Easter College

DEPARTMENT OF NURSING
Easter School Road, Guisad, Baguio City

In Partial Fulfillment of Requirement in

R.L.E.

CASE ANALYSIS
in
SURGERY WARD

SUBMITTED BY:

Taloma, Andrey Felix E.

Cato, Cindy Mae D.
Doctor, Ligaya A.
Nabus, Riory Jhed B.
Pasngadan, Sheena M.

SUBMITTED TO:

NELIA SUMALAG ALFONSO

Clinical Instructor

SUBMITTED ON:
September 6, 2021

Prepared by: Brando B. Badecao

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Page 1 of 9
 COURSE CODE:
NCM 113L: COMMUNITY HEALTH NURSING 2 (POPULATION, GROUPS & COMMUNITY AS CLIENTS)

AREA/WARD: SURGICAL WARD

INSTRUCTIONS:
CONGRATULATIONS for pursuing with your dream of becoming a nurse.
Read the case of a patient whom you are to provide nursing care. Take time to analyze and process the information
provided, before answering the activities following each section of your module.
You may take a break, as necessary. You can ask your friends, classmates, parents, or any person whom you think
can help you understand but remember a greater amount of output should come from you, as you are the LEARNER
here.
Of course, you can ask me, your clinical instructor, for clarification on areas you do not seem to understand and do not
know what to do. Would be thankful and gladly help you on your learning needs. You can contact me through my
number: ________________________.
For you to conduct all the requirements for this rotation, we shall follow the schedule below:
Online:
Day 1: AM: read on your patient’s case and answer the given activity. In the afternoon we shall process 1 nursing
problem (actual).
Day 2: AM: processing of 2nd nursing problem (actual/potential), PM –partial or full processing of concept map
Day 3: AM: processing of concept map if yet done, PM – rotational exam (20 points)
Modular: Remember that you are given 3-5 days to finish this task.

ENDORSEMENT:
Situation: Endorsed patient X to 3-11 shift assigned in the Surgical Ward, the following data are:

o Patient is admitted to Bed 2

o Lying on bed with right leg slightly elevated, Awake, Alert, Responsive and Oriented to time, place and people
o Right leg is injured with surgical cast and swelling noted, Patient verbalized, “Ipadpadas ko man nga ingato,
ngem nasakit gamin no ikuti ken nagsakit jay na-fracture”, Reluctant to attempt movement
o Facial grimace noted, Patient verbalized pain scale of 7 out of 10.
o Heplock noted on Left arm
o Patient is on DAT
o Patient has Limited ROM
o Needs assistance in doing ADL

o Meds: Tramadol 50 mg TID, Oral every after meals

o VS: BP - 110/80 mmHg

RR – 17 cpm
PR – 85 bpm
T – 37.2 0 C
Spo2 – 95%

HISTORY:
- Narrative presentation of the scenario
- Brief description of the case focusing on the following:
 Patient’s Profile: Name: Patient X
Age: 34 years’ old
Sex: Male
Civil status: Married
Height: 5 feet, 5 inches
Weight: 80 kg
BMI: 29.3
Address: La Trinidad
Occupation: Laborer
Nationality: Filipino
Religion: Roman Catholic
Date and time of admission: August 27, 2021 @ 6: 00 PM
Bed #: 2
Ward: Surgical Ward

 Admitting diagnosis: Alcohol Intoxication, multiple physical injury secondary to motor vehicular accident, fracture
closed, complete tibia- fibula
 Chief complaints: Pain to multiple injuries secondary to motor vehicular accident

 HPI – Patient X,34 years old male, was rushed into the Emergency Room of Benguet General Hospital around 3:00 in
the afternoon due to Motor Vehicular Accident near McDonalds in La Trinidad. According to the patient, under the
influence of alcohol, he was driving his motorcycle fast around the area when he did not notice the vehicle backing up

Prepared by: Brando B. Badecao

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 from the driveway bumping him on his right side sustaining injury on his right leg. People then called an ambulance
rushing him into the ER of Benguet General Hospital. After the emergency intervention was done, the patient was
assessed by the attending physician. The physical assessment reveals the skin is pink and moist, head, eyes, ears,
nose and throat reveals no abnormalities. Pulmonary and cardiovascular systems are within normal limits. The
abdomen is observed to be flabby, non-distended, soft, and non-tender. FEPD (Filter Embolic Protection Device)
placement was done to the lower extremities and a GCS of 15. The physician then further admitted the patient to the
surgery ward with the admitting diagnosis of Alcohol Intoxication, multiple physical injury secondary to motor vehicular
accident, fracture closed, complete tibia- fibula. Laboratory Diagnostics was done such as CBC, PT and PTT and an
Ultrasound with the findings of both normal kidneys in sizes, no contour distortion, multiple tiny gallstones, thin-walled
cystic focus noted in the right kidney measuring 2.68x 2.59cm, urinary bladder well-filled, no intraluminal lesion is seen,
prostate gland is not enlarged. Lab results are Sodium- 141 mmol/L, Sodium- 141 mmol/L, Sodium- 141 mmol/L,
CREA SOX- 100mmol/L, CREA SOX- 100mmol/L. The physician ordered the patient to be on an NPO diet then
transferred him into the surgery ward. Physician prescribed medications such as mecobalamin, cefuroxime 1.5 IV after
ANST, Tramadol 50 mg PRN, and PCT 1g.

 Past Surgical/Medical History: Patient did not mention any past medical or surgical history.

 Family History: Family has no history of hypertension. He lives with his wife and sister.

 SEH: Patient X works full time as a laborer and likes to drink alcohol after a long day at work.

ACTIVITY 1: Underline using a red pen the pertinent positive and negative date or finding that you think are relevant in the
formulation of your nursing diagnoses
FEEDBACK: Congratulations you can now proceed with the activity.
Note: can also be given through text

PHYSICAL EXAMINATION & REVIEW OF SYSTEMS

- Results of the 13 areas of assessment (for 2nd years – fill all areas to review HA)
- Focused assessment on the organs/system affected (3 rd /4th yrs.) and state pertinent findings appropriately (+/-)
General Survey Received on bed 2, the patient is male, conscious, conversant and on a semi-fowler’s position, right leg
is slightly elevated, on DAT, with intact heplock on the left hand, grimaces when moving, with limited
body movements, unable to move side to side
Skin, Head, Eyes, Ears, Nose, Throat (+) skin is pink and moist
(+) abrasion on the legs, and arms
CHEST & LUNGS (Breast, Heart) Pulmonary and cardiovascular systems are within normal limits.
(+) Respiratory rate- 17 cpm
(+) PR- 85 bpm
GASTROINTESTINAL (+) Abdomen is flabby, non-distended, soft, and non-tender.
(+) NPO diet
GENITO-URINARY (+) both kidneys are normal in sizes no contour distortion
(+) multiple tiny gallstones
(+) thin-walled cystic focus noted in the right kidney measuring 2.68x 2.59cm
(+) urinary bladder well-filled
(+) no intraluminal lesion is seen
(+) prostate gland is not enlarged
Peripheral / Vascular (+)110/80 mmHg
(+) SPO2- 95%
Musculoskeletal (+) fracture closed, complete tibia- fibula
(+) Swelling
Neurologic (+) GCS 15
Hematologic (+) Sodium- 141 mmol/L
(+) Potassium- 3.82 mmol/L
(+) Chloride- 106.9 mmol/L
(+) CREA SOX- 100mmol/L
Endocrine (+) BUN- 4.75 mmol/L
Psychiatric (+) attentive
(+) conversant

ACTIVITY 2: Recalling the concepts of health assessment, anatomy, and physiology, you have to identify FIVE pertinent PE findings
that show abnormality. Read your book or notes for you to elaborate on the cause of your patient’s clinical signs and symptoms. In
your own words to explain the condition or summarizing what you have read or understood is HIHGLY encouraged. You must also
supply the textbook or material that you have utilized as reference.

PERTINENT ABNORMAL PE/ROS EXPLANATION

1. Pain rated as 6/10 Since the patient had a fracture due to the motor vehicular accident on his
right leg, the nerve endings that had surrounded the bones that contain pain
fibers were irritated when the bone was broken causing pain.
2. Facial grimace Since the patient is in pain, the muscles tenses up causing the patient to
contort his face when he is in pain.
Prepared by: Brando B. Badecao
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 3. Swelling on the right leg Since the patient had a fractured leg, as blood clots starts to form, the immune
system responds as a healing process by sending cells to get rid of small bone
pieces and kill any present germs.
4. Limited ROM Since the patient is on pain, and has a broken bone in his leg, there is
restriction on his mobility.
5. Abrasions on legs and arms Since the patient had been bumped on a motor vehicular accident, the patient
had accumulated multiple injuries causing the abrasions on his legs and arms.
Reference/s: Smeltzer & Bare (2004). Brunner & Suddarths Textbook of Medical-Surgical Nursing: Fracture. 10 th Ed.Vol.1. p.
734

FEEDBACK: You might find it easier for you if you have your textbooks with you. Congratulations you can now proceed with the
activity.

DIAGNOSTIC STUDIES
- Highlight on the patient’s lab result/ diagnostic findings
- Depending on the case provide at least 2-5 lab procedures that are related/pertinent to the case under study
ACTIVITY 3: Using a reference book (can specify), you have to fill in the values that are asked and summarize or using your own
words indicate the appropriate rationale for the abnormality.
Lab test & Pertinent Lab Reference/normal values Interpretation Purpose
Result
1. Serum electrolytes 135-145 mmol/L Sodium =141.0 The purpose of this test is to
3.5-5.5 mmol/L Potassium =3.82 measure whether the patient
98-108 mmol/L Chloride =106.9 has enough electrolytes in his
Normal results body.
2. BUN 2.80-7.20mmol/L 4.75 The purpose of this test is to
measure the amount of uric
acid of the patient’s body.
3. CREA SOX 70-115.0umol/L 100.00 -The purpose of this test is to
measure how well the kidneys
patient is performing in
filtering the waste from the
blood.
 Option: can put the normal values on some or put rationale for some and they will identify the specific lab test
 Option: instead of rationalizing on the cause of abnormal lab result, indicate the purpose and nursing implications
o Ex: ABG’s … requires 5 minutes pressure application on the site or the specimen should be placed in an ice bucket
FEEDBACK: That the spirit, keep going. You might want to have a few minutes break before proceeding to the areas of the module.

MEDICAL/SURGICAL DIAGNOSIS:

ACTIVITY 4: Read about your patient’s diagnosis using your textbook (MedSurg/ specify). Focus on the description of the disease, the
etiology or cause, what are the signs and symptoms and why do they occur, what are the recommended interventions and nursing
interventions. Digest the information that you have obtained. Take time to process and analyze them. Once you are ready, in 500 words
or briefly answer the following questions.

Description of the disease Etiology S/Sx (book) S/Sx (patient)

FRACTURE: Traumatic incidents such as sporting  Pain when moving  Close tibia-
injuries, vehicle accidents and  a snap or grinding sound fibula fracture
A fracture is a broken bone. It can falls. Conditions such as when the injury occurs  Changes in
range from a thin crack to a complete osteoporosis and some types of  swelling, physical
break. Bone can fracture crosswise, cancer that cause bones to fracture  redness, and function
lengthwise, in several places, or into more easily, meaning even minor  bruising in the injured area  Pain in the right
many pieces. Most fractures happen trauma and falls can become  difficulty supporting weight lower leg
when a bone is impacted by more serious. with the injured area  Facial grimace
force or pressure than it can support.  visible deformity in the
injured area
CLOSED FRACTURE:  Changes in physical
function or personality
A closed fracture is also called a
simple fracture. In a closed fracture,
the broken bone doesn’t break your
skin.

Reference: “Fractures: Types, Causes, Symptoms, and Treatment.” Www.medicalnewstoday.com,

www.medicalnewstoday.com/articles/173312.

FEEDBACK: KEEP UP THE GOOD WORK, what you are doing will keep you focused and enable to understand your patient the best
way possible. It may be hard on you at the start but doing it often, you will soon find it easier. Remember, no pain no gain.

PRESCRIBED THERAPEUTIC (MEDICAL/SURGICAL) MANAGEMENT, AND HEALTH PROMOTION PROGRAMS

- Provide appropriate medical / surgical interventions
Prepared by: Brando B. Badecao
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- Limit to at least 5 drugs if necessary

Activity 5: After reading your textbook or notes on pharmacology and/or medsurg book, answer what are asked on the following table.
Drug/ Classification Dose/Route/ Mechanism of action Common Side Effects Nursing responsibilities
Frequency
1.Ketorolac 30mg Inhibits prostaglandin synthesis,  headache  Explain to the pt. About
IV producing peripherally mediated  dizziness importance and purpose of the
Nonsteroidal anti- Q8 analgesia. Also has antipyretic and  drowsiness drug.
inflammatory agents, anti-inflammatory properties.  diarrhea  Monitor BP upon administration.
non-opioid analgesics  constipation High blood pressure can make
 gas the condition worsen if taking
 sores in the mouth ketorolac.
 sweating  Monitor signs of GI bleeding,
including abdominal pain,
 ringing in the ears
vomiting blood, blood in stools,
 pain at injection site
or black, tarry stools. Report
 small red or purple dots on these signs to the physician
the skin immediately.
 Monitor signs of allergic
reactions Notify physician
immediately if these reactions
occur.
 Assess pain and other variables
(range of motion, muscle
strength) to document whether
this drug is successful in helping
manage the patient's pain and
decreasing impairments.
 Be alert for signs of prolonged
bleeding time such as bleeding
gums, nosebleeds, and unusual
or excessive bruising. Report
these signs to the physician.
 Monitor injection site for pain,
swelling, and irritation. Report
prolonged or excessive injection
site reactions to the physician
2.Acetaminophen 1 tab Thought to produce analgesia by  nausea,  Explain to the pt. About
(Paracetamol) Oral inhibiting prostaglandin and other  stomach pain, importance and purpose of the
Q4 substances that sensitize pain  loss of appetite, drug.
Analgesics PRN receptors. Drug may relieve fever  itching,  Monitor vital signs
antipyretic through central action in the  rash,  Take with food or milk to
hypothalamic heart- regulating center  headache, minimize GI upset.
 Report N&V. cyanosis,
 dark urine,
shortness of breath and
 clay-colored stools,
abdominal pain as these are
 or jaundice (yellowing of signs of toxicity.
skin or eyes).  Report paleness, weakness,
and heartbeat skips
 Report abdominal pain,
jaundice, dark urine, itchiness or
clay-colored stools

3.Tramadol 50mg Modulates the descending pain  sleepiness  Explain to the pt. About
-opioid analgesic 1 tab / oral pathways within the central nervous  difficulty falling asleep importance and purpose of the
TID system through the binding of parent or staying asleep drug.
and M1 metabolite to μ-opioid  headache  Assess type, quality, onset,
receptors and the weak inhibition of  nervousness location, and intensity of pain.
the reuptake of norepinephrine and  uncontrollable  Take the drug with food or milk
serotonin. shaking of a part of to prevent GI upset.
the body  Instruct pt. To increase fluid
 muscle tightness intake to prevent dry mouth and
constipation
 changes in mood
 Reassess level of pain at least
 heartburn or
30 mins. After administration.
indigestion
 Tell pt. To report if side effects
 dry mouth occur

4.Cefuroxime 1.5 g Cephalosporins exert bactericidal  Nausea,  Explain to the pt. About
IV activity by interfering with bacterial  vomiting, importance and purpose of the
Second-Generation Q8 cell wall synthesis and inhibiting  diarrhea, drug.
Cephalosporin (true cross-linking of the peptidoglycan.  strange taste in the  Determine history of
2nd generation The cephalosporin’s are also thought mouth, or stomach hypersensitivity reactions to
Prepared by: Brando B. Badecao
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cephalosporin) to play a role in the activation of pain may occur. cephalosporin’s, penicillin’s and
bacterial cell autolysins which may history of allergies particularly to
contribute to bacterial cell lysis. drugs before therapy is initiated.
 Report onset of loose stools.
 Inspect IM and IV injection sites
frequently for signs of phlebitis.
5.Mecobalamin 2 amps Mecobalamin plays an important role  Nausea  Check doctor’s order
Belongs to the class Q12 in transmethylation as a coenzyme in  Vomiting  Verify patient’s identity
of vitamin the synthesis of methionine from  Diarrhea  Give with food if GI upset occurs
B12 (cyanocobalamin homocysteine. The drug is well  Loss of appetite  Encourage patient to comply
and analogues). transported to nerve cell organelles  headache with the diet recommendation. -
and promotes nucleic acid and protein  Ask the patient to notify any of
synthesis. the health care team if he feels
nausea, vomiting, abdominal
pain or tarry stools occur -

IVF Amount Infusion rate Purpose: Nursing responsibilities

Plain Normal Saline
Solution (PNSS) 1000ml
IV line 42-43 gtts/min 42-43 gtts/min To replenish lost fluids in our  Check the iv site if there is
Left Hand body swelling or edema
 Monitor I and O of the pt
 Decontaminate hands before
direct contact to the pt..
Procedure Description Purpose Nursing Responsibilities

Ultrasonography *A procedure that *Uses sound waves to  Explain the procedure

Type of Examination: uses high-energy produce pictures of the inside  Do not eat or drink for certain period of time before the exam.
Abdomino Prostate sound waves to look of the body. It is used to help  Instruct patient to remove any metal or jewelries.
at tissues and organs diagnose the causes of pain,  Instruct patient to relax during the procedure.
Impression: inside the body. The swelling and infection in the  After the procedure, assist patient on a comfortable position.
 Multiple tiny sound waves make body's internal organs and to
gallstones echoes that form examine a baby in pregnant
 Renal cyst, Right pictures of the tissues women and the brain and hips
Normal liver, pancreas, and organs on a in infants.
spleen, left kidney and computer screen
urinary bladder (sonogram)
Reference/s: Davis Drug Handbook.
 Option: provide some information and the students will fill in the missing parts

FEEDBACK: I hope you were not intoxicated by these drugs. Remember that these are important in saving your patient’s life and it
should be monitored for its therapeutic and side effects.

ACTIVITY 6: Applying the nursing process, integrate all the significant findings obtained in the analysis of the case and formulate a
nursing care plan for your patient. Use the given table/format presented.
(ON ANOTHER PAPER)

FEEDBACK: CONGRATULATIONS, you have just shown how prepared you are in meeting your patient’s needs. If this
continues, expect that a lot of your patient will be smiling and thanking you for saving their lives.

COLLABORATION
Activity 7: As a future nurse you should be able to work with your co-nurses and other health care professionals and form a team sharing knowledge
and resources to solve or provide patient care.
- Concepts: referral to physician, respiratory therapist/PT, nutritionist, family planning, rehab, psyche etc.
- Justify (in 3-5 sentences)

Collaboration is important especially when it comes to improving and enhancing the patients’ health. For our patients case it is a need to
collaborate with:
• Orthopedic surgeon- is an expert with extensive training in the proper diagnosis and both non-surgical and surgical treatment of injuries
and diseases of the musculoskeletal system. Orthopedic surgeons treat patients of all ages— from newborns to the elderly.
• Physical therapists (PT) - The PTs will help the patient improve their physical function and ability to move. The PT’s role is to teach the
patient how to be as independent and safe as possible in their environment. The PT will give the patient exercises and re-train their muscles
and nerves. The aim is to restore normal function. The PT will also help the patient strengthen their muscles and improve endurance, walking,
and balance.
FEEDBACK: WELL, DONE! You have contributed in making the health care team working as one for the benefit of the patient.

ETHICO-MORAL-LEGAL CONCERNS (may be added for 2nd years last ward duty)

Prepared by: Brando B. Badecao

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Activity 8: These principles concern the ethics of caring rather than 'curing' by exploring the everyday interaction between you as a nurse and the
person in your care.
- Concepts: justice, beneficence, nonmaleficence and autonomy
- What will you be your nursing action?
- Justify (in 3-5 sentences)

As nurses on duty, it is our responsibility to ensure that our patient is receiving quality care. Since our patient is diagnosed with Multiple
physical injury secondary to motor vehicular accident, medication like Tramadol were given for treatment. Therefore, we must administer the
medications right on time and as ordered. Monitoring the patient for side effects and adverse reaction will also signify how we are able prevent
any harm to our patient. However, if in any instances that our patient refuses to take his medication, we will then first inform and explain to him
and to his watcher of the consequences of refusing treatment to his health using layman’s term, before respecting his right for autonomy and
having him sign a legal document, that will not hold us liable for negligence of duty. Encouraging our patient to at least elevate the injured leg
with 1 or 2 pillows, also explaining the use and effect of it will probably help in persuading our patient to do so.

FEEDBACK: WELL, DONE! you are almost done, its not time to give up. Take a deep breath, cool down, and proceed. Now summarize what you
have done by formulating the concept map/table.
ACTIVITY 9:
Incorporating all the data that had been presented to you and your readings, create a concept map on the pathophysiology of the patient’s disease/condition.
Incorporate the risk factors present in your patient based on his/her history, the signs and symptoms presented by your patient as shown on his/her PE and ROS, the
lab results provided by the various diagnostic exams.
Group all cues together showing how you were able to arrive to a certain nursing diagnosis/es.
Lastly, include the various medications and or procedures that were given to your patient placing them on their right places at the map.
If you do not have colored pens you may use place them in colored boxes, if it is still not feasible do not worry you do not need them at the moment, just use what you
have.
Do not forget to include the arrows to show connections and/or relationships among the various concepts.
Study the given sample below for you to understand. You may use a different style as long as the essential components are present and appropriately linked.
Should you have clarifications I am a text away.
Good luck.

Prepared by: Brando B. Badecao

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 Non- Modifiable Factors: Modifiable Factors:

 34 years old  Motor Vehicular Accident

 Male  Alcohol Intoxication
 Limited PPE’s


 Sudden Injury


 Inability of the bone to
 absorb too much
 pressure exerted on it


 Break in the continuity of
 the bone

 Fractured closed


 Disruption of surrounding
 tissues periosteum, blood
 vessel and nerve supply
Deformity
 e

Damage of bone tissues

Immobility

Intense inflammatory
Loss of Function
response

Initial Vasoconstriction

Vasodilation Increase vascular Bleeding  Decrease

permeable Blood
volume

Hyperemia  Decrease
Outpouring of the plasma Hematoma
Perfusion
blood to the site formation
 Decrease
RBC and
Redness Heat Cellular WBC
Swelling and Edema
proliferation

cefuroxime PCT, Increased pressure

Remodeling
e irritation of nerve
endings.

Bone healing mecobalamin

tramadol Pain

Acute pain r/t

S/Sx:
multiple physical
Pain scale of 7/10
injuries secondary to
Facial Grimace
motor vehicular “Nasakit day sakak no ikutik” as
accident. verbalized by pt.

Prepared by: Brando B. Badecao

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Feedback: Congratulations, you are helping yourself achieve your dream of becoming a nurse. Keep up the good work.

COMMUNICATION
Activity 10: Your shift is about to end, using ISBAR (a patient safety communication structure that aids simplified, effective, structured and
anticipated communication between healthcare personnel). Fill in your end of shift report to help guide the incoming student nurse.
Identify yourself: your name: 4B3 role: student nurse ward/area: Surgery Ward
Situation: What is your patient’s name, age & gender, current situation/status (stable but in danger of deterioration, unstable), concern or your
observations, what needs to monitor/observe (ex; abnormal VS, labs, active clinical signs/symptoms)
Patient X, 34 years old male, lying on bed #2 with an intact heplock on Left arm. Pt. Is currently experiencing acute pain in the right leg
with the pain scale of 5/10 from 7/10. Tramadol 50mg Oral, T.I.D. was given as prescribed by the physician. Pt. Needs to elevate the right leg
with 2 pillows high as ordered. Latest Vital signs are as follows: BP: 110/90 mmHg; PR: 92 bpm; RR;20cpm; T; 37 C and SPO 2 of 98%. Patient
is currently waiting for his Orif surgery. Patient has limited ROM and needs assistance in performing ADL’s.

Background: Give the relevant details such as presenting problems and clinical history that will help the incoming staff interpret the situation easily;
may also include meds / procedures already administered
Pt. X is suffering pain at the right leg due to multiple injuries and fracture at the right leg caused by motor vehicular accident. Patient has an
ongoing medication of 50mg tablet of Tramadol. No past clinical and surgical history. CBC, ultrasonography, X-ray procedures were already done.

Assessment: What is your assessment? (Base it on your observation on your patient during your shift what is his/her current condition, risks & needs).
Received patient lying on bed with his right leg elevated by two pillows with notable surgical cast. He is awake, afebrile, responsive and
alert. Facial grimace was noted; patient is in pain with a pain scale of 7 out of 10. Patient has limited range of movement and needs assistance
in performing activities. Initial vital signs were: BP; 110/80 mmHg; PR: 85 bpm; RR: 17 cpm; T; 37.2C, and a SPO 2 of 95%.

Recommendation: What do you recommend being done to correct the situation? Be clear about what you are requesting. (e.g
transfer/review/treatment? When should it happen?
Continuously monitor the patient. provide comfort to relieve pain from patient. Provide analgesic as ordered by physician when needed.
Always raise the side rails up for patient’s safety.

Feedback: CONGRATULATIONS, you have carried out your task. I will be getting back to you in after I have read your output.

Prepared by: Noted by:

Brando B. Badecao Brando B. Badecao

Note: can be same format for online case analysis/presentation; Feedback: SMS, private message, zoom conference (immediate)

Prepared by: Brando B. Badecao

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