case study on schizophrenia

8/12/2019 Case Study on Schizophrenia

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URDANETA CITY, PANGASINAN

COLLEGE OF NURSING

A CASE STUDY ONSCHIZOPHRENIA

Submitted to:Ms. Maribel Murillo RN, MAN

Clinical Instructor

Submitted by:Kristin Abee E. GuarinSN Batch !"#

I. PATIENT ASSESSMENT DATABASE

A. Personal Data

Name:Mr. MP

Address:Las Pinas, Philippines


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Ae:35

Se!:Male

B"rt#da$: June 5, 1976

B"rt# Pla%e:

C"&"l Stat's:Single

Nat"onal"t$:Filipino

Rel""on:Roman Catholi Ed'%at"onal Atta"nment! 3r"#ear ollege, $S Management

O%%'(at"on:%one

P#$s"%"an:&r. Corte'

Date o) Adm"ss"on:Jul# 1(, )**(

Adm"tt"n D"anos"s:Shi'ophrenia

*os("tal Name:Mother +heresa -ome that Cares

B. C*IEF COMPLAINT

% /he "oesn0t ooperate upon interie2

C. *ISTORY OF PRESENT ILLNESS

%/he "oesn0t ans2er m# 4uestion aout his present illness

D. PAST *EALT* *ISTORY

% /he "oesn0t reall his past health histor#

E. FAMILY ASSESSMENT

%ame Relation ge Se upation 8"uational ttainment

Mr. MP Patient 35 Male %one 3

r"

#ear ollegeMr. CP Father 7 Male &oesn0t reall &oesn0t reall

Mrs. &P Mother 6 Female &oesn0t reall &oesn0t reall

F. SYSTEM RE+IE

1. HEALTH PERCEPTION HEALTH MANAGEMENT PATTERN

%ot assess eause patient "oesn0t ans2er m# 4uestions aout health pereption an" health management

2. NUTRITIONAL METABOLIC PATTERN

%

3. ELIMINATION PATTERN

Patient usuall# urinates 6 times a "a# an" "e:eates ) times "ail#


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4. ACTIVITY- EXERCISE PATTERN

*;Fee"ing * ;&ressing *;; Re4uires use o: assistane

>>; Re4uires assistane an" superisions # others>>>; Re4uires assistane or superisions :rom another an" e4uipments an" "eies

>? @ &epen"ent, "oesn0t partiipate

5. COGNITIVE PERCEPTUAL PATTERN

*ear"n: she "oesn0t hae an# hearing prolems

+"s"on: she0s haing lurre" ision an" she use rea"ing glass

Sensor$: our patient is responsie an" is ale stimulate" # losing her e#es an" instrute" to point 2hat hae een pointe" on her

sAin. +here is no prolem 2ith sense o: taste an" smell. Learn"n St$les: m# patient "oesn0t ans2er m# 4uestion an" sometimes not ooperatie

6. SLEEP- REST PATTERN

or"ing to m# patient he sleeps at 9pm to 6am. -e also state" that sometimes he ha" prolems in sleeping.

7. SELF- PERCEPTION AND SELF- CONCEPT PATTERN

%

8. ROLE- RELATIONSHIP PATTERN

%

9. COPING- STRESS TOLERANCE PATTERN

N-A10.VALUE- BELIEF PATTER

N-A

G. DE+ELOPMENTAL *ISTORY

T#eor$ Ae Se! Des%r"(t"on

8riAson0s Ps#hosoial +heor# 35 #ears ol" Male

Int"ma%$ &s Isolat"on

Mr. MP "oesn0t ans2er m# 4uestions sometimes an" "oesn0t partiipate to theatiities eause he "oesn0t trust me as his nurse.


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H. P*YSICAL ASSESSMENT

A. General S'r&e$

1. O&erall a((earan%e and room"n: upon assessment patient is neat an" lean, he mani:este" a goo" grooming.2. A%t'al #e"#t and .e"#t &s/ "deal 0od$ .e"#t: na

3. S$m(toms o) d"stress: he is not ans2ering m# 4uestion mostl# an" he pre:er to e alone sometimes

4. Post're and a"t: upon assessment her posture an" gait are 2ell oor"inate".5. A))e%t and mood: he is not ans2ering m# 4uestion mostl# an" he pre:er to e alone sometimes.

B. Re"onal e!am1 't"l"2e IPPA te%#n"3'e

". *a"r:Bpon inspetion, his hair is eenl# "istriute", thiA, its teture is silA# an" resilient hair an" there is no presene o: in:estation/lie an" ariale in amount.

*ead and )a%e:his hea" is roun", smooth sAull ontour, s#mmetri in si'e an" onsistent 2hile her :ae is s#mmetri in :aial

moement.. E$es:Bpon inspetion o: the lient0s e#es, its e#ero2s an" e#elashes are s#mmetriall# aligne", urle" slightl# out2ar" an" hair is

eenl# "istriute".

$. Nose:Bpon inspetion, lient0s nose is s#mmetrial, no "isharges, uni:orm in olor, he reaths properl# through the nares.#. Ears:+hrough inspetion, lient0s ears are s#mmetrial the aurile is aligne" 2ith the outer anthus o: the e#es an" same 2ith the

olor o: :aial sAin.

%. Mo't# and t#roat:+hrough inspetion, lient0s lips an" ual muosa is pinA in olor. %o retration o: gums, 2ith inomplete teeth.

+ongue moes :reel#.&. Ne%4 and l$m(# nodes:+he lient0s neA musles are e4ual in si'e, no enlargement o: no"ules or masses upon palpation. -ea"

moement is oor"inate" an" smooth moement 2ith no "isom:ort.'. S4"n:$ro2n in olor, 2arm to touh an" e4uall# "istriute" # hair.

(. Na"ls::ingernail plate has one urature an" an angle o: nail plate aout 16*D, smooth teture, :inger nail an" toenail e" olor is

pale, 2ith intat epi"ermis.

). T#ora! and l'ns:Chest is s#mmetri, spine ertiall# aligne", spinal olumn is straight, right an" le:t shoul"er are at same height."!. Breast and a!"lla:not assesse""". . A0domen:not assesse"

". E!trem"t"es:there is no presene o: e"ema or anormal :in"ings"$. Gen"tals:not assesse"

"#. Re%t'm and an's:not assesse"

"%. Ne'rolo"%al-Cran"al ner&es:not assesse".


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INTRODUCTION

Shi'ophrenia is a ps#hoti "isor"er /or a group o: "isor"ers marAe" # seerel# impaire" thinAing, emotions, an" ehaiors. Shi'ophrenipatients are t#piall# unale to :ilter sensor# stimuli an" ma# hae enhane" pereptions o: soun"s, olors, an" other :eatures o: their enironment.

Most shi'ophrenis, i: untreate", gra"uall# 2ith"ra2 :rom interations 2ith other people, an" lose their ailit# to taAe are o: personal nee"s an"

grooming.

Cl"n"%al Man")estat"ons

+he s#mptoms o: shi'ophrenia are "ii"e" into t2o maEor ategories!

A. +he positie s#mptoms inlu"e!

"elusions an" its t#pes,

halluinations,

loose assoiations an"


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i'arre or "isorgani'e" ehaior

B. +he negatie s#mptoms inlu"es!

restrite" emotions,

anhe"onia,

aolition,

alogia,

atatonia an" soial 2ith"ra2al.

D"anost"% Test

Clinial "iagnosis is "eelope" on historial in:ormation an" thorough mental status eamination.

%o laorator# :in"ings hae een i"enti:ie" that are "iagnosti o: shi'ophrenia.

Routine atter# o: laorator# test ma# e use:ul in ruling out possile organi etiologies, inlu"ing C$C, urinal#sis, lier :untion tests,

th#roi" :untion test, RPR, ->? test, serum eruloplasmin / rules out an inherite" "isease, 2ilson0s "isease, in 2hih the o"# retains

eessie amounts o: opper, P8+ san, C+ san, an" MR>. Rating sale assessment!

Sale :or the assessment o: negatie s#mptoms.

Sale :or the assessment o: positie s#mptoms.

$rie: ps#hiatri rating sale

Treatment

omprehensie treatment program an inlu"e!

ntips#hoti me"iation

8"uation support, :or oth ill in"ii"uals an" :amilies

Soial sAills training

Rehailitation to improe atiities o: "ail# liing

?oational an" rereational support

Cognitie therap#

N'rs"n Inter&ent"ons:

A. Strent#en"n D"))erent"at"on

Proi"e patient 2ith honest an" onsistent :ee"aA in a non threatening manner.


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oi" hallenging the ontent o: patient0s ehaior

Fous interations on patient0s ehaior.

"minister "rugs as presrie" 2hile monitoring an" "oumenting patient0s response to "rug regimen.

Bse simple an" lear language 2hen speaAing 2ith the patient.

8plain all proe"ures, test an" atiities to patient e:ore starting them

B. Promot"n So%"al"2at"on 8nourage patient to talA aout :eelings in the ontet o: a trusting, supportie relationship.

llo2 patient to reeal "elusions to #ou 2ithout engaging in po2er struggle oer the ontent or the entire realit# o: the "elusions.

Bse supportie, emphati approah to :ous on patient0s :eelings aout trouling eents or on:lits.

Proi"e opportunities :or soiali'ation an" enourage partiipation in group atiities.

$e a2are o: personal spae an" use touh Eu"iiousl#.

-elp patient to i"enti:# ehaiors that alienate signi:iant others an" :amil# memers.

C. Ens'r"n Sa)et$

Monitor patient :or ehaiors that in"iate inrease" aniet# an" agitation. Collaorate patient to i"enti:# anious ehaiors as 2ell as auses.

8stalish onsistent limits on patients ehaior an" learl# ommuniate these limits to patients, :amil# memer, an" health are proi"ers.

Seure all potential 2eapons an" artiles :rom patients room an" the unit enironment that oul" e use" to in:lit inEur#.

&etermine the nee" :or eternal ontrol, inlu"ing selusion or restraints. Communiate the "eision to patient an" put plan into ation.

Fre4uentl# monitor the patient 2ithin gui"elines o: :ailit#0s poli# on restritie "eies an" assess the patients leel o: agitation.

Ghen patient0s leel o: agitation egins to "erease an" sel: ontrol regaine", estalish a ehaioral agreement that i"enti:ies spei:i

ehaiors that in"iate sel: ontrol against are esalation agitation.

ANATOMY AND P*YSIOLOGY

I/ Str'%t'res

. +he ne'rolo"% s$stemonsists o: t2o main "iisions, the entral nerous s#stem /C%S an" the peripheral nerous s#stem /P%S. +he

autonomi nerous s#stem /%S is ompose" o: oth entral an" peripheral elements.1. +he CNSis ompose" o: the rain an" spinal or".

). +he PNSis ompose" o: the 1) pairs o: the ranial neresan" the 31 pairs o: the spinal neres.3. +he ANSis omprise" o: iseral e::erent /motor an" the iseral a::erent /sensor# nulei in the rain an" spinal or". >ts peripheral

"iision is ma"e up o: iseral e::erent an" a::erent nere :iers as 2ell as autonomi an" sensor# ganglia.
http://nursingcrib.com/anatomy-and-physiology/cranial-nerves/http://nursingcrib.com/anatomy-and-physiology/cranial-nerves/


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$. +he 0ra"nis oere" # three memranes.1. +he d'ra matteris a :irous, onnetie tissue struture

ontaining seeral loo" essels.). +he ara%#no"d mem0raneis a "eliate serous memrane.

3. +he ("a matteris a asular memrane.

C. +he s("nal %ordeten"s :rom the me"ulla olongata to the lo2er

or"er o: the :irst lumar erterae. >t ontains millions o: nere :iers,an" it onsists o: 31 neres @ erial, 1) thorai, 5 lumar, an" 5saral.

&/ Cere0ros("nal )l'"d5CSF6:orms in the lateral entriles in the

horoi" pleus o: the pia matter. >t :lo2s through the :oramen o: Monro

into to the thir" entrile, then through the a4ue"ut o: S#lius to the:ourth entrile. CSF eits the :ourth entrile # the :oramen o:

Magen"ie an" the t2o :oramens o: LusAa. >t then :lo2s into the istemamagna, an" :inall# it irulates to the suarahnoi" spae o: the spinal

or", athing oth the rain an" the spinal or". Flui" is asore" # thearahnoi" memrane.

II/ F'n%t"on

A/ CNS

1. Bra"nT#e %ere0r'm is the enter :or onsiousness, thought, memor#, sensor# input, an" motor atiit# it onsists o: t2o hemispheres /le:t an"

right an" :our loes, eah 2ith spei:i :untions. +he :rontal loe ontrols oluntar# musle moements an" ontains motor areas, inlu"ing the area :or speeh it also ontains the enters :or

personalit#, ehaioral, autonomi an" intelletual :untions an" those :or emotional an" ar"ia responses. +he temporal loe is the enter :or taste, hearing an" smell, an" in the rain0s "ominant hemisphere, the enter :or interpreting spoAen

language. +he parietal loe oor"inates an" interprets sensor# in:ormation :rom the opposite si"e o: the o"#.

+he oipital loe interprets isual stimuli.

+he t#alam's:urther organi'es ereral :untion # transmitting impulses to an" :rom the ererum. >t also is responsile :or primitieemotional responses, suh as :ear, an" :or "istinguishing et2een pleasant an" unpleasant stimuli.
http://nursingcrib.com/anatomy-and-physiology/cerebrospinal-fluid/http://nursingcrib.com/anatomy-and-physiology/cerebrospinal-fluid/


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L#ing eneath the thalamus, the #$(ot#alam's is an automati enter that regulates loo" pressure, temperature, lii"o, appetite, reathing,sleeping patterns, an" peripheral nere "isharges assoiate" 2ith ertain ehaior an" emotional epression. >t also helps ontrol pituitar# seretion

an" stress reations.

+he ereellum or hin"rain, ontrols smooth musle moements, oor"inates sensor# impulses 2ith musle atiit#, an" maintains musle

tone an" e4uilirium.

+he rain stem, 2hih inlu"es the mesenephalon, pons, an" me"ulla olongata, rela#s nere impulses et2een the rain an" spinal or".

7/ T#e s("nal %ord:orms a t2o;2a# on"utor path2a# et2een the rain stem an" the P%S. >t is also the re:le enter :or motor atiities that "onot inole rain ontrol.

B/ T#e PNSonnets the C%S to remote o"# regions an" on"uts signals to an" :rom these areas an" the spinal or".

C/ T#e ANSregulates o"# :untions suh as "igestion, respiration, an" ar"ioasular :untion. Superise" hie:l# # the h#pothalamus, the %Sontains t2o "iisions.

1. +he s$m(at#et"% ner&o's s$stemseres as an emergen# prepare"ness s#stem, the H:light;:or;:ightI response. S#mpatheti impulsesinrease greatl# 2hen the o"# is un"er ph#sial or emotional stress ausing ronhiole "ilation, "ilation o: the heart an" oluntar# musle loo"essels, stronger an" :aster heart ontrations, peripheral loo" essel onstrition, "erease" peristalsis, an" inrease" perspiration. S#mpatheti

stimuli are me"iate" # norepinephrine.). +he (aras$m(at#et"% ner&o's s$stemis the "ominant ontroller :or most iseral e::etors :or most o: the time. Paras#mpatheti

impulses are me"iate" # aet#lholine.

PAT*OP*YSIOLOGY

Distur!"#$ i" "$ur%tr!"s&itt$r

Br!i" ($)$*%+&$"t ,r%& #%"#$+ti%" t% $!r*'

A"!t%&i# !"( ,u"#ti%"!* (isru+ti%" i" "$ur!* #%""$#ti)it' !"(

I&+!ir$( !i*it' t%I&+!ir&$"t i" %"$ %r &%r$ s$#%"(-%r($rI&+!ir&$"t i" ! ,u"(!&$"t!* #%"iti)$

*redis+osin-actorStr$ss


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LABORATORY RESULT

Ele%trol$tesResult %ormal ?alues Signi:iane

So"ium 136 135;1(5 Githin normal range

Potassium 3.9 3.5;5.* Githin normal range

Ur"nal$s"s

RESULTS SIGNIFICANCE RESULTS SIGNIFICANCE

Color!ello2 Githin normal range

Sugar!negatie Githin normal range

+ransparen#! Spei:i grait#!

/%%s$"$ss %, !i*it' i"

SS D$*usi%" !"(

Dis%r!"i$( t%ut

S%#i!* is%*!ti%"


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Clear Githin normal range 1.*1* Githin normal range

Reation! Mirosopi!

PusleuAo#tes!

lumin!

i"i lumin Githin normal range 8r#thro#tes!

Roentroenolo"%al re(ort

F"nd"ns:

+here are ha'# in:iAtrates at oth suprahilar area heart is not enlarge" "iaphragm an" suli are intat

Im(ress"on

Suprahilar pneumonitis, ilateral AohKs etiolog# not rule" out

DRUG STUDY

Gener"% Name: -aloperi"ol

Brand Name: -al"ol

Dr' Class")"%at"on: ntips#hotiDosae:)*mg 1( ta &

Ind"%at"on: Management o: mani:estations o: ps#hoti "isor"ers

Me%#an"sm o) A%t"on Ad&erse E))e%ts Contra"nd"%at"ons S"de E))e%ts N'rs"n Cons"derat"ons


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nti;ps#hotis loAposts#napti "opamine

reeptors in the rain,"epress the RS,

inlu"ing those parts o:the rain inole" 2ith

2aAe:ulness an" emesis.

?ertigo, hea"ahe

%asal ongestion

Pol#uria

Cereral e"ema

+remor

taia

rthostati

h#potension

Car"iomegal#

S>&-

8osinophilia

Leuopenia

Jaun"ie

Brtiaria

Coma

Seere C%S

"epression

$one marro2

"epression $loo" "#srasia

Cirulator# ollapse Suortial rain

"amage

Cereral

arterioslerosis Coronar# "isease

Seere h#potension

or h#pertension

&ro2siness

$lurring o: ision

&r# mouth

%ausea an" omiting

+ah#ar"ia,

ra"#ar"ia

insomnia

Proi"e sa:et# to the patient

Maintain :lui" intaAe an" use

preautions against heatstroAe orheat 2eather

Monitor eletrol#tes leel Monitor ?ital Signs ontinuousl#

Proi"e rest an" om:ort

Monitor C$C, $B%, Creatinine


13/21


Competitiel# loAs thee::ets o: histamine at

h1 reeptor sites, hasatropine;liAe, anti;

pruriti an" se"atiee::ets

Fatigue

Con:usion

$lurre" ision

-ea"ahe

&iplopia +remors

Palpitations

$ra"#ar"ia

&iarrhea

Constipation

Brinar# :re4uen#

noreia

suria

rash

+hir" trimester o:

pregnan#

Latation

Used %a't"o'sl$

."t#: %arro2 angle

glauoma

sthmati attaA

$la""er neA

ostrution

Pregnan#

Stenosing pepti

uler

S#mptomati

prostatih#pertroph#

&ro2siness

Se"ation

&i''iness

&isture"

oor"ination %ausea an" omiting


ssist patient in amulation


preautions against heatstroAe orheat 2eather

Monitor eletrol#tes leel

"minister these "rugs 2ith :oo"

i: upset our Monitor ?ital Signs ontinuousl#




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ts as an

anti"epressant #inhiiting C%S neuronal

uptaAe o: serotoninloAs uptaAe o:

serotonin 2ith little

e::et on norepinephrine

gitation

Se"ation

Sei'ure

normal gait Palpitations

Flatulene

C#stitis

>mpotene

alopeia

h#persensitiit# to

:luoetine an"pregnan#

&i''iness

-ea"e"nes

%erousness

S2eating an" "r#

mouth

%ausea an" omiting

&iarrhea

onstipation

ra"#ar"ia


+eah patient aout relaation

tehni4ue

>nrease :lui" intaAe Maintain :lui" intaAe an" use

preautions against heatstroAe or

heat 2eather

Monitor eletrol#tes leel

8at :oo"s high in :ier

Monitor ?ital Signs ontinuousl#


Gener"% Name: Fluphena'ine "eanoate

Brand Name: Mo"eate

Dr' Class")"%at"on: ntips#hoti

Dosae: initial "ose, 1).5 @ )5mg >M

Ind"%at"on: Management o: ehaioral ompliation in patients 2ith mental retar"ation



15/21

nti;ps#hotis loA

"opamine reeptors inthe rain, "epress the

RS, inlu"ing thoseparts o: the rain

inole" 2ith2aAe:ulness an" emesis.

?ertigo, hea"ahe

%asal ongestion

Pol#uria

Cereral e"ema

+remor

taia rthostati

h#potension

Car"iomegal#

S>&-

8osinophilia

Leuopenia

Jaun"ie

Brtiaria

Coma

Seere C%S

"epression

$one marro2

"epression

$loo" "#srasia Cirulator# ollapse

Suortial rain

"amage Cereral

arterioslerosis

Coronar# "isease

Seere h#potension

or h#pertension

&ro2siness

$lurring o: ision

&r# mouth

%ausea an" omiting

+ah#ar"ia,

ra"#ar"ia

insomnia



preautions against heatstroAe or

heat 2eather

Monitor eletrol#tes leel Monitor ?ital Signs ontinuousl#




16/21


nti;ps#hotis loA

"opamine reeptors inthe rain, "epress the

RS, inlu"ing thoseparts o: the rain

inole" 2ith

2aAe:ulness an" emesis.

+remor

&isture" sleep

Se"ation

S2eating &r# mouth

Brtiaria

Rash

leuAopenia

Seere C%S

"epression

-istor# o: sei'ure


17/21

ntiholinergi atiit#

in the C%S that iseliee" to help

normali'e theh#pothesi'e" imalane

o: holinergi an""opaminergi

neutransmission in the

asal ganglia in the raino: a parAinsonism

patient.

Memor# loss

gitation

&epression

&ro2siness

+ah#ar"ia

Palpitations -#potension

Rash

Brtiaria

2eaAness


18/21

S'08e%t"&e:

O08e%t"&e:

Oinailit# to trust

OlaA o: interest

&isture" thoughtproesses relate" to

inailit# to trustei"ene" #

"elusional thinAing.

:ter 1;) "a#s o:ren"ering nursing

interentions, thepatient 2ill e ale

to "eelop trustingrelationship 2ith

nurse

$e sinere an" honest 2henommuniating 2ith the

lient. oi" ague oreasie remarAs.

$e onsistent in setting

epetations, en:oring rules,

an" so :orth.

&o not maAe promises that#ou annot Aeep.

8nourage the lient to talA2ith #ou, ut "o not pr# :orin:ormation.

8plain proe"ures, an" tr# t

o e sure the lientun"erstan"s the proe"ures

e:ore arr#ing them out.

>nitiall#, "o not argue 2iththe lient or tr# to oninethe lient that the "elusions

are :alse or unreal.

&elusional lients areetremel# sensitie aout

others an" an reogni'einsinerit#. 8asie

omments or hesitationrein:ores mistrust or

"elusions.

Clear, onsistent limits

proi"e a seure struture:or the lient.

$roAen promises rein:orethe lient0s

mistrust o: others.

Proing inreases thelient0s suspiion an"

inter:eres 2ith the

therapeuti relationship.

Ghen the lient has :ullAno2le"ge o: proe"ures, he

or she is less liAel# to :eel

triAe" # the sta::.

Logial argument "oes not"ispel "elusional i"eas an"

an inter:ere 2ith the"eelopment o: trust

:ter ) "a#s o:ren"ering nursing

interentions, thepatient 2as

"eelop trustingrelationship 2ith

nurse

Assessment N'rs"n D"anos"s Plann"n Inter&ent"ons Rat"onale E&al'at"on


19/21

S'08e%t"&e:

O08e%t"&e:

Ounommuniatie

OseeAs to e aloneO proEets hostilit#

Osa""ull a::et

Soial >solation relate"to alteration in mental

status


interentions, lient2ill i"enti:# :eelings

o: isolation

Oestalish atherapeuti

relationship # eingemotionall# present

an" authenti

Oosere :or arriersto soial interation

Oproi"e positie

rein:orement 2henthe lient seeAs out

others

O"isuss auses o:

pereie" or atualisolation

Oeing emotionall#present an" authenti

:osters gro2th inrelationships an"

"erease isolation

Oa"e4uate in:ormationshoul" e gathere" so

appropriateinterentions an e

planne"

Osoial support

ontriutes to positie2ell eing

Othe in"ii"ual0s

eperiene o: illness

the irumstanes o:eer#"a# liing that

in:luene a 4ualit# o:li:e


interentions, lient2ill i"enti:# :eelings

o: isolation


20/21

Assessment N'rs"n

D"anos"sPlann"n Inter&ent"ons Rat"onale E&al'at"on

S'08e%t"&e:

O08e%t"&e:O laAing e#eontat

Olittle interest inatiities

OlaA o: soial

interation

Situational lo2

sel:;esteem

relate" toognitieimpairment

:ter );3 hours o:

ren"ering nursing

interentions, thepatient 2illerali'e

un"erstan"ing o:things that

preipitate urrent

situation an""emonstrate

ehaiors thatsho2 positie sel:;

esteem.

8nourage lient to epress

honest :eelings in relation to

loss o: prior leel o::untioning

Reise metho"s :or assisting

lient to epress :eelingsproperl#.

8nourage lient0s attempts toommuniate. >: erali'ationsare not un"erstan"ale, epress

to lient 2hat #ou thinA heinten"e" to sa#. >t is neessar#

to reorient lient :re4uentl#.

8nourage reminisene an"

"isussion o: li:e reie2

8nourage to partiipate in

atiities

::er support an" empath#

Client ma# e :ie" in anger

stage o: grieing proess,

2hih is turne" in2ar" onthe sel:, resulting in"iminishe" sel:;esteem.

+o eplore the :eelings o:

the lient there# allo2ing

him to aAno2le"ge hiso2n strength an" 2eaAness

+he ailit# to ommuniate

e::etiel# 2ith others ma#enhane sel:;esteem

-elp lient resume

progression through the

grie: proess assoiate"2ith "isappointing li:e

eents an" inrease sel:;esteem

Positie :ee"aA :romgroup memers 2ill

inrease sel:;esteem

Fous on aomplishmentsto li:t sel:;esteem

:ter 3 hours o:

ren"ering nursing

interentions, thepatient 2aserali'e"

un"erstan"ing o:things that

preipitate urrent

situation an""emonstrate"

ehaiors that sho2positie sel:;esteem.

DISC*ARGE PLAN

Med"%at"on:


21/21

>nstrut patient to ontinue taAing her me"iations

&o not stop aruptl# taAing the me"iations

Report an# ompliations or seere e::ets o: "rugs to #our health are proi"er

E!er%"se:

8nourage patient to hae regular eerise een he is at their home.

Treatment:

>nstrut patient to ontinue taAing her me"iations.

Cl"n"%al Follo.1'(:

>nstrut patient to hae her :ollo2;up heA; up a:ter one 2eeA.

D"et:

"ise the patient to eat green lea:# egetales, rih in iron an" itamin C

Daner s"ns:

>nstrut patient to seeA me"ial a"ie to ph#siian i: she eperiening "isom:ort an" ompliations

case study on schizophrenia

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