abnormalities in the structure and Iunctioning oI the brain compared to normal testsubjects.

These discoveries have been made with the help oI imaging techniques suchascomputed
tomography scans (CT scans).When a psychiatrist assesses a patient Ior schizophrenia, he or she
will begin byexcluding physical conditions that can cause abnormal thinking and some other
behaviorsassociated with schizophrenia. These conditions include organic brain
disorders(including traumatic injuries oI the brain), temporal lobe epilepsy, Wilson's disease,
priondiseases, Huntington's chorea, andencephalitis. The doctor will also need to ruleout heavy
metal poisoningand substance abuse disorders, especially amphetamine use.AIter ruling out
organic disorders, the clinician will consider other psychiatric conditionsthat may include
psychotic symptoms or symptoms resembling psychosis. Thesedisorders include mood disorders
with psychotic Ieatures; delusional disorder;dissociative disorder not otherwise speciIied
(DDNOS) or multiple personality disorder ;schizotypal, schizoid, or paranoid personality
disorders; and atypical reactive disorders.In the past, many individuals were incorrectly
diagnosed as schizophrenic. Some patientswho were diagnosed prior to the changes in
categorization should have their diagnoses,and treatment, reevaluated. In children, the doctor
must distinguish between psychoticsymptoms and a vivid Iantasy liIe, and also identiIy learning
problems or disorders. AIter other conditions have been ruled out, the patient must meet a set oI
criteria speciIied:
W
the patient must have two (or more) oI the Iollowing symptoms during a one-month period:
delusions; hallucinations; disorganized speech; disorganized or catatonic behavior; negative
symptoms

W
decline in social, interpersonal, or occupational Iunctioning, includingselI-care
W
the disturbed behavior must last Ior at least six months
W
mood disorders, substanceabuse disorders, medical conditions, anddevelopmental disorders have
been ruled out.
Nursing intervention
1.Assess the pat ient' s abilit y to carry out the act ivit ies oI daily living, paying
specialattention to his nutritional status. Monitor his weight iI he isn't eating. II he thinks thathis
Iood is poisoned, allow him to Iix his own Iood when possible, or oIIer him Ioodsin closed
containers that he can open. II you give liquid medication in a unit-dosecontainer, allow the
patient to open the container.
2.Maintain a saIe environment, minimizing st imuli. Administer medicat ion to
decreasesymptoms and anxiety. Use physical restraints according to your Iacility's policy
toensure the patient's saIety and that oI others.
3.Adopt an accept ing and consistent approach wit h the pat ient. Don't avoid
or overwhelm him. Keep in mind that short, repeated contacts are best until trust has been
established.
4.Avoid promoting dependence. Meet the patient 's needs, but only do Ior the
patientwhat he can't do Ior himselI.
.Reward posit ive behavior to help the pat ient improve his level oI Iunct ioning
.6.Engage the pat ient in realit y-oriented activit ies that involve human contact:
inpat ientsocial skills training groups, outpatient day care, and sheltered workshops. Provide
reality-based explanations Ior distorted body images or hypochondriacal complaints.ClariIy
private language, autistic inventions, or neologisms, explaining to the patientthat what he says
isn't understood by others. II necessary, set limits on inappropriate behavior.
7.II the pat ient is hallucinat ing, explore the content oI the hallucinat ions. II he
hasauditory hallucinations, determine iI they're command hallucinations that place the patient or
others at risk. Tell the patient you don't hear the voices but you knowthey're real to him. Avoid
arguing about the hallucinations; iI possible, change thesubject.
8.Don't tease or joke with the pat ient. Choose words and phrases that are
unambiguousand clearly understood. For instance, a patient who's told, That procedure will
bedone on the Iloor, may become Irightened, thinking he is being told to lie down on theIloor.
9.Don't touch the pat ient without telling him Iirst exact ly what you're going to do.
For example, clearly explain to him, I'm going to put this cuII on your arm so I can takeyour
blood pressure. II necessary, postpone procedures that require physical contactwith Iacility
personnel until the patient is less suspicious or agitated.
10.Remember, institutionalization may produce new symptoms and handicaps in the patient that
aren't part oI his diagnosed illness, so evaluate symptoms careIully.
11.Mobilize community resources to provide a support system Ior the patient and reducehis
vulnerability to stress. Ongoing support is essential to his mastery oI social skills.12.Encourage
compliance with the medication regimen to prevent relapse. Also monitor the patient careIully
Ior adverse eIIects oI drug therapy, including drug-induced

parkinsonism, acute dystonia, akathisia, tardive dyskinesia, and malignant neurolepticsyndrome.

Make sure you document and report such eIIects promptly

2.Document nursing or caregiver observat ions oI sleeping and wakeIul

behaviors.Record number oI sleep hours. Note physical (e.g., noise, pain or discomIort,
urinaryIrequency) and/or psychological (e.g., Iear, anxiety) circumstances that
interruptsleep.3.Instruct patient to Iollow as consistent a daily schedule Ior ret iring
and arising as possible.4.Avoid including in the meal alcohol or caIIeine as well as
heavy meal.Increase dayt ime physical act ivit ies as indicated.6.Recommend an
environment conducive to sleep or rest (e.g., quiet, comIortabletemperature,
ventilation, darkness, closed door).COLLABORATIVE

Administer sedatives as ordered.

Evaluation
AIter 8 hours oI Nursing Interventions, the patient was able to show improvement inhis sleeping
pattern.
Nursing care plan
Assessment
Subjective'Ang aking mga sugat ay nangangati as verbalized by the patient

Objective

(pain)

Localized erythema

Disruption oI the skin

Diagnosis
Impaired skin integrity related to inIlammatory response secondary to inIection.
Planning
Following a 3-day nursing intervention, the client will be able to display improvement inwound
healing as evidenced by:

Intact skin or minimized presence oI wound.

Absence oI redness or erythema.

Absence oI purulent discharge.

Absence oI itchiness.
Intervention

Assessed skin. Noted color, turgor, and sensation. Described and measured woundsand observed
changes.

Demonstrated good skin hygiene, e.g., wash thoroughly and pat dry careIully.

Instructed Iamily to maintain clean, dry clothes, preIerably cotton Iabric (any T-shirt).

Emphasized importance oI adequate nutrition and Iluid intake.

Demonstrated to the Iamily members on how to make a guava decoction to apply tothe wound as
alternative disinIectant.

Instructed Iamily to clip and Iile nails regularly.

Provided and applied wound dressings careIully

.
Evaluation
At the end oI the 3-day nursing intervention, the client was able to display improvementin wound
healing as evidenced by:

Minimized presence oI wounds.

Several wounds have dried up.

Minimized erythema.

Minimized purulent discharge.

(Continue cleaning the wound with disinIectant)

Presence oI itchiness (Continue instructing client to avoid scratching the wound)

Nursing process Recording
Mr. Apo drawn a heart and uses a red crayon to make it. He described the drawing as asymbol
love and passion. He also said that symbolizes people who love each other. My patient thinks oI
love and the way people express it, and show it, in the way that peoplecan appreciate the true
meaning oI LOVE. Why do people Iall in love and what is it Ior.Is it important to people to love
in able to attain peace or to unite people and be happy

with their special someone. The answer is clear and the only thing that makes people