A Case Study On:

Ectopic Pregnancy

Presented to the Faculty of the College of Nursing

Capitol University

In Partial Fulfillment of the

Requirement for the Subject

Related Learning Experience 7

By:

Cabading, Daryl Ann

Cadiz, Joan
CAdungan, Alyssa Marie
Callano, Rex Andrew
Camilotes, Katleen Mae
Castillo, Bryan Angelo
Cecilio, Abigail
Chang, Christian Philip
Bombeo, Stephanie Soy
Boquiron, Bumbee

Submitted to:
Mrs. Rochelle Y. Lamberang RN
Clinical Instructor
INTRODUCTION
Ectopic pregnancy affects about 1% of pregnancies. In a normal pregnancy, an egg is
fertilised by sperm in a fallopian tube (the tubes connecting the ovaries to the womb).
The fertilised egg moves into the womb, and implants itself in the womb lining, where it
grows and develops. An ectopic pregnancy occurs when a fertilised egg is implanted
outside the womb.

Over 95% of ectopic pregnancies occur in a fallopian tube, which is known as a tubular
pregnancy. Ectopic pregnancies can also occur in an ovary, in the abdominal space, or
in the cervix (neck of the womb).

If it's not treated, an ectopic pregnancy can be fatal. It can split (rupture) the fallopian
tube causing internal, abdominal bleeding that can lead to a life-threatening amount of
blood loss.

However, the number of ectopic pregnancies that result in death is small. For example,
from 2000 to 2002, there were 31,000 ectopic pregnancies in the UK. Of these, 11
(0.035%) resulted in death.

We had chosen this case presentation in order to identify and determine the general
health problems and needs of the patient with an admitting diagnosis of Ectopic
Pregnancy. One of the goals of this presentation also is to help our patient as well as
the significant others to promote health and medical understanding of this disease
condition through the application of the nursing theories and nursing skills.

The following are the specific objectives of this study:

• To raise the level of awareness of the patient and the family regarding the health
problems that are present.

• To facilitate patient in taking necessary actions to solve and prevent the identified
problems on his own and with the help of the family and other support groups.

• To motivate the patient and family to continue the health care provided by the
health workers in Northern Mindanao Medical Center most especially by the
students and Clinical Instructor of Capitol University.

• To add into the current case presentation output that has been collected for how
many years in the College of Nursing, Capitol University.
 • And lastly, to help the RLE 7 students to be more knowledgeable in making and
conducting a case presentation in the higher years.

This case presentation would also try to develop the critical analysis of each case
presenter in order to come up with a very good output and a team effort.
ASSESSMENT

1. Client’s Profile

Patient X is a 28-year-old female, Filipino citizen and is a Iglesia Filipina

Independente. She is currently residing at Manticao, Misamis Oriental. She is single.

Patient X is currently unemployed.

Her family was always supportive to her, most specially in problems regarding her
health. In times of distress, relaxation, such as walking and sleeping, is his best coping
strategy.
2. Vital signs
Upon assessment, the following data was obtained from Patient X: Blood
pressure=90/60 mm Hg; Axillary temperature= 36.1oC; Pulse rate= 110 beats per
minute; Respiratory rate= 30 counts per minute.

3. Chief complaints
Patient X complains a scant vaginal spotting.

4. Family health- Illness History

Her family has a history of hypertension.

5. History of present illness

1 month PTA patient X experienced amenorrhea. She experienced
nausea and vomiting every morning. Patient X tried to use a pregnancy test
and resulted to be positive. 3 days PTA she suffered from scanty vaginal
spotting.
6. Statement of patient general appearance.
Patient X is conscious and coherent. With fair skin.
7. Nutritional and metabolic pattern
Patient X eats three times a day with no special diet. She usually experience
nausea and vomiting every morning.
8. Elimination pattern
Patient defecates twice a week, foul smelling stool.
She urinates four to five times a day.
9. Activity and Exercise Pattern
The patient claims she does not exercise.

10. Cognitive-Perceptual Pattern

The patient was well oriented to time, place and person. She appears to be worried
upon interaction. She is in pain with a pain scale of 7/10 and feels dizzy.
She could converse using Filipino and Bisaya languages. She is High school
graduate .

11. Sleep-Rest Pattern

Patient X usually sleeps at 10pm and gets up at 5am but sometimes she has a
disturbed sleep pattern due to polyuria.
 CAPITOL UNIVERSITY
College of Nursing

NURSING ASSESSMENT FORM

A. Demographic Data
Name of Client _X___________________ Unit/Ward _NMMC - DR___ Bed ____4____
Age __28_______ Sex __Female_______ Civil Status _Single___ Religion __Iglesia Filipina Independente__________
Date of Admission ___July 9, 2010______ Medical Diagnosis: Ectopic pregnancy________________________
Examiner : ______________________ Information given by patient herself
B. Vital Signs

Temp _36.6_ oral axilla rectal BP: 90/60 mmHg___  lying  sitting  standing
Pulse __110_beats/ min.  regular  irregular Resp _ 30 _c/ min.  regular  irregular
Height _5”4_____ cm. Weight 62 kg.

C. Health Patterns Assessment: Complete information, including patient’s words. Indicate N/A if non-applicable. Circle,
code, or check all findings as appropriate.

1. Health Perception and Health Management Pattern

Reason for hospitalization/chief complaint: Vaginal Spotting____________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
___________
History of present illness: 1 month PTA patient X experienced amenorrhea. She has experienced nausea and vomiting every
morning. Patient X tried to use a pregnancy and resulted to be positive. 3 days PTA she suffered from mild to severe stabbing
pain noted at her left lower abdominal quadrant with scant vaginal spotting._______________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Previous hospitalizations/surgeries: Patient X was admitted for surgery due to ectopic pregnanvy at COMC last December
2007________________________________________________________________________________________________
____________________________________________________________________________________________________
What other health problems have you had? Urinary Tract Infection______________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Things done to manage health: Patient places herself in a comfortable position and drink lots of water to relieve pain. She is
also using Shane Herbal Oil and applied to the affected part.____________________________________________________
____________________________________________________________________________________________________
___________________________________________________________________________________________________
Statement of patient’s general appearance: Patient X is conscious and coherent. Has a coarse hair, with sunken eyes, dry____
mucous membrane, weak and pale in appearance.____________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________

Tobacco use:  Yes  No Used to smoke _1-2_________ packs/day for _____5_____ years
Alcohol use:  Yes  No Amount: _500-800 ml (approxi.) Frequency: _occasionally__ Duration: _up to the present
Coffee/Cola/Tea Intake:  Yes  No Amount: _4 cups__ Frequency: every day_ Duration: _ up to the present ___
Recreational/Illicit Drug use:  Yes Specify: _____________________  No
Allergies:  Yes (list with reaction experienced)  No
Food: __________________________________________ Medications:_____________________________________
Others: ________________________________________________________________________________________

Medications:
NAME DOSE SCHEDULE INDICATIONS
Methotrexate
Leucovorino
Mifeprestone
Have you been taking your medication(s) as prescribed?
Yes__________________________________________________________________________________________
OTHER PERTINENT DATA:
_____________________________________________________________________________________________
_
_____________________________________________________________________________________________
_________
2. Nutrition and Metabolic Pattern
Special diet? _Low fat_low fat_,_____________________________________ Supplements: Vitamins rich in folic acid
Pattern of daily food/fluid intake (describe amount/quantity) __3 times a day minimum quantity______________________
Appetite: _good_____________________________________ Wt. loss/gain? _unassessed___________________________
Nausea/Vomiting: nausea and vomiting every morning_________________  Hematemesis  Coffee-ground vomitus

Food/eating discomforts: __none______________________ GI pain __none____________________________________

Nutritional state:  well-nourished  poorly nourished  obesity  cachexia

Mouth: Lips:  pinkish  pallor  cyanosis  dryness/cracks  lesions: ________________________________

Mucosa:  pinkish  pallor  cyanosis
Tongue:  midline  R/L deviation  atrophy  fasciculation
Teeth:  complete  missing teeth  caries  dentures: ________________
Gums:  pinkish  pallor  bleeding  tenderness

Pharynx: Uvula:  midline  R/L deviation Mucosa:  pinkish  pallor  reddish

Tonsils:  not inflamed  R/L inflamed  R/L with exudate
Posterior Pharynx:  inflammation/congestion

Neck: Trachea:  midline R/L deviation Cervical lymph nodes:  lymphadenopathy  tenderness
Thyroids:  non-palpable  enlarged Others:  neck enlargement  normal ROM  neck rigidity

Skin: General Color:  pinkish  pallor  jaundice  dusky  cyanotic  flushed  mottled
Texture:  smooth  rough  others: __ ________________________
Turgor:  supple  firm  dehydrated  others: _ __________________________
Temperature:  warm  cool  others: ______________ Moisture:  dry moist/clammy  oily
Others:  petechiae  ecchymosis  hematoma lesions/rashes: ____________________________________
 edema: ____ pitting ____ non-pitting ____ pedal: R/L ______ bipedal Grading: _______

Wounds/drains/dressings: _______________________________________________________________________________
Intravenous fluids:_____________________________________________________________________________________
OTHER PERTINENT DATA: ___________________________________________________________________________

3. Elimination Pattern
Usual bowel pattern (describe character of stool, frequency, discomforts) __brown in color, foul smelling, defecates once a
day_______________
_________________________________________________________________ Date of last BM: 2/4/10________________
 Melena  Hematochezia
Any problems with hemorrhoids/incontinence? __none_______________________________________________________
Use of anything to manage bowels (e.g. laxatives, enema, suppositories, “home remedies” anti-diarrheals): none________
___________________________________________________________________________________________________

Abdomen: General :  superficial veins  straie  scars/lesions: right lower abdominal quadrant_______
Configuration:  symmetrical  asymmetrical  flat  globular  protuberant  scaphoid
Bowel Sounds:  normoactive  hyperactive  hypoactive  absent
Percussion:  tympanitic  hypertympanitic  dullness at _________________________________
 fluid wave  shifting dullness
Palpation:  muscle guarding  direct tenderness  rebound tenderness  bladder distention
 organomegaly: ___ liver ___ spleen  masses at _____________________________________

Usual urinary pattern (describe frequency, character, amount, problem in control, etc.): Urinates at least 10 times a day, the
urine color varies from light yellow to dark-yellow with blood.
 dysuria  hematuria  nocturia  retention  flank pain  polyuria  oliguria anuria
Excess perspiration/nocturnal sweats: _______________________________________________________________________
OTHER PERTINENT DATA:_____________________________________________________________________________
______________________________________________________________________________________________________
 4. Activity – Exercise Pattern
Exercise Pattern? (Type, Regularity) _deep breathing exercises __________________________________________________
Leisure Activities? _walking _________________________________________________________________

Cardiovascular Status:  chest pain/radiation: _______________________  palpitations  dyspnea on exertion

 orthopnea  paroxysmal nocturnal dyspnea  jugular vein distention
Precordial area:  flat  bulging  tenderness  heave  thrill
Point of Maximal Impulse (PMI) _______________ Apical rate & rhythm _________________________________
Heart Sounds: distinct  regular  faint  irregular S1 < > S2 at the base S1 < > at the apex
Others:  S3  S4  Murmur best heard at ________________  Pericardial rub
Peripheral pulses:  symmetrical  regular  absent  faint/weak  strong  bounding
Capillary refill __3 seconds___________________________  clubbing
Presence of Pacemaker/A-V Shunt/Hemodynamic monitoring __none_______________________________________

Respiratory Status: Breathing Pattern:  regular  irregular  eupnea  hyperpnea  tachypnea  bradypnea
 dyspnea: rest / exertion  use of accessory muscles  ICS retractions/bulging  pain on respiration
Shape of Chest: Anterior-Posterior-Lateral Ratio AP_2____: L__1___  barrel chest  funnel  pigeon
Lung Expansion:  symmetrical  R / L decreased/lag
Vocal/Tactile Fremitus:  symmetrical  decreased / increased at _________________
Percussion:  resonant  dullness at ___________________  hyperresonant at ___________________
Breath Sounds:  vesicular  bronchovesicular at _________________  bronchial at __________________
 rales/crackles at______________  wheezes at ___________________  rhonchi  pleural friction rub
Cough:  productive  non-productive Sputum: color _________ amount________ consistency __________

O2 supplement/ventilatory assistance:none_______________________________________________________________
Resp. tubes (e.g. ET, trach, chest tube – describe
secretions/drainage)__none___________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
____________________________________________________________________________________________________

Activities of Daily Living/ Mobility Status: Use the Activity Level Code below to assess ADL & mobility status
ADL Status Mobility Status
0 – total independence Feeding __0______ Meal Preparation_0____ Bed mobility __0___________
1 – assist with device Bathing __0______ Cleaning _0_________ Chair/toilet transfer_0_______
2 – assist with person Dressing __0_____ Laundry _0_________ Ambulation ____0__________
3 – assist with device & person Grooming _0_____ Toileting _0_________ R.O.M. _______0__________
4 – total dependence
Reasons for ADL/Mobility limitation ______________________________________________________________________
Device used for assistance
_none_______________________________________________________________________________
Exercise pattern (describe type, regularity) _walking every morning______________________________________________

Back and Extremities: Range of Motion:  full  symmetrical  decreased ROM (specify joint) _________________
 Joint tenderness/pain  joint swelling at ________________  varicose veins  deformities _____________
Muscle tone and Strength:  equally strong  symmetrical in size  R / L Upper / Lower Atrophy
 R / L Upper / Lower Paresis  R / L Upper / Lower Paralysis
Spine:  midline  Kyphosis  Lordosis  Scoliosis
Gait:  coordinated  smooth  uncoordinated  shuffling  staggering
OTHER PERTINENT DATA _____________________________________________________________________________
______________________________________________________________________________________________________

5. Cognitive – Perceptual Pattern

Level of Consciousness:  conscious  alert  confused  drowsy  stuporous  comatose  others_______

Orientation:  oriented  disoriented to : time / person / place
Emotional state:  calm  worried/anxious  restless  others: ______________________________________
Appropriate behavior/communication: ______________________________________________________________________
 dizziness  numbness  tingling sensation

Head:  normocephalic  asymmetrical  enlarged  masses: _____________  others: ___________________

Facial Movements:  symmetrical  asymmetrical: lag at R / L
Fontanels:  closed  sunken  bulging  open: specify _____________________
Hair:  fine  coarse  dry  normal/even distribution  alopecia
 Scalp:  clean  dandruff  lice  wounds/scars/lesions: specify_______________________________

Eyes: Lids:  symmetrical  R / L edema/swelling  R / L ptosis  lesions: __________________________

Periorbital region:  edema  sunken  discoloration
Conjunctiva:  pink  pale  lesions  discharges
Cornea & Lens:  opacity: R / L  lesions: __________
Sclera:  anicteric  subicteric icteric  hemorrhages
Pupils:  equal: size _2____mm.  unequal: R= _____mm. L= _____mm.
Reaction to Light: R -  brisk  sluggish  fixed L -  brisk  sluggish  fixed
Reaction to Accommodation:  uniform constriction / convergence  unequal constriction / convergence
Visual Acuity:  grossly normal  farsighted  nearsighted  wears eyeglasses/contact lenses
Peripheral Vision:  intact/full  decreased/ limited: _______________________________________________

Ears: External Pinnae:  normoset  symmetrical  tenderness  lesions  gross abnormalities ______________
External Canal:  discharge: ___foul smelling ___ serous ___ purulent ___mucoid  Cerumen: ____impacted
Tympanic Membrane:  intact
Gross Hearing:  normal  decreased  symmetrical  R / L deafness

Nose:  alar flaring  shallow nasolabial fold Septum:  midline  deviated  perforated
Mucosa:  pinkish  pale  reddish Discharge:  serous  mucoid  purulent  bloody
Patency:  both patent  R / L obstruction  masses/lesions: describe __________________________________
Gross Smell:  normal/symmetrical  R / L olfactory deficiency
Sinuses:  tenderness: ____ maxillary ____ frontal
Cognition: Primary language _Bisaya __________ Speech deficit _none_______________________________
Educational attainment _College level______________________________________________________
Any learning difficulties? _none________________________________________________________________________
Any change in memory lately? ________________________________________________________________________

Pain:  no problem  problem (describe location, type, intensity, onset, duration of pain): left lower abdominal quadrant,
stabbing pain, pain scale of 8/10
Methods of pain management: _rest_______________________________________________________________________

6. Sleep – Rest Pattern

Usual sleep/rest pattern: disturbed sleeping pattern due to polyuria_________________________________________

Adequate  yes  no Factors affecting sleep/rest: _UTI__________________________________________
Methods to promote sleep
_none____________________________________________________________________________
History of sleep disturbances:____________________________________________________________________________
______________________________________________________________________________________________________

7. Self-perception and Self-concept Pattern

How do you describe yourself ? _a loving and caring wife_____________________________
Are there any ways you feel differently about yourself since you’ve been ill/hospitalized? _none_____________________
__________________________________________________________________________________________________
Description of non-verbal behaviors: ____________________________________________________________________
_________________________________________________________________________________________________

8. Role – Relationship Pattern

Marital status _married_____ Age and health of significant other _husband: 26 years old_________________________
Age and health of children _______________________________________________________________________________
Illnesses in the family _none____________________________________________________________________________
Live  alone  family  others: ___________________________________________________________________
Family feelings regarding illness/hospitalization _”Galisod gyapon me, mahal man gud ang gasto sa akong pagpahospital
pero kinahanglan paningkamutan para maayohan”, as verbalized ___________________________________
Who are the people that will help you most at this time? _my husband__________________________________________
Occupation: (any stresses/hazards?) _saleslady_______________________________________________________
Financial support system: _he usually seeks financial support from her husband and parents aside from her monthly income_

9. Sexuality – Reproductive Pattern

Any changes/problems with sexual relations? ______________________________________________________________
Female: Menstrual pattern:__ _________________________________ Problems/changes: _ N/A______
Date of LMP _ November 2, 2009__________________ Pregnancy history __ G0T0P0A1L0M0_______________
Use of birth control measure  yes  no  N/A Type: ___Pills____________________________________
Any problem with use ? ______________________________ Monthly self-breast exam  yes  no
 External Genitalia: Labia:
 symmetrical  asymmetrical  lesions __________________
 pinkish  discoloration  edema
Urethra:  pinkish  red/inflamed Vaginal Orifice Discharge:  purulent  bloody  foul-smelling
Others:  swelling  lumps/nodules
Breast:  equal  unequal Surface:  smooth  retraction  dimpling  edema  lesions
 tenderness  masses at _____________________  others: __________________________

Male: Prostate problems? _____________________________ Monthly self-testicular exam  yes  no

Penis:  discharge ________________  nodules/growths/lesions  tenderness
Scrotum:  equal shape w/ L lower than R  non-tender  R/L enlargement  R/L undescended testes
 tenderness  nodules/growths/lesions
Others:  hernia  hydrocoele

10. Coping – Stress Tolerance Pattern

Have you experienced any recent stressful situations in addition to your illness/hospitalization?  Yes  No
If “Yes”, please describe briefly _usually financial matters aside from the typical family problems and misunderstandings
Are there any ways we can be of assistance? _”wala, okay ra man,” as verbalized________________________________
How do you usually manage stresses? _”magtanaw lang ug T.V.,” as verbalized_________________________________
What do you do for relaxation? _sleep, rest, watch television_________________________________________________
Support groups/counseling resources used: _none__________________________________________________________
Were they helpful? _N/A______________________________________________________________________________

11. Value – Belief Pattern

Religion _Roman Catholic__
Is it important in your life? How? Yes, patients current health condition intensifies his faith and trust to God___________
Religious practices _Attend the Eucharistic mass almost every Sunday__________________________________________
__________________________________________________________________________________________________
Will illness/hospitalization interfere? _No_________________________________________________________________
Anatomy and Physiology
Laboratory and Diagnostic Exam
 NURSING
DRUG ORDER MECHANISM OF CONTRAINDICATIO ADVERSE RESPONSIBILITIES/
(Generic name, brand ACTION NS EFFECTS OF THE PRECAUTIONS
name, classification, INDICATIONS DRUG
dosage, route, frequency)

GENERIC NAME: The reduced form Minimizes Hypersensitivity HEMAT:

of folic acidthat hematologic Preparations thrombocytosis
Leucovorin calcium serves as a effects of high containing benzyl MISC: allergic
BRAND NAME: cofactor in the doses alcohol should nt be reactions
Folinic acid synthesis of DNA methotrexate used in neonates.
and RNA. therapy. Folic acid
CLASSIFICATION: deffeciency
antidotes unresponsive to
oral replacement.
DOSAGE:

ROUTE:

FREQUENCY:
 NURSING
DRUG ORDER MECHANISM OF CONTRAINDICATIO ADVERSE EFFECTS RESPONSIBILITIES/
(Generic name, brand ACTION NS OF THE DRUG PRECAUTIONS
name, classification, INDICATIONS
dosage, route,
frequency)

GENERIC NAME: Interferes with folicAlone with other Hypersensitivity, CNS: dizziness,
Methotrexate acid metabolism. treatment modalities pregnancy or drowsiness,
Result to inhibition in the treatment: lactation. headaches, malaise
NAME: of DNA synthesis trophoblastic EENT: blurred
BRAND Trexall and cell neoplasm,leukemias, vission,
reproduction. breast cancer, head RESP: pulmonary
CLASSIFICATION: carcinoma, neck fibrosis,
Antieoplastics, Therapeutic effects: carcinoma, lung GI: anorexia,
antirheumatics, death of rapidly carcinoma, treatment hepatoxicity, nausea
immunosuppresants replicating cells, of svere psoriasis, stomatitis, vomiting
particularly and rheumatoid GU: infertility
DOSAGE: malignant ones, arthritis, DERM: alopecia
and unresponsive to HEMAT: aplastic
ROUTE: immunosuppresant conventional therapy. anemia, anemia,
PO s. Treatment of leukopenia,
mycosis fungoides. thrombocytopenia
FREQUENCY: METAB:
hyperurecemia
MISC: nephropathy
 NURSING
DRUG ORDER MECHANISM OF CONTRAINDICATIO ADVERSE EFFECTS RESPONSIBILITIES/
(Generic name, brand ACTION NS OF THE DRUG PRECAUTIONS
name, classification, INDICATIONS
dosage, route,
frequency)

GENERIC NAME: Antagonizes Medical termination Prence of CNS: dizziness,

Mifepristone endometrial and of intrauterine intrauterine device. fainting headache,
mymetrial effects of pregnancy through Confirmed or weakness
BRAND NAME: progesterone. 49-day pregnancy. suspected GI: abdominal pain,
Mifeprex Termnaton of
pregnancy. Chronic diarrhea, nausea,
pregnancy.
CLASSIFICATION: arenal failure, vomitting
Sensetizes the
abortifacients GU: uterine
myometrium to
contration-inducing bleding, uterine
DOSAGE: activity of cramping, ruptued
prostaglandins. ectopic pregnancy,
ROUTE: pelvic pain.

FREQUENCY:
 DISCHARGE PLANNING

Medication

• Discuss to the patient the importance of taking medications as prescribed by the

physician.
• Instruct to the patient the proper dosages of taking medicines.
• Emphasize to the patient the adverse effects of the drugs.
• Discuss to the patient to comply medication regimen.
• Ephasize to the patient the indications and mechanism of action of the drugs.

EXERCISE
• Demonstrate ROM exercise as tolerated to promote and maintain join function
and prevent further deterioration.

• Demonstrate the types of exercise like pelvic rock exercise, tailor’s sitting,
abdominal breathing and kegel’s exercise.

Economic Status

• Tell the patient to visit the nearest Health Center for free check up
• Encourage the patient to avail services from government like philhealth.

Treatment

• Provide proper care and optimal infection control measures should be used.

• Emphasized the importance of providing comfort if the patient experiences fever,

chills or shivering.

• Iron supplements with vitamin C for better absorption.

Healthteachings

• Emphasized the necessities of personal hygiene and environmental cleanliness,

proper cooking techniques or food storage.

• Identify signs and symptoms that require medical evaluation (e.g increase
temperature, tachycardia, rashes and changes in bladder function.

• We also give her advices not to overworked and have a complete rest.

Out Patient

• Teach the patient to call his physician if he is experiencing such manifestation

that could eventually complicate his condition.
• Visit attending physician at out patient department as scheduled.
 • Have a Regular Consultations after discharge.

Diet

• Emphasized the importance of proper nutrition like the best sources for iron, are
in lean red meat, beef and pork and in plant broccoli and other leafy vegetables.

• Increase fluid intake for adequate hydration.

Spiritual

• Encourage patient to pray always and ask for the guidance from God.
• Asked for divine providence for Faster Recovery
 Related Learning Experience

Within three weeks of exposure at JR Borja General Hospital and Mary’s

Child Lying-in we could say that it was an unforgettable experience because we have
learned a lot with regards to quality care towards our client. It was more busy for we had
managed our time well.
On the first day of our duty, we were told by our clinical instructor that we
were to assess baby delivery. Because there were many pregnant mothers who were to
give birth at that time. We were lucky for all of us had given the opportunity to grab
cases. We had assessed six cases on the same day.
What makes it more exciting was to witness a surgery of a mother with an
ectopic pregnancy. It was our first time to assess such a complicated case. It’s because
in our previous exposure, we had handled normal deliveries.
On the following days, more deliveries were assessed and more
opportunities were given to us. We admitted that we’re too nervous on how we’ve been
able to deal with the staff especially to the midwives on duty. We observed that the staff
shouted at their client.
Although the midwives were not therapeutic, we acknowledged the notion
imparted on us. We became more knowledgeable with regards to the practice of theory
and skills on the field of Maternal and Child nursing.
Our clinical instructor has corrected us about the malpractices that were
exercised by the staff. He has taught us to deal with the client in ideal way. With regards
to our performance, he understands our imperfection and we’ve been able build
confidence when we doubted on our roles in the area.
In regards with our Practicing Clinical Instructor, He had able to cater our
needs. We had fun every time he conducted quiz bees.
All of our duty mates were cooperative. Teamwork during duty were
established. We could assess that we had improved. And we would practice nursing
skills in ideal way.