In partial Fulfilment of the Requirement in

Related Learning Experience

Sta. Catalina Rural Health Unit

Presented to:

Joyreina F. Ragasa RN, MAN

Clinical Instructor

Presented by:

Christine Roiz C. Wailan

Bachelor of Science in Nursing IV- B

1
 TABLE OF CONTENTS

I. Introduction…………………………………………………………………….4

II. Objectives………………………….……..……….….......................................5

III. Patient’s Profile…………………………..........................................................6

IV. History of Past and Present Illness…………………..……………...................7

V. Mental Status Examination…………………………….…………………..….8

VI. Diagnostic Procedures………….. ……………………………………..…….12

VII. Drug Study………………………………………………………....…..……..14

VIII. Nursing Care Plan……….…………………………………………..…..…....19

IX. Nurse- Patient Interaction…..……………………………………............. .....28

X. Interpretation…………………………………………………...……….….…43

XI. References……………………………………………………………...……..45

2
I. INTRODUCTION

Our mental health is an important component makes us “us”. It influences how we

make decision, feel, and behave. Just as physical health needs attention and care so does

mental health. Yet, due to absence of emotional resilience, cognitive abilities, and capacity to

cope with life's challenges, encompasses a spectrum of mental incapacities such as anxiety-

related disorders, mood disorders, personality disorders, and schizophrenia. Awareness on

our mental health contributes positively and important on how we approach every facet of our

lives.

The patient to be mentioned in this analysis is 46 years old, male, living in

Dalaquisen, Lagangilang Abra Ilocos Sur. He was incarcerated in February 2013 in a

provincial jail in Abra and been transferred in the center from after being noticed that he is

quiet, and at times he had blank stares while jail. Hence, the court ordered to bring him to the

center for evaluation. He was admitted at the center on May 31, 2013, until present. His

admitting diagnosis was for observation psychosis and later diagnosed for undifferentiated

schizophrenia from his psychological tests results that happened on June 7,15, & 17, 2013.

In February 2024, after his latest mental status examination, concluded that he is

competent to stand on his court trial and later that month took over the court trial and

dismissed his case. It was recommended from the institution to discharge the patient back in

3
jail or origin and to direct the jail warden or his July authorized representative to fetch him

from the resumption of court proceedings to effect once back in jail. They also recommend

for the patient to continue taking his medications and regular out- patient follow- ups with

psychiatrist in order that his mental state can be monitored thereby prevent further relapse.

Schizophrenia is the most common thought disorder altering the perception of reality

and the ability to think clear and manage emotions and behavior. Characterized by different

symptoms including hallucinations, delusions, disorganized thinking, cognitive deficits.

Living with it is a constant battle for them as it impacts their life significantly.

Treatments for mental disorders varies depending on the condition and

individual needs. However, one barrier to seeking help for mental health issues is stigma.

Society often associates mental illness with weakness or instability, leading individuals to

feel ashamed or reluctant to share their struggles. Misconceptions and stigma often lead to

discrimination and social exclusion. People may view individuals with schizophrenia as

dangerous or unpredictable, perpetuating fear and misunderstanding. This stigma can prevent

people from seeking timely treatment, exacerbating their symptoms, and prolonging their

suffering.

Understanding the complexity of schizophrenia allows us to provide more empathy,

support, and effective therapies for those affected by this challenging condition. Building a

support network that comes with understanding, encouragement, and helpful support may

make a significant impact for someone dealing with mental health challenges. Educating

oneself and others about mental health, encouraging open conversations, and establishing a

culture of acceptance and inclusion are all important steps towards reducing stigma and

4
building an encouraging environment for all people.

II. OBJECTIVES

General Objective:

The main goal of the author is to present the behavioral analysis of the given case scenario

that

would provide a comprehensive discussion of the diagnosis of the specific disease to yield

significant information for the behavior analysis.

Specific Objectives:

In order to meet the general objectives, the proponent aims to:

 To build a trusting relationship with the patient based on empathy, respect, and genuine

concern for their well-being.

 To interpret the pertinent data gathered from the patient,

 To state past and present health history of the patient,

 To identify and describe the behaviors that are being observed and analyzed. This

includes describing the behavior in observable and measurable terms.

 Identify the events, stimuli, or conditions that precede the occurrence of the target

behavior. This helps in understanding what triggers or influences the behavior.

 To define the complete nursing diagnosis of the patient,

 To interpret the laboratory test result of the patient,

5
 To discuss the medical treatment and diagnostic procedures performed to the patient

 To present a specific, measurable, attainable, realistic, and time-bounded nursing

care plan

III. PATIENT’S PROFILE

A. Biographical Data

Name: Pingol, Louie Anquillano

Gender: Male

Age: 46 years old

Birthday: October 27, 1977

Place of birth: Pampanga

Address: Dalaquisen, Lagangilang Abra Ilocos Sur

Civil Status: Single

Religion: Catholic

Nationality: Filipino

Occupation: N/A

B. Medical Profile

Date of Admission: May 31, 2013

Time of Admission: 12:40 PM

Institution: National Center for Mental Health

Ward: Ward 35

Admitting Diagnosis: For observation psychosis

Admitting Clerk: Teodora Acosta Bayaga

6
Admitting Physician: Marlou G. Davenga, MD

IV. HISTORY OF PAST AND PRESENT ILLNESS

A. History of Present Illness

Patient P was presented at Pavilion 35, Ward 3, 46 years old, male with a diagnosis of

undifferentiated schizophrenia. Initially, he was incarcerated at Provincial Jail of Abra in

February 2013. While in jail, he was noted to be quiet and at times he had blank stares hence

the court ordered to bring him to the center for evaluation.

B. Past Health History

In the investigation report, it was stated that on or about 12:15 AM of September 30, 2011, at

Sitio Tammogong, Brngy. Presentar, Lagangilang Abra, Philippines and within the

jurisdiction of the honorable court, the said accused (patient P), with lewd design, did, then

and there willfully, unlawfully, and feloniously hold the private parts, kiss, and embrace a

minor, 16 years of age, against her will and consent, thereby committing a prejudicial to the

child’s development.

7
V. MENTAL STATUS EXAMINATION

8
MENTAL STATUS EXAMINATION

Appearance Behavior Conversation Affect Perception Cognition Rapport Insight

Body build Retardation Rate Stability  Patient Orientation  Patient is  Patient has
 Medium  Movements  Patient  Patient denies  Patient is easy to talk poor insight
Posture are slow talks has fixed, halluci- oriented and shares on his state of
 Slouched Agitation slowly blunted nation and has his thoughts condition as
Eye contact  Patient with long emotion and good as well he noted that
 Patient keeps appears to pauses Intensity illusions memory of  He noted to it was his
eye contact be unable to before  Patient  Exhibits long-term have no girlfriend who
while sit still, answering has flat delusion events but friend in caused his
conversation tremors, queries affect s has poor their ward incarceration
Dress habitually Rhythm  Emotions short-term and doesn’t  Unable to
 Patient is brushes hair  Patient or memory talk or state the
wearing clean Gait appears to reactions  Patient can socialize reason of his
and neat blue  Patient stutter are not remember with others admission in
hospital walks slowly sometimes coordinat names, has the institution
uniform Volume ed to the
Grooming  Patient circumsta capacity to
 Patient’s hair is talks in low nce read and
close to scalp tone voice write and

9
 haircut or Affect spell his
 Beard also whispered  Patient own name.
shaven like voice appears
 Nails are Amount neutral,
trimmed and  Patient anxious,
pale in color talks or and
 Patient looked answer depressed
neat and well- queries in  Does not
groomed brief words socialize
Manner or with
 Patient was monosyllab others
cooperative to ic  decreased
queries Articulation interest in
 Does not Patient appears activities
socialize with
to mumble that
others
Attentiveness sometimes and would
 Patient appears slurred otherwise
to be Speech be
preoccupied Exhibits alogia interestin
and distracted (reduction or g
but attentive poverty in
Distinguishing

10
features speech)
 Patient has a
mole forehead
on the right
side, left side
on cheeks and
mustache area.
 Has a scar on
the back of his
right hand

11
VI. DIAGNOSTIC PROCEDURES

CBC Result

Hematology Result Normal Values Nursing Responsibility

Hemoglobin 131 F: 123-153 g/L  Inform the patient about the

purpose of the procedure,
M: 140- 175 g/L
what it entails and reassure
Hematocrit 0.39 F: 0.36- 0.45 g/L them about the routine nature
of the procedure.
M: 0.42- 0.56 g/L
 Obtain informed consent
RBC Count 4.5 M: 4.5- 5.9 x 10^12 L depending on institutional
policies and the patient's
F: 4.1- 5.9 x 10^12 L
condition, ensure informed
WBC Count 6.1 4.4- 11.3 x 10^9 L consent is obtained before
proceeding with the blood
Differential Count
draw.
Neutrophil 0.61 0.45- 0.65  Assess the patient's vital signs
before, during, and after the
Lymphocyte 0.24 0.20- 0.35
procedure to detect any
Monocyte 0.10 0.02- 0.06 adverse reactions.
 Document the patient's
Eosinophil 0.05 0.02- 0.05
consent, preparation, and the
Red Cell Indices procedure details in the
MCV 87 80- 96 fL patient's medical record
accurately.
MCH 29.4 27.5- 33.2 pg  Record any observations, such
MCHC 0.337 0. 334- 0. 355 g/L as difficulty in obtaining
blood or patient reactions
Clinical Chemistry during the procedure.
BUN 2.87 2.80- 7.20 mmol/L  Follow up with the patient to
monitor for any delayed
Crea 80-70 58.00- 110.0 umol/ L complications and address any
Uric Acid 435.0 H 208. 0- 428. 0 umol/ L concerns or questions they
may have regarding the
SGPT (ALT) 34. 00 0.00- 45. 00 procedure or test results.
SGOT (AST) 38. 00 H 0.00- 35. 00 u/L

Radiograph Report: Chest

12
Suspicious opacities are seen in the right upper lung
Hear is not enlarged
Aorta is not dilated
Diaphragm & Sulci are intact
Bony thorax is unremarkable
Impression: suggest Apicolordotic view

Psychological Report
Date examined: June 7, & 15, 2023
Date evaluated: June 17, 2013
Reason for referral: to assess capacity/ incapacity to stand trial

Assessment Tools:
Clinical Interview
Weschsler Adult Intelligence Scale- Revised Test
Bender Visual Motor Ocstalt Test
Sach’s Sentence Completion Test

Behavioral Observation
Subject has small body physique, brown complexion, messy hair but neat. His voice was
almost inaudible, and his responses were slow. He denied the case being accused by him (Act
of Lasciviousness) as he said that “ka live- in ko yun”. However, he failed to elaborate how
long they lived together as well as the details of the incident was not elicited. He further
negated having mental illness as he denied hallucinatory experiences. History of such illness
in the family was not also uncovered. Use of prohibited drugs was denied but claimed that he
only drank alcoholic beverages on occasional basis while cigarette smoking was 1 pack a
day.

Results of evaluation:
WAIS- R
Verbal Scale IQ- 59
Performance Scale IQ- 71
Full Scale IQ- 62
Classification: Mild Mental Retardation

13
VII. DRUG STUDY
Drug Name Dose, Route, & Mechanism of Indication Contraindication Adverse Effects Nursing
Frequency Action Responsibility
Generic name: Dose: 5-10 mg Unclear. Thought Treat Hypersensitivity CNS: dizziness, Patient monitoring
 Watch for signs
Aripiprazole Route: Oral to exert partial schizophrenia to drug insomnia, akathisia,
and symptoms of
Frequency: BID agonist activity at agitation, anxiety, depression and
evaluate patient
Therapeutic (two times a central dopamine headache,
for suicidal
class: day) D2 lightheadedness, ideation.
 Monitor
Antipsychotic, and type 1A drowsiness, tremor,
neurologic status
neuroleptic serotonin (5- tardive dyskinesia, closely.
Patient teaching
Pharmacologic HT1A) seizures, neuroleptic
 Inform patient
class: Quinolone- receptors and malignant syndrome, that symptoms
will subside
derived atypical antagonistic increased
slowly over
antipsychotic activity at suicide risk several weeks.
 Tell patient that
agent serotonin 5- CV: orthostatic
drug may cause
HT2A receptors. hypotension, urinary
incontinence.
Also has hypertension,
 Caution patient to
alpha-adrenergic peripheral edema, avoid strenuous
exercise and hot
and histamine1- chest pain,
environments
blocking bradycardia, whenever
possible.
properties. tachycardia

14
 EENT: rhinitis  Instruct patient to
move slowly
GI: nausea,
when rising to
vomiting, diarrhea, avoid dizziness
from sudden
constipation,
blood pressure
jaundice, abdominal decrease.
pain,
esophageal motility
disorders,
dysphagia
GU: urinary
incontinence
Respiratory: cough
Skin: rash
Other: fever,
hypersensitivity
reactions (including
anaphylaxis)
Generic Name: Dose: 200 mg Unknown. May Acute Hypersensitivity CNS: sedation, Patient monitoring
Chlorpromazine Route: Oral block schizophrenia to drug, other drowsiness, ● Monitor blood
Frequency: OD postsynaptic or mania phenothiazines, extrapyramidal pressure closely
Therapeutic HS (once a day dopamine sulfites reactions, tardive during I.V. infusion.
class: at bedtime) receptors in brain (injection), dyskinesia, 2Stay alert for signs
Antipsychotic, and depress areas benzyl alcohol pseudoparkinsonism, and symptoms
anxiolytic, involved in (sustained- neuroleptic of neuroleptic

15
antiemetic wakefulness and release capsules) malignant syndrome, malignant syndrome
emesis. Also ● Angle-closure seizures (hyperpyrexia,
Pharmacologic possesses glaucoma CV: tachycardia,
muscle rigidity,
class: anticholinergic, ● Bone marrow hypotension altered
Phenothiazine antihistaminic, depression (especially with I.M.mental status,
and adrenergic- ● Severe hepatic or I.V. use) irregular pulse or
blocking or cardiovascular EENT: blurred
blood
properties. disease vision, dry eyes, lens
pressure, tachycardia,
opacities, nasal
diaphoresis, and
congestion arrhythmias). Stop
GI: constipation,
drug immediately if
ileus, anorexia, dry these occur.
mouth ● Assess for
GU: urinary
extrapyramidal
retention, menstrual symptoms.
irregularities, Patient teaching
galactorrhea, ● Tell patient to take
gynecomastia, capsules or tablets
inhibited ejaculation,
with a full glass of
priapism water, with or
Hematologic: without food.
eosinophilia, ● Instruct patient not
agranulocytosis, to crush
leukopenia, sustained-release
hemolytic capsules.
anemia, aplastic
● Tell patient to mix
oral concentrate
anemia,
in juice, soda,
thrombocytopenia applesauce, or
pudding.
Hepatic: jaundice,
● Caution patient to
hepatitis avoid driving and

16
 Skin: rash, other hazardous
activities until he
photosensitivity,
knows how drug
pigmentation affects concentration
and alertness.
changes, sterile
● As appropriate,
abscess review all other
significant and life-
Other: allergic
threatening adverse
reactions, reactions and
interactions,
hyperthermia, pain at
especially those
injection site related to the drugs,
tests, herbs, and
behaviors mentioned
above.
Generic Name: Dose: 500 mg Water-soluble Recommende Prolonged use of Transient mild
Ascorbic Acid Route: Oral vitamin with d dietary excessive doses soreness at I.M. or
Frequency: OD antioxidant allowance contraindicated subcutaneous
Therapeutic (once a day) properties; in diabetes injection site;
class: stimulates mellitus, sodium- transient light-
collagen restricted diet, headedness or
formation and concurrent dizziness (with rapid
enhances tissue anticoagulant I.V. administration)
repair use, and history
of recurrent renal
calculi
● Use cautiously
in
hypersensitivity
to tartrazine or
sulfites (if

17
 product contains
these
compounds),
before tests for
occult blood in
stool, and in
breastfeeding
patients. Do not
exceed
recommended
amount in
pregnant patients.
● Avoid rapid
I.V. infusion.

VIII. NURSING CARE PLAN

Assessment Nursing Diagnosis Scientific Planning Nursing Rationale Evaluation
Background Intervention

18
 “Girlfriend ko Disturbed thought Dysregulation Short Term Dependent Short Term
po yung process related to of dopamine Date: July 11, Assess attention This determines Date: July 11, 2024, 4
span/distractibilit the ability of the
nagpakulong sa cognitive neurotransmissi 2024 PM
y and ability to client to
akin ma’am, dysfunction as on 1-4 PM shift make decisions or participate in After 4 hours of
siya po ang evidenced by After 4 hours of problem-solving. planning/executing nursing- patient
care. A reduced
nagsabi sa mga reduced emotional Disorganized nursing- patient interaction and music
attention span may
pulis kaya nila expression, thinking linked interaction and explain poor and dance therapy, the
ako hinuli” inability to state the to impaired music and dance performance patient was able to
across a few
 “6 years na po date that same day, prefrontal therapy, the engage in mindfulness
domains like
ako dito difficulty to recall cortex function patient will be language memory exercises, verbalize
ma’am” events from able to engage in due to limited feelings from the
 “Milyonaryo po yesterday Metacognition mindfulness processing. activity, and verbalize
ang tatay ko and “Girlfriend and thought exercises to Reorient to The inability to the date and time of
ma’am” as ko po yung deficits increase time/place/person, maintain shift of student nurses
verbalized by nagpakulong sa awareness of as needed. orientation is a as evidenced by
the patient. akin ma’am, Disturbed thought patterns sign of actively singing “Anak
siya po ang thought process and their impact, deterioration. by Freddie Aguilar”
Objective: nagsabi sa mga Accordingly, a and dancing during the
 Reduced pulis kaya nila  Verbalize multi-component music and dance
emotional ako hinuli”, “6 feelings from family therapy, “masaya po
expression years na po ako the activity reorientation ma’am, gusto ko po
 Inability to dito ma’am” at  Verbalize the kumakanta ng

19
 state the date “Milyonaryo po date and time strategy has videoke” and “July 11,
that same day ang tatay ko of shift of recently been 2024, ala una
 Difficulty to ma’am” as student proposed to hanggang alas kwatro
recall events verbalized by nurses achieve better sa hapon” as
from yesterday the patient. Long Term outcomes. verbalized by the
After 2 weeks of Validation therapy patient. Goal met.
Present reality
nursing- patient is a technique used
concisely and
interaction and for older adults Long Term
briefly and do not
therapies, the who are confused. Date: July 18, 2024
challenge illogical
patient will be The focus is on the 1-4 PM
thinking. Avoid
able to increase emotional aspect After 2 weeks of
vague or evasive
emotional of the nursing- patient
remarks.
expression, communication. It interaction and
 Maintain does not reinforce therapies carried by
perception of incorrect the student nurses the
reality perceptions but patient was able to
 Actively focuses on increase emotional
participate in validating the expression,
activities or client’s feelings maintain perception of
therapies (Ernstmeyer & reality, actively
managed by Christman, 2021). participate in activities
the student or therapies managed

20
 nurses by the student nurses,
 Verbalize verbalize events and
events and happenings from
Physical activity
happenings and exercise are yesterday without
from Collaborative beneficial for brain difficulty recalling it
Encourage the health. According
yesterday as evidenced by
to one study,
without client to engage in frequently showing
exercise was
difficulty regular activities associated with a feelings and
and therapies slight
recalling it. expressions like
improvement in
managed by the smiling and laughing
cognition.
student nurses. during nursing- patient
interactions and
therapies, no
verbalization about his
victim as his
“girlfriend” when
being asked, maintain
participation in
activities and “nag ahit
kami kahapon at nag
nail cutter” as
verbalized by the

21
 patient, recalling the
events from yesterday
without difficulty.
Goal met.

Subjective Social isolation Neurotransmitt Date: July 12, Dependent Date: July 12, 2024, 4
“Wala akong related to inability ers imbalances/ 2024, 1-4 PM Conduct one-on- The goal is to PM
kabigan sa loob to engage in or cognitive shift one conversation gradually increase After 30 mins. of
ma’am” maintain impairments After 30 mins. of (nurse- patient the patient's nurse- patient
“Wala po akong relationships as nurse- patient interaction) comfort with interaction, the patient
kausap, natutulog evidenced by Negative interaction, the social interactions was able to engage in
na po ako agad” as alogia, fixed flat, feedback loops patient will be and build trust group activities within
verbalized by the blunted affect, and able to engage in with healthcare group therapy
patient. prefers being alone, perpetuation of group activities providers. sessions, demonstrate
sits or stand at the isolation within group Offer yourself as Establishing a improved
Objective back of everyone, therapy sessions, a nonjudgmental therapeutic communication skills
 Alogia increased tremors Social isolation recreational listener. relationship during interactions
 Fixed flat, when being asked related to activities promotes trust and with peers and other
blunted affect
in front of inability to  demonstrate a safe space for the student nurses as
 Prefers being
alone everyone (sign of engage in or improved patient to discuss evidenced by sharing

22
 Sits or stand at social anxiety), maintain communicati sensitive matters feelings towards their
the back of lack support from relationships on skills Re- motivational
everyone
family and friends during Group therapy therapy with others
 Increased
tremors when “Wala akong interactions Encourage sessions can help “masaya ako sa flower
being asked in kabigan sa loob with peers Participation in patients overcome at nakakagaan ng
front of
ma’am” and other Group Therapy social anxiety, loob”. Goal met.
everyone (sign
of social “Wala po akong student Sessions improve
anxiety) kausap, natutulog nurses communication Date: July 19, 2024,
 Lack support
na po ako agad” as skills, and foster a 1-4 PM shift
from family or
friends verbalized by the Long Term sense of belonging After 2 weeks of
patient. After 2 weeks of within the nurse- patient
nursing- patient psychiatric ward interaction, the patient
interaction, the community. was able to
patient will be independently initiate
able to will Collaborative This intervention social interactions and
independently Conduct group aims to build their activities as evidenced
initiate social therapies with confidence and by actively
interactions and other student competence in participating during
activities, nurses along with social interactions, grand socialization.
 report his peers thereby reducing Goal partially met.
decreased feelings of
feelings of

23
 loneliness isolation.
and increased
satisfaction
with social
interactions
 express
increase of
sense of self-
worth
Subjective Risk for loneliness Negative Short term Assess the The patient’s point Short Term
"Natutulog na ako related to impaired symptoms of Date: July 12, patient’s feelings of view provides a Date: July 12, 2024,
agad pagkatapos social interaction schizophrenia 2024, 1-4 PM and perceptions baseline for 4PM
kami bilangin sa as evidenced by shift about the establishing the After nurse- patient
loob ma'am" flat, fixed, blunted Cognitive and After 30 mins. of situation. plan of care. It interaction, the patient
"Di na po ako affect, lack of emotional nurse- patient gives an insight was able to acquire an
nakikipag usap sa social interaction, changes interaction the into whether the understanding of the
iba" difficulty in patient will be patient thinks that importance of being
"Wala pa pong engaging in a Social able to verbalize he or she has connected to other
bumibisita sa akin conversation, and withdrawal positive self- control over the people and has ways to
simula nakulong “Natutulog na ako statements to situation and do so as evidenced by
ako ma'am" as agad pagkatapos Increased help cope with wants to be alone nodding and listening
verbalized by the kami bilangin sa feelings of or if the situation to student nurses and

24
patient. loob ma'am" isolation loneliness. is not within the participating in group
"Di na po ako  has an client’s control. activities like play
Objective nakikipag usap sa Risk for understanding Provide Provide emotional therapy. Goal partially
 flat, fixed, iba" loneliness of the supportive care encouragement, met.
blunted affect "Wala pa pong related to importance of guidance, and
 lack of social bumibisita sa akin impaired social being empathy to the Long Term
interaction simula nakulong interaction connected to patient. Date: July 19, 2024,
 difficulty in ako ma'am" as other people Guide patient self- Assist the patient 1-4 PM shift
engaging in a verbalized by the and has ways exploration in exploring their After nurse- patient
conversation patient. to do so. own feelings and interaction the patient
Long term thoughts so that will be able to practice
Date: July 12, they can gain communication skills
2024, 1-4 PM insight into their to improve social
shift motivations, interactions. will
After 2 weeks of needs, and fears. acquire social skills to
nurse- patient Assist in Educate the patient interact with society,
interaction, the developing coping on effective will express the feeling
patient will skills coping strategies of increased self-worth
practice and provide and appear more
communication support while confident as evidence
skills to improve implementing new by talking with peers
social during socialization

25
interactions coping skills. and playing games
 patient will Praise the client Showing with them.
acquire social for making appreciation keeps Goal partially met.
skills to progress the patient
interact with motivated and
society increases self-
 patient will esteem
express the
feeling of Collaborative
increased Encourage social Promote the
self-worth involvement. patient's
and appear involvement in
more social activities
confident with other student
nurses in order to
help foster
relationships and
build community.

26
IX. NURSE- PATIENT INTERACTION
Nurse Patient Therapeutic communication Rationale
technique used
“Good afternoon po sir, ako po ‘“Hello ma’am” Giving information By using this technique in orientation
si Christine Wailan o pwede phase will allow the student nurse to
niyo po ako tawagin na establish trust with the patient.
Christine, galling po kami sa
Vigan, Ilocos Sur at ako po
ang magiging student nurse
niyo ngayon hanggang sa
susunod na linggo po.” This technique helps the student nurse
“Hindi naman ma’am, pero Making observation notice nonverbal signals such as facial
“Kamusta po kayo sir, parang sumayaw din kami kaninang expressions and body language which
napagod po kayo sumayaw umaga” can help the student nurse reveal

27
kanina?” underlying concerns.

“Louie Pilong”
“Ah Mabuti naman sir. Pwede
ko po ba malaman ang Using this technique and being able to
pangalan ninyo sir?” Seeking information gather information initially will allow
“46 years old na ako” the student nurse to know or identify the
“Ilang taon na po kayo sir?” patient.
“Sa Bangued, Abra po ma’am”
“Saan po kayo nakatira sir?”

“Yung kuko ko mahaba na Using broad openings This technique allows the patient to
“May nais po ba kayong meron kaming schedule ng nail begin a conversation or a topic that they
ikwento sir?” cut” want to discuss freely, this creates a
welcoming environment where the
patient feel valued and heard.
This technique allows the patient to
elaborate what he stated and allows the
“Ganon po ba sir, tuwing “Sa sunod na araw, pati ahit Encouraging description student nurse to understand and learn
kalian po kayo mag nail cut din ma’am.” about the patient.
sir?“
In sharing perception, it allows the
student nurse validates the patient’s
thoughts or experiences.
“Oo ma’am” Sharing perception
“Maganda po yun sir, para di
po kayo mainitan at General leads create opportunities for
maaliwalas po sa pakiramdam” the student nurse to focus or delve
deeper on a certain topic based on what
“Naliligo kami ng sabay Offering general leads she finds most relevant.

28
“Ano pa po ginagawa niyo dito ma’am tapos pinapainom ako
araw-araw sir?” ng gamot, dalawa yung gamot Restating helps the student nurse to
ko” confirm or elaborate on what the patient
said. This also shows that the student
nurse is actively listening and attentive
Restating to the patient’s narrative.
“Umiinom po kayo ng gamot “Oo ma’am para malakas ang
niyo sir?” resistensya at malusog.” Using this technique encourages client to
reflect on their own thoughts and
experiences.

Sharing perception Exploring on a topic involves delving

“Opo sir inumin niyo po yung “Oo ma’am tapos isang gamot deeper into the patient’s feelings or
gamot niyo para malusog po sa tanghali tapos dalawa na thoughts. This will allow the student
kayo, kumakain po ba kayo naman sa hapon” nurse to have thorough understanding
bago uminom ng gamot sir?” and also allows the patient to express
Exploring their thought and self-reflect.
“Ano naman po ginagawa niyo “Mag uusap kami konti tapos
sir pagkatapos uminom ng matulog na”
gamot sa hapon?”
“Nakikipag usap po kayo sa
mga kasama niyo sir” “Oo ma’am”
“Mga kaibigan niyo sir?” “Isa lang kaibigan ko dito si
Oscar”

“Bukod po kay sir Oscar, may “Wala ma’am, 7 years ng

iba po ba kayong nakakausap walang bumibisita sakin dito”
sir, may bumibisita po ba sa
inyo?” Showing empathy will allow the nurse to
Empathy show that she understands the patient’s
*nods thoughts and feelings of the patient

29
“Ah naiintindihan kong creating a support for client and leading
mahirap ito sa inyo” to effective therapeutic relationship.

Silence Silence allows time to process their

thought and feelings to reflect on what
*short silence has been discussed.

Exploring on a topic allows the student

Exploring nurse to gather more or reveal more
“Naghiwalay si mama at papa information or concerns that is
“Maari ko ba malaman kung kaya yung tito ko sa Abra nag significant for therapeutic
saan po ang inyong mga alaga sakin.” communication.
magulang sir?”
This allows the patient to explain more
Encouraging description on a certain topic and this creates and
“Nagtatanim po kami ng palay build more trust for the nurse and patient
“Ganon po ba, ano po tapos inaani namin, siya din as the conversation keeps going.
ginagawa niyo noon kasama nagturo sakin sumayaw”
po ang uncle niyo”
Recognition acknowledges the patient’s
“Nangingisda din ako ma’am talents and supports self- esteem and that
sa Pampanga kasama ang papa Giving recognition their efforts are being noticed and
“Ah ang dami niyo naman po ko noon” valued.
palang talento sir”

“Oo ma’am pero saglit lang,

nagtrabaho din ako sa junk
“Talaga po, tumira din po kayo shop, nag aayos ng mga By offering general leads allow the
sa Pampanga noon?” sasakyan” patient to expand on their thoughts and a

30
 Offering general leads sign that the student nurse is engaged
“Yung mama ko nasa Abra din and interested in listening.
“Ah ano pa po sir?” kinakatay niya baboy tapos
binebenta sa palenke, yung iba
niluluto niya para may kainin
kami”
By seeking information about the foods
Seeking information will allow the student nurse to know and
“Hindi ma’am, manok gusto gather idea regarding the patient’s
“Ah paborito niyo po ba ang ko” preference.
baboy sir?”
Accepting the patient’s statement by
Accepting nodding when he mentioned he doesn’t
like carrots will allow the nurse to show
“Ah naiintindihan ko po” that she understands and open to hearing
and working through difficult emotions.

By using this technique will allow the

nurse to know more about the concern
the patient has said.
Exploring

“Dito po pinapakain po ba “Hindi ma’am, minsan gulay o

kayo ng manok?” baboy” It helps to make the conversation or
Sharing perception topic continue and remains meaningful
and focused.
“Kinakain niyo naman sir?” “Oo ma’am” Sharing perception will allow the student
nurse to clarify misunderstanding or
“Mabuti naman po sir, para “Oo ma’am ayoko lang ng share her knowledge on something.
mabusog pa din po kayo at carrots kaya tinatapong ko sa
masustansya po ang gulay” basurahan pag may carrots.” This encourages the client to explore and
reflect on their own and helps deepen the

31
 Offering general leads therapeutic relationship.
“Oo ma’am tinatapon ko sa
“Ayaw niyo po ng carrots sir?” basurahan”

*Break time
Using broad opening after a short break
“Oo ma’am naubos ko, gutom allows to lighten the atmosphere
“Masarap po ba yung tinapay kasi ako” between the student nurse and patient
na binigay ko sir?” Using broad openings and be able to start on another topic.
“Wala naman ma’am”
“May gusto po ba kayong
ikwento ngayon sir, kung ano Encouraging descriptions will help the
po nasa isip niyo ngayon” patient provide more details to ensure
*nods that the student nurse completely
“Ako nalang po magtatanong understand the information.
sir, okay lang po?” Encouraging description
“Pito kami sa iba ibang tatay, Showing empathy will strengthen the
“Ilan po kayong magkakapatid yung isang kapatid ko sa relationship between the student nurse
sir?” kaparehas na tatay ma’am and patient and will allow patient to
patay na” know that the student nurse understand
his situation.
Empathy
“Oo ma’am”
“Nahirapan po siguro kayo sir
at namimiss niyo rin siya”
Silence shows respect for the patient’s
feelings and experiences and giving time
to express themselves fully.
Silence
Exploring in termination phase allows
*Silence the student nurse to gather information
and ideas that can be useful for their

32
 socialization.
Exploring
“Blue ma’am”
“Ano naman po ang
paboritong kulay niyo sir?”

“Hansel ma’am”
“Ano naman po ang
paboritong pagkain niyo sir?” “Oo ma’am” Offering self in this phase ensures that
“Yung biscuit po sir?” the student nurse have understood
Offering self fostering a more genuine connection.
“Wala naman ma’am, Hansel
“Ah sige po sir, meron po ba nalang” By giving recognition shows that the
kayong mga gusto o hiling na student nurse acknowledges the patient
regalo po?” in sharing his stories and by trusting the
Giving recognition student nurse for being open and
“Thank you, ma’am,” vulnerable.
“Okay po sir sa susunod po, sa
socialization natin bibigyan ko Clarifying by asking whether the patient
po kayo ng Hansel sir” has remembered the student nurse’s
name creates a light environment and a
“Okay ma’am, thank you din Clarifying deeper connection.
“Salamat po sa oras niyo sir na po”
magkwento at ibahagi sakin
ang mga karanasan niyo noon Offering self in this phase ensure the
sir, babalik po kami bukas patient that there still days that he will be
hanggang sa susunod na linggo able to talk freely and socialize with
po.” others.
“Christine ma’am”
“Maalala niyo pa po ba Offering self
pangalan ko sir?”

33
 *Smiled
“Opo sir, thank you sir. Balik
po kami bukas.”

Nurse Patient Therapeutic Communication Rationale

Used
“Hello po, sir. Good afternoon “Hello”
po.”

“Kamusta po kayo sir?” “Okay naman” Reflecting This allows the patient to express his
thoughts freely and openly.

“Ano naman po masasabi niyo “Masaya ma’am” Exploring By using this technique will allow the
sa activity natin kanina sir?” student nurse to determine whether the
patient thoughts on the activity done

“Opo parang masaya nga po “Sa CD noon ma’am kay papa Making observation By making observation will help the

34
kayo, kumanta pa po kayo sa ko” patient to verbalize feelings to the
harap nung paboritong kanta student nurse.
niyo po”

“May gusto po ba kayong “Nag ahit kami kahapon Using broad openings Using this technique encourages the
ikwento ngayong hapon sir at ma’am at nail cutter.” patient to choose on a topic that he
hindi namin kayo nakausap desires and so that he will gain more
kahapon?” trust to the student nurse.

“Ah oo nga po, pansin ko naka “Sila sir yung mga Giving recognition This technique shows that the student
ahit na po kayo at maliit na po nagbabantay sa amin.” nurse is aware on the patient’s behavior
ulit kuko niyo, Sino po ang and changes.
nag ahit at nail cut sa inyo
sir?”
“Di na mainit sa gabi ma’am”
“Ah Mabuti po sir, maaliwalas
na po ba sa pakiramdam sir?”
“Tinapay at itlog ma’am.”
“Maganda po pa ganon sir, ano
naman po kinain niyo
kaninang umaga sir?”
“Walang binigay na kanin sa Seeking information Seeking information will allow the
“Hindi po kayo kumain ng umaga ma’am” student nurse to gain more knowledge
kanin sir?” regarding to the patient
“Baboy ma’am yung sabaw
“Sa tanghali po sir ano naman niya ay kulay orange, di ko po
po kinain niyo?” alam ano yun”

“Ah caldereta po yun siguro

sir”
“Oo ma’am pero adobo yung Clarification Clarification encourages the patient to

35
“Diba po paborito niyo ang luto” make the information understandable and
baboy?” ensure that what the student nurse has
knowledge is true.

“Sa mama ko ma’am, tinuruan Focusing This allows the conversation to stay
“Saan niyo po natikman yung niya din ako” focus on the topic and gather more
masarap na lutong adobo sir?” information and allow patient to speak
more about himself in a comfortable
manner.

“Unahin mo mantika ma’am

“Paano po sir, pwede niyo po tapos igisa mo yung sibuyas Offering self
baa ko turuan para kapag tsaka mo lagyan ng bitsin tsaka Using this technique allows the patient to
nagluto ako yung paraan mo yung soy tapos ihuli mo yung know that the student nurse
po yung gagawin ko?” baboy” acknowledges his ideas and talents.
“Wala na pong paminta sir?” “Kahit di na ma’am masarap
na yun”
“Ah sige po sir, ano naman po “Wala na, yun lang”
isasahog ko na gulay?” “Kapag nalusaw na yung
“Ah tapos pano mo po sabaw at malambot na yung
malalaman kung luto na?” baboy”

“Ah thank you po sir, lulutuin *Smiled

ko po yan sa susunod”
Clarifying
“Oo nga pala sir, nagustuhan “Oo ma’am masarap po” Clarifying by asking the question again
niyo po ba yung meryenda so that the student nurse ensures that the
niyo sir, Hansel po binili patient appreciate and like the food he
naming yung paborito niyo loves.
po”
Seeking information Seeking information will help the student

36
 “Rebisco ma’am, yung nurse to acquire more information about
“Ano pa pong meryenda ang strawberry po” the patient’s preference so she has idea
gusto niyo kainin sa susunod what to give to the patient the other time.
sir?” “Oo ma’am kahit natikman ko
“Ah sige po sir, paborito niyo na lahat”
rin po yun?”
“Okay po sir” Silence
Silence allows a comfortable and trusting
*Silence atmosphere as it gives time to the patient
to think and reflect on himself.

Using broad openings

“Yung tita ko ma’am” Using broad openings after a silent
“Ano po nasa isip niyo ngayon atmosphere allows the patient to decide
sir?” what to talk about again to promote open
and active listening.

Focusing Focusing allows the patient to talk more

“Oo ma’am” about on what he just said so he can let
“Miss niyo na po siya sir?” “Nung namatay lolo ko out his thoughts and feelings.
“Kailan niyo po siya huling ma’am”, bago pa ako
nakita?” makulong”
“Miss ko na siya”
“Pag nakalaya ako dito siya
una gusto kong makita”
“Ano po naramdaman niyo
sir?” Empathy shows that the student nurse
Empathy understands the patient’s feelings

“Ah naiintindihan ko po
nararamdaman niyo sir”

37
*Silence “Okay ma’am”

“Gusto niyo din po ba

makisabay at manood kasama
po sila sir?”

“Okay po sir”

Nurse Patient Therapeutic Technique Used Rationale

“Hello sir, kamusta po kayo?” “Okay naman”

“Ang ganda po ng pagkakulay *smiled Giving recognition Recognition acknowledges the

ninyo sir” patient’s talents and supports
self- esteem and that their efforts
are being noticed and valued.

“Nagustuhan niyo din po ba yung “Oo ma’am” Encouraging description This technique allows the patient
gawa niyo sir?” to elaborate what he stated and
allows the student nurse to
understand and learn about the
patient.

“Wala na po kayong gustong “Wala na ma’am, okay na yan” Offering general leads By offering general leads allow
idagdag?” the patient to expand on their
thoughts and a sign that the
“Ah sige po sir, pahinga muna student nurse is engaged and
kayo” interested in listening.
*silence

“Ano po pala ginawa niyo kanina *difficulty recalling Exploring Exploring on a topic allows the
38
sir?” student nurse to gather more or
reveal more information or
concerns that is significant for
therapeutic communication.
“Ano nalang po kinain niyo “Itlog ma’am tsaka tinapay” Using broad openings
kanina sir?” Using broad opening after a short
break allows to lighten the
atmosphere between the student
nurse and patient and be able to
start on another topic.
“wala pong kanin sir?” “Nung tanghali lang ma’am” Seeking information Using this technique will allow
the student nurse to gather further
“Ah pero kaninang umaga po?” “Wala ma’am” information about the patient.

“Ah ano po ginawa niyo sir “Wala ma’am, tulog lang sa

pagkatapos kumain?” loob”

“Di po kayo nag uusap sa kasama “Hindi ma’am”

ninyo sa loob sir?”

“Eh si sir Oscar po yung kaibigan “Ah hindi kami nag uusap” Restating
na sabi niyo sir?” Restating helps the student nurse
to confirm or elaborate on what
the patient said. This also shows
that the student nurse is actively
listening and attentive to the
*silence patient’s narrative.
Silence
Silence allows time to process
their thought and feelings to
reflect on what has been
discussed.

39
“Wala po bang student nurses na “Wala ma’am” Offering general leads
bumisita po dito sir?” By offering general leads allow
the patient to expand on their
“Ah kaya natulog lang po kayo, “Oo ma’am” thoughts and a sign that the
maganda naman tulog niyo sir?” student nurse is engaged and
interested in listening.

“Mamaya din sir, matulog po “Anong gagawin natin bukas Giving information By using this technique will
kayo ng maaga para sa ma’am” allow the patient to know and
socialization bukas, mag ipon po become oriented with upcoming
kayo ng maraming energy kasi events.
marami tayong gagawin sir ha?”

“Maglalaro po tayo sir, at yung “Lorena ma’am” Seeking information

kantahan po diba hiningi po Using this technique and being
naming yung gusto niyong able to gather information will
kakantahin, ano po ulit yun sir?” allow the student nurse to know
and make sure about the
“Ah opo na kinanta po ni Willy “Oo ma’am” information given by the patient.
Garte sir no?”

“Yun po talaga gusto niyo sir “Hindi ma’am, yung Anak po

no?” paborito ko”

“Bat hindi po yun kakantahin “Yung Lorena muna ma’am”

niyo sir?”

“Sabagay nakanta niyo naman na “Oo ma’am”

po noon yung Anak sir”

“Basta sir ha, matulog po kayo ng “Okay ma’am, may sakit ako

40
maaga at galingan niyo po bukas” ma’am, may ubo ako”

“May plema po sir?” “Meron ma’am” Exploring

Exploring on a topic involves
“Meron po ba kayong iniinom na “Meron ma’am yung vitamins” delving deeper into the patient’s
gamot po?” feelings or thoughts. This will
allow the student nurse to have
thorough understanding and
effective in therapeutic
communication.
“Ah inumin niyo po yun sir ah at “Opo ma’am” Sharing perception
uminom po kayo ng maraming It helps to make the conversation
tubig, kapag uubo din kayo sir or topic continue and remains
wag po kayo humarap sa kasama meaningful and focused.
niyo po para di po sila mahawaan Sharing perception will allow the
at iluwa niyo po sa labas yung student nurse to clarify
plema niyo sir ah?” misunderstanding or share her
knowledge on something.
“Opo para gumaling po kayo “Okay ma’am”
agad sir”

“Sige po sir kunin ko lang po “Okay ma’am, Salamat ma’am” Termination phase
yung gamit ko pangkuha ng BP
niyo po, oxygen saturation at
temperature sir pagkatapos non
ay mag memeryanda na po kayo”

41
X. DRAWING INTERPRETATION

First drawing
Left side: Flower that looks like a tree the color of the branches are green and the flowers are
colored red
Right side: Colorful house surrounded by color orange, blue, and green
Interpretation:
 Left side symbolizes our past
 Warm colors indicate joy and stability
 Flower suggests becoming aware of own personality and waiting to bloom & connection
to nature. Also indicates happiness and love for family.
 Tree on the other hand, symbolizes a person or thing from the past that he does not
happen to forget. Might also fear insecurity and would want to be protected.
 Color red represents power and associate strong feeling
 Color green symbolize growth in personal development or aspects of the self that are
evolving

 Right side represents our future, expresses oneself and communicate hidden thoughts
 House with windows and door are likely to be happy.
 Tall, thin or simple house suggests a critical mind and does not show an open- minded
approach towards different things.
 According to Dr. Burns drawing houses place a high value on shelter & security
 Color orange shows social communication & optimism
 Color blue shows stability, strength, trust & peace

Second drawing
Left side: flower outlined in red color and the petals is colored in orange
Right side: star outlined in red and colored in blue
Interpretation:
 Left side symbolizes our past
 Soft, rounded petals in his drawing suggests an amiable, family- centric person
 The circle means warmth
 Orange shows social communication & optimism

42
 Right side symbolizes our future, to express oneself, and communicate hidden thoughts
 Color red represents power and associate strong feeling
 Stars indicate feelings of hopefulness, looking forward to things and optimism
 Blue star indicates calmness or serenity

Third drawing
Left side: rice fields drawn in color green and birds drawn in color blue
Right side: Sun drawn in bright yellow with plenty of rays
Interpretation:
 Left side symbolizes our past
 Rice fields shows desire for order, stability and control despite chaos or confusion
 Color green shows
 Birds indicates freedom, aspiration, or desire to escape
 Color blue indicates calmness or serenity

 Right side symbolizes our future, to express oneself, and communicate hidden thoughts
 The sun represents his father
 Bright color indicates joy
 Yellow indicates optimism & cheerfulness

Based on his drawings, he shows or express longing towards his family and indicates need for
security, and hopefulness towards his future.

43
XI. REFERENCES

Wagner, M. 2024. Social Isolation Nursing Diagnosis & Care Plans. Nurse Together.

Christman, E., & Barone, D., et. al. (2022). Nursing Mental Health and Community

Concepts. Chippewa Valley Technical College.

Wayne, G. (2024). Impaired Thought Processes & Cognitive Impairment Nursing Care Plan

and Management. NurseLabs.

Vass, Zoltan. (2012). A Psychological Interpretation of Drawings and Paintings.

ResearchGate.

(2024). Psychology Meaning of Drawings. Nature Whisper Blog.

Website

https://www.mims.com/

44