4.4.

1 Pre- Operative
OBJECTIVE CONTENT METHODOLOGY TIME ALLOTED RESOURCES EVALUTAION

General Objectives: At the end of 8 hours of holistic nursing care, the patient and significant others will be able to acquire knowledge, gain understandding that will be used in inculcating the therapeutic regimen and exhibit a positive attitude towards deep breathing exercises.

Specific Objectives: After 45 minutes of student nursepatient and significant others interaction, the patient and significant others will be able to: Objectives: After 45 minutes of student nursepatient and significant others interaction, the patient and significant others was be able to:

1. State the importance of deep breathing exercises.

Importance of Discussion Deep Lecture Breathing Exercises - to improve pulmonary gas exchange -to maintain respiratory function -to help the patient feel relaxed and focused. -to cope up with pain and anxiety.

5 minutes

Fundamentals of Nursing Barbara Kozier, pg 987

State the importance of deep breathing exercise

2. Identify the effects of deep breathing exercises.

Breathing exercise can help you breathe more efficiently and can help you relax if you are suffering from shortness of breath and pain. Benefits of deep breathing exercise: -Stress reliever -relaxation of bowel -Improve body organs and cleanse the body -releases you from anxiety -promotes you wellbeing -improves physical and mental health -helps lower your blood pressure -can relief you form nervousness. Deep breathing during the stretch, ensures lung

Discussion

7 minutes

Fundamentals of Nursing Barbara Kozier, pg 987

Identify the benefits of deep breathing exercises.

3. enumerate the health benefits of deep breathing exercise.

Discussion

10 minutes

Fundamentals of Nursing Barbara Kozier, pg 987

Enumerated the health benefits of deep breathing exercise

4. gain information about the direct benefits of deep

Discussion

8 minutes

Fundamentals of Nursing Barbara Kozier, pg 987

Gained information about the benefits of deep breathing

breathing exercises.

aeration, flushing out the CO2 and bringing in fresh air. This mechanism promotes greater stretching capabilities and vital lung capacity. Steps in deep breathing exercise; 1. Sit in a hard-back, stable chain and relax. 2. Take in 2-3 deep breaths through your nose and exhale slowly through pursed lips. 3. Fold your arms across your abdomen. 4. Take in a comfortable deep breath through your nose. 5. Lean forward, pressing your arms against your abdomen and cough while leaning forward. 6. Relax, rest Demonstration and return demonstration 10 minutes Fundamentals of Nursing Barbara Kozier, pg 987

exercise

5. Demonstrate the beginning skills in deep breathing exercise.

Demonstrated how to perform deep breathing exercise properly.

5-10 minutes 7. Perform again if needed.

4.5 SOAPIE Charting (Pre Operative) Students Name: Bereso, Emmanuel II A. Patients Name: Mr. John Francis Balerio Physician: Dr. Roland Tomaro

Date: April 11, 2011 Sex: Male Age: 8 years old

SOAPIE # 2 S sakit ako tiyan, as verbalized by the patient O seen patient lying on bed conscious; coherent; responsive and communicative with IVF #3 D5LR 1 liter at 30 gtts/min at right arm; vital signs of T = 37.1oC, PR= 80bpm, RR= 18 breaths/min, BP=
90

/60 mmHg; breakdown of the skin tissue; guarding his abdomen, on a

fetal position, pain scale of 6 as 10 is the highest and 0 as no pain. A Alteration in comfort: pain related to inflammation on tissues secondary to appendicitis. P to alleviate pain from a pain scale of 6 to at least 4. I monitored and charted vital signs; reposition the patient into a much comfortable position; provide comfort measures such as back rub; encourage deep breathing exercises; promote a non stimulating environment; divert patients attention. E gamay nalang saki sa ako tyan di pareha ganiha. As verbalized by the patient.

Bereso, Emmanuel II A. SLRC SN

Ms. Kristy Nillet Pongos, RN, MAN Clinical Instructor

Students Name: Bereso, Emmanuel II A. Patients Name: Mr. John Francis Balerio Physician: Dr. Roland Tomaro

Date: April 11, 2011 Sex: Male Age: 8 years old

SOAPIE # 2 S cge lagi siya ug suka, as verbalized by the mother O seen patient lying on bed conscious; coherent; responsive and communicative with IVF #3 D5LR 1 liter at 30 gtts/min at right arm; vital signs of T = 37.1oC, PR= 80bpm, RR= 18 breaths/min, BP= 90/60 mmHg; sunken eyeballs; pale conjunctiva and mucus membrane; A Fluid volume deficit: Nausea and vomiting r/t distention of intestinal tissues. P to maintain fluid volume at a functional level. I monitored and charted vital signs; replaced fluid loss; provide comfort measures such as back rub; encourage deep breathing exercises; promote a non stimulating environment; encouraged fluid intake; advised patient not to lean forward. E wan a kaau ko nag suka. As verbalized by the patient.

Bereso, Emmanuel II A. SLRC SN

Ms. Kristy Nillet Pongos, RN, MAN Clinical Instructor

TABLE OF CONTENTS I. INTRODUCTION -----------------------------------------------------------------------------------------2 II. OBJECTIVES ---------------------------------------------------------------------------------------------3 III. NURSING ASSESSMENT 1. Personal History 1.1 Patients Profile ------------------------------------------------------------------------5 1.2 Family and Individual Information, Social and Health History -----------------5 1.3 Levels of Growth and Development 1.3.1 Normal Growth and Development at Particular Stage -----------------6

2. Diagnostic Result ---------------------------------------------------------------------------------9 3. Present Profile of Functional Health Patterns -----------------------------------------------12 III. PATHOPHYSIOLOGY AND RATIONALE 4.1The Normal Anatomy and Physiology of the Organ Affected ---------------------------16 4.2 Disease Process and its effect on different organ/system -----------------------18 4.3Schematic Diagram showing the Pathophysiology of the disease -----------------------19 4.4Classical and Clinical signs and symptoms ----------------------------------------23 VI. NURSING INTERVENTIONS 5.1. Nursing Assessment --------------------------------------------------------------------------24 5.2 .Nursing Care Plans ---------------------------------------------------------------------------30 5.3.Drug Therapeutic Record ---------------------------------------------------------------------35 5.4.Health Teaching Plan -------------------------------------------------------------------------75 5.5.SOAPIE -----------------------------------------------------------------------------------------89 VII. EVALUATION AND RECOMMENDATION ---------------------------------------------------90 VIII. EVALUATION NAD IMPLICATION OF THE STUDY TO: 7.1.Nursing Practice -------------------------------------------------------------------------------90 7.2.Nursing Education ----------------------------------------------------------------------------92 7.3.Nursing Research ------------------------------------------------------------------------------93 IX. BIBLIOGRAPHY --------------------------------------------------------------------------------------94