UAYAYAU

Western Mindanao State University
College of Nursing
Zamboanga City
Alternative Learning System

Related Learning Experience
Surgical ward
Instructions:
Answer the provided questions comprehensively following the subsequent format.
A. Use the Times Roman Font Style
B. Utilize at least three (3) or more references
C. References should be 2015 and latest
D. Output should be submitted as posted in the Google Class Assignment in PDF Format
E. You will be graded according to the Rubric
PLEASE ACCOMPLISH THIS IN CHUNKS:
CHUNK 1: Includes the following:

pathogenesis of the disease condition, Life threatening pathway.
CHUNK 2: Includes the following: SIC, diagnostic exams, medical procedures.
CHUNK 3: Includes the following:
drug study and NCP (2 NCP’s )
CASE SCENARIO: Tonsillitis
A 25-year-old boy was taken to the hospital because he was having sore throat, high
temperature and runny nose. Symptoms started a couple of days ago and his mother reported that
he also complained of pain in the right ear at night. The doctor checked his ears with the
otoscope and saw that both eardrums were congested and looked reddish especially on the right.
On examination, patient verbalized that he had frequent episode of tonsilitis. He has

trouble swallowing. Febrile with temp of 38.5, the doctor examined his throat it is red, and
tonsils are covered in a whitish and yellow coating.
The doctor order to start D5LR 1L @ 30 gtts/mins, Paracetamol 1 amp every 4 hrs for
fever prn, for coagulation test is also ordered.
Vital signs:
Blood pressure ; 120/80 mmhg

Heart rate : 90 bpm
Respiratory rate ; 22 b/min
Temperature : 38.5 degree Celsius
Height : 5’4”
Weight ; 54.q kg
Laboratory results:
Examination Patient; s result Normal value Indication

white blood cell 20,500/μL
count (20.5×109/L),
Coagulation test
Prothrombin time
10-12 seconds
(PT)
Partial
thromboplastin time 30-45 seconds
(PTT)
International
normalized ratio 1:2 ratio
(INR)
Based on the physical exam, history, the patient is diagnosed with chronic tonsilitis, and
scheduled to undergo tonsillectomy, and with the following doctor’s order:
1. Secure consent
2. Nothing Per Orem (NPO)
3. Under GA
After surgery, the patient is wheeled to the Post Anesthesia Care Unit (PACU) with the
following orders:
1. Tramadol hydrochloride (Ultram) 100 mg IV every 6 hours PRN for pain

2. Co- amoxiclav 1.2g IVTT every 8 hours for 3 doses
3. Series IVF
4. Paracetamol 1 amp every 4 hrs prn for fever
5. vs every 4 hrs
Your Tasks:
1. Determine the need for the required laboratory and diagnostic examinations
 Give the indications for the abnormal result/values
2. Illustrate the organ involved and label accordingly.
3. Discuss the normal function of the organ involved.
4. Explain the pathophysiology based on the diagnosis.
A. Create the pathologic pathway of the pathogenesis (the development of the

disease and the chain of events leading to the illness) contributing to the patient’s
illness condition.
B. Synthesize the life-threatening pathway as a consequence of the patient’s refusal /

non-compliance with treatment
 Example:
A. Pathogenesis of Appendicitis
Fecaliths / Appendicoliths Intraluminal Scarring Tumors Pathogens Other Disease
Obstruction of the Appendiceal Lumen
Bacterial Overgrowth
Inflammation
Subjective Cues: Objective Cues:

1. Periumbilical Pain 1. Localized tenderness
2. Anorexia, Nausea & Vomiting 2. Rebound tenderness
3. Persistent, Continuous Pain in the RLQ 3. Muscle guarding
localized at McBurney’s point 4. Flexed right leg
5. Low grade fever
Resolved through Surgery (Appendectomy)

B. Life-Threatening Pathway (Patient’s refusal / non-compliance with
treatment)
THIS IS AN EXAMPLE;
How will you prevent the

patient’s status from Signs & Symptoms of Over 48 hours
worsening? Without Intervention
Give at least 2
interventions and the
rationale PERFORATION
Leak of Content into the Omentum and Surrounding Tissues
COMPLICATIONS
Small bowel obstruction Abscess Formation Peritonitis
Escalating diffuse abdominal pain with rapid development

of toxicity as evidenced by:
Dehydration
Signs of sepsis
Oliguria
Hypotension
Acidosis
High-grade fever
5. Explain the Surgical Procedure done on your patient.
6. Enumerate the instruments that will be used during surgery. (Use the internet as a source
of reference). Classify them according to their category and indicate their functions
(following the template below)
7. Formulate an IMMEDIATE post-operative Nursing Care Plan of a patient who
underwent tonsillectomy based on the NANDA approved Nursing Diagnosis.
 Give at least two (2)
 PRIORITIZE the problems and cite your reference/s
8. Develop a Drug Study based on your patient’s preop and postop medications to include
Intravenous Fluid infusions
B. Rubric for ALS (surgical ward)
4 3 2 1
Follows and
Exceeds Follows some Demonstrates
CATEGORY Follows
expectations but not all little
instructions
noted in instructions comprehension
instructions
I. STUDY OF ILLNESS CONDITION (total score = 40 points)
1. Assessment
 Differentiates between subjective and objective cues
 Analyzes laboratory examinations
2. Anatomy
 Indicates and labels the affected organ
 Cites reference/s & Paraphrases
3. Physiology
 Discusses the normal functions of the organ involved
4. Pathophysiology
 Explains the pathophysiology based on the diagnosis
 Develops the pathologic pathway of the patient’s

current illness
 Synthesizes the life-threatening pathway as a

consequence of the patient’s refusal / non-compliance
with treatment
5. Analysis
 Correlates signs & symptoms to the illness condition
 Relates laboratory / diagnostic exams to the illness

condition
II. SURGICAL PROCEDURE & INSTRUMENTS (total score = 20 points)

1. Operation Performed
 Discusses the surgical procedure done

2. Instruments and Accessories Used
 Lists the instruments used during the procedure
 Categorizes the instruments
 Explains the functions per category & cites references
III. NURSING CARE PLAN (total score = 36 points)

6. Nursing Care Plan (2)
 Utilizes the Nursing Process
 Assessment
 Diagnosis
 Planning
 Objective of Care
 Interventions
 Rationale
 Implementation
 Evaluation
 Cites reference/s
IV. DRUG STUDY (total score = 12 points)

7. Drug Study
 Comprehensive drug information and cites references
 Nursing Responsibilities
 Indication / contraindication
TOTAL POINTS
FINAL RATING
60% Passing Rate

Score Grade Score Grade
110 -106 1.00 61-65 3.25
101-105 1.25 56-60 3.5
96-100 1.5 51-55 3.75
91-95 1.75 46-50 4.0
86-90 2.0 41-45 4.25
81-85 2.25 36-40 4.5
76-80 2.5 31-35 4.75
71-75 2.75
30 below 5.0
66-70 3.0
Prepared by:
MA. MAGDALENA M. TABOBO, MN, RN
Clinical Instructor
Noted by:
DR. MARIA SOCORRO C. DOMINGO

Curriculum Chair
Approved:
DR. MARY JOSELYN C. BIONG
OIC- Dean

UAYAYAU

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Western Mindanao State University

Alternative Learning System

PLEASE ACCOMPLISH THIS IN CHUNKS:

CHUNK 1: Includes the following:

CASE SCENARIO: Tonsillitis

On examination, patient verbalized that he had frequent episode of tonsilitis. He has

Blood pressure ; 120/80 mmhg

Examination Patient; s result Normal value Indication

1. Tramadol hydrochloride (Ultram) 100 mg IV every 6 hours PRN for pain

A. Create the pathologic pathway of the pathogenesis (the development of the

B. Synthesize the life-threatening pathway as a consequence of the patient’s refusal /

Fecaliths / Appendicoliths Intraluminal Scarring Tumors Pathogens Other Disease

Obstruction of the Appendiceal Lumen

Subjective Cues: Objective Cues:

Resolved through Surgery (Appendectomy)

How will you prevent the

Leak of Content into the Omentum and Surrounding Tissues

Small bowel obstruction Abscess Formation Peritonitis

Escalating diffuse abdominal pain with rapid development

5. Explain the Surgical Procedure done on your patient.

B. Rubric for ALS (surgical ward)

 Analyzes laboratory examinations

 Develops the pathologic pathway of the patient’s

 Synthesizes the life-threatening pathway as a

 Cites reference/s & Paraphrases

 Relates laboratory / diagnostic exams to the illness

II. SURGICAL PROCEDURE & INSTRUMENTS (total score = 20 points)

 Cites reference/s & Paraphrases

 Categorizes the instruments

 Explains the functions per category & cites references

III. NURSING CARE PLAN (total score = 36 points)

IV. DRUG STUDY (total score = 12 points)

60% Passing Rate

DR. MARIA SOCORRO C. DOMINGO

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