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A Case Study
Presented to
The Faculty of the College of Nursing
Isabela State University
Echague, Isabela

In Partial Fulfillment
Of the Requirements of the Degree
Bachelor of Science in Nursing

James Ragasa

a severe mental disorder in which thought and emotions are so impaired that contact is
lost with external reality.

Psychosis is classically associated with schizophrenia spectrum disorders, and,

although there are other symptoms, one of the defining criteria for schizophrenia is the
presence of psychosis.

Symptoms of psychosis

The classic signs and symptoms of psychosis are:

 Hallucinations - hearing, seeing, or feeling things that do not exist

 Delusions - false beliefs, especially based on fear or suspicion of things that are
not real

 Disorganization - in thought, speech, or behavior

 Disordered thinking - jumping between unrelated topics, making strange

connections between thoughts

 Catatonia - unresponsiveness

 Difficulty concentrating
The milder, initial symptoms of psychosis might include:

 Feelings of suspicion

 General anxiety
 Distorted perceptions

 Depression

 Obsessive thinking

 Sleep problems

 Genetics - research shows that schizophrenia and bipolar disorder may share
a common genetic cause.

 Brain changes - alterations in brain structure and changes in certain chemicals

are found in people who have psychosis. Brain scans have revealed reduced gray
matter in the brains of some individuals who have a history of psychosis, which may
explain effects on thought processing.

 Hormones/sleep - postpartum psychosis occurs very soon after giving birth

(normally within 2 weeks). The exact causes are not known, but some researchers
believe it might be due to changes in hormone levels and disrupted sleep patterns.


Antipsychotic drugs

Acute and maintenance phases of schizophrenia

Personal Data
Name: Dk Akapa

Address: Brgy. 178, Kalookan City, Third District

Age: 34

Gender: Male

Birthday: February 22, 1984

Birthplace: DK

Nationality: Filipino

Religion: DK

Date of Admission: 01/09/18 1:17am

Additional Diagnosis: unspecified non-organic psychosis


History of past Illness:

No information given

Family History

No information given

Health History:

Patient is conscious, coherent, not in cardiorespiratory distress. With vital signs

of 120/100mmHg, HR- 101 bpm, RR- 19cpm, T. 36C taken last February 2018

Social History:

Patient is Unresponsive when asked, a male adult, single and unemployed.

Mental Status Assessment

A. General Appearance and Behavior

DK is a 34 year-old male based on his chart. At the time of examination, he was

well groomed and newly dressed. On appearance, were no signs of tremor or
abnormal movements. Dk wasn’t able to respond to my question due to psychotic
drug he takes. He maintained eye contact he spoke softly throughout the
conversation, particularly when mentioning past memories.

A. Affect

Patient seen and examined as an adult male, thinly built a hospital blue-scrub
with good eye contact. He was euthymic and joy affect.

B. Mood

Subjectively,he feels no emotion when he knew that there is a student will be

having affiliation in there pavilion. Objectively, he wasn’t able to respond to every
questions i asked. His emotional expression is liable, of full range and
appropriate to content. \

C. Thought Processes
1. Use of Language

He answered questions by nodding or doesn’t respond at all..

2. Common Thought Disorders

His thoughts are unspecified. There is evidence of flight of ideas,
loosening of association, perseveration, tangentiality or thought blocking.
D. Thought Content
He mentioned Basketball when I was asking him “what are you
thinking right now?” and nothing follows
E. Cognitive Evaluation
Dk doesn’t know what time but he knows the reasons why he’s at the


He fail to give information due to DK’s unresponsiveness and unreliable

nodding answers.


Fair. He cooperates with Nurses and other staff actually he is helper at


Psychodynamic for Undifferentiated Schizophrenia

Predisposing Factors
Socio-cultural and environmental Factors Psychological Factors
Some theorist proposed that the Psychodynamics theorists
proverty, society, and cultural disharmony believe that schizophrenia involves
could cause schizopheria or that people regression to a pre-ego stateof primary
chose to become schizophrenic to cope narcissism and restitutive efforts to
with insanity of the modern world. Others reestablish ego control. Behaviorists
proposed that schizophrenia was caused by theorize that schizophrenic people fail
living in the city or living in isolation in the to attend to relevant social cues and as
country. An enduring and consistent finding a result develop bizarre responses to
has been the strong association between the environment. The family
schizophrenia and lower socio-economic environment contains such confusing
status. This unenviable status enhances elements as aschizophrenic mother,
their vulnerability by exposing them to double-bind communication, marital
constant stressors. schism and marital skew. R.D.
Mr. Red he grew up in Camarines Mr. Red has claimed that he
Norte, but recently he was living in Imus used to be cared for by his parents
Cavite. He failed to finish his course. when was still young. When he grew up
he was not in good terms with his

Biological Factors

Genetic: based on the principle that some people inherit a biological prediposition
to schizophrenia, is upported by studies of severalkids, including twins studies,
adoption studies, and chromosomal mapping studies
Health factors Psychological factors
Information processing overload: Mr. Red misses his family. He talks
too much information is sent at the same about his relationship to his father.
time to be filtered by the frontal lobe. In
He was cooperative and maintain
schizophrenia , the frontal lobe loses its
eye contact upon conversation.
ability to slow down the transmission and
reception stimuli causing an overload.
Abnornal gating mechanism: this is
manifested by the ability to selectively
attend to stimuli.

Environmental Factors
-clients is usually living with his parent in Cavite
-some of his relatives knows about his situation but
the client didnt know what they think about him.
- he failed to finish his study when he was admitted in
NCMH misunderstandings started between him and
his father.

Health; lack of exercise

Environmental: lack of social support, inability to mingle with other people.
Attitudes: low self concept, lack of self confidence, poor social skills,difficulty in expressing emotions.


Loss of family


Failed from
to finish
Low his family
in mental
self-esteem institution
Weak EGO


Feeling of withdrawal Problems in ADLs Cause of deliquency

Problems in Metabolic Activity

Decrease amount of cerebral blood flow inthe frontal lobe of the cerebal cortex

Failure use ego
of coping
be retrieved mechanism
Marked changes in the process of organizing, planning, learning from experience