N212: Health Differences Across the Life Span 2

Health Differences Across the Lifespan 2 Study Guide may also display complete lack of expressions and avolition (a lack of motivation). The major needs of schizophrenic patients are structure, diversion to distract them from disturbing thoughts, and stress reduction to minimize the severity of the disorder. Do not argue with or support a psychotic patient’s delusions. Paranoid schizophrenia patients believe others are out to get him or her. Patients may be hostile, suspicious, and aggressive. The patient has excessive feelings of importance and power over others. The patient may also have delusions that focus on religious content. The somatic type is when the patient has delusions fixed on an irrational belief about his or her body. The nihilistic type is when the patient has delusions of nonexistence. The persecutory type is when the patient has delusions that others are out to get him or her or are plotting against him or her. Thought broadcasting is when the patient believes that others can hear his or her thoughts. Thought insertion is when the patient believes that others have the ability to put thoughts in his or her mind against the his or her will. Interventions for schizophrenia include management of delusions and hallucinations, establishing a trusting and therapeutic relationship, encouraging expression of feelings and thoughts, and communicating with the patient using clear and direct statements. Nurses should provide an environment with a low degree of stimulation and express understanding of the patient’s belief about the delusion or hallucination but not share in it. Do not argue with the patient. Avoid physical contact or touching the patient, encourage the patient to verbalize feelings and thoughts openly, identify support symptoms, observe for self-destructive behaviors, provide opportunities for the patient that promote socialization and decrease isolation, involve the patient in setting realistic goals in a treatment plan, and provide daily living skills groups for patients to participate in. Anti-Social Personality This disorder involves individuals that exhibit inflexible and maladaptive responses to stress. Signs and symptoms include patients who are intelligent, charming, and self-centered, with a “con artist” inability to feel guilt or learn from past experience. Other symptoms are repeated lying and cheating, stealing, emotionally immature, lacking impulse control, and low frustration tolerance. Manipulation of others to fulfill wants and needs is another sign, and so is resisting authority, rules, and laws. Patients are often impulsive, lacking judgment, and using rationalization to justify behavior.

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