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Mr. Apo a 49yr old male single patient in dorm two was born on March 12, 1960. He weight 74 pounds and height of 5’10. He lived at barrio matalaba lingayen. He has a Filipino nationality and his religion is Roman catholic. His educational attainment was a 2nd year college only. He was admitted at NCMH on August 13,1960, involuntarily and accompanied by his relatives especially his sister Arlene. His sister decided to admit Mr. Apo due to unwanted behavioral changes like restlessness and Sleeping disturbance. He was diagnosed as undifferentiated schizophrenia and now his current diagnosis was undifferentiated schizophrenia.
is a mental disorder which is part of the family of disorders broadly known as “schizophrenia.” There are a number of subcategories of schizophrenia including paranoid schizophrenia, catatonic schizophrenia, disorganized schizophrenia, residual schizophrenia, and schizoaffective disorder; undifferentiated schizophrenia is often
defined as a form in which enough symptoms for a diagnosis are present, but the patient does not fall into the catatonic, disorganized, or paranoid subcategories. Schizophrenia is characterized by a lack of grounding in reality, known as psychosis. People in a state of psychosis can experience hallucinations, delusions, and other events in which they break from reality. Individuals with schizophrenia experience psychosis and can also develop symptoms such as disorganized speech, lack of interest in social
interactions, a flat affect, inappropriate emotional responses to situations, confusion, and disorganized thinking. Patients with undifferentiated schizophrenia do not experience the paranoia associated with paranoid schizophrenia, the catatonic state seen in patients with
catatonic schizophrenia, or the disorganized thought and expression observed in patients with disorganized schizophrenia. However, they do experience psychosis and a variety of other symptoms associated with schizophrenia, including behavioral changes which may be noticeable to family and friend.
One of the reasons for the ongoing difficulty in classifying schizophrenic disorders is incomplete understanding of their causes. It is thought that these disorders are the end result of a combination of genetic, neurobiological, and environmental causes. A leading neurobiological hypothesis looks at the connection between the disease and excessive levels of dopamine, a chemical that transmits signals in the brain (neurotransmitter). The genetic factor in schizophrenia has been underscored by recent findings that first-degree biological relatives of schizophrenics are ten times as likely to develop the disorder as are members of the general population. Prior to recent findings of abnormalities in the brain structure of schizophrenic patients, several generations of psychotherapists advanced a number of psychoanalytic and sociological theories about the origins of schizophrenia. These theories ranged from
as well as human endogenous retroviruses (HERVs). the need to adjust to living in large urban areas. The possibility that HERVs may be associated with schizophrenia has to do with the fact that antibodies to these retroviruses are found more frequently in the blood serum of patients with schizophrenia than in serum from control subjects. Damage to the hippocampus would account for schizophrenic patients' vulnerability to sensory overload. Another hypothesis suggests that schizophrenia may be caused by a virus that attacks the hippocampus.hypotheses about the patient's problems with anxiety or aggression to theories about stress reactions or interactions with disturbed parents. Psychosocial factors are now thought to influence the expression or severity of schizophrenia rather than cause it directly. . a part of the brain that processes sense perceptions. As of 2004. Black immigrants from Africa or the Caribbean appear to be especially vulnerable. researchers are focusing on the possible role of the herpes simplex virus (HSV) in schizophrenia. migration is a social factor that is known to influence people's susceptibility to psychosis. Psychiatrists in Europe have noted the increasing rate of schizophrenia and other psychotic disorders among immigrants to almost all Western European countries. The stresses involved in migration include family breakup. As of 2004. and social inequalities in the new country.
. Martians.Symptoms Patients with a possible diagnosis of schizophrenia are evaluated on the basis of a set or constellation of symptoms. the FBI. which he regarded as diagnostic of the disorder. there is no single symptom that is unique to schizophrenia. the CIA. Thought insertion and/or withdrawal refer to delusions that an outside force (for example. such as the notion that one's brain is radioactive. In 1959. etc. the German psychiatrist Kurt Schneider proposed a list of so-called first-rank symptoms. These symptoms include: • • • • • delusions somatic hallucinations hearing voices commenting on the patient's behavior thought insertion or thought withdrawal Somatic hallucinations refer to sensations or perceptions concerning body organs that have no known medical cause or reason.) has the power to put thoughts into one's mind or remove them.
His previous medications are Nozinan and haloperidol. His current medications are nozinan. The fasting blood sugar of the patient is 5. place and time. He has lesions in legs.History The patient diagnosed as undifferentiated schizophrenia and current undifferentiated schizophrenia. The skin of the patient was dry with scar. and at the back of the body. The patient has no skeletal deformities. Apo was regular exercise everday. transparency was slightly turbid. blood pressure was 120/90. He does not undergo in any surgery. back of the body and knee.010. The weight of Apo is 74 pounds. The patient was on regular diet. Related Treatment . The color of urinalysis is light yellow. Nursing physical assessment Apo was alert and oriented to person. The patient’s temperature 36. His medications are only for his mental illness.31 and specific 1. The patient scars was located at leg. arms. arms.0 Celsius. respiratory rate 20. The bowel sounds of the patient is good. The musculoskeletal status of the patient are weakness and tremors. The patient stated her pain level. pulse rate was 80. haloperidol and chlorpromazine.
nausea and vomiting associated with terminal illness. Nozinan 10mg/ capsule it is used in the treatment of schizophrenia and is also used in the management of pain. Haloperidol 10mg/capsule it is used in the treatment of schizophrenia and is also used in the management of pain. Chlorpromazine is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking. which an typical antipsychotic medication. and strong or inappropriate emotions) and other psychotic disorders (conditions that cause difficulty telling the difference between things or ideas that are real and things or ideas that are not real) and to treat the symptoms of mania (frenzied. It is used to treat undifferentiated schizophrenia. not on the basis of internal psychological processes. Apo is now receiving a Haloperidol 1mg tablet. distress. It works by changing the effects of chemicals in the brain. discovered that patients with schizophrenia have certain . nausea and vomiting associated with terminal illness. loss of interest in life.Mr. a condition that causes episodes of mania. Nursing care plan Nursing Diagnosing & Patient Goal A doctor must make a diagnosis of schizophrenia on the basis of a standardized list of outwardly observable symptoms. There are no specific laboratory tests that can be used to diagnose schizophrenia. and other abnormal moods). Researchers have. abnormally excited mood) in people who have bipolar disorder (manic depressive disorder. however. distress. episodes of depression.
the clinician will consider other psychiatric conditions that may include psychotic symptoms or symptoms resembling psychosis. In the past. After ruling out organic disorders. Some patients who were diagnosed prior to the changes in categorization should have their diagnoses. After other conditions have been ruled out. dissociative disorder not otherwise specified (DDNOS) or multiple personality disorder. temporal lobe epilepsy. The doctor will also need to rule out heavy metal poisoning and substance abuse disorders. prion diseases. Wilson's disease. and treatment. These discoveries have been made with the help of imaging techniques such as computed tomography scans (CT scans). schizoid. negative symptoms . When a psychiatrist assesses a patient for schizophrenia. and atypical reactive disorders. delusional disorder. and encephalitis. schizotypal.abnormalities in the structure and functioning of the brain compared to normal test subjects. he or she will begin by excluding physical conditions that can cause abnormal thinking and some other behaviors associated with schizophrenia. the patient must meet a set of criteria specified: • the patient must have two (or more) of the following symptoms during a onemonth period: delusions. Huntington's chorea. and also identify learning problems or disorders. disorganized speech. or paranoid personality disorders. especially amphetamine use. reevaluated. These disorders include mood disorders with psychotic features. many individuals were incorrectly diagnosed as schizophrenic. the doctor must distinguish between psychotic symptoms and a vivid fantasy life. These conditions include organic brain disorders (including traumatic injuries of the brain). disorganized or catatonic behavior. In children. hallucinations.
interpersonal. including self-care • • the disturbed behavior must last for at least six months mood disorders. Keep in mind that short. Don't avoid or overwhelm him. Provide . 4.• decline in social. Nursing intervention 1. 3. or occupational functioning. Maintain a safe environment. 6. allow him to fix his own food when possible. If you give liquid medication in a unit-dose container. substance abuse disorders. or offer him foods in closed containers that he can open. Monitor his weight if he isn't eating. but only do for the patient what he can't do for himself. If he thinks that his food is poisoned. Use physical restraints according to your facility's policy to ensure the patient's safety and that of others. Administer medication to decrease symptoms and anxiety. allow the patient to open the container. outpatient day care. medical conditions. paying special attention to his nutritional status. Assess the patient's ability to carry out the activities of daily living. 2. and sheltered workshops. repeated contacts are best until trust has been established. Avoid promoting dependence. Reward positive behavior to help the patient improve his level of functioning. 5. Meet the patient's needs. and developmental disorders have been ruled out. minimizing stimuli. Adopt an accepting and consistent approach with the patient. Engage the patient in reality-oriented activities that involve human contact: inpatient social skills training groups.
or neologisms. autistic inventions. If he has auditory hallucinations. Clarify private language. change the subject. explaining to the patient that what he says isn't understood by others. 10. That procedure will be done on the floor. Mobilize community resources to provide a support system for the patient and reduce his vulnerability to stress. Avoid arguing about the hallucinations. Choose words and phrases that are unambiguous and clearly understood. Also monitor the patient carefully for adverse effects of drug therapy. Don't touch the patient without telling him first exactly what you're going to do. clearly explain to him. 8.reality-based explanations for distorted body images or hypochondriacal complaints. 12. For instance. I'm going to put this cuff on your arm so I can take your blood pressure. institutionalization may produce new symptoms and handicaps in the patient that aren't part of his diagnosed illness. Encourage compliance with the medication regimen to prevent relapse. a patient who's told. set limits on inappropriate behavior. 9. may become frightened. Don't tease or joke with the patient. thinking he is being told to lie down on the floor. Ongoing support is essential to his mastery of social skills. If necessary. 11. explore the content of the hallucinations. For example. including drug-induced . if possible. If the patient is hallucinating. Remember. If necessary. determine if they're command hallucinations that place the patient or others at risk. so evaluate symptoms carefully. 7. postpone procedures that require physical contact with facility personnel until the patient is less suspicious or agitated. Tell the patient you don't hear the voices but you know they're real to him.
The patient was demonstrate behaviors that show positive self esteem as evidenced by inability to have an eye contact.parkinsonism. He is oriented to time when asked what day it is. . that we may play a part in the rehabilitation of our mentally-ill patients. akathisia. and malignant neuroleptic syndrome. Evaluation The client was able to maintain reality orientation. tardive dyskinesia. Recommendation He is advised to take part in complying with the treatment. Even if nursing students find it difficult to establish therapeutic relationships with mentally-ill patients because of the relatively short time spent in the clinical area. and improve our therapeutic technique in caring for our patients. acute dystonia. time and trust to our patients. still we have to render amounts of effort. the medication and therapeutic regimen designed for his rehabilitation. Make sure you document and report such effects promptly. He should realize the importance of complying with his medication and the benefits this practice would bring to the improvement of his well-being.
A case study Presented to the faculty of Our lady of Fatima University College of Nursing .
Gillian abegail F.A Case Study on Undifferentiated Schizophrenia Submitted to: Ms. ay ang haba pala ng kuko ko” as verbalized by the patient . Leyden Dela cruz RN Clinical instructor Submitted by Belardo. Group A Nursing care plan Assessment Subjective “Sobrang lamig ng tubig nakakatamad maligo.
The patient has an impaired ability to provide self care requisites due to environmental and psychological factors. R: underlying cause affects choice of interventions/ strategies. Discuss on importance of hygiene. Orient client to different equipment for self-care like various toiletries. R: basic hygienic needs may be forgotten. R: to gain client’s trust and facilitate a good working relationship. 3. Identify reason for difficulty in self-care. R: makes client aware of how hygiene is vital in caring for oneself.Objective Untrimmed fingernails and toenails with visible dirt noted Diagnosis Self care deficit bathing/ hygiene related to lack of motivation. 2. . 5. the client will be able to a) Verbalize self care need b) Demonstrate techniques to meet self care needs Interventions 1. Establish rapport. 4. Planning After 2 hours of nusing care. Determine hygienic needs and provide assistance as needed with activities like care of nails and brushing teeth.
Discuss the possible negative implications of not taking a bath such as infections and odor. R: promotes independence and sense of control. Evaluation GOAL PARTIALLY MET After 2 hours of nursing care. may decrease feelings of helplessness. R: Enhances esteem and convey aliveness. 8. Assist with dressing neatly or provide colorful clothes.R: increases the client’s awareness of different materials for self-care. 6. Let the patient enumerate his ideas on the importance of hygiene. R: Encourages the patient to understand the need for hygiene. Allot plenty of time to perform tasks. . R: Broadens the patient’s idea about the problem and encourages him to meet the need. Do not rush client. Encourage client to perform self-care to the maximum of ability as defined by the client. 10. 7. R: cognitive impairment may interfere with ability to manage even simple activities. the client was able to: a) b) verbalize self care need but was unable to demonstrate techniques to meet self-care needs. 9.
Nursing care plan Assessment Subjective “Hindi ako masyado makatulog sa gabi” as verbalized by the patient Objective restlessness .
length. . aids. positions. Intervention INDEPENDENT 1. Patient will be able to report feeling rested and show improvement in sleep/rest pattern. depth.5˚C P: 54 R: 12 BP: 110/ 80 Diagnosis Disturbed Sleep Pattern related to hyperactivity Planning After 8 Hours. Assess past patterns of sleep in normal environment: amount. bedtime rituals. dark circles under eyes irritability frequent change of mood V/S taken as follows T: 36. and interfering agents.
Increase daytime physical activities as indicated. 6.g. anxiety) circumstances that interrupt sleep. Avoid including in the meal alcohol or caffeine as well as heavy meal 5. Record number of sleep hours.2. 4. quiet..g. 3. fear. Recommend an environment conducive to sleep or rest (e. urinary frequency) and/or psychological (e. the patient was able to show improvement in his sleeping pattern.. Nursing care plan Assessment Subjective “Ang aking mga sugat ay nangangati” as verbalized by the patient . closed door). noise. comfortable temperature. Instruct patient to follow as consistent a daily schedule for retiring and arising as possible. Note physical (e. Document nursing or caregiver observations of sleeping and wakeful behaviors. ventilation. COLLABORATIVE Administer sedatives as ordered.. darkness.g. Evaluation After 8 hours of Nursing Interventions. pain or discomfort.
Demonstrated good skin hygiene. e. . Absence of redness or erythema. Absence of purulent discharge. Described and measured wounds and observed changes. wash thoroughly and pat dry carefully. Planning Following a 3-day nursing intervention. Noted color. Intervention Assessed skin. Absence of itchiness. the client will be able to display improvement in wound healing as evidenced by: Intact skin or minimized presence of wound.g.Objective (pain) Localized erythema Disruption of the skin Diagnosis Impaired skin integrity related to inflammatory response secondary to infection. turgor.. and sensation.
and show it. preferably cotton fabric (any Tshirt). Why do people fall in love and what is it for. (Continue cleaning the wound with disinfectant) Presence of itchiness (Continue instructing client to avoid scratching the wound) Nursing process Recording Mr. He described the drawing as a symbol love and passion. Provided and applied wound dressings carefully. Emphasized importance of adequate nutrition and fluid intake. Is it important to people to love in able to attain peace or to unite people and be happy . Minimized purulent discharge. Apo drawn a heart and uses a red crayon to make it. He also said that symbolizes people who love each other. Evaluation At the end of the 3-day nursing intervention. Instructed family to clip and file nails regularly. Instructed family to maintain clean. dry clothes. My patient thinks of love and the way people express it. the client was able to display improvement in wound healing as evidenced by: Minimized presence of wounds. Several wounds have dried up. Demonstrated to the family members on how to make a guava decoction to apply to the wound as alternative disinfectant. Minimized erythema. in the way that people can appreciate the true meaning of LOVE.
The answer is clear and the only thing that makes people happy is because of LOVE. .with their special someone.
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