Psychiatric Nursing III

Republic of the Philippines
BATAAN PENINSULA STATE UNIVERSITY

Balanga Campus
Balanga City, Bataan
COLLEGE OF NURSING AND MIDWIFERY
Mariveles Mental Hospital
Process Recording and Mental Status Assessment
MTW Group 6
Submitted to:
Mrs. Leonora Llandilar R.N
Clinical Instructress
Submitted by:
Lindon Enriquez Cruz (process recording)
Lorryleen Galicia (MSA)
Alma Joy Bumagat Lupido (psychotherapy)
Process
Recording
and Theme
Identification
I. PERSONAL DATA
Name: Mr. G.M

Address: Duliman Pangasinan
Age: 69 years old
Gender: Male
Date of Birth: Oct. 15, 1941
Place of Birth: Malaysia
Religion: Iglesia ni Cristo
Last 15 years of Patient’s Life:

During the conversation with our client he mentioned that he’s living
Duliman Pangasinan, supervising their mango farm as ordered by his father and
sometimes after that he also worked at the military. Even up to now Mr. G.M
believes that he is still working as a Military Spy at MMH and that his fellow
clients are NPA’s.
II. OBJECTIVES:
A. Client-Centered Objective
 To reorient the client to reality by gradually setting his mind apart
from the world he is recognizing at present which is distant to
reality.
 To entertain clients and provides a means of enjoyment through
series of therapeutic activities that we’re prepared in order to uplift
and improved their social wellness and well being.
 To encourage the client to verbalized and express his thoughts
and feelings in order to provide a feeling of comfort and freedom as
well from hidden fears and anxities.
B. Nurse-Centered Objective
 To encourage and explore the clients feeling and condition in order
to understand his situation.
 To gain client trust and cooperation throughout the therapeutic
activities.
 To maintain the therapeutic relationship with the clients through
series of therapeutic communication in order to assess the client’s
feeling and behaviors.
III. DESCRIPTION OF SETTING
A. Describe the environment:

It was a warm yet windy afternoon when we received our client aroung 2
in the afternoon we held our conversation in the tennis court of MMH
under the shade of the mango tree which help us gain a comportable area
and eases our conversation. The surrounding was fairly clean except from
pieces of dried fallen leaves. It was a silent area ideal for conversation.
B. Describe the nature, behavior, affect and mood of the client.
During the conversation the facial expression was normally serious and
often stares at his feet but as we go on the conversation the he would
respond and start making eye contact. And would occasionally smile
when answering our questions.
IV. PROCESS RECORDING
Nurse-Client Conversation Therapeutic Analysis and Interpretation based

Communication on Theories
Technique Used
SN: Magandang umaga po! Asking broad open- The nurse should ask neutral
Kami po ang student nurse enfded question question that encourage the client
nyo ngayong hapon Mang to express her concerns. It is
G.M. Ako po si Lorryleen at essential for us to assess the client
ako naman po si Lindon. moods and behavior and feelings
Makakasama nyo po kami ng through means of asking broad
apat na linggo. Dalawang open-ended questions that allow
Linggo po kaming us to understand the client
makakasama sa hapon mula condition and thus be able to apply
2:00pm hanggang 4:30pm at appropriate therapeutic techniques
sa susunod na dalawang of communication with the client.
linggo po ay umaga naman
po tayo magkikita sa oras na
9:00am to 11:00am.
SN: Kamusta naman po kayo

Mang G.M?
C: Ok naman ako
SN: Ilan taon na po kayo

Mang G.M?
C: 69 yrs old
(naglalakad papuntang
grooming area)
SN: Mang G.M taga san po
kayo?
C: Malaysia
SN: Sa malaysia din po ba

kayo pinanganak Mang
G.M?
C: Oo,dun ako pinanganak.
SN: Mang G.M ano po ba

ang relihiyon nyo? Clarifying The nurse helps the client to put
unclear thought and ideas into
C: Iglesia ni Cristo Clarifying words. This will avoid
misunderstanding and
SN: Mang G.M alam nyo po misinterpretations that will facilitate
ba kung nasaan kayo? a good flow of conversation
between the nurse and the client.
C: Oo, nasa Mariveles,
Mental Hospital
SN: Mang G.M alam nyo po

ba kung bakit kayo nasa
mental hospital?
C: Oo, kasi ako ay isang

impormatiko
SN: impormatiko? Ano po ba

ang ibig nyong sabihin sa
impormatiko?
C: impormatiko, nagmamasid
sa mga NPA
.
SN: NPA po Mang G.M? Ano
po ang ibig nyong sabihin?
C: mga NPA kasi ang

kasama ko dito.
SN: Ganon po ba Mang G.M.

kamusta naman po ang mga
kasama nyo dito sa mental?
C: di ko naman sila
kinakausap dahil baog daw
ako.
SN: sila?sino pang sila Mang

G.M?
SN: ah Mang G.M may

pamilya pa po ba kayo?
C: Oo meron pa. Clarifying The nurse helps the client to put

unclear thought and ideas into
SN: Kilala nyo pa po ba ang words. This will avoid
mga magulang nyo Mang misunderstanding and
G.M? misinterpretations that will facilitate
a good flow of conversation
C: Oo, ang nanay ko si between the nurse and the client.
Cremia at ang aking ama ay
si Juan Crisostomo Clarifying
SN: Mang G.M asan po ba

sila?
C: Di ko alam
Using silence Silence often encourage the client
SN: Mang G.M may asawa to verbalized, provided that is
po ba kayo? interested and expectant.
C: Meron
SN: Ano po ang pangalan ng

asawa nyo?
C: Lianne
SN: May mga anak po ba Placing event into time

kayo ni Aling Lianne? and sequence.
C: Meron mga siyam.
SN: Mang G.M kilala nyo ba

silang lahat?
C: si jelly, steve at at limot ko

na ang iba.
SN: Nasan na po sila Mang Giving information. It is necessary for the nurse to give
G.M? and share information to the client
that is relevant to her health care
C: Nasa underground and well being. Therapeutic
activities are prepared in order to
SN: Underground? Ano po enchance the client skills,
ang ibig nyong sabihin? creativity, as well as cognitive
ability in order to facilitate the
C: Nagtratraining ang mga process.
anak ko sa underground
para maging Militar. Giving the procedure of the activity
is important to create a productive
SN: eh si aling Lianne po working environment
nasaan?
C: Nandun sa Duliman
SN: Duliman?san po yun
Mang G.M?
C: Sa pangasinan, nandun Clarifying The nurse helps the client to put

siya sa may calabawan unclear thought and ideas into
pinaparusahan at words, this will avoid
ginagahasa ng madaming misunderstanding and
lalaki. misinterpretation that will facilitate
good flow of conversation between
SN: (natahimik) the nurse and client.
SN: Mang G.M may mga

kapatid pa po ba kayo?
C: Oo, 3 kaming
magkakapatid.
SN: Kilala nyo parin po ba

sila Mang G.M?
C: Si Nine ang panganay, si

Anita ang pangalawa at ako
ang bunso.
SN: Dinadalaw po ba nila

kayo dito?
C: Oo, dinadalaw pa nila ko.

Using silence Silence often encourages the client
SN: Kelan po yung huling to verbalized, provided that it is
dalaw nila? interested and expectant.
C: matagal na di ko na
maalala.
SN: ganoon po ba Mang G.M

sino po ba ang mas madalas
dumalaw sa inyo Mang G.M?
C: Si Anita, sa kanya din

binibigay yung mga
dukomento na binibigay ng
doktor at mga papeles na
bibilin nya.
SN: ah, Riseta po ang tawag

dun.
SN: may mga pinapainum po Summarizing Point out the highlights of the
ba sa inyong gamot Mang important content in the
G.M? communication. By this nurse
could emphasized the important
C: Oo at sa tuwing aspect that the client should know
pinapainum ako ng gamot na about the activity. It could also
yon lumiliit ako. enhance the client memory and
cognitive ability by incorporating
SN: Lumiliit po Mang G.M? important and relevant ideas
ano po ang ibig mong through summarizing. And base
sabihin Mang G.M? from Henderson’s 14 fundamental
needs theory, learning is one of
C: Lumiliit ako sa tuwing the needs of an individual in order
pinapainum ako ng gamot na to grow and mature.
yun. Pero bumabalik din ako
sa dati kapag kumakain.
SN:Sino po ang nagbibigay

ng tableta sa inyo Mang
G.M?
C: mga nakaputing damit.

Minsan pinagtutulungan nila
kong lahat at iniinjectionan.
SN: mga nakaputi po ba

Mang G.M?sila po ang mga
nurse nyo na nagbibigay ng
mga gamot nyo.
SN: Mang G.M ano po ba Direct question

ang trabaho nyo?
C: militar ako at
binabantayan ko ang mga
NPA dito.
SN: San po ba kayo naka- Direct question

base dati?
C: madami, sa Germany,
U.S.A, Valenzuela,
Zambales, Subic.
C: kaya nga ang dami kong

asawa hindi ko mabilang.
Nung nagtratrabaho ko sa
parola sa subic nakita ko si
Kris Aquino, Rosa Rosal,
Korina Sanchez.
SN: Mang G.M may ano po Direct question

ba sa Parola sa Subic bakit
nyo nakita sila Kris Aquino,
Rosa Rosal at Korina
Sanchez?
C: wala, pinaasawa sakin si

Kris Aquino, Korina Sanchez
at Rosa Rosal.
SN: (natahimik) Using silence The nurse allows periodic pauses

to give nurse and client to reflect
C: Nagkaanak pa ko kay Kris

Aquino at Rosa Rosal 31
anak kay Kris Aquino at 2
kay Rosa Rosal (smiling)
SN: Ganon po ba Mang
G.M?
SN: Mang G.M kilala nyo po

ba ang presidente ng
Pilipinas ngayon?
C: ako!
C: ako yung presidente

ngayon paiba-iba lang ako
ng pangalan.
C: dati tinatawag nila akong

Gloria, Erap at Cory. Tsaka
ako din si Rizal pero hindi
ako yung namatay na Rizal.
Ako yung Rizal na
pinatatayuan ng Monumento.
SN: Mang G.M alam nyo po
ba ang mga napag-usapan
natin kanina?
C: ang naaalala ko ay
napag-usapan natin ang
pamilya ko at ang
underground si Lianne ang
asawa ko at si Anita ang
kapatid ko.
V. THEME IDENTIFICATION
Content Theme
The conversation were mostly about the family of our client. His activities
during his last 15 years of his life, his working experiencing, the places he’d been
to, the personalities he’d met and the rest was about his basic personal
information.
Interaction Theme
During the interaction with our client. Mr. G.M was cooperative and
answered most of our question. He willingly narrate his life to us and told us
things about himself.
Mood Theme
During the conversation our client was serious and has no facial
expression, he would only answer our question and when asked how he feel he
only said “ayos lang” but as our conversation lengthen he would occasionally
smile at us while talking.
VI. Nursing Diagnosis
Impaired memory r/t psychological disturbances as manifested by

forgetting his past experiences such as place, time and event.
VII. Nursing Intervention
Implement appropriate memory retraining techniques such as keeping

calendars, writing list, memory we games, mnemonic devices and so forth.
Provides for importance of pacing learning activities and having appropriate rest
to avoid fatigue.
VII. SUMMARY AND EVALUATION
All in all the interaction between us and our client had ended without any
unwanted events. We had met our objective which is to gather the personal data
and asses the mental status of Mr.G.M as well as to establish rapport and gain
our client’s trust as evidenced by his expression of feelings and willing narration
of his own life. Mr.G.M tried to answer all the questions that we asked and we
utilized our therapeutic communication technique during the course of our whole
conversation.
VIII. REFERENCE
Nursing Pocket Guide 10th Edition

I.Personal Data
A. Name Mr. G.M
B. Address Pangasinan
C. Age 41 years old
D. Gende Male
E. Date/Place of Birth December 12, 1966, Pangasinan
F. Religion Roman Catholic
G. Place where the patient spent the last 15 years of life:
The client Mang G.M was previously well ang living a normal life as
a farmer until 2002 he started exhibiting odd behaviors. His father Mang
A.M brought the client to the faithealer in their Area and seek medical
advice for four months. However, when after four months had past and the
client condition still did not improve. His family decided to consult in
NCMH where in Mang G.M was admitted confined at ACIS for 15 days
until he was taken home with prescribed medication.
Until returning home, the client resumed farming and started

neglecting his medication until he discontinued taking it when client was
still symptomatic. During that time the client would sometimes exhibit
oddities but was tolerated. Aside from his occasional manifestation of
oddities the client and his family didn’t encounter anymore problem.
That was until 2008, when the clients brother started to building a
house in the land that the client believed was all his. 4 days after the
house was build, the client broke the jalousy of his brother new house thus
the client family decided to seek medical attention at Mariveles Mental
Hospital.
Source: Client Chart
II. OBJECTIVES
A. Client-Centered Objectives
 To reorient the client to reality by gradually setting his mind

apart from the world he is recognizing at present which is distant
to reality.
series of therapeutic activities that we’re prepared in order to
uplift and improved their social wellness and well being.
and feelings in order to provide a feeling of comfort and freedom
as well from hidden fears and anxities.
B. Nurse-Centered Objectives
 To Encourage and explore the clients feeling and condition in

order to understand his situation.
activities.
series of therapeutic communication in order to assess the
client’s feeling and behaviors.
III. Description of Setting
A. Describe the set-up/environment
It was a cloudy afternoon when we received our client at already 2:00pm

he smiled at us even before we get our personal contact. Some clients
inside the ward were just staring at us while the other client were saying
some things which are not clear. The weather is cool even without the
contact blowing across the atmosphere. The trees were standing still and
there were only few leaves falling from the trees unlike last week. We
moved chair to avoid interruption while he is reading the comics. The
environment is quite and peaceful except for the bit noise produced by the
other client inside the ward.
B. Describe the nature, behavior, affect and mood of the client
Just before we received our client, Mang G.M was already smiling at us
from his ward. He seemed to be more happy and lively than last week,
although we saw the same facial expression from him. Serious face.
IV. Process Recording
Nurse-Client Therapeutic Analysis and

Conversation Communication Interpretation Based on
Technique Used Theories
SN: Magandang umaga Asking broad-open The nurse should ask
po, kamusta na po kayo ended questions. neutral questions that
Mang G.M? encourage the client to
express concerns. It is
C: ok lang ako. essential for us to know
the client mood,
SN: Mang G.M naaalala Asking broad-open behavior, and feelings
nyo pa rin po ba kami? ended questions. through means of asking
broad open-ended
C: Hmmm.. nalimutan ko questions in order to
na e. understand the client’s
conditions and be able to
SN: Mang G.M apply appropriate
ipapakilala po ulet namin therapeutic
ang aming pangalan. Ako communication with the
po si Leen at ako po si client. In relation to the
Lindon. theory of Peplau:
Interpersonal theory, in
C: naaalala ko lang kasi order to come up to a
yung mukha nyo pero therapeutic relationship,
ang pangalan hindi. one of the 4 phases we
should undergo is the 1st
SN: oh dapat Mang G.M phase.
wag nyo pong kalimutan
ang pangalan ng mga Giving information It is necessary for the
student nurse nyo. nurse to give and share
information to the client
C: (smile) that is relevant to her
health care and well
SN: Mang G.M pupunta being. Therapeutic
muna tayo sa grooming activities are prepared in
area. Para po makapag- order to enchance the
ayos kayo at malinis ang client skills, creativity, as
katawan nyo at well as cognitive ability in
mapreskohan po kayo. order to facilitate the
process.
C: (tumatango lang)
Giving the procedure of
SN: (after maglinis) the activity is important to
create a productive
SN: Kamusta naman po working environment.
ang pagkaen nyo ng
tanghalian?
C: Mabuti naman,
nabusog naman ako.
SN: ah masarap naman Giving information. It is necessary fo the

po ba ang mga pagkaen nurse to give and share
nyo? information to the client
that is relevant to her
C: Masarap naman ang health care and well
pagkaen. being therapeutic
activities are prepared in
SN: Mang G.M ano po order to enhance the
ang nararamdaman nyo client’s skill, creativity as
kapag nakakalabas po well as cognitive ability in
kayo ng ward? order to facilitate the
process.
C: ah masaya presko
SN: tara po Mang G.M

doon po tayo mauupo.
(under the mango trees)
SN: Mang G.M ngayon

po ay magkakaroon tayo Clarifying The nurse helps the
ng dalawang therapy. client to put unclear
Ang unang therapy po ay thoughts and ideas into
ang comics reading words, this will avoid
mayamaya po ay misunderstanding and
bibigyan namin kayo ng misinterpretations that
comics at babasahin nyo will facilitate a good flow
poi to. Kapag po natapos Direct Question of conversation between
kayo sa pagbabasa the nurse and the client.
tatanungin po naming
kayo kung ano po ang
aral na natutunan yo sa
binasa nyo. Asking broad open- The nurse should ask
ended question. neutral questions that
C: (tumango) encourage the client to
SN: Mang G.M alam nyo essential for us to know
po ba ang comics? the client mood, behavior
and feeling through
C: Oo, alam ko ang means of asking broad
comics open-ended question in
order to understand that
SN: Mang G.M alam nyo client’s condition and be
po ba ang comics? able to apply appropriate
therapeutic therapy.
C: Oo alam ko ang
comics
SN: ano po ba ang ibig

sabihin ng comics? Direct question
C: mga cartoons sa papel
SN: Mang G.M marunong

po ba kayong magbasa?
Focusing The nurse ask goals
C: Oo, marunong akong directed question to help
magbasa. the client focus on a
specific area of concern.
SN: Mang G.M ito na po This will also help the
yung comics at basahin nurse to further
nyo na po. understand the topic that
is introduced.
C: Kinuha ang comics at
nagbasa.
SN: Mang G.M tapos na

po ba kayong magbasa
ng comics?
C: Oo tapus ko na
basahin.
SN: Amina po ang

comics Mang G.M at
tatanungin ko po kayo
about sa nabasa nyong
comics.
Mang G.M ano po ang
pamagat ng binasa
nyong comics?
C: Si Tesang Chismosa
SN: tama po. Sino

naman po ang main
character ng kwento?
C: Si Tesa yung
madaldal (client laugh)
SN: Ano naman po yung

natutunan nyong
magandang aral sa
nabasa nyo?
C: wag po mangboboso
(smiling)
SN: Hindi po,ang aral po

ay wag po makialam sa
buhay ng may buhay at
wag pag-usapan ang Accepting An accepting response
kapitbahay. indicate the nurse has
and followed train or
though.
(Photo Language
Therapy)
SN: Mang G.M ang
gagawin po natin ngayon
ay photo language
therapy. Ito po yung
therapy nating
pangalawa. Mamimili
lang po kayo ng
dalawang picture. Yung
pinakafavorite nyo po.
Pag nakapili na po kayo,
tatanungin po naming
kayo kung bakit ayun
yung napili nyong picture.
Clarifying The nurse helps the
SN: Mang G.M tara na client to put unclear
ho. At mamili na kayo ng thoughts and ideas into
picture. words; this will avoid
(namili ng picture si Mang misinterpretation.
G.M)
Encouraging Comparison Comparing ideas,
C: Eto na yung picture na experiences or
napili ko. relationship bring out
many recurring themes.
SN: ah ang napili nyo
pong litrato ay isang
manok at isang babae. Focusing The nurse asks goal
Mang G.M sa dinamidami directed questions to help
ng litrato na pinakita the client focus on a
namin ito pong dalawang specific area of concern.
picture nato ang This will also help the
nagustuhan nyo?simulan nurse to further
po natin sa manok. understand the topic that
is introduced to the client.
C: kasi dati nag-aalaga
kami ng manok sa bahay
tas bibinibigyan ko din ng
manok ang mga
kapitbahay.
SN: Mang G.M ano po
ang dahilan bakit Summarizing The nurse summarizes a
binibigyan ng manok ang given activity or
mga kapitbahay nyo? intervention by reviewing
the main point discussion
C: para dumami at and making appropriate
mangitlog tas ibabalik conclusion. With this, we
nila sakin ulit yung can gather all the
manok. activities rendered into a
simple thought that will
SN: ah ganon po ba provide the client an
Mang G.M. understanding of what
activities has been done.
C: Marami akong manok
dati sa Monsalud.
SN: Monsalud, san po Giving recognition Informing the client of

yun? facts increases his or her
knowledge about a topic
C: dun sa Duliman. or lets the client know
what to expect. The
C: kasama ko si Jelly at nurse is functioning as a
Steve nangunguha ng resource person giving
itlog information also builds
trust with the client.
SN: e Mang G.M yung
isang larawan naman po.
Bakit babae yung kinuha
nyo?
C: Maganda kasi
SN: May naaalala po ba

kayo sa picture na yan?
C: Oo, asawa ko siya e.

(smiling)
SN: ano po ba ang

pangalan nya?
C: Si Bibie Ranny
SN: Bibie Ranny?Sino po Seeking clarification The nurse helps the

siya ulit? client to put unclear
thoughts and ideas into
C: Siya ang asawa ko. words; this will avoid
SN: Mang G.M hindi po misinterpretation.
siya ang asawa nyo. Ang
nasa larawan po ay isang
artista/singer.
SN: Mang G.M ano Direct question

naman po ang
pinagkaiba ng dalawang
litrato?
C: yung manok may tuka,

palong,feather (L.O.L)
yung tao o wala non.
SN: bukod pa po doon General leads Encouraging

Mang G.M? continuation; using
neutral expressions to
C: ang tao encourage client to
nakakapagsalita ang continue talking
manok hindi.
SN: e ano naman po ang

pinagkaparehas ng
dalawang picture?
C: parehas kumakain
kaso ang sa tao foods
ang sa manok
palay/feeds (laughing) at
ang manok kinakain ng
tao. At ang tao din
kinakain kapag
nakahubad. (L.O.L)
SN: Mang G.M

natatandaan nyo pa po
ba ang mga ginawa natin
ngayong araw?
C: Pinagbasa nyo ko ng
comics tungkol kay
tesang chismosa.
The nurse summarizes a
SN: ano nga daw po ulit summarization given activity or
ang aral sa kwento intervention by reviewing
ngayon? the main point discussion
and making appropriate
C: wag maging conclusion. With this, we
chismoso. can gather all the
activities rendered into a
SN: Mang G.M mabuti po simple thought that will
ba o masama ang provide the client an
pagtsitsismis? understanding of what
C: Masama
SN: tama po. Pagkatapos Asking direct question

nating magbasa ng
comics anong therapy pa
po ang ginawa natin?
C: Photo Language
theory
SN: tama po ulit. Ano po

ulit ang ginawa natin sa
photo language therapy?
C: ano.. pinapili ako sa

madaming picture at
pinapili ng dalawa.
SN: Mang G.M naaalala summarizing The nurse summarizes a

nyo pa po ba kung ano given activity or
ang picture na napili nyo? intervention by reviewing
the main point discussion
C: Oo, yung manok at and making appropriate
yung magandang babae. conclusion. With this, we
can gather all the
activities rendered into a
simple thought that will
provide the client an
understanding of what
V. Theme Identification
Content Theme
During our interview with our client, the content of our conversation and
interaction revolved around the outcome of our therapeutic activities (comic
reading and photo language therapy) on what they’ve learned from it, on what
ideas they can share regarding the activity and what they feel after doing the
therapeutic activities.
Mood Theme
When we received our client, his mood appears to be happy and peaceful as
well as during the whole process of therapeutic activities as manifested by his
serious and calm facial expression and verbalization of his feelings “Masaya” he
claimed with a smile. We’ve also noticed that during our comic and photo
language therapy, his facial expression turned a bit excitement.
Interaction Theme
Our client participate and cooperated well during the entire therapeutic
activities we’ve prepared.
Knowledge deficit r/t cognitive limitation as manifested by inaccurate follow

through of instruction.
Vll. Nursing Intervention
We should prepare therapeutic activities that will enhance the learning and
cognitive ability of the client. Base on the theory of Virginia Henderson: Learning
is one of the 14 fundamental needs of a human being. It is need for an individual
to grow and mature and what he has learned will help him survive in the world
outside his place at present. His learning will help him to cope up with different
processes and obstacles in life such as searching for a job. We should provide
therapeutic activities that provide step by step approach from a simple to a
complicated one that will provide an enhancement on his capabilities to analyze
things and put this into perspective. We should also provide activities that will
provide that will create a means of entertainment and enjoyment to provide
relaxation that will refresh the mind of the client.
VIII. Summary and interpretation.

XI. references:
Lippincott Williams & wilkins : handbook of nursing
I. Personal Data
A. Name Mr. G.M
C. Age 41 years old
D. Gende Male

Hospital.
Source: Client chart
II. Objectives:

reality.
 To encourage the client to verbalized and express his thoughts and
feelings in order to provide a feeling of comfort and freedom as well
from hidden fears and anxities.
C. Nurse-Centered Objectives
 To encourage and explore the clients feeling and condition in

order to understand his situation.
activities.
series of therapeutic communication in order to assess the
client’s feeling and behaviors.
II. Description of Setting
A. Describe the set-up/environment
It’s a bright sunny afternoon when we received our patient at already

2:00pm the sun was high and the heat is on. Some of the client in the
dorm were quite silent and our client’s face is serious at first but after a
while it became bright and calm. The weather get humid. As we headed to
the yard outside the BPSU student center, the place. Seemed to be messy
due to the leaf that had fallen across the ground due to the sudden rain
earlier. Though the environment seemed to be distracting,still, the air was
calm with on and off soft blowing of wind that keeps the atmosphere cozy
and relaxing. The environment was peaceful and quite.
As we received our client, Mang G.M seems to have a bright mood that
reflects upon his face that look so calm. He smiled at us whenever we
smiled and greeted him. The clients seems to be familiar to the daily
routine of grooming care as we observes on his iniative in grooming his
own. He automatically went to the sink and wash his face and arms then
brushes his teeth without or due assistant. Our client is also happy as
manifested by his facial expressions and verbalization of “ok naman” and
“Masaya” he claimed.

SN: Magandang hapon Asking Broad Open- The nurse should ask
po, kamusta kayo Mang Ended questions neutral question that
G.M? encourage the client to
Asking Broad Open- express concerns. It is
C: mabuti Ended questions essential for us to know
the client’s mood,
SN: Ano po ba ang behavior, and feelings
nararamdaman nyo Asking Broad Open- through means of asking
ngayon? Ended questions questions in order to
understand the client
C: masaya(client smile) conditions and be able to
apply appropriate
SN: ah eh kamusta therapeutic
naman po ang tanghalian communication with the
nyo? client.
C: mabuti, nabusog
naman ako.
SN: ah ano naman po ba Giving information It is necessary for the

ang nararamdaman nyo nurse to give and share
kapag nakakalabas kayo information to the client
ng dorm at nakakalakad that is relevant to her
dito sa paligid. health care and well
being. Therapeutic
C: masaya, presko activities are prepared in
order to enchance the
(at the BPSU student client skills, creativity, as
center ground) well as cognitive ability in
order to facilitate the
SN: Mang G.M, ngayon process.
po ay magkakaroon tayo
ng dalawang therapy. Giving the procedure of
Ang unang therapy po ay the activity is important to
ang puzzle therapy. create a productive
Bibigyan po kayo ng working environment.
dalawang puzzle na Based on the theory of
magkaiba. Isang simple Virginia Henderson,
puzzle at isang complex. learning is included as
one of the 14
(SN: show the actual fundamental needs of
puzzle) human being and by
giving information, we are
Ito po ang bubuuin nyong assisting them to have
puzzle Mang G.M learning.
guguluhin po natin ang
puzzle at ibabalik nyo po Assesing Relationship Assesing relationship will
sa dati. aid the nurse in exploring
relation with the other
C: (client nods) person affect the mood,
(after the explanation of feeling and behavior of
the procedure, we the client.
proceeded to the conduct
of puzzle therapy and
facilitates a group
dynamics)
(after doing the puzzle

therapy, we proceeded to
our one on one interview
with our client)
SN: napansin po naming

na natagalan po kayong
buuin ang complex
puzzle.
C: Oo, madami kc at
mahirap buuin.
SN: Alin po pra sa inyo

ang madaling buuin?
Yung simple o yung
complex?
Verbalized what the
C: Yung complex ay yung nurse sees on the client’s
simple pala kasi naaalala Making Observation appearance and
ko ang puno sa tabi ng behaviors as well as
bahay namin. action. This will provide
an access for the nurse
SN: Mang G.M ang in assessing the client’s
susunod naman pong moods thought and
therapy ay ang play feelings through non-
therapy. Dito po ay verbal cues.
maglalaro po tayo ng
pasahan ng bola at
maglalaro ng baraha.
C: (Client smile,nods) Accepting

(after the explanation of
the procedure, we
of play therapy and
facilities group
dynamics.)
Direct question
(after doing the play
with our client)
SN: Mang G.M napansin

po namin na ang saya
nyo habang naglalaro
kanina na ng pasahang
bola.
C: Naalala ko kasi na
nilalaro ko ‘to kasama
ang dalawang anak ko na
si Steve at Jelly.
SN:San nyo naman po

nilalaro yung pasahan ng
bola Mang G.M?
C: doon,samin sa
Sta.Cruz
SN: ah ganon po ba
Mang G.M
SN: Masaya naman po

ba kayo Mang G.M
kapag nakakalaro kayo
ng anak nyo?
C: Oo, masaya ako
SN: nag-enjoy naman po

ba kayo sa ginawa nating
therapy Mang G.M?
C: Oo Masaya at
natutuwa ako at enjoy
(client smile)
Content Theme
The content of our interaction with our client revolves around the learning
that have retained from his mind based on the series of therapeutic activities that
we’ve conducted last week and a few moments ago as well as his mood feelings
white doing the activities.
Mood Theme
When we received our client this afternoon, his mood seemed to be

serious at first but on the latter part, his bright and calm facial expressions as well
as his cheerful eyes appeared again and he verbalized a feeling if happiness
such as “Masaya” and nag-enjoy ako” he claimed.
Interaction Theme
During our therapeutic activities, our client participated and cooperated

well on our prepared activities. He often answered to the facilitator’s question; he
even tried to fixed the complex puzzle (puzzle therapy) even if he find some
difficulties.

VII. Nursing Interventions
We prepared therapeutic activities that will enhance the learning and

is one of the 14 fundamentals needs of a human being. It is a need for an
individual to grow and mature and what he learned will help him to survive in the
world outside his place at present. His learning will help him to cope up with
different processes and obstacles in life such as searching for a joy. We should
also provide an active environment that is conducive for therapeutic activities that
will further facilitate a productive outcome. Based on nightingale theory,
environment affects the health of a person, thus any alteration in the factor: fresh
air, pure water, efficient drainage, cleanliness and direct sunlight will cause
health deficiency not only physically, but emotionally and mentally as well. We
should also provide therapeutic conversation with the client in order to encourage
him to verbalized his feeling, thoughts, mood as well as fears and activities.
Based on the interpersonal theory of Peplau, to attain therapeutic relationship,
the nurse must undergo the 4 phases: orientation, identification and resolution
through the series of therapeutic communication.
VIII. Summary and Interpretation
During the whole interaction, our client participates and cooperates well to
our prepared therapeutic activities. He always responds to our questions and
tried to reach out even if he find some difficulties in answering our questions. He
occasionally smiles. Sometimes, he just stares at us and keep quite for a while.
The client seems to be happy and possesses a peaceful mood. He enjoyed our
therapy especially the play therapy with our observations and manifestations
from the client. He seems to have a great time with his co-client. Though
sometimes that he smiles while telling sad events, then sometimes he has no
reaction while stating wonderful events.
XI.: References
Lippincott Williams & wilkins: handbook of nursing

I.Personal Data
A. Name Mr. G.M

C. Age 41 years old
D. Gende Male

Hospital.
II. Objectives:
B. Client-Centered Objectives
reality.
and feelings in order to provide a feeling of comfort and freedom as
well from hidden fears and anxieties.
C. Nurse-Centered Objectives
 To encourage and explore the clients feeling and condition in order
to understand his situation.
activities.
series of therapeutic communication in order to assess the client’s
feeling and behaviors.
III. Description of setting
A. Describe the set-up environment.

It’s a bright sunny morning when we received our client at
already 10am the sun was high and heat is on some of the client in the dorm
were quite silent and still our client face is quite serious. As we headed to the
BPSU student center, the place seemed to be cool because of the on and off
blowing of the wind that keeps the atmosphere relaxing and the environment
was peaceful and quiet.

As we received our client this morning, Mang G.M seemed to be
serious. But as we proceeded to the grooming station, our client facial
expressing changes he’s smiling though his eyes seemed to be different.
We’ve waited for a few minutes in the grooming station because other client,
were also using the sink. Our client just sit patiently until Mang G.M turn to
groom. But as we headed to the BPSU student center the seemed to be
serious and in the mood. But as we asked him how is he, Mang G.M replied
“mabuti” with a smile. His facial expression was not so bright as before.
Nursing-Client Conversation Therapeutic Analysis and Interpretation

Communication Based on Theories
Technique Used
SN: Magandang Umaga Po! Asking broad open-
Kamusta po kayo? ended question
C:OK naman
SN: Napapansin po naming na Direct Question Asking direct question to

mukhang malalim ang iniisip the client will merely
nyo? Ano po ba ang assess the clients
nararamdaman nyo? capability to think,
rationalize and give
answer to a specific
question.
C: Wala
SN:Wala?e ang seryoso po ng

mukha nyo.
C: Wala (laugh)
SN: Kamusta po ba ang tulog

nyo?
C: Ok naman, nakatulog
naman ng maayos.
SN: Natatandaan nyo pa po ba

kami Mang G.M?
C: Oo, Leen at Lindon
SN: Mabuti naman po at Giving recognition Giving recognition uplifts

naaalala nyo pa po kami. the self esteem of an
individual through means
of complementing and
performance thus making
him feels important and
valuable as well.
(At the BPSU student center)
SN: Mang G.M ngayon po ay Giving information It is necessary for the

magkakaroon tayo ng nurse to give and share
panibagong therapy at ang information to the client
theraphy po na ito ay ang that is relevant to her
Bibliotherapy. Ang health care and well
bibliotherapy po ay being. Therapeutic
nasasagawa po kami ng isang activities are prepared in
maikling dula-dulaan na ang order to enchance the
istorya ay hango sa bibliya. client skills, creativity, as
Ang mga karakter po ay well as cognitive ability in
ginagampanan ng mga ginawa order to facilitate the
naming puppets na makikita process.
nyo po sa loob ng ginawa
naming telebisyon. Ang Giving the procedure of
gagawin nyo lang po ay the activity is important to
manood, makinig at intindihin create a productive
ang istorya dahil po mamaya working environment.
magtatanong po kami sa
mapapanood nyo kung may
natutunan po kayong aral.
C: (client nods) Based on the theory of
Virgina Henderson,
learning is included as one
of the 14 needs of human
being and by giving
information: we are
assisting them to have
learning.
(after the explanation fo the
procedure we proceeded to
the conduct of bibliotherapy
and facilitates a grou[p
dynamics.)
(after doing the bibliotherapy,

we proceeded to our one on
one interview with the client)
SN: Ano po ang pamagat ng
dula-dulaan naming ipinalabas
kanina?
C: ah.. Noeh at ang Baha
SN: Sino po ang bida sa dula- Focusing The nurse asks goal
dulaan? directed questions to help
the client focus on a
specific area of concern
this will also help the
nurse to further
understand the topic that
is introduced to the client.
C: Si Abraham at Noeh
SN: Hindi po Mang G.M ang Seeking Clarification The nurse helps the client
bida po sa ating dula-dulaan to put unclear thoughts
ay si Noeh. Hindi po kasali sa and ideas into words, this
kwento si Abraham. will avoid understanding
that will facilitate a good
flow of conversation
between the nurse and the
client.
C: (client nods)
SN: Anong hayop naman po

ang kasama ni Noeh ng
kausapin siya ng Diyos sa
burol?
C: ah yung cornel
SN: hindi po Mang G.M hindi Seeking clarification It is necessary for the
po cornel yun. Ang hayop na nurse to
kasama ni Noeh ay camel.
SN: e san naman po galing

ang malaking baha Mang
G.M?
C: sa depmacho! (soft laugh)
SN: Depmacho? Ano po yung

ibig nyong sabihin don?
C: Doon galing ang tubig.
SN: Mang G.M sa ulan po

galling ang tubig kaya
nagkakabaha at hindi po
depmacho.
C: (client serious)
SN: Mang G.M nararanasan

nyo po bang sumakay sa
Daong?
C: Oo, nakasakay na ng
Daong ako ang nagpapaandar
ng Daong (client laugh)
SN: ah kayo po ang

nagpapaandar ng daong?pano
nyong napapaandar?
C: Dahil sa exploimaker.
SN: exploimaker?ano pong
ibig nyong sabihin Mang G.M?
C: nagpapaangat sa barko
yung exploimaker may elisi
SN:ah ganon po ba? Accepting Indicating that the nurse
has heard and is willing to
hear the client wants to
say and will facilitate the
flow of conversation as
well as verbalization of
feelings.
SN: Mang G.M, Mang G.M, Direct Question
Mang G.M Nakikinig po ba
kayo?
C: Oo (stairing his feet)
SN: Naintindihan nyo po ba

ang kwento Mang G.M?
(client is not responding)
SN: Mang G.M! Mang G.M!

Mang G.M! Ano po ba yang
hawak nyo?
C: Eto?kahoy ng dahon
SN: San nyo naman po

nakuha yan?
C: Wala hawak ko na ‘to

kanina pa!
SN: Mang G.M! Mang G.M!

Mang G.M!
(client is turnig his head left to
right and his hand is making a
fist)
C: May bumubulong sakin!

(eyeball rolling from left to
right)
SN: Bumubulong? Sino po

Mang G.M?
C: hindi ko kilala pero

tumatawa sya!
(client look irritable)
SN: Mang G.M ok lang po ba

kayo?
(client is not answering)
SN: Mang G.M gusto nyo na

po bang magpahinga?
(still the client not responding)
SN: Siguro po Mang G.M

kailangan nyo na pong
magpahinga.
(client brought back to the
dorm)
(when the client is entering the
gate of the dorm he says)
C: Madami ding akong aklat na

ganyan at kaya ko ding
magdrawing at magkulay ng
ganyan.
Content Theme
The content of our interaction with our client revolves around the
Bibliotherapy that we conducted. About what he thinks, feels and imagines as he
watched the show. What does he learned and gain from the therapy as well as
his impression about the said activity.
Mood Theme
The mood of the client seemed to be serious at first based on the latter
part, he turned more serious and unattentive whenever we asked him questions.
But he still replies “ok lang” whenever we asked him about what he feels and
accompanies with smile on his face.
Interaction Theme
During our therapeutic activities, our client participated and cooperated on

our activities even though we’ve noticed that he had some difficulties explaining
what he saw in the bibliotherapy. He also not responds to our questions during
the interview and when we asked him a question about the sotry of “Noe at
Malaking Baha” he finds it hard to answer, he thinks first and tell us his idea
about the story.
VII. Nursing Diagnosis
Impaired memory r/t Psychological disturbances as manifested by

Vll. Nursing Intervention
We should prepare therapeutic activities that will enhance the learning and
is one of the 14 fundamental needs of a human being. It is need for an individual
to grow and mature and what he has learned will help him survive in the world
outside his place at present. His learning will help him to cope up with different
processes and obstacles in life such as searching for a job. We should provide
therapeutic activities that provide step by step approach from a simple to a
complicated one that will provide an enhancement on his capabilities to analyze
things and put this into perspective. We should also provide activities that will
provide that will create a means of entertainment and enjoyment to provide
VIII. SUMMARY AND INTERPRETATION
Xl. References
Lippincott Williams and Wilkins: Handbook of Nursing
I. Personal Data
A. Name Mr. G.M

C. Age 41 years old
D. Gende Male

Hospital.
II. Objectives:

 To educate the client about the therapeutic activities and assist the
client to review the information that he had learned and transfer the
learningsto her relationship with other.
 To enhance the client skill and creativity through series of
therapeutic activities that will provide her an active mind.
 To learn and explore the client’s feelings and conditions in order

to understand his situation so as to apply the appropriate
therapeutic communication and activities for the client.
 To enhance our skills and creativity through the series of
therapeutic activities that we’ve prepared.
 To expand our knowledge in every therapeutic communications
that we’ve conducted through the theories that we use to co-
relate with our client conversation.
III. Description of Setting
A. Desribe the set-up/environment
It was sunny morning when we received our client at already 9:00am he

smiled at us even before we got our personal contact. Some client inside
the word were just staring at us while the other clients were saying
somethings which are not clear. The weather is cool even without even
the constant wind blowing across the atmosphere. The trees were
standing still and there were only few leaves falling from the trees unlike
yesterday.
Just before we received our client Mang G.M was already smiling at us
from his door. He seemed to be happy and lively than yesterday, although
we saw the same facial expression from his: a serious face like what he
used to do during our grooming care session. He automatically went to
the sink and wet his face, when we offered him a toothbrush and
toothpaste brushes his teeth without our due assistance. He used all the
stuff that we’ve offered him without any hesitancy thus we easily done our
grooming sessions. Our client seemed to be fine and happy. Based on
facialy expression and his verbalization of “Masaya” and “Mabuti” with a
smile. Though are some instances that we found our client having a blank
stare. We also notice that our client seemed to be more interested in our
prepared therapeutic activities today rather than yesterday.

SN: magandang umaga Asking broad open- The nurse should ask
po, kamusta na po kayo? ended question neutral questions that
encourage the client to
C: mabuti Asking open-ended express concerns. It is
question essential for us to know
SN: ano po ang the client’s mood,
nararamdaman nyo behavior, and feelings
ngayon? through mean of asking
broad open-ended
C: Masaya (client smiles) question in order to
understand the client
SN: ah e kamusta naman Asking broad open- conditions and be able to
po ang pagtulog nyo? ended question apply appropriate
therapeutic
C: mabuti nakatulog communication with the
naman akong maayos. client. In relation to the
theory of Peplau:
SN: ah ano naman po interpersonal theory, in
ang almusal nyo ngayon? order to come up to a
therapeutic relationship
C: champorado one of the 4 phases we
should undergo is the 1st
SN: ang sarap naman po! phase which is
orientation.
C: oo, masarap nga
SN: marunong po ba
kayong magluto nun?
C: hindi eh pero kanin

lang yon at may
kasamang shabu.
SN: po?shabu po?ano Seeking Clarification The nurse helps the

pong ibig nyong sabihin client to put unclear
Mang G.M? thoughts and ideas into
words, this will avoid
C: yung shabu nilalagay misunderstanding and
sa kanin para di ako misinterpretations that
makatulog. will facilitate a good flow
of conversationbetween
SN: gumagamit po ba the nurse and client.
kayo ng shabu Mang
G.M?
C: oo hinihithit nga namin

yun
SN: namin?may mga

kasama po kayong
gumagawa noon?
C: oo mga katrabaho ko
dati
SN: ah san nyo naman

po nakukuha yung
shabu?
C: binibili namin yun
SN: ah ganun po ba? Accepting Indicating that the nurse

has heard and is willing
SN: Mang G.M ngayon to hear what the client
po ay magkakaroon tayo wants to say and will
ng dalawang therapy. facilitate the flow of
Ang unang therapy po ay conversation.
expressive therapy. Ang
expressive therapy po ay Giving information It is necessary for the
expressive art therapy ay nurse to give and share
gagamit tayo ng papel, information to the client
posporo at pandikit. Ang that is relevant to her
gagawin nyo lang po ay health care and well
iayos ang posporo sa being. Therapeutic
kung ano po ang naiisip activities are prepared in
nyo. Pwede pong, bahay, order to enchance the
puno or tanawin. client skills, creativity, as
Mamaya po ay bibigyan well as cognitive ability in
namin kayo ng papel, order to facilitate the
pandikit at posporo. process.
Giving information
(SN:shows the actual regarding the procedure
paper) of the activity is important
Dito po ilalagay ninyo to create a productive
ang disenyo na naiisip working environment.
nyo. Based on the theory of
Virginia Henderson,
C: (client nods) learning is included as
(after the explanation of one of the 14
the procedure, we fundamental needs of
proceeded to the conduct human being and by
of expressive art therapy giving information, we are
a group dynamics.) assisting them to have
learning.
(after doing the
expressive art therapy,
we proceeded to our one
on one interview.)
The nurse help the client
SN: Mang G.M napansin Encouraging elaboration describe more fully the
po naming na ang concerns of even
ginawa nyong expressive problem under the
art ay letters or alphabet? discussion with the
Ano pong ibig sabihin ng technique, the client will
tatlong A at isang O? have the opportunity to
express more of his ideas
C: yung 3 A Art,Active, in mind without
Activity hesitancy.
SN: ano po ang ibig Seeking clarification The nurse helps the
nyong sabihin sa tatlong client to put unclear
yan Mang G.M? thoughts and ideas into
C: nakalimutan ko na eh.. misunderstanding and
misinterpretation that will
SN: eh yung O po? facilitate a good flow of
conversation between the
C: around yan at tsaka nurse and client.
yan ang butas ng mga
babae.
SN: butas? Ano pong ibig Giving information It is necessary for the
nyong sabihing butas ng nurse to share
mga babae? information to the client
that is relevant to his
C: yun “kiki” (client laugh) health care and well
being. Therapeutic
SN: ganon po ba Mang activities were planned
G.M? and prepared in order to
enhance the client’s skills
SN: group dynamics, ang Giving information creativity as well as
pangalawa po nating cognitive ability.
therapy ay ang song It is necessary for the
therapy. Lahat po ba ang nurse to give and share
marunong kumanta? information to the client
that is relevant to her
C: oo, ako sa videoke health care and well
ako kumakanta being. Therapeutic
activities prepared in
SN: yung kakantahin po order to enhance the
natin ngayon ito yung client skills, creativity, as
kakantahin natin sa well as cognitive ability in
grand socialization. order to facilitate the
process. Giving
SN: kaya po dapat information regarding the
makabisa po natin ang procedure of the activity
kanta dahil ito po yung is important to create
kakantahin natin sabay- productive working
sabay at ito na rin po ang environment.
ating huling therapy.
Dahil ito na po yung huli
nating pagsasama. Pero
magkikita pa rin po tayo
sa isang linggo. Sa
January na po ulit yung
susunod na mga bagong
student nurses.
(at the BPSU student

center ground)
the procedure and
explain to the client the
termination phase are
of song therapy and
facilities a group
dynamics)
(after doing the song
with our client while there
are eating)
Verbalized what the
SN: napansin po naming Making observation nurse sees on the client
na ang seryoso nyo appearance and
kanina habang behaviors as well as
sumasayaw. actions. This will provide
an access to the nurse in
C: di ko kasi alam yung assessing the client
kanta. moods, thoughts and
feelings through non
SN: pero po verbal cues.
nakakasunod kayo sa
step di po ba?
C: oo pero nahihirapan
ako e.
SN: wala po ba kayong

naaalala kapag
kumakanta kayo?
C: ang mag-videoke
SN: nag-enjoy po ba
kayo Mang G.M
C: oo masaya.
V. Theme identification
Content Theme
interaction revolves the outcome of our therapeutic activities (expressive art and
song therapy) on what they’ve learned from it, on what ideas they can share
regarding the topic and what they feel after doing the therapeutic activities.
Mood Theme
When we received our client, his mood appears to be happy and peaceful
as well as during the whole process of therapeutic activities as manifested by his
bright and sometimes a serious expressions and verbalization of his feelings
“Masaya” he claimed with a smile. We’ve also noticed that during our song
therapy, his facial expression turned a bit serious like he’s definitely
concentrating on his every moves while singing during the song therapy.
Interaction Theme
Our client participated and cooperated well during the entire therapeutic
activities we’ve prepared. Even though we’ve noticed that he had some
difficulties following the flow of the song but still he tried to reach out and follow
the step the whole practice. He also respond to our question during the interview
and when we asked him a question he think first tell something which is not
related to the question.

VII. Nursing Intervention
We should prepare therapeutic activities that will enhance the leaving

and cognitive ability of the client. Base on the theory of Virginia Henderson:
Learning is one of the 14 fundamentals need of human being. It is a need for an
individual to grow and mature and what he has learned will help him survive in
the world outside his place at present. His learning will help him to cope up with
different processes and obstacles in life such as searching for a job. We should
provide therapeutic activities that provide a step by step approach from a simple
to a complicated one that will provide an enhancement on his capabilities to
analyze things and put this into perspective. We should also provide activities
that will provide that create means of entertainment and enjoyment to provide
VIII. Summary and Interpretation
During the whole interaction, our client participate and cooperates well to
our prepared therapeutic activities. He tried to compensate on our song activity
by trying to follow the steps of the song although he finds some difficulties in
following the song. He still participates on the practice as well as responds to our
questions during the conversation. During our expressive art therapy, even
though he had some difficulties doing the art, we’ve noticed her determination to
continue and watched closely as we demonstrates him how to do the art. All in
all, he showed interest on our therapeutic activities.
References:
Lipponcott Williams and Wilkins: Handbook of Nursing
I. Personal Data
A. Name Mr. G.M

C. Age 41 years old
D. Gender Male

Hospital.
II. Objectives:

series of therapeutic activities that we’re prepared in order to
uplift and improved their social wellness and well being.
 To educate the client about the therapeutic activities and assist
the client to review the information that he had learned and
transfer the learningsto her relationship with other.
 To enhance the client skill and creativity through series of
therapeutic activities that will provide her an active mind.
 To learn and explore the client’s feelings and conditions in order

to understand his situation so as to apply the appropriate
therapeutic communication and activities for the client.
 To enhance our skills and creativity through the series of
therapeutic activities that we’ve prepared.
 To expand our knowledge in every therapeutic communications
that we’ve conducted through the theories that we use to co-
relate with our client conversation.
III. Description of settings
A. Describe the environment:

It was sunny morning when we received our client at already 9:30am he
smiled at us even before we got our personal contact. Some client inside
the word were just staring at us while the other clients were saying
somethings which are not clear. The weather is cool even without even
the constant wind blowing across the atmosphere. The trees were
standing still and there were only few leaves falling from the trees.
B. Describe the nature, behavior, affect and mood of the client:

During the conversation the facial expression was normally serious
and often stares at his feet but as we go on the conversation the he would
respond and start making eye contact. And would occasionally smile
when answering our questions.
Nurses – client Therapeutic Analysis and

Conversation communication interpretation based on
Technique used theories
SN: Magandang umaga Asking open – ended The nurse should ask
po Mang G.M. kamusta question neutral question that
po ang tulog nyo? encourage the client to
C: ok naman ako at essential for us to know
maayos ang tulog ko. the client’s mood,
behavior, and feelings
SN: mabuti naman po through means of asking
kung ganun Mang G.M. questions in order to
Nakapag almusal po ba understand the client
kayo? conditions and be able to
apply appropriate
C: oo, sardinas nga ang therapeutic
almusal naming ngayon. communication with the
client.
SN: nabusog naman po
ba kayo Mang G.M?
C: ( clients nodes)
SN: Mang G.M. naaalala Direct question

nyo pa po ba yung
kantang pinag aralan
natin nung nakaraang
linggo?
C:oo, yung star ng pasko!
SN: ang galing nyo Giving recognition

naman po at naaalala
nyo pa po yung tinuro
namin senyo. Ngayon po
kasi natin kakantahin
yung tinuro namin senyo.
C: (client smile)
SN: Mang G.M. ngayon Giving information Giving information

na po ang huling araw na regarding the procedure
magkikita tayo. Diba po of the activity is important
nung isang linggo sinabi to create a productive
na po namin senyo na sa working environment.
susunod na linggo ang Based on the theory of
huling pagkikita natin.? Virginia Henderson,
learning is included as
C: oo, naaalala ko pa one of the 14
yun. fundamental needs of
human being and by
SN: ngayon po ay Giving information giving information, we are
magkakaroon tayo ng assisting them to have
grand socialization. Kung learning.
saan po magkakaroon
tayo ng maliit na
programa. At kainan mga
palaro Bilang
pasasalamat. Kaya dapat
Mang G.M. sasali po
kayo sa mga palarung
inihanda po namin.
C: (client nodes)

the procedure and
explain to the client the
termination phase, we
proceed to the conduct of
grand socialization)
(while in the middle of the

ceremony)
( the speaker called
Mang G.M name to
participate in the game.)
SN: Mang G.M.

tinatawag po ang
pangalan nyo. Pinapasali
po kayo sa laro.
C: ayoko maglaro.
SN: ano po ba ang

dahilan kung bakit ayaw Asking broad open – The nurse should ask
nyo maglaro? ended question neutral question that
encourage the client to
C: alam ko na lahat nag express concerns. It is
larong yan! Nalaro mo na essential for us to know
lahat yan! the client’s mood,
behavior, and feelings
SN: hindi nyo po ba through means of asking
nagustuhan ang larong questions in order to
sinasagawa ngaun? understand the client
conditions and be able to
C: alam ko na kasing apply appropriate
lahat yan. Dati kasi therapeutic
sumasali ako sa larong communication with the
pambasa. client.
SN; ano pong ibig nyong Seeking clarrification The nurse helps the
sabihin sa larong client to put unclear
pambansa? thoughts and ideas into
C: mga laro misunderstanding and
yun..madaming laro at misinterpretation that will
ako ang champion sa facilitate a good flow of
lahat ng laro sa palarong conversation between the
pambansa.( client laugh) nurse and client.
SN: marami na pala

kayong nalarong mga
laro..ayaw nyo po ba
talagang maglaro?
Tignan nyo sila ang saya
nila at halos nakikilaro
din sila sa mga palarong
hinanda namin.
C: ayokong maglaro. May

nakaitim na nakatingin
sakin kaya ayoko
maglaro.
SN: naka itim? Wala

pong naka itim dito Mang
G.M. lahat po kami ay
nakaputing damit.
C: hindi may nakaitim at

tinitignan nya ko.
SN: wala pong nakaitim.
C: ayun sya sa gilid at

tinitignan nya ko.kaya
ayokong maglaro.
SN: Mang G.M hindi po Confronting Giving a realistic

yon tao. Trash bag po explanation of what the
yon. Lalagyan ng basura. client sees or hears
without arguing with the
C: (staring his feet) client
SN: Mang G.M. ayaw nyo

po ba talagang sumali sa
laro.? Tignan nyo oh, ang
saya saya nila.
C: ayoko.
SN: ano po ba ang
nararamdaman nyo?
Pagod na po ba kayo?
C: ok lng ako (Client

smile)
SN: pag katapos po ng

mga laro. Kakantahin na
po natin yung kantang
tinuro namin sa inyo
nung nakaraang linggo.
(after the song was

conducted)
SN: galing nyo po kanina Giving recognition

kumanta. Napapa indak
pa po kayo Mang G.M.
C: maganda kasi yung

kanta.
SN: mabuti naman po at

nagustuhan nyo. Eto nga
po pala ang pagkaen nyo
Mang G.M.
SN: Mang G.M naaalala summarizing The nurse summarizes a

nyo pa po ba kung ano given activity or
po ang ginawa natin intervention by reviewing
ngayong araw? the main point discussion
and making appropriate
C: nanood ako ng mga conclusion. With this, we
naglalaro at kumantat’ can gather all the
sumayaw.kasama ang activities rendered into a
mga SN. simple thought that will
provide the client an
SN: ano po ang understanding of what
nararamdaman nyo na activities has been done.
ngayon ang ang huling
pag kikita ntin?
C: malungkot, kasi wala

ng SN. Pero sabi nyo
naman may mga papalit
senyong SN sa January.
Hihintayin ko na lang sila.
V. Theme identification
Content Theme
interaction revolves the outcome of our termination phase (grand socialization)
on what they’ve learned from on our previous therapies, on what ideas they can
share regarding the topics and what they feel after doing the grand socialization.
Mood theme
During the conversation our client was serious and has no facial
expression, he would only answer our question and when asked how he feel he
only said “ok lang” but as our conversation lengthen he would occasionally smile
at us while talking.
Interaction Theme
During our Grand socialization, our client participated and cooperated on

our song number even though we’ve noticed that he had some difficulties in
following the steps. But our client is not participate in our games.
VI. Nursing diagnosis
Knowledge deficit r/t cognitive limitation as manifested by inaccurate follow

through of instruction.
VII. Nursing Interventions
We should prepare therapeutic activities that will enhance the leaving

and cognitive ability of the client. Base on the theory of Virginia Henderson:
Learning is one of the 14 fundamentals need of human being. It is a need for an
individual to grow and mature and what he has learned will help him survive in
the world outside his place at present. His learning will help him to cope up with
different processes and obstacles in life such as searching for a job. We should
provide therapeutic activities that provide a step by step approach from a simple
to a complicated one that will provide an enhancement on his capabilities to
analyze things and put this into perspective. We should also provide activities
that will provide that create means of entertainment and enjoyment to provide
VIII. Summary and Evaluation

XI. References:
Lippicott Williams & wilkins: handbook of nursing
Mental
Status
Assessment
ORIENTATION
DAY 1 2 3 4 5 6 7 8 9 10 11 12
Self - Awareness
Person / / / / / /
Orientation
Place / / / X / /
Holiday
Holiday
School
School
Date / / / X / x
Time / / / / / /
Situation X X X X X x
ANALYSIS AND INTERPRETATION
Day 1: ORIENTATION
Day2: SELF-AWARENESS
Day3: It was day 3 when we had our first conversation with our client. The conversation
with Mr. G.M. includes the collection of the names of the members of the family,
answers where he is, what the date was, what kind of weather that day have,
which he was able to answer all of it correctly. But when he asked what he is
doing to MMH the client said that he was working. One of the roles of the nurse
according to Hildegard E. Peplau was the “role of the stranger”. As a stranger to
the client the nurse must treat the client with courtesy and should not be prejudice
and accept the client as a “person”.
Day4: During the conversation with Mr. G.M. he was able to tell us the name of his
father, children and also was able to recall our names. He also knew that he was
residing at Mariveles Mental Ward but he thought that he was there for work.
When asked, Mr. G.M. was able to tell us that today was Nov. 15, 2010 and was
able to describe the environment and time.
Day5: Mr. G.M. was oriented to person, he was able to remember our names and the
names of his student nurse in the morning shift. He was able to tell us the current
date as well as describe the afternoon environment. When ask he knew that he
was at Mariveles Mental Hospital but was not aware that he was there because of
mental illness instead he thought he was there for work.
Day6: HOLIDAY
Day7: upon interaction our client Mr. G.m. was able to recall and identify us, his student
nurses. He was able to describe the day saying “ maaraw, pero hindi naman
mainit” when he was asked to described it. He told us that he didn’t know the date
today so we’ve told him the date and asked him repeat it. When asked if he knew
where he was, Mr. G.M. said he was in his hometown atD.I.P., and even after
we’ve made an attempt to correct him he insisted that he was in D.I.P.
Day8: During the interaction with the client, Mr. G.M. was able to remember us his
student nurses, was able to tell us the date and was able to describe the time by
saying “mainit ngayon, ma araw…” And when asked where he was, he said
“Mariveles Hospital” but according ti him it’s a hospital that treats’ injured
soldier.
Day9: SCHOOL
Day10: HOLIDAY
Day11: Mr. G.M. was not oriented to date and said that he’s at MMH because of
his work as a soldier.
Day12: SCHOOL
DEFENSE MECHANISMS
DAY 1 2 3 4 5 6 7 8 9 10 11 12
Repression X X / X X X
Suppression X X X X X X
Regression X X X X X X
Fixation X X X X X X
Denial / / X X / /
Displacement X X X X X X
Conversion Self – Awareness X X X X X X
Identification X X X X X X
Orientation
Intellectualization X X X X X X
Holiday
Holiday
School
School
Introjections X X X X X X
Projection X X X X X X
Rationalization X X X X X X
Sublimation X X X X X X
Substitution X X X X X X
Symbolism X X X X X X
Undoing X X X X X X
Reaction
X X X X X X
Formation
Fantasy / / / / / X
Day 1: ORIENTATION
Day3: During our conversation with Mr. G.M. that day he said that he was in “MMH”
because he is currently working as a ”military spy”, (“informatiko ako”) and that
his fellow clients NPA’s providing that our client is still in the state of denial.
Fantasy: during the course of our conversation, our client mentioned that he had
met well-known personalities including; Kris Aquino, Rosa Rosal, and Carina
Sanchezand have had sexual intercourse with them.

According to Hildegard E. Peplau’s four psychobiological experience which
includes; 1. Needs; 2. Frustrations; 3. Wants; 4. An anxiety, these experiences are
somehow transformed into some form of action that leads to destructive responses
from patients.
Day4: during the interaction with Mr. G.M. we’ve noticed that repression is present
whenever Mr. G.M. was asked where and when he study at school he would say
that he can’t recall it. Also Mr. G.M. manifest denial about his situation, he said
he was at MMH for work and would also manifest fantasizing that he met and had
sexual intercourse with well-known personalities such as Corina Sanchez.
Day5: Denial: during the conversation Mr. G.M> said that he was at MMH only because
he was working. Even though he knew it was a hospital but a hospital for persons
with liver problems, he insisted that he was there for military works despite our
questions of what might he be doing at a hospital.
Fantasy: Mr. G.M. said that he owned the “earth globe” and that he had traveled
and studied at different countries of the world.
Day6: HOLIDAY
Day7: during the conversation the patient was telling us that he had been there when the
Noah’s ark was built and when the great storm passed he said that he experienced
it with Noah.
Day8: Mr. G.M said that the reason he was at MMH was only because it’s a hospital for
injured soldier like him. During the conversation Mr. G.M said that his mother,
Mrs. R.M was actually his first wife and that it’s a saint that uses “agimat” to fly.
Day9: SCHOOL
Day10: HOLIDAY
Day11: Mr. G. M said that he was at MMH because he’s working there as a
military spy.
Day12: SCHOOL
EXTRAPYRAMIDAL SYMPTOM
DAY 1 2 3 4 5 6 7 8 9 10 11 12
Pseudoparkinsonism
1. Mask-like Face X X X X X X
2. No Swining of
X X X X X
Arms X
3. Hesitancy of
X X X X X X
Speech
4. Decrease Muscle
/ / / X X X
Strenght
5. Shuffling Gait X X X X X X
6. Drooling X X X X X X
7. Fine Intention
X X X X X X
Tremors
Acute Dystonic
Reaction
Self - Awareness
1. Muscle spasm of
Orientation
Holiday
jaw,tongue, neck, X X X
Holiday
X X X
School
School
eyes.
2. Laryngeal Spasm X X X X X X
Akathisia X
1. Restlessness X X X X X X
2. Tenseness X X X X X X
3. Inability to Sit Still X X X X X X
4. Rocking back and
X X X X X X
forth on feet
5. Crossing Leg
X X X X X X
Frequently
6. Inability to Relax X X X X X X
Tardive Dyskinesia
1. Involuntary
movements of mouth,
tongue, face, may X X X X X X
extend to fingers,
arms and trunk.
Day 1: ORIENTATION
Day3: during our interaction with Mr. G.M., we’ve noticed that he’s weak in appearance
and when asked what activities he normally does, he said that he just usually sit in
one corner of the ward and look at the other client the whole day because
according to him he is “observing” them. The lack of activities may also be the
reason for the decrease muscle strength.
According to Faye Glenn Abdellah’s 21 nursing problem, To promote optimal
activity, exercise and sleep that should exist in a balance is one of the needs the
client should meet in assistance by a nurse.
Day4: for extrapyramidal symptoms we only noticed that our client Mr. G.M. is weak in
appearance and walks and moves slowly. And when asked what activity he
normally does for a day to day basis Mr. G.M. said that he spend his days sitting
in the corner of the ward and observing other client there.
Day5: During the day’s activity we’ve noticed that Mr. G.M. was not smiling and when
asked Mr. G.M. said that he was tired from the previous activity even though
we’ve just started our therapy. During the previous encounter Mr. G.M. told us
that only sit in the corner of the ward everyday and would only walk whenever
there’s activity/ therapy.
According to Abdellah’s 21 Nursing problem, promotion of optimal activity,
exercise and sleep should be in equilibrium and must be met by nurse’ assistance.
Day6: HOLIDAY
Day7: none of the above extrapyramidal symptoms were manifested by our client.
Day8: None of the above extrapyramidal symptoms was manifested by our client.
Day9: SCHOOL
Day10: HOLIDAY
Day11: None of the above extrapyramidal symptoms was manifested by our
client.
Day12: SCHOOL
THINKING AND COMMUNICATION
DAY 1 2 3 4 5 6 7 8 9 10 11 12
Looseness of
Association
1. Neologism X / X / / X
2. Word
X / / / / /
Salad
3. Echolalia X X X X X X
4. Echopraxia X X X X X X
5. Clang
Self - Awareness
Associatio X X X X X X
Orientation
Holiday
Holiday
School
School
6. Illogical
X X X / / /
thinking
Alogia X X X X X X
Concrete
X X X X X X
Thinking
Lack of
X X X / X X
Insight
Aphasia X X X X X X
Apraxia X X X X X X
Agnosia X X X X X X
Flight of
X X X / / /
Ideas
Day 1: ORIENTATION
Day3: none of the above communication and thinking above had been manifested by our
client.
Day4: During the second day of interaction with our client the topic of our conversation
revolves around the therapies we’ve facilitate today. While we were discussing
the story in the comics we’ve ask Mr. G.M. some questions including what course
did he take school and Mr. G.M. answered “spanlile” and when we proceed to
clarify the meaning the word our client said “ anu yun… lotus… in the water…
dun sa creek”. Aside from neologism, the conversation reveals that Mr. G.M.
sometimes got words mix and even after analyzing it… it held no meaning or
nonsense at all.
Day5: during the conversation with Mr. G.M. he would say words or phrases that do not
make any sense, considering our conversation. He manifested verbalization of
word salads when the topic of the conversation goes to his father and his job.
Day6: HOLIDAY
Day7: during the conversation the client verbalized a few neologisms while answering
our questions some of those are: “Lebroy”-super intendent; “demacho”-“yung
source ng tubig”, “cornel”-yung isang klase ng camel. Marami yan iba-iba”;
“exploimaker”-“nagpapaangat ng barko”.
While we are trying to discuss the story of Noah’s ark Mr. G.M. would mention
quite a few words that does not make sense at all. He would sometimes answer us
with his own story and would try to evade our questions by changing the topic of
our conversation. He would introduce other character such as Adam and Eve as
well as Abraham and at the end he seemed to be confused, and would refuse to
answer at all.
Day8: During the conversation with our client he mentioned “lorten” and when asked
what that means he said “yung samit sa paggawa ng bahay” The client says
something that we didn’t understand and some ideas are not related to the topic
being discussed. And he would also bring a lot of topics different from our
current conversation. While we were talking about his finished product in
expressive arts he suddenly said that his mother was a saint, and that he had many
wives.
Day9: SCHOOL
Day10: HOLIDAY
Day11: During the conversation when we are trying to go back to all the
activities and therapies that we’ve done and ask our client to tell us what he could
remember he would answer us with words that does not makes any sense and
some ideas that was not related to the topic.
Day12: SCHOOL
PERCEIVING AND INTERPRETING
DAY 1 2 3 4 5 6 7 8 9 10 11 12
Delusions
1. Reference X X X X X X
2. Persecution X X X X X X
Self - Awareness
3. External
X X X X X X
Orientation
Influence
Holiday
Holiday
School
School
4. Somatic X X X X X X
5. Grandiose / / / / / /
Hallucinations / / / / X X
Illusions / / X X X /
Attending to
X X X / X X
irrelevant Stimuli
Poor Reality testing X X / / / /
Day 1: ORIENTATION
Day3: Grandiose: Mr. G.M. said that he is the president of the Philippine Island and that
he bought and owned it. He also claimed that he is Jose P. Rizal and George W.
Bush when he was younger.
Hallucinations: during the conversation Mr. G.M. said that there is an
underground in the MMH and that his son and daughter is training there to be a
military personnel.
According to Hildegard E. Peplau’s nursing Role as the “resource person” the
nurse should provide specific answer to questions that that arises from the context
of a large problems and determines what response is appropriate for the sake of
learning and orienting either giving straight forward factual answer or providing
counselling.
According to Merie Mishel uncertainty is the inability to determine illness related
events that occurs when the client is unable to assign definite value to events,
objects and persons.
Day4: delusion of grandiose is evidently present during our conversation with Mr. G.M.
He said that he had been to different countries including Tokyo, Japan; United
States of America; Malaysia and that he’s the president of the Philippines as well
as its owner. Hallucination was still present; Mr. G.M. mentioned the existence of
the underground in MMH where his children kept today as well. As for Illusions,
today he mentioned that his children ( Steeve and Jelly) turned to a kid after
taking the tablets that could turn a man to a child, according to him it was the
same tablet that was given to him in MMH.
Day5: Grandoise. According to Mr. G.M. he have had dramatic affairs with Rosa Rosal
and Kris Aquino and they both bear his child.
Hallucination. During the conversation with Mr. G.M. yet again mentioned the
underground that exist in the MMH despite our correction on our part. According
to Hildegard Peplau’s Nursing Role, the nurse can assume the role of the
“resource person” the nurse provides the specific answer to questions that arises
from the context of a larger problem and determine what response is appropriate
for the sake of learning.
Illusion: according to Mr. G.M. there is a tablet that was given to his children, the
same tablet that was given to him by a person in a white dress, when asked if he
knew the person he said he didn’t, we presume that the tablets are his medicine
and that the person in white is either a doctor or a nurse.

Day6: HOLIDAY
Day7: During the conversation Mr. G.M. claimed that he owned the whole Philippines
he said he bought it, but when asked from who, or when he said he already forgot
it.
Hallucinations: at the later part of our interaction with Mr. G.M. suddenly whisper
something to his right side, and when we asked him who he was talking to he said
he could hear voices laughing at him.
Attending to different stimuli. While we were discussing the story Mr. G.M.
would sometimes refuse to answer and would simply sit there and play with the
piece of twigs in hi hands. We’ve tried to gain his attention and interest but to not
avail.
Poor reality testing. Mr. G.M. said that; he could hear voices; that he experienced
Noah’s ark and the great storm when it happened and that he own the Philippines,
Day8: while we were in the middle of our conversation about the client’s house in
Olongapo, he suddenly said that he was the owner of the whole city and the
president of the Philippines because he said the people there likes him and thus
voted him for the position.
Day9: SCHOOL
Day10: HOLIDAY
Day11: during the grand socialization day when our client was asked to participate
in games he said “ayaw ko” and when asked for the reason, he first said that he
didn’t need to participate because he’s the champion of ‘Palarong Pambansa’.

And when asked again he said that there were people in black standing at the ruin
building and watching him so he didn’t want to play.
Day12: SCHOOL
FEELING AND AFFECT
DAY 1 2 3 4 5 6 7 8 9 10 11 12
AwarenessSelf -
Flat X X X X X X
Orientation
Blunted X X X X X X
Holiday
Holiday
School
School
Inappropriate / X X X X /
Lability X / X X X X
Day 1: ORIENTATION
Day3: During the conversation with Mr. G.M. we observed that he had inappropriate
feelings while saying that his wife Lianne was sexually abused by many men. Mr.
G.M. was smiling while he was narrating that to us.
Day4: during the conversation Mr. G.M. was serious. He does not smile even after
we’ve greeted him “magandang hapon po” he would simply reply “ ayus lang”.
During the therapy he also assumed a serious mood. But as we go on our
conversation when we we’re discussing the picture he picked in photo therapy
Mr. G.M. suddenly change his mood, he would smile and laugh when the topic
goes on how he could differentiate a woman from a chicken.
Day5: none of the above feeling and affect was manifested by our client.
Day6: HOLIDAY
Day8: The feeling and affect is normal and congruent.
Day9: SCHOOL
Day10: HOLIDAY
Day11: During the interaction when Mr. G.M was asked how he feels he said
“Masaya” without smiling and keeping a serious expression. The clients feeling
and affect is incongruent.
Day12: SCHOOL
BEHAVING AND INTERACTING
DAY 1 2 3 4 5 6 7 8 9 10 11 12
Withdrawal X X X X X X
Motor
X X X X X X
Hyperactivity
Motor
Self – Awareness
X X X X X X
Hypoactivity
Orientation
Holiday
Holiday
School
School
Ambivalence X X X X X X
Anhedonia X X X X X X
Abolition X X X X X X
Poor Personal
X X X X X X
Hygiene
Impulsive X X X X X X
Paranoia X X X X / /
Day 1: ORIENTATION
Day3: none of the above characteristics was manifested by our client.
Day4: During the conversation with Mr. G.M. he said that he ha no friends and never
talk to his fellow client. As for motor hypoactivity, we’ve observed that Mr. G.M.
moves slowly, always sit still and are weak in appearance. Paranoia as previously
explained he thinks that his entire fellow clients are his enemy that’s why he
never talks to them.
Day6: HOLIDAY
Day8: During the interaction today, our client seemed restless and when we asked, he
said he didn’t sleep well last night. When we asked for the reason he said it’s
because of the food that he ate. When we asked him to elaborate it, he said
someone might have slipped some ‘shabu’ in his food because he couldn’t sleep
at all.
Day9: SCHOOL
Day10: HOLIDAY
Day11: Our client refuse to participate in games because he said there was people
watching his moves.
Day12: SCHOOL
NEGATIVE COGNITION
DAY 1 2 3 4 5 6 7 8 9 10 11 12
Overgeneralization X X X X X X
Self - Awareness
All-or-Nothing
X X X X X X
Orientation
Thinking
Holiday
Holiday
School
School
Should Statements X X X X X X
Labeling X X X X X X
Mind Reading X X X X X X
Fortune Telling X X X X X X
Day 1: ORIENTATION
Day3: none of the above negative conditions are manifested by our client.
Day6: HOLIDAY
Day8: Our client didn’t display any manifestation under negative cognition skills.
Day9: SCHOOL
Day10: HOLIDAY
Day11: No manifestation seen on the client.
Day12: SCHOOL
OTHERS
DAY 1 2 3 4 5 6 7 8 9 10 11 12
Amnesia X X X X X X
Fugue X X X X X X
Depersonalization X X X X X X
Phobias X X X X X X
Self – Awareness
Memory
Orientation
Holiday
Holiday
School
School
1. Remote / / / / / /
2. Recent / X / / / /
3. Recent part / X / / / /
4. Immediate
/ X / / / /
memory
5. Immediate
/ X / / / /
recall
Day 1: ORIENTATION
Day3: during the later part of our conversation, Mr. G.M. was able to recall for us, the
memories of his life and many other memories of recent duration.
Day4: Mr. G.M. was able to tell us what he was doing last week, what his last meal was,
his previous activity/therapy with the morning shift, was able to summarize the
comic therapy but was not able to recall in details his childhood memory.
Day5: Mr. G.M. was able to answer questions that would determine his ability to
remember. During the conversation Mr. G.M. was able to tell us his morning
activity with the morning shift. He was able to tell us what his last meal was and
what it tastes like as well as the previous activity we’ve had. When Mr. G.M. was
asked about things regarding his past, such as his previous task/jobs he was able
to tell it to us but can’t remember the exact date.
Day6: HOLIDAY
Day7: during our conversation with our client he was able to recall his last meal, the
name of his new student nurse and answer our other question.
Day8: During the interaction the client was able to tell us and describe the taste of his
last meal, as well as to recall our recent activities and conversations.
Day9: SCHOOL
Day10: HOLIDAY
Day11: The client had difficulty recalling some of our activities in the past 4
weeks but he managed to recall the few he’d missed with our help.
Day12: SCHOOL
Psycho
therapy
COMIC READING THERAPY
DEFINITION
Comic reading therapy helps the client to assess how their reading skills work in terms of
reading a comic. How they relate scripted words in their everyday life, this is used to test
how they can read comprehensively and make their mind work.
GOALS
1. To let the client understand and verbalize words.
2. To develop their comprehensive ability.
3. To promote thorough process.
4. To understand the level of ability in terms of reading.
PROCEDURES
1. The facilitator orients the client about the therapy and how it should be done.
2. The client allows reading.
3. After reading, they were asked a few questions about the content by their student
nurse.
4. All the clients were asking to state their thought regarding the therapy.
ANALYSIS & INTERPRETATION
Once were started the therapy, our client started reading it silently for several
min. After reading it for 20 min., he said that he’s finished so we’ve proceed with
discussing the story of the comic “tesang tsismosa”. When we asked our client what are
the parts of the story that he could remember, he hesitantly said he can’t remember it. He
was only able to tell us the Title and the lead character “tesa”. So we took the comics
from him and retell the story for him. All in all Mr. G.M participated in the therapy
without any complaints though he has difficulties remembering the whole story, he was
able to tell us what he has learned from it. But when asked to relate it to his life or if there
is a similar story or situation that has happened to him, he simply said that he didn’t know
and stays silent. He would smile occasionally to us when he didn’t know the answer to
our question.
We relate Mr.G.M’s passive behaviors and answer to his state of denial to his situation.
PHOTO LANGUAGE THERAPY
DEFINITION
Photo Language Therapy helps the client to verbalized and state the level of their
thinking by formulating an idea on the photos they picked, this is used to test thinking
skills of the client and make their mind work.
GOALS
1. To let the client to verbalized his/her insights, thoughts and feelings about the
picture.
2. To develop client’s cooperation.
3. To promote thought process and verbalization of the client.
4. To let the client participate and socialize in a group discussion.
PROCEDURE
1. The facilitator orients the clients about the therapy and give instructors.
2. The client was asking to pick two photos they like.
3. After a minute of looking of the photos, they were asked to speak out the idea
they made about the photo and asked why did they picked that pictures
4. All the clients were asking to state their thought regarding the photos.
Once we have started the therapy, we noticed that MR. G.M had high enthusiasm
on choosing an image for the therapy. He took some time choosing the two pictures and
seemed hesitant to let go of the third photo he’s having difficulty choosing from. He had
decided to the picture of a chicken and a woman. He said that he used to keep a lot of
chicken ion his former house. He said he keep them for the eggs and their meat. And the
other picture reminds him of his wife. When the topic became his wife we’ve noticed that
our client became uncomfortable and when asked he simply said he’s fine. When asked
what other things he remember he said he cant remember it anymore, and started saying
word salads. We’ve also encourage him to compare the pictures for their similarities and
differences. He was able to give us correct answers, so we’ve proceed with summarizing
the conversation.
PLAY THERAPY
DEFINITION
Play therapy refers to social recreation activity that requires strategies & physical
strength. There 2 kinds of play therapy, first is the indoor games, which are played inside
the house example of this are snake & ladders, chess, damath, etc. ; the other one is
outdoor games, this are played outside the house examples are basketball, volleyball,
badminton & etc.
This therapy is used to help to interact & for socialization purposes and, to
encourage them to be competitive in any type of game. It is a tool to encourage client to
have their exercise them forget their boredom.
GOALS
1. To help the client to socialize & other people.
2. To help the client to be competitive & to trust their planned strategies.
3. To encourage their client to conceptualized ideas on how to win.
4. To give client new information outside the hospital.
PROCEDURE
1. The facilitator commences the assigned activity of that day, explaining its nature,
description and how it will be done.
2. Prepare the necessary equipment needed for indoor games (chess, cards,snakes, &
ladders, puzzles) outdoor (Badminton, Basketball, Volleyball).
3. Stretching
4. Game process
5. Summarization and discussion of therapy.

At the beginning of the therapy our client’s mood was serious, but it lightens a
little when we start with the games and stretching, though he only seldom smiles. We
first star the outdoor game “pass ball” we participated at firs and joined the circle, but as
the games goes on we’ve made it so that the client are the only one’s playing. After
several minutes the playing goes down to three, including our client so we declared them
all winners. Our client said the game tires him so he refuses to play badminton when
offered, but participated in the indoor games and willingly plays the card. We’ve played
it 3 times. And he seemed to be happy winning the games. He smiled a lot. After the
games we’ve had a brief discussion of the therapy Mr.G.M said he like the games and
that he enjoyed it.
BIBLIO THERAPY
DEFINITION
It cultivates & enhances the client’s memory capacities as well as reasoning & learning
ability in recalling the title. The character & the values regarding the story play which is
based from the Bible. It also served as a means of instruments in recognizing good
manners & values since the story was based from the bible.
GOALS
1. To enhance the client’s intellectual & memory capacity in recalling the important facts &
details to the therapeutic activities and retain this to his mind in order to use it for
future goals.
2. To provide a means of the entertainment & enjoyment in order to provide a lively &
active working environment to the client.
3. To enhance the client thought about good manners & values and be able to apply it to
his relationship with others.
4. To assess the client feelings and thoughts regarding his view about the story and its
relationship to her experiences in life in order to explore the feelings of the client even
more.
5. To enhance the clients understanding & reminding regarding the thought of the topic &
be able to express the opinion.
PROCEDURE
1. Prepare all the necessary equipment/ materials.
2. Make a television image the put curtains around it.
3. Present the improvised television together with the puppets handled by the student
nurses behind the blanket.

4. Allow the clients to watch the whole play & ask them if they recall the important details
regarding the story on a group dynamics as wells as one on one interview with the
client.
Our client seemed to be attentive. During the play he was quiet and was looking at
the stage with serious expressions. During the discussion our conversation centered at
the parts of the story that he could remember. But when asked Mr.G.M have
difficulty answering us. He can’t even remember the title of the play. He would try to
avoid the questions by saying irrelevant things and by introducing new topic. But
when we refocus the conversation, he would no longer answer and stays silent. We
tried to reestablish the conversation by starting in a lighter topic, but to no avail. At
the end of the therapy we noticed that Mr.G.M’s mood change, he seemed to be
angry, and started talking to himself. And when asked he claimed that he could hear
voices that are laughing at him. After clearing to him that we’re the only person there
and no one else is, we’ve decide to return him to the ward to rest.
PUZZLE THERAPY
DEFINITION
A puzzle is a problem or enigma that tests the ingenuity of the solver. Puzzle
therapy is purposely to evaluate the client’s cognitive and problem-solving ability. Puzzle
was created to advance development this instilling aptness on the part of the client.
GOALS
1. To access the client’s memory, cognition and problem-solving ability.
2. To augment their thinking abilities and independence.
3. To imbibe self-esteem and fulfillment on the client.
PROCEDURE
1. The facilitator commences the assigned activity of that day, explaining its nature,
description and how it will be done.
2. Give the necessary materials for the activity, 2 simple and 2 complex puzzles.
3. Let the client choose 1 simple and 1 complex.
4. Start with the simple puzzle. Give sufficient amount of time for the client to scan and
see what the puzzle look like.
5. Record the duration of the first puzzle building.
6. Present the next puzzle, the complex. Again, give sufficient amount of time for the client
to scan and see what the puzzle look like.
7. Record the duration of the second puzzle building.
8. Evaluate the outcomes of the activity with the client.

We primed two pictures of simple and puzzle and one picture of a complex puzzle. Mang
G.M selected the tree, As a simple puzzle. First, we give the simple puzzle which is
composed of six pieces. He was able to form the simple puzzle at one minute and ten
seconds. Then we give the complex puzzel which is composed of 12 pieces, a picture of
a mountain and river. He was able to form the complex puzzle at 4 minutes and 50
seconds. Evidently, Mang G.M. took longer time in forming the complex puzzle. he had a
hard time in distinguishing the picture he was forming. Verbalized that he find it difficult
in forming the complex puzzle. Mang G.M. initial reaction after finishing the two puzzle
is a smile of fulfillment.
EXPRESSIVE ARTS THERAPY
DEFINITION
Expressive arts therapy is the use of the creative arts as a form of therapy. It is predicted
on the assumption that a client can heal through use of imagination and the various forms
of creative expression. It is also about reclaiming innate capacity as human beings for
creative expression of an individual and collective human experience its artistic form.
GOALS
1. To express his ideas and feelings.
2. To lessen the anxiety felt by the client in terms of entertainment.
3. To help the client to express his thoughts.
4. To assess the clients working attitudes.
5. To assess clients creativeness.
PROCEDURE
1. The facilitator commences the assigned activity of the day, explaining its nature,
description and how it is done.
2. Prepare the necessary materials needed (A4 paper, glue, and matches w/o the head
part).
3. Instruct the client to make us of the matchsticks by creating images/ figures that comes
into their mind and stick then with glue.
4. Allow their to finish their work and then interpret what image they create.
During the expressive art therapy Mang G.M. mood was quit serious but he still willingly
participate in the activity.After the brief discussion of the activity and the instruction for
the therapy Mr. G.M took the materials, the matches and the glue and stay silent for three
mins. Only looking at the bond paper in front of him. After that he took pieces of matches
in the match box and started forming shapes. He first formed three triangles placed side
by side with one another across the bond paper then he silently glued it and told us its d
one. When we’ve asked him what the symbol means he told us that it’s a letter,”3
A’s” he said”A,A,A yan”. Then we’ve asked him to think of other things and to add
another symbol in the paper after quite a while he put a square shape below the three
letter A’s and when asked what that is he said it’s a letter O.We’ve discuss the meaning
of the letters that he formed he said that “yung A para sa arts ibig sabihin arte, yung isa
pang A,active gawa un gawa, at yung isa pang A ibig sabihin gamit”. We’ve asked for
the meaning of letter O and he said “around yun” dun sa loob pinag usapan naming
yun…matagal na di ko na matandaan..pagod yun around sa hapon”.When we asked to
elaborate what he was sayinghe said Yung ano yan ng mga babae…yung kuwan
nila…iyon.”Then for a few mins. The client would refuse to answer to our questions and
would simply nod when wew would call his name.

SONG THERAPY
A. Definition
Song therapy will motivate client to enhance their memory by memorizing lyrics
of song as well as the steps or interpretation of it. It will also develop their interpretation
about the meaning of the song on w/c they will easily understand the message of the
song. They will also have their to energize their physical strength.
B.Goals
1.) To encourage client to express feelings by singing a song that is appropriate with their
emotions.
2.) To enhance their memory by singing the song repetitively.
3.) To enhance their physical strength by having exercised while dancing so that they can
use their strength in more progressive way.
4.) To develop their talents about singing & dancing where in client will regain their self-
esteem.
5.) To assess client capacity to follow instruction by copying steps from the steps from
the students nurses.
6.) To enhance client social relationship w/ others by dancing & singing all together.
C.Procedure
1.) Find & select an aspiring song that is appropriate for the community song.
2.) Get the lyrics of the song. Download the song.
3.) Write the lyrics in the Manila paper.
4.) Practice the song until memorized.
5.) Create steps threat will match the sentences from every stanzas.
6.) Practice together with the patient. Teach them the song & steps.
7.) Sing a loud & clear & play the steps. Gracefully.
D.Analysis & Interpretation

During the therapeutic activity (Song Therapy), our client participate and cooperate well
on ourprepared therapy. He followed the steps and listened to the tone of the song, Mang
G.M. find it hard to follow the steps and even the lyrics, he didn’t memorized the song
but he remember some of the stanza.
Bro Ikaw ang Star ng Pasko Lyrics
Kung kailan pinakamadilim Salamat sa liwanag mo
Ang mga tala ay mas nagniningning Muling magkakakulay ang pasko
Gaano man kakapal ang ulap
Sa likod nito ay may liwanag Kikislap ang pag-asa
Kahit kanino man
Ang liwanag na ito Dahil ikaw Bro, dahil ikaw Bro
Nasa ‘ting lahat Dahil ikaw Bro
Mas sinag ang bawat pusong bukas Ang star ng pasko
Sa init ng mga yakap
Maghihilom ang lahat ng sugat Salamat sa liwanag mo
Muling magkakakulay ang pasko
Ang nagsindi nitong ilaw
Walang iba kundi ikaw Salamat sa liwanag mo
Salamat sa liwanag mo Muling magkakakulay ang pasko
Salamat sa liwanag mo Ang nagsindi nitong ilaw
Muling magkakakulay ang pasko Walang iba kundi ikaw
Salamat sa liwanag mo
Tayo ang ilaw sa madilim na daan Muling magkakakulay ang pasko
Pagkakapit bisig ngayon higpitan
Dumaan man sa malakas na alon Ang nagsindi nitong ilaw
Lahat tayo’s makakaahon Walang iba kundi ikaw
Salamat sa liwanag mo
Ang liwanag na ito Muling magkakakulay ang pasko
Nasa ‘ting lahat
Mas sinag ang bawat pusong bukas Ang nagsindi nitong ilaw
Sa init ng mga yakap Walang iba kundi ikaw
Maghihilom ang lahat ng sugat Salamat sa liwanag mo
Ang nagsindi nitong ilaw
Walang iba kundi ikaw Dahil ikaw Bro, dahil ikaw Bro
Salamat sa liwanag mo Dahil ikaw Bro
Muling magkakakulay ang pasko Ang star ng pasko!
Past Medical History
The client Mr. G.M was previously well and leading a normal life as a
farmer until 2002 when he started exhibiting odditres. His father Mr. A.M brought
the client to faith healers in their area to seek medical/health advise from them.
But when 4 months had past and the client’s condition still did not improved his
family decided to consult in NCMH wherein Mr. G.M was admitted and confined
at ACIS for 15days until he was taken home with prescribed medications. After
returning home the client resumed farming and discontinued taking the medical
cation while he was still symptomathic.
During that time the client would sometimes exhibit odd behavior. The client and
his family did not encounter anymore problems aside from the occasional
manifestation of odd behavior that was tolerable of brief duration.
That was until 2008, when the clients brother started building a house in the land
that the client believe was all his. Four days after the house was built, the client
broke the jalousie of his brother’s new house. Thus, the client’s family decided to
seek medical attention at Mariveles Mental Hospital on May 5, 2008.
Mr. G.M was admitted dad in blue sando, dark shorts, barefooted and on
handcuffs with a chief complaints of “Nagsusunog ng bahay”, “nagbabasag ng
salamin”, interrupted sleep and irrelevant speech”.
Upon the admission the client was behaved, responsive to questions but briefly
and with a tendency to became evasive and irrelevant. Mr. G.M denied the
presenting complaints. He was admitted with a diagnosis of a paranoid

schizopherema and was transferred to the ward at July 26, 2008.
Present Medical History
Mr. G.M currently resides at Marivelse Mental Hospital, Dorm A. He is always
silent whenever he is inside the dorm. He doesn’t talk to anybody and would
normally sit in one corner of the room. During his stay in the dorm he was taking
the following medication: Akineton, Thorazine Haldol and flu pentixol.
Mr. G.M shows only a few of the presenting complaints, such as: interrupted
sleep and irrelevant speech. As of now, Mr. G.M was manageable and shows
little manifestation during daily interaction. Mr.G.M would participate in therapies
and other activities.
Family History
According to our client he’s living in Infanta Pangasinan together with his sister.
He is the second eldest son of Mr. A.M and Mrs. R.M he had 5 other siblings. His
parents sources of income was from farming, and even though our client lived
separately from his parents his first source of income is also farming, then he
was hired to do bromite mining. He was also not in good terms with his father
Mr.A.M, during the interaction the client mentioned that he bears ill emotions
towards his father. Because his father gave their land to his older brother without
his knowledge. Our client Mr. G.M had a wife and two children but he is living
separately from them.

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Psychiatric Nursing III

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Republic of the Philippines

BATAAN PENINSULA STATE UNIVERSITY

Mariveles Mental Hospital

Process Recording and Mental Status Assessment

Name: Mr. G.M

Last 15 years of Patient’s Life:

III. DESCRIPTION OF SETTING

A. Describe the environment:

B. Describe the nature, behavior, affect and mood of the client.

IV. PROCESS RECORDING

Nurse-Client Conversation Therapeutic Analysis and Interpretation based

SN: Kamusta naman po kayo

SN: Ilan taon na po kayo

SN: Sa malaysia din po ba

C: Oo,dun ako pinanganak.

SN: Mang G.M ano po ba

SN: Mang G.M alam nyo po

C: Oo, kasi ako ay isang

SN: impormatiko? Ano po ba

C: mga NPA kasi ang

SN: Ganon po ba Mang G.M.

SN: sila?sino pang sila Mang

SN: ah Mang G.M may

C: Oo meron pa. Clarifying The nurse helps the client to put

SN: Mang G.M asan po ba

SN: Ano po ang pangalan ng

SN: May mga anak po ba Placing event into time

C: Meron mga siyam.

SN: Mang G.M kilala nyo ba

C: si jelly, steve at at limot ko

C: Sa pangasinan, nandun Clarifying The nurse helps the client to put

SN: Mang G.M may mga

SN: Kilala nyo parin po ba

C: Si Nine ang panganay, si

SN: Dinadalaw po ba nila

C: Oo, dinadalaw pa nila ko.

SN: ganoon po ba Mang G.M

C: Si Anita, sa kanya din

SN: ah, Riseta po ang tawag

SN:Sino po ang nagbibigay

C: mga nakaputing damit.

SN: mga nakaputi po ba

SN: Mang G.M ano po ba Direct question

SN: San po ba kayo naka- Direct question

C: kaya nga ang dami kong

SN: Mang G.M may ano po Direct question

C: wala, pinaasawa sakin si

SN: (natahimik) Using silence The nurse allows periodic pauses

C: Nagkaanak pa ko kay Kris

SN: Mang G.M kilala nyo po

C: ako yung presidente

C: dati tinatawag nila akong

VI. Nursing Diagnosis

Impaired memory r/t psychological disturbances as manifested by

VII. Nursing Intervention

Implement appropriate memory retraining techniques such as keeping

VII. SUMMARY AND EVALUATION

Nursing Pocket Guide 10th Edition

Until returning home, the client resumed farming and started

Source: Client Chart

 To reorient the client to reality by gradually setting his mind

 To Encourage and explore the clients feeling and condition in

III. Description of Setting

A. Describe the set-up/environment