MEDICAL COLLEGES OF NORTHERN PHILIPPINES

Alimannao Hills, Peñablanca, Cagayan 3502

Tel: (078) 304 – 1010; Telefax (078) 846 – 7549

COLLEGE OF NURSING

RELATED LEARNING EXPERIENCE

Area: PSYCHIATRY WARD

Inclusive dates: August 8,9,10,12
Year Level: 4
Group No: 4

CASE STUDY: Into the Mind of Mr. K: A Case of Schizophrenia

Guidelines:
1. The group will accomplish and present a case analysis based on the given clinical
scenario. Presentation shall be done during the last day of RLE rotation (August 12,
2021).
2. All outputs must be originally done. Plagiarism is strictly prohibited.
3. Outputs must be uploaded in the google drive a day before the presentation for review
purposes (to include manuscript and powerpoint presentation).
4. Each student must submit a Reflective Insight for the whole rotation
5. At the end of the rotation, all outputs must be compiled and submitted with proper labels.

Mr. K is a 39 year old single (never married, no children) male who experienced his
first symptoms of mental illness in 2010, 11 years ago. He was living in the province
at the time and sought treatment at his local hospital. At this time he reported
having feelings of déjà vu experiences off and on for the past two years and these
experiences were intensifying. He received some medications (Haloperidol) in the
emergency room but was not admitted. He had completed college and had worked
full-time ever since. Back then, Mr. K was employed full-time in an occupation that
required him to travel from different provinces. Mr. K reported that he smoked
marijuana once per week and drank alcohol occasionally. In June of 2012, at the age
of 30, Mr. K was hospitalized for 6 days in his home town. At this time he was
experiencing delusions, paranoia and isolation. Examples of his delusions included
the following:
● beliefs that the television was sending him messages;
 ● belief that mythological creatures were trying to entice him to battle;
● belief that a celebrity on TV wanted to marry him;
● misinterpretation of numbers to indicate that he was GOD.
Again he received medication but stopped it once he felt better. Mr. K contends that
he was never instructed to get the medication refilled once he left the hospital. He
was again hospitalized for one week in January of 2013. Records indicate that upon
admission, he reported feeling down, depressed, and crying a lot and that he
believed he was not himself. He also expressed beliefs that he had been in the
military but that he was not sure. In actuality, he had been a part of the Philippine
Army for approximately 4 months but was discharged due to reported feelings of
suicide. At the hospital he reported that his thoughts seemed jumbled. Records
indicate that he was treated with Risperdal and diagnosed with Schizophrenia. Again,
he took the medication until the prescription ended but did not seek a renewal. In
April 2013, at the age of 30, Mr. K was travelling and had stopped to get some
dinner at a restaurant. He reported feeling very paranoid as if someone was going to
harm him. He stated that he believed some of the people in the restaurant looked
like devils and were possessed by demons. Mr. K went back to his vehicle and
secured a knife for protection. He reentered the restaurant and sat down to have
dinner. Another patron approached him and began a casual conversation. At this
time Mr. K responded by pulling the knife and stabbing the bystander to death. Mr. K
left the restaurant but stopped to talk to the cashier on his way out the door as if
nothing out of the ordinary had transpired. He was arrested a short time later. After
Mr. K’s arrest he spent time at CVMC for restoration to competency. After receiving
medications, he was able to be restored and he was also evaluated for a second
opinion sanity evaluation requested by his public Attorney. In December, 2013 he
was found Not Guilty by Reason of Insanity and subsequently committed to the
custody of the commissioner to begin the privileging process. Mr. K’s initial progress
in the hospital was slow and was laden with numerous medication changes in order
to maximize his treatment efficacy. Psychiatric treatment was complicated with the
medical problem of brittle diabetes. Additionally, once Mr. K was stabilized and was
able to fully appreciate the gravity of the fact that he had committed murder, he was
despondent, isolated and overwhelming remorseful thus requiring further medication
 adjustments. He began to work with a therapist to address the guilt and shame that
he felt due to his actions. Slowly, Mr. K began to make progress and by November,
2017 he was able to receive approval from the Forensic Review Panel for Unescorted
Community Visits (up to 8 hours) to a day program. Although Mr. K’s psychiatric
stability remained constant, his insulin levels were unpredictable and often
dangerous. At one point his passes for unescorted community were held for two
months in order to regain control of his medications for his diabetes. However, by
March, 2018 Mr. K was ready to request 48 hour overnight passes. Until that time,
he had continued to do well psychiatrically and was especially vigilant of his blood
sugar levels and has learned to administer his own insulin and other medications
such as Haloperidol, Fluphenazine Decanoate IM injections, Chlorpromazine,
Setraline, Biperiden and Cogentin tabs

● Contents of the case study

o Introduction / Background of the Disease
▪ Must contain the following information: brief description of the disease;
Diagnostic criteria based on DSM-V, manifestations, treatment modalities,
and nursing management
o Psychopathology – focus on neurobiologic properties of the disease
o Nursing Care Plan – at least 5 priority nursing diagnosis
o Drug study
o NPI with application of therapeutic communication

Patient’s Verbal response Nurse’s Response Therapeutic Analysis / Rationale

Communication Strategy

“May lason yang pagkain

na binibigay nyo”
“Meron akong naririnig na
bumubulong sakin”

Pinaplano nyo lahat na

patayin ako

Nalulungkot ako at hindi ko

alam kung bakit

Ayoko ng ibang kausap

Ayokong sumama sa mga

therapy nyo. Papatayin nyo
lang ako
Ako ang tunay na Diyos!

Wala akong ganang

makisalamuha sa ibang
pasyente. Mga baliw yang
mga yan

INTRODUCTION
 Schizophrenia is a persistent, severe mental illness that has an impact on a
person's relationships with others as well as their thinking, acting, and emotional
expression. Despite not being as prevalent as other severe mental illnesses,
schizophrenia can be the most persistent and incapacitating.
Schizophrenia patients frequently struggle to function well in relationships, the
workplace, and academic settings. They can appear to have lost their sense of reality,
feel afraid and withdraw. This chronic illness cannot be cured, but it can be managed
with the right care.
Criteria based on DSM-5.
 At least two of five main symptoms.
 Duration of symptoms and effects.
 Social or occupational dysfunction.
Stages
 Onset (prodrome)
 Active
 Residual
Early symptoms of schizophrenia
 Changes in emotional state
 Changes in how they relate to others
 Changes in behavior
Active stage symptoms
 Delusions
 Hallucinations
 Disorganized or incoherent speaking
 Disorganized or unusual movements
 Negative symptoms
Although schizophrenia cannot be cured, it is frequently treatable. People with
schizophrenia do occasionally fully recover from it. There is no way to predict who
would experience a relapse of this ailment and who won't, therefore this isn't a cure. As
a result, medical professionals refer to patients who recover from this ailment as being
"in remission." 
 A mix of medication, counseling, and self-management approaches is typically used
to treat schizophrenia. While most mental health illnesses can be effectively treated
with therapy alone, maintaining schizophrenia typically necessitates medication. Early
detection and intervention are crucial since they improve the likelihood of a successful
outcome.

PSYCHOPATHOLOGY
NURSING CARE PLAN

ASSESSMEN DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

T
Subjective:  Risk for injury Short term • Established  Develop trust between patient Goal met
“I felt that directed to self goal: trust and  and nurse to improve Short term
someone was and others At the end of rapport effectiveness of interventions goal:
out there to related to the shift, the and cooperation At the end of
harm me and delusional patient will the shift the
I believed that thinking, paran not harm • Assesed pt’s  This will allow the nurse to patient did not
some of the oia, and a others. general gauge the patient’s present harm others.
people in the history of status condition and the likelihood
restaurant violence Long term that an injury or violence could
looked like against others goal: occur. Long term
devils and secondary to The patient goal:
were schizophrenia. will • Assessed for  Patients should be directly The patient
possessed by demonstrate a plan for asked if they have a plan to was able to
demons” as self-control violence hurt someone else so staff can demonstrate
verbalized by with intervene accordingly. self-control
the pt. decreased with decreased
hyperactivity • Observed  Monitor closely for changes in hyperactivity as
Objective: as evidenced for early behavior that may indicate a evidenced by
History of by relaxed cues of loss of control such as change relaxed posture
violence posture and distress in body posture or facial and non-violent
against others non-violent expression, or a lack of behavior.
behavior. cooperation.

• Maintained  Staff should remain calm so as

and convey not to further escalate a
a calm situation. When interacting
attitude with the pt., communication
should be straightforward to
prevent the patient from
feeling suspicious or
• Explained all
 procedures manipulated
slowly and
carefully  Reduces paranoia and
before encourages cooperation. Pt’s
beginning are less likely to feel “tricked”
if they understand what is
happening to them. Even
• Maintained taking a bp can be frightening
distance if not fully explained first.
from the pt.
 While constant supervision
may be required, staff should
keep themselves safe by never
turning their back on the pr
• Provided and never touching them
safe without permission (unless
environment required).

• Utilized  Keep the patient safe by

safety removing any object that could
measures to be used as a weapon 
protect
patient’s or  Patient’s delusional thinking
others, if might dictate to them that they
the patient might have to hurt others or
believes themselves in order to be safe.
they need External controls might be
to protect needed.
themselves
against a
specific
person.
Precautions
needed.
• Administere
 d
medication
appropriatel
y  Routine medications may be
given to help improve
symptoms. A patient that
cannot be “talked down” or
• Administere presents a risk to others may
d require the use of anti-anxiety
tranquilizers or antipsychotic medications.
as ordered
 A contract gets the subject out
in the open and places some of
• Applied the responsibility for his safety
restraints as with the
ordered client.                                    

 Manual restraints are a last

resort when all other
interventions have failed, the
patient’s safety remains a
priority for the nurse and a
patient in restraints should be
monitored per facility policy
and restraints should be
removed as soon as the
patient's agitation subsides.

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjectives: Disturbed Short- Term Independent: Goal met
"Nakita ko, thought Goal: • Attempted to  Important clues to underlying Short- Term
nakita ko sa processes At the end of understand fears and issues can be Goal:
tv, habang related to the shift of the found in the client’s At the end of
nagsasalita disrupitve in nursing significance seemingly illogical fantasies. the shift of
yung babae cognitive interventions, of these nursing
nakatitig siya operations and the patient beliefs to the interventions,
sa akin, sinabi activities as will: client at the the patient was
niyang dapat evidenced by • Perceiv time of their able to
ko siyang inaccurate e the presentation. perceived the
lapitan. interpretation environ environment
(beliefs that of environment ment • Recognizes  Recognizing the client’s correctly;
the ( presence of correctl the patientt’s perception can help you demonstrated
television delusions ) y. delusions as understand the feelings he or decrease
was sending • Demon the client’s she is experiencing. anxiety level
him strate perception of within 24
messages;) decreas the hours;
• Kailang e environment. andtalked
an ko anxiety about concrete
ng level happenings in
lumaba within • Identified  When people believe that the
s dito, 24 feelings they are understood, anxiety environment
may hours. related to might lessen. without talking
magag • Talk delusions. about delusions
anap about for 5 minutes.
na concret • Explained the  When the client has full Long- Term
digmaa e procedures knowledge of procedures, he Goal:
n. happen and try to be or she is less likely to feel After 3 months
Susugo ings in sure the tricked by the staff. of nursing
d sila the client interventions,
dito, environ understands the patient was
mga ment the able to
tikbalan without procedures demonstrate
g, talking before satisfying
kapre about carrying relationships
at delusio them out. with real
 aswang ns for 5 people;
, minute demonstrated
kailang s. • Interacted  When thinking is focused on two effective
an   with clients reality-based activities, the coping skills
nating   on the basis client is free of delusional that minimize
lumaba Long- Term of things in thinking during that time. delusional
n(belie Goal: the Helps focus attention thoughts;
f that After 3 months environment. externally. verbalized
mytho of nursing recognition of
logical interventions, • Distracted delusional
creatu the patient client from thoughts if they
res will: their persist.
were  Demonstrate delusions by Refrained from
trying satisfying engaging in acting on
to relationships reality-based delusional
entice with real activities thinking;
him to people. (e.g., card developed trust
battle) • Demon games, one staff
. strate simple arts member and
Pinakita two and crafts sustained
kanina sa effectiv projects attention and
tv, nagpo e etc.). concentration
propose coping to complete
sakin si skills task or
Nadine that • Do not touch  Suspicious clients might activities; free
Lustre. minimiz the client; misinterpret touch as either from delusions
Maganda e use gestures aggressive or sexual in or demonstrate
naman delusio carefully nature and might interpret it the ability to
siya, pero nal as threatening gesture. function
hindi ko thought People who are psychotic without
siya gusto. s. need a lot of personal space. responding to
Pero okay • Verbaliz persistent
lang e • Initially do  Arguing will only increase delusional
naman. recogni not argue client’s defensive position, thoughts; and
Papayag tion of with the thereby reinforcing false stated that the
ba'ko? delusio client’s beliefs. This will result in the “thoughts”
(belief nal beliefs or client feeling even more were less
that a thought convince the isolated and misunderstood. intense and
celebrity s if client that less frequent
on TV they the delusions with the help of
wanted persist. are false and the medications
to marry • Refrain unreal. and nursing
him; )Six from  All are vital to help keep the interventions
six six it's acting Encouraged healthy client in remission.
hell, it's on habits to optimize
death, I delusio functioning:
am the nal • Maintained
God of thinkin medication
death, I g. regimen.
am a God. • Develo • Maintained
(misinter p trust regular sleep
pretation in at pattern.
of least • Maintained
numbers one self-care.
to staff • Reduced
indicate membe alcohol and
that he r drug intake.  The client’s delusion can be
was (within • Show distressing. Empathy conveys
GOD)", as 1 empathy your caring, interest and
verbalized week) regarding the acceptance of the client
by the • Patient client’s
patient. will feelings;
• He also sustain reassure the
reporte attentio client of your
d n and presence and
feeling concent acceptance.
very ration
paranoi to  When client is ready, teach
d as if comple Teached client strategies client can do
someo te task coping skills that alone.
 ne was or minimize “worrying”
going activitie thoughts. Coping
to s. skills include:
harm • State • Singing or
him. He that Listening to a
stated the song.
that he “thoug • Talking to a
believe hts” are trusted
d some less friend.
of the intense • Thought-  During acute phase, client’s
people and stopping delusional thinking might
in the less techniques. dictate to them that they
restaur frequen might have to hurt others or
ant t with self in order to be safe.
looked the External controls might be
like help of needed.
devils the
and medicat • Utilized  Enhances client’s sense of
were ions safety well-being and helps make
possess and measures to non delusional reality a more
ed by nursing protect positive situation for the
demon interve clients or client.
s. ntions. others, if the
  • Be free client believe
Objectives: from they need to
Presence delusio protect
of ns or themselves
delusions: demons against a
(+) trate specific
Referential the person.
delusions/ ability Precautions
ideas of to are needed.
reference functio • Give positive
(+) n feedback for
Paranoid without the client’s
 delusions respon successes
(+) ding to
Religious persiste Dependent:
delusions nt  Administered
delusio haloperidol(
nal Haldol) as
thought ordered.
s

Collaboration:
 Engaged  Cognitive behavioral
patient in therapy (CBT) is a
cognitive treatment approach that
behavioral helps you recognize negative
therapy and or unhelpful thought and
occupational behavior patterns. CBT aims
therapy. to help you identify and
explore the ways your
emotions and thoughts can
affect your actions.
Occupational therapy on
the other hand, is an allied
health profession that
involves the therapeutic use
of everyday activities, or
occupations, to treat the
physical, mental,
developmental, and
emotional ailments that
impact a patient's ability to
perform day-to-day tasks.

ASSESSME DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

NT
Subjective Impaired Social Short term Independent: Goal met.
Data: Interaction goal: • Initiated  To gain the patient’s trust.
“Iyong mga related to At the end of active
tao mukha exaggerated my shift, the listening and Short term goal:
silang mga response to patient will provided a At the end of my
demonyo, alerting stimuli. verbalize safe shift, the patient
sinasapian awareness of environment verbalized
sila ng mga factors causing to the client awareness of
masasamang impaired social for self- factors causing
ispirito! Balak interactions. disclosure. impaired social
nilang akong interactions.
saktan.” as • Assessed if  Many of the positive
verbalized by Long term the symptoms of
the patient. goal: medication schizophrenia Long term goal:
After 1 week has reached (hallucinations, delusions,
Objective of nursing therapeutic racing thoughts) will After 1 week of
Data: interventions, levels. subside with medications, nursing
• Anxio the patient will which will facilitate interventions, the
us be able to interactions. patientbe able to
• Agitat demonstrate demonstrate
ed appropriate • Identified the  Increased anxiety can appropriate skill
• Distan skill to initiate symptoms intensify agitation, to initiate and
t and maintain clients aggressiveness, and maintain an
• Social an interaction. experience suspiciousness. interaction.
isolati when they
on begin to feel
• anxious in
front of
others.
 Client might respond to
• Provided the noises and crowding with
patient a agitation, anxiety, and
non- increased inability to
stimulating concentrate on outside
environment events.
 (loud noise,
crowds) as
much as
possible.

• Avoided  Touch by an unknown

touching the person can be
client. misinterpreted as a sexual
or threatening gesture.
This particularly true for a
paranoid client

• Planned  Client can lose interest in

activities that activities that are too
work at the ambitious, which can
client’s pace increase a sense of failure.
and activity

• Structured  Helps client to develop a

times each sense of safety in a non-
day to threatening environment
include
planned
times for
brief
interactions
and activities
with the
client on
one-on-one
basis

 To promote awareness.
• Educated the
patient
 factors that
contributed
to his
impaired
social
interaction.

• Engaged the  Client is free to choose his

patient in a level of interaction;
solitary or however, the
one-on-one concentration can help
activities that minimize distressing
require paranoid thoughts or
concentration voice.
.
• Provided very  Even simple activities help
simple draw client away from
concrete delusional thinking into
activities with reality in the environment
the patient
such as
painting.

• Planned one-  Learn to feel safe with one

on-one person, then gradually
activities with might participate in a
a “safe” structured group activity.
person
initially.

• Incorporated  Increase likelihood of

the strengths client’s participation and
and interests enjoyment
of the
 patient.

• Taught to  Teach client skills in

withdraw dealing with anxiety and
temporarily increasing a sense of
when patient control.
felt agitated
and
encouraged
to engage in
exercise to
reduce
anxiety such
as
meditations
or deep
breathing
exercise).

• Provided  These are fundamental

patient useful skills for dealing with the
coping skills world, which everyone
such as uses daily with more or
conversation less skill.
al and
assertiveness
skills.

• Acknowledge  Recognition and

d and appreciation go a long way
recognized to sustaining and
positive steps increasing a specific
the client behavior.
takes in
 increasing
social skills.

• Educated
patient about  Social skills training helps
adaptive the client adapt and
social skills in function at a higher level
a non- in society, and increases
threatening the client’s quality of life.
environment.
Such as
appropriate
distance,
maintain
good eye
contact, calm
manner/beha
vior,
moderate
voice tone).

• Provided the
client a  Gradually the client learns
graded to feel safe and competent
activities with increased social
according to demands.
his level of
tolerance
such as
simple games
with one
“safe”
person; and
slowly add a
third person
 into “safe”.

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective: Defensive Short term goal: Independent: Goal Met
“May lason coping related After 8 hours of • One staff at the  In order to
yang pagkain to suspicion of nursing intervention, same time should promote Short term goal
na binibigay the motives of the patient identifies handle the patient development of After 8 hours of
niyo. Meron others factors relating to his as possible trusting nursing
akong naririnig condition and able to relationship interventions,
na communicate and the client was
bumubulong interact • Avoided physical  Suspicious client able to
sakin. appropriately  contact may perceive communicate
Pinaplano niyo touch as a and interact
lahat na Long term goal: threatening appropriately
patayin ako. After 4 months of gesture and identified
Ayokong nursing factors related
sumama sa interventions, the • Avoided laughing,  Suspicious client to his condition
mga therapy patient will be able whispering, or often believe
niyo, to demonstrate use talking quietly others are Long term
papatayin niyo of more adaptive where the client discussing them, goal:
lang ako” as coping skills as can see but not and secretive After 4 months
verbalized by evidenced by hear what is being behaviors of nursing
the patient appropriateness of said. reinforce the intervention,
  interactions, paranoid feelings. the patient was
Objective: decrease suspicious able to
(+) behavior, and • Removed all  It may cause demonstrate
Persecution willingness to sharps that may harm to patient use of more
Delusion participate in the cause harm with suicidal adaptive coping
(+) Paranoia therapeutic ideation and for skills as
(+) Auditory community also the safety of evidenced by
Hallucination others appropriateness
 of interactions,
• Activities should  Competitive decrease
never include activities are very suspicious
anything threatening to behavior, and
competitive. suspicious client  participated in
Activities that the therapeutic
encourage a one- community.
to-one relationship
with the nurse or
therapist are best.

• Use clear and  Minimize the

simple language opportunity for
when miscommunication
communicating and misconstruing
with a suspicious the meaning of
client. the message

• Creative approach  Sealed foods may

used to encourage help the patient to
food intake decrease
suspicious food
poisoning

• Be honest and  To promote

keep all promises trusting
relationship

• Encourage client  Verbalization of

to verbalize true feelings in a
feelings. As a nonthreatening
nurse we should environment may
avoid becoming help client come
defensive when to terms with long
 angry feelings are unresolved issues.
directed at him

• An assertive,  A suspicious
matter-of-fact, yet person does not
genuine approach have the capacity
is least threatening to relate to an
and most overly friendly,
therapeutic overly cheerful
attitude.
• Monitored patient
while taking  To ensure that
medication or the client is taking
mouth check or swallowing his
following medicines
medication
administration if
necessary.

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective: Readiness for Long term: Independent: Goal met.
pakiramdam ko enhanced After 3 months of  Evaluated ability  Provides Long term:
umaayos na ang coping related nursing to understand information
kalagayan ko, to positive interventions, the about After 3 months
events, and
gusto kong responses to patient will be able perception, of nursing
provide realistic
magtuloy tuloy na the adverse to: cognitive ability interventions,The
appraisal
ito para makahingi situation or  Assess and whether the patient can
situation.
na ako ng 48 hrs crisis patient is aaware assessed current
current
overnight pass” as of facts of the situation
situation
verbalized by the situation. accurately.
accurately. 
patient. Identified
 Identify
 Superficial effective coping
effective  Noted the
Objective: interactions with behaviors and
coping degree of
 Problem behaviors involvement in others can limit verbalized
solving to  Verbalize activities and sense of congruent with
meet goals congruent relationships connectedness behavior based
 Ability to set with with others. and reduce on an awareness
personal behavior. enjoyment of of current status.
goals. relationship.
 Desire to  Established a  Enhances
enhance therapeutic feelings of worth
social relationship, and comfort
support showing positive inspiring to
 Congruency regard. continue pursuit
of of goals.
expectation
s with
desires.  Evaluated  Understanding
decision making the ability
ability. provides a
starting point for
developing plan
and determining
what information
needs to develop
more effective
coping skills.

 Identified  Helps to deal

activities to with situation in
achieve goals manageable
and facilitate steps, enhancing
contingency chances for
planning. success and
sense of control.

 Explored  To Provides
 interrelated of opportunity to
unresolved address issues
emotions, that may limiting
behaviors, fears, the ability to
and guilt. improve life
situation.

 Identified ways  To support sense

to strengthen of belonging and
sense of connection that
interconnected promotes
with others. feelings of
wholeness.

 Determined  Accurate
stressors/ identification of
causes are situation that is
currently dealing with
affecting provides
patient. information for
planning
interventions to
enhance coping
abilities

 Assisted to  An individualized
create cognitive program such as
and behavioral relaxation,
management  meditation,
and involvement
caring for others
enhance coping
skills.
  Educated  Remind the
patient about importance of
prescribed taking the exact
medications, dose
including name, prescribed and
dosage, time, awareness of
frequency, and adverse effect.
possible adverse
effect.
 So that the
 Instructed the patient remain
patient to stable as long as
continue the possible.
prescribed
medications.

DRUG STUDY

DRUGS CLASSIFI ACTION INDICATION CONTRAINDICAT NURSING RESPONSIBILITIES

 CATION ION
Generic Name: Antipsychot • Block HALOPERIDOL  • Presence of • Assess for cautions and
HALOPERIDOL ic DOPAMINE • Acute diseases contraindications
(neurolepti receptors psychiatric • CNS • Perform thorough physical
Brand Name: c) drugs • Depress the situations  depression assessment
HALDOL RAS.  • Dementia • Do not allow patient to chew or
FLUPHENAZINE • Glaucoma, crush the sustained release
• Management peptic ulcer, capsule
Generic Name: of urinary or • Keep patient in recumbent
FLUPHENAZINE  manifestations intestinal position for 30 minutes when
of psychotic obstruction administering parenteral.
Brand Name: disorders • Seizure • Monitor CBC results
PROLIXIN CHLORPROMAZINE disorders • Monitor blood glucose levels for
• Older • Active long term use
antipsychotic alcoholism • Provide comfort measure
Generic Name: drug • Immunosupp • Provide safety measures
CHLORPROMAZI ression, • Educate the client on drug
NE  cancer therapy
• Pregnancy
Brand Name: and lactation
THORAZINE

Generic Name: Anticholine • Returns the Adjunctive therapy • Allergy to • Administer drug with caution for
BENZTROPINE rgic agents balance to to Parkinson’s dopaminergi patients exposed in hot weather
the basal disease cs or environments
Brand Name:  ganglia • Angle- • Give drug with meals
COGENTIN closure • Monitor bowel functions
glaucoma, GI • Have patient void before taking
and GU the drugs
Generic Name: obstruction, • Monitor laboratory results
AKINETON prostatic
 hypertrophy
Brand Name: • Myasthenia
BIPERIDEN gravis
• Tachycardia,
dysrrhythmia
,
hyper/hypote
nsion
• Hepatic
dysfunction
• Lactation
• Pregnancy

Generic Name: Tricyclic • Blocks the Treatment of • Allergy to • Arrange for lower dose in
SETRALINE agents reuptake of depression, OCDs, SSRIs elderly patients
5-HT and panic attacks, social • Hepatorenal • Limit drug access if patient is
therefore anxiety disorders diseases suicidal
Brand Name: increase its • Severely • Monitor patient for 4 weeks
ZOLOFT level in the depressed, • Established suicide precautions
synaptic suicidal • Administer drug once a day in
cleft patients the morning

INSULIN Antidiabetic • Lowers • Treatment for • Hypoglycemi  Ensure uniform dispersion of

blood type 1 DM a insulin
glucose • Treatment for  Give maintenance doses
levels Type 2 DM subcutaneous.
• Regulates  Use caution when mixing two
carbohydrat types of insulin
e, protein  Store insulin in cool dry place
and fat away from direct sunlight.
metabolism  Monitor urine or serum glucose
levels frequently.
 ADVERSE EFFECT
• Hypoglyce
mia
• Insulin
resistance
• Lipotraphy
• Hypokalemi
a
• Blurred
vision

NURSE-PATIENT INTERACTION (NPI)

 PATIENT’S VERBAL NURSE’S RESPONSE THERAPEUTIC ANALYSIS / RATIONALE
RESPONSE COMMUNICATION
STRATEGY
DAY 1 Talaga? Saglit lang po Voicing Doubt Another means of responding to distortions of
“May lason yang pagkain sir, kuhanan kita ng reality is to express doubt. Such expression
na binibigay nyo” bago para ikaw po permits the client to become aware that others
magbukas. do not necessarily perceive events in the same
way or draw the same conclusions.
“Meron akong naririnig na Ano ba ang Encouraging To understand the client, the nurse must see
bumubulong sakin” ibinubulong sa'yo? description of things from his perspective.
Pwede mo bang perception
ilahad?
When client deals with topics superficially,
Exploring exploring can help him examine the issue more
fully.

Pinaplano nyo lahat na (Nodding) Accepting An accepting response indicates the nurse heard
patayin ako Sir, dalawa lang the client. It doesn't indicate agreement and is
tayong nag-uusap not judgmental.
dito, wala nang iba.

When the client is misinterpreting, the nurse can

Presenting reality indicate what is real. The nurse does this by
calmly and quietly expressing his own feelings.

DAY 2
Before: sad face
Nurse:Making "Oh, parang malalim Making observation Sometimes clients cannot verbalize or make
observation ang iniisip natin ha? themselves understood. Or the client may not be
ready to talk.
Nalulungkot ako at hindi “May gusto ka bang
ko alam kung bakit sabahin? Nandito lang It allows the client to take the lead in the
ako nakikinig” Broad opening interaction. It is helpful for clients who are
 hesitant about talking.

Narrator: Mas The nurse can offer his or her presence, interest
napapalagay na yung Offering self and desire to understand. It is important that this
loob ng patient sa nurse ( offer is unconditional.
established trust and
rapport)
Ayoko ng ibang kausap “Pakiramdam mo ba Verbalizing the implied Putting into words what the client has implied or
walang nakakaintindi said indirectly tends to make the discussion less
sayo?” obscure
Ayokong sumama sa mga “Marahil pwedeng Suggesting The nurse seeks to offer a relationship in which
therapy nyo. Papatayin nating pag-usapan collaboration the client can identify problems in living with
nyo lang ako ang mga sanhi ng others, grow emotionally, and improve the ability
iyong pagkabalisa?” to form satisfactory relationships.

Ako ang tunay na Diyos! “Napakahirap Voicing doubt Such expression permits the client to become
paniwalaan yan, sir!” aware that others do not necessarily perceive
events in the same way or draw the same
conclusions.
Wala akong ganang “Isa ba ito sa mga Encouraging The nurse asks the client to consider people and
makisalamuha sa ibang dahilan ng iyong expression events in life of his own values. It encourages
pasyente. Mga baliw yang pagkabalisa?” the client to make his own appraisal than accept
mga yan the opinion of others.

REFERENCES
https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443#:~:text=Risk
%20factors&text=Having%20a%20family%20history%20of,teen%20years%20and%20young%20adulthood

https://www.verywellmind.com/what-is-deja-vu-why-do-we-experience-it-5272526

https://www.texasinstituteforneurologicaldisorders.com/uncategorized/effects-high-sugar-diet-brain/

Book: Carl E. Balita Ultimate learning guide

Book: Top Ranker’s Guide

https://my.clevelandclinic.org/health/diseases/4568-schizophrenia

https://nurseslabs.com/schizophrenia-nursing-care-plans/5/?fbclid=IwAR3YnBf3Omqspa8K4I3nfhN-
9dt2YvzktBYAVQ2TM0Dbxxn9Mjm94TIhsBQ