G

A
A
R O U P 1 - A R L E
“A BEAUTIFUL MIND”
b o n i t a l l a , D o r o t h y K .
l c a n t a r a , M h e a B e l l e D .

Clinical-in-Charge: Mrs. Aissa R. Carlit

A p u y a , R e a Ly n M .
A r n a l d o , U r i e l Ca r l o T.
A u m a n , M a e K h a i l a B .
B i h a g , C a r m e l a Y.
B o l a - B o l a , Sh e a l a E v e M a r i e S .
B r i o n e s , C h r i s t i a n J a m e s n .
C a p u t o l a n , K a t e A s h l e y C .
F u e n t e s , C h a r l e n e
 
1.PSYCHIATRIC ASSESSMENT TOOL GUIDE
 
I.
  DEMOGRAPHIC DATA (Check patient’s chart)

Name: John Nash Age: 31 Gender:Male

Date of Birth: June 13, 1928 Marital Status: Married Address: Princeton, New Jersey
Date and Time of Admission: __________________________________________
Mode of Admission: ___ Voluntary / Involuntary
Admitting Medical Diagnosis: Schizophrenia
Significant Other Present During Admission: Alicia Nash
Legal Guardian: ____________________________________________________
 II. CHIEF PSYCHIATRIC COMPLAINTS (As stated by the patient/guardian)
“ John's always been a little weird. He said he was doing code-breaking, that it was eyes-
only. Top secret, part of the military effort. I noticed that he is always anxious and
paranoid. He never told me about his work because he said it is confidential. I often
caught him talking alone, it's like he is having a conversation with someone. He is always
afraid and vigilant, also lately he'd become so much more agitated” as verbalized by the
wife
III. PAST PSYCHIATRIC HISTORY
(First onset of illness, past diagnosis, treatment history, medications, hospitalizations)
The first delusional and hallucinatory episodes started when he was 22 years old. In which he believes that he
had a roommate named Charles.
IV. SUBSTANCE ABUSE/ DEPENDENCE
/ Alcohol use _ Illegal Drug Use _Injected drug use / Tobacco product use _Prescription Drug Abuse
_Non-prescription abuse (OTC)
_ Alcohol / Drug overdose _ Alcohol/ Drug Withdrawal _Problems caused by gambling __ Trouble
stopping any substance
_Other/Describe: ____________________
SUBSTANCE ABUSE TREATMENT HISTORY:
_None _Outpatient _Intensive Outpatient _Residential/ Inpatient _Detox
_Other/
SUBSTANCE TYPE AGE OF DAYS SINCE LAST AMOUNT ROUTE OF
Include all use in last 30 1st Use USE ADMINISTRATIO
days N
Alcohol 21 7 days 1000 ml Oral

Tobacco 18 2 days ago 6 sticks Oral

V. CURRENT MEDICAL CONDITIONS
Paranoid schizophrenia disorder with presentations of grandiose and persecutory delusions and visual and
auditory hallucinations.
VI. CURRENT & PAST MEDICATIONS
MEDICAITON NAME DOSE FREQUENCY ROUTE CURRENT COMMENTS
Insulin 100–150 units 5 days a week Intravenous   Patient was undergoing insulin shock therapy for 2
weeks and 5 times per week he was responding
well with the therapy.

Chlorpromazine 50 mg QID Per orem   Patient was taking his medications as prescribed
(Thorazine) but has decided on his own to stop that resulted to
relapse.

VII.ALLERGIES:
None
VIII. PRIMARY CARE PHYSICIAN: Dr. Rosen
 
IX FAMILY HISTORY (GENOGRAM IF POSSIBLE)
X. TRAUMA HISTORY (None, Witnessed. Abuse, Neglect, Violence, Sexual Assault)
None
 
XI.LIVING SITUATION (Current status and Functioning: Primary residence, how long living, house hold composition)
Summarize significant results:
John resides with his wife and son in a modest two-story house facing the Princeton Junction train station parking lot in
West Windsor,
XII. EDUCATIONAL / EMPLOYMENT STATUS
John enrolled in chemical engineering at the Carnegie Institute of Technology in Pittsburgh before he switched to chemistry
and then to mathematics, in which he finally received both bachelor's and master's degrees in 1948. He is a mathematician
and a professor at Princeton University. In 1951 he joined the faculty of the Massachusetts Institute of Technology (MIT),
where he pursued research into partial differential equations. He resigned in the late 1950s after bouts of mental illness.

XIII. MENTAL STATUS EXAMINATION (Check all that apply.)

 
A. GENERAL APPEARANCE: / Healthy / As stated age; __Older than stated age; __Young looking; __Tattoos __Unkept;
__Malodorous; __Overweight; __ Obese; __Other/ Describe:
____________________________________________________________________________
B.BEHAVIOR & PSYCHOMOTOR: Normal; / Overactive; __Hypoactive; __Tremor; __Tics; __Combative; __Other/ Describe:
The patient exhibits unsteady gait and inappropriate mannerisms that involves gestures that seem contrived and are not inappropriate to
the situation such as scratching the forehead when talking and poor eye contact
 
C. ATTITUDE: __Optimal; __Constructive; __Motivated; Obstructive; __Adversarial; __Inaccessible
__Cooperative; __Seductive; / Defensive; __Hostile; __Guarded; __Apathetic; __Evasive;
__Other/Describe:The patient is straight forward and tactless.

D.SPEECH: Normal; __Spontaneous; ___Slow; __Impoverished; __Hesitant; __Monotonous; __Soft/ Whispered;

__Mumbled; __Rapid; __Pressured; / Verbose; __Loud; __Slurred; __Impediment; __Other/ Describe:
_________________
E. MOOD: __Dysmorphic; __Euthymic; __Expansive; / Irritable; __Labile; __Elevated; __Euphoric;
__ Ecstatic; __Depressed; __Grief/ Mourning; __Alexithymic; __Elated; __Hypomanic; __Manic; __Anxious; __Tense;
__Other/Describe: _________________________
F. AFFECT: __Appropriate; __Inappropriate; / Blunted; __Restricted; __Flat; __Labile; __Tearful; __Intense;
__Other/Describe: _____________________
G. PERCEPTUAL DISTURBANCES: __None; / Hallucinations: / Auditory: / Visual; __Olfactory: __Tactile;
__Other/Describe: __________________________
H. THOUGHT PROCESS: __Logical/ Coherent; __Incomprehensible; __Incoherent; __Flight of ideas
__ Loose Associations: __Tangential; __Circumstantial; __Rambling; / Racing Thoughts; __Perservatoon; __Thought
Blocking; __Concrete; __Other/ Describe: ___________________
I. THOUGHT CONTENT: __Preoccupations; __Obsessions; __Compulsions; __Phobias; __Delusions; __Thought
Broadcasting; __Thought Insertion; __Thought Withdrawal; __Ideas Reference; __Ideas Influence: / Delusions;
__Others/Describe: ___________________________
J. SUICIDAL/ HOMOCIDAL IDEATION: __Suicidal Thoughts; __Suicidal Attempts; __Suicidal Intent; __ Suicidal
Plans; __History of Self Injurious Behavior; __Homicidal Thoughts; __Homicidal Attempts; __Homicidal Intent;
__Homicidal Plans__Other/Describe: _______________
K. SENSORIUM/ COGNITION (Estimate): __Alert; __Lethargic; __Somnolent; __Stuporous
Oriented to: __Person; __Place; __Time; __Situation __Normal Concentration; __Impaired Concentration
__Others/ Describe: _______________
L. MEMORY Remote Memory: / Normal; __Impaired
Recent Memory: __Normal; __Impaired
Immediate Recall: __Normal; __Impaired
__Others/ Describe:_______________
M. INTELLECTUAL FUNCTIONING (Estimate): / Above Average; __Normal/ Average; __Borderline
Mental Retardation: __Mild; __Moderate; __Severe__Others/ Describe:___________________________
N. JUDGEMENT: __Critical Judgement Intact; / Impaired Judgement; __Other/ Describe:_________
O. INSIGHT: __True Emotional Insight; __ Intellectual Insight; __Some Awareness of illness/ Symptoms; / Impaired
Insight; / Denial; __Others/ Describe:_____________________
P. IMPULSE CONTROL: __Able to Resist Impulses; / Recent Impulsive Behavior; / Impaired Impulse Control;
__Compulsions; __Others/ Describe: ___________________
XIV. RISK ASSESSEMENT: Assess potential of harm to self or other; including patterns of risk behavior
and/or risk due to personality factors, substance use, criminogenic factors, exposure to elements,
exploitation, abuse, neglect, suicidal or homicidal history, self – injury, impulsiveness, etc.
A. RISK OF HARM TO SELF: Prior suicidal attempt; __Stated Plan/ Intent; __Access to means (Weapons, pills,
Etc.); Recent loss; / Presence of Behavior cues (Isolation, giving away possessions, rapid mood swings, etc.).
__Family History of Suicide; __Terminal Illness; __Substance Abuse; __Marked lack of support; / Psychosis;
__Suicide of friend/ acquaintance;
__Others/ Describe: Unintentional self harm
B. RISK OF HARM TO OTHERS: __Prior acts of violence; / Destruction of property; __Arrests for violence;
__Access to means (Weapons); __Substance use; __Physically abused as child; __ Was physically abusive as a child;
__Harms Animals; __Fire setting; / Angry mood/ Agitation;
__Prior hospitalizations for danger to others; / Psychosis/Command hallucinations;
__Others/ Describe
The patient had a history of almost drowning his child in the bathtub and pushing his wife.
D. CLIENT SAFETY & OTHER RISK FACTORS: / Feels unsafe in current living environment;
/ Feels currently being harmed/ hurt/ abused/ threatened by someone; __Engages in dangerous sexual behavior; __Past
involvement with Child or Adult Protective Services;
/ Relapse / Decompensation triggers; __Others/ Describe: _________________
D. Describe recipients’ preferences and desires for addressing risk factors, including any Mental Health
Advance Directives or plan of response to periods of decompensation/ relapse (Ex. Resources recipient feels
comfortable reaching out to for assistance in a crisis).
The patient was able to identify his wife as an agent or representative whom he trusted to be legally
empowered in making healthcare decisions for his behalf. These decisions include the use of all or certain
medications, preferred facilities, and listings of visitors allowed in facility-based care.

XV. CULTURAL AND LANGUAGE PREFERENCES (Language, Customs, Values. Preferences)

A. Spiritual Beliefs/ Preferences:
The patient is a christian and prefers practices/rituals such as prayer or meditation and engagement
with religious community members.
B. Cultural Beliefs/ Preferences:
The patient was born and raised in Texas, USA. He prefers his wife to be involved in decision making for his
medications, treatment and therapy.
SUMMARY:
SUMMARY OF FINDINGS
The patient was diagnosed with schizophrenia as
manifested by presence of delusions and hallucinations.
The patient was admitted in the hospital involuntarily.
RATIONALE
Hallucinations are false perceptual
distortions that occur in maladaptive
neurobiological responses. The patient
actually experiences the sensory distortion as
being real and responds accordingly.
However, with a hallucination, there is no
identifiable external or internal stimulus.
Involuntary admission or commitment
means that the
patient did not request hospitalization and
may have opposed
it or was indecisive and did not resist it.
Most laws permit commitment of the
mentally ill on the following three grounds:
dangerous to self or others, mentally ill and
in need of treatment, and unable to provide
for own basic needs.
REFERENCE
Videbec, S. (2020) Psychiatric
Mental Health Nursing 8th edition;
Lippincott Williams & Wilkins
Commerce Square, 2001 Market
Street, Philadelphia, USA; Page
Stuart G. (2013) Principles And
Practice Of Psychiatric Nursing,
10th Edition; Elsevier-Mosby 3251
Riverport Lane St Louis, Missouri
63043; Page 113

“John seems weird he believes he is a government
spy” as verbalized by the wife
The patient undergoes insulin shock therapy and is
being prescribed with chlorpromazine (thorazine).
atient undergoes insulin shock therapy and is being
prescribed with chlorpromazine (thorazine).
Patient exhibits abnormal gait and
inappropriate mannerisms that involves
gestures that seem contrived and are not
inappropriate to the situation such as
scratching the forehead when talking and poor
eye contact.
The patient lacks insight regarding to
his condition.
Problems with thought content includes the presence of
delusions in persons with psychosis. A delusion is a
personal belief based on an incorrect inference of
external reality.
Insulin-shock treatment, the patient is given increasingly
large doses of insulin, which reduce the sugar content of
the blood and bring on a state of coma.  https://www.britannica.com
Staggering, intentional stepping, and walking with the
toes touching the ground first are abnormal gaits
common in people with schizophrenia. Mannerisms
involve gestures that seem contrived and are not
appropriate to the situation.
People with schizophrenia tend to overestimate or
underestimate their own capability. The abnormal brain
dysfunction during an acute episode of schizophrenia
makes it difficult for patients to realize that they need
help. This lack of insight is a neurological deficit
involving the frontal and prefrontal lobes of the brain. It
is called anosognosia, a condition in which the patient
does not recognize that there is anything wrong or that
there are deficits of any kind.
Stuart G. (2013) Principles And Practice Of
Psychiatric Nursing, 10th Edition; Elsevier-
Mosby 3251 Riverport Lane St Louis, Missouri
63043; Page 349
Das, D. (2013). Shock Theraphy. Encyclopaedia
Britannica. Retrieved from
/science/shock-therapy-psychiatry.
Stuart G. (2013) Principles And Practice Of
Psychiatric Nursing, 10th Edition; Elsevier-
Mosby 3251 Riverport Lane St Louis, Missouri
63043; Page 354
Stuart G. (2013) Principles And Practice Of
Psychiatric Nursing, 10th Edition; Elsevier-
Mosby 3251 Riverport Lane St Louis, Missouri
63043; Page 348
The patient presents irritable, anxious and
tense mood.
The patient has blunted affect.
The patient was experiencing auditory and
visual hallucinations.
The patient has incoherent thought process as
manifested having trouble organizing his
thoughts or making logical connections.
People with schizophrenia may also feel depressed, Schizophrenia. (2016).
anxious or irritable. The symptoms can be frightening https://www.mydr.com.au/mental-health/schizophrenia/#:~:text=Peo
for the person with schizophrenia and may cause them ple%20with%20schizophrenia%20may%20also,to%20become%20
to become agitated and afraid. agitated%20and%20afraid
.
Blunted affect, also referred to as emotional blunting, is a Kilian, S., Asmal, L., Goosen, A., Chiliza, B., Phahladira, L., & Emsley,
prominent symptom of schizophrenia and is regarded as a R. (2015). Instruments measuring blunted affect in schizophrenia: a
negative symptom of the disorder. Patients with blunted systematic review. PloS one, 10(6), e0127740.
affect have difficulty in expressing their emotions, https://doi.org/10.1371/journal.pone.0127740
characterized by diminished facial expression, expressive
gestures and vocal expressions in reaction to emotion
provoking stimuli. Blunted affect can be a feature of both
primary and secondary negative symptoms . In
schizophrenia, blunted affect closely resembles symptoms
of depression making it difficult to distinguish between the
two in the absence of appropriate instruments . Symptoms
such as lack of facial expression, apathy and psychomotor
slowing are often associated with both.
Hallucinations are false perceptual distortions that occur in Stuart G. (2013) Principles And Practice Of Psychiatric Nursing, 10th
maladaptive neurobiological responses. The patient actually Edition; Elsevier-Mosby 3251 Riverport Lane St Louis, Missouri 63043;
experiences the sensory distortion as being real and Page 351
responds accordingly.
The symptoms of schizophrenia are divided into two major Videbeck, S. L. (2020). Psychiatric - MENTAL HEALTH NURSING
categories: positive or hard symptoms/signs, which include (8th ed.). China: Wolters Kluwer.
delusions, hallucinations, and grossly disorganized thinking,
speech, and behavior, and negative or soft symptoms/signs,
which include flat affect, lack of volition, and social
withdrawal or discomfort.
 THE PATIENT IS EXPERIENCING PERSECUTORY
AND GRANDIOSE DELUSIONS.
The patient has History of Self Injurious Behavior.
The patient has trouble in concentrating.
IN SCHIZOPHRENIA, DOPAMINE IS TIED TO DELUSIONS JABLENSKY A. THE DIAGNOSTIC CONCEPT OF
BECAUSE THE BRAIN AREAS THAT “RUN” ON DOPAMINE SCHIZOPHRENIA: ITS HISTORY, EVOLUTION, AND
MAY BECOME OVERACTIVE. DELUSIONS OF GRANDEUR FUTURE PROSPECTS. DIALOGUES CLIN
AND DELUSIONS OF PERSECUTION ARE TWO OF THE NEUROSCI. 2010;12(3):271-287.
MOST COMMON TYPES OF DELUSIONS IN DOI:10.31887/DCNS.2010.12.3/AJABLENSKY
SCHIZOPHRENIA WHERE GRANDIOSE IS WHEN A PERSON
HAS AN OVER-INFLATED SENSE OF WORTH, POWER,
KNOWLEDGE, OR IDENTITY. THEY COULD BELIEVE
THEY HAVE A GREAT TALENT OR MADE AN IMPORTANT
DISCOVERY. PERSECUTORY IS WHEN SOMEONE WHO
HAS THIS BELIEVES THEY (OR SOMEONE CLOSE TO
THEM) ARE BEING MISTREATED, OR THAT SOMEONE IS
SPYING ON THEM OR PLANNING TO HARM THEM.
Self-injurious behavior (SIB), displayed by individuals with Kennedy Krieger Institute. Behavioral Disorders/Self
autism and intellectual disabilities, involves the occurrence of Injurious Behavior. Retrieved April 28, 2021, from
behavior that results in physical injury to one's own body. https://www.kennedykrieger.org/patient-care/conditio
Common forms of SIB include, but are not limited to, head- ns/behavioral-disorders-self-injurious-behavior
hitting, head-banging and hand-biting. In the most severe
cases, SIB can result in retinal detachment, blindness, broken
bones, bleeding or death. These estimates are higher among
individuals living in institutions and among those with
greater cognitive impairments.
Cognition is another area of functioning that is affected in Torres, F. (2020). What Is Schizophrenia?
schizophrenia leading to problems with attention, https://www.psychiatry.org/patients-families/schizoph
concentration and memory, and to declining educational renia/what-is-schizophrenia
performance.
 Memory problems in schizophrenia
stem from disruptions in the brain's
dorsolateral prefrontal cortex
(DLPFC). This area of the brain
The patient has
plays a key role in working
impaired memory.
memory--the system for
temporarily storing and managing
information required to carry out
complex cognitive tasks.
 2. Drug
Study
2. Drug Study
Name of Drug
Generic Name : INSULIN
Brand Name: Humulin R,
Novolin R, Regular Insulin,
Velosulin, Velosulin BR,
Velosulin Human
 
Therapeutic Classification:
HORMONE AND
SYNTHETIC SUBSTITUTE;
ANTIDIABETIC AGENT;
INSULIN
 
Pregnancy Category: B
Dosage, Route and Indication
Frequency
100–150, IV, 5 days a Emergency treatment of diabetic
ketoacidosis or coma, to initiate therapy
week for two weeks in patient with insulin-dependent
diabetes mellitus, and in combination
with intermediate-acting or long-acting
insulin to provide better control of blood
glucose concentrations in the diabetic
patient. Used IV to stimulate growth
hormone secretion (glucose counter
regulatory hormone) to evaluate
pituitary growth hormone reserve in
patient with known or suspected growth
hormone deficiency. Other uses include
promotion of intracellular shift of
potassium in treatment of hyperkalemia
(IV) and induction of hypoglycemic
shock as therapy in psychiatry.
Mechanism of Action
Short-acting, clear, colorless
solution of exogenous unmodified
insulin extracted from beta cells in
pork pancreas or synthesized by
recombinant DNA technology
(human). Enhances transmembrane
passage of glucose across cell
membranes of most body cells and
by unknown mechanism may itself
enter the cell to activate selected
intermediary metabolic processes.
Promotes conversion of glucose to
glycogen.
Contraindication Drug to Drug Interaction
Hypersensitivity to Drug: Alcohol, ANABOLIC
insulin animal STEROIDS, MAO
INHIBITORS, guanethidine,
protein. SALICYLATES may potentiate
hypoglycemic effects;
dextrothyroxine,
CORTICOSTEROIDS,
epinephrine may antagonize
hypoglycemic effects;
furosemide, THIAZIDE
DIURETICS increase serum
glucose levels; propranolol
and other BETA BLOCKERS
may mask symptoms of
hypoglycemic reaction. Herbal:
Garlic, ginseng may potentiate
hypoglycemic effects.
Adverse Effect
Body as a Whole: Most adverse effects are related
to hypoglycemia; anaphylaxis (rare),
hyperinsulinemia [Profuse sweating, hunger,
headache, nausea, tremulousness, tremors,
palpitation, tachycardia, weakness, fatigue,
nystagmus, circumoral pallor; numb mouth,
tongue, and other paresthesias; visual disturbances
(diplopia, blurred vision, mydriasis), staring
expression, confusion, personality changes, ataxia,
incoherent speech, apprehension, irritability,
inability to concentrate, personality changes,
uncontrolled yawning, loss of consciousness,
delirium, hypothermia, convulsions, Babinski
reflex, coma. (Urine glucose tests will be
negatives). CNS: With overdose, psychic
disturbances (i.e., aphasia, personality changes,
maniacal behavior). Metabolic: Posthypoglycemia
or rebound hyperglycemia (Somogyi effect),
lipoatrophy and lipohypertrophy of injection sites;
insulin resistance. Skin: Localized allergic
reactions at injection site; generalized urticaria or
bullae, lymphadenopathy
Nursing Responsibility
Monitor for hypoglycemia (see
Appendix F) at time of peak action
of insulin. Onset of hypoglycemia
(blood sugar: 50–40 mg/dL) may
be rapid and sudden.
Check BP, I&O ratio, and blood
glucose and ketones every hour
during treatment for ketoacidosis
with IV insulin.
Notify physician of S&S of
diabetic ketoacidosis.
Check blood glucose regularly
during menstrual period; loss of
diabetes control (hyperglycemia or
hypoglycemia) is common; adjust
insulin dosage accordingly, as
prescribed by physician.
Name of Drug
Generic Name:CLOZAPINE
Brand Name
Clozaril, Fazaclo
Therapeutic Classification:
CENTRAL NERVOUS
SYSTEM (CNS) AGENT;
PSYCHOTHERAPEUTIC
AGENT; ANTIPSYCHOTIC;
ATYPICAL
Dosage, Route and Indication Contra- indication
Frequency
Schizophrenia Indicated only in the Severe CNS depression, blood
Adult: PO >16 y: management of severely ill dyscrasia, history of bone marrow
Initiate at 25–50 mg/d schizophrenic patients who depression; patients with
and titrate to a target have failed to respond to myeloproliferative disorders,
dose of 350–450 mg/d other neuroleptic agents. uncontrolled epilepsy; clozapine-
in 3 divided doses at 2 induced agranulocytosis, severe
wk intervals, further granulocytosis, chemotherapy, coma,
increases can be made leukemia, leukopenia, neutropenia,
if necessary, max of myocarditis, concurrent administration
900 mg/d of benzodiazepines or other
psychotropic drugs; renal failure,
dialysis, hepatitis, jaundice; infants,
lactation.
Mechanism of Drug-to-Drug Adverse Effects Nursing Responsibility
Action Interaction
Mechanism is not Drug: Alcohol and other CV: Orthostatic hypotension, Before:
defined. Interferes CNS DEPRESSANTS tachycardia, ECG changes, -Do not engage in any hazardous activity until
increased risk of myocarditis response to the drug is known.
with binding of compound depressant
especially during first month of -Take drug exactly as ordered.
dopamine to D1 and effects; therapy, pericarditis, pericardial During:
D2 receptors in the ANTICHOLINERGIC effusion, cardiomyopathy, heart -Monitor diabetics for loss of glycemic control.
limbic region of AGENTS potentiate failure, MI, mitral insufficiency. GI: -Monitor for seizure activity; seizure potential
brain. It binds anticholinergic effects; Nausea, dry mouth, constipation, increases at the higher dose level.
primarily to ANTIHYPERTENSIVE hypersalivation. Hematologic : -Closely monitor for recurrence of psychotic
nondopaminergic AGENTS may potentiate Agranulocytosis. CNS: Seizures, symptoms if the drug is being discontinued.
sites (e.g., alpha- hypotension. Herbal: St. transient fever, sedation, -Monitor cardiovascular and respiratory status,
adrenergic, John's wort and kava may neuroleptic malignant syndrome especially during the first month of therapy
serotonergic, and increase sedation. (rare), dystonic reactions (rare). After:
Metabolic: Hyperglycemia, -Report immediately any of the following:
cholinergic receptors) unexplained fatigue, especially with activity; shortness
diabetes mellitus. Urogenital:
Urinary retention. Other: of breath, sudden weight gain or edema of the lower
Increased mortality from severe extremities.
hematologic, cardiovascular, and  
respiratory adverse effects.  
-Report flulike symptoms, fever, sore throat, lethargy,
malaise, or other signs of infection.
Name of Drug: Dosage, Route and Frequ Indication Contra
ency indication

Generic Name: 50 mg Per.Orem, QID Treatment of Psychosis, Contraindicated in patients

chlorpromazine and mania. hypersensitive to drug; in those
with CNS depression, bone
Brand marrow suppression, or
name:Thorazine subcortical damage, and in those
in coma.

Therapeutic
classification:
Antipsychotic
Mechanism of Action Drug-to- Drug Interaction Adverse Effects Nursing Responsibility

Antacids: May inhibit absorption of oral Before:

A piperidine phenothiazines. Separate antacid and
CNS: extrapyramidal reactions,
•Observe the 5R’s of drug administration.
phenothiazine that may sedation, tardive dyskinesia, •Obtain baseline blood pressure measurements
phenothiazine doses by at least 2
block postsynaptic hours. Anticholinergics such as tricyclic pseudoparkinsonism, neuroleptic before therapy, and monitor regularly. Watch
malignant syndrome, seizures, for orthostatic hypotension, especially with
dopamine receptors in antidepressants, antiparkinsonians: parenteral administration.
May increase anticholinergic activity, dizziness, drowsiness. CV: orthostatic
the brain. aggravated parkinsonian symptoms. hypotension, tachycardia, quinidine-
During:
•Tell patient not to withdraw drug abruptly
Use together cautiously. like ECG effects. EENT: ocular unless required by severe adverse reactions.
Anticonvulsants: May lower seizure •Warn patient to avoid activities that require
changes, blurred vision, nasal alertness or good coordination until effects of
threshold. Monitor patient closely. congestion. GI: dry mouth, drug are known. Drowsiness and dizziness
Barbiturates, lithium: May decrease usually subside after first few weeks.
constipation, nausea. GU: urine
phenothiazine effect. Monitor patient. •Tell patient to avoid alcohol while taking
Centrally acting antihypertensives: May retention, menstrual irregularities, drug.
decrease antihypertensive effect. inhibited ejaculation, priapism. •Tell patient to use sunblock and to wear
Monitor blood pressure. CNS Hematologic: leukopenia, protective clothing to avoid oversensitivity to
the sun. This drug is more likely to cause sun
depressants: May increase CNS agranulocytosis, aplastic anemia, sensitivity than other drugs in its class.
depression. Use together cautiously. thrombocytopenia, eosinophilia, •Tell patient to relieve dry mouth with
Electroconvulsive therapy, insulin: May hemolytic anemia. Hepatic: jaundice. sugarless gum or hard candy.
cause severe reactions. Monitor patient Skin: mild photosensitivity reactions,
•Advise patient receiving drug by any method
closely. Lithium: May increase other than by mouth to remain lying down for
neurologic effects. Monitor patient
pain at I.M. injection site, allergic 1 hour afterward and to rise slowly.
closely. Meperidine: May cause reactions, sterile abscess, skin
excessive sedation and hypotension. pigmentation changes. Other:
Don’t use together. Propranolol: May gynecomastia, lactation, galactorrhea.
increase levels of both propranolol and
chlorpromazine. Monitor patient closely.
Warfarin: May decrease effect of oral
anticoagulants. Monitor PT and INR.
Nursing Responsibility

After:
•Monitor patient for tardive dyskinesia, which may occur after prolonged use. It may
not appear until months or years later and may disappear spontaneously or persist for
life, despite stopping drug.
•Watch for evidence of neuroleptic malignant syndrome (extrapyramidal effects,
hyperthermia, autonomic disturbance), which is rare but usually fatal. It may not be
related to length of drug use or type of neuroleptic; more than 60% of affected
patients are men.
•If jaundice, symptoms of blood dyscrasia (fever, sore throat, infection, cellulitis,
weakness), or persistent extrapyramidal reactions (longer than a few hours) develop,
or if such reactions occur in children or pregnant women, withhold dose and notify
prescriber.
3. Nursing Care
Plan
CUES
Subjective Cues:
“Charles is my room mate he is
majoring in literature in
Princeton. ”
“Is that the baby?”
“He's been injected
with a cloaking serum.I can see
him
because of a chemical...that
was released
into my bloodstream...
when my implant dissolved. I
couldn't tell you,
it was for your own
protection!”
 
Objective Cues:
 
Extremely disorganized
or abnormal motor
behavior.
 
Hallucinations
Delusions
Disorganized thinking
Nursing Diagnosis Scientific Basis Nursing Goal
Disturbed Thought A state in which a person Short term
Process related to Panic expresses or reports fixed false After 6 hours of nurse-patient intervention
level of anxiety as individually held beliefs or the patient will be able to verbalize
evidenced by experiences inconsistent with recognition to to delusional thoughts.
Inappropriate non-reality- reality.
based thinking   Long term
Pathophysiology: Describes an After 8 weeks of nurse-patient intervention
individual with altered the patient will be able to:
perception and cognition that -demonstrate satisfying relationships with
interferes with daily living. real people.
Causes are biochemical or -demonstrate decrease anxiety level.
psychological disturbances like  
depression and personality
disorders.
References
Doenges, M. E., Moorhouse, M. F.,
&Murr, A. C. (2008a). Nurses
Pocket Guide (11th ed.).
Philadelphia, Pennsylvania: F.A
Davis Company
Nursing Intervention Rationale Evaluation

Independent: Short term

Identify feelings related to delusions. For example:
• If client believes someone is going to harm him/her, client
is & If client believes someone or something is controlling
his/her thoughts, client is experiencing helplessness.
• Recognizes the client’s delusions as the client’s perception
of the environment
• Initially do not argue with the client’s beliefs or try to
convince the client that the delusions are false and unreal.
Dependent:
• Encourage healthy habits to optimize functioning:
 
• Maintain medication regimen.
• Maintain regular sleep pattern.
• Maintain self-care.
Collaborative:
• Ascertain from SO patient’s usual level of mentation
• When people believe that they are understood, anxiety might
lessen.
 
•  Recognizing the client’s perception can help you
understand the feelings he or she is experiencing
 
• Arguing will only increase client’s defensive position,
thereby reinforcing false beliefs. This will result in the client
feeling even more isolated and misunderstood.
• All are vital to help keep the client in remission.
• Provides comparison to evaluate progression/resolution of
impairment
After 2 days of nurse-patient intervention
the goal has been met. The patient was
able to verbalize recognition of delusional
thoughts when asked.
Long term
After 8 weeks of nurse-patient
intervention the goal of care has been
met. The patient was able to:
-demonstrate satisfying relationships with
real people such as health care providers
and other patients
-demonstrate decrease anxiety level as
evidenced by being less irritable, tense
and nervous.
Assessment
ROS
•The first delusional and hallucinatory
episodes started when he was 22 years old.He
believes that he had a roommate named Charles.
•The patient thinks that he is a spy, and he
is working for the government through a
man named William Parcher.
ASSESSMENT
Subjective:
•“I think the Russians
feel my profile is too high. That's
why they simply
just don't go away from me. They're
keeping me here
to try to stop me!”
•”I’ve been doing a top secret work
for the government there are threats
that exist we need to stop the
Russians. They are keeping me here
to stop me from doing my work.”
•“Yes, I could see them now
Charels, Marcee and William.”
Nursing Scientific Bases
Diagnosis
Disturbed Sensory DEFINITION
Change in the amount or patterning of
Perception related incoming stimuli accompanied by a
to presence of
diminished, exaggerated, distorted, or
hallucinations and impaired response to such stimuli.
delusions PATHOPYSIOLOGY Schizophrenia is a
mental illness in which patients experience
symptoms such as delusions, (mistaken
beliefs) hallucinations,and disorganized
behavior. The disease causes increased
dopamine levels (dopamine hypothesis)
causes disturbed thought processes. The
dopamine neuron transmitter’s function is
for motor movements, sensor, integration
and emotional behaviors.
REFERENCES
Doenges et.al (2018) Nurse's Pocket Guide,
15th edition: Diagnoses, Prioritized
Interventions and Rationales; F. A. Davis
Company 1915 Arch Street Philadelphia,
PA 19103; Page 790
Nursing Goal
Short term goals:
After 4 hours of nursing interventions
the client will :
•Establish contact with reality.
Long term goals
After 8 weeks of nursing intervention
and nurse-patient interaction the
patient will:
•Be free from injury and refrain from
harming others throughout
hospitalization.
•Exhibit compliance with medication
management.
•Verbalize a decrease in the frequency
of delusions and hallucinations or
demonstrate the ability to function
without responding to persistent
delusional thoughts.
CUES
Objective:
•Poor eye contact
•Blunted affect
•Neglecting to eat
•Paranoid feelings of persecution
•Vigilant and agitated
•Hearing noises or sounds, most commonly in the form of voices.
•Visual hallucinations
 
 Nursing Intervention
Independent
• Protect the client from harming himself or others.
 
• Talk with the client about simple, concrete things;
avoid ideological or theoretical discussions.
• Reassure the client that the environment is safe
by briefly and simply explaining routines,
procedures, and so forth.
• Reorient the client to person, place, and time as
indicated (call the client by name, tell the client
where he is.)
• Show empathy regarding the client’s feelings;
reassure the client of your presence and
acceptance. Convey your interest and caring.
• Never convey to the client that you accept the
delusions as reality.
 
Dependent
• Be aware of as needed (PRN) medications and
the client’s varying need for them.
 
• Explore stressors contributing to psychotic
symptoms.
Rationale
• Client safety is a priority. Self-destructive ideas may come
from hallucinations.
• The client’s ability to deal with abstractions is impaired.
 
 
• The client is less likely to feel threatened if the surroundings
are known.
 
 
• Repeated presentation of reality is concrete reinforcement
for the client.
 
 
• The client’s delusions can be distressing. Empathy coveys
your caring, interest and acceptance of the client.
 
• Indicating belief of the delusions reinforces the delusions.
 
 
• Medication can decrease psychotic symptoms and can help
the client gain control over his own behavior.
Evaluation
Short term:
After 4 hours of nursing interventions the goal
of care has been met patient was able to:
•Establish contact with reality.
As evidenced by: Patient was able to determine
usual reality orientation as manifested by
asking for reorientation each time he
experiences hallucinations.
Long term:
After 8 weeks of nursing interventions and
nurse-patient interaction the goal of care was
partially met:
•Patient maintains a non-hostile behavior and
does not injure self or others.
•Patient takes medication on the right dose,
time and route.
•Patient was able to identify ways on how to
ignore hallucinations ”I see and hear voices
less often compared before. Although they are
always there, I choose not to acknowledge
them. Like a diet of the mind, I choose not to
indulge certain appetites.” as verbalized by the
patient
NURSING INTERVENTION
• Explore stressors contributing to psychotic
symptoms.
• Set limits on the client’s behavior when he is unable
to do so (when the behavior interferes with other
clients or becomes destructive). Do not set limits to
punish the client.
• Engage the client in one-to-one activities at first, then
activities in small groups, and gradually activities in
larger groups
Collaborative
• Remove the client from the group if his or her
behavior becomes too bizarre, disturbing, or
dangerous to others.
• Ask the client to notify the clinic of the response to
medication within 3 days.
RATIONALE
• Such behaviors are critical clues regarding risk for
self harm.
•  Limits are established by others when the client is
unable to use internal controls effectively. Limits are
intended to protect the client and others, not to punish
inappropriate behaviors.
• A distrustful client can best deal with one person
initially.Gradual introduction of others when the
client can tolerate is less threatening
 
• The benefit of involving the client with the group is
outweighed by the group’s need for safety and
protection.
 
• Client is to assume responsibility for resuming
medication compliance.
CUES Nursing Scientific Bases Nursing Goal
Diagnosis
ROS Impaired Social DEFINITION OF THE NSG. DX Short term care
Patient is Interaction related as a state in which an individual participates in After 1 day of nurse- patient interaction the patient
experiencing either an insufficient or an excessive quantity of will be able to:
to hallucinations 1.Prevent from harm
hallucination and social exchange, or with an ineffective quality
of social exchange. 2.Develop an alliance with the patient and family
always feeling
agitated    
ASSESSMENT PATHOPHYSIOLOGIC BASIS Long term care
.Hallucinations are sensory experiences that After 8weeks of nurse- patient interaction the patient
Subjective:Subje will be able to:
appear real but are created by your mind. They
ctive  
“The truth is that I don't can affect all five of your senses. For example, 1.Patient will improve social interaction with family,
like people much. And they you might hear a voice that no one else in the friends, and neighbors.
don't room can hear or see an image that isn't real.  
much like me.”
2.Patient will use appropriate social skills in
Objective interactions.
References
-Sudden get angry 3.Patient will engage in one activity with a nurse by
-delusional thoughts Doenges, M. E., Moorhouse, M. F., the end of the therapy
-disorganized &Murr, A. C. (2008a). Nurses Pocket 4.Patient will maintain an interaction with another
behavior. Guide (11th ed.). Philadelphia, client while doing an activity (e.g., simple board game,
Pennsylvania: F.A Davis Company. drawing).
-Tendency to argue
5.Patient will engage in one or two activities with
- Violent behavior minimal encouragement from nurse or family
members. 6.Enhance the patient’s adaptation to life in
the community
Nursing Intervention
INDEPENDENT
1.)Keep client in an environment as free of stimuli (loud
noises, crowding) as possible.
 
 2.)Structure activities that work at the client’s pace and
activity.
 
3.)If client is delusional/hallucinating or is having trouble
concentrating at this time, provide very simple concrete
activities with client (e.g., looking at a picture or do a
painting).
 
4.)Structure times each day to include planned times for brief
interactions and activities with the client on one-on-one basis
5.Provide opportunities for the client to learn adaptive social
skills in a non-threatening environment.
 
6.Eventually engage other clients and significant others in
social interactions and activities with the client
DEPENDENT
Administeredanti-psychotic medications, as ordered
COLLABORATIVE
1.Provide for occasional follow up
Rationale
1.)Client might respond to noises and crowding with agitation,
anxiety, and increased inability to concentrate on outside
events.
 
2.)Client can lose interest in activities that are too ambitious,
which can increase a sense of failure
 
3.)Even simple activities help draw client away from delusional
thinking into reality in the environment.4.)To prevent gastric
irritation
 
 4.Helps client to develop a sense of safety in a non-threatening
environment.
 
 
5.Social skills training helps the client adapt and function at a
higher level in society, and increases the client’s quality of life.
6.Client continues to feel safe and competent in a graduated
hierarchy of interactions.
1.To ease symptoms such as delusions and hallucinations.
 
 
1.For reinforcement of positive behavior after professional
relationship has ended
Evaluation
Short term care
After 1 day of nurse patient interaction the
short term goal has been met.The patient was
able to:
2. Prevented from harming himself
3. Developed an alliance with the patient and
family
Long term care
After 8 weeks of nurse patient interaction the
long term care was partially met. The patient
was able to:
2.Express positive changes in social behaviors
and interpersonal relationships
3..Responsed to intervention and actions
performed.
4. Patient was able to maintain an interaction
with another client while doing an activity
(e.g., simple board game, drawing).
5. Patient was able to improve social
interaction with family, friends, and neighbors.
4. THERAPIES THAT
CAN BE APPLIED
◦HEALTH EDUCATION PLAN
◦ 
◦LEARNER’S CHARCTERISTICS: A man who is at his
30’s is diagnosed with paranoid schizophrenia.
◦ 
◦REASONS FOR DEVISING THE TEACHING PLAN:
The utilization of the health education plan will allow the
learner to have healthy interactions in all aspects of life,
displaying good manners, communicating effectively with
others, being considerate of the feelings of others and
expressing personal needs in daily life, at work, and in
social situations.
◦ 
◦TOPIC: Social Skills Training (SST)
◦ 
TEACHING OBJECTIVES CONTENT OUTLINE TEACHING – LEARNING
STRATEGIES & METHODS

COGNITIVE: Orient the learner what the therapy is about and Discussion
After 45 minutes of the rules. The learner will be in a group  
Interactive discussion, the composed of 6-8 members.
learner will be able to a. Please stay on the group topic.
understand and apply the different social skills b. Only one person may speak at a time.
to promote interpersonal relationships and c. No name-calling or cursing.
independent living skills for improved d. No criticizing or making fun of each other.
functioning in his community. e. No eating or drinking during group.
   
AFFECTIVE: Teaching about the components of social skills:
After 45 minutes of a. Expressive behaviors
Interactive discussion, the • Speech content
learner will be able to • Paralinguistic features
participate in social discussion and engage in • Voice volume
socializing with peers. • Speech rate
PSYCHOMOTOR: • Pitch
After 45 minutes of • Intonation
Interactive discussion, the learner will be able b. Nonverbal behaviors
to adapt to social gathering with the use of the • Eye contact (gaze)
methods and strategies learned to his • Posture
community. •Facial expression
 
CONTENT OUTLINE TEACHING – LEARNING STRATEGIES & METHODS

• Proximics Role-playing
• Kinesics
c. Receptive behaviors (social perception)
 
• Attention to and interpretation of relevant cues  
•Emotion recognition
d. Interactive behaviors
•Response timing
• Use of social reinforcers
• Turn taking
 
-Different skills to use during problem situations in order to possess the full range
of conversational and perceptual skills to be effective in most social situations.
Role-playing
a. Assertiveness Skills  
b. Conversational Skills  
•starting conversations,
•maintaining conversations,
•ending conversations.
c. Heterosocial Skills
d. Independent Living Skills
 
 Open forum on how the session went for the learner and reinforce any lessons
 
learned, skills or objectives achieved. Discussion
TIMEFRAME INSTRUCTIONAL MATERIALS METHODS OF EVALUATION

5 minutes Question and Answer

  Visual aids  
Flash cards

20 minutes
 

15 minutes
 

5 minutes
 HEALTH EDUCATION PLAN
 
LEARNER’S CHARCTERISTICS: Patient is diagnosed with paranoid schizophrenia with positive symptoms of delusions and hallucinations.
 
REASONS FOR DEVISING THE TEACHING PLAN: The utilization of the health teaching plan will allow the learner to increase self-awareness and self-worth,
decrease stress and anxiety, cope with stress, boost self-esteem, and improve physical, mental and emotional well-being.
 
TOPIC: Art Therapy
 

TEACHING OBJECTIVES CONTENT OUTLINE TEACHING – LEARNING

STRATEGIES & METHODS

COGNITIVE: Prepare the art materials needed. Discussion

After 1 hour of interactive learning,    
the patient will be able to understand - Introduce yourself to the patient and
the art therapy and apply his learning orient him about the art therapy.
to boost self esteem, being aware of  
himself and cope up with stress.
 
 
TEACHING OBJECTIVES
AFFECTIVE:
After 1 hour of interactive learning, the
patient will be able to organize his
thoughts, feelings and emotions, able to
express himself better, and find his
purpose in life.
 
PSYCHOMOTOR:
After 1 hour of interactive learning, the
patient will be able to create art as his
approach to relieved stress, able to
transfer his frustration through drawing or
painting, and able to communicate with
his internal emotions and communicate
better with other people especially his
love ones.
CONTENT OUTLINE TEACHING – LEARNING
STRATEGIES & METHODS
Art therapy is a therapeutic technique with the Discussion and Demonstration
creative process to improve mental health and  
well-being. You can draw, paint, sculpt, make a  
collage and etc. For this session, I will allow
 
you to draw and color your drawing with the
crayons given to you.  
   
- Give the patient 1 long size bond paper,  
pencil and crayons. Let him draw any object he  
likes that represents his emotion today.  
 
- Let the patient show and explain his drawing.  
  Open-ended type of question
- Question and answer portion. Ask your
patient about the following:
Does that drawing symbolize anything?
Does that drawing has a relationship between
your feelings and thoughts right now?
TIMEFRAME INSTRUCTIONAL MATERIALS METHODS OF EVALUATION

2 minutes 3 Long bond paper Question and answer

Pencil
3 minutes
Crayons

20 minutes
 

10 minutes

25 minutes
 HEALTH EDUCATION PLAN
 
LEARNER’S CHARCTERISTICS: Patient is diagnosed with paranoid schizophrenia with positive symptoms of delusions and
hallucinations.
 
REASONS FOR DEVISING THE TEACHING PLAN: The utilization of the health teaching plan will allow the learner to reduce anxiety,
reduce the physical and mental effects of stress, reduce his symptoms, improves self-expression and communication with other people,
allow him to relaxed and clear his mind.
 
TOPIC: Music Therapy
TEACHING OBJECTIVES CONTENT OUTLINE TEACHING – LEARNING
STRATEGIES & METHODS

COGNITIVE: Introduce yourself to the patient and Discussion

After 1 hour of interactive learning, orient the patient about what is music  
the patient will be able to understand therapy and its benefits to his mental
what is music therapy and it’s benefits health.
to his mental health in order to
promote self-expression and building
self-confidence.
TEACHING OBJECTIVES
AFFECTIVE:
After 1 hour of active learning, the patient
will be able to relaxed and express his
feelings through music.
 
PSYCHOMOTOR:
After 1 hour of active learning, the patient
will be able to know what ways he will do
to relaxed his mind and body when
encountering a stressful situations.
CONTENT OUTLINE TEACHING – LEARNING
STRATEGIES & METHODS
Music therapy uses music and used within a  
therapeutic relationship to address physical,
emotional, cognitive, and social needs of
individuals. This therapy allows you to sing,
play instruments, composed a song and etc. For
this session, I will let you composed a song and
any genre will do.
 
- Let the patient listen to a song of his choice or Active Learning
his favorite music.
 
- Let him create an original song or poem that Active Learning
can fit any content at any level.
- Let him sing his song in front of you. Performance method
- Question and answer portion. Ask him about:
How does it feel during and after you Open-ended type of question
TIMEFRAME INSTRUCTIONAL MATERIALS METHODS OF EVALUATION

5 minutes A tape recorder and recorded Assessing patient’s response to

music stress by asking questions.
10 minutes  
Paper and pencil
20 minutes

5 minutes

20 minutes
 5.
SYNOPSIS
OF THE
MOVIE
◦John Nash, a brilliant but asocial mathematical genius began studying at Princeton
University for Graduate School in 1947. He dreamed of coming up with an original idea that
would make a revolutionary breakthrough. He met Sol, Bender, Hansen, and his roommate
Charles, who became his closest friend and is his source of lightheartedness that apparently
seemed lacking in his life. Nash doesn’t attend the lectures thinking it’s only a waste of
time. By a fluke, Nash stumbled upon a game theory that challenges the assumption of
Adam Smith, the father of modern economics. Because of his discovery, he was able to
obtain a prestigious Wheeler Lab at the Massachusetts Institute of Technology (MIT), along
with Sol and Bender.
◦Nash was invited by the Department of Defense to crack an encryption. He was able to
decipher the code. Parcher, who was also working for the Department of Defense, asked
Nash to partake in a mission which is to look for patterns in magazines and newspapers, to
prevent a Soviet plot. He was implanted with a radium diode on his wrist, began writing a
report of his findings, and placed them in a specified mailbox.
◦Nash was teaching in MIT for his Calculus class when he met Alicia, one of his students
who seemed to show an interest in him. They began to develop a romantic relationship and
got married eventually.
◦When he was dropping a report in the specific mailbox, Parcher announced that he was
being chased by the Russians and an exchange of gunfire happened. Nash became
increasingly paranoid and begin to behave erratically.
◦On a return visit to Princeton, Nash rekindled his friendship with his former roommate
Charles and meets Charles' young niece Marcee. Sometime when he was delivering a
lecture at Harvard University, he saw Parcher and other suspicious men enter the hall,
making him freak out. Although he attempted to flee, he was forcibly sedated and sent to a
psychiatric facility. Nash believed that the Soviets were trying to extract information from
him. He thinks that the officials of the psychiatric facility were Soviet kidnappers.
The psychiatrist explained Nash’s conditions to Alicia and told her that Charles, Marcee, and Parcher were only a product of Nash’s mind, and Nash has
paranoid schizophrenia. In her desperate attempt to prove that the psychiatrist was wrong, she visited the mailbox and retrieved all the documents that
were never opened.

Nash cut his wrist to take the radium diode out of his system he was faced by the fact that there was no implant at all. He undergone a series of insulin
shock therapy sessions before he was released by the institution, while still receiving antipsychotic medications. However, the side effects of the
medication were damaging his relationship with his wife and limiting his intellectual capacity. Nash secretly stopped taking the medication triggering his
relapse. He began seeing Marcee, Charles, and Marcee once again.
Alicia accidentally discovered that Nash had relapsed when she saw that the abandoned shed near their house was turned into an office for his work for
Parcher. She rushed inside their house only to find that Nash left their son in the tub which is halfway filled with water. Nash tried to reason out, saying
that Charles was watching their son. Alicia tried to call the psychiatric institution while Nash accidentally knocks Alicia and their son into the ground
while trying to knock Parcher down. Alicia fled out of the house and Nash began to realize that Marcee isn’t real since she doesn’t age ever since he met
her. With this thought, he accepted that he’d been hallucinating everything. Nash tried to live with his life without taking medications, against the advice
of the psychiatrist while Alicia supported his decisions.

Nash approached his old colleague Hansen, who’s now the head of Princeton mathematics department hoping to get a job to get in touch with reality.
Hansen permitted him to work in the library and audit classes. Nash was still able to experience visual hallucinations but he managed to ignore these
symptoms. He also began taking newer antipsychotic medications which helped him deal with reality.
After some time, Nash was permitted to teach again. In 1994, Nash was able to obtain a Novel Memorial Prize in Economics for his revolutionary work
on game theory. As they left the auditorium, Nash briefly looked at Charles, Marcee, and Parcher together before leaving with his wife.
 
◦6. Learning
Insights
Learning Insight 1

The strong suit of the movie is that it is based on a true story and existing person during the time of its release. Even though it is loosely inspired to the late Mr. John
Nash and his family, overall, the movie did justice and served its purpose to spread awareness and information about psychological disorders more specifically on
schizophrenia.
 
Mr. Nash’s personality has not changed throughout the movie, but his thought processes was greatly affected resulting to disablement. When it comes to portraying the
signs and symptoms of schizophrenia–taken that it is exaggerated for the sake of viewership, it accurately depicted hallucinations, delusions, and disordered thinking or
the combination of these. In the movie, Mr. Nash was shown as asocial–he does not interact to people assuming that they would not develop their liking towards him.
Moreover, environmental change and stress can also be noted in the movie as he is transitioning to graduate school. Up to date, there is still no known exact cause of
schizophrenia research says that it is a combination of factors and or triggers. The same answer too as to why some people develops symptoms while others do not.
 
One of the highlights of the movie is the demonstration of the treatment that is used for schizophrenic patients before, the insulin coma therapy. Patients were given
insulin to induce a comatose state that could last about 15 to 60 minutes. The procedure as displayed in the movie is horrid that is why it has been eventually discredited
and is no longer used as anti-psychotic drugs were slowly introduced. There is still no curefor schizophrenia, it is treatable and manageable with medication and
behavioral therapy, especially if diagnosed early and treated continuously.In the movie, after spending months in the psychiatric facility Mr. Nash is discharged but is
required to take medications to treat his symptoms. However, the medications presented a problem to him Mr. Nash claims that while he is on chlorpromazine he
cannot think freely and he cannot respond to his wife. The situation prompts him to stop taking his medications and this led to the relapse of his condition. In the middle
of his psychotic episode following the relapse Mr. Nash snapped out of it by making himself aware of the reality that the girl he sees is not real because she is not
getting old. This is where he starts to acknowledge that it is all in his mind and this kept him somewhat in touch with reality.
 
In the movie, the discrimination to those who had these types of mental conditions is presented lucidly. Mr. Nash is being ridiculed and humiliated for having
schizophrenia as the people around him had little to no knowledge about his condition. Fortunately, his wife never left his side Mrs. Nash believed in Mr. Nash that he
can get through with this without getting back to the facility for treatment and offered him her unending support. In time, Mr. Nash’s friends and former colleagues
helped him to slowly integrate himself in the society. It was not an easy feat for Mr. Nash and his family to live with schizophrenia, they battled with it for decades–it is
difficult, but he figured it is manageable. In conclusion, the movie gave us an overview on what it is like to have a mental disability during the 1950’s. A beautiful mind
may not be that accurate in representing schizophrenia through and through, but for me it perfected in portraying certain ideas and facts about the condition that has the
ability to educate others.
 
Learning Insight 2
John Nash was a genius from West Virginia who was a co-recipient for the Carnegie Scholarship for mathematics in Princeton University. He was
diagnosed with schizophrenia which according to the movie started in graduate school. He was socially awkward and distant to people. This, I learned
are some of the signs that this kind of mental disorder may exhibit. It may also be the lack to care for oneself, which in the movie is forgetting to eat.
John then has an imaginary roommate called Charles. He was one escape for the loneliness that John has felt from being isolated. John appeared weird
to people as his curiosity and thirst to do something great overpowered him. He is also straight forward that sometimes they misunderstood him and
drive them away. Because of that he was afraid to speak his mind, until he met Alicia who helped and supported him throughout his journey.

Schizophrenia is a disease that impairs the ability to think properly. It makes an imaginary reality to those who experience it. They sometimes inflict
harm to their selves from their frustrations and fears, and to others as they continue to indulge in their makeshift reality. This can make them paranoid
and delusional, having imaginary persons that only they can see and talk, such as William, Charles and Marcee in the movie. This makes them lost grip
in the reality. Because of this, it can make relationship strains, work strains and functioning strains. This does not only affect the patient itself, but also
those people around him/her. Schizophrenia is a degenerative disorder that needs treatment and medications, that when not taken religiously can provide
more problems such as relapse and worsening of the condition.

After watching the movie, I learned that mental disorders could take form in many quiet and sneaky ways and that how important mental health is. The
movie depicted the practical example of how the disorder would affect us in our daily lives and how it manifested in simple manners. That not every
person who we think is healthy is really healthy, and that not what is shown outside is what is really in the inside. The movie made me realize that we
should be aware of the things that we must be concern and aware of. Another thing that I’ve got from the movie is that extraordinary things can happen.
With the right help and support from the people around you, you can still be yourself and function accordingly. Perseverance and commitment are also
the key to have a normal life and “recovery”. Most importantly, that every person with this disorder still has the chance to live a normal life and that they
deserve to have another chance.
 
◦“Perhaps it is good to have a beautiful mind, but an even
greater gift is to discover a beautiful heart.”
◦THANK YOU!