MANILA ADVENTIST COLLEGE

School of Nursing
Psychiatric Case Study

Duty Week

Student Name Date of Duty

Clinical Instructor Block Area

PATIENT INFORMATION
Name Pavillion/Ward Date of Admission Attending Physician

Age Sex Civil Status Diagnosis

CASE DESCRIPTION
Demographic Data

Admission Data

Chief complain

History of Present Illness Past Medical History

Past Psychiatric History

Personal History
Psychopathophysiology Diagram

Psychopathophysiology Narrative

Includes but not limited to description of diseases, risks and predisposing factors and signs and symptoms. Description of normal physiology may also be discussed very briefly.
 NURSING CARE PLAN
(Minimum of 3 problems with 5 interventions each)

Nursing Problem Nursing Objectives Nursing Interventions Rationale of Evaluation

with Cues Diagnosis (SMART) Interventions
(with references)

Subjective: Short-term goal: Short-term goal:

Long-term goal: Long-term goal:

Objective: Rationale with
Reference:
Drug Study (5 Medications) Complete 5 Medications. If your patient has less than 5, include any drugs with different classification that are
related to your client’s drug.

A. GENERIC NAME A. INDICATION TO PATIENT: (Why A. SIDE EFFECTS

(BRAND NAME) is the drug given to the patient) DRUG ACTION
(Brand Name in parenthesis) B. OTHER INDICATION FOR USE

B. GENERAL CLASSIFICATION OF C. DOSAGE (as prescribed for

THE DRUG patient) B. PRECAUTIONS AND
SPECIAL CONSIDERATION