should might participate in
be planned. a structured group
activity.

Try to incorporate the

Increase likelihood
strengths and interests the
of client’s
client had when not as
participation and
impaired into the activities
enjoyment.
planned.

Teach client to remove

Teach client skills in
himself briefly when feeling
dealing with
agitated and work on some
anxiety and
anxiety relief exercise (e.g.,
increasing a sense
meditations,rhytmic exercise,
of control.
deep breathing exercise).

These are
fundamental skills
Useful coping skills that client
for dealing with the
will need include
world, which
conversational and
everyone uses daily
assertiveness skills.
with more or less
skill.

Remember to give Recognition and

acknowledgment and appreciation go a
recognition for positive steps long way to
client takes in increasing sustaining and
social skills and appropriate increasing a
interactions with others. specific behavior.
Provide opportunities for the
client to learn adaptive social
skills in a non-threatening
environment. Initial social
skills training could include
basic social behaviors (e.g.,
appropriate distance,
maintain good eye contact,
calm manner/behavior,
moderate voice tone).
Social skills training
helps the client
adapt and function
at a higher level in
society, and
increases the
client’s quality of
life.

As the client progresses,

provide the client with graded Gradually the client
activities according to the learns to feel safe
level of tolerance e.g., (1) and competent
simple games with one “safe” with increased
person; (2) slowly add a third social demands.
person into “safe”.

As the client progresses,

Coping Skills Training should
be available to him/her
(nurse, staff or others).
Basically the process:

Increases client’s
 Define the skill to ability to derive
social support and
be learned. decrease
 Model the skill. loneliness. Clients
will not give up the
 Rehearse skills in
substance
a safe of abuseunless
environment, they have
alternative means
then in the to facilitate
community. socialization they
belong.
 Give corrective
feedback on the
implementation
of skills.
 Eventually engage other
Client continues to
clients and significant others
feel safe and
in social interactions and
competent in a
activities with the client (card
graduated
games, ping pong, sing-a-
hierarchy of
songs, group sharing
interactions.
activities) at the client’s level.

3. Disturbed Sensory Perception: Auditory/Visual

This nursing diagnosis is chosen related to altered sensory perception experienced by the
patient. Auditory and visual hallucinations are the most common in schizophrenia.

Nursing Diagnosis

Disturbed Sensory Perception: Change in the amount or patterning of incoming stimuli

accompanied by a diminished, exaggerated, distorted or impaired response to such stimuli.

Related Factors

Here are the common related factors for disturbed sensory perception that can be as your
“related to” in your schizophrenia nursing diagnosis statement:

 Altered sensory perception.

 Altered sensory reception; transmission or integration.
 Biochemical factors such as manifested by inability to concentrate.
 Chemical alterations (e.g., medications, electrolyte imbalances).
 Neurologic/biochemical changes.
 Psychologic stress.

Defining Characteristics

The commonly used subjective and objective data or nursing assessment cues (signs and
symptoms) that could serve as your “as evidenced by” for this nursing care plan for
schizophrenia:
  Altered communication pattern.
 Auditory distortions.
 Change in a problem-solving pattern.
 Disorientation to person/place/time.
 Frequent blinking of the eyes and grimacing.
 Hallucinations.
 Inappropriate responses.
 Mumbling to self, talking or laughing to self.
 Reported or measured change in sensory acuity.
 Tilting the head as if listening to someone.

Desired Outcomes

Expected outcomes or patient goals for disturbed sensory perception nursing diagnosis:

ADVERTISEMENT

 Patient will learn ways to refrain from responding to hallucinations.

 Patient will state three symptoms they recognize when their stress levels are
high.
 Patient will state that the voices are no longer threatening, nor do they interfere
with his or her life.
 Patient will state, using a scale from 1 to 10, that “the voices” are less frequent
and threatening when aided by medication and nursing intervention.
 Patient will maintain role performance.
 Patient will maintain social relationships.
 Patient will monitor intensity of anxiety.
 Patient will identify two stressful events that trigger hallucinations..
 Patient will identify to personal interventions that decrease or lower the intensity
or frequency of hallucinations (e.g, listening to music, wearing headphones,
reading out loud, jogging, socializing).
 Patient will demonstrate one stress reduction technique.
 Patient will demonstrate techniques that help distract him or her from the voices.
Nursing Interventions and Rationale

In this section are the nursing actions or interventions and their rationale or scientific
explanation for the disturbed sensory perception (nursing diagnosis for schizophrenia):

Nursing Interventions Rationale

Validating that
Accept the fact that the voices
your reality does
are real to the client, but
not include voices
explain that you do not hear
can help client
the voices. Refer to the voices
cast “doubt” on
as “your voices” or “voices that
the validity of his
you hear”.
or her voices.

Might herald
hallucinatory
activity, which can
be very
Be alert for signs of frightening to
increasing fear, anxiety or client, and client
agitation. might act upon
command
hallucinations
(harm self or
others).

Exploring the
hallucinations and
sharing the
experience can
help give the
Explore how the hallucinations
person a sense of
are experienced by the client.
power that he or
she might be able
to manage the
hallucinatory
voices.
 Hallucinations
Help the client to identify the might reflect
needs that might underlie the needs for anger,
hallucination. What other ways power, self-
can these needs be met? esteem, and
sexuality.

Helps both nurse

and client identify
Help client to identify times situations and
that the hallucinations are times that might
most prevalent and be most anxiety-
frightening. producing and
threatening to the
client.

If voices are telling the client

to harm self or others, take
necessary environmental
precautions.

 Notify others and

police, physician,
and People often obey
hallucinatory
administration
commands to kill
according to unit self or others.
protocol. Early assessment
and intervention
 If in the hospital,
might save lives.
use unit protocols
for suicidal or
threats of violence
if client plans to
act on commands.
 If in the
community,
 evaluate the need
for hospitalization.

Clearly, document what the

client says and if he/she is
a threat to others,
document who was
contacted and notified (use
agency protocol as a
guide).

The client can

sometimes learn
Stay with clients when they are to push voices
starting to hallucinate, and aside when given
direct them to tell the “voices repeated
they hear” to go away. Repeat instructions.
often in a matter-of-fact especially within
manner. the framework of
a trusting
relationship.

Decrease the
potential for
Decrease environmental
anxiety that might
stimuli when possible (low
trigger
noise, minimal activity).
hallucinations.
Helps calm client.

Intervene before
anxiety begins to
escalate. If the
Intervene with one-on-one,
client is already
seclusion, or PRN medication
out of control, use
(As ordered) when
chemical or
appropriate.
physical restraints
following unit
protocols.

Keep to simple, basic, reality- Client’ thinking

based topics of conversation. might be confused
 Help the client focus on one and disorganized;
idea at a time. this intervention
helps the client
focus and
comprehend
reality-based
issues.

If clients’ stress
triggers
hallucinatory
Work with the client to find activity, they
which activities help reduce might be more
anxiety and distract the client motivated to find
from a hallucinatory material. ways to remove
Practice new skills with themselves from a
the client. stressful
environment or
try distraction
techniques.

Redirecting the
client’s energies
to acceptable
Engage client in reality-based
activities can
activities such as card playing,
decrease the
writing, drawing, doing simple
possibility of
arts and crafts or listening to
acting on
music.
hallucinations and
help distract from
voices.

4. Disturbed Thought Process

Disturbed thought process as a nursing diagnosis for schizophrenia. Patients usually exhibit
disturbed perception and delusions that greatly affect their thought process.

Nursing diagnosis
Disturbed Thought Process: Disruption in cognitive operations and activities.
Related Factors

Here are the common related factors for disturbed thought process that can be as your
“related to” in your schizophrenia nursing diagnosis statement:

 Chemical alterations (e.g., medications, electrolyte imbalances).

 Inadequate support systems.
 Overwhelming stressful life events.
 Possibility of a hereditary factor.
 Panic level of anxiety.
 Repressed fears.

Defining Characteristics

The commonly used subjective and objective data or nursing assessment cues (signs and
symptoms) that could serve as your “as evidenced by” for this nursing care plan for
schizophrenia:

ADVERTISEMENT

 Delusions
 Inaccurate interpretation of environment
 Inappropriate non-reality-based thinking
 Memory deficit/problems
 Self-centeredness

Desired Outcomes

Expected outcomes or patient goals for disturbed thought process nursing diagnosis:

 Patient will verbalize recognition of delusional thoughts if they persist.

 Patient will perceive the environment correctly.
 Patient will demonstrate satisfying relationships with real people.
 Patient will demonstrate decrease anxiety level.
  Patient will refrain from acting on delusional thinking.
 Patient will develop trust in at least one staff member within 1 week.
 Patient will sustain attention and concentration to complete task or activities.
 Patient will state that the “thoughts” are less intense and less frequent with the
help of the medications and nursing interventions.
 Patient will talk about concrete happenings in the environment without talking
about delusions for 5 minutes.
 Patient will demonstrate two effective coping skills that minimize delusional
thoughts.
 Patient will be free from delusions or demonstrate the ability to function without
responding to persistent delusional thoughts.

Nursing Interventions and Rationale

In this section are the nursing actions or interventions and their rationale or scientific
explanation for the disturbed thought process (nursing diagnosis for schizophrenia):

Nursing Interventions Rationale

Important
clues to
underlying
Attempt to understand the fears and
significance of these beliefs to the issues can be
client at the time of their found in the
presentation. client’s
seemingly
illogical
fantasies.

Recognizing
Recognizes the client’s delusions the client’s
as the client’s perception of the perception can
environment. help you
understand the
feelings he or
 she is
experiencing.

Identify feelings related to

delusions. For example:

 If client believes
someone is going to
harm him/her, client When people
is experiencing fear. believe that
they are
 If client believes
understood,
someone or anxiety might
lessen.
something is
controlling his/her
thoughts, client is
experiencing
helplessness.

When the
client has full
Explain the procedures and try to knowledge of
be sure the client understand the procedures, he
procedures before carrying them or she is less
out. likely to feel
tricked by the
staff.

When thinking
is focused on
Interact with clients on the basis reality-based
of things in the environment. Try activities, the
to distract client from their client is free of
delusions by engaging in reality- delusional
based activities (e.g., card games, thinking during
simple arts and crafts projects that time.
etc). Helps focus
attention
externally.
 Suspicious
clients might
misinterpret
touch as either
aggressive or
sexual in
nature and
Do not touch the client; use
might
gestures carefully.
interpret it as
threatening
gesture. People
who are
psychotic need
a lot of
personal space.

Arguing will
only increase
client’s
defensive
position,
Initially do not argue with the thereby
client’s beliefs or try to convince reinforcing
the client that the delusions are false beliefs.
false and unreal. This will result
in the client
feeling even
more isolated
and
misunderstood.

Encourage healthy habits to

optimize functioning:

 Maintain medication
regimen. All are vital to
 Maintain help keep
the client in
regular sleep pattern. remission.
 Maintain self-care.
 Reduce alcohol and
drug intake.
 The client’s
delusion can be
Show empathy regarding the distressing.
client’s feelings; reassure the Empathy
client of your presence and conveys your
acceptance. caring, interest
and acceptance
of the client.

Teach client coping skills that

minimize “worrying” thoughts.
Coping skills include:

 Going to a gym.
 Phoning a helpline. When client is
ready, teach
 Singing or Listening strategies
to a song. client can do
alone.
 Talking to a
trusted friend.
 Thought-stopping
techniques.

During acute
phase, client’s
delusional
thinking might
Utilize safety measures to protect
dictate to them
clients or others, if the client
that they might
believe they need to protect
have to hurt
themselves against a specific
others or self in
person. Precautions are needed.
order to be
safe. External
controls might
be needed.
5. Defensive Coping
This nursing diagnosis is chosen related to the perceived lack of self-efficacy, perceived
threat to self, and suspicious motives of others. This is characterized by a difficulty in reality
testing of perceptions, difficulty maintaining relationships, hostility, and aggression.

Nursing diagnosis

 Defensive Coping: Repeated projection of falsely positive self-evaluation based

on a self-protective pattern that defends against underlying perceived threats to
positive self-regard.

Related Factors

Here are the common related factors for defensive coping that can be a, your “related to” in
your schizophrenia nursing diagnosis statement:

 Perceived lack of self-efficacy/vulnerability

 Perceived threat to self
 Suspicions of the motives of others

Defining Characteristics

The commonly used subjective and objective data or nursing assessment cues (signs and
symptoms) that could serve as your “as evidenced by” for this nursing care plan for
schizophrenia:

ADVERTISEMENT

 Denial of obvious problems

 Difficulty in reality testing of perceptions
 Difficulty establishing/maintaining relationships
 False beliefs about the intention of others.
  Fearful
 Grandiosity
 Hostile laughter or ridicule of others
 Hostility, aggression, or homicidal ideation
 Projection of blame/responsibility
 Rationalization of failures
 Superior attitude towards others

Desired Outcomes

Expected outcomes or patient goals for defensive coping nursing diagnosis:

 Patient will avoid high-risk environments and situations.

 Patient will interact with others appropriately.
 Patient will maintain medical compliance.
 Patient will identify one action that helps client feel more in control of his or her
life.
 Patient will demonstrate two newly learned constructive ways to deal with stress
and feeling of powerlessness.
 Patient will demonstrate learn the ability to remove himself or herself from
situations when anxiety begins to increase with the aid of medications and
nursing interventions.
 Patient will demonstrate decreased suspicious behaviors regarding with the
interaction with others.
 Patient will be able to apply a variety of stress/anxiety-reducing techniques on
their own.
 Patient will acknowledge that medications will lower suspiciousness.
 Patient will state that he/she feels safe and more in control with interactions with
environment/family/work/social gatherings.
Nursing Interventions and Rationale
In this section are the nursing actions or interventions and their rationale or scientific
explanation for defensive coping (nursing diagnosis for schizophrenia):
Nursing Interventions
Explain to client what you
are going to do before you
do it.
Assess and observe clients
regularly for signs of
increasing anxiety and
hostility.
Use a nonjudgemental,
respectful, and neutral
approach with the client.
Use clear and simple
language when
communicating with a
suspicious client.
Diffuse angry verbal attacks
with a non defensive stand.
Rationale
Prepares the client
beforehand and
minimizes
misinterpreting your
intent as hostile or
aggressive.
Intervene before
client loses control.
There is less chance
for a suspicious client
to misinterpret intent
or meaning if content
is neutral and
approach is
respectful and non-
judgemental.
Minimize the
opportunity for
miscommunication
and misconstruing
the meaning of the
message.
When staff become
defensive, anger
escalates for both
client and staff. a

Set limits in a clear matter-
of-fact way, using a calm
tone. Giving threatening
remarks to Jeremy is
unacceptable. We can talk
more about the
proper ways in dealing with
your feelings.
Be honest and consistent
with client regarding
expectations and enforcing
rules.
Maintain low level of
stimuli and enhance a non-
threatening environment
(avoid groups).
Be aware of client’s
tendency to have ideas of
reference; do not do things
in front of client that can be
misinterpreted:
 Laughing or
whispering.
 Talking
quitely when
client can see
non-defensive and
non-judgemental
attitude provides an
atmosphere in which
feelings can be
explored more easily.
Calm and neutral
approach may diffuse
escalation of anger.
Offer an alternative
to verbal abuse by
finding appropriate
ways to deal with
feelings.
Suspicious people are
quick to discern
honesty. Honesty and
consistency provide
an atmosphere in
which trust can grow.
Noisy environments
might be perceived
as threatening.
Suspicious clients will
automatically think
that they are the
target of the
interaction and
interpret it in a
negative manner
(e.g., you are
laughing or
whispering about
them).
 but not hear
what is being
said.

Initially, provide solitary,

If a client is
noncompetitive activities
suspicious of others,
that take some
solitary activities are
concentration. Later a game
the best.
with one or more client that
Concentrating on
takes concentration (e.g.,
environmental
chess checkers, thoughtful
stimuli minimizes
card games such as ridge or
paranoid rumination.
rummy).

Provide verbal/physical
limits when client’s hostile
behavior escalates: We Often verbal limits
cannot allow you to verbally are effective in
attack someone here. If you helping a client gain
cant held/control yourself, self control.
we are here in order to help
you.

6. Interrupted Family Process

The presence of a mental disorder such as schizophrenia greatly has an impact on the roles
and interaction within the family.

Nursing Diagnosis

Interrupted Family Process: Change in family relationships and/or functioning.

ADVERTISEMENT
Related Factors

Here are the common related factors for interrupted family process that can be as your
“related to” in your schizophrenia nursing diagnosis statement:

 Developmental crisis or transition.

 Family role shift.
 Physical or mental disorder of a family member.
 Shift in health status of a family member.
 Situational crisis or transition.

Defining Characteristics

The commonly used subjective and objective data or nursing assessment cues (signs and
symptoms) that could serve as your “as evidenced by” for this nursing care plan for
schizophrenia:

 Changes in the expression of conflict in the family

 Changes in communication patterns
 Changes in mutual support
 Changes in participation in decision making
 Changes in participation in problem-solving
 Changes in stress reduction behavior
 Knowledge deficit regarding community and health care support
 Knowledge deficit regarding the disease and what is happening with ill family
member (might believe the client is more capable than they are)
 Inability to meet the needs of family and significant others (physical, emotional,
spiritual)

Desired Outcomes

Expected outcomes or patient goals for interrupted family process nursing diagnosis:
 Family and/or significant others will recount in some detail the early signs and
symptoms of relapse in their ill family member, and know whom to contact in
case.
 Family and/or significant others will state and have written information identifying
the signs of potential relapse and whom to contact before discharge.
 Family and/or significant others will state that they have received needed support
from community and agency resources that offer education, support, coping skills
training, and/or social network development (psychoeducational approach).
 Family and/or significant others will state what medications can do for their ill
family member, the side effects and toxic effects of the drugs, and the need for
adherence to medication at least 2 to 3 days before discharge.
 Family and/or significant others will name and have a complete list of community
supports for ill family members and supports for all members of the family at least
2 days before the discharge.
 Family and/or significant others will attend at least one family support group
(single family, multiple family) within 4 days from onset of acute episode.
 Family and/or significant others will be included in the discharge planning along
with the client.
 Family and/or significant others will meet with nurse/physician/social worker the
first day of hospitalization and begin to learn about neurologic/biochemical
disease, treatment, and community resources.
 Family and/or significant others will problem-solve, with the nurse, two concrete
situations within the family that all would like to discharge.
 Family and/or significant others will recount in some detail the early signs and
symptoms of relapse in their ill family member, and know whom to contact.
 Family and/or significant others will demonstrate problem-solving skills for
handling tensions and misunderstanding within the family member.
 Family and/or significant others will have access to family/multiple family support
groups and psychoeducational training.
 Family and/or significant others will know of at least two contact people when they
suspect potential relapse.
 Family and/or significant others will discuss the disease (schizophrenia)
knowledgeably:
 o Know about community resources (e.g., help with self-care activities,
private respite).
o Support the ill family member in maintaining optimum health.
o Understand the need for medical adherence.

Nursing Interventions and Rationale

In this section are the nursing actions or interventions and their rationale or scientific
explanation for interrupted family process (nursing diagnosis for schizophrenia):

Nursing Interventions Rationale

Family might
have misconceptions and
Assess the family
misinformation about
members’ current level
schizophrenia and
of knowledge about
treatment, or no
the disease and
knowledge at all. Teach
medications used to
client’s and family’s level
treat the disease.
of understanding and
readiness to learn.

Inform the client

family in clear, simple
terms about
psychopharmacologic
Understanding of the
therapy: dose,
disease and the treatment
duration, indication,
of the disease encourages
side effects, and toxic
greater family support
effects. Written
and client adherence.
information should be
given to the client and
family members as
well.
Identify the family’s
ability to cope (e.g., Family’s need must be
experience of loss, addressed to stabilize the
caregiver burden, family unit.
needed supports).

Rapid recognition of early

warning symptoms can
Teach the client and
help ward off potential
family the warning
relapse when immediate
symptoms of relapse.
medical attention is
sought.

Provide information on
disease and treatment
Meet family members’
strategies at the
needs for information.
family’s level of
understanding.

Provide an opportunity
for the family to Nurses and staff can best
discuss feelings related intervene when they
to ill family member understand the family’s
and identify their experience and needs.
immediate concerns.

Schizophrenia is an
Provide information on overwhelming disease for
client and family both the client and the
community resources family. Groups, support
for the client and groups, and
family after discharge: psychoeducational
day hospitals, support centers can help:
groups, organizations,
psychoeducational
 Access caring
programs, community
respite centers (small  Access
homes), etc. resources
 Access
support
  Develop
family skills
 Improve
quality of life
for all family
members
 Minimizes
isolation

References and Sources

Here are references and sources for schizophrenia:

ADVERTISEMENT

 Bartels, S. J., Mueser, K. T., & Miles, K. M. (1997). A comparative study

of elderlypatients with schizophrenia and bipolar disorder in nursing homes and
the community. Schizophrenia Research, 27(2-3), 181-190. [Link]

See Also

You may also like the following posts and care plans:

 Nursing Care Plan: The Ultimate Guide and Database – the ultimate database
of nursing care plans for different diseases and conditions! Get the complete list!
 Nursing Diagnosis: The Complete Guide and List – archive of different nursing
diagnoses with their definition, related factors, goals and nursing interventions
with rationale.

Mental Health and Psychiatric Care Plans

Care plans about mental health and psychiatric nursing:

 Anxiety and Panic Disorders | 7 Care Plans

 Bipolar Disorders | 6 Care Plans
 Major Depression | 6 Care Plans
 Personality Disorders | 4 Care Plans
 Schizophrenia | 6 Care Plans
 Sexual Assault | 1 Care Plan
 Substance Dependence and Abuse | 8 Care Plans
 Suicide Behaviors | 3 Care Plans

WANT TO LEARN MORE ABOUT NURSING?

Subscribe To Our Newsletter!

Receive updates on our new posts which includes study guides, quizzes, and
more!

ADVERTISEMENT

Shop Related Products

Nursing Care Plans: Diagnoses, Intervention…

$63.99
 (326)

Nursing Care Plans: Diagnoses, Intervention…

$45.23$61.95

(86)

Nursing Diagnosis Handbook: An Evidenc…

$61.60$68.95

(146)
 Nurse's Pocket Guide: Diagnoses, Prioritized Int…

$34.33$49.95

(327)
Ads by Amazon

 TAGS

 Defensive Coping

 Disturbed Sensory Perception

 disturbed thought process

 Impaired Social Interaction

 Impaired Verbal Communication

 Interrupted Family Process

 Mental Health Nursing

 schizophrenia
 Paul Martin, BSN, R.N.

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as
a medical-surgical nurse for five years, he handled different kinds of patients and learned how to
provide individualized care to them. Now, his experiences working in the hospital is carried over to
his writings to help aspiring students achieve their goals. He is currently working as a nursing
instructor and have a particular interest in nursing management, emergency care, critical care,
infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical
knowledge and skills to students and nurses helping them become the best version of themselves
and ultimately make an impact in uplifting the nursing profession.

1 COMMENT

1. Ichi Barrera Dumpit September 28, 2016 at 10:18 AM

Hello i am new to this site, hopong that this site well help me to review
for n my nclex😁

Reply

LEAVE A REPLY

Save my name, email, and website in this browser for the next time I comment.
Notify me of follow-up comments by email.

Notify me of new posts by email.

ADVERTISEMENT

ABOUT US

Nurseslabs.com is an education and nursing lifestyle website geared towards helping

student nurses and registered nurses through supplementation of information for the
betterment of their nursing careers. Since we started in 2010, Nurseslabs has been visited
over 100 million times (as of 2018) and has become one of the most trusted nursing
websites helping thousands of aspiring nurses achieve their goals. Our ultimate goal is to
help address the nursing shortage: inspiring aspiring nurses that a career in nursing is an
excellent choice, guiding students become nurses, and the working nurse – helping them
achieve success in their careers.

Read more about Nurseslabs on our About Us page.

Contact us: hello@nurseslabs.com

FOLLOW US

 ABOUT
 PRIVACY
 DISCLAIMER
  CONTACT
© 2019 Nurseslabs | Ut in Omnibus Glorificetur Deus!

We use cookies to ensure that we give you the best experience on our website. If you continue to use this
site we will assume that you are happy with it. OkPrivacy policy