Jennifer Goodlet

BSN346-02
Cognition VCBC
Reflective journal

1.What concepts do you think are important in this scenario and why?
a. Functional ability is an important interrelated concept cognition and the scenario of
Eric due to his inability to complete activities of daily living and his poor nutrition caused by his
auditory and commanding hallucinations and his noncompliance with his medication due to the
insurance issue. Erics cognition affects his social behavior and his repetitive behaviors such as
activities of daily living and self-care due to impaired cognition (Giddens, 2017).
b. Nutrition is another essential interrelated concept that is related to cognition and Eric
scenario and is a dual effect of nutrition and cognition. In Eric scenario he has loss of appetite
due to auditory and command hallucinations which inhibits glucose to the brain depriving the
brain of the critical fuel such as carbohydrates that creates the glucose needed to function
properly (Giddens, 2017). On the other hand, his poor appetite and lack of nutrients is starving
his brain of needed fuel and is causing physiological problems such as weight loss and increasing
his risk for altered organ functions.
2. What abnormal signs and symptoms did you recognize and how did you prioritize
your care of this patient?
a. The first abnormal sign that is physiological important to Eric scenario he
presents initially with hypertensive, tachypneic and elevated temperature since these
are measurable and essential to the safety and life of a patient; blood pressure and
temperature are factors that can lead to the death of patient. Eric high blood pressure
can be associated to his lack of nutrition and sleep in the last week due to his
schizophrenia current episode possibly brought on to his lapse of medication regime of
Risperdal. As an intervention Recommending to the doctor an anti-anxiety medication to
calm him which in return will lower his blood pressure and respirations with frequent
check of his temperature for a change.
b. The other abnormal signs and symptoms are his comments about the voices
in his head and the louder and more apparent they have become over the last week and
his paranoid delusions of strangers watching him. Due to his auditory, commanding
hallucination and his paranoid delusions has led to his last week of poor eating habits,
loss of weight, decrease in his daily activities such as bathing, self-hygiene, missing
work and school. For the last nine days he has been unable to get his medication
covered by insurance and has not taken it, which can be a contributing factor to his
onset of this psychosis episode. The recommendation to his doctor would be administer
a stat dose of Risperdal with a schedule dosage of twice a day. Another intervention is
safety precautions which should be implemented right away due to his history of past
suicide attempt and three hospitalizations for his mental illness.
Jennifer Goodlet
BSN346-02
Cognition VCBC
Reflective journal
3. How would you change your actions or interventions if you had a second chance to
care for this patient?
a. One of the interventions I would alter would be more emphases on Eric music
that he uses as a coping mechanism and aides him in drowning out the voices. I would
suggest music therapy and encourage more reliance on his support system and
identifying positive coping mechanism that he can include in a safety plan. Eric ability to
identify positive, negative and cognitive symptoms of his schizophrenia, so he is able to
put into motion his safety plan.
b.
4. How would you apply what you have learned from this scenario to future patients?

References
Giddens, J. (2017). Concepts for Nursing Practice (with Pageburst Digital Book Access on VST).

Elsevier Gezondheidszorg.