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Paranoid Personality Disorder (Picmonic)
Blank Nursing Care Plan_CS (Cheat Sheet)
Example Care Plan_Paranoid Disorders (Cheat Sheet)
Schizophrenia Pathochart (Cheat Sheet)
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Transcript
Hi everyone. Today, we're going to be creating a nursing care plan for paranoid disorders. So, let's get started. So first let's go over the pathophysiology. With paranoid disorders, such as paranoid personality disorder and paranoid schizophrenia, clients exhibit bizarre behavior and feel intense feelings of distrust or fear. These clients will not confide in others and may be difficult to talk to as they often misinterpret harmless conversation or behavior. Nursing considerations: we want to assess neurological status, monitor behavior, be aware of the client's personal space, offer praise, and administer medications. The desired outcome: the client's going to be able to identify appropriate coping techniques and the client's going to be safe and free from harm.
So, we're going to go ahead and get into the care plan. We're going to be going over some subjective data and we're going to be going over some objective data. So, what are we going to see with these patients? One of the main things is they're going to be suspicious. So, they're going to have suspicion. They're going to have fear. They're going to have a poor self-image. Some objective data you're going to see with these patients. They are going to be in social isolation. Hostility is big with these patients. Some other examples: fear of being deceived, feelings of being persecuted, perfectionism, rigid behaviors and beliefs, self-righteous attitude. They get easily offended, detached and argumentative.
So, some interventions we're going to be doing. We first want to assess the client's neurological status. So, we're going to be doing a new assessment. So, we want to determine if any other issues may be causing the symptoms, or if the disorder has any progress to any other serious condition, such as schizophrenia. Another intervention that we want to be doing, we want to talk openly with the client about their beliefs and thoughts, showing empathy and support. We want to make sure we're helping build trust and rapport with patients. Paranoid clients may be more reluctant to trust anyone, but an open communication generally offers more cooperation. Another intervention we want to do is we want to remain aware of the client's personal space. We want to avoid startling the client, any sudden movements, or touching the client unnecessarily. Even the best of intentions, such as a handshake, maybe tidying a room, or any body language can be misinterpreted as being threatening and may lead to aggressive behavior by the client. We want to make sure that we're showing the client space and possessions, and we want to make sure we're building that trust with them. Another intervention we want to minimize environmental stimuli. So, you want to decrease environmental stimuli. Over stimulation from loud noises, excessive talking, television or radio may increase paranoia and prompt, erratic, or aggressive behaviors. Another intervention is we want to set behavioral boundaries. And we want to enforce per facility protocol with medications or restraints as necessary. You want to promote the safety of the clients during an agitated moment and the safety of others around them because of the aggressive behavior. You want to make sure you're following the facility specific protocol regarding supervision, restraint use, and documentation. Another intervention we want to do is administer any sort of medications appropriately and make sure we're monitoring for any sort of reactions. This can be antipsychotics, which may be given to manage delusions and behaviors. We also, with these patients, want to offer praise and encouragement for accomplishments of tasks. This is going to promote a sense of self-worth and improve self-esteem for these patients.
Alright, let's go over some key points. So, it is a bizarre behavior and feelings of distrust and fear. The exact cause is not known but is said to be a combination of biological and psychological factors. Some subjective objective data for these patients: they'll have suspicion, feelings of being prosecuted, poor self-image, perfectionism, rigid behaviors, beliefs, easily offended, social detachment, and hostility. We want to make sure we're assessing neurological status, behaviors, talk openly about their beliefs, and be aware of their personal space. Very big with these patients, their personal space. You want to make sure to set boundaries with them and enforce them, and administer medications as needed. And that's the care plan.
You guys did a wonderful job. We love you. Go out, be your best self today, and as always happy nursing.
So, we're going to go ahead and get into the care plan. We're going to be going over some subjective data and we're going to be going over some objective data. So, what are we going to see with these patients? One of the main things is they're going to be suspicious. So, they're going to have suspicion. They're going to have fear. They're going to have a poor self-image. Some objective data you're going to see with these patients. They are going to be in social isolation. Hostility is big with these patients. Some other examples: fear of being deceived, feelings of being persecuted, perfectionism, rigid behaviors and beliefs, self-righteous attitude. They get easily offended, detached and argumentative.
So, some interventions we're going to be doing. We first want to assess the client's neurological status. So, we're going to be doing a new assessment. So, we want to determine if any other issues may be causing the symptoms, or if the disorder has any progress to any other serious condition, such as schizophrenia. Another intervention that we want to be doing, we want to talk openly with the client about their beliefs and thoughts, showing empathy and support. We want to make sure we're helping build trust and rapport with patients. Paranoid clients may be more reluctant to trust anyone, but an open communication generally offers more cooperation. Another intervention we want to do is we want to remain aware of the client's personal space. We want to avoid startling the client, any sudden movements, or touching the client unnecessarily. Even the best of intentions, such as a handshake, maybe tidying a room, or any body language can be misinterpreted as being threatening and may lead to aggressive behavior by the client. We want to make sure that we're showing the client space and possessions, and we want to make sure we're building that trust with them. Another intervention we want to minimize environmental stimuli. So, you want to decrease environmental stimuli. Over stimulation from loud noises, excessive talking, television or radio may increase paranoia and prompt, erratic, or aggressive behaviors. Another intervention is we want to set behavioral boundaries. And we want to enforce per facility protocol with medications or restraints as necessary. You want to promote the safety of the clients during an agitated moment and the safety of others around them because of the aggressive behavior. You want to make sure you're following the facility specific protocol regarding supervision, restraint use, and documentation. Another intervention we want to do is administer any sort of medications appropriately and make sure we're monitoring for any sort of reactions. This can be antipsychotics, which may be given to manage delusions and behaviors. We also, with these patients, want to offer praise and encouragement for accomplishments of tasks. This is going to promote a sense of self-worth and improve self-esteem for these patients.
Alright, let's go over some key points. So, it is a bizarre behavior and feelings of distrust and fear. The exact cause is not known but is said to be a combination of biological and psychological factors. Some subjective objective data for these patients: they'll have suspicion, feelings of being prosecuted, poor self-image, perfectionism, rigid behaviors, beliefs, easily offended, social detachment, and hostility. We want to make sure we're assessing neurological status, behaviors, talk openly about their beliefs, and be aware of their personal space. Very big with these patients, their personal space. You want to make sure to set boundaries with them and enforce them, and administer medications as needed. And that's the care plan.
You guys did a wonderful job. We love you. Go out, be your best self today, and as always happy nursing.
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