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Nursing Care Management For A Patient With Schizophrenia and Generalized Anxiety
Nursing Care Management For A Patient With Schizophrenia and Generalized Anxiety
for a Patient
with Schizophrenia and
Generalized Anxiety
INTRODUCTION
Schizophrenia is a serious mental disorder in which people interpret reality
abnormally. Schizophrenia may result in some combination of hallucinations,
delusions, and extremely disordered thinking and behavior that impairs daily
functioning, and can be disabling.
CHIEF COMPLAINT
Episodes of hallucination and delusions
PATIENT'S PROFILE
ADMITTING
STATUS Married Dr. M.A.C
PHYSICIAN
PATIENT’S HISTORY OF PRESENT ILLNESS
The patient had trauma after captivated and escaped from terrorist. On September 24,
2022, the patient started to experience mild to severe hallucinations and delusions by
seeing and hearing things like footsteps, explosions and gunshots.
FAMILY HISTORY
The patient is an retired Filipino military army and lives with his two children.
The patient does drink alcohol beverages and does smoke.
NURSING CARE PLAN
NURSING
ASSESSMENT PLANNING INTERVENTION RATIONALE EVALUATION
DIAGNOSIS
Subjective: Short term goal: Established Rapport To giant the trust of Goals Met
Defensive
“Andyan na ang mga After 3-7 days, of proper the client
coping
kalaban sa labas, nursing intervention the Short term goal:
related to
kailangan ko na patient will: Explain to the patient Prepares the patient After 3-7 days of
magtago” as suspicion of Interact with others the activity. to minimize proper nursing
verbalized by the the motive of appropriately; misinterpretation intervention the
patient. others Avoid high-risk patient:
environments and Interacted with his
Objective: situations. Use a non- Less chance for the family, friends
Fearful judgemental, patient to misinterpret normally
Agitate Long term goal: respectful, and neutral the actions Avoided high-risk
Aggression After 3-4 weeks of proper approach. environments and
Suspicious look in nursing intervention the situations for a
the eyes patient will: Use clear and simple Minimize while
Delusions Demonstrate ways in language. miscommunication or
Unable to dealing stress and misconstructing the Long term goal:
maintain/ establish feeling of meaning of the After 3-4 weeks of
relationship powerlessness; message proper nursing
Be honest and Honesty and
Decrease in intervention the
suspicious behaviors; consistent regarding consistency provides
patient:
Apply a variety of outcomes and an environment in
Demonstrate
stress/anxiety enforcing rules. which trust can grow
ways in dealing
reducing techniques. stress and
Keep Chaotic environment
feeling of
environmental,quiet can be perceived as
powerlessness;
and free of stimuli. threatening
Decrease in
suspicious
Provide patient with To help the patient eat
packed meals or with ease behaviors;
Subjective: Short term goal: encourage same staff To promote Short term:
Disturbed
Patient verbalized “I After 4 hours of nursing to work with the client development of Patient was able to
Sensory
can hear someone’s intervention, the nurse will as much as possible. trusting relationships. recognize that
Perception
calling me”. be able to present reality avoid physical Suspicious clients may hallucinations occur
related to to the patient. contact perceive touch as a at times of extreme
Objective: Auditory threatening gesture. anxiety
Looks fearful Hallucinations Long term goal: be honest and keep This honesty and
GAD is diagnosed when a person finds it difficult to control worry on more days than
not for at least six months and has three or more symptoms. This differentiates GAD
from worry that may be specific to a set stressor or for a more limited period of time.
Generalized Anxiety Disorder affects 6.8 million adults, or 3.1% of the U.S population.
GAD is characterized by constant and excessive worrying, for at least six months or
more. GAD can be considered a primary or secondary disorder, depending on the
time of onset. Diagnosis at a young age is considered a primary disorder, and
secondary is normally diagnosed later in life and is associated with other disorders.
GAD is most often associated with other disorders that involve anxiety and
depression and can lead to or worsen pre-existing conditions. Many of the bodies
systems can be affected by GAD, including: Cardiopulmonary, Musculoskeletal,
Gastrointestinal and Neurological systems. This disorder can manifest in several
ways, incorporating physical, behavioral, and cognitive characteristics.
CASE SCENARIO
A 26 year-old patient K.F presents to the clinic with complaints of trouble falling asleep
at night, headache and is unable to get a good night’s rest. She often feels "restless" or
"on edge", which she associates with not sleeping. She states she constantly worries
about her performance in school, her family, and her mother’s health, who has recently
been diagnosed with Stage IV Small Cell Carcinoma. Patient also states she wakes up
at night with throbbing headaches that last for a couple hours. She feels tense the
majority of the day, causing her to feel stiff. She also has difficulty paying attention in
class and finishing her homework.
CHIEF COMPLAINT
Having sleep problems such as trouble falling asleep, headache, feeling restless and on-
edge, constant worrying and difficulty concentrating.
PATIENT'S PROFILE
Patient started having difficulty sleeping and paying attention for almost a year
because of her school.
However, constant worrying and feeling restless started when the pt’s mom was
diagnosed with stage IV small cell carcinoma four months ago.
Patient was diagnosed with PTSD in May of 2004 and was treated with CBT by
a clinical psychologist following a car crash which caused the death of her eldest
sister.
PERSONAL HISTORY
FAMILY HISTORY
Dependent:
Long term goal: Cognitive behavioral Helps with learning to
After 1-2 days of nursing therapy and recognize and change
intervention the patient relaxation therapy thought patterns and
will be able to: behaviors that lead to
Report improvement anxious feelings. This
in sleep/ rest pattern type of therapy helps
and increase sense of limit distorted thinking by
well-being and feeling looking at worries more
rested. realistically.
Collaborative:
Refer to psychiatrist Specializes in
diagnosing and
treatment.
REFERENCES:
ADAA. (2022). Generalized Anxiety Disorder (GAD). Retrieved March 19, 2023 from https://adaa.org/understanding-
anxiety/generalized-anxiety-disorder-gad
Krishnan, P., & Hawranik, P. (2008). Diagnosis and management of geriatric insomnia: a guide for nurse practitioners. Journal of
the American Academy of Nurse Practitioners, 20(12), 590-599.
MOORER, D., & HOCKER, K. (n.d.). Generalized Anxiety Disorder Case Study 2017. Retrieved March 19, 2023 from
https://www.physio-pedia.com/Generalized_Anxiety_Disorder_Case_Study_2017
Mayo Foundation for Medical Education and Research. (2020, January 7). Schizophrenia. Mayo Clinic. Retrieved March 19, 2023,
from https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-
20354443#:~:text=Schizophrenia%20is%20a%20serious%20mental,with%20schizophrenia%20require%20lifelong%20treatment.
World Health Organization. (n.d.). Schizophrenia. World Health Organization. Retrieved March 19, 2023, from
https://www.who.int/news-room/fact-
sheets/detail/schizophrenia#:~:text=Some%20people%20with%20schizophrenia%20experience,worsening%20of%20symptoms%2
0over%20time.&text=Schizophrenia%20affects%20approximately%2024%20million,%25)
Nursing Care Management for a Patient
with Schizophrenia and Generalized
Anxiety