IV.

ACTIVITIES OF DAILY LIVING BEFORE HOSPITALIZATION July 17, 2010 Midnight Gumigising siya ng ala una ng madaling araw para dumede, pagtapos niyang ubusin yung isang bote, natutulog agad siya, as verbalized by the clients mother. Breakfast Nakakdalawang bote siya ng gatas sa umaga, yung 8 oz., nauubos niya lahat yun, as verbalized by the clients mother. Lunch Sa tanghali, 3 bote naman ng gatas iniinom niya, hanggang hapon na yun, as verbalized by the clients mother. DURING HOSPITALIZATION July 20, 2010 Nong Tuesday, maghapon, magdamag yan hindi siya dumede kasi yan yung araw na dinala naming siya dito, tska inoperahan siya Sabi din nong doctor, wag ko daw muna siya padedein o pakainin, as verbalized by the clients mother. July 21, 2010 Breakfast Nong umaga, hindi siya dumede non, wala siyang gana, as verbalized by the clients mother. Lunch Dalawang bote ng gatas yung naubos niya nong tanghali pero tig-3 oz. lang, sabi kasi nong doctor, wag ko daw masyado padedein ng marami, bawasan ko daw kasi bagong opera as verbalized by the clients mother. INTERPRETATION AND ANALYSIS Interpretation The client is 6 months old; he must be introduced with soft foods that contain nutrients, which cannot be found in formula milk. Formula milks have components that might have disadvantages to some infants. The clients diet after surgery is controlled slowly from NPO to DAT, to prevent GI shock. Analysis Artificial feeding is costly. Besides the milk formula, money is spent on the bottles and nipples, cooking utensils, fuel, cold storage and even medical care because infection seems frequent and often severe. (Basic Nutrition and Diet Therapy, Revised Edition by Maria Lourdes C. Caudal, RND; Chapter 8, page 189) The use of formula milk may lead to such intestinal irritation that slight but continuous gastrointestinal bleeding occurs, resulting in anemia. (Maternal & Child Health Nursing: Care of the Childbearing & Childbearing Family 5th Edition, Volume II

NUTRITION

Dinner Tatlong bote yung inubos niya non, 8 oz. palagi tinitimpla ko sa kanya para maubos niya, as verbalized by the clients mother. Dinner Isang boteng 3 oz. lang yung naubos niya nong July 18, 2010 Midnight kinagabihan, as Gumising ulit siya ng verbalized by the clients madaling araw para mother. uminom ng isang boteng gatas, pasado July 22, 2010 ala una yun, basta Midnight tuwing ala una Isang bote ng gatas gigising siya para naubos niya nong dumede pagkatapos madaling araw nagising agad matutulog, as kasi siya mga pasado alas verbalized by the dos, as verbalized by the clients mother. clients mother.

Breakfast Dalawang boteng gatas na tig-8 oz. yung naubos niya nong araw nay un, tuwing umaga talaga 2 bote yung iniinom ta nauubos naman niya, as verbalized by the clients mother. Lunch Tatlong bote ng gatas inubos niya nong araw nay un hanggang hapon ulit, as verbalized by the clients mother, Dinner Dalawang dede naubos niya nong gabi, tapos nong nagtimpla ulit ako ng panibago, kalahati lang ata naubos niya, nakatulog agad siya, as verbalized by the clients mother. July 19, 2010 Breakfast Nong araw bago siya maospital, hindi na siya ginanahan dumede non, umaga tinimplahan ko siya ng isnag boteng gatas tapos di pa niya inubos naka 3 oz. lang siya, as verbalized by the clients mother. Lunch Hindi siya uminom ng gatas nong tanghali, wala siya gana masakit kasi tiyan niya, as verbalized by the clients mother.

Breakfast Ngayong umaga, 3 bote ng gatas naubos niya, 3 oz. parin tinitimpla ko, as verbalized by the clients mother. Lunch Dalawang bote palang naiinom niya simula nong tanghali hanggang ngayon, as verbalized by the clients mother. Dinner Heto, isa plang naiinom niya ngayong gabi, as verbalized by the clients mother.

by Adele Pillitteri; Chapter 28, page 843) Once nausea and vomiting have subsided and the patient is fully awake and alert, the sooner he or she can tolerate a usual diet, and the more quickly normal GI function will resume. The return to normal dietary intake should proceed at a pace set by the patient. (MedicalSurgical Nursing 12th Edition by Brunner and Suddarth, Volume I; Chapter 20, page 476)

ELIMINATION

Dinner Nong gabi pinadede ko siya, tinimplahan ko siya ng isang boteng gatas kaso hindi nanaman niya naubos, 5 oz. lang yung naubos niya, as verbalized by the clients mother. Bago siya dalhin dito hindi siya makaihi, meron man, kontingkonti lang patak-patak lang ata Suka rin siya ng suka non, anim na beses siya sumuka nong gabi, puro gatas Hindi rin siya tumae nong araw na yun, masakit yung tiyan niya kaya dinala naming siya dito sa hospital, as verbalized by the clients mother.

Pinapalitan ko diaper niya mga apat na beses sa isang araw, punung-puno yun. Dilaw yung ihi niya, malinaw nman walang halo.

Interpretation The client had constipation and oliguria before hospitalization. Clients stool and urine is obstructed from their pathways. The client is Limang beses siya persistently vomiting tumatae, tubig tubig yung because the stomach tae niya kulay yellow, cannot accommodate ang dalas niya dumumi, any food intake due to papalitan ko pa lang yung obstruction. diaper niya tatae nanaman siya The accumulated stool and urine was rapidly Mga tatlong kutsara released the day after yung dami ng tae niya, surgery. as verbalized by the clients mother. Analysis Inguinal hernia is a protrusion of a section of the bowel into the inguinal ring. It occurs usually in boys (9:1) because, as the testes descend from the abdominal cavity into the scrotum late in fetal life, a fold of parietal peritoneum also descends, forming a tube from the abdomen to the scrotum. If it fails to close, intestinal descent into it (hernia) may occur at any time when there is an increase in intra-abdominal pressure. Pain at the site implies

that the bowel has become incarcerated in the sac, an emergency that requires immediate action to prevent bowel obstruction and ischemia. After surgery, the infant will need frequent diaper changes and good diaper-area care. (Maternal & Child Health Nursing: Care of the Childbearing & Childbearing Family 5th Edition, Volume II by Adele Pillitteri; Chapter 45, page 1441) Interpretation The mother provides stretching exercises for her child, which is good for the development of his joints. Analysis Infants benefit from outings in a carriage or stroller because sunlight provides a natural source of vitamin D. It is not necessary to enroll infants in normal exercise programs for them to secure adequate exercise. Such programs may put unusual strain on muscles and tendons. (Maternal & Child Health Nursing: Care of the Childbearing & Childbearing Family 5th Edition, Volume II by Adele Pillitteri; Chapter 28, page 850) Interpretation When the diaper was not frequently changed, the urine or stools might overflow and can stain

EXERCISE

Nagpapadyak-padyak lang siya sa bahay tapos inuunat-unat ko lang yung mga paa tska kamay niya paggising sa umaga at sa hapon tuwing naglalaro siya, as verbalized by the clients mother.

Dito sa hospital di ko na inuunat mga paat kamay niya. Exercise niya lang dito yung pagpadyakpadyak niya, as verbalized by the clients mother.

HYGIENE

Isang beses lang siya naliligo sa isang araw tuwing umaga yun tapos nililinis ko rin dila niya tuwing

Hindi ko pa siya pinapaliguan kasi minsan nilalagnat siya. Mula nong dinala siya dito di ko pa siya nililinisan,

naliligo, as verbalized by the clients mother.

pinapalitan ko lang diaper niya kapag punung-puno na Gasa yung takip ng sugat niya, doctor yung naglilinis Pag nilalagnat siya, yung pagpunas-punas ko sa katawan niya, yun na yung paglinis ko sa kaniya, as verbalized by the clients mother.

the surgical incision that may lead to infection. This may also subject for skin irritation if there is prolonged diaper change. Analysis After surgery, keep the suture line dry and free from urine or feces to prevent infection. Most incision in the area is closed by a tissue adhesive, which is waterproof and seals the incision form urine and feces. Even so, the infant will need frequent diaper change and good diaper-care. (Maternal & Child Health Nursing: Care of the Childbearing & Childbearing Family 5th Edition, Volume II by Adele Pillitteri; Chapter 45, page 1441) When parents do not change the childs diaper frequently, feces are left in contact with skin, and irritation may result in the perineal area. Urine that is left in diapers too long breaks down into ammonia, a chemical that is extremely irritating to infant skin. (Maternal & Child Health Nursing: Care of the Childbearing & Childbearing Family 5th Edition, Volume II by Adele Pillitteri; Chapter 853, page 850)

SLEEP & REST

Nong gabi bago kami pumunta ng ospital, di siya makatulog, iyak siya ng iyak kasi masakit nga yung tiyan nia. Nkakaidlip siya pero mga kalahating oras lang iiyak nanaman siya as verbalized by the clients mother.

Sa gabi lang siya nakakatulog 8 hanggang 4 ng umaga, paputulputol yun, isa o kalahating oras bago siya matulog ulit Sa araw idlip-idlip lang, mababaw tulog niya kasi mainit tapos maingay pa yung ibang bantay ng kabilang kama, as verbalized by the clients mother.

Interpretation The child has disturbed sleep because of the painful sensation felt in his stomach The clients sleep is disturbed because of the hospital settings and medical procedures. Analysis Illness that causes pain or physical distress, can result in sleep problems. People who are ill require more sleep than normal, and the normal rhythm of sleep and wakefulness is often disturbed. The researchers believe that sleep has been undervalued by nursing practice. For example, noise is a major disturbance in the hospital setting, making it difficult for clients to sleep. Clients are often awakened early for obtaining lab specimens, weights, assessments, and medication administration. (Fundamentals of Nursing by Kozier and Erb, 8th Edition, unit X, page 1169 - 1170)

SUBSTANCE USE

Nong nasa bahay kami, araw-araw ko yan pinapainom ng vitamins pagkatapos kumain yung Celine tska yung Tiki-Tiki

Ngayon, di ko siya napapinom ng vitamins kasi hindi naming nadala, nasa bahay Reseta ng doctor yung co-amoxiclav para sa ubo niya tska paracetamol kapag nilalagnat siya, as verbalized by the mother

Interpretation The mother provides supplemental nutrients for her baby that can help to his growth and development. The child takes coamoxiclav to treat his respiratory infection and paracetamol to reduce

fever. Analysis Nutrients function in groups or teams. Therefore, if diet supplementation is warranted, it is likely that both vitamins and some additional minerals are needed. (Essentials of Pharmacology for Health Occupations 5th Edition by Ruth Woodrow; Chapter 11, page 142) Penicillin is used to treat many streptococcal and some staphylococcal and meningococcal infections, including intestinal and respiratory infections. Amoxicillin has also been used in combination with other drugs to treat Helicobacter pylori infection associated with duodenal ulcer disease. (Essentials of Pharmacology for Health Occupations 5th Edition by Ruth Woodrow; Chapter 17, page 278) Paracetamol or Acetaminophen can be clasdified as antipyretic and analgesic. It works as antipyretic by reducing fever by acting directly on the hypothalamic heatregulating center to cause vasodilation and sweating, which helps dissipate heat. (Lippincotts Nursing

Drug Guide 2010 by Amy M. Karch, page 71)