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A.

Health Perception / Health Management

The patient defined health as a state in which she does not feel any pain or discomfort or when she does not notice something peculiar about her body and when she is able to perform her tasks in everyday living without any difficulty. Meanwhile, illness for her is the state in which her activities of daily living are hindered by some discomfort or pain, moreover, the presence of symptoms of a particular disease. When asked about her present health condition, she believes she is a 7 in a scale of 1-10 in terms of wellness. Albeit alterations in her diet due to her new found diabetes mellitus type 2, she still considers herself healthy and treats her pregnancy as a joyous addition to their growing family.

The patient said to have never tried smoking but claimed to have lived with someone who smoked prior to her first pregnancy. She reported that her live in partner was a smoker and was consuming 5 sticks of cigarettes daily, however, with the conception of their first born, he quit smoking. Furthermore, she denied being an alcoholic beverage drinker and an illicit drug user. Protective devices were not practiced such as wearing a helmet during a motorcycle ride. With this current pregnancy, the patient was prescribed multivitamins + ferrous sulphate 1 tablet twice daily and calcium carbonate 1 tablet once daily during her prenatal check up to which she took religiously and without fail. When fever, cough or colds occurred, over-the-counter medications like biogesic (paracetamol) and neozep is used for treatment. She also believed in the efficacy of herbal medications such as lagundi concoctions in the treatment of cough. For her, alternative modes of treatment such as hilot, was a ready aid for minor muscle strains after a hard days work.

The patient admitted that she only consults a doctor when she feels something is terribly wrong with her body. However, prenatal check-up was really a must for her, in order to protect her baby from harm. She had been diagnosed with type 2 DM but unfortunately lacked the means of owning a glucometer. Financial constraint was one of the reasons why she had not complied reliantly to her treatment for diabetes. But with her present pregnancy, she made it to a point to make regular visits to the doctor and comply with the prescribed medications and diet in order to keep her baby healthy. She verbalized that support from her family and the fear of dying were her motivations to keep her body in good condition.

The patient claimed to have received vaccinations when she was a child but was not able to recall what had been given to her. She was having second thoughts on being a fully immunized child. She was given Tetanus Toxoid vaccine during one of her prenatal visits.

She lives with her family in a house with 3 rooms and is made of makeshift materials. One is utilized as the living room cum kitchen, the other 2 rooms serve as a haven for them and their children. The community wherein they belong is quite populated. They get their water from MCWD.

B. Nutritional- Metabolic The patient stated that she ate breakfast during the day she went to VSMMC which include a cup of coffee, a cup of rice and mixed vegetables. But she was shifted to nothing per orem diet when she was admitted to the facility. She said that on her usual mornings, she just eats bread and coffee. At lunch and dinner, she cooks meat, fish, or vegetables depending on whats available. She said that she always drinks sugary beverages such as ready mix juices and carbonated beverages. She also eats snacks in between meals. She is also a fan of using condiments with viands. She said she consumes 5-6 glasses of water daily. She admitted to have a good appetite at home. Before she was diagnosed with DM type 2, she had no diet restrictions and ate everything she wanted. However, with the new found illness, she minimized her intake of sweet foods and beverages. Sometimes she admitted to have been not so compliant with her new diet especially during special occasions where food was abundant.

Moreover, she has no special preferences with food, as long as it eases her hunger and provides her with energy to live the day. She sees to eat that she prepares food for her family because for her, nothing beats a home-cooked meal. Sometimes when they have spare cash, they eat at fast food chains. Since they are situated near a market place, its easy for her to shop. When there are leftovers, she stores it in the refrigerator. She said that she doesnt take vitamin and mineral supplements, except now that she has special needs because of the growing life within her. She describes a healthy diet as being able to eat lots of fruits and vegetables as well as moderate intake of fatty and fast foods. When she shops, food labels are not an issue.

In terms of dental hygiene, she brushes her teeth twice daily. She doesnt floss her teeth nor rinses her mouth with an oral antiseptic and/or gargle. She has never visited a dentist her entire life.

With her current pregnancy, she said that she had gained weight. On the first trimester, she experienced some changes in her appetite. She despised strong smelling foods and had had morning sickness.

Generally, the present pregnancy and her diabetes mellitus imposed changes in her eating habits. She became more conscious with her diet knowing that her child is also affected by her choices. As with her DM type 2, she altered some of her normal dietary intake in order to become better.

C. Elimination Pattern

Defecation has never been a problem for M.A. for she clears her bowel every morning. She said her stool is usually golden brown, sometimes greenish, depending on what she eats for the day. Usually, she passes a sausageshaped, smooth and soft stool. Sometimes, she experiences defecating hard stools especially if her fluid intake is inadequate. According to her, she never uses laxatives when this happen, she just drinks lots of water and eats fruits such as papaya. With her current pregnancy, she noticed that she had been constantly constipated, however, she managed to find ways to alleviate abdominal cramps and hard to pass stools.

When it comes to her bladder elimination patterns, the patient said she urinates more than 5 times a day, depending on her fluid intake and the

weather. Usually, amber yellow in color, but sometimes, yellow-orange if she hasnt urinated for quite a while. Her urine is mostly clear, but she also experienced urine turbidity during her 2 nd trimester. She also experienced urinary frequency during her 1st and 3rd trimester.

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