Western Mindanao State University

College of Nursing
Zamboanga City

Alternative Learning System

Related Learning Experience
Delivery Room

Instructions:
Answer the provided questions comprehensively following the subsequent format.
A. Use the Times Roman Font Style
B. Utilize at least three (3) or more references
C. References should be 2015 and latest
D. Output should be submitted as posted in the Google Class Assignment in PDF Format
E. Use the templates in pages 5 – 8 as guides in accomplishing your output
F. You will be graded according to the Rubric in page 10

Case Scenario: Placenta Previa in Labor

At 6 am nurse Phoenix at Delivery Room received a 35-year-old G3 P2 A0, 34 weeks pregnant woman
from ER via stretcher looking pale and exhausted was admitted due to Lumbosacral pain and noticeably with
mild bleeding. As claimed by patient, pain and blood on her underwear started the night before admission.
Upon physical examination, VE tip of finger, FH – 30 cm, FHT – 130 bpm.

Vital Signs
1) Blood pressure (BP) : 130/90mmHg
2) Heart rate (HR) : 99 bpm
3) Respiratory rate (RR) : 28 b/min
4) Temperature : 37.1 0 C
5) Height : 167 cm (5’4)
6) Weight : 58.2 kg

Laboratory results:

Examinations Patient’s Result Normal Value Indication

Blood Exam
RBC 4.4 x 1,000,000/mm3
Hemoglobin 12.0 g/dL
WBC 6.2 x 1000/mm3
Platelets 250 _ 109/L
Urinalysis
Appearance Clear
Color Dark yellow
pH 5.0
Protein Negative
Sp. Gravity 1.005
Glucose Negative
Casts None
WBC 1–2
RBC 0–1
Fecalysis
Color Dark brown
Consistency Soft-formed
Occult blood Positive
Ova & parasites None seen
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 The patient is diagnosed with Placenta Previa as shown in UTZ results with the following orders from
attending physician:

1. Nothing Per Orem (NPO)

2. Intravenous hydration –
1) D5LR 1 liter to run for 8 hours, followed by
2) 0.9% Normal Saline 1 liter at 30 drops per minute
3. Secure Consent for Emergency Caesarian Section
4. Secure 2 units of PRBC
5. Start IV Cefuroxime (Ceftin) 750 mg IV
6. O2 inhalation via face mask at 4L/min

After surgery, the patient is wheeled to the Post Anesthesia Care Unit (PACU) with the following orders:
1. Tramadol hydrochloride (Ultram) 100 mg IV every 6 hours PRN for pain
2. Cefuroxime (Ceftin) 750 mg IV every 8 hours for the first 48 hours then may shift to oral for 5 days
3. Baclofen 40 mg tab 2x a day for 3 days then PRN

Your Tasks:

1. Determine the need for the required laboratory and diagnostic examinations
• Give the indications for the abnormal result/values
2. Illustrate the organ involved and label accordingly.
3. Discuss the normal function of the organ involved.
4. Explain the pathophysiology based on the diagnosis.
A. Create the pathologic pathway of the pathogenesis ( the development of the disease and the
chain of events leading to the illness) contributing to the patient’s illness condition.
B. Synthesize the life-threatening pathway as a consequence of the patient’s refusal / non-
compliance with treatment
• Example:

A. Pathogenesis of Appendicitis

Fecaliths / Appendicoliths Intraluminal Scarring Tumors Pathogens Other Disease

Obstruction of the Appendiceal Lumen

Bacterial Overgrowth

Inflammation

Subjective Cues: Objective Cues:

1. Periumbilical Pain 1. Localized tenderness
2. Anorexia, Nausea & Vomiting 2. Rebound tenderness
3. Persistent, Continuous Pain in the RLQ 3. Muscle guarding
localized at McBurney’s point 4. Flexed right leg
5. Low grade fever

Resolved through Surgery (Appendectomy)

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 B. Life-Threatening Pathway (Patient’s refusal / non-compliance with treatment)

How will you prevent the

• Signs & Symptoms of Over 48 hours
patient’s status from
worsening? • Without Intervention
• Give at least 2
interventions and the
PERFORATION
rationale

Leak of Content into the Omentum and Surrounding Tissues

COMPLICATIONS

Small bowel obstruction Abscess Formation Peritonitis

Escalating diffuse abdominal pain with rapid development

of toxicity as evidenced by:
1. Dehydration
2. Signs of sepsis
• Oliguria
• Hypotension
• Acidosis
• High-grade fever

5. Explain the Surgical Procedure done to your patient.

6. Enumerate the instruments that will be used during surgery. (Use the internet as a source of reference).
Classify them according to their category and indicate their functions (following the template below)
7. Formulate an IMMEDIATE post-operative Nursing Care Plan of a patient who underwent CS based
on the NANDA approved Nursing Diagnosis.
• Give at least two (1)
• PRIORITIZE the problems and cite your reference/s
8. Develop a Drug Study (2)based on your patient’s pre and postop medications to include Intravenous
Fluid infusions

Page 3 of 9
 A. Output Template

1. Study of the Illness Condition

ASSESSMENT ANATOMY PHYSIOLOGY PATHOPHYSIOLOGY ANALYSIS

• Illustrate and label • Normal function of the organ • Include the diagram of the 1. Correlate the patient’s sign and
1. Signs & Symptoms involved following: (see page # 3) symptoms to the disease condition
manifested by the patient 1) Pathogenesis 2. Discuss the indications for the
2. Lab values 2) Life-threatening pathway
3. Diagnostic Procedures laboratory examinations
3. Explain the significance of the
abnormal results

Reference/s: Reference/s: Reference/s: Reference/s: Reference/s:

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2. Surgical Procedure and Instruments Used

Surgical Procedure Instruments Category Functions

Name Image

Reference/s:

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3. Nursing Care Plan

PLANNING
NURSING
ASSESSMENT OBJECTIVE OF IMPLEMENTATION EVALUATION
DIAGNOSIS INTERVENTION RATIONALE
CARE
Subjective Cues:

Objective Cues:

Reference/s:

Page 6 of 9
4. Drug Study

GENERIC NAME: MECHANISM OF ACTION: SIDE EFFECTS/ADVERSE REACTION NURSING RESPONSIBILITY

BRAND NAME: INDICATION:

DRUG ILLUSTRATION:

CLASSIFICATION CONTRAINDICATION:

DOSAGE/FREQUENCY/ROUTE:

Reference/s:

Page 7 of 9
B. Rubric for ALS (OR)

4 3 2 1
Follows and
Exceeds Follows some Demonstrates
CATEGORY Follows
expectations but not all little
instructions
noted in instructions comprehension
instructions
I. STUDY OF ILLNESS CONDITION (total score = 40 points)
1. Assessment
• Differentiates between subjective and objective
cues
• Analyzes laboratory examinations
2. Anatomy
• Indicates and labels the affected organ
• Cites reference/s & Paraphrases
3. Physiology
• Discusses the normal functions of the organ
involved
• Cites reference/s & Paraphrases
4. Pathophysiology
• Explains the pathophysiology based on the
diagnosis
• Develops the pathologic pathway of the
patient’s current illness
• Synthesizes the life-threatening pathway as a
consequence of the patient’s refusal / non-
compliance with treatment
• Cites reference/s & Paraphrases
5. Analysis
• Correlates signs & symptoms to the illness
condition
• Relates laboratory / diagnostic exams to the
illness condition
II. SURGICAL PROCEDURE & INSTRUMENTS (total score = 20 points)
1. Operation Performed
• Discusses the surgical procedure done
• Cites reference/s & Paraphrases
2. Instruments and Accessories Used
• Lists the instruments used during the procedure
• Categorizes the instruments
• Explains the functions per category & cites
references
III. NURSING CARE PLAN (total score = 36 points)
6. Nursing Care Plan (2)
• Utilizes the Nursing Process
• Assessment
• Diagnosis
• Planning
➢ Objective of Care
➢ Interventions
➢ Rationale
• Implementation
• Evaluation
• Cites reference/s
IV. DRUG STUDY (total score = 12 points)
7. Drug Study
• Comprehensive drug information and cites
references
• Nursing Responsibilities
• Indication / contraindication
TOTAL POINTS
FINAL RATING

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Prepared by: Noted:

DR. MARIA SOCORRO C. DOMINGO FREDIE M. OMAR, MAN, RN

Clinical Coordinator Curriculum Chair

60% Passing Rate

Score Grade Score Grade
106 -110 1.00 61-65 3.25
Approved: 101-105 1.25 56-60 3.5
96-100 1.5 51-55 3.75
91-95 1.75 46-50 4.0
DR. MARY JOSELYN C. BIONG 86-90 2.0 41-45 4.25
Dean 81-85 2.25 36-40 4.5
76-80 2.5 31-35 4.75
71-75 2.75 30
5.0
66-70 3.0 below

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