Miami Dade College Schizophrenia Concept Map

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Health Medical

Miami Dade College

Description

I need a concept maps on three case studies including

- Subjective/objective data;

- Nursing diagnosis (for example Disturbed thought process relate to... as evidenced by...);

- Nursing Action;

- Outcomes

Case studies on:

- Schizophrenia

-Major depressive disorder

-Bipolar disorder

Case Studies will be in word document along with concept map template

Unformatted Attachment Preview

CONCEPT MAP TEMPLATE Schizophrenia Objective: Subjective: Nsg. Dx: Disturbed Thought Process Nsg. Dx: Ineffective Coping Nursing Action: Nursing Action: Outcome: Outcome: Nsg. Dx: Disturbed Sensory Perception r/t Nursing Action: Outcome: Case study 1 - Schizophrenia Caroline, age 22, was diagnosed with schizophrenia at age 19. She led a relatively normal life during school age and high school years. She left her parents at age 17 to attend a college somewhat distant to her home. She apparently had no problems during her first year, but when she returned for Thanksgiving break during her second year, her parents noticed her distancing herself from others. She spent a lot of time alone, was irritable, and had begun chain smoking and drinking alcohol. She failed two courses that fall and was placed on probation. When she went back to school in the spring, her former roommate refused to stay with her, saying, “She acts so crazy sometimes. She talks out of her head, and I’m afraid of her.” In late February, Caroline’s parents got a call from the dean of students who related that the campus police had to be called to Caroline’s room to quiet her. She had been “yelling and screaming” and no one could understand what it had all been about. She had apparently really frightened the other students in the dormitory. These bizarre behaviors continued and during spring break in March, Caroline’s parents moved her back home and made an appointment with a psychiatrist for an evaluation. During the assessment, Caroline’s thought processes were loose, vague, and often circumstantial. She exhibited behaviors that suggested auditory hallucinations (stopping midsentence and “cocking” her head to the side as if listening), although when questioned about whether or not she heard voices, she denied it. Paranoid delusional thinking was evident. She made statements such as, “There is no one I can trust at that college. Every student in that dorm has been told to keep an eye on me. They all know I am too smart to be there, so they will do what they can to make me fail. If I pass, then everyone else fails.” She also expressed somatic delusions, “I’m pregnant, you know. It will be a virgin birth. That’s another reason the college kids are out to get me. They are so jealous! I am the chosen one.” Since that time, she has been on several antipsychotic medications (chlorpromazine, clozapine, and risperidone), each with only minimal success, and which she would eventually quit taking altogether. She currently lives at home with her parents who are beside themselves with concern and frustration. The psychiatrist has admitted Caroline to the hospital at this time to evaluate her behavior and to begin her on a trial of fluphenazine decanoate which will eventually be administered only every 3 weeks by IM injection in an effort to encourage increased medication compliance on Caroline’s part. Design a nursing care plan for Caroline during this hospital admission. Case study 2 - MDD Valerie, age 25, is admitted to the psychiatric unit by her psychiatrist after stating that she no longer wanted to live. She has a long history of psychiatric problems, beginning at age 15, when she swallowed a handful of aspirin and acetaminophen. Valerie’s mother has a history of depression and her father is very authoritarian. He ruled Valerie and her sister with an iron hand and rarely showed affection or gave positive feedback. In college Valerie met Bob, with whom she immediately fell in love. He was very affectionate, and she felt she received some nurturing from him that she had not received from her parents. In the semester before graduation, Bob told her he was leaving to go to graduate school in another state and that he was not ready to get married at this time. Valerie became hysterical and went into a deep depression. After a few weeks she met Jack, with whom she immediately began a sexual relationship and became pregnant. Jack agreed to marry Valerie, and so they began a short, but extremely stormy, relationship. Six months after the birth of their baby boy, they began divorce proceedings, with a great deal of negative negotiations regarding custody and child support. The child is 4 years old now, and Valerie has had several “serious” relationships since her divorce, having just broken off from the most recent one this week. Ralph told her that she is just “too intense, draining him of all his energy.” She said he told her that she expects too much from their relationship—more than he has to give. She admits that she got serious really fast, but that she really believes she loves him. She says to the admitting nurse, “What’s the matter with me? Why can’t I have normal relationships like other people? If it weren’t for my little boy, I wouldn’t even be here now.” Design a plan of care for Valerie’s hospital stay. Case study 3 - Bipolar Noreen, age 32, had always been described as “moody.” Depending upon what was happening in her life at the time, she could be very sad and depressed, or very lighthearted and happy. During her “down” times she would feel tired, experience loss of appetite, and sleep a lot. During her “happy” times, she would party a lot, be very outgoing, and have a remarkable amount of energy. Noreen did well in college and graduated at age 26 with an MBA. Since that time, she has been employed in the administration department of a large corporation, in which she has had several promotions. Two weeks ago, management was to make the announcement of who would be fulfilling the position of vice president of corporate affairs. Noreen and a male colleague, Ted, were vying for the position. It was a choice position that Noreen desperately wanted. She became very depressed when the announcement was made that Ted had been chosen. She stayed at home, in bed, and slept a lot for several days. On about the 4th day, she got up, feeling exhilarated, and decided to go shopping. She spent more than $1,000 on clothing. She then decided to have a party for several hundred people, ordering it catered, and planning all the details. Tonight was the party. Noreen wore a new, very expensive dress, drank a lot of champagne, was very jovial and seductive, and bragged to everyone who would listen that she would soon be getting a new job, and that the people at her old organization would be sorry they had failed to promote her. She left the party with a man she hardly knew. At 3:00 a.m., she was picked up by the police, under the grandstand at the local baseball stadium wearing only her underclothes, high-heeled shoes, and carrying a half-filled bottle of champagne. She was alone and speaking very loudly and rapidly. The police brought her to the emergency department of the local hospital where she was admitted to the psychiatric unit with a diagnosis of manic episode. Design an initial care plan for Noreen.
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Explanation & Answer

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Running head: CONCEPT MAPS

1

Concept Maps
Author
Institution

Running head: CONCEPT MAPS

2

CONCEPT MAP FOR SCHIZOPHRENIA

Schizophrenia

Subjective data:
➢ Hallucinations
➢ Somatic
delusions

Objective:
➢ Loose, vague
and
circumstantia
l thought
process

Nsg. Dx:
➢ Somatic delusions related
to her paranoia as
evidenced by religious
preoccupation thoughts

Nsg. Dx:
➢ Disturbed thought
process related to
paranoia as evidenced
by her disruptions.

Nursing Action:
➢ Encouraging the
patient to take
their medicine

Nursing Action:
➢ Encourage
communication by
patient,
➢ Use of simple language
➢ Establish trust with the
patient.

Objective:
➢ Paranoid
delusional
thinking
➢ Agitated
➢ Irritable

Nsg. Dx:
➢ defensive Coping related
to paranoia, as evidenced
by her suspicions of other
people’s motives

Nursing Action:
➢ Assess the patient’s
signs
➢ Encouraging the
patient in a
nonjudgmental way

Running head: CONCEPT MA...


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