6. What strengths does John demonstrate? John is a smart man, a mathematician.

He can formulate equations and diagrams and solve problems with almost anything that he sees, for example, a group of playing touchball, a cluster of pigeons fighting over bread crumbs and even for a woman chasing a man who got her purse. He lives for math, and math lives because of him. He is also a competitive man. If someone challenges him for a duel, like the board game against Sol, he will not hesitate to compete but he lost the duel though. He is also very hardworking, working with his doctorate topic about Governing Dyanamics all winter until summer showed his eagerness to submit an original topic and as for the latter part of the story, he still continues to fill up his mind with new ideas making him more knowledgeable and smart, earning him a recognition (Pen-giving) and receiving a Nobel Prize. Also in the latter part, John can control his delusions (Charles, his niece and Big Brother) and he ignores and doesnt talk to them anymore. He wanted to change and change gave him the chance to do so though his delusions will not diminish, he knows that they are not real and he was doing it for his wife and family. 7. What treatment plan would you outline? Medications. In Johns case, his medications should be followed strictly. In the movie, he is seen hiding all of his medications in his drawer. Strict compliance is a must. The following medications are to be used to minimize the occurrence of the symptoms - Typical antipsychotics- these medications control symptoms by affecting the neurotransmitters. It is traditionally been effective in managing the symptoms of delusions and hallucinations. - Atypical antipsychotics- It is also effective in managing hallucinations, or other symptoms such as loss in motivation and lack of emotion. ** Dont stop the medications without telling the doctor even if he is feeling better. Relapse may happen if the medications are stopped abruptly. Individual therapy. Cognitive behavioral therapy has been proven effective. A mental health provider may help him look back on his personal history. This can help reduce the severity of the symptoms and improve communication skills, relationships, work Family therapy. The family maybe involve in the activity so that the family understands his illness. Social and vocational skills- Training in social and vocational skills to live independently is an important part of recovery from paranoid schizophrenia. Pay attention to warning signs. John and his caregivers may have identified things that may trigger your paranoid schizophrenia symptoms, cause a relapse or prevent you from carrying out your daily activities. Make a plan so that he knows what to do if symptoms return.

8. Considering the nursing problems of John in the movie, identify at least three priority problem and formulate a nursing care plan for John in a form of a matrix? DISTURBED THOUGHT PROCESSES INEFFECTIVE ROLE PERFORMANCE RISK FOR INJURY

Inability to trust

Dysfunctional family system

Seizures, Hallucinations, Panic level of anxiety The client will not experience physical injury

Hypervi gilance

Inapproriate non-reality based thinking

Change in usual patterns of responsibility After 1 week, the pt. will verbalize understanding that physical symptoms interfere with role performance

Will develop trust in atleast one staff member within 1 week.

Frequently orient client to reality and surrounding. Monitor V/S every 15 minutes initially and less frequently as acute symptoms subside.

Assess clients level of disorientation. Place client in quiet, private room

Encourage staff to work with client as much as possible Be honest an keep all promises

Avoid physical contact Encourage pt. to verbalize true feelings

Help client identify changes he would like to see within the family system Encourage family participation on the devt of plans to effect positive change.