Nursing Care Plan

Assessment Nursing Planning Implementation Rationale Evaluation

Diagnosis
Subjective: Disturbed SHORT TERM: INDEPENDENT: Goal has been met in
“Sumasakay ako thought related Within 3 days of 1. Orient the client to 1. The inability to 3 days of the nurse-
sa eroplano to alterations in nurse- patient the place, time and maintain orientation is patient interaction as
tuwing gabi brain activity interaction patient date a sign of deterioration evidence of
pumupunta ako secondary to will: 2. Communicate with “masarap po ang
sa america” as Undifferentiated 1. The patient the client with tulog ko kagabi”
verbalized by the Schizophrenia will be pleasant and 2. To establish rapport verbalized
patient. participating approach in a slow
in unit and calm manner 3. To connect the client
activities. 3. Always response to to the reality.
2. Delusional the client base on
materials will be reality.
stated less DEPENDENT:
frequently by the 1. Follow the instructions
patient. of the pavilion's nursing
supervisor and the clinical
instructor.
COLLABORATIVE:
1. Encourage the 1. Participating to the
client to participate group activities will
to the group help them to improve
activities prepared the socialization skills.
by the student
nurses.
DRUG STUDY

Generic Brand Dosage Action/Indication/ Shape and color of the medication Nursing
Name Name contraindication card responsibilities
Clozapine Clozaril tab twice ACTION:  Ensure the 12
TRONO, FLORiCEL day
a antipsychotic drug, blocker of rights of
CLOZAPINE dopamine type 2 receptors. Known medical
to relive symptoms of administration
1tab BID schizophrenia such as  Monitor
8AM hallucinations. patient
regularly for
INDICATION: the side effects
Indications for clozapine in patients of the
with schizophrenia. medication
 Follow
CONTRAINDICATION: guidelines for
Contraindicated in patients with a discontinuation
previous hypersensitivity to or reinstitution
clozapine or any other component of the drug.
of this drug

WU-P SN ‘2 4
DRUG STUDY

Generic Brand Name Dosage Action/Indication/contraindication Shape and color of the Nursing
Name medication card responsibilities
Multivitamin Neurobion 1 tablet OD Action:  Administer
s used to treat or prevent vitamin TRONO, FLORICEL vitamins
deficiency due to poor diet or with food
certain illnesses MULTIVITAMINS to
1 tab OD promote
Indication: absorption
to provide vitamins that are not 8AM  Store
taken to the diet. vitamins in
light-
Contraindications: resistant
Contraindicated if you have container.
diabetes, liver disease, alcohol
dependence.

WU-P’SN 24