Name of Patient: Abadiez Michael Age: 31 years old Diagnosis: Schizophrenia Undifferentiated

BRUNSWICK LENS MODEL

BRUNSWICK LENS MODEL
Measures to increase engagement in satisfying activities: 1.1 1.2 1.3 1.4 1.5 1.6 Note onset of physical/mental illness and whether recovery is anticipated or condition is chronic/progressive Do physical exam, paying particular attention to any illnesses that are identified. Establish therapeutic nurse-client relationship. Introduce client to those with similar/ shared interest and supportive people. Provide positive reinforcement when client makes moves towards others. As client progresses. Produce the client with graded activites according to level of tolerance e.g. simple games with one safe persons, slowly add a third person into safe activities, introduce simple group activites and then groups in which client participants more Eventually engage other clients and significant ithers in social interactions and activities with the client. Teach client to remove himself from briefly when feeling agitated and work on some anxiety-relief exercises e.g. deep breathing. Provide opportunities for the client to learn adaptive social skills in a non threatening environment. Useful coping skills that client will need include conversation and assertiveness skills. Measures to help patient in demonstrating reality based thought process: 1. plan short, frequent periods with client throughout the day 2.use simple words and keep directions simple 3.keep voice low and keep directions simple 4.use therapeutic techniques to try to understand clients concerns 5.focus on and direct clients attention to concrete things in the environment 6. give positive feedback to client 7. show empathy regarding the clients feelings, reassure the client of the nurses presence and acceptance 8. Keep environment quiet and free of stimuli as possible

I. Psychologic Deficit Social Isolation Objective cues: >Prefers to stay in one place away from the crowd. > (talks a little) patient doesnt talk much. >doesnt participate in activities conducted by the student nurses. Subjective cues: ari rko di ko ganahan mo apil samok as verbalized by the patient

A case of Mr. Abadiez, Michael, 31 years old, was diagnosed as Schizophrenia Undifferentiated.

1.7 1.8 1.9 1.10

75% resolution of physiologic problem

II. Psychologic Deficit Impaired Thought Process Objective cues: Inappropriate verbalization thought blocking flight of ideas circumstantial subjective cues: gusto ko mugawas, adto sa America niya musakay ko ug spaceship then immediately proceeded with this statement: di ba doctor man ka? Naa lage ka dri? still as verbalized by the patient

1.Social Isolation: withdrawal realated to neurochemical alteration in the brain. 2. Impaired Thought Process: Flight of ideas r/t biochemical alteration in the brain. 3. Self care deficit: poor personal hygiene related to perceptual and cognitive impairment 4. Disturbed Sleep Pattern: Frequent awakening r/t environmental disturbances

III. Psychologic Deficit Self-care deficit Objective cues: >untrimmed fingernails >dirty shirt and shorts >long hair >inability ro maintain appearance in a satisfactory level. >disheveled Subjective Cues: ugma nko maligo oi,kapoy man as verbalized by the client. IV.physiologic deficit: Disturbed Sleep Pattern Objective cues: -Mood alterations(irritable) -Takes small nap in the morning and the afternoon( 1-3 times a day) -Interrupted sleep -Yawning frequently -irritable look expressed (eyebrows frowned) -restlessness -looks sleepy/drowsy at waking hours Subjective cues: Wala koy damgo kay sige ko ug mata-mata, naa man gud sigeg shagit-shagit as verbalized by the client

Measures to improve personal hygiene: 1. encourage communication among those who are involved in the clients health promotion. 2. encourage patient to take a bath 3. assess barriers to participation in regimen 4.identify degree of individual functional level 5 .provide privacy during personal care activities 6. provide positive feedback about appearance and praise efforts 7. assist with necessary adaptation to accomplish ADLs. begin with familiar , easily accomplished tasks 8. Discuss employee dress code. Measures to help client in achieving optimal amounts of sleep: 1.instruct client to follow consistently a daily schedule for retiring and arising of clothing at a time in sequential order. Talk 9. After one item 2.through each step to avoid heavy meals, alcohol, caffeine or instruct the client of the task one at a time smoking before sleeping 3.increase daytime activities or indicated but instruct patient to avoid heavy activities before sleeping 4.organize or cluster nursing care 5.encourage proper positioning to provide comfort. 6. limit fluid intake in the evening. 7. minimize or eliminate unnecessary environmental noise 8.provide dim environment

ACTUAL STATENEED/PROBLEMS/ OF THE PATIENT

NURSING CUE

NURSING INTERVENTIONS DIAGNOSIS

9. After one item of clothing at a time in sequential order. Talk through each step of the task one at a time

GOAL

General Objective: After 1 week of holistic nursing care, the patient will attain optimum level of health, Improving Social days of student nurse client Process, the client will be able to: After 5 Isolation, Improving ThoughtinteractionImproving self-Care, Improving Sleeping Pattern 1. engage in satisfying activities within personal limitations. 2. demonstrate reality based thought process in verbal communication as evidenced by expression of realistic, achievable ideas 3. show an improvement in personal hygiene as evidence by taking a bath and wearing clean clothing. 4. achieve optimal amounts of sleep as evidenced by rested appearance, verbalization of feeling rested and improvement of sleep pattern

Goal: after 1 week of student nurse- patient interaction, the patient will be able to attain optimum level of functioning.