Schizophrenia Nursing Care Plan: 2 Sample Plans and Interventions

Schizophrenia is a chronic brain disorder that affects how a person thinks, perceives, and behaves. Clients may have hallucinations, delusions, disorganized speech, or withdrawal. Your priorities are safety, reality orientation, and safe antipsychotic use.

A · AssessmentD · DiagnosisP · PlanningI · InterventionE · Evaluation

Each care plan below follows the nursing process (ADPIE).

CARE PLAN 1 · NURSING DIAGNOSIS

Disturbed Sensory Perception

Related to

Altered brain chemistry
Stopping antipsychotic medication
High stress

As evidenced by

Hears voices or sees things others do not
Talking or laughing to self
Looking around as if listening
Poor focus

PLANNING · EXPECTED OUTCOMES

Short-term goals

Client tells staff when hallucinations occur within 48 hours
Client names one way to manage voices

Long-term goals

Client takes medication as prescribed and has fewer hallucinations

ASSESSMENT

Content of hallucinations, especially commands to hurt self or others
Behavior and cues that the client is hallucinating
Medication use and side effects

INTERVENTIONS AND RATIONALES

INTERVENTION	RATIONALE
Ask directly about command hallucinations	Voices telling the client to harm someone are a safety emergency.
Accept that the voices are real to the client, but do not agree with them	This builds trust while presenting reality.
Focus on real, present events and activities	Reality-based activity pulls attention away from hallucinations.
Give antipsychotics as ordered	These reduce hallucinations and delusions.

EVALUATION

Client reports hallucinations to staff
Client uses a coping strategy when voices start
Hallucinations are less frequent

CARE PLAN 2 · NURSING DIAGNOSIS

Risk for Other-Directed Violence

Risk factors

Command hallucinations
Paranoid delusions
Agitation and history of violence

PLANNING · EXPECTED OUTCOMES

Short-term goals

Client does not harm self or others during the hospital stay
Client uses words instead of actions to express anger within 72 hours

Long-term goals

Client controls behavior and seeks help when feeling agitated

ASSESSMENT

Early signs of agitation such as pacing, clenched fists, or loud speech
History of violence
Neuromotor side effects such as EPS and signs of neuroleptic malignant syndrome

INTERVENTIONS AND RATIONALES

INTERVENTION	RATIONALE
Watch for early signs of agitation and step in early	Early action can prevent escalation.
Use a calm voice, keep a safe distance, and stay near an exit	This protects staff and lowers the threat the client feels.
Offer PRN medication as ordered when de-escalation is not enough	Medication can calm severe agitation.
Use seclusion or restraints only as a last resort per policy	These carry risks and require close monitoring and orders.

EVALUATION

No harm to self or others
Client tells staff when feeling angry
Agitation episodes decrease

Practice this in Pharmacy

Spot antipsychotic side effects like EPS and NMS before they become dangerous.

Play Pharmacy

Quick answers

A client on haloperidol has a high fever, rigid muscles, and confusion. What is happening?

These are signs of neuroleptic malignant syndrome. Hold the drug and notify the provider right away.

What lab must be monitored for a client on clozapine?

The absolute neutrophil count, because clozapine can cause agranulocytosis.

For learning only. Individualize every care plan to your client, and follow your program, current guidelines, provider orders, and facility policy.