A Clinical Case Analysis Committee of the

College of Nursing and School of Midwifery

City University of Pasay

Pasadeña St. F.B Harrison Pasay City

In partial fulfillment of the requirements in

NCM 109 Related Learning Experience 

By:

DAITOL, SHERYL A.

ESPINOSA, ANDY

EVORA, SICHEM D.

GUNDRAN, MARIA JAYZEN F.

HERNANDEZ, PRECIOUS R.

JUVIDA, CLARISSA

Submitted to: 

ARCELLI FRANCISCO RND, RN, MAN

LEONILA PADILLA BAQUIANO RN, MAEd

APRIL 3, 2022
 • Introduction:
Hypertension in pregnancy, some women have high blood pressure during
pregnancy. This can put the mother and her baby at risk for problems during the
pregnancy. High blood pressure can also cause problems during and after delivery.
The good news is that high blood pressure is preventable and treatable.

High blood pressure, also called hypertension, is very common. In the United States,
high blood pressure happens in 1 in every 12 to 17 pregnancies among women ages
20 to 44.3

According to Health line, common causes of hypertension in pregnancy are; being

overweight or obese, not getting enough physical activity, smoking, drinking alcohol,
a family history of pregnancy-related hypertension, and first-time pregnancy

Meanwhile, the risks of hypertension in pregnancy includes; Decreased blood flow

to the placenta, Injury to other organs, Premature delivery, and Future
cardiovascular disease.

The effects of it can put the mother and her baby at risk for complications like pre-
eclampsia, eclampsia, stroke, need for labor induction and Placental abruption for
the mother. Other complications such as; preterm delivery and low birth weight for
the baby. High blood pressure can also cause problems during and after delivery

The most important thing to do is talk with your health care provider about any
blood pressure problems so you can get the right treatment and control your blood
pressure before you get pregnant. Getting treatment for high blood pressure is
important before, during, and after pregnancy to prevent complications.

• Objectives:

GENERAL OBJECTIVES
The objectives of this study is to obtain knowledge about Mother and Child
Care with Abnormalities by presenting this study with sufficient information to serve
as a guide for student nurses. This study also serves as a promotion to healthcare of
the patient and to enhance the skills in the nursing process and management.

SPECIFIC OBJECTIVES
At the end of this study, the group will be able to:

COGNITIVE

1.Recognize the effect of the drugs administered on the patient,

2.Interpret the collected data from the patient and patient's medical record, an
3.Formulate effective nursing care plan

PSYCHOMOTOR
• Gather reliable information about the patient’s condition through a thorough interview,
• Provide curative intervention through health teachings,
• Conduct an assessment about hypertension, and
• Properly perform nursing interventions.

ATTITUDE
• Establish excellent communication skills to easily build rapport with the patient and with
patient’s family members, and
• Be respectful to people and rules such as keeping their confidentiality and acknowledge
their beliefs and culture.

• Limitations:
This case study mainly focuses on the health-related problem and risks associated
with hypertension in pregnancy.

I. Personal Data

NAME: Ms. Cruz

ADDRESS: Pasay City
AGE: 28 years old
SEX: Female
CIVIL STATUS: Single
RELIGION: Roman Catholic
BIRTHDAY: March 5, 1993
BIRTHPLACE: Cavite
ATTENDING PHYSICIAN: Dr. Irene Mutas
CHIEF OF COMPLAINT: Dizziness and Fatigue
DIAGNOSIS: Hypertension

II. Medical History

• History of Present Illness:

The patient is on her trimester period with a gestational age of 35 weeks and 4 days
who is experiencing an on and off dizziness for at least 1-2 hours depending on her
activities or situation, accompanied with a slight shortness of breath even before her
 2nd pregnancy, her blood pressure is 140/90 mmHg; Temperature is 36.6 °C;
Respiratory Rate is 16 cpm and her Pulse Rate is 78 bpm. “minsan para akong nahihilo
ako or parang parang ngalay ung leeg ko, tapos minsan naman mabilis ako hingalin or
mapagod” as verbalized by the patient

• Past Medical History:

Last 2005, the patient was admitted to the hospital due to high fever/dengue.
Then last 2017 or 2018, months or almost a year after delivery with her first-born
child the patient is experiencing the sign and symptoms of hypertension which is
dizziness with shortness of breath.

• Family Medical History:

As per the mother’s statement, There’s the same case on the side of the father of this
baby.

SISTER MS.C
• Social History:
The patient is the youngest among her siblings. The patient usually spends her time
managing her online business and her house and child. Her daily activities usually begin
with some light exercise, cleaning, cooking, taking care of her children and browsing her
phone for orders. She usually eats at least 4-5 times a day, bathing 2-3 times a day and
sometimes hanging out with her friends on some occasions. Her sleeping pattern,
usually she sleeps 8-9 hours and rest or nap in the afternoon for at least 2-3 hours a day.

• Environmental History:
• The patient lives and own their house, it is well ventilated place with 5 windows
(2 in the living room, 1 on each bedroom and 1 in the back or kitchen) and has 3
doors and a gate. It is made a concrete, has their own bathroom, Nawasa is their
source of water and Mineral water as for their drinking. Meralco is their source
of electricity. They have a motorcycle as a transportation especially to her
husband who is working. Their house is near the hospital, malls, groceries,
school, pharmacy, wet market and public transportation and have a daily
garbage collector. Their source of income is from her husband’s salary and her
online business.

• OB HISTORY
G T P A L M
2 1 0 0 1 0

• The patients OB score is G2P0: 1-0-0-1-0.

• On 2015, she had a full-term normal pregnancy and delivered a baby boy
by Spontaneous Vaginal Delivery (SVD) at a lying-In Clinic in Cavite and
the weight of the baby was 2.6kg and is alive and well.
 G. Gynecology History
She attained her menarche at the age of 12-year old with 28 to 30days regular
cycle with 7days of menses. She denied dysmenorrhea, menorrhagia,
intermenstrual bleeding, dyspareunia and postcoital bleeding.

As for contraception, she uses Implants (Injectectable) for 2 years from 2017 to
2019 between the first and the second pregnancy. She was then on Oral
Contraceptive Pills for 3 months and had stop taking them in around 2020. After
this pregnancy, she is planning on Contraceptive Implant.
She had never had pap smear done before.

H. Immunization History (for Pedia Client):

 Hepa B vaccine
 Tetanus Toxiod

Covid Vaccine: 2doses of Sinovac

H. Developmental History:

STAGES NORMAL ACTUAL ANALYSIS/

INTERPRETATION
Abraham Physiological Ms. C is living The biological
Maslow’s needs. with her parents needs of human
Hierarchy of These are and siblings. Their survival and
Needs biological source of finance secondary need
requirements for is her husband’s are met.
human survival, income and her
e.g. air, food, income in online
drink, shelter, business.
clothing, warmth,
sex, sleep. She states that
If these needs are she eats a meal 3
not satisfied the times a day
human body (breakfast, lunch,
cannot function dinner) and
optimally. snacks 4 to 5
Maslow times a day
considered
physiological
needs the most
important as all
the other needs
become
secondary until
these needs are
met.

Safety and Ms. C lives in a The needs of the

security community patient for the
Once an around the area safety and security
individual’s of barangay 91 in are fulfilled and
physiological Pasay City. The satisfied.
needs are community has
satisfied, the barangay and
needs for security police roving
and safety every day and she
become salient. lives near the
People want to necessary
experience order, establishment
predictability and (like pharmacy,
control in their hospital, malls,
lives. These needs school, etc.) and
can be fulfilled by emergency
the family and services (like
society (e.g. police station, fire
police, schools, station, etc.)
business and
medical care).

Love and Ms. C had Stated The needs of the

belongingness that she is in an patient for her
needs intimate interpersonal
After relationship with relationships are
physiological and her husband and satisfied.
safety needs have a good
been fulfilled, the relationship with
third level of her
human needs is family(parents,
social and siblings, children),
involves feelings friends/peers and
of belongingness. neighbors.
The need for
interpersonal
relationships
motivates
behavior
Examples include
friendship,
intimacy, trust,
and acceptance,
receiving and
giving affection
and love.
Affiliating, being
part of a group
(family, friends,
work)

Esteem needs Ms. C stated that The patients need

Which Maslow she feels of confidence and
classified into two comfortable dignity, respect
categories: (i) around others and reputation are
esteem for and has a sense acquired and
oneself (dignity, of dignity and satisfied.
achievement, confidence in
mastery, and herself.
independence)
and (ii) the desire
for reputation or
respect from
others (e.g.,
status, prestige).
Maslow indicated
that the need for
respect or
reputation is
most important
for children and
adolescents and
 precedes real
self-esteem or
dignity.

Self-actualization Ms. C believe that The needs of the

needs she already has a patient was still on
Realizing self- fulfillment process as she still
personal and personal has plans for the
potential, self- growth in life future, but her as
fulfillment, for her present
seeking personal Her goal in life is desire and
growth and peak to have a whole fulfillment in life
experiences. A and healthy life she stated that she
desire “to for herself and is satisfied for
become her loved ones. now.
everything one is
capable of
becoming”

Erik Erickson’s During this Ms. C’s first The patient is still
Intimacy vs. period, we begin relationship was committed and
Isolation to share at the age of 15, intimate with her
ourselves more their relationship husband for 9
intimately with lasted for about 1 years and has a
others. We year during high- happy relationship
explore school. Her 2nd with her child,
relationships relationship was family and friends.
leading toward when she was 18
longer-term years old that
commitments lasted for only a 1
with someone year and then to
other than a her
family member. 3rdrelationship
Successful (which is her
completion of this current husband)
stage can result in which is when she
happy was 20 or 21
relationships and years old.
a sense of
commitment, Ms. C’s still in a 9-
safety, and care year strong
within a relationship with
relationship her husband and
Avoiding a happy
 intimacy, fearing relationship with
commitment and my family and
relationships can friends.
lead to isolation,
loneliness, and
sometimes
depression.
Success in this
stage will lead to
the virtue of love.

Freud’s Genital For Freud, the Ms. C’s age Before pregnancy,
Stage proper outlet of during her first the patient and
the sexual instinct coitarche was 15 her husband are
in adults was years old still sexually active
through until her 2nd
heterosexual Ms. C is still pregnancy.
intercourse. sexually active
Fixation and with her current
conflict may partner but with
prevent this with family planning.
the consequence
that sexual Ms. C is a
perversions may heterosexual
develop.

III. Patterns of Functioning – Altered System

PATTERN OF BEFORE DURING ANALYSIS/

FUNCTIONING PREGNANCY PREGNANCY INTERPRETATION
Health The patient She constantly Even before or
Perception- was concerned followed her after pregnancy,
Health about her health the patient has a
Management health due to management good
Pattern her high blood during her understanding of
pressure, she second how to be active,
followed a pregnancy healthy, and
good diet, checkups, but presentable to
exercised she stopped others.
regularly, and drinking her
took medicine prescription out
to stay fit and of fear that it
 healthy. She is would harm the
very conscious baby (self-
of her weight declaration).
and She never
appearance, forgets about
and she herself,
ensures that particularly her
she is attractive appearance
to others.
Nutritional- Since the The patient After the patient
Metabolic Patient was tried to eat became
experiencing carefully during hypertensive she
Hypertension her pregnancy, managed her diet
symptoms, she and she was due to fear of
focused on her very disciplined affecting her high
nutritional and limited blood pressure,
requirements, when she had but due to her
avoiding fatty, desires.. current
processed pregnancy the
foods and patient became
carbonated more discipline
beverages. She on what to eat
was afraid it especially when
might get she is craving for
worse, so she food.
decided to do
something
about it.
She tried to eat
carefully during
her pregnancy,
and she was
very disciplined
and limited
when she had
desires.
Elimination The patient Eliminate only The patient usual
usually once a day and elimination
eliminates once urinate for at before and after
a day (morning) least 5-6 times a pregnancy
but sometimes day. remained as is.
every 2 days
and she pee at
least 5-6 times
 a day
Activity-Exercise The patient During her The patient is
Pattern always does a pregnancy the always active in
light exercise in patient only do doing activities
the morning a light walking and exercise even
like walking/ and doing before or during
jogging household her pregnancy.
sometimes chores as her
dancing or exercise
doing exercise
at home to
keep herself in
check.
Cognitive- The patient is The patient is The patient is
Perceptual oriented to aware of the aware of her
pattern what she is time, location, surroundings.
doing because and person, and
of the time, she responds
place, and appropriately to
person. the inquiries.
The client is
aware of the
time, location,
and person,
and she
responds
appropriately
to the inquiries.
Sleep-Rest Depending on During her The patients
Pattern her work and pregnancy she sleep rest pattern
responsibilities, became sleepier changed during
the patient has and lazier as the her pregnancy.
a different days go by. She
sleeping usually naps
pattern each more in the
day. She sleeps afternoon thebe
at least three she usually
to four times a sleeps between
week, from 11 9pm – 11pm.
p.m. to 1 a.m..
Self-Perception The patient The patient The patient
–Self- seems to be verbalized that seems to be
Conception productive and sometimes she productive and
pattern focused of is not happy focused on
 herself. She about herself herself, but
knows what because during because she is
she wants and her pregnancy pregnant now
what she wants sometimes there’s a lot of
to achieve and there is a limitations on
do to her life. limitation in what she can do.
And she seems what I Want and
to be confident what I Want to
about herself do to myself
Role- The patient is a The Patient is A The patient is
Relationship mother of one mother with a satisfied with her
Pattern child and a two Child and a current
devoted wife to loving Wife to relationship
her husband. her husband
Sexuality- The patient is The Mother is The patient is still
Reproductive content and Pregnant and intimate during
Pattern continues to having a child in and before
have a close her womb and pregnancy.
relationship there’s still an
with her intimate
husband. They relationship but
continue to no sexual
engage in Activity.
sexual activity,
but with the
use of
contraception
to avoid
unplanned
situations.
Coping-Stress When the When the With the help of
Tolerance patient is patient feels her family and
Pattern stressed she stressed she friends, the
she prefers to only consult and patient can cope
talk, drink, and talk to her with or relieve
socialize with husband and stress..
her family and family about it.
friends.. Sometimes she
will be
engrossed
herself in her
online business,
or just relaxing
watching
 Korean drama
or Netflix.
Value- Belief The Patient The patient is The value and
Pattern belief in life is still praying for belief of the
that her family her family to be patient is
is the top whole and satisfied.
priority for healthy during
everything… this pandemic.
she always
prays for their
good health

IV. Physical Examination / Review of System

BODY PARTS NORMAL ACTUAL FINDINGS ANALYSIS/

FINDINGS INTERPRETATION
Patient is well Normal Findings
groomed -well groomed
GENERAL
Patient behave -Patient behave
APPEARANCE
according to according to her age
AND
her age
BEHAVIOR
Appearance
and behavior
are
appropriate
SKIN Generally, • Generally, Normal Findings
uniform in uniform in
color except in color except
the areas in areas
exposed to the exposed to
sun. Skin is the sun.
intact, when • No mass,
pinched it area of
springs back to tenderness
its previous • Warm to
state touch
immediately. • When
Warm to pinched it
touch springs back
 to its
previous
state
HAIR hair is black, Normal Findings
evenly -hair is brown and
distributed, blonde (due to hair Though there is a
shiny, lustrous dye) presence of
and no split -evenly distributed flakes on her hair.
ends and -shiny
dandruff. No -has presence of
areas of flakes/dandruff
tenderness -no areas of
tenderness
FACE Oval shape, -oval shape Normal Findings
free from -free from wrinkles
wrinkles, no - no area of
area of tenderness or
tenderness or masses
masses

EYES Black or brown -black in color Normal Findings

in color, -symmetrical in
symmetrical in shape and Eye grade: 20/20
shape and movements, non-
size, non- protruding
protruding, no -no redness
redness
Eye grade: 20/20
Eye grade:
20/20

EYEBROWS Black, Black, symmetrical, Normal Findings

symmetrical, thick, can raise and
thick, can raise lower eyebrows
and lower without difficulty,
eyebrows Parallel and evenly
without distributed
difficulty,
Parallel and
evenly
distributed
EYELASHES Black, evenly Black, evenly Normal Findings
distributed distributed and
and parallel to parallel to each
 each other other
EARS Parallel, -parallel Normal Findings
symmetrical, -symmetrical
proportional -proportional to the
to the size of size of the head
the head
NOSE Mid line, -mid line Normal Findings
symmetrical -symmetrical and
and patent patent
LIPS Inspection: -thin Normal Findings
thin, pinkish - pinkish
TEETH Inspection: (-) -plaque Normal Findings
plaque, carries -no dentures
dentures
GUMS Pinkish and Pinkish and moist no Normal Findings
moist no swelling or lesions
swelling or
lesions
TONGUE Inspection: -symmetrical Normal Findings
symmetrical, -slightly reddish and
slightly reddish moist
and moist
VOICE No hoarseness -no hoarseness and Normal Findings
and well – well-modulated
modulated
NECK Inspection: -proportional to the Normal Findings
proportional size of the body and
to the size of straight.
the body and - no palpable lumps,
straight. masses, or areas of
Palpation: no tenderness
palpable
lumps, masses,
or areas of
tenderness
CHEST: GENERAL The skin is -the skin is brown, Normal Findings
APPEARANCE brown, with with moles, no scars
moles, no and lesions The patient has a
scars and - presence of tattoo presence of
lesions. tattoo on her left
clavicle
POSTURE AND Symmetrical. -symmetrical Normal Findings
SHAPE OF THE
THORAX
SYMMETRY OF Symmetrical. -symmetrical Normal Findings
THE CLAVICLE
RIB SYMMETRY Symmetrical. -symmetrical Normal Findings
AND
MOVEMENT
TEMPERATURE Warm to -warm to touch Normal Findings
touch.
AREAS OF There is no -no presence of Normal Findings
MASSES, presence of mass, lumps and
TENDERNESS mass, lumps areas of tenderness.
AND LUMPS and areas of
tenderness.
BREATH SOUND No presence -no presence of any Normal Findings
of any crackles, wheezing,
crackles, or abnormal sounds.
wheezing, or
abnormal
sounds.

BREAST The breast is -the breast is white, Normal Findings

white, with moles.
with/without The nipple of the
moles. patient is
darkening due to
Symmetrical in Symmetrical pregnancy
size and shape

Skin or nipple Nipple is ever ted

change and dark in color

No scars or No scars or lesions.

lesions.

No mass,
lesions, lumps
and area of
tenderness
HEART Auscultation: -no presence of any Normal Findings
No presence adventitious sound.
of any
adventitious - no murmur
sound.
Palpation &
 Percussion: No
enlargement
of heart.
Stay in 5th left
intercostal to
7th intercostal
space.

ARM Warm and Warm to touch, no Normal Findings

smooth, no bruise or lesion but The patient has a
presence of there is a presence presence of
mass, lesions of tattoo, no area of tattoo on her left
and area of tenderness and arm
tenderness. masses.
Warm to
touch
UMBILICAL Concave -concave Normal Findings
V. Anatomy & Physiology:

Hypertension occurs when the body’s smaller blood vessels (the arterioles) narrow, causing the
blood to exert excessive pressure against the vessel walls and forcing the heart to work harder
to maintain the pressure. Although the heart and blood vessels can tolerate increased blood
pressure for months and even years, eventually the heart may enlarge (a condition called
hypertrophy) and be weakened to the point of failure. Injury to blood vessels in the kidneys,
brain, and eyes also may occur.
Blood pressure is actually a measure of two pressures, which is the systolic and the diastolic.
The systolic pressure (the higher pressure and the first number recorded) is the force that blood
exerts on the artery walls as the heart contracts to pump the blood to the peripheral organs
and tissues while diastolic pressure (the lower pressure and the second number recorded) is
residual pressure exerted on the arteries as the heart relaxes between beats. A diagnosis of
hypertension is made when blood pressure reaches or exceeds 140/90 mmHg and can be read
as “140 over 90 millimetres of mercury”.

PATHOPHYSIOLOGY
 Hypertension is defined as blood pressure greater than or equal to 130/80 mm Hg.
The condition is a serious concern for some pregnant women. There are several
possible causes of high blood pressure during pregnancy like being overweight or
obese, not getting enough physical activity, smoking or drinking alcohol, a family
history of pregnancy-related hypertension, having diabetes or certain autoimmune
diseases. It is thought to be related to a mechanism of reduced placental perfusion
inducing systemic vascular endothelial dysfunction. This arises due to a less effective
cytotrophoblastic invasion of the uterine spiral arteries. The resultant placental
hypoxia induces a cascade of inflammatory events, disrupting the balance of
angiogenic factors, and inducing platelet aggregation, all of which result in
endothelial dysfunction manifested clinically as the preeclampsia syndrome.
Angiogenic imbalances associated with the development of preeclampsia include
decreased concentrations of angiogenic factors such as the vascular endothelial
growth factor (VEGF) and placental growth factor (PIGF) and increased
concentration of their antagonist, the placental soluble fms-like tyrosine kinase 1
(sFlt-1).

VII. Laboratory and Diagnostic Examination – Recent to past

LABORATORY AND DIAGNOSTIC EXAMINATION

RADIOLOGY REPORT
PELVIC ULTRASOUND
ULTRASOUND FINDINGS:
Fetal number Single
Fetal Presentation Cephalic
Placental Location, grade Left posterolateral, high grade II
Amniotic Fluid Adequate
Fetal movement Active
Cardiac activity 153 bpm
Sex Female

IMPRESSION:
Single, live intrauterine pregnancy in cephalic presentation about 35 weeks 4 days
age of gestation based on BPD, FL and AC.
Normal placental localization and amniotic fluid volume.
 OBSTETRICAL ULTRASOUND
ULTRASOUND FININGS:
Fetal Number – Single
Fetal Presentation - complete breech
Placenta – posterior grade II, 2.5 cm from internal os
Amniotic fluid volume – adequate AFI = 11.0 (3.7, 2.0, 3.6, 1.7)
Heart rate – 157 bpm
Gender – Female

IMPRESSION:
Single live intrauterine fetus, complete breech, compatible to 20 weeks 6 days
gestation by fetal biometry (sonar gestation)
Low lying placenta
Right ovary – unremarkable
Left ovary – not visualized

Laboratory Result Normal Values Analysis/

Examination Interpretation
Urinalysis
Pus Cells 3-5 (0-4/ HPF) Normal

Red Cells (0-4/ HPF) Normal

Color Yellow
Appearance/ Slightly Turbid
Transparency
PH Normal 6.0
SP. GR Normal 1.015
Protein Normal
Sugar Normal Negative
Appearance/ Slightly Turbid
Transparency

HEMATOLOGY

NORMAL ACTUAL ANALYSIS/

 FINDINGS FINDINGS INTERPRETATION
Hemoglobin M: 12.0 – 17.0 10.4 Low Hemoglobin
gms Level
F: 11.0 – 15.0 gms
Hematocrit M: 40 – 54 vol% 30 Low Hematocrit
F: 37-47 vol% Level
WBC 5,000 – 10,000 / 11,000 High WBC
(Leukocyte) cu.mm
Platelet 150,000 – Adequate Adequate
400,000 / cu.mm
Blood / RH A(+)
type
Differential Count
Bands / Stab 0–7
Segmenter 50 – 70 66 Normal
Eosinophil 0–5 09 High

Basophil 0–1
Lymphocyte 20 – 40 25 Normal
Monocyte 0–7
Other

• MEDICAL AND SURGICAL INTERVENTION

N/A

• DRUG STUDY
Nam Classificati Mechan Indication Contraind Adverse effect/s Nursing
e on ism of ication Respons
action ibilities
Coza Angiotensi Angiote Hypertension Hypersens CNS: Dizziness, Monitor
ar™ n receptor nsin II itivity to insomnia, headache BP at
(Losa blockers receptor losartan, GI: Diarrhea, drug
rtan) (ARBs), (type pregnancy dyspepsia trough
anti- AT1) [category Musculoskeletal: (prior to
hypertensi antagon C (first Muscle cramps, a
ve ist acts trimester) myalgia, back or leg schedule
as a , category pain d dose).
potent D (second Respiratory: Nasal
vasocon and third congestion, cough, Monitor
strictor trimesters sinusitis drug
and )], effective
primary lactation ness,
vasoacti especiall
ve y in
hormon African-
e of the America
renin– ns when
angiote losartan
nsin– is used
aldoster as
one monoth
system erapy.

Inadequ
ate
respons
e may
be
improve
d by
splitting
the daily
dose
into
twice-
daily
dose.
 Lab
tests:
Monitor
CBC,
electroly
tes, liver
& kidney
function
with
long-
term
therapy.
Ferro Iron An iron Iron Deficiency Hypersens Constipation Avoid
us suppleme supplem Anemia itivity use in
Sulfa nt ent used Diarrhea peptic
te to treat Hemochro ulcer
or matosis, Dark stools disease,
prevent hemolytic ulcerativ
low anemia Nausea e colitis,
blood regional
levels of Stomach pain enteritis,
iron and
(e.g., for Superficial tooth patients
anemia discoloration (oral receivin
or solutions) g
during frequent
pregnan Urine discoloration blood
cy). Iron transfusi
is an Vomiting ons.
importa
nt Absorpti
mineral on is
that the variable
body and
needs to incompl
produce ete.
red
blood Liquid
cells dosage
and forms
keep contain
you in 20%
good element
health. al iron;
 dried
forms
(usually
monohy
drate)
have 30-
33%.
Avoid
use in
prematu
re
infants
until
vitamin
E stores,
which
are
deficient
at birth,
are
replenis
hed.

Avoid
administ
ering
iron for
more
than 6
months
except
in
patients
with
continuo
us
bleeding
or
menorrh
agia.
vitam Vitamin D The Vitamin D sarcoidosi Most people do not Do not
in D (ergocalcif active supplements s. commonly take this
erol-D2, form are used to high experience side drug if
cholecalcif of vitam treat adults with amount of effects with vitamin experien
erol-D3, in severe vitamin phosphat D, unless too much is cing of
alfacalcido D binds D deficiency, e in taken. Some side hypercal
l) is a fat- to resulting in loss the blood. effects of taking too cemia
soluble intracell of bone mineral high much vitamin D and
vitamin ular content, bone amount of include weakness, fa report
that helps receptor pain, muscle calcium in tigue, sleepiness, immedia
your body s that weakness and the blood. headache, loss of tely to
absorb cal then soft bones excessive appetite, dry mouth, physicia
cium and function (osteomalacia).  amount of metallic n.
phosphoru as Osteoporosis. vitamin D taste, nausea, vomiti
s. transcri in the ng, and others. Consult
ption body. physicia
factors kidney n before
to stones. taking
modulat decreased an OTC
e gene kidney medicati
expressi function. on.
on. Like Calcium,
the phospha
receptor te, or
s for magnesi
other um-
steroid containi
hormon ng
es and laxatives
thyroid and
hormon antacids,
es, mineral
the vita oil, and
min vitamin
D recept D
or has prepara
hormon tions
e- may
binding increase
and adverse
DNA- effects
binding of
domains calcifedi
. ol and
therefor
e should
be
avoided.
 Note:
Patients
undergoi
ng
dialysis
may
require
aluminu
m
carbonat
e or
hydroxid
e gels to
bind
intestina
l
phospha
te and
thus
lower
serum
phospha
te levels.
Do not
breast
feed
while
taking
this
drug.

Obim Vitamin Obimin A pre-and If the Diarrhea, May be

in and (Calcium postnatal patient is constipation or taken
Plus minerals Lactate) supplement to allergic to upset stomach may with or
acetate, help provide any occur. This effect is without
when adequate supply compone usually temporary food
taken of vitamins, nt of the and may disappear
with minerals and product. as your body adjust May also
meals, omega-3 fatty this medication be taken
combin acids, DHA and Hypersens with
es with EPA, during itive to . Hypercalcemia is meals
dietary pregnancy and this discussed elsewhere for
phospha lactation. medicatio better
 te to n or any absorpti
form an of the on or to
insolubl ingredient reduce
e s. GI
Obimin discomf
(Calcium ort.
Lactate)
phospha Give the
te prescrib
complex ed drug
, which to the
is patient.
excrete
d in the
feces,
resultin
g in
decreas
ed
serum
phosph
orus
concent
ration.

X. Nursing Care Management

B. Nursing Care Plan (NCP)

Note: Minimum of 3 identified problems per classification (actual, potential/risk, wellness)

ACTUAL NURSING CARE PLAN

Assessment Diagnosis Planning Intervention Evaluation

Subjective: Short Term: Independent
Acute Pain in Patient was
“Sumasakit lumbar area After 30 Advise the able to identify
yung likod ko due to poor minutes of patient to sleep methods of
kapag body mechanics nursing on her side alleviating back
nagbubuhat ako intervention pain and
o kaya nakatayo the patient is Backache can preventing it
ng matagal” as knowledgeable be relieved by
stated by the in how to applying warm Patient
patient alleviate her compress on hasimproved
back pain and the area. comfort while
Objective: to also prevent doing her
it Advise the activities of
Temp: 36.6 C patient to squat daily living
BP: 140/90 Long Term: in picking up
RR: 18 objects to
PR: 78 bpm After 3 to 4 improve body
Days the mechanics
Provoking patient is able
Factors: lifting, to report Advise the
standing for improved patient to lift
long period comfort while objects by
doing her holding them
Quality: deep activities of close to the
aching pain daily living body for less
effort
Region: lumbar
area radiating Advise patient
to thoracic and to wear low
shoulder heeled
footwear
Severity:4/10

Temporal:
occasional
onset of pain

POTENTIAL NURSING CARE PLAN

Assessment Diagnosis Planning Intervention Evaluation

Subjective Risk for Pre- Short Term: Educate the The patient can
“Minsan bigla mature delivery After 1 hour of mother of the identify
na lang related to nursing risks of methods of
tumataas yung Gestational intervention the gestational reducing blood
BP ko pag Hypertension patient is aware hypertension to pressure to
nagpapakuha of the risk of her baby prevent
ako hindi ko having complications in
alam kung gestational Teach the her pregnancy
bakit” as hypertension to mother
verbalized by her baby methods of
the patient controlling her
The mother will Blood Pressure
Objective: be
Temp: 36.6 C knowledgeable Advice the
BP: 140/90 of controlling mother to
RR: 18 her blood reduce salt
PR: 78 bpm pressure to intake in her
prevent diet
complications

Long Term:

WELLNESS NURSING CARE PLAN

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION EVALUATION

Subjective: Readiness for Short term: Encourage Goal met:
“Ano ba ang enhanced self After 2 hours of client The client will
mga kailangan health Nursing to do daily be able to
kong gawin management intervention, exercises like understand and
para related to high the walking, jogging apply the ways
mapababa ang blood pressure. client will be or do aerobic to keep and
blood pressure able to exercise every manage her
ko” as understand the week. blood pressure
verbalized by ways to keep within normal
the patient. her blood Teach client in range.
pressure within determining
Objective: normal range. stressors which
Temp: 36.6 C may affect her
BP: 140/90 Long term: blood pressure.
RR: 18 After 1 day Of
PR: 78 bpm nursing Encourage
intervention, client
the client will to follow a
be able to heart-healthy
apply ways on diet like eating
how to manage more fruits,
her vegetables,
blood pressure. whole grains
and other
high-fiber
 foods.

References:

https://www.cdc.gov/bloodpressure/about.htm#:~:text=High%20blood%20pressure%2C
%20also%20called,blood%20pressure%20(or%20hypertension).

https://www.cdc.gov/bloodpressure/pregnancy.htm

https://www.mims.com/philippines/drug/info/obimin

https://www.who.int/health-topics/hypertension/#tab=tab_1