General Objectives

This case study aims to identify and determine the general health problems and needs
of the patient with an admitting diagnosis of Paranoid Schizophrenia. This study also
intends to help patient promote health and medical understanding of such condition
through the application of the nursing skills.
Specific Objectives:
After the completion of this case study, the students will be able to:

Define Schizophrenia
Trace the pathophysiology
Enumerate the different sign and symptoms
Identify and understand different types of medical treatment
formulate and apply nursing care plan utilizing nursing process

Introduction :
Schizophrenia is a mental disorder characterized by the disturbances in
thoughts, sensory perception and deterioration in psychosocial functioning. It also
characterized by a week ago. The common defense mechanism used by individual are
regression, projection, withdrawal and denial. There are four As to acknowledge in
having schizophrenia associative looseness, blunted affect, ambivalence and autistic
thinking.
Paranoid schizophrenia is the most common type of schizophrenia in most parts
of the world. The clinical picture is dominated by relatively stable, often paranoid,
delusion usually accompanied by hallucinations particular auditory variety, and
perceptual alterations. Disturbances of affect, volition, speech. And catatonic symptoms

are not prominent. Paranoid schizophrenia is manifested primary through impaired

thought process, in which the central focus is on distorted perceptions or paranoid
behavior and thinking. Delusion is most cases grandiose, persecutory or both (WHO
2005)
With paranoid schizophrenia, the ability to think and function in daily life is better
compare with other types of schizophrenia. It may not have as many problems with
memory, concentration or dull emotions. Still paranoid schizophrenia is a serious.
Lifelong condition that can lead to many complications including suicidal behavior.
Patient who have paranoid schizophrenia that has though disorder obvious in
acute states, but if so it does not prevent the typical delusion or hallucinations from
being described clearly. Affect is usually less blunted than in order varieties of
schizophrenia, but minor degree of incongruity is common, as are mood disturbances
such as irritability, sudden anger, fearfulness, and suspicion. Negative symptoms such
as blunting of affect and impaired volition are often present but do not dominate the
clinical picture.
By using precise methods in its diagnosis and a large representative population,
the incidence rate of schizophrenia seems consistent across the world for the last halfcentury. Schizophrenia affects around 0.30.7% of people at some point in their life, or
24 million people worldwide as of 2011 (about one of every 285). Each year, one in
10,000 people age 12 to 60 develops schizophrenia. It is diagnosed 1.4 times more
frequently in males than females and typically appears earlier in menthe peak ages of

onset are 2028 years for males and 2632 years for females. Onset in childhood is
much rarer, as is onset in middle- or old age.
Generally, the mean age of first admission for schizophrenics is between 25 and
35. Studies have suggested that lower income individuals tend to have their disorder
diagnosed later after the onset of symptoms, relative to those of better economic
standings. As a result, the lower social classes are more likely to be living with their
illness untreated. One recovery center in the United States reported that 92% of its
clients received government benefits because their income fell below the poverty line.
These statistics show that a number of people suffering from mental illnesses are a part
of disenfranchised and impoverished groups, and are therefore unable to attain the
adequate healthcare they need in order to effectively treat their mental disorders.
It is generally accepted that women tend to present with schizophrenia anywhere
between 4-10 years after their male counterparts. However, using broad criteria for
diagnosing schizophrenia shows that males have a bimodal age of onset, with peaks at
21.4 years and 39.2 years old, while females have a trimodal age of onset with peaks at
at 22.4, 36.6, and 61.5 years old.
According to the World Health Organization. It describe about mental disorders of
a year (2008). Schizophrenia is a severe form of mental illness affecting about 7 per
thousand of a adult population. Mostly in the age group of 15-35 years. Though the
incident is low (3-10,000), the prevalence is high due to chronicity. According to the
facts it reveals schizophrenia affects about 24 million people worldwide. Schizophrenia

is a treatable disorder, treatment being more effective in its initial stages. More than
50% of persons with schizophrenia are in developing countries.
In the U.S. mental disorders are diagnosed based on the Diagnosis and Statistic
Manual of Mental Disorders, fourth edition (DSM-IV)
(http://www.howstuffworks.com/framed.htm?
parent=schizophrenia.htm&url=http://www.nimh.nih.gov/health/publications/the
numbers-count-mental-disorders-in-america.shtml)
Theoretical Framework
Maslow's hierarchy of needs is often portrayed in the shape of a pyramid with the
largest, most fundamental levels of needs at the bottom and the need for selfactualization at the top. While the pyramid has become the de facto way to represent
the hierarchy, Maslow himself never used a pyramid to describe these levels in any of
his writings on the subject.
The most fundamental and basic four layers of the pyramid contain what Maslow
called "deficiency needs" or "d-needs": esteem, friendship and love, security, and
physical needs. If these "deficiency needs" are not met with the exception of the most
fundamental (physiological) need there may not be a physical indication, but the
individual will feel anxious and tense. Maslow's theory suggests that the most basic
level of needs must be met before the individual will strongly desire (or focus motivation
upon) the secondary or higher level needs. Maslow also coined the term "meta

motivation" to describe the motivation of people who go beyond the scope of the basic
needs and strive for constant betterment.
The human mind and brain are complex and have parallel processes running at the
same time, thus many different motivations from various levels of Maslow's hierarchy
can occur at the same time. Maslow spoke clearly about these levels and their
satisfaction in terms such as "relative," "general," and "primarily." Instead of stating that
the individual focuses on a certain need at any given time, Maslow stated that a certain
need "dominates" the human organism. Thus Maslow acknowledged the likelihood that
the different levels of motivation could occur at any time in the human mind, but he
focused on identifying the basic types of motivation and the order in which they should
be met.