Institute of nursing SY: 2012-2013

A CASE PRESENTATION on a patient with Hypertension

Submitted by: GROUP !" A RO#UE$ Che%sie Ann ROSA&IA$ 'oy Anne SANTOS$ (ionee TA(ENA$ 'esse Israe% TONGO&$ )ristine Gra*e Anne

Submitted to: Emelita Luansing RN, M N

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"I#$R %&I' ( ) Name: Patient +T Address: Panso% St,$ -a%ara$ #ue.on City A/e: 01 years o%d Gender: +ema%e (ate o2 -irth: No3ember 4$ 5674 P%a*e o2 -irth: Nue3a E*i8a Ethni* /roup: none Primary %an/ua/e spo9en: Ta/a%o/ :arita% Status: :arried Edu*ationa% Attainment: E%ementary /raduate O**upation: none Re%i/ious Orientation: Roman Catho%i* Hea%th Care 2inan*in/ and usua% sour*e o2 medi*a% *are: none In*ome: Php, 0$!!!; month 2rom *hi%dren

II!

N*RSIN$ &IS)#RY:

(MI))IN$ (I $N#SIS &+,ertension, Emergen-+ t.- 'erebro/as-ular --ident

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(ate of dmission: September 1$ !5< ttending %0+si-ian: (r, 'oseph -a%domero Initial 1ital Signs )em,erature: %ulse Rate: Res,irator+ Rate: "lood %ressure:

'0ief -om,liant The patient has a *hie2 *omp%aint o2 *hest pain and se3ere heada*he with a de/ree o2 4 in an o3er 5!"pain s*a%e, She has a%so di22i*u%ty o2 breathin/ and reported pain at %ower ba*9,

&IS)#RY #2 %RESEN) ILLNESS -e2ore admission$ the patient was as9ed o2 the history o2 i%%ness, At Apri% this year$ she was a%so admitted to +e (e% :undo Hospita% due to se3ere heada*he, She was re=uested by the physi*ian to ha3e CT S*an, Resu%ts ha3e shown that there are p%a=ues on her b%ood 3esse%s that made her ha3e *ontinuous heada*he 2or < *onse*uti3e days, She was /i3en medi*ations by that time but the patient did not re*a%% it, On the same year$ she had her b%ood pressure rise

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up to 5>!;55!, She has her maintenan*e dru/s o2 Am%odipine and other medi*ations that she ta9es e3eryday but *annot be re*a%%ed a%so, That was the ni/ht be2ore she was admitted$ at Sept, 7$ !5<, A%so by that ni/ht$ she is e?perien*in/ ba*9 pain 2o%%owed by se3ere *hest pain, She has di22i*u%ty o2 breathin/ so she *a%%ed 2or her dau/hter who %i3es at :ani%a, His husband was the on%y one with her at Nue3a E*i8a, -y mornin/ o2 September 1$ !5<$ she was admitted a/ain at +e (e% :undo Hospita% due to Emer/en*y Hypertension, @hen the patient and the dau/hter were as9ed 2or other diseases e?perien*ed 2or the past years$ they didnAt say anythin/, The dau/hter 8ust 3erba%i.ed$ Ngayon na nga lang ulit tumaas ang bp ni nanay kasi kapag nagiisip lang yan at napapagod. Kahit ano na lang kasi pinagiisip.

% S) &E L)& &IS)#RY :s, +T remembered that she has been /i3en -CG$ Hepatitis -$ (PT$ ::R 3a**ines, The patient doesnAt ha3e a%%er/ies to any 2ood or any substan*e and had not e?perien*ed any type o2 a**ident, He didnAt tra3e% outside or inside the *ountry within the past two years, The *%ientAs stated that durin/ his *hi%dhood$ she had meas%es but she *annot remember the e?a*t date when she had that disease, The patient had *omp%aint about her se3ere heada*he %ast Apri% !5< and she under/one CT s*an and the *%ient stated that kaya daw sumasakit yung ulo ko kasi may mga nagbabarang ugat sa ulo ko. :s, +T does ha3e dru/ maintenan*e 2or her b%ood pressure$ *ho%estero% and 2or *hest pain and when she was si*9 she usua%%y ta9es medi*ations %i9e para*etamo% when she has a 2e3er$ diatabs when she has a diarrhea et*,

III!

E'LE)I' M#(EL: %atterns of 2un-tioning

%&YSI#L#$I' L '#%IN$ % ))ERN

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-e2ore hospita%i.ation$ the *%ient *an *ope to prob%ems we%%, She ta%9s to her 2ami%y and espe*ia%%y to her husband whene3er there are prob%ems, @hene3er she 2ee% stressed she usua%%y had *on3ersion to her 2ami%y and thou/ht o2 their happy moments to/ether, The patient 2ee% satis2ied on re%ie3in/ her stress whene3er she had *on3ersation on her 2ami%y, (urin/ hospita%i.ation$ somethin/ *han/ed on the patientAs %i2e, She answered that her *ondition now is a bi/ *ha%%en/e to her %i2e, She *annot 2un*tion we%% be*ause she is now e?perien*in/ *hest pain, The patient said that it is di22erent now$ the demands o2 her *ondition adds stress to her, The hospita% bi%%s$ the medi*ines and e3en the bud/et o2 their 2ami%y are *ompromised, Inter,retation: -e2ore hospita%i.ation the patient *opes we%% to su*h prob%ems and e3en /ets opinion to her husband, -ut durin/ hospita%i.ation$ the *%ient has a di22erent %i2e now and there are a %ot o2 *han/es in their %i3es, One 2a*tor that /a3e stress to her is the 2a*t that she had been hospita%i.ed a/ain, :any were a22e*ted to that$ not on%y her but a%so her who%e 2ami%y,

nal+sis: Copin/ may be des*ribed as dea%in/ with prob%ems and situations or *ontendin/ with them su**ess2u%%y, It a%so 3aries amon/ indi3idua%s and is o2ten re%ated to the indi3idua%As per*eption o2 the stress2u% e3ents, Su**ess2u% *opin/ re=uires the person to dea% e22e*ti3e%y with stress2u% e3ents and minimi.e distress asso*iated with them those resu%ts in adaptation, B)o.ier et, A% +ON 4th ed, P,5! !C IN)ER ')I#N % ))ERN The patient %i3es with her husband a%one in Nue3a E*i8a, Their 2our *hi%dren and /rand*hi%dren are stayin/ in :ani%a, -ut the patient said that their 2ami%y is 3ery *%ose and inta*t to ea*h other, They a%ways ma9e sure that they ha3e *onstant *ommuni*ation with ea*h other$ their *hi%dren *a%% them e3ery day throu/h mobi%e, Their *hi%dren usua%%y 3isit them when there is spe*ia% o**asion or when theyAre not busy in their wor9, Sin*e$ the patient %i3es with her husband a%one she used to /o outside and *hat with their nei/hbors as she 3erba%i.ed Pag tapos na akong maglinis, nasa labas ako lagi nakikipag chikahan, kasi pag sa loob ako ng bahay tahimik lang baka mabaliw kami ng asawa ko. She a%so said that$ whene3er she hears the Sunday mass$ she is with her husband and nei/hbors,

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(urin/ hospita%i.ation$ she said that nothin/ has *han/ed when it *omes to intera*tin/ to peop%e inside the hospita%, She *an sti%% ta%9 to her two *hi%dren who are stayin/ beside her, (urin/ the inter3iew$ the patient seems to be approa*hab%e and a**ommodatin/ to our =uestions,

Inter,retation: The patient has a /ood intera*tion to her 2ami%y and 2riends, She spends time to *hat with her nei/hbors, Now that sheAs hospita%i.ed she *an sti%% ta%9 with her *hi%dren and 3isitors, She is a%so open to her *hi%dren about what she rea%%y 2ee%s, She Is a**ommodatin/ and approa*hab%e, nal+sis: The e22e*ti3eness o2 open *ommuni*ation espe*ia%%y within the 2ami%y determines the 2ami%yAs abi%ity to 2un*tion *ooperati3e%y$ /rowth"produ*in/ unit, :essa/es are *onstant%y bein/ *ommuni*ated amon/ the 2ami%y members both 3erba% and non"3erba%, This intera*tion must a%so be present within the so*iety to in2%uen*e members to wor9 and 2u%2i%% their assi/ned ro%es$ in*orporate 2ami%y 3a%ues and de3e%op s9i%%s to 2un*tion within the so*iety, B)o.ier et, A% +ON 4 th ed, P/, 56<C

'#$NI)I1E % ))ERN -e2ore her hospita%i.ation$ she doesnAt ha3e prob%ems in her senses parti*u%ar%y to the sense o2 tou*h$ taste$ hearin/ and sme%%, @hen readin/$ sheAs wearin/ her /%ass$ whi*h has a /rade o2 51! in both eyes, As with her edu*ationa% attainment$ she admitted that she is an e%ementary /raduate, SheAs not e?perien*in/ any di22i*u%ties in writin/, SheAs a%so not 2or/et2u% and she *an easi%y re*a%% thin/s, A**ordin/ to her$ the easiest way to %earn is to 2o*us to what youAre doin/ and ha3in/ the patien*e in pursuin/ what you want in %i2e, (urin/ her stay in the hospita%$ she sti%% doesnAt ha3e any prob%ems with her senses, She a%so remains mind2u% about the past e3ents in hers %i2e, (urin/ the inter3iew$ she thin9s be2ore she spea9s, Her answers dire*t%y answer the =uestions bein/ as9ed to her, Inter,retation:
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-e2ore hospita%i.ation$ patient seems to ha3e we%%"or/ani.ed thou/hts, Her 2i3e senses were /ood, There is no memory impairment noted, (urin/ hospita%i.ation$ there is no si/ni2i*ant *han/e in her 2i3e senses, She spea9s sensib%y, Her thou/hts are we%% *onstru*ted as obser3ed by the way she answers =uestions, No memory impairment was a%so noted, nal+sis: Inte%%i/en*e is the measurab%e produ*t o2 inte%%i/en*e 2un*tionin/$ whi*h *onsist o2 memory$ *omprehension$ and *on*entration, Person that inte/rates in2ormation obtained throu/h 3ision$ hearin/$ tou*hin/$ taste or sme%% with pass e?perien*es to understand or ma9e sense o2 the en3ironment,

SEL2-'#N'E%) Patient stated that she 2ee%s better now *ompared be2ore when she was admitted, Thou/h she is sti%% su22erin/ a %itt%e pain in her *hest she stated that she 2ee%s o9ay as she 3erba%i.ed$ Okay naman yung pakiramdam ko ngayon medyo masakit nalang ang dibdib ko. @hen as9ed about the pain she rated it as < out o2 5! *ompared to the pain that she e?perien*e be2ore she was admitted and rated it as > out o2 5!, She a%so wished to be 2ine the soonest so that she *an /o home and be with her husband at Nue3a E*i8a be*ause she 9nows that her husband is a%one in their house, She thin9s that a hea%thy person is someone who doesnAt ha3e an i%%ness and has a /ood and stron/ body, He a%so be%ie3es that$ eatin/ nutritious 2ood *an he%p in attainin/ a hea%thy body, Inter,retation: The *%ient 3iews herse%2 as not rea%%y a hea%thy person due to her *ondition ri/ht now but hopin/ to /et we%% as soon as possib%e to be with her husband, She a%so 2ee%s that she is not rea%%y hea%thy be*ause o2 her *on2inement, nal+sis:

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Se%2"*on*ept is ones menta% ima/e o2 one se%2, A positi3e se%2"*on*ept is essentia% to a personAs menta% and physi*a% hea%th, Indi3idua%s with a positi3e se%2"*on*ept are better ab%e to de3e%op and maintain interpersona% re%ationships and resist psy*ho%o/i*a% and physi*a% i%%ness, An indi3idua% possessin/ a stron/ se%2"*on*ept shou%d be better to a**ept or adapt to *han/es that may o**ur o3er %i2espan; B)o.ier et, A% +ON 4th ed, P614C

EM#)I#N L % ))ERN Patient +T said that she 2ee%s sad ri/ht now be*ause o2 her *on2inement, Wala naman akong ibang gagawin dito kundi humiga lang as 3erba%i.ed by the patient but she is a%ways ha3e this positi3e out%oo9 that she wi%% be 2ine a2ter her *on2inement and she is a%so happy be*ause her dau/hter is with her a2ter sometime that their not to/ether, @hen as9ed about how she 2ee%s whene3er she is /oin/ throu/h some prob%em in %i2e she said that Pag nagkakaproblema ako sinasabi ko sa asawa ko o kaya nakikipagkwentuhan lang ako sa kapit bahay ko. Pag may nakakaaway naman kinakalimutan ko nalang. She said that a2ter her *on3ersation with her husband or nei/hbors she 2ee%s /ood and a%so added that she is too o%d to *on*ei3e hatred,

Inter,retation: The patient 2ee%s sadness about her *on2inement but sti%% happy that she is now 2ee%in/ we%% and she is with her dau/hter, (urin/ the inter3iew the patient sti%% smi%es and 3ery a**ommodatin/ to answer our =uestions,

nal+sis: The abi%ity to mana/e the stress is to e?press emotion appropriate%y, Emotion we%%ness in3o%3es the abi%ity to re*o/ni.e$ a**ept and e?press 2ee%in/s, B+undamenta%s o2 Nursin/ 4th ed by -arbara )o.ier, Pa/e 54<C

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SE3* LI)Y % ))ERN The *%ient stated that she has a /ood re%ationship with her husband, She per*ei3ed herse%2 as a woman and e?presses her 2eminity, C%ient 3erba%i.es that she and her husband was no %on/er a*ti3e in se?, The patient when as9ed about the type o2 2ami%y p%annin/ methods she used she said that she /ot an IU( in 5667, The *a%endar method$ the withdrawa% method and the use o2 *ondoms are some o2 the methods the patient a%so 9nows, -ut now a2ter the patient has been hospita%i.ed$ she thin9s that she *annot do the thin/s she is doin/ way ba*9 then, Inter,retation: The patient has some *han/es on the ways she per*ei3es himse%2, She *an no %on/er do tas9s$ un%i9e when she was youn/ and hea%thy, She thin9s that she 2un*tions %ess now rather than be2ore he was hospita%i.ed, nal+sis: OneDs se?ua% se%2"*on*ept determines with whom one wi%% ha3e se?$ the /ender and 9inds o2 peop%e a person is attra*ted to$ and the 3a%ues about when$ where with whom$ and how one e?presses se?ua%ity, A positi3e se?ua% se%2"*on*ept enab%es peop%e to 2orm intimate re%ationships throu/hout %i2e, A ne/ati3e se?ua% se%2"*on*ept may impede the 2ormation o2 re%ationship, B+undamenta% o2 Nursin/ >th ed, P,5! <C

2 MILY '#%IN$ A**ordin/ to the patient she is %i3in/ to/ether with her 2ami%y and whene3er they ha3e prob%em within the 2ami%y$ they immediate%y ta%9 about it to so%3e the prob%em easi%y within that day be*ause they *hoose to open up their prob%ems and so%3e it ri/ht away$ so that the prob%em wonAt /et worst, And they be%ie3ed that whate3er happens in the end they wi%% sti%% be a 2oundation to ea*h other 2or a better and stron/er 2ami%y ,She des*ribes her 2ami%y as simp%e but they are happy and satis2ied with ea*h other,

Inter,retation: They 3iew their 2ami%y as their sour*e o2 stren/th and as mu*h as possib%e they stand a%%
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to/ether$ hand in hand in order to o3er*ome %i2e stru//%es, nal+sis: +ami%y *opin/ me*hanisms are the beha3iors 2ami%ies used to dea% with stress or *han/es imposed 2rom either within or without, Copin/ me*hanisms *an be 3iewed as an a*ti3e method o2 prob%em so%3in/ de3e%oped to meet %i2eAs *ha%%en/es, The *opin/ me*hanism 2ami%ies and indi3idua%s de3e%op re2%e*ts their indi3idua% resour*e2u%ness, B+undamenta% o2 Nursin/ >th ed, P,7<1C

S#'I#-'*L)*R L % ))ERNS '*L)*R L % ))ERNS The patient pra*ti*es their own tradition and be%ie2s, The patient 3erba%i.ed that Sabi ng matatanda kapag daw may patay bawal daw maligo, pero ngayon kasi wala ng mga pamahiin kasi kapag hindi naligo possible daw mamatay dahil sa inpeksyon The patient a%so 3erba%i.ed that E ung simpleng pagmamano lang sa matanda dahil yan yung sabi sakin ng mga magulang ko nung bata pa ako. Inter,retation: The *%ient e?presses respe*t towards her own be%ie2 and tradition, She be%ie3es it is to prote*ted and passed down to the 2uture /enerationsF 8ust as her parents tau/ht it to her, And now$ she doesnAt be%ie3e in any superstitions,

nal+sis: :any *u%tura% /roups ha3e their own 2o%9 be%ie2s and pra*ti*es with a number o2 them re%ated to diet$ hea%th$ i%%ness and %i2esty%e, B+undamenta% o2 Nursin/$ )o.ier G Erbs >th edition$ p, 767C

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SI$NI2I' N) REL )I#NS&I% The patient stated that be2ore hospita%i.ation the *%ient has *%ose re%ationship to a%% members o2 the 2ami%y in*%udin/ her 2our dau/hters, She a%so has 3irtuous re%ationship to her re%ati3es, The patient said that she is a happy person and they a%ways thin9 about their happy moments, She is not e?pressi3e to her 2ee%in/s but whene3er someone or other re%ati3e approa*h her$ she wi%% respond to them appropriate%y, The patient *an see9 he%p to her 2ami%y whene3er she needs it, Sometimes her dau/hters 3isit their house in Nue3a E*i8a and they ha3e time 2or bondin/ and to dis*uss other 2ami%y *on*erns, Sin*e$ the patient has been hospita%i.ed be*ause o2 hypertension$ she stays in the hospita% that ma9es her 2ar away 2rom home and her husband is a%ways there 2or her and their dau/htersA 3isits her in the hospita%, Inter,retation: C%ient has *%ose and inta*t re%ationship to her 2ami%y and re%ati3es, Her 2ami%y and other re%ati3e support 2inan*ia% needs in the hospita%, -e*ause o2 the *ondition$ her so*ia% re%ationship to a%% members o2 the 2ami%y and re%ati3es was *han/ed, nal+sis: Ha3in/ a support networ9 B2ami%y$ 2riends$ or a *on2idantC he%ps peop%e a3oid i%%ness, Support peop%e a%so he%p the person *on2irm that i%%nesses e?ist, Peop%e with inade=uate support networ9s sometimes a%%ow themse%3es to be*ome in*reasin/%y i%% be2ore *on2irmin/ the i%%ness and see9in/ therapy, Support peop%e a%so pro3ide the stimu%us 2or an i%% person be*ome we%% a/ain, !"undamentals o# Nursing by Ko$ier %th edition page &%'(

RE'RE )I#N L % ))ERN The patient states that be*ause o2 her a/e ri/ht now a%% that she *an do is to *%ean their house e3ery day$ wat*h their te%e3ision and *oo9 2or her husband, She a%so said that e3ery a2ternoon she is *hattin/ with her nei/hbors outside her house, A**ordin/ to her due to their o%d a/e their *hi%dren are the ones supportin/ them, She added that on*e a month her

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/rand*hi%dren 3isit, Now that she is *on2ined in the hospita% she said that she wi%% 8ust ta9e a rest and pray to /et we%% soon,

Inter,retation: The patient re*reationa% a*ti3ity is too %imited 2or her a/e, Now that she is *on2ined her mo3ements are %imited, She wi%% 8ust stay in her bed a%% day and *hat with her dau/hter, nal+sis: I%%ness brin/s about *han/es in both the in3o%3ed indi3idua% and in the 2ami%y, The *han/es 3ary dependin/ on the nature$ se3erity and duration o2 i%%ness$ attitudes asso*iated with the i%%ness by the *%ient and others$ the 2inan*ia% demands$ the %i2esty%e *han/es in*urred$ ad8ustments to usua% ro%es, I%%ness a%so o2ten ne*essitates a *han/e in %i2esty%e, In addition to parti*ipatin/ in treatments and ta9in/ medi*ations$ the i%% person may *han/e diet$ a*ti3ity and e?er*ises$ and rest and s%eep patterns, , !"undamentals o# Nursing by Ko$ier 'th edition page )*%(

EN1IR#NMEN) The patient stated that she is %i3in/ in a simp%e two storey house with her husband, She said that their house is surrounded by trees$ *%ean$ =uiet en3ironment with /ood 3enti%ation and not *on/ested, There were 2%ies$ *o*9roa*hes and rats but thatAs why she a%ways ma9es sure to *%ean her house e3ery day, ENaglilinis lang ako sa bahay pra hindi kami papamugaran ng mga insekto kasi madameng sakit yan eh kagaya ng lamok as 3erba%i.ed by the patient, She a%so added that the *ana% near their house is not sta/nant, Inter,retation: The *%ient is %i3in/ in sa2e and *%ean house and /ood en3ironment, She a%ways *%ean her house to a3oid de3e%opin/ diseases that *an /et in inse*ts, There is a%so a proper draina/e in the *ommunity *an pre3ent su*h diseases,

nal+sis:
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A sa2e en3ironment has no /enera% *hara*teristi*s$ meanin/ 2reedom 2rom in8ury, A sa2e en3ironment is where anyone *an 2un*tion norma%%y and obtain a sense o2 se*urity, !"undamentals o# Nursing by Ko$ier %th edition page +'*C E'#N#MI' % ))ERN Sin*e the patient is not wor9in/$ her *hi%dren are /i3in/ her month%y a%%owan*e, She is bein/ /i3en an estimated amount o2 5!$ !!! per month by her *hi%d who is wor9in/ abroad, -ut sometimes it is more than 5!$!!! per month, A**ordin/ to the patient$ she is the one who bud/ets their dai%y e?penses at home, She spends <$!!! to 7$!!! a month 2or her medi*ations and they spend a%most 7$!!! per month 2or their 2ood, She said that their month%y a%%owan*e is enou/h 2or them and sometimes it is more than enou/h 2or their needs, (urin/ her hospita%i.ation$ they are not ha3in/ a hard time payin/ the e?penses be*ause she has her *hi%dren beside her and her *hi%d who is wor9in/ abroad, They are a%so ab%e to sustain the patientAs needs inside the hospita% and a%so the 2ood, Inter,retation: -e2ore her hospita%i.ation the in*ome o2 the 2ami%y was enou/h 2or their e3eryday needs, And durin/ the hospita%i.ation$ their resour*es are sti%% enou/h to pay the e?penses in the hospita%, nal+sis: The 2ami%yAs so*io"e*onomi* status is based on 2ami%y in*ome$ parenta% edu*ation %e3e%$ o**upation and so*ia% status in the *ommunity, B+ON 4th ed, P,<! C

S%IRI)* L % ))ERN RELI$I#*S "ELIE2 4 %R ')I'ES

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The patient is a Roman Catho%i* and /oes to *hur*h with 2ami%y e3ery Sunday, -e2ore admission$ the patient usua%%y attends mass e3ery day or at %east more than on*e, She is parti*ipatin/ in other a*ti3ities at their *hur*h and she a%ways be%ie3es that God prote*ts her 2ami%y a%ways, Patient +T a%so 9nows that a%% the b%essin/s they ha3e are a%% 2rom God, (urin/ admission$ sin*e it was 8ust her 2irst day at the hospita%$ the patient pra*ti*es same re%i/ious be%ie2s, E3en thou/h she e?perien*es pain and other i%%nesses$ she ne3er b%ames God 2or whate3er she has durin/ her stay at the hospita% but rather she a%ways prays and as9 God 2or her re*o3ery, Inter,retation (urin/ the inter3iew$ the patient has a stron/ 2aith to God, As an adu%t *iti.en$ the patient usua%%y does the *hur*h a*ti3ity as an habit sin*e she has no other thin/s to do at their p%a*e, -ut sti%%$ e3en with or without i%%ness$ nothin/ *han/ed with her re%ationship to God, nal+sis 'ust as e3erybody has a spiritua% dimension$ a%% *%ients ha3e needs that re2%e*t their spiritua%ity, These needs are o2ten brou/ht 2orward by an i%%ness or other hea%th *risis, C%ients who ha3e we%% spiritua% be%ie2s are *ha%%en/ed by their hea%th situationF *%ients who ha3e no de2ined be%ie2s may sudden%y be*ome 2a*e to 2a*e with *ha%%en/in/ =uestions re%ated to the meanin/ and purpose o2 %i2e, B+undamenta% o2 Nursin/ 4th edition p,661C

1 L*ES 4 1 L*IN$ A**ordin/ to the patient she and her husband said that the importan*e o2 eatin/ hea%thy 2oods ma9e them 2ee% stron/ and 2ree 2rom diseases, Patient does not smo9e nor drin9 as she understands the e22e*ts o2 smo9in/ on the body, Patient stated that she sudden%y dis*ontinue ta9in/ her medi*ations that %ed to her hospita%i.ation be*ause o2 this she a%so prioriti.ed the importan*e o2 ta9in/ medi*ation 2or her 2ast re*o3ery, Patient as obser3ed durin/ the inter3iew a%thou/h she had di22i*u%ty in spea9in/ be*ause o2 her *ondition she sti%% answers some o2 our =uestion appropriate%y and *ooperate to us, Inter,retation: -e2ore patient hi/h%y prioriti.es nutritious 2ood and understands the importan*e o2 it to

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ha3e a hea%thy body, (urin/ hospita%i.ation patient a%so in*%uded the importan*e o2 her medi*ine in re%ation to her 2ast re*o3ery, (espite o2 his *ondition patient +T sti%% a*=uired /ood 3a%ues when *ommuni*atin/ to others,

nal+sis: Ha%ues are endurin/ be%ie2s or attitudes about the worth o2 a person$ idea or a*tion, It is important be*ause they in2%uen*e de*isions and a*tions, Peop%e need so*ieta% 3a%ues to 2ee% a**epted$ and they need persona% 3a%ues to ha3e a sense o2 indi3idua%ity, B+undamenta%s o2 Nursin/ >th ed, P,>!C

')I1I)IES #2 ( ILY LI1IN$ 3 (a+ (iet Meal :EA& -REA)+AST :ON(AI pie*es pandesa% Bmedium si.eC 5 *up *o22ee 5 /%ass o2 water TUES(AI 5 s%i*e o2 spam J *up o2 2ried ri*e 5 *up o2 *o22ee 5 /%ass o2 water &UNCH 5 s%i*e 2ried mi%92ish 5 *up o2 ri*e < /%asses o2 water 5 *up o2 mon//o soup 5 *up o2 ri*e J *up o2 soup Bni%a/an/ baboyC 7 sma%% s%i*es o2 banana with su/ar,
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@E(NES(AI 5 pie*e pandesa% Bmedium si.edC 5 s%i*e o2 spam /%asses o2 water

< /%ass o2 water :ERIEN(A pie*es o2 pandesa% Bmedium si.eC 5 /%ass o2 water (INNER 5 s%i*e 2ried mi%92ish 5; *up o2 ri*e /%asses o2 water 5 pie*e o2 *ho*o%ate bread B2ud/ee barC 5 /%ass o2 water 5 /%ass o2 steri%i.ed mi%9 pie*es o2 *ra*9ers Bs9y 2%a9esC 5 /%ass o2 water

J *up o2 ri*e 5 /%ass o2 water

(L 2luid 4Nutrition

"efore

(uring

Inter,retation nal+sis Inter,retation:

and

&os,itali5ation &os,itali5ation The patientAs 2%uid The patient pre2eren*es are *onsumes on%y ha%2 o2 her 2ood, Her *o22ee and water, o2 4" *o22ee >

(ue to hypertension and *hest pain the patient %oss her appetite and on%y *onsumes ha%2 o2 her 2ood, nal+sis: A*ute and *hroni* diseases may a22e*t the metabo%ism and uti%i.ation o2 nutrients$
16 | P a g e

SheAs ha3in/ a *up appetite was e3ery de*reased$ be*ause o2 taste the 2ood, %asa yun/ pa/9ain mornin/, She drin9s she was unab%e to /%asses water a day, Her EParan/ wa%an/ usua% mea%s in*%ude 3e/etab%es and 2ish, eh, Simu%a nun/

She is not 2ond o2 martes n/a n/ /abi eatin/ *up o2 por9, ri*e She di na9o 9uma9ain and masa9it dibdib 9oK %esser As 3erba%i.ed by the usua%%y *onsumes a masyado 9asi sometimes 2a3orite ba/oon/

whi*h are a%ready a%tered by the a/in/ pro*ess, BOASAS$ !!4,C

than that, And her patient, The *%ient 2ood is 2%uid inta9e a%so she de*reased 2rom the

,e#erence-

!.e/tbook

o#

0edical1Surgical

Nursing

&2th 3dition, 4ol. & page '5 by 6runner 7 Suddarth8s(

3erba%i.ed that she usua% 4"> *%asses to *annot eat a mea% 7"1 /%asses, without a ba/oon/ on the side dish, E6er-ise The patient said that Sin*e wa%9in/ mornin/ husband is her 2orm with she was

Inter,retation

e3ery hospita%i.ed

she The *%ient is *urrent%y 2ee%s bed, He is ha3in/

her *annot do any more wea9 and unab%e to /et out and those simp%e thin/s o2 o2

*%eanin/ her house she used to do, The di22i*u%ty in sittin/ be*ause patient *anAt e3en o2 her *hest pain but he is wa%9 be*ause the ab%e to *han/e his position do*tor instru*t 2or whi%e %yin/ in bed, *omp%ete bed rest, Pag ata as %au/h, the upo nalang magiging nal+sis: menta% and e?er*ise,

e/ercise ko ngayon E?er*ise is essentia% 2or patient maintainin/ 3erba%i.ed this and physi*a% hea%th, Indi3idua%s who ha3e ina*ti3e %i2esty%e or who are 2a*ed with ina*ti3ity be*ause o2 i%%ness or in8ury are at ris9 2or many prob%ems that *an a22e*t ma8or body systems, !"undamentals o# Nursing
17 | P a g e

'th edition, p.&&&%( -e2ore &+giene hospita%i.ation$ C%ient +T had not Inter,retation: the ta9en a she bath The patient is *urrent%y had unab%e to /et out o2 bed that she is in a

patient +T maintains be*ause

her proper hy/iene been admitted that be*ause the do*torAs order by ta9in/ a bath day, She was 8ust said brushes her teeth with the he%p o2 her thri*e a day durin/ dau/hter mornin/ on on*e a day, She doin/ spon/e bath *omp%ete bed rest without bathroom pri3i%e/es, She is that basi*a%%y *on2ined to the %imitations and brushes her her

upon day, She brushes %imits o2 her bed$ due to

wa9in/ up$ in the her teeth thri*e a these and at ni/ht durin/ uses a mouthwash bath bed patient time, a%so The with the he%p o2 her trims dau/hter, Her nai%s

a2ternoon a2ter mea% day and sometimes dau/hter /i3es her a bed teeth;dentures, nal+sis: Hy/iene is an essentia% indi*ator o2 how a *%ient *an maintain his;her hea%th, It in*%udes bathin/$ /roomin/$ toi%etin/ and ora% *are, One must do hy/ieni* pra*ti*es a3oid *ondition, in2%uen*ed pre2eren*es, ,e#erence- !"undamentals o# Nursing Practice 9th edition, Ko$ier and 3rb, Substan-e *se -e2ore admission$ A2ter bein/ pg.5%2( Inter,retation: The patient
18 | P a g e

her 2in/ernai%s and were obser3ed to be toenai%s e3ery time %on/ and not *%ean, she thin9s it is %on/, She a%so washes hands be2ore and a2ter eatin/,

e3ery It is by

day

to the the

*ompromisin/

main%y

en3ironment$ and persona%

the *%ient stated she hospita%i.ed$ she dis*ontinued we as9ed her understands the importan*e o2 ta9in/ her her maintenan*e now *ontinues her medi*ations be*ause she wants to 9eep a hea%thy %i2esty%e and a3oid *omp%i*ations, medi*ine and when

3erba%i.ed the importan*e o2 her medi*ine to 9eep her body hea%thy despite 2inan*ia% *onstraints and wants to *ontinues her %i2esty%e 2ree 2rom 3i*e,

dau/hter she added medi*ations and that kaya hindi yan umiinom ng gamot kasi pala hindi yung nya gamot sinasabi na ubos na nya dahil wala na naman daw syang nararamdaman as 3erba%i.ed dau/hter by o2 the the

nal+sis: Ana%ysis: Substan*e abuse is a ma8or threate to hea%th o2 indi3idua%s,Pro%on/ed use *an %ead to physi*a% and psy*ho%o/i* dependen*y and subse=uent hea%th prob%ems, B+undamenta%s o2 nursin/ >th edition$ )o.ier G Erb$ p, <60C

patient, The patient does not drin9 nor smo9e and p%ans to 9eep hea%thy, her body

Slee, %attern

and

Rest -e2ore patient +T @hi%e durin/ was admitted$ she hospita%i.ation$ the has a /ood s%eepin/ at >pm and wa9es up 1am the ne?t patient has di22i*u%ty she was brou/ht to emer/en*y room,

Inter,retation: There is a *han/e in

pattern, She s%eeps 2a%%in/ as%eep sin*e

s%eepin/ pattern when she was admitted, The patient has a depri3ed s%eep durin/ hospita%i.ation *ompared to be2ore she was admitted due to the pain she is

mornin/, She was E3en she was in her ne3er depri3ed o2 room at the hospita%$ s%eep be*ause and it was hours a2ter

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the two o2 them$ with The her

she was admitted to su22erin/ and thin9in/ o2 the i%%ness she has, nal+sis: The norma% ran/e 2or s%eep 2or indi3idua% is between 0 to > hours, S%eep maybe disrupted by the en3ironment$ stress$ and other 2a*tors that disturbed the brain o2 a person, BSnyder S,$ )o.ier -,$ Erb$ G,$ -erman Pro*ess$ A,$ and +undamenta%s o2 Nursin/: Con*epts$ Pra*ti*e, Sin/apore:Pearson Edu*ation, Pa/e 5507,C

husband ward$ but sti%% she

stays at their house, *annot s%eep, She en3ironment said$ EHindi a9o was a%so =uiet so ma9atu%o/ 9asi she *an rest the masa9it pa rin yun/ who%e day, (urin/ dibdib 9o, KTsa9a the a2ternoon$ she ewan 9o hindi a%so she s%eeps a2ter ta%a/a a9o 2inished ma9atu%o/,K

wat*hin/ te%e3ision,

Elimination %attern

The patient de2e*ates two times a day without e?perien*in/ dis*om2orts$ usua%%y mornin/ and a2ternoon, Stoo% is brown in *o%or and is we%%"2ormed and the patient 3oids 0"> times a day with a %i/ht ye%%owish *o%or

The patient de2e*ates on*e a day but not e3eryday, Stoo% is so2t$ is minima% in amount and is brown in *o%or, And she added that she 3oids <"7 times a day$ amber in *o%or without pain and

Inter,retation: There was a *han/e in the 2re=uen*y$ *onsisten*y and amount o2 stoo%, And a%so a *han/e in the 2re=uen*y and amount o2 urine, nal+sis: Conditions that a%ter norma% 2%uid inta9e and out$ su*h as ha3in/ in2%uen.a or ha3in/ sur/ery$ *an *ompromise the
20 | P a g e

without pain and dis*om2ort,

dis*om2ort

9idneyDs abi%ity to 2i%ter$ maintain a*id"base ba%an*e and maintain e%e*troy%yte ba%an*e in e%ders, B+undamenta%s o2 nursin/ >th edition$ )o.ier G Erb$ p, 5 >>C

+e*es are norma%%y brown$ *hie2%y due to the presen*e o2 ster*obi%in and urobi%in B+undamenta%s o2 nursin/ >th edition$ )o.ier G Erb$ p, 5< 1C

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