Beruflich Dokumente
Kultur Dokumente
INTRODUCTION
Patient S.S. is 46-year old female residing at Prk. Pepsi zone 2, Bacolod city. She is a
Filipino and a Catholic. She is currently staying at National Center for Mental Health. She has
been staying in the facility for almost 2 years and was brought by BJNP last November 23, 2013.
She is a college commerce graduate but did not practice because she lacked confidence. She has
a history of 2 miscarriages because she accidentally slipped. She lives with her father and
siblings. She provides for her family by working as a Labandera and manning their Sari-sari
store. The patients daily food intake consisted of rice, fish, vegetables and whatever was being
served in the facility. Her favorite food is tocino and energen. Sometimes, she would walk
around the ward as a form of exercise. She gets about 8 hours of sleep and takes naps during
morning or afternoon. Patient doesnt smoke, drink or use drugs. When asked how she felt,
patient said that she was happy. One of the problem that bothers her is when there are
emergencies back home which she cant resolve because she is unable to leave the facility.
21 years (1994) prior to admission, she was diagnosed with schizophrenia and was given
medications. 9 months prior to admission, the patient was not compliant with taking the
medications because of financial problems. 6 months prior to admission, patient was arrested for
murdering an 8-month baby which was known to be the patients nephew. According to her she
accidentally killed the baby by stabbing the back of the head with a bolo knife or a machete
twice. Afterwards, she laughed and members of her family saw her. During the Nurse-Patient
Interaction, Patient S.S. verbalized that she was out of her mind and heard auditory
hallucinations. She was sent to jail with a case of murder. After a few months of her stay in the
jail, the moderator noticed that patient S.S. was sleepless and was talking to herself. She was
then borught o NCMH by ship and was assessed. She was diagnosed with Schizophrenia and was
transferred to Pavillion 35 (Forensic Area) According to the patient, family problems triggered
her condition.
Schizophrenia causes distorted and bizarre thoughts, perceptions, emotions, movement, and
behavior. It cannot be defined as a single illness; rather thought as a syndrome or disease process
with many different varieties and symptoms. It is usually diagnosed in late adolescence or early
adulthood. Rarely does it manifest in childhood. The peak incidence of onset is 15 to 25 years of
age for men and 25 to 35 years of age for women. (Videbeck, 2011)
Significance of Management
Ideal Management
Schizophrenia is associated
with a wide variety of abnormal
behaviors;
therefore,
assessment
findings
is
important to know proper
treatment. Medications are
given
everyday
because
continuity of care seems to be a
significant factor in psychiatric
nurse care as documented by
research studies (Backrush,
1981).
Antipsychotic
medication
Education & support,
for both ill individuals and
families
Social skills training
Rehabilitation to
improve activities of daily
living
Vocational and
recreational support
Cognitive therapy
Reference: (Vera, 2012)
Lab Results:
Nursing Responsibilities:
Monitor patient for
symptoms of
tardive dyskinesia,
it may occur after
prolonged use
Monitor for weight
gain
Monitor for
hyperglycemia
Monitor for EPS
Analysis:
Medication is one of the cornerstones of treatment. Once the acute stage of a psychotic
episode has passed, most people with schizophrenia will need to take medicine indefinitely. This
is because vulnerability to psychosis doesnt go away, even though some or all of the symptoms
do. In North America, atypical or second generation antipsychotic medications are the most
widely used. However, there are many first-generation antipsychotic medications available that
may still be prescribed. A doctor will prescribe the medication that is the most effective for the ill
individual
Another important part of treatment is psychosocial programs and initiatives. Combined
with medication, they can help ill individuals effectively manage their disorder. Talking with
your treatment team will ensure you are aware of all available programs and medications.
In addition, persons living with schizophrenia may have access to or qualify for income
support programs/initiatives, supportive housing, and/or skills development programs, designed
to promote integration and recovery. (Vera, 2012)
IV. PATHOPHYSIOLOGY
Schizophrenia
Patient S.S. (46 years old)
Precipitating factors:
Jail for a case of murder
Family Problems
History of miscarriages
Risk factors:
Genetic Predisposition
Environmental, Social, and
Psychological Factors
Neurodevelopmental
abnormalities and target features.
Brain dysfunctional
Improper balance of chemicals
Antipsychotic
Medications:
Resperidone
Schizophrenia
Positive:
Delusion
Hallucination
Ideas of reference
Flight of ideas
Negative:
Ambivalence
Anhedonia
Apathy
Thought blocking
V. NURSING CARE
Short-term goals
Anxiety
Altered thought processes
Long-term goals
Reference:
(Doenges,
Lastly, the 3rd priority problem is Ineffective individual coping is Inability to form a valid
appraisal of stressors, inadequate choices of practiced responses, and/or inability to use available
resources Maladaptive coping can result in unnecessary distress for the person and others
associated with the person or stressful event. In nursing literature, effective and ineffective
coping are often differentiated. Effective coping results in adaptation, while ineffective coping
results in maladaptation.
VII. REFERENCE
Doenges, M. E., Moorhouse, M., & Murr, A. C. (2008). Nurse's Pocket Guide . Joanne Patzek
DaCunha.
NANDA. (2010). NCP for Schizophrenia. Retrieved from NANDA Nursing: http://nandanursing.blogspot.com/2010/10/nursing-care-plan-for-schizophrenia.html
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner and Suddarth's
textbook of medical-surgical nursing. Wolters Kluwer Health.
Vera, M. (2012, Feb 23). Schizophrenia Nursing Care & Management. Retrieved from
NursesLabs: http://nurseslabs.com/schizophrenia-case-study-types-diagnosis-interventionstreatment/
Videbeck, S. L. (2011). Psychiatric-Mental Health Nursing. Wolters Kluwer | Lippincott
Williams & Wilkins.