ALMIN, RAZELLE S.

BSN 3Y2-2

NCMB317

CU 3 WEEK 3 LEC SCHIZOPHRENIA

John, 33 years old, has been admitted to the hospital for the third time with a diagnosis
of Schizophrenia. John had been taking Haloperidol (Haldol) but stopped taking it 2
weeks ago, telling his case manager it was, and “The poison that is making me sick”
Yesterday John was brought to the hospital after neighbors called the police because
he had been up all-night yelling loudly in his apartment. Neighbors reported him saying,
“I can’t do it. They don’t deserve to die!” And similar statements.
John appears guarded and suspicious and has very little to say to anyone. His
hair is matted, he has a strong body odor, and he is dressed in several layers of heavy
clothing even though the temperature is warm. So far, John has been refusing any
offers of food and fluids. When the nurse approached John with a dose of Haloperidol,
he said “Do you want me to die? “

DISCUSSION: ANSWER THE FOLLOWING QUESTIONS.

  DISCUSS YOUR UNDERSTANDING OF SCHIZOPHRENIA SPECTRUM

ANSWER: People who are suffering from schizophrenia spectrum fail to have contact

with real life. They might face a range of symptoms like delusions, hallucinations, disorganized
thinking, abnormal behavior etc.

 Describe various theories of etiology of Schizophrenia

ANSWER: The etiology of schizophrenia is unknown, but risk factors are linked with the
disease's development, which includes both genetic and environmental factors. Schizophrenia
can be hereditary. Many research has come up with strong evidence that schizophrenia is
heritable.

 Identify three (3) priority problems of John

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 ANSWER:
o Disorganized thinking as he thinks that Haloperidol is a poison and it is going to kill
him.
o Abnormal behavior as he is shouting and yelling at night.
o Not taking medicine- Haloperidol is a medicine that will help him to recover but
refusing to take it is a big problem.
ASSESSMENT NURSING PLANNING INTERVENTION RATIONALE EVALUATION
DIAGNOSIS
o Disorientation Disturbed Able to do his o Interact with o To gain his The client has
thought function without the patient attention. improved
processes related responding to his more cognitive
to delusion as unwanted frequently. thinking.
evidenced by thoughts.
o Impaired poor cognitive o Encourage to o To avoid the
judgement thinking express his delusional
feelings. thoughts.

o Poor thoughts
o Establish o To increase
o Lack of therapeutic his confident.
confidence relationship to
have trust on
patient.
 Make a nursing care plan of John based from the problem identified

ASSESSMENT NURSING PLANNING INTERVENTION RATIONALE EVALUATION

DIAGNOSIS
o Negative thoughts Impaired social The client able to o Assess the o To The client was
interaction socialize with client level of understand verbalized his
o Low self esteem related to others. functioning. the client desire to interact
absence of social desirable with others.
activities as behavior.
o Poor communication evidenced by lack o Assess the o To
of peers, family. client process understand
of grieving. the client's
o Lack of acceptance
feeling of
self-worth.
o To increase
o Orient the
the positive
client to the
thoughts.
surrounding
environment.

ASSESSMENT NURSING PLANNING INTERVENTION RATIONALE EVALUATION

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LECTURE NCMB317
 DIAGNOSIS
o Fear Anticipatory The client should o Assess the o Assess the The client has
grieving related feel supported patient level patient level reduced fear and
o Anxiety to fear of death and free from of acceptance of acceptance increased hope
as evidenced by fear. to his to his on life.
anxiety, condition. condition.
o Lack of hope restlessness.
o Assess the o Assess the
o Poor knowledge level of level of
anxiety and anxiety and
thought thought
process. process.

o Give space to o Give space to

the client to the client to
Express his Express his
feelings. feelings

o Promote o Promote
positive positive
effects on effects on
medication. medication.

ASSESSMENT NURSING PLANNING INTERVENTION RATIONALE EVALUATION

DIAGNOSIS
o Lack of self esteem Self-care deficit The client is able o Encourage the o To motivate The client has
related to to meet his self- patient for the client on shown improved
o Lack of interest schizophrenia as care hygiene. bathing, his activities. self-care
evidenced by dressing. activities.
poor hygiene,
o Repetition of similar lack of proper o Allow the o To increase
dressing. patient to his interest
thoughts
perform towards the
independently. dressing.

o Demonstrate o To change
the client to whatever
perform the necessary.
activities.

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LECTURE NCMB317