Psychiatric Presentation

Personal Data

Name of the Patient: Mr. XAge: 40 years old

Gender: MaleAddress: Nueva EcijaCivil Status: SingleNationality: Filipino

Religion: Roman CatholicDate admitted: January 31, 2009

(2:35 pm)Admitting Diagnosis: Paranoid

Schizophrenia

Patient X

History of Present Illness

Patient has previous admission at Mariveles Mental Hospital. He was discharged from male ward on December, 2007. He had 1-2 consultations with Dra. Medina. His parents cannot afford to bring him in Cabanatuan.

Upon discharge he resumed smoking and after few months he resumed alcohol intake and he became suspicious and verbally assaultive when not giving cigarettes.

After few hours upon admission, he heard his female cousin and a neighbour

talking to each other and felt rejuvenated. He went down the house and with carrying an ice pick. He stabbed at his cousin who sustained several abrasions in the forearm and she got a scar on the head and on her right lower quadrant of abdomen. The neighbor placed him in restraints and informed his father who was out in the farm.

History of Previous Illness The patient was first admitted on October 4, 200 at Mariveles Mental Hospital

with chief complaints of poor appetite, cannot able to sleep and hears a female voice on his ear. A year prior to admission, the patient used illegal drug such as shabu. After using shabu, few months prior to admission he was engaged to abused substances like alcohol and cigarettes. He started to become violent and shouts to his parents. Few hours upon admission, he was saw laughing by him only, becomes aggressive and always shouting.

His father took him to MMH hence the reason for his admission. His condition

becomes better and he was discharged on August 19, 2001. But he was then readmitted on November 15, 2002 for the reason of he took things from the stores and insisted that it was his property. On the nest seven succeeding years, he was in and out of MMH with an admitting diagnosis of Undifferentiated Schizophrenia. But early this year, January 9, 2009, he was again readmitted with a new diagnosis of Paranoid Schizophrenia.

GenericName:

Route ofAdministration

:

Dosage andFrequency:

Chemical Effect:

TherapeuticEffect: Indication/Purpose:

Clonazepam Per Orem 2mg HS

May act by facilitating effects ofinhibitoryneurotransmitterGABA.

Prevents orstops seizureactivity.

For patients with acute manicepisodes, panicdisorders, orseizures.

Haloperidol Per Orem 5mg tab tid

May blockpostsynapticdopaminereceptors in brain

Decreasespsychoticbehaviors.

This is given tothe patient with chronically psychotic disorder who needs prolongedtherapy.

PSYCHOTHERAPIES IMPLEMENTED

REMOTIVATION THERAPY

NEWSPAPER THERAPY

PLAY THERAPY

DANCE THERAPY

SONG THERAPY


REMOTIVATION THERAPYDefinition: A simple group therapy which aims to bridge the fantasy- world of the Psychotics to the real world.

Is a technique of simple group therapy, objective in nature, used with a group of patients in an effort to reach the “unwounded” areas of each patient’s personality & to get them back into reality.

Title of the poem: Ang BulaklakThe short poem describes the importance of flower in our nature. Goals:• To stimulate patients to be fellow explore the real world.• To develop their ability to communicated and share ideas and experiences with the other people.• To develop feelings of acceptance.• To promote group harmony and identification. Role of the nurse:• To be a facilitator in the activity• To encourage clients feeling about the topic• To present the reality to the client about the poem.



NEWSPAPER THERAPY

PLAY THERAPY

DANCE THERAPY

SONG THERAPY


NEWSPAPER THERAPY Definition: Newspaper therapy is giving information to the clients about events and what is happening outside Newspaper therapy is cutting clippings from newspaper and sharing this information to the clients and knowing their feelings and ideas about the information given. Providing basic information about places/events may motivate the clients to follow the medical regimen to be well. The facilitator let the clients to read the topic, then ask them questions. Title of the cut news: BoxingThe news was all about boxing competition held in Araneta Coliseum & who won for that competition. Goals:• To give information to the clients on what is happening outside and to give latest news today.•To encouraged emotions and reactions about the news Role of the Nurse:•To introduce topics that will encourage clients participation/cooperation• To assess level of intelligence of the clients•To encourage the clients to express/verbalize feelings/ideas regarding to the topic



NEWSPAPER THERAPY

PLAY THERAPY

DANCE THERAPY

SONG THERAPY


PLAY THERAPY Definition: A form of psychotherapy used to help them express or act out their experiences, feelings, and problems by playing with dolls, toys, and other play material. Name of the Play: Ball catching Procedure:The clients are instructed to catch the ball with their respective partners. Goals:•To establish rapport since it is the first recreational activity of the client•To encourage release/ express clients emotions•To let the client learn on how to cooperate•To let the client play freely and actively Role of the Nurse:•To be the facilitator of the game•To let and encourage the clients to participate on the play



NEWSPAPER THERAPY

PLAY THERAPY

DANCE THERAPY

SONG THERAPY


DANCE THERAPY Definition Dance is the most fundamental of the arts, involving direct expression through the body. Dance /movement therapy effects changes in feelings, cognition, physical functioning, and behavior. Title of the dance song: Cha-Cha-ChaFacilitators are in the front, dancing different steps, in able for the client to followeasily the facilitators. Goals:•To encourage release/ express clients emotions•To let the client learn on how to dance in simple steps•To let the client dance freely and actively Role of the Nurse:•To be the facilitator of the game•To let and encourage the clients to participate on the dance



NEWSPAPER THERAPY

PLAY THERAPY

DANCE THERAPY

SONG THERAPY


SONG THERAPY Definition: A kind of recreational therapy under the music category, which connects us with our creativity, innate wisdom and our vast inner resources for growth and wellbeing. It has a soothing and pleasing effect and provides for emotion and release. Title of the song: Tag-ulan Procedure:1.Using the visual aids that has the written lyrics, the patients read it first.2.The nurse sings the song with the use of guitars.3.Nurses, together with the patients, sing the song.4.Lastly, let the patients sing to the tune of guitars. Goals:•Develop patient’s ability to read and reflect.•Develop patient’s listening skill.•To encourage them to participate and cooperate.•Patients will learn to express emotions and feelings. Role of the Nurse:•Explain the procedure to the patients.•To be a good facilitator.•To be an active participant too.To promote trust.



NEWSPAPER THERAPY

PLAY THERAPY

DANCE THERAPY

SONG THERAPY


ART THERAPY Definition: is the use of art materials for self-expression and reflection. Name: House-Tree-Person Procedure: Patients are provided with crayons and 3 pieces of paper as drawingmaterials. They are then asked to draw a house, afterwards a tree, and lastly, a personon each of the papers with the use of crayons. Series of questions constitute the post drawing interrogations. During post drawing phase, paients are given opportunity to define,describe, and interpret the objects drawn. Goals: To obtain data concerning patient’s progress. To aid in the establishment of rapport between the nurse and the patient. Help the patients gain insight through interpretations. Measure patient’s self perception and attitudes. Role of Nurses: Explain the procedure of the activity. Provide the means of the therapy (crayons, papers). Interrogate patients during post drawing phase. Assessing and interpreting answers based on Buck’s HTP interpretation. Develop a deeper nurse-patient relationship through building of trust.


OCCUPATIONAL THERAPY Definition: Any activity, mental or physical, prescribed and guided to aid an individual’s recovery from diseases or injury. This activity excludes competition and pressure. There is opportunity for creativeness and produce something tangible out of patient’s own thinking and imagination. Self confidence and personal achievements are also experienced. Title: Designing Picture Frame Procedure: Designing Picture Frame Nurses play a great role in making this therapy successful. Nurses give picture frame. Different shapes of cut cartolina & different styles of stickers are also

END.

Documents

Psychiatric Presentation