Case study for a client with schizophrenia

Case study for a client with schizophrenia and has had three admissions to hospital the last one five years ago ,her name hala ,at the age of 35 year old ,she live with her brother but tend to be a bit overprotective ,not allowed to take much responsibility in the home or to go out alone . The clinical picture of the client: It include the, signs symptoms for the client. Hala has moderately severe negative symptoms ,The negative symptoms of schizophrenia, defined as the absence or diminution of normal behaviors and functions , negative symptoms account for much of the long-term morbidity and poor functional outcome of patients with schizophrenia.. The signs and symptoms of schizophrenia are numerous and debilitating , these symptoms are the lack of important abilities . Some of these include: 1)Alogia: or poverty of speech, is the lessening of speech fluency and productivity, inability to carry a conversation ,thought to reflect slowing or blocked thoughts, and often manifested as short, empty replies to questions. 2) Affective flattening: is the reduction in the range and intensity of emotional expression, including facial expression, voice tone, eye contact (person seems to stare, doesnt maintain eye contact in a normal process), and is not able to interpret body language nor use appropriate body language. 3) Avolition: is the reduction, difficulty, or inability to initiate and persist in goal-directed behavior; it is often mistaken for apparent disinterest. ) Inappropriate social skills or lack of interest or ability to socialize with other people. (examples of avolition include: no longer interested in going out and meeting with friends, no longer interested in activities that the person used to show enthusiasm for, no longer interested in much of anything, sitting in the house for many hours a day doing nothing.) . 4) Catatonia: Apparent unawareness of the environment, near total absence of motion and speech, aimless body movements and bizarre postures, lack of self-care. 5) Social isolation : person spends most of the day alone or only with close family, and inability to make friends or keep friends, or not caring to have friends. 6) Low energy :the person tends to sit around and sleep much more than normal. The client is being worked upon with the following MDT: Psychiatrist: the psychiatrist works with the client using needed medication, such as Prozac. Psychologist: the psychologist works with the client using different approaches, in order to understand her, and her behaviors, through talking, observingà ¢Ã¢â€š ¬Ã‚ ¦ Social worker: the social worker works with the client in understanding difficulties that the client has, that affect her social lifeà ¢Ã¢â€š ¬Ã‚ ¦for example not going to work, the thing that affects her social relations and networks. Physician and nursing: the physician is a general doctor that follows up the clients medical status. On the other hand, the nursing team is available in the institution for the clients need to be supervised by a medical team, for if someone would have a relapse, an action would be done, such as giving injections. Finally, the MDT works together, by meetings and reports about each client. She is treated with medication and visits the out patient clinic at the hospital every three months to see her doctor. she reliable about raking her medication and keeping her outpatient appointments. treatment may include: behavioral therapy: patients with schizophrenia improve their social skills and put structure in their lives. Through social skills training, they may learn how to make requests, express feelings, and adjust their voices and facial expressions. The impact of the illness will have on the clients occupational functioning The impact of these symptoms on ADL, work, and liesure. Activities of daily living require the ability to start and repeat purposful task performance so that become habitual or routine and these tasks or activities include: bathing, grooming, and dressing, washing hands before a meal, eating with resonable table manners, then cleaning up. Persons who have schizophrenia may find routin task performance interrupted by symptoms, side effects of medication, and progression of schizophrenia. Auditory or visual hallucinations may interrupt attention, and tactile discomfort with texture of materials may limit occupational performance. Many ADL routines become challenging in the presence of motor problems produced by negative symptoms and the neurological side effects of medications. Incoordination, tremores, rigidity, or slow movement may interfere with tasks like replacing caps on bottles, shaving, and using eating utensils. In the psychological area, major barriers to ADL are pathy, avolition, or extreme withdrawal. Even persons who show inter est in social interaction may not complete the self-maintenance tasks that would increase social acceptance. They are unable to engage themselves in tasks and may depend on others to involve them. fainally, self-management difficulties in schizophrenia influenece ADL performance to a great extent. Routines are abandoned when persons are unable to cope with environmental or internal stressors. Time management and self control become weak. Work Ofen persons with schizophrenia have difficulty finding satisfactory housing or keeping a job because of psychological, and self-management performance difficulties. Also, negative symptoms such as withdrawal, avolition, substance abuse, neurological impairment, medication side effects, and coexisting medical conditions make work performance impossible for many. The modelframe of reference I used to guide the assessment and intervention with the client: Frame of reference :MOHO model of human occupation I chose MOHO because it : 1)Furnishes a detailed framework of the occupational functioning of hala. 2)Enables precise measurement and useful description of hala occupational characteristics . 3)Give specific and detailed guidelines and tools for evaluating hala ,a specific language for describing the difficulties or challenges encountered ,and a framework for setting treatment goals and selecting the most appropriate strategy to achieve the desired level of change . 4)allows for a flexible approach to individualized therapy for hala and provides a comprehensive picture of the occupational functioning . 5)provides a conceptualization of the process and stages of change that was useful for guiding the sequence of therapy (including deciding when hala is ready to move from one level of change to another). how I assess the client I chose an activity during the assessment ,I chose washes plastic plates I chose ACIS assessment (( assessment of communication and interaction skills)). The ACIS is a formal observational tool ,to measure an individuals performance in an occupational form within a social group ,that allows occupational therapist to determine a clients strengths and weaknesses in interacting and communicating with others in the course of daily occupations. I chose ACIS assessment because ,it is most effectively used to generate a profile of strengths and weaknesses and qualitative details about my client ,this profile is the most important source of information for deciding what skills to target for change. ACIS is often helpful for understanding why is my client having difficulty with some interaction skills . The Canadian Occupational Performance Measure (COPM): to detect change in a clients self-perception of occupational performance over time. Follow the links below for further information about the COPM.   intervention process Assess clients level of disorientation to determine specific requirements for safety. Skill training interventions: Identify areas of skill deficit person is willing to work on. determine the goals for the client (shortlong terms goals) first I will establish the goals together with hala I will determine the goals from the deficit in her function ,from observation during the activity ,from the assessment ,and the client can ask me about some ability that she want to return it . Long term goal: to let her take much responsibility in the home ,allow her go out alone without any danger to her ,or her health or people .for example let her visit the hospital to see her doctor. Let her work for example secretary as she trained in the past ,or work in an office as she worked at age 21. Let her feeling more confident in social situations , can be operationalised by identifying performance indicators Short term: engaging in activity, increased motivation,improved judgment, increased energy, ability to experience pleasure and cognitive Function. factors that affect or important in assisting the client to reach the goals: important factor: the client :good response to the medication ,the acceptance of his situation, less number and the range of episodes, if she like the activity .her tolerance and endurance during the activity ,assessment and medication. Environment :good interaction with his environment ,feel some degree of safety in the therapy environment and in his living environment . Factors that might affect the clients program: Client :forget take the medication, she didnt like the activity or it is not suitable for her ,there is no therapeutic relationship., Family members may require support as clients in their own right.   They may also play a key role as an extension of the therapy team.   Where children are involved, a careful assessment of child safety is required, generally by someone specifically trained in this area such as a child protection worker

Test Taking Strategies

Test-Taking Strategies For 10 years, I was the one testing the students, teaching strategies and finding new ones to help students study. Suddenly, I found myself returning to school and the anxiety, stress, lack of time, and just all the unknowns seemed to overwhelm my life. The last couple of years I have learned to incorporate strategies that work best for me, but there is always room for improvement and strengthening. Learning, study and test taking skills are some of the most important things to have when furthering your education. Upon reading Strategies for Test Success by Linda Anne Silvestri, I was able to scrutinize some of my weaknesses, reevaluate my learning style, and look at some new test taking strategies while assessing my current strategies. Helpful Test Taking Strategies Tests usually have significant validity on your grade. The better you are prepared for different types of tests, the better grade you will receive. Meyers, 2000) Some helpful test strategies that I gathered from this assignment include: techniques for reducing test anxiety, avoid reading into the question, avoid changing answers, learning how to study in a manner that works best, and improving retention of information. Test anxiety is an unpleasant experience and can interfere with test performance. This is one area that I struggle with myself. Linda Anne Silvestri suggests incorporating some of the following techni ques in order to reduce anxiety while preparing for and taking an exam. First, evaluate yourself to determine what may be causing the anxiety. Is it stress, pressure to succeed, or negative thoughts? Second, figure out techniques that will help to reduce the anxiety such as: avoid procrastination, relaxation techniques before and during an exam, maintain a healthy lifestyle and diet, and maintain a positive attitude which will lead to success. (Silvestri, 2010) In that moment of despair, when my memory just seems to go blank, I often find myself digging from my own life experiences to find a rationale to the question being asked. Linda Anne Silvestri explains reading into a question as â€Å"One is considering issues beyond the information presented in the question. †(Silvestri, 2010) I am guilty of this on many occasions, and learning to identify the information the question contains and what it is asking will help improve my test scores. Changing answers is another area which I struggle. â€Å"You know the information; go with your first instinct, don’t second guess yourself! † I have said this to many students over the years, why does it seem so hard to incorporate into my own strategies now that I am a student? By reevaluating this area, hopefully I can become more confident in the answering of questions and learn to trust my instincts and knowledge. â€Å"One must also remember not change an answer unless you are absolutely sure you have made a mistake,† as stated in the book The Secret of Taking Any Test by Learning Express. (Meyers, 2000) In Kaplan’s How to Study vide o about learning to study in a manner that work best for you, suggests that you find a quiet room or area that you can use just for studying. I often find myself trying to study in the family room where it seems like the TV is shouting at me and my books are scattered all over the couch and floor. I am currently working on this by converting a spare room into my study space. It was recommended that in this area you are to consider good body position, such as using a chair and desk not sitting or lying on your bed. This area must also have good lighting and be free of distractions. In doing this I hope that I will be able to separate my school time and family time from each other. Visualize, organize, recite, repeat is suggested by Kaplan in order to retain information. The goal of most students is to retain what they are learning. Spending too much time studying is and major complaint of students. By making vivid associations of the content with a picture, group and organize topics together because items are best learned in groups, recite your knowledge out loud to figure out what you do not understand, and finally repeat it often. By using this strategy instead of trying to memorize text out of a book, one should have to spend less time studying and more information should be retained. (Kaplan Nursing: Lipponcott) Test Strategies Not so Helpful There are so many strategy recommendations for students. While each have good points, some are more helpful than others. Strategies that don’t seem as helpful to me are simulating actual test like circumstances when studying for the exam, study groups, note taking by using the fancy systems. These three strategies just seem to increase my stress level to the point I feel like I am not learning. Simulating actual test like circumstances has just never worked for me as I usually don’t pick the correct information to test myself on and the important information gets left behind. Study groups cause me too much pressure because I find that one or two people seem to be putting the study guides together. This is a pet peeve for me; I don’t mind sharing my ideas but don’t expect me to do all the work and then hand it to you. The final one that has never worked for me is taking notes by using one of the many note taking systems. I find myself spending too much time trying to remember what needs to be written where, organizing, how to fold the paper. I have developed my own crazy way of taking notes over the years. Note taking is an area that I feel is individualize for each person. Learning Style The VAK Learning Style Assessment indicates that I learn visually followed closely by being a kinesthetic learner. I feel this is a very accurate assessment of my learning style. I am the person who likes to observe how things are done either by reading the instructions or watching someone perform the task. I also learn by holding, touching, and feeling. The whole hands-on experience works well for me. Auditory learning is sometime difficult for me. I find using the auditory portion of an E-book is not beneficial to me because my mind seems to wander and I have a hard time concentrating on the information. I am someone who likes to have the textbook in hand to touch and feel. Diagnosis of Test Taking Weakness My personal diagnoses of test taking weakness would be: Anxiety related to taking examinations as evidenced by sympathetic stimulation including increased respiratory rate, heart rate, apprehension and facial flushing. I will display decreased test anxiety before and after each exam for the next twelve months. I will learn how to control sympathetic stimulations during exams for the next year. Interventions will include getting enough sleep before exams, practicing relaxation techniques such as deep breathing by inhaling deeply through nose and exhaling slowly, thinking positive thoughts, avoiding reading extra information into the question, and changing answers on the exam. Interventions will be confirmed effective if vital signs reflect baseline, there is decreased sympathetic stimulation, and able to control test anxiety by using stated techniques. Risk for impaired emory related to inability to retain sufficient knowledge and information. I will retain sufficient knowledge and information from the ADRN program to pass all exams for the next year. I will demonstrate use of techniques to help reduce memory loss for twelve months. I will utilize anxiety reducing techniques, non-distracting study areas, visualize, organize, recite, and repeat techniques into current study and test taking p ractices . Intervention will be confirmed effective if I pass all exams and the NCLEX. References Ackley, B. & Ladwig, G. (2008). Nursing diagnosis handbook: An evidence-based guide to planning care, (8th ed. ). St. Louis, MO: Mosby, Inc. , an affiliate of Elsevier Inc. Kaplan Nursing: Lipponcott, W. a. (n. d. ) Kaplan Nursing. Retrieved September 1, 2011, from Kaplan nursing: How to study, Nursing school success http://www. nursing. kaplan. com/student/User_Home. aspx# Meyers, J. N. (2000). The secret of taking any test. Learning Express Silvestri, L. A. (2010). Saunders strategies for success for test success: Passing nursing school and the NCLEX exam. Philadelphia, PA: Elsevier Saunders an imprint of Elsevier.

The Fourteenth Amendment and Equality Under the Law Essay

The Fourteenth Amendment and Equality Under the Law The Fourteenth Amendment was adopted in 1868 as one of the longest amendments to the Constitution with five parts in total. The most significant part is section one. In the very first sentence of section one, ? All persons born or naturalized in the United States and subject to the jurisdiction thereof, as citizens of the United States and of the state where in they reside? citizenship was universalized. The Amendment was designed to prohibit state governments from curtailing the rights of former slaves after the Civil War, however it has been used to grant all of the personal liberties and rights conveyed in the Bill of Rights. The Amendment gives definition to citizenship,†¦show more content†¦The purpose of the Fourteenth Amendment was to make citizenship of black individual permanent and secure. The amendment did not entirely universalize citizenship because it left out the right to vote, hence the need for the Fifteenth and Nineteenth Amendments granting the right to vote to blacks and then to women, respectively. The Supreme Court under Justice Miller rejected that the ?amendment?s privileges and immunity clause incorporated the Bill of Rights, holding that the only rights protected were access to Washington D.C., and coastal seaports; the right to protection the high seas; the right to use navigable waters of the United States; the right to assembly and petition; and the privilege of Habeas Corpus.? It wasn?t until the 1960?s that this amendment really came into play. The amendment is used to protect our civil rights and liberties as Americans. The Supreme court recognized in 1925 with Gitlow v. New York that the Bill of Rights was meant for all people, not just rich, white males. The court held that freedom of speech and of the press were basic personal rights that were protected by the due process clause of the Fourteenth Amendment, ?No?State shall deprive any person of life, liberty or property with out due process of law; nor deny to any person..equal protection of the law.? In the 1960?s the court then applied that clause to those accused of crimes. They more thoroughly interpreted the Eighth Amendment,Show MoreRelated 14th Amendment -EQUAL PROTECTION UNDER THE LAW Essay939 Words   |  4 Pages EQUAL PROTECTION UNDER THE LAW In school especially, as well as throughout our daily lives, we learn in America to live by the idea of freedom and equality for all. We do not allow race, class, or creed to determine a person’s stature in the community. It may seem as if this is the standard of society, but these ideas of equality have been fought over since the beginning of written history, and even in America today, prejudice still exists. 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Religions Place in Education Essay - 1325 Words

Abstract There have been many lawsuits that involve the issues between religion and government state laws and regulations. As of today religion is still a very emotional issue between Christian churches and schools. Issues such as prayer in school, reciting the pledge of allegiance (under God), teaching the Ten Commandments or evolution, are prohibited in public schools today. Educational administrators must be aware of these issues and the laws that must be adherent to. Religious Issues The Constitution made no reference to religious liberties of United States citizens during ratification of states; the Bill of Rights does address religious freedom but over the past decade the conflict between church and state has increased†¦show more content†¦Because of the decision made in the Cantwell case, the Fourteenth Amendment makes the First Amendment applicable to state action, which makes the establishment clause significant for the administration of public schools (Essex, 2002). One of the most highly debated issues in schools today is prohibiting of school-sponsored prayer. Before the issues with prayer in schools, prayer was offered in public places before an event of at the start of a day. The problems that arise from having prayer in school was that because of the many cultures in schools some students were being force to deny their own belief and religious freedom. Congress, state legislatures, and citizens tried to find an alternative to this situation by adopting a prayer that was school-sponsored, non-denominational, voluntarily, and to be recited by each class in the presence of the classroom teacher which was composed by the New York Board of Regents in 1962. The prayer read â€Å"Almighty God, we acknowledge our independence upon thee and we beg thy blessing upon us, our parents, our teachers and our country† (Essex, 2002, p 17). 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