CASE ANALYSIS:

"Dr. Phil’ Guest 19-Year-Old Haley Believes She’s Pregnant With Baby Jesus"
I. Summary
According to the patient’s sister they both had been sexually molested and abused
when they were kids, which she thought could be the contributing factor to the patient
odd behavior that now was diagnosed to “paranoid schizophrenia”. The patient did
reveal that she had been diagnosed with paranoid schizophrenia, but still firmly believes
that she is pregnant and felt the baby kicking believing that she is conceiving the
messiah (baby Jesus). And that her mother admitted that the patient is treated like she’s
actually pregnant to “avoid conflict.” That may have also contributed to a fantasy like
world to the patient. It may have been better that the family corrected her perceptions
and seek an immediate possible treatment. Whereas, according to Dr. Stork, the
ultrasound showed that the patient had dilated loops of bowel (air in the intestines) that
explains her bloated abdomen, as well as the feeling that there’s something moving.
Added to this is her usual lies and has even claimed that the rapper Eminem is her
father. Patient also believes that she’s appeared as a contestant on American Idol, and
that she’s donated a kidney to her brother, saying that she was only conceived for
“spare parts. In the end her mother said she can’t keep living like this, and sought out
the help of Dr. Phil to find out if the patient is acting or really does need psychological
help.
II. Analysis
1. What happened to Haley?  What type of Schizophrenia is she suffering from? 
Explain.
The patient had a distorted perception from reality to fantasy. She lost the ability
to tell what's real and what's not real. Apparently, she believes that she is
pregnant (as manifested by her enlarged abdomen) and is conceiving the
Messiah. She is suffering from paranoid schizophrenia. That is according to WHO
Schizophrenia is a chronic and severe mental disorder that is characterized by
distortions in thinking, perception, emotions, language, sense of self and
behavior.
2. What signs and symptoms did she manifest to confirm her disorder/illness? 
Explain.
The patient manifests paranoid schizophrenia such as delusions. Given the fact
that she already had 6 negative pregnancy test results. An ultrasound of an
empty fetus instead a diagnosis of dilated loops of bowel. She still believes she is
pregnant and stated “I know it’s Jesus. I don’t care if my family disowns me. I
don’t care what the home pregnancy test or a doctor says, when I give birth to my
baby, no one is going to deny him because he’s my savior.” And still defend
herself that “she is not crazy and not stupid”. Makes obvious false claims all the
time, and added to this are her usual lies.
 3. What interventions, management and treatment must be provided to Haley?
The possible treatment that is appropriate to the patient includes the following:
Medications - antipsychotic medications. To control symptoms by affecting the
brain neurotransmitter dopamine. The goal of treatment with antipsychotic
medications is to effectively manage signs and symptoms at the lowest possible
dose.
Psychosocial and social (psychosocial) interventions. Individual therapy - may
help to normalize her thought patterns. Also, learning to cope with stress and
identify early warning signs of relapse can help the patient manage her illness.
Family therapy - provides support and education to the patient’s family in dealing
with her condition.
Hospitalization - hospitalization is necessary to ensure her safety, proper nutrition
and treatment for her dilated loops of bowel.
4. What is the most appropriate nursing diagnosis for Haley?  Why?
Disturbed thought process. Because of the defining characteristic that the patient
is manifesting from prior assessment (subjecting data provided by the patient and
the family and objective such as diagnostics) such as: delusions, inappropriate
non-reality-based thinking and self-centeredness.
III.  Conclusion/Recommendations 
   To help clients who are suffering from Schizophrenia, what suggestions can you offer
to the following:
a. Government (especially DOH)
Currently, the government and said department has already organized a mental
health programs, policies and law that addresses mental illnesses. But despite of
how long they started the program. It is likely that don’t have that much program
accomplishments. And still the number of diagnosed patients in increasing and yet
some are still not diagnosed and some are loitering around the streets with no
prior security. That is why I strongly suggest not to revise the existing policies and
laws but to implement it right. And let the public know about the existing programs
and let the program stay continuously not just annually, or quarterly. And
specifically, for schizophrenia, as the top mental illness recorded, it is better that
the government establish a specific program for the condition.
b. Academe (Nurse Educators)
It is the academes that teach following nurses on how to care for a patient. That is
why it is vital that nurse educators teach their soon subordinates the right
information to specific topics like schizophrenia. So that as when they go on, they
won’t have trouble dealing with patients with schizophrenia. Like the vital
knowledge like triggering factors, onset, symptoms, possible unnecessary
incidence, possible treatment and even their own experiences as a nurse on
 practice. Most of all things is that, academes shouldn’t be biased on giving away
information.
c. Parents
Being a parent is vital. Having a child suffering from schizophrenia is a lot more
painful. Some parent may not let their child into psychiatrist or receive any
treatment because of societal-stigma. Accept the fact and think for possible
regimens because I say your child has the right to receive a proper treatment. Do
not tolerate their non-reality statements and actions. Seek for an immediate help if
any early symptoms are detected. So that it may not progress to a lot of more
uncontrolled complications.
d. Client
Clients is bound to be educated. And client has the right to know his/her condition
despite of decreased cognitive intellect. That is why the thing that I can suggest to
the patient is “to ask questions”. It is to answer their left answered thoughts and
initiate communication to health providers. And also, to have a basis of their
current thoughts and mindsets.
References (link).
https://www.mayoclinic.org/diseases-conditions/schizophrenia/diagnosis-treatment/drc-
20354449