Nursing Care Plan for Schizophrenia

Basic Concept of Schizophrenia

Definition

Schizophrenia is a syndrome with various descriptions of the cause (many not yet known) and history (not necessarily chronic or deteriorating) wide, and a number of consequences which depend on consideration of the influence of genetic, physical and socio-cultural (Rusdi Maslim, 1997; 46).

Causes
Offspring
It has been proven by research that the morbidity rate for the half-brother from 0.9 to 1.8%, 7-15% for siblings, for children with one parent who suffered from Schizophrenia 40-68%, 2-15% twins two eggs and one egg twins 61-86% (Maramis, 1998; 215).

Endocrine
This theory is put forward in connection with the frequent occurrence of Schizophrenia at the time of puberty, pregnancy or puerperium time and time climacterium., But this theory can not be proven.

Metabolism
This theory is based for Schizophrenia patients appear pale, unhealthy, a little tip extremity cyanosis, decreased appetite and weight declined and catatonic stupor in patients with decreased oxygen consumption. This hypothesis is still in the proof with the hallucinogenic drug administration.

Central nervous system
Schizophrenia Causes CNS disorders is directed at the diensefalon or brain cortex, but the pathological abnormalities found may be due to postmortem changes or is artefakt in time to make preparations.


Assessment

Assessment is the beginning and the main basis of the assessment phase of nursing process consists of collecting data and formulation of clients' needs or problems.

The data collected consist of biological, psychological, social and spiritual. Grouping of data on mental health pengakajian can also be the predisposing factor, precipitation factor, the assessment of stressors, coping resources and coping abilities possessed clients (stuart and Sunden, 1998). Other studies focus on the way 5 (five) dimensions: physical, emotional, intellectual, social and spiritual. The contents of the study include :

1. Client identity
2. The main complaint / reason for entry
3. Predisposing factors
4. Dimensional physical / biological
5. Psychosocial dimensions
6. Mental status
7. Preparation needs to go home
8. Coping mechanism
9. Psychosocial and environmental problems
10. Medical Aspects

The data obtained through direct observation or examination referred to objective data, the data is delivered in a talk to clients and families through the interview treatment called subjective data.


Nursing Diagnosis

Risk injuring themselves and or others / environment related to changes in sensory perception / hallucinations

General Objectives :
Clients do not mencideri themselves and or others / environment.

Specific objectives :

1. Clients can be a trusting relationship :
   Nursing Intervention :
   • Construct a trusting relationship
     • Regards therapeutic
     • Introducing yourself
     • Explain the purpose of interaction
     • Create a calm environment
     • Create a contract that clearly at every meeting (topics, time and place to talk).
   • Give clients the opportunity to express his feelings.
   • Listen to the client expression of empathy.
2. Clients can recognize hallucinations
   Nursing Intervention :
   • Make frequent contact and brief
     Rational: to reduce the client's contact with the hallucinations.
   • Obeservasi client behavior associated with hallucinations; talk and laugh without the stimulus, kesekitarnya looked as if there is someone to talk.
   • Help clients to know the hallucinations;
     • If the client answered no, proceed; what was said ?
     • Say that the nurse believes the client to hear.
     • Tell that other clients also have such clients.
     • Say that the treatment will help the client.
   • Discuss with the client about;
     • Situations that can cause / not cause hallucinations.
     • Time and frequency of occurrence of hallucinations (morning, afternoon, evening, night or when alone or when upset / sad).
   • Discuss with the client about what is felt when there hallucinations (angry / scared / sad / happy) and the opportunity to express feelings.
3. Clients can control the hallucinations
   Nursing Intervention :
   • Identification with the client ways / actions taken when there hallucinations (sleep / angry / busy myself)
   • Discuss the benefits of the ways in which clients, if useful give a compliment.
   • Discussion of new ways to cut / control the occurrence of hallucinations :
     • Say "I do not want with you" (the hallucinations).
     • Meet with other people (nurses / friends / family members to talk to say hallucinations.
     • Create a schedule of daily activities - the day that hallucinations do not have time to appear.
     • Ask other people (nurses / friends of family members) say hello if looks speak for herself.
   • Help clients decide how to select and train / control the hallucinations gradually.
   • Give the opportunity to perform the way they are trained, evaluated the results and praise when successful.
   • Encourage clients to participate in group activity therapy (stimulation of the realization and perception of orientation).