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Liceo de Cagayan University

R.N. Pelaez Boulevard, Kauswagan,


Cagayan de Oro City
College of Nursing


A Case Study on


Submitted by:
Gallano, Charmaine
HAmoy, Hazel Ruth
Ghan, Elaine
Roa, Mel Titus
Torres, Daniel John
MAbelin, Aryan
Ricci, Gloriefe
Manduriao, Tristan Jan




Submitted to:
Mrs. Ma. Dolores Mercado, RN,MN, MAN
Clinical Instructor










TABLE OF CONTENTS

I. INTRODUCTION
A. Overview
B. Objective and Purpose of the study
C. Scope and Limitation
D. Spot Map
E. Patients Profile
II. ANAMNESIS
A. Maternal and Paternal Lineage
B. Parents
C. Subjects
III. COURSE IN THE HOSPITAL
A. Mental Status Examination
B. Progress Notes
IV. Psychodynamics
A. Tabular Presentation
B. Schematic Presentation
V. Laboratory Exam AND Results of Psychological Test
A. Neuropsychological test
B. Laboratory test if any
VI. DIAGNOSIS\
VII. MULTI- AXIAL DIAGNOSIS
VIII. NURSING MANAGEMENT
IX. MEDICAL MANAGEMENT
X. PROGNOSIS AND RECOMMENDATION
XI. BIBLIOGRAPHY
XII. DOCUMENTATION










I. Introduction
A. Overview
The term schizophrenia was coined in 1908 by the Swiss psychiatrist Eugen
Bleuler. The word was derived from the Greek skhizo (split) and phren (mind). Over
the years, much debate has surrounded the concept of schizophrenia. Various
definitions of the disorder have evolved, and numerous treatment strategies have
been proposed, but none have proved to be uniformly effective or sufficient.
Although the controversy lingers, two general factors appear to be gaining
acceptance among clinicians. The first is that schizophrenia is probably not a
homogeneous disease entity with a single cause, but results from a variable
combination of genetic predisposition, biochemical dysfunction, physiological factors,
and psychosocial stress. The second factor is that there is not now and probably
never will be a single treatment that cures the disorder. Instead, effective treatment
requires a comprehensive, multidisciplinary effort, including pharmacotherapy and
various forms of psychosocial care, such as living skills and social skills
training,rehabilitation, and family therapy.
Of all the mental illnesses that cause suffering in society, schizophrenia
probably is responsible for lengthier hospitalizations, greater chaos in family life,
more exorbitant costs to individuals and governments, and more fears than any
other. Because it is such an enormous threat to life and happiness and because its
causes are an unsolved puzzle, it has probably been studied more than any other
mental disorder. Potential for suicide is a major concern among patients with
schizophrenia.
Schizophrenia may be the most devastating mental illness that humans can
experience. Its onset is typically during adolescence or early adulthood, a period
when individuals are just beginning to achieve a firm sense of self, to establish
enduring relationships, and to make productive contributions to society. Unlike those
with illnesses such as Alzheimers disease, cancer, and heart disease, patients with
schizophrenia usually are unable to point to decades of health predating the onset of
illness. A large majority of patients with the illness are unable to maintain
independent living or gainful employment for any significant period in their lives after
the onset of the illness. The public health effects of schizophrenia are staggering.
Although the prevalence of the illness is approximately 1% in the United States,
patients with schizophrenia occupy 25% of all inpatient hospital beds and represent
50% of all inpatient admissions. The overall cost of schizophrenia in the U.S. in 2002
was estimated to be $62.7 billion. Schizophrenia is one of the top 10 causes of
disability-adjusted life years. (pp. 407408).
This case study explored schizophrenia residual type disorder. This was
focused on CB, a 32-year old patient who is afflicted with schizophrenia in which
she was observed for impairments or alterations in thinking, memory, judgment,
sensation, motivation, emotions, sleep, mood, attention, learning, movement,
cognition, communication, behavior, and personality which are hallmarks of
schizophrenia (Ignatavicius& Workman, 2002). They are of concern to health
workers since they are major public burdens. Many of those afflicted with the said
disorder do not seek care since they feel ostracized due to stigma.
In order to put together the puzzles of CBs life and determine the exact
cause of her schizophrenia residual type, CB was monitored and cared for by the
group for 3 days. CB and the group worked through the Orientation and Working
Phases and her problems, difficulties, fears; and anxieties were explored, and her
adaptive and maladaptive coping mechanisms were identified and coined. Members
in the family especially the mother were interviewed. The neighbours were also
asked.
Using subjective and objective cues noted by the group on site at the patients
residence, CBs psychiatric disorder was finally identified as schizophrenia residual
type based from the criteria established by Diagnostic and Statistical Manual of
Mental Disorders, 4th Edition, Text Revision (DSM IV-TR). She was positive for
restlessness, inability to sleep, panic, anxiety, murmurs and is always preoccupied.
Schizophrenia is properly managed through a combination of pharmacological
treatments using antipsychotic medications with the commitment and proper
treatment regimen. Patient education and assistance with social problems including
but not limited to unemployment or domestic violence by referral to appropriate
agencies, and most importantly, the building of social support networks (Patel,
Vikram et al, 2005).

B. Objectives and Purpose of the Study
This study was conducted keeping in mind the general purpose of which w as
that at the end of atleast 3visitations, the nursing students will be able to gain
knowledge about the different Psychiatric problems learned from Psychiatric
Nursing, develop skills in assessment and problem identification in actual setting and
enhance supportive role and attitude to psychiatric patients that needs guidance and
impart health teaching for the benefit of individuals with mental disorders.
Through the formulation of daily and weekly plans of activities the group will
be able to meet the following goals:
initially, to establish rapport with the patient and her family;
to conduct a complete and thorough nursing assessments on the patient
as well as to obtain her medical and nursing history using both primary
and secondary sources of information;
to use therapeutic communication skills especially during Nurse-Patient
Interactions so as to gain patients trust and confidence and impart
genuine interest, empathy, acceptance and positive regard;
to identify maladaptive behaviours through the assessments done;
to plan courses of action and to perform nursing interventions in bringing
comfort and safety to patient with health teachings.

C.Scope and Limitation
The group had chosen this specific case in order to better understand the
factors that contribute to the development of mental illness specifically
schizophrenia, and how they affect all the aspects of an individuals personality,
keeping in mind the application of the nursing process as well as nursing
management of the signs and symptoms of the disease.
This case focused on CB who was home managed for years already. 3
visitations were spent for the Nurse-Patient Interaction phases. The feelings,
emotions, thoughts, behaviours, and actions were all taken into account. Pertinent
data were obtained from relatives and neighbours of the individual under study.
The study was patient-centered. The patient may not manifest all of the signs
and symptoms that are expected from schizophrenia.
The scope of the study are as follows: 1. Must be a resident of Cagayan de
Oro City 2. Mother must be healthy and is able to give information 3. And patient is
of sound mind in the course of interview.





















D.Spot Map
In going to our patients house which is at Gusa, Villa Ernesto phase 2, we start in
school by riding a Jeepney (C2 or R1) with a fare of php 6.00 for students and php
7.00 as regular fare. Then will stop at the loading zone by Centrio and more or less
1km from the school. From this point you will ride again another Jeep going to gusa
(RC cugman or RD gusa) The fare for this ride caused a bit more, php 7.00 for
students and php 8.00 for regular fare and more or less 4 Km from centrio mall
which was our last stop.

































E.Patients Profile
NAME: Miss CB
ADDRESS: Purok 2B, Gusa, Cagayan de Oro City
AGE: 32 yrs. old
SEX: Female
RELIGION: Roman Catholic
MARITAL STATUS: Single
DATE OF BIRTH: February 18, 1982
NATIONALITY: Filipino
BIRTH PLACE: Cagayan de Oro City
HEIGHT: 5 feet, 2 inches
WEIGHT: 55kg
NUMBER OF SIBLINGS: 2
BIRTH RANK: 2
nd
from the eldest
EDUCATIONAL ATTAINMENT:
Elementary: Gusa Elementary School (1989-1995)
Secondary: MOGCHS
College: None
Post Graduate Studies: None
ARREST, COURT DATES, PROBATION: None
VITAL SIGNS:
BP: 100/60mmHg TEMP: 36.7
0
C RR: 24cpm HR: 90bpm
FOOD AND DRUG ALLERGY:
Allergic to dried fish and clams
USE OF STREET DRUGS: (specify amount, when & how it started, history of
blackouts)
Use of street drugs when she was in 3rd year high school

II. ANAMNESIS
Name: N.B
Primary Care provider: AB (mother)
Date of Birth:February 18, 1982
Age: 32 years old
Sex: Female
Race: Filipino
Ethnicity: Filipino
Marital Status: Single
no. of marriages: none
If married/divorce/separated, how long?: N/a
Occupation: none
Highest Educational Attainment: 3
rd
year high school
Religious affiliation: Roman Catholic
City of Residence: Cagayan de Oro City
Primary dialect/language spoken: Vernacular/ bisaya
Accompanied by: Mother
Admitted from: N/A
Previous psychiatric hospitalizations (#): Lumbia (facility not known)
Chief Complaints:
DSM-IV TR Diagnosis: Schizophrenia Residual Type


A. Maternal and Paternal Lineage
According to the interview to the mother , there family has a
good relationship with one another but when her husband died,
everything was torn apart. Her mother told us upon interview
that they have no history of mental illness and also her
husbands side. But when we interview her, there are signs that
she also have a mental illness on the way she answers us.
B. Parents
Father
CBs father died last last February 2, 1996 because of his
heart enlargement. According to the mother, CBs father
was kind and good to all of them. He was very
responsible and when her their father died they
experienced financial problems.
Mother
The mother of the patient clearly shows signs of mental
problem. She does not show enough care to herself
neither to her family. Upon interview the mother of CB
always stressed to us that she loved her daughters so
much and she dont want them to be hurt but according
to CB her mother is so strict and she pays more attention
to her youngest sibling who is mentally retarted and tend
to neglect CB and her older sister.
Siblings
CB has 2 siblings. The older sister lives now in Samar,
Leyte and has a family of her own. And CBs younger
sister is 29 years old and is mentally retarted. Her
younger sibling needs more attention because of her
condition.

C. Subject
Prenatal
During the prenatal period, the mother mentioned that
she completed the visitations in her pre natal in the
Health Center and no problems happened on the course
of her pregnancy.
Birth
NB is a full term baby and delivered through normal
spontaneous vaginal delivery in their home and she was
referred to Northern Mindanao Medical Center.
INFANCY AND CHILDHOOD CHARACTERISTICS
The mother was breastfeeding NB when she was still a
baby. The patient had a good development during her
childhood days. The patient started to walk when she
was still 9 month old and after a year, she begun to
speak a few words such as mama and papa. CBs
mother said that no problems were seen during CBs
growing up years and only minor sickness such as colds,
cough and minor fevers are felt by CB as a child.
PSYCHOSEXUAL FACTORS
According to CB she had her first sexual intercourse
when she 17 and she got pregnant when she was 21 and
then her second pregnancy was when she was 23. He
relationship with men was not successful because she
said that they are all jealous and she cant understand
them.
PLAY LIFE
During her childhood days, CB has problems when it
comes mingling with other people and she was shy
because when she was young her mother always
restricts her to play with other kids in their
neighbourhood.
Religious Life
CB is a Roman Catholic and she told us that they always
go to church on a Sunday and in every special occasion.
They also pray when they are having their meals and
their religious beliefs are evident because there are
saints in their house.






INTERVIEW WITH NEIGHBOURS:

Informant 1
Name: Mrs.AB
Address: Purok 2B Gusa, Carmen CDO City
Relationship to client :Neighbor
Length of time known to client: 32 years
Aparrent Understanding to the cleints Illness:
Nagsugod ng sakit ni CB tong high school pana sya. Kay ana ang iya mama
napasmuhan daw n sya busa ingon ana na sya karun.

Informant 2:
Name: Mr P.
Address: Purok 2B Gusa, CDO City
Relationship to client : Neighbor
Length of time known to client: 25 years
Aparrent Understanding to the cleints Illness
mag lakaw lakaw na sya sa dalan sauna nga ga panty rah mao ng
naburusan na sya. Ga ato manang high school pana sya sa MOGCHS. Kana pud
ang iya mama sauna kay ga yaw yaw pd na sya ug sya rah usa. Kaliwat na guro na
nila

Informant 3:
Name: Mrs. LO
Address: Purok 2B Gusa. Carmen CDO City
Relationship to client :Neighbor
Length of time known to client: 27 years
Aparrent Understanding to the cleints Illness
sauna kay napasmuhan na sya tong high school pa sya. Muadto rana sya sa
skwelahan nga walay kaon.
III.COURSE IN THE HOSPITAL

Mental Status Exam
DAY 1

DAY 2 DAY 3
DATE OF VISIT


A. GENERAL
APPEARANCE

Improper
dressed
Properly
dressed
Properly dressed
B. BEHAVIORS

Shy Friendly and
Approachable
Friendly and
Approachable
C. GENERAL
MOBILITY

Mannerism
noted
Mannerism
noted
Mannerism noted
D. NPI

Cooperative Cooperative Cooperative

A1 SPEECH
DAY 1

DAY 2 DAY 3
SOFT





LOUD


HESITANT


SLURRED


SUPERIOR


HUMOR



FRIGHTENED




A2 DOES HER STYLE AND VOCABULARY CONVEY?


DAY 1 DAY 2 DAY 3
COYNESS







SUSPICIOUSNESS


ARROGANCE


SECRECY


SUPERIORITY


HUMOR


FEAR




A3 STREAM OF TALK


DAY 1 DAY 2 DAY 3
SPONTANEOUS


DELIBERATE


PRESSURED




A4 ORGANIZATION OF TALK


DAY 1 DAY 2 DAY 3
RELEVANT





IRRELEVANT




INCOHERENT


LOOSE
ASSOCIATION


FLIGHT OF IDEAS


TANGENTIALITY


CIRCUMSTANTIALITY


PERSEVERATION


CLANG
ASSOCIATION


NEOLOGISM


ECHOLALIA


ECHOPRAXIA




A5 MOOD AND AFFECT


DAY 1 DAY 2 DAY 3
1. MOOD


EUTHYMIC

DEPRESSED




EUPHORIC


2. AFFECT


FLAT


BLUNT


ANGRY


ELATED


ANXIOUS


FEARFUL



A6 RANGE OF AFFECTIVE EXPRESSION


DAY 1 DAY 2 DAY 3
CONSISTENT


LABILE


ANHEDONIC


APPROPRIATE
TO THE
SITUATION
AND
FEELINGS
VERBALIZED




A7 PERCEPTION
DAY 1 DAY 2 DAY 3
HALLUCINATION
AUDITORY
VISUAL
OLFACTORY
GUSTATORY
TACTILE
DELUSION
GRANDEUR
PERSECUTORY
REFERENCE
ILLUSION
DEREALIZATION
DEPERSONALIZATION
IDENTIFICATION
THOUGHT
BROADCASTING

Dj vu
JAMAIS VU

A8 ORIENTATION AND MEMORY


DAY 1 DAY 2 DAY 3
1.
IDENTIFIES
DATE
CORRECTLY


2.
ESTIMATES
TIME OF
THE DAY


3. KNOWS
WHERE SHE
IS


4. KNOWS
THE
EXAMINER


5. RECALLS
EVENTS
PRIOR TO
ADMISSION


6. RECALLS
ACTIVITIES
DONE
WITHIN 24
HOURS




7. RECALLS
ACTIVITIES

DONE
WITHIN 1
WEEK



A9 NEURO-VEGATATIVE FUNCTIONING


DAY 1 DAY 2 DAY 3
SLEEP AND REST
PATTERN



NORMAL SLEEP


EARLY MORNING
AWAKENING




MIDDLE NIGHT
AWAKENING


HYPER
INSOMNIA

DIFFICULTY
FALLING ASLEEP


INTERRUPTED
SLEEP





A10 ELIMINATION
DAY 1 DAY 2 DAY 3
BOWEL 2 1 1
BLADDER 5 6 6

A11 ABSTRACT THINKING ABILITY
DAY 1 DAY 2 DAY 3
Good Fair Good


A12 JUDGMENT
DAY 1 DAY 2 DAY 3
Good Good Good




PROGRESS NOTES
GENERAL OBJECTIVE:
At the end of 3 days visit to CB, we will be able to gain knowledge
and information about patient CB and correlate the information gathered with
the development of mental illness from which CB is diagnosed.

February 15, 2014
SPECIFIC OBJECTIVE:
At the end of our first visit, we will be able to establish rapport to
patient CB and make a contract.

On our first visit to CB, we are all new to her except our one classmate
because she has her 1
st
interaction to CB before us. On our way to their
house, we can see that she is very interested and she likes students. She is
accommodating and she always smile. We told her about the contract and she
agreed on it. Our planned activity was to play badminton and she told us that
she loved badminton also. After playing badminton, we asked her several
questions and upon our interview, there are times that she tend to change the
topic and its as if all that she is saying is shes not that sure. Her mother is
not in their house upon our visit. We then bid farewell to her and promised
that we would go back on her birthday.

February 18, 2014
2
nd
visit

On our 2
nd
visit, it was on her birthday and we had brought some food
and gifts for her. She was so happy and she cant really put into words the
happiness that she feels because on the event that we sang happy birthday,
she was very very happy. We had gift giving and she thanked all of us for the
gifts that we had given her. Her mother and her sister are in their house but we
were not able to talk to them because they are inside their room. CB was so
happy and she told us that she had her children being adopted and she dont
know who adopted them. Some informations were gathered and we bid then
goodbye again to her.
April 28, 2014
3
rd
visit
On our 3
rd
and last visit, CB was not on their house because she was on
their neighbours house taking care of an old woman. It is good to know that
she can take care of somebody on her condition and that proves that she is of
sound mind now. On our last visit, we had told her about the end of the
contract and we had an activity with a sport again of badminton and she was
so happy also. Their are times that she keeps on asking when are we coming
back and we told her that its the end of our contract but some of our
classmates are coming back to visit her again.


IV. PSYCHODYNAMICS

RATIONALE PRESENT FACTORS

Predisposition to mental
illness is genetically
transmitted and
inherited.

The client's mother has
a history of mental
illness

A. Hereditary

People with a younger
age of onset have
poorer outcomes and
less effective coping
skills, than those people
with a late age of onset.
A possible reason is that
younger clients have not
had enough
experiences of
successful independent
living and have less well
developed sense of
personal identity than
older clients
(Buchaman and
Carpenter, 2000).


The client was 16 years
old during the onset of
her illness

B. Age

Abnormally high
dopaminergic
transmission has been
and psychosis linked to
schizophrenia (Dr
AnanyaMandal, MD)

Alteration in the
neurotransmitter system
of the brain

C. Biochemical


Deficits in information
processing may leave
people vulnerable to the
behaviors typically seen
as symptoms

Client manifested flight
of ideas and
irrelevance.o

D. Cognitive


V. LABORATORY EXAM AND RESULTS OF PSYCHOLOGICAL TEST
a. Neuropsychological test
The patient has no neurological test
b. Laboratory test
The patient has no laboratory test

VI. DIAGNOSIS
DSM-IV Diagnosis: Schizophrenia, Residual Type;
ICD-9 CM Code ICD-9 CM Name
295.65 Schizophrenic disorders, residual
type
ICD-10 CM Code ICD-10 Name
F20.5 Residual Schizophrenia

VII. MULTI-AXIAL DIAGNOSIS
Axis Code Description Justification
Axis I
Is for identifying
all major
psychiatric
disorders except
mental retardation
and personality
disorders.

295.60
T/C Schizophrenia
(Residual Type)
The essential feature of
schizophrenia are a mixture of
characteristics signs and
symptoms (both positive and
negative) that have been
present for a significant portion
of time during a 1 month
period with some signs of the
disorder persisting for at least
6 months. This falls into
criterion A, wherein there is
presence of delusion,
hallucinations, and
disorganized speech.
The client displayed
signs and symptoms
of schizophrenia
residual type that
includes delusions,
anxiety, anger,
disorganized speech
and difficulty making
decisions.
Axis II
Is for reporting
mental retardation
and personality
disorders as well
as prominent
maladaptive
personality
features and
defense
mechanisms.
Devaluation The individual deals
with emotional conflict
or internal or external
stressors by
attributing
exaggerated negative
qualities to self or
others.
Axis III
Is for reporting
current medical
conditions that are
potentially
relevant to
understanding or
managing the
persons mental
disorder as well
as medical
conditions that
might contribute
to understanding
none None
the person.
Axis IV
Is for reporting the
psychosocial and
environmental
problems that
may affect the
diagnosis,
treatment, and
prognosis of
mental disorders.
V15.81












V61.20
Non-Compliance with
treatment











Parent-Child Relational
Problem







Patient often
disregard
medication
administration due
to the side effect of
sinusitis. She
doesnt see the
consequence of
non-adherence to
medication to
regimen.


Her mother is more
concerned of CBs
sister and she
tends to neglect CB
and lets CB work
but her mother also
goes with her
whenever she have
check-ups
Axis V
Presents a Global
Assessment of
Functioning,
which rates the
persons overall
psychological
functioning on a
scale of 0 to 100.
81-70
(current)
Some mild symptoms or some
difficulty in social,
occupational, or school
functioning but generally
functioning pretty well has
some meaningful interpersonal
relationships.
CB exhibits mild
anxiety as evidenced
by tapping her fingers
and swiping her
hands in the table














VIII. NURSING MANAGEMENT

S
Usahay dili ko ganahan muinom ug tambal as verbalized by the client
O

-rejected offered medications
-high toned voice

A Ineffective health maintenance Related to Deficient knowledge regarding
treatment and control of psychological condition
P
At the end of 2
nd
our visit, the patient will be able to describe positive health
maintenance behaviour such as keeping scheduled appointments (home
visitation), improving home environment and following her medication
regimen.


I
1. Provided client information on home health services to help her
choose one that will work for her.
2. Encouraged client to make appointment with home health before
leaving the hospital to ensure:
a) she doesnt forget.
b) she has access to a healthcare team to answer questions she
may have.
3. Involved clients father in conversations about home health and
lifestyle changes to create a support system for her.
4. Offered suggestions on lifestyle changes that may be may include
diet and exercise that can easily be worked into her current routine to help
her become willing to make changes.
5. Made a reminder card for client to keep with her to remind her to make
healthful choices daily.


E
At the end our visit, the patient was be able to described positive health
maintenance behaviour such as keeping scheduled appointments (home
visitation), improving home environment and following her medication
regimen.








S
nah pag mutukar na sya dretso na sya mudagan sa dalan maski naa
sakyanan as verbalized by the mother

O
- Not mindful of what she is doing
- Absent minded

A
Risk for Injury related to mental illness
P
At the end of our 3
rd
visit, the patient will be able to demonstrate and
understand ways on how to reduce injury
I
-approached the client in a non-threatening manner
-discussed the importance of self-monitoring of conditions that contributes to
the occurrence of the injury

-demonstrated use of relaxation techniques such as deep breathing
exercise

-encouraged use of assertive type of communication and positive self-image
E
At the end of our 3
rd
visit, patient was able to understand and demonstrate
proper ways to prevent injury and demonstrated the techniques being taught













IX. MEDICAL MANAGEMENT

GENERI
C NAME
OF
ORDERE
D DRUG
BRAND
NAME
CLASSIFIC
ATION
DOSE/
FREQUE
NCY/
ROUTE
MECHA
NISM OF
ACTION
SPECIFI
C
INDICATI
ON
CONTRAI
NDICATIO
N
SIDE
EFFECTS/
TOXIC
EFFECTS
NURSING
PRECAUTION
chlorpro
mazine
Thorazin
e
antipsychotic 100mg/O
D
Antipsych
otic drugs
block the
postsyna
ptic
dopamin
e
receptors
in the
brain:
depress
those
part of
the brain
involved
with
wakefuln
ess and
emesis
Manage
ment of
manifesta
tion of
psychotic
disorders
Contraindic
ated with
hypersensi
tivity to
chlorproma
zine,
parkinsons
disease,
severe
hypotensio
n or
hypertensi
on
>drowsines
s
>weakness
>nasal
congestion
>dyspnea
>fever
>sweating
Assess mental
status prior to and
periodically during
therapy.
Monitor BP and
pulse prior to and
frequently during
the period of
dosage
adjustment. May
cause QT interval
changes on ECG.
Observe patient
carefully when
administering
medication, to
ensure that
medication is
actually taken and
not hoarded.
Monitor I&O ratios
and daily eight.
Assess patient for
signs and
symptoms of
dehydration.


GENERI
C NAME
OF
ORDERE
D DRUG
BRAND
NAME
CLASSIFIC
ATION
DOSE/
FREQUE
NCY/
ROUTE
MECHA
NISM OF
ACTION
SPECIFI
C
INDICATI
ON
CONTRAI
NDICATIO
N
SIDE
EFFECTS/
TOXIC
EFFECTS
NURSING
PRECAUTION
Flupentix
ol
antipsychotic 100mg/O
D
Antipsych
otic drugs
block the
postsyna
ptic
dopamin
e
receptors
in the
brain:
depress
those
part of
the brain
involved
with
wakefuln
ess and
emesis
Manage
ment of
manifesta
tion of
psychotic
disorders
Contraindic
ated with
hypersensi
tivity to
chlorproma
zine,
parkinsons
disease,
severe
hypotensio
n or
hypertensi
on
-dry mouth
-
constipatio
n
-
hypersaliva
tion
-blurred
vision
-nausea
-dizziness

Assess mental
status prior to and
periodically during
therapy.
Monitor BP and
pulse prior to and
frequently during
the period of
dosage
adjustment. May
cause QT interval
changes on ECG.
Observe patient
carefully when
administering
medication, to
ensure that
medication is
actually taken and
not hoarded.
Monitor I&O ratios
and daily eight.
Assess patient for
signs and
symptoms of
dehydration.

X.PROGNOSIS AND RECOMMENDATION













Multiple factors appear to influence prognosis (disease outcome) in schizophrenia.
Family history of schizophrenia is relevant. Multiple relatives who share schizophrenia
outcomes is a bad sign. Other good signs include good social and professional adjustment
prior to the onset of symptoms, and awareness and insight of symptoms as signs of a problem
(rather than just reaction to symptoms without insight); patients demonstrating both of these
signs may sometimes recover completely. Chances for recovery are improved if the disease
comes on suddenly, as opposed to when it comes on slowly.
If schizophrenia is treated quickly and consistently with good response to treatment, the
prognosis is usually very good. A short amount of time that people suffer with severe
symptoms and a lack of symptoms reported during periods between severe psychotic
episodes is also good indicators of recovery potential. A personal history or family history of
mood disorders may help a person to move through a schizophrenic phase quickly because
their primary condition may be some other affliction. Since schizophrenia is a brain disorder, a
CRITERIA OF DATA POOR GOOD
Onset of Illness X
Duration of Illness X
Precipitating Factors X
Mood and Affect X
Attitude Toward Taking Medication
and Treatment
X
Any Depressive Features X
Family Support X
good outcome is predicted when the brain has a normal structure and function as indicated by
a brain scan.

Recommendation
In order for our patient Ms. CB. to gain her maximum recovery as
possible, it would be helpful if she and her significant others or her family members
should take into consideration the following recommendations.
1. Indulge into other activities that promote physical, emotional, and spiritual healing by
participating activities in the community.
2. Continue to provide emotional support by accepting and understanding client's current
condition, providing continuous medication and observing compliance as ordered.
3. Provide client with teachings that promote health and wellness both physical, emotional
and as well as spiritual healing.
4. It is also important that the client be provided that they will eat three times a day and the
importance of good health and exercise for better recovery.
5. Allow patient to verbalize feelings of hopelessness




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