Types of Schizophrenia
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Outline
Overview
- There are 5 different types of schizophrenia, categorized by their unique behaviors and symptoms
Nursing Points
Assessment
-
- Catatonic schizophrenia
- Stupor and immobility
- Other motor abnormalities
- Disorganized schizophrenia
- Disorganized speech/thoughts
- Inappropriate affect
- Social withdrawal
- Can’t perform ADL’s
- Inappropriate silliness
- Paranoid schizophrenia
- Anxiety
- Anger
- Persecution
- Delusions
- Suspiciousness
- Violence (See Module 02.10)
- Residual schizophrenia
- Positive symptoms only present at a low-intensity (hallucinations, delusions)
- Received diagnosis in the past
- Undifferentiated schizophrenia: has schizophrenia, but doesn’t fall into the above subtypes
- Catatonic schizophrenia
Nursing Concepts
- Safety
- Mood Affect
- Cognition
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Transcript
In this lesson I just want to quickly review the 5 different types of schizophrenia. They all have very similar characteristics like we talked about in the last lesson, but we want to help you differentiate the unique aspects of each one of these.
The first type is Catatonic Schizophrenia, which is characterized by psychomotor and behavioral abnormalities. It’s the only one where you really see the movement abnormalities like this. They will experience Stupor, which, if you remember from neuro – is a state where they’re completely unresponsive to stimuli, but they’re awake. So they may just sit and stare off at nothing. They may be fully immobile as well, as if they’re paralyzed. They may also experience something called Waxy flexibility – think of this like a wax figure or a gumby doll (I think I’m dating myself with that one!) – when you move their arm to one position, they will hold it there. If you turn their head or twist their hand a certain way – they hold it there – so you may see them holding these weird positions for a long period of time. And, finally they may also exhibit mutism or the inability to speak. So that’s catatonic schizophrenia. It’s very interesting.
The next one is disorganized schizophrenia – we see this a lot in adolescents with schizophrenia. Their thought processes and behaviors are just all over the place and never seem to be appropriate for the situation. Their thoughts and speech are disorganized – sometimes we call it “Word Salad”. They’ll say something like “Peanuts basketball jumping sharks blue yesterday” and fully expect you to get what they’re trying to say. They may have an inappropriate affect where their expression isn’t appropriate to the situation. Some people even say they are acting “silly” because they’re laughing randomly or at weird time. They may also struggle to even complete ADL’s because they can’t get their thoughts organized enough to complete tasks – this often leads to social withdrawal. One way I found to kind of depict what’s going on is this little animation. This is an example of a chaotic pattern – it never repeats, it’s not predictable, and if you continue to let it swing wildly you won’t really be able to accomplish what you want. It’s also interesting because if you were to start the swing at a slightly different place, you’d get a completely different result. So you can see how difficult it is to have a normal life and that every patient would be different.
The third type is Paranoid Schizophrenia. We will talk more about paranoia in the next lesson, but just recognize that paranoid schizophrenia is more intense and longer lasting than just a simple feeling of paranoia. They’re anxious, may be angry, and may have delusion of persecution – like everyone is out to get them. They’re suspicious and on alert all the time and may be prone to violence when their anxiety or anger is too high. Again, we’ll talk about this in the next lesson – but I want to say it here, too – NEVER whisper around these clients – even if you’re whispering about what to get for lunch. This is a big safety concern, okay?
The last two types are residual and undifferentiated. Residual is exactly what it sounds like – it’s leftover schizophrenia – they received the diagnosis in the past and they may still have some of those positive symptoms we talked about, but only at a low intensity and usually managed well. Undifferentiated schizophrenia is a patient who meets criteria for schizophrenia but doesn’t fall into any of the other subtypes we just talked about.
So a quick way to remember each one – Catatonic schizophrenia has psychomotor symptoms, disorganized is all over the place or chaotic, paranoid has paranoia and delusions, residual is leftover and low intensity, and undifferentiated is everyone else with schizophrenia.
Okay, so those are the types of schizophrenia – keep working your way through this module to learn more. Now, go out and be your best self today. And, as always, happy nursing!
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05.02 Liver Overview and Disease for CCRN Review
Airway Suctioning
Antidiabetic Agents
Cirrhosis Case Study (45 min)
Colonoscopy
Encephalopathies
Enteral & Parenteral Nutrition (Diet, TPN)
Gastrointestinal (GI) Bleed Concept Map
Insulin
Insulin Mnemonic (Ready, Set, Inject, Love)
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Cushings Syndrome
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Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care Plan (NCP) for Anemia
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Nursing Case Study for Hepatitis
08.01 Psychological Review for CCRN Review
Addiction – Behavioral Problems Nursing Mnemonic (The 5 D’s)
Albumin Lab Values
Alcohol Withdrawal (Addiction)
Alcohol Withdrawal Case Study (45 min)
Alcoholism – Outcomes Nursing Mnemonic (BAD)
Alprazolam (Xanax) Nursing Considerations
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Alzheimer – Diagnosis Nursing Mnemonic (The 5 A’s)
Ammonia (NH3) Lab Values
Anorexia – Signs and Symptoms Nursing Mnemonic (ANOREXIA)
Antianxiety Meds
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Antidepressants
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Antipsychotics
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Atypical Antipsychotics
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Blood Urea Nitrogen (BUN) Lab Values
Bulimia – Signs and Symptoms 1 Nursing Mnemonic (BULIMIA)
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Cognitive Impairment Disorders
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Day in the Life of a Hospice, Palliative Care Nurse
Day in the Life of a Mental Health Nurse
Defense Mechanisms
Defense Mechanisms
Dementia Nursing Mnemonic (DEMENTIA)
Depression
Depression Assessment Nursing Mnemonic (SIGNS)
Depression Concept Map
Diazepam (Valium) Nursing Considerations
Disruptive Behaviors, Aggression, Violence for Progressive Care Certified Nurse (PCCN)
Dissociative Disorders
Divalproex (Depakote) Nursing Considerations
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Encephalopathy Case Study (45 min)
End of Life for Progressive Care Certified Nurse (PCCN)
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Escitalopram (Lexapro) Nursing Considerations
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Generalized Anxiety Disorder
Glomerular Filtration Rate (GFR)
Grief and Loss
Grief and Loss
Haloperidol (Haldol) Nursing Considerations
Handling Death and Dying
Head to Toe Nursing Assessment (Physical Exam)
Homicidal and Suicidal Ideation for Certified Emergency Nursing (CEN)
Hypochondriasis (Hypochondriac)
Lamotrigine (Lamictal) Nursing Considerations
Lithium (Lithonate) Nursing Considerations
Lithium Lab Values
Liver Function Tests
Lorazepam (Ativan) Nursing Considerations
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Manic Attack – Signs and Symptoms Nursing Mnemonic (DIG FAST)
MAO Inhibitors Nursing Mnemonic (TIPS)
MAOIs
Meds for Alzheimers
Mental Health Course Introduction
Metabolic Alkalosis
Methadone (Methadose) Nursing Considerations
Midazolam (Versed) Nursing Considerations
Mood Disorders (Bipolar, Depression) for Certified Emergency Nursing (CEN)
Mood Disorders (Bipolar)
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Mood Stabilizers
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Nursing Care Plan (NCP) for Alcohol Withdrawal Syndrome / Delirium Tremens
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Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)
Nursing Care Plan (NCP) for Mood Disorders (Major Depressive Disorder, Bipolar Disorder)
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Nursing Care Plan (NCP) for Schizophrenia
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Nursing Case Study for (PTSD) Post Traumatic Stress Disorder
Nursing Case Study for Bipolar Disorder
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Postmortem Care
Potassium-K (Hyperkalemia, Hypokalemia)
Psychological Disorders (Anxiety, Depression) for Progressive Care Certified Nurse (PCCN)
Quetiapine (Seroquel) Nursing Considerations
Schizophrenia
Schizophrenia Case Study (45 min)
Self Concept
Senile Dementia – Assess for Changes Nursing Mnemonic (JAMCO)
Sertraline (Zoloft) Nursing Considerations
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Somatoform Disorder Case Study (30 min)
SSRI’s Nursing Mnemonic (Effective For Sadness, Panic, and Compulsions)
SSRIs
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TCAs
Therapeutic Communication
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Thought Disorders (Psychosis, Schizophrenia) for Certified Emergency Nursing (CEN)
Total Bilirubin (T. Billi) Lab Values
Types of Schizophrenia
Urinalysis (UA)
Vitamin B12 Lab Values
12 Points to Answering Pharmacology Questions
6 Rights of Medication Administration
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Adenosine (Adenocard) Nursing Considerations
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Epoetin Alfa
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IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Infusions (Solutions)
IV Insertion Angle
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IV Placement Start To Finish (How to Start an IV)
IV Pump Management
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Medication Errors
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
Medications in Ampules
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Mood Stabilizers
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Needle Safety
Neostigmine (Prostigmin) Nursing Considerations
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nitro Compounds
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
Nystatin (Mycostatin) Nursing Considerations
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Olanzapine (Zyprexa) Nursing Considerations
Opioid Analgesics in Pregnancy
Oral Medications
Oxycodone (OxyContin) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pediatric Dosage Calculations
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Pharmacology Course Introduction
Phenobarbital (Luminal) Nursing Considerations
Phytonadione (Vitamin K) for Newborn
Pill Crushing & Cutting
Positioning
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Sedatives-Hypnotics
Selecting THE vein
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
Struggling with Dimensional Analysis? – Live Tutoring Archive
SubQ Injections
Supplies Needed
Tattoos IV Insertion
TCAs
The SOCK Method – C
The SOCK Method – K
The SOCK Method – O
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations
03.02 Diabetes Insipidus for CCRN Review
03.01 Syndrome of Inappropriate Antidiuretic hormone (SIADH) for CCRN Review
03.03 Hypoglycemia for CCRN Review
03.04 DKA vs HHNK for CCRN Review
05.02 Liver Overview and Disease for CCRN Review
Absolute Neutrophil Count (ANC) Lab Values
ACE (angiotensin-converting enzyme) Inhibitors
Addisons Assessment Nursing Mnemonic (STEROID)
Addisons Disease
Airway Suctioning
Anion Gap
Calcium Channel Blockers
Causes of Pancreatitis Nursing Mnemonic (BAD HITS)
Cirrhosis Complications Nursing Mnemonic (Please Bring Happy Energy)
Coagulation Studies (PT, PTT, INR)
Crohn’s Morphology and Symptoms Nursing Mnemonic (CHRISTMAS)
Cushings Assessment Nursing Mnemonic (STRESSED)
Diabetes Insipidus Case Study (60 min)
Diabetes Insipidus Nursing Mnemonic (DDD)
Diabetes Management
Diabetes Mellitus (DM) Module Intro
Diabetes Mellitus & Those Dang Blood Sugars! – Live Tutoring Archive
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diabetic Emergencies for Certified Emergency Nursing (CEN)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)
Diagnostic Criteria for Lupus Nursing Mnemonic (SOAP BRAIN MD)
DKA Treatment Nursing Mnemonic (KING UFC)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia for Progressive Care Certified Nurse (PCCN)
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypertonic Solutions (IV solutions)
Hypoparathyroidism
Hypothermia (Thermoregulation)
Hypotonic Solutions (IV solutions)
Insulin
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin Mnemonic (Ready, Set, Inject, Love)
Intake and Output (I&O)
Iron (Fe) Lab Values
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Leukemia Case Study (60 min)
Lymphoma
Metformin (Glucophage) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Multiple Myeloma
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan for Cirrhosis (Liver)
Nursing Case Study for Type 1 Diabetes