Adapted from Halter: Varcarolis’ Foundations of Psychiatric Mental…
Adapted from Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing, 7th Edition
Chapter 12: Schizophrenia and Schizophrenia Spectrum Disorders
Case Studies and Nursing Care Plans #1: Schizophrenia #1
Mrs. Maine, age 56, is brought to the emergency department (ED) by her son, who is very concerned. The son tells the ED nurse, that he found his mother wandering in the house, aimlessly talking to the furniture. She had not eaten in days. Envelopes covered the kitchen table, along with reams of paper with unintelligible writings. An unopened bottle of Clozaril was found in the kitchen. The son states that his mother was diagnosed with schizophrenia 2 years after her husband died, 20 years ago. She usually suffers one occurrence every year related to discontinuation of her medication. She lives at home and is assessed by a home aide daily. Her home aide left for vacation without informing Mrs. Maine’s son. Mrs. Maine has no contact with her neighbors.
Mrs. Maine displays no eye contact and speaks in a singsong voice. She asks, “Why am I here? There is nothing wrong with me. I don’t know why that man brought me here; he’s obviously a prison guard and wants to put me in jail.” She states that she is hearing “four or five” voices. “They tell me I’m a bad person, and they plan to beat me and take my shoes,” she says, adding, “Sometimes they turn my mother parts around.” At this she pats her abdomen and giggles. Otherwise her affect is flat, and she demands to be discharged.
The nurse views both the client and her son with sympathy. Schizophrenia has a serious impact not only on the client, but also on the family. Mrs. Maine’s son looks obviously worried and frustrated. It must be very difficult for him to continuously care for an ill parent.
The client will be challenging. The optimal recovery for the client will have her returning to her home in the community with the assistance of a home health aide.
Assessment: Based on the patient information provided what is the objective and subjective data?
Subjective Data
Objective Data
“Why am I here? There’s nothing wrong with me.”
Flat affect
Hearing “Four or five voices”
Singsong voice
“They say I’m a bad person, and they plan to beat me and take my shoes.”
No eye contact
“Sometimes they turn my mother parts around.
Hallucinations (somatic, auditory, and visual)
“I don’t know why that man brought me here; he’s obviously a prison guard and wants to put me in jail.”
Lack of nutrition
Unopened bottle of medication (Clozapine)
Giggling
She doesn’t know who her son is
Unintelligible writings
Assessment: What positive and negative symptoms of Schizophrenia is Mrs. Maine showing?
Positive Symptoms Negative Symptoms
Identify priority patient problems from the assessment data.
What data supports the client is having problems with sensory perception?
What data supports the client has problems with her thought process?
What data supports that the client has problems caring for herself?
In the table below formulate a plan of care for Mrs. Maine using the problems you identified from the data. Remember goals should be measurable and time limited. Make your plan of care only for the next two days. Use the key words to help you structure your plan of care. Use Chapter 12 of Varcarolis to assist you in completing this table.
Short-Term Goals Interventions Rationale Evaluation
Client will (what do you want the client to do) in 2 days. Mrs. Maine will(what do you want the client to do? How will you know your interventions worked?)
Client will (what do you want the client to do) in 2 days. Mrs. Maine is able to (what do you want the client to do? How will you know your interventions worked?)
.
.
Consider the medication Clozaril.
Why is the client taking this medication?
What should the nurse know about this medication?
How could it be determined if the client has been taking the medication?
Potential Long-Term Outcome for Mrs. Maine:
Mrs. Maine is released from the hospital within 2 weeks. She remained longer than 2 days because her symptoms did not abate quickly. Also, it was noted that even after the symptoms had diminished, Mrs. Maine still had many cognitive and emotional deficits. She was deemed unfit to return home and was discharged to a nursing home until the family could make further arrangements.
Is this an expected outcome for someone with Schizophrenia? Consider normal growth and development in your answer.
Collepals.com Plagiarism Free Papers
Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.
Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS
Why Hire Collepals.com writers to do your paper?
Quality- We are experienced and have access to ample research materials.
We write plagiarism Free Content
Confidential- We never share or sell your personal information to third parties.
Support-Chat with us today! We are always waiting to answer all your questions.