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Subjective Cue: Disturbed Thought
³ Nung nasa Taiwan ako Processes related Short term outcome: INDEPENDENT:
napossess ako. Dinala ako to disruption in 1. Providing general 1. A calm approach Outcome
dito ng tatay ko sa Pilipinas cognitive After 8 hours of nursing leads helps to avoid Achieved:
tapos nasaktan ko yung operations and intervention, the pt will a. Approach the distorting the
nanay ko nung may kausap activities as be able to : client in slow, client¶s sensory ? The
siya sa phone ´, as evidenced by ? Demonstrate calm, matter-af- perceptual field patient
verbalized by the patient confused facial reality based fact manner which helps could demonstr
expression thinking in b. Maintain facial promote disturbed ated
Objective: verbal and non expression and thoughts and reality
GA: verbal behavior behaviors that are perceptions based
? Poor personal ? Demonstrated consistent with Peplau defined thinking in
grooming reduction of verbal statements Psychodynamic verbal
? Confused facial frequency of nursing as being and non
expression delusions able to understand verbal
? r
? Participate in one¶s own behavior.
social activities behavior to help ? The
and group others identify felt patient
Sensory & Cognition: therapies difficulties and to demonstr
? Conscious, oriented to apply principles of ated a
time, person & place human relations to reduction
? Impaired memory on the problems that of
personal information arise at all levels frequency
? Poor concentration of experience. of
regarding delusions.
specific topics ? The
2. Delusions cannot patient
be changed thru participate
logic and d in social
challenging the activities
belief of the such as
patient, no matter group
how irrational. As therapies.
the client may be
forced to cling to it
and defend it.
Roger¶s described
2. Providing specific a variation of self
questions as the inherent
? Avoid challenging the potentialities of the
client¶s delusional actualizing
system or arguing tendencies that
with the client. can suffer the
distorted
expression when
maladjustment
occurs resulting in
behavior
destructive to
oneself and
others.
COLLABORATIVE: CHLORPROMAZINE is
classified as a low
1. Continue to potency antipsychotic
administer and and in the past was used
monitor the effects of for the treatment of both
the prescribed acute and chronic
medication psychosis, including
? CHLORPROMAZINE Schizophrenia.
(Thorazine) It is still well
? Haloperidol recommended for short
? Fluprenazine term management of
severe anxiety and
aggressive episodes.