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Documente Profesional
Documente Cultură
I. Introduction
Whatever happened to Rizal’s famous quote “The youth is the hope of the
nation” when a large percentage of the youth today are into intoxicating drugs and
substances?
These “future leaders” have indulged themselves into vices that are slowly
killing them and destroying their bright future, the country’s bright future. Through
sniffing and injecting cocaine the enjoyed a few minutes of ecstasy but unknowingly
they have let in a poison run through their veins destroying them from the inside. By
the time they realize ( if ever they do) what’s happening, it is usually too late to repair
Brgy. Camputhaw, Cebu City who, like the youths mentioned above, got herself into
an addictive vice like sniffing cocaine and injecting it into her own vein. She’s been
using it for nearly five years, realized last June that it wasn’t really doing her any
good, stopped, made a narrow escape from the cocaine’s deadly consequences but
the effects of drugs including alcohol, medications and toxin. Psychotic symptoms
feeling, tasting or smelling things that are not there and delusions are fixed, false
disorder that begins during substance use can last as long as the drug is used while a
psychosis that begins during withdrawal may first manifest up to four weeks after an
Interesting in a sense that the student nurse is about the client’s age and it brings up
the possibility of finding an answer to the question: What could possibly have lead
those youths to bring about their own destruction? Controversial in a way because it
involves a prominent issue such as drug addiction and gives rise to questions such as:
What is the government doing to control these stuff and why are drug dens
( Kamputhaw is a famous one), even though everybody knows where they are, still
impregnable to authorities?
This case study aims to shed light on, as much as possible, all of the factors
As her student nurse and as someone who has sentiments over a co-youth who
have gone astray, the author seeks to delve more on here case and find means to help
her and her significant others deal with the disorder substance-induced psychosis.
3
II. Objectives
General Objectives:
This case study aims to help the student nurse in effectively providing
also aims to aid the patient in coping with life situations, and incorporating it into
her reorientation to reality and activities of daily living for her optimum level of
functioning.
Specific objectives:
adolescent,
2. establish rapport and interact with the patient at the patient’s own level
nurse-client interaction, the client and her significant others will be able to:
exercises,
1. Personal History
Sex: Female
Religion:Roman Catholic
Impression/Diagnosis:Substance-induced psychosis
April Mechelle Tecson, 20-year old and single, was admitted by her father,
family and is the eldest among three siblings. She is a known alcoholic and
cocaine abuser and a cigarette smoker. Hours prior to admission, client was
Client was formerly enrolled at Abellana High School but stopped when
she reached second year high school. She was known to have started using
“shabu” injectables when she was fifteen years old. According to her mother,
Mrs. Rosalie Tecson, client was noticed to have stopped taking the said the
said drug last June and that’s when she started exhibiting the positive
symptoms such as talking and laughing by herself. When confronted that she
was acting weird, client responded angrily saying: “Ako man hinuoy praning!
Psychiatry ward last 1980. Her father’s sister have had postpartum psychosis
last 1989 which was known to be recurrent. She already got well but the
include the fact that she was a battered wife and her husband was always
abroad and she was left with the responsibility of taking care of their only son
Island when she was still days old and was diagnosed to have had meningitis.
Her mother expressed that it was probably due to the fact that April was
delivered not in the hospital but in their house. Mrs. Tecson gave birth with
beliefs like having the baby taste her first feces as a form of “sumpa” against
evil spirits.
7
When April Mechelle was fourteen years old, she was admitted by her
According to her mother, April Mechelle has only one bestfriend that she
knows of. Her name was “Ilang” and April shares with her all her problems.
Ilang was close to April’s mother so she can tell her what was going on with
April. However, Ilang got married and transferred residence so April lost
contact with her. Since then, Mrs. Rosalie Tecson was not able to get
Upon admission, client was time, person and place oriented, has an
intact short and long term memory, with poor concentration and exhibited
On this case, the client, Ms. April Mechelle Tecson, 20 years old, is
twenty years old, while a young adult is twenty to forty years old.
Physiologic Development
characteristics
with puberty between sexes and within the same sex. Girls tend to begin
their physical changes earlier than boys. April have had her menses at the
age of 11.
9
growth spurt. The growth spurt for girls generally begins between 8-14
years of age. Height increases 2-6 inches and weight increases by 15-55
pounds. The final 20 % to 25% of adult height and 50% of adult weight is
The client’s build is within the normal range. The client’s height is
adults
competence
behavior
10
Psychosocial
stage signals a task that must be achieved. The resolution of the task can
stage ( 12-20 y.o.) with a central task identity vs. role confusion. A
coherent sense of self and plans to actualize one’s abilities are indicators
adulthood. 20’s is the time when a person assumes new roles. April is at
Cognitive
11
can develop. There are five major phases and April, based on her age, is
condition does not enable the student nurse to assess fully her cognitive
Moral Development
There are three levels and six stages. April is at the conventional
rules of the family, group, nation, or society. There is a sense of guilt that
the client is due to the limited time of contact with the client. Stage 3:
12
caring for self and others prevailed. The concept of responsibility now
Spiritual Development
According to Wersterhoff
experiences faith through interaction with others who are living particular
faith tradition.
independence from the parent and other adults. Even though April has
married life wasn’t on her list of priorities for the past years because she
got hooked with an illegal substance and all she could think of were means
observable considering that what she had done and what she had gotten
herself hooked to is a menace to the society and one of the major reasons
why the crime rate is rapidly escalating. Values and ethical system are
realized.
Psychosocial development
providing her5 eldest daughter with the appropriate nutrition whenever she
People who are orally fixated exhibit signs such as sucking thumb
beyond toddlerhood, biting or always puting objects into her mouth such
14
Client was unsuccessful in her industry vs. inferiority task during her
school age years. She has not developed a sense of competence and
failure, she has difficulty progressing through the adolescent central task
Client has not matured enough and based on her actions, has not
Cognitive Development
formal operations phse has not been observed by the student nurse from
15
the client. Priamary reason for this is the client’s current state: psychosis
due to substance abuse, specifically cocaine. Due to this fact, the student
Moral Development
lead to the client’s condition was her peers. At 15, she got mixed up with a
bad crowd and started using drugs due to peer pressure. “Gipasuway man
ko nila,” as verbalized by the client when asked regarding the start of her
vice.
There was a time when the student nurse touched the topic about the
client’s siblings. Before that, the client answered the student nurse’s
questions sensibly; however, when asked how were her siblings at home
and whether she missed them or not, the client exhibited circumstantiality.
She tried to avoid the topic. Her mother said that the client is deeply
concerned when it comes to her siblings. During her stay in the ward,
whenever she has extra food, she would tell her mother to save it for her
siblings. These behaviors gave the student nurse clues as to the client’s
16
sense of responsibility. She’s concerned not only on her own welfare but
Spiritual
person like April who is suffering from a substance abuse psychosis and
who refuses to answer when it comes to questions such as: do you think
Her mother stated that she goes to church and prays with the family
A. Appearance
Client was seen wearing a red shirt and maong pants, with a brown step-in
sandals to match. She was not wearing any make-up. The only accessory she had
on was a multi-colored bracelet in her left arm. Client is thwenty years old and
looks her age. She has dry skin and on it are four genuine tattoos found on her left
ring finger, another one on her forearm(dorsal part), on her scapular region which
B. Affect
Client’s facial expression does not convey emotion most of the time, that
was during the student nurse-client interaction. It remained constant all through
During the whole interaction, client did not exhibit any strange,
evidence of unusual mannerisms or motor activity. She has a normal gait and
stands up whenever the student nurse sits beside her. During interviews, she
Client spoke coherently and enunciated clearly. She responded only when
questioned and spoke with a loud voice. Client did not exhibit neologism nor
E. Content of Thought
Client claimed to have not experienced any delusions nor any kind of
F.Orientation
During the two interactions that took place, client appeared to be person-
oriented, place-oriented and time-oriented. When asked, client could say her name
in full.
G.Memory
When asked, client could recall certain fragments about her childhood and
high school life.She was able to tell the student nurse what happened hours prior
H. Intellectual Ability
Client can use facts comprehensively. When asked if she can recall student
nurse’s name, client discretely glanced at the student nurse’s name plate which
19
indicates that she can read.Client can do simple mathematical equations such as
backwards.
J. Spirituality
Client is a Roman Catholic. Does not respond when asked about her
spiritual values.
K. Sexuality
Client haven’t express any concerns regarding sexual identity and function
. According to her mother, she did not have any boyfriend since she was sixteen
years old.
When April was fourteen years old, she was admitted by her boyfriend at
North General Hospital due to massive bleeding. She was diagnosed to have had
uterine laceration.
L. Neurovegetative Changes
despite their current condition. They currently sleep on a bench in the Psychiatric
20
ward common room. Client’s appetite has improved according to her mother. Her
mother stated that the client seldom eats at home, especially when she’s “tama”.
The Brain
the body, it is commonly discussed in terms of its four major regions- cerebral
encloses the shallow third ventricle of the brain, the hypothalamus which is an
important part of the limbic system and the epithalamus which has the pineal
Structures of the brain stem are the midbrain, wherein reflex centers for
vision and hearing are found, the pons which is involved in the control of
breathing and the medulla oblongata which regulate vital visceral activities.
The limbic system sets the emotional tone of the mind, filters external
controls appetite and sleep cycles, promotes bonding, directly processes the
internal environment as is the brain. Other body tissues can withstand the
that continually occur, particularly after eating or exercising. If the brain were
remember that certain ions (Na and K) are involved in initiating nerve
neurons are kept separated from blood borne substances by a so-called blood
body.Of water soluble substances, only water, glucose and essential amino
acids pass easilty throught he walls of these capillaries.The blood brain barrier
22
why blood-borne alcohol, nicotine, cocaine and anesthetics can affect the
brain.
3.2 Psychopathology
either because they don’t know any better or by mistake. Alternatively, people
shrub, Erythroxylon coca.. In the late 19th century, Sigmund Freud proposed
cocaine for the treatment of depression, cachexia, and asthma. It later became
prescribed for almost any illness and could be found in numerous tonics. In
United States. This drink was later named Coca-Cola. In 1914, the Harrison
Narcotics Act banned all nonprescription use of cocaine. Finally, in 1970, the
States, except for limited medical uses. The Diagnostic and Statistical Manual
of Mental Disorders notes that a diagnosis is made only when the psychotic
symptoms are above and beyond what would be expected during intoxication
or withdrawal and when psychotic symptoms are severe. The following are
-Fatigue
-Insomnia or hypersomnia
-Increased appetite
Phase1(crash) Phase2(withdrawal)
9hrs.-4days 1-10 weeks
Early Early
Cocaine Binge dysphoria- Sleep normalized
depression,anxiety Euthymic mood
and agitation Low cocaine
craving
Middle Low anxiety
Fatigue
Depression Middle&Late
No cocainecraving Anhedonia
Insomnia with Anergia
increased need for Anxiety
sleep High cocaine
craving
Late Conditioned cues
Exhaustion exacerbate craving
Hypersomnolence craving
Hyperphagia
No cocaine Phase3(extinction)
craving indefinite
abstinence
Neuronal fast sodium channel blockade produces a local anesthetic effect that
26
channel blockade, cocaine blocks fast cardiac sodium channels, which results
cocaine use.
and serotonin reuptake blockade) occurs in both the central and peripheral
hallucinations.
Delusion, fixed but false Client did not exhibit An excess of dopamine
Source:Psychiatric-Mental
Source: Psychiatric-Mental
Alogia, poverty of content Client often speaks very Organic functional changes
neurotransmitter levels in
information is processed in
the brain.
Source: Psychiatric-Mental
based on reality
Source: Psychiatric-Mental
Anhedonia (loss of pleasure Client rarely interacts with A negative symptom caused
or interest)
her siblings anymore and by an inadequate amount of
Source: Psychiatric-Mental
Source: Psychiatric-Mental
or organic functional
Source: Psychiatric-Mental
nucleus accumbens,
intense craving.
Cyclopedic Medical
Dictionary
a. Treatment Settings
31
client typically spends six to twelve months in such programs, which may
also include vocational training and other features. But of course, the client’s
financial status and ability to cover treatment is also an issue that affects the
transferred to a drug rehabilitation center but April’s mom still has difficulty
b. Psychotherapy
urine testing) with point or vouchers which patients can exchange for such
therapy help users learn to recognize and avoid situations most likely to lead
to cocaine use and to develop healthier ways to cope with stressful situations
most likely to lead to cocaine use and to develop healthier ways to cope with
stressful situations.
Clients in similar situation with April should also be assessed for risk
of harm to self or to others. This also may mandate further inpatient care.
Careful assessment for suicidal ideation, plans, and level of intent to act on
hospitalization, but one also may have a duty to warn an intended victim.
cues and help modify patients' responses to cues they encounter. For example,
a relapse prevention strategy may include minimizing the free cash the
desired behaviors.
3000 cc/ day) and promote intake of fresh fruits, vegetables and bran
given to April.
effect so medication must be taken with food. With the help of the dietitian
d. Medications
reducing cocaine use. Disulfiram may increase the aversive effects of cocaine
and reduce its use. Other recent work has suggested that a cocaine vaccine
Name of Client: April Mechelle Tecson Age: 20 years old Hospital No. 6184112 Date: 09/17/07
Diagnosis: Substance-induced psychosis Sex: Female Ward No. XII Physician: Dr. Yazar
communication communicat pleasurable client will be 1. attempt to decode 1.reveal how the client is
Cues: incomprehe its action on trust, gain communication patterns while the responsibility of
ble the ventral attitude towards 2. seek validation and 2.prevents making
- client is silent segmental area. stressful clarification on ambiguous assumptions and genuinely
loud voice cause increasing After 30-45 3.facilitate trust and 3.This approach conveys
does not fullblown 4. anticipate and care for 4.Client’s safety and
respond at all paranoid 1.express client’s needs until comfort are nursing
the client hallucinations. wherein her name and validate those restoration of functional
Nursing;
Lippincott
Williams &
Wilkins
Cues: maintaining involved with evidenced by verbalize problems and indications of hopeless
-client has eye contact bonding and maintenance of perceptions of reasons of ness, powerlessness,
difficulty related to social eye contact and problems anxiety, grief and hate-
“glazed look” damaged due to questions 2. determine the use of 2. It affects the ability to be
-client answers several factors coping skills and defense involved in social
time ability to
Taber’s
person, and
Nursing Plan;Doenges
II. Psychologic Impaired A cocaine binge 3. exhibit a III. decrease erratic thinking
processes:
overload: thought may cause coherent train
1. reorient the client to the
processes: increasingly of thoughts, as time, place and day 1. to promote reality based
Lippincott Doenges
Name of Client: April Mechelle Tecson Age: 20 years old Hospital No. 6184112 Date: 09/17/07
Measures to:
Diagnosis: Substance-induced psychosis Sex: Female Ward No. XIIthe quality of verbal Physician:
I. improve Dr. Yazar
communication
I. Psychologic deficit: - attempted to decode incomprehensible communication
A. Impaired verbal communication patterns
-statements are often - sought validation and clarification on ambiguous
II. promote social interaction
statements
incomprehensible --facilitated
encouraged client
trust andtounderstanding
verbalize problems and perceptions
by maintaining staff of reasons of
- silent most of the time problems
assignments as possible
-client usually responds in short -- determined
anticipated and the use
careoffor coping
client’s skills
needsanduntil
defense mechanisms
functional
statements -communication
encouraged client to keep
patternthinking a daily journal
returns processes: of social interactions
B. Impaired social interaction III. decrease
-assisted the erratic
client to develop positive social skills
-“Tan-aw
II. nila ugoverload:
Psychologic
-client
praning na ko,” as
has difficulty maintaining eye contact -oriented client
-reoriented thetoclient
realitytoby thename
time,and validate
place and those aspectspractice of
day
through
verbalized by the clientprocesses skills in real
of -scheduled
communicationsocial situations
that help accompanied
differentiate by
between a support
what isperson, and
A. Impaired
-client thought
has a “glazed look” Specific Objectives:-encouraged structured
reading, activities
listening to and rest
news and periods
remotivation therapy
- inappropriate answers to questions
II. Impaired
I. Impaired
social interaction:
verbal
After communication:
30-45 difficulty real
min. of student
andnurse-client
-gave what’s questions
simple notinteraction, the client will be able
-client answers curtly in short statements most of theGoal:After 2 weeks of student nurse-client interaction, the
-usually responds in short statements III Impaired
maintaining thought processes:
incomprehensible
eye contact
to: related
statements
to client’s - asked leading questions
time inappropriate client
answers will
to be able
questions to establish trust, gain rapport, gain insight
-do not sa
respond withdrawal related 1.express of
fromtosociety
looseness herself
association - clarified
effectively and refocus
, as evidenced by an if interaction
client exhibits circumstantiality
wherein her
-“Excuse te ha,”directly
as verbalized by the client
related of responses
reason of admission
to circumstantiality and showbyadaptive
can be understood the studentattitude
nursetowards
Actual
Of patient’s
state condition Cues Nursing Diagnoses
stressful situations Nursing Actions Desired Outcome
41
Name of Client: April Mechelle Tecson Age: 20 years old Date: 09/17/07
Physician: Dr.
Yazar
side effects
43
source: pg.
235,
Psychiatric-
Mental
Health Ng. by
Shives
44
dermatitis extrapyrami of
al side
effects
encourage
complian
ce of
taking
medicati
on on
time
48
Name of Client: April Mechelle Tecson Age: 20 years old Date: 09/17/07
Physician: Dr.
Yazar
Within 2 weeks of
student nurse-client
interaction, the
acquire adequate
knowledge, attitude
need arises.
Specific:
Within 45 min. of
student nurse-client
interaction, the
to:
despite current
crisis
2. Hazards of not
health mechanisms
coping drugs
dcuring illness
situations mechanisms
available
-talking to a
bestfriend or
significant other
about problems
other relaxation
5. client’s
verbalization of
willingness to use
the coping
mechanism
4. choose a
coping
mechanism
she is
comfortable
with
5. verbalize
willingness
52
to try to use
the coping
mechanism
Name of Client: April Mechelle Tecson Age: 20 years old Date: 09/17/07
Physician: Dr.
Yazar
SOAPIE No.2
O- client is still silent most of the time but responds with a loud voice when talk to,
usually responds in short statements and when asked about her siblings, she does not
circumstantiality
I- reoriented the client to the time, place and day; scheduled structured activities and rest
periods; gave simple questions; asked leading questions; clarified and refocused if client
exhibits circumstantiality
E- client was still not ready to openly discuss her troubled past
53
Name of Client: April Mechelle Tecson Age: 20 years old Date: 09/17/07
Physician: Dr.
Yazar
SOAPIE No.3
O- -client has difficulty maintaining eye contact; client has a “glazed look”; client
determined the use of coping skills and defense mechanisms; encouraged client to keep a
daily journal of social interactions; assisted the client to develop positive social skills
through practice of skills in real social situations accompanied by a support person, and
E- client still answered in short statements but was able to stay with the student nurse for
approximately 5 minutes without the presence of her mother
54
Name of Client: April Mechelle Tecson Age: 20 years old Date: 09/17/07
Physician: Dr.
Yazar
I. Objectives
a. General Objective:
establish trust, gain rapport, gain insight of reason of admission and show adaptive
b. Specific Objectives:
After 30-45 min. of student nurse-client interaction, the client will be able to:
1. establish trust on the student nurse-client interaction, the client will be able to:
2. abide by the “lagda” or contract set by the student nurse and agency
II. Setting
c. Place: Vicente Sotto Memorial Health Center Psychiatric Ward- bench in the
common room
III. Appearance
The client was seen sitting on a bench in the common room. She was wearing a
relatively clean black shirt and pink pants. He rhair was neatly combed. Her belongings
were packed in a bag. She was well taken care of by her mother who was with her since
IV. Behavior
The client was cooperative; communicates but in short statements only. She maintains
eye contact when talked to. She was silent most of the time. She does not mingle with
V. Communication
56
The client did not exhibit neologisms, nor of pressured speech but exhibit flight of
ideas, jumping from topics unrelated to the current topic of discussion and inability to
VI. Interaction
communication
“Maayong Client nods and Giving -none used- The nurse calls
esteem and
promote
reorientation to
her identity.
Doctors’ giving
University” information
about self or
client.
“Makahatag ka “Gidala ko nila Asking direct -none used- The nurse asks
Sabado” orientation.
Client pauses
and stares at
student nurse.
“Murag Martes
ta karon”
ka sa eksaktong orientation to
ensure that
guessing.
Nurse provides
buntag.” reality.
expression of
feelings
through
continued
communication.
“Unsa man ang Client lies down Exploring -regression- Nurse delves
ana?” information.
VII. Evaluation
Client was not very cooperative and appeared to be uncomfortable when the
student nurse talked to her and asked her questions. She exhibited regression when she
felt uncomfortable.
60
Name of Client: April Mechelle Tecson Age: 20 years old Date: 09/17/07
Physician: Dr.
Yazar
I. Specific Objectives:
After 30-45 min. of student nurse-client interaction, the client will be able to:
2. state the present date, time and place of the current interaction
II. Setting
c. Place: Vicente Sotto Memorial Health Center Psychiatric Ward- bench in the
common room
III. Appearance
61
The client was seen sitting on a bench in the common room. She was wearing a red
shirt with maong pants. The client was able to perform activities of daily living, as
IV. Behavior
The client was constantly glancing outside the window. She was always standing up
to check the activities going on outside. Client can maintain eye contact for quite
sometime but her eyes wander off constantly when asked about her family.
V. Communication
The client did not exhibit neologisms, nor of pressured speech but exhibit
circumstantiality, giving much unnecessary details that delay meeting a goal or stating a
point.
VI. Interaction
communication
62
name to boost
the client’s
self-esteem
and promotes
reorientation
to her
identity.
interaction, to
assess the
client’s
memory and
orientation
“Unsa man tang “Nakalimot Asking direct -none used- The nurse
sa buntag” orientation.
gaaway” reality.
nahadlok ka sa asked an
question to
start a
conversation.
“Nya unsa man “Wala” Client Asking direct -none used- The nurse
clarification.
question to
continue
conversation.
“Ganahan jud Client’s mother Asking direct -none used- Nurse asked
ganahan na jud of
nako. Lahi sa
iyang mga
igsoon”
Client closes
her eyes.
65
divert Student
nurse’s
attention
from the
unwanted
topic.
The student
pasabot?”
Student nurse
oras.Naa ra ka place.
dire gihapon?”
VII. Evaluation
Client was cooperative, answers questions but seemed distracted. She was awake,
alert and oriented, with no impairments in mobility. She did not seem to want to talk
about her family, as evidenced by the circumstantiality she exhibited at the last part of the
conversation.
Name of Client: April Mechelle Tecson Age: 20 years old Date: 09/17/07
Physician: Dr.
Yazar
I. Specific Objectives:
After 30-45 min. of student nurse-client interaction, the client will be able to:
2. state the present date, time and place of the current interaction
5. agree with the student nurse regarding the date, time and place of the next
interaction
II. Setting
c. Place: Vicente Sotto Memorial Health Center Psychiatric Ward- bench in the
common room
III. Appearance
The client was seen walking away from the area of the culminating activity carrying
with her a cellophane with food. Shea was walking towards her mother. Client was
68
wearing a brown halter top and pyjama pants. Her hair was neatly combed, and she was
clean from her bath.She has already brushed her teeth and attended to her personal needs.
IV. Behavior
The client was uncommunicative at first. Every time the student nurse tries to sit
beside her and start a conversation, she tries to excuse herself and walks toward her
mother. She became cooperative after a few minutes, after she was done eating her burger
and fries. She answered the student nurse’s questions. She did not exhibit any violent
V. Communication
The client spoke in short, curt statement.She had no echolalias nor palilalias.She
nurse’s questions.
VI. Interaction
Student Client’s verbal/ Communication Client’s Analysis
communication
name to boost
esteem and
client is
recognized as
an individual.
To boost the
client’s
confidence and
VII. Evaluation
The student nurse-client interaction was more productive this time because client
was more cooperative and less avoidant compared with the previous conversations.
Student nurse was able to get through the barrier of communication (e.g. in her case, the
client’s significant other ; because student nurse has difficulty communicating with the
client whenever the significant other is around because client expects the significant other
to answer for her). Client was able to interact well with the individualized art therapy.
Name of Client: April Mechelle Tecson Age: 20 years old Date: 09/17/07
71
Physician: Dr.
Yazar
I. Specific Objectives:
After 30-45 min. of student nurse-client interaction, the client will be able to:
2. state the present date, time and place of the current interaction
5. agree with the student nurse regarding the date, time and place of the next
interaction
II. Setting
c. Place: Vicente Sotto Memorial Health Center Psychiatric Ward- bench in the
common room
72
III. Appearance
The client was seen sitting at a bench in the OPD with her mother.She was scheduled
for a n interview with Dr. Yazar. Client was well-groomed, wearing a clean brown shirt
with a clean maong pants. Howver, her hair wasn’t properly kempt, as if she just arouse
from bed. She has already taken a bath according to her significant other and has already
IV. Behavior
The client was much more cooperative compared with the previous interactions. She
exhibited signs of nervousness as evidenced by her frequent glancing at the stairs and at
V. Communication
The client answered the student nurse’s questions regarding the content of her
auditory hallucination. Apart form, date and time disorientation, client was coherent all
VI. Interaction
communication
73
the client is
recognized as
an individual.
Assess the
ko.Wa ra ko current
nakulbaan” emotional
Padung ko mag-
interview”
karun sa OPD
para sa imong
interview kang
Dr. Yazar”
Yazar?” reality.
VII. Evaluation
75
The student nurse-client interaction was brief but productive. Client was
cooperative and less avoidant. Student nurse was able to get through the barrier of
communication, which in this case, was her mother because the client does not usually
talk to the student nurse whenever her mother isn’t by her side.
Name of Client: April Mechelle Tecson Age: 20 years old Date: 09/17/07
I. Specific Objectives:
After 30-45 min. of student nurse-client interaction, the client will be able to:
2. state the present date, time and place of the current interaction
3.recall the past experience with the student nurse for the past week
II. Setting
c. Place: Vicente Sotto Memorial Health Center Psychiatric Ward- bench in the
common room
III. Appearance
The client was seen sitting on a bench in the common room with her mother.She was
talking to her mother about her food and at the same time she was getting ready fo the
morning stretch. She had already taken a bath according to her mother. However, her hair
wasn’t properly kempt probably due to her frequent scratching of her head. Client was
IV. Behavior
The client was cooperative but exhibited irritability at some points of the interaction.
She was much more talkative during this interaction compared with the previous ones. In
fact, she was the one who initiated the conversation when the student nurse arrived at the
common room. She got irritated when she was asked the second time regarding the
V. Communication
The client was much more talkative this time and was observed to have exhibited
flight of ideas. She often does not state her ideas coherently, making it difficult for the
student nurse to understand her statement. She easily gets distracted with ativities around
her as evidenced by her frequent standing up and glancing outside while the conversation
VI. Interaction
communicatio
ate”
name to
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boost the
client’s self-
esteem and
shows that
the client is
recognized as
an individual.
“Kumusta man “Okay ra. Muapil Asking direct -none used- The nurse
exercise.Mubalik question by
sa ha.” client’s
orientation to
later…
“Kumusta man Client smiles and Asking direct -none used- Assesed if
ang morning wipes sweat off question client is
stretch?” her forehead. aware of
uy.” on around
her.
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therapy taod- “Di lang. mutan- Asking direct -none used- The nurse
to orient the
client to
reality and
give the
client a
choice as a
sign of
respecting
her dignity.
“Ah sige.AT,
diba?” date.
“O sakto ka na
ha!”
“O sige
maminaw na ta”
After about 5
minutes
ako
musuwat?Ganaha
n man gud ko
“Wala pero naa
magsuwat-suwat.”
koy papel ug
mother.
crayon
dire.Suwat-
suwat lang,
tagaan tika.”
After about 5
minutes
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“Nindot ug agi
ate? Pailisdan
present topic
of
conversation
and shifted
her attention
minutes presently
“AT naka discussed.
dumdum pa ka
mechanisms
taught by the
nakadumdum
kay magsturya
appropriately.
“Last day na
ha?” appropriately
“Di na mi
mubalik sunod
client. client is
being
84
recognized as
a person.
VII. Evaluation
The student nurse-client interaction was productive because client was more
cooperative. Student nurse was able to get through the barrier of communication ( e.g. in
her case, the client’s significant other ; because student nurse has difficulty
communicating with the client whenever the significant other is around because client
expects the significant other to answer for her). Client was able to interact well and was
able to assess whether the client has learned something from the previous interactions.
Client has improved a great deal since the first interaction as evidenced by more
two-year period indicate that people addicted to cocaine have a better chance
Somehow, April’s being a young adult at the time she was admitted is
working to her advantage because it is during this time that a significant other
or care giver can guide and support her with her chosen lifestyle. Later than
this stage, it is much harder to convince her to change her lifestyle because
wher3e needs and therapies specific for her condition can be provided.
be chosen . One that will not cost the family too much since April has three
center would further pull down the family’s already unstable financial status.
Nursing Practice
86
professions in the medical field are more prone to being a drug dependent due
to the easy access to medications. The nurse should know how to recognize
the signs and symptoms of drug dependence if ever they see one not only to
promote the integrity of their profession but also for the benefit of their
clients.
Nursing Education
Since most of the client’s significant others are directly affected with
and pharmacotherapy.
Nursing Research
The human mind is a subtle and mysterious part of the human body;
induced psychosis but the larger part of the condition lies largely unexplained.
It differs from person to person and affects the society in varied ways. This
nursing research aims to give us a peek of what it is like in April’s world not
87
only for a more holistic care but also to help prevent another innocent life
VII. Bibliography