Schizophrenia Concept Map

Schizophrenia Concept Map
Etiology
Schizophrenia is defined as a group of different that may have very similar as well as varying
features. There may also be overlapping etiologies. The facts about schizophrenia are that brain
chemistry, structure and activity differs from those without the disorder. In addition, scientists
have agreed that the disorder can occur when inherited gene abnormalities combine with
nongenetic factors and influenced by the environment and social elements. The result of this is
the alteration of structures in the brain that lead to disruptions in the neurotransmission system in
the brain. The effects of these alterations are called the diathesis- stress model.
Diagnosis
Schizophrenia typically manifests in late adolescence or early adulthood. Individuals living with
schizophrenia usually have disturbing and disabling symptoms that usually requires a
multilayered approach to care and treatment. A physician or psychologist will complete an
assessment on the individuals thinking and behavior. Diagnosis is determined based on the
elimination of other possible conditions, physician or psychologist clinical judgment, symptoms
present for at least one month that have lasted for at least six months and symptoms that are
severe enough to have an impact on the person’s social, educational or occupational functioning
and abilities. The DSM-5 requires that the patient has experienced at least 2 of the following
symptoms: delusions, hallucinations or disorganized speech.
Labs/Diagnostic Tests
There currently are not any diagnostic tests for the diagnosis of Schizophrenia. However,
healthcare providers may run other tests to rule out other conditions. Computed
tomography (CT), magnetic resonance imaging (MRI) or other imaging test may be used to rule
out conditions that alter brain structure such as stroke or tumors. Blood, urine and spinal tap test
have the ability to identify chemical changes that can explain behavior changes or rule out heavy
metal toxicity, poisoning or infection.
Assessment Findings
During the assessment of an individual with schizophrenia the nurse will focus largely on the
symptoms that are present, coping, functioning, and safety. The assessment involves
interviewing the person and observing their behavior for obvious indicators of the disorder.
Some indicators may include: strange or odd experiences, auditory disturbances such as hearing
voices others cannot hear, seeing things that others cannot, false beliefs, disorganized or
catatonic behavior, negative symptoms such as flat affect, alogia, avolition, social or
occupational dysfunction, and disturbances that persist over a 6-month period.
Risk Factors
The risk factors for schizophrenia include genetic factors, neurobiological factors, brain structure
abnormalities, pre-natal stressors, psychological stressors and environmental stressors. An
individual is at greater risk of inheriting schizophrenia when a close family member has the
condition. Schizophrenia may be influenced by brain development factors before and around the
time of birth, and during childhood and adolescence. Also, individuals who have experienced
social hardship or trauma during childhood could at greater risk. Cannabis use has also been
shown to increases the risk of developing schizophrenia in youth and of triggering the early onset
of the condition in those that are genetically vulnerable.
Signs & Symptoms

Many of the symptoms of schizophrenia have the same symptoms and presentations of other
disorders. The following are the four main groups of symptoms associated with schizophrenia:
positive symptoms, negative symptoms, cognitive symptoms, and affective symptoms. Positive
symptoms may present as hallucinations, delusions, disorganized speech and bizarre behavior.
Negative symptoms may present as blunt affect, poverty of thought (alogia), loss of motivation
(avolition) or inability to experience pleasure or joy (anhedonia). Cognitive symptoms may
include inattention and distractibility, impaired memory, poor problem solving, poor decision
making, illogical thinking and impaired judgment. Affective symptoms may be present as
dysphoria, suicidality and hopelessness.
Potential Complications
Schizophrenia has many potential complications that can be due specifically to the condition or
associated with it. Some of the complications include suicide, suicidal thoughts and attempts,
anxiety and obsessive compulsive disorder, depression, drug or alcohol abuse, inability to work
or attend school, financial issues and homelessness, social isolation, health and medical
problems, being victimized and aggressive behavior. Individuals with schizophrenia may also
experience ttreatment-resistant schizophrenia, this occurs when the condition fails to respond to
at least two antipsychotic medications for at least six weeks. In addition to the previously
mention conditions individuals with the condition are at increased risk of developing other
comorbidities such as heart disease, diabetes and infections.
Medical Management
There are currently 2 groups of medication for the treatment of schizophrenia, they are first-
generation and second-generation antipsychotics. The first generation antipsychotics mainly
block dopamine receptors and treat positive symptoms some of the medications in this class
include Loxapine and Haloperidol. Second-generation antipsychotics partially block dopamine
receptors and serotonin receptors they treat both positive and negative symptoms, medications in
this class include quetiapine, olanzapine and risperidone. In some cases, adjunct medications
may be prescribed in addition to anti-psychotic medication these include antidepressant,
antimanic medications, valproic acid, divalproex sodium or lamotrigine and benzodiazepines. In
addition to pharmaceutical management Electroconvulsive Therapy may be used to correct
biochemical changes. Repetitive transcranial magnetic stimulation may be used to
stimulate brain nerves cells and change neuron firing patterns. Psychological treatments may also
be used to reduce stress, support employment and develop social skills. Cognitive behavioral
therapy (CBT) to develop skills and strategies to stay healthy and navigate perceptions and
problems. Supportive psychotherapy to increase coping skills and positive defense mechanisms.
Nursing Management/Care
Dealing with individuals with schizophrenia the nurse should establish therapeutic rapport, trust
and communication. The monitoring and management of symptoms is required to ensure
effective medication management of positive and negative symptoms. Collaborate with
interdisciplinary team to ensure the patients’ needs are addressed holistically. Assess risk for
current or history of suicidal ideations, intent or plans and initiate any necessary interventions.
Arrange referrals for dual-diagnosis treatment for patients who have issues with substance abuse.
Teaching
When the individual has been diagnosed with schizophrenia the nears should provide teaching on
the condition and provide resource for the patient to learn more on the condition, as well as make
all necessary referrals to for psychoeducation. When the individual has an understand of the
condition a relapse plan should be discussed and developed. The patient should also be provided
with treatment information and education which includes the benefits of sticking to the treatment
plan, side effects of medication (sexual problems, weight gain, unusual feelings) and the
potential consequences of discontinuing medication suddenly. The should advise the patient to
stay away from drugs and alcohol as they can lead to relapse. Due to the high risk of metabolic
syndrome from medication the nurse should encourage and provide teaching on the importance
of maintaining a healthy lifestyle.

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Schizophrenia Concept Map

Signs & Symptoms

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