CA5L ÞkL5LN1A1ICN CI A

ÞA1ILN1 WI1n A
DIAGNC5I5 CI
n¥ÞLk1LN5ICN
5U8MI11LD 8¥ť AkCUI2Aţ LDLLINA IŦ
85N 3ŴC GkCUÞ 1
5U8MI11LD 1Cť MkŦ IAVILk
n¥ÞLk1LN5ICN
nypertens|on (n1N) or h|gh b|ood pressure ls a
chronlc medlcal condlLlon ln whlch Lhe blood
pressure ln Lhe arLerles ls elevaLedŦ lL ls classlfled as
elLher prlmarv (essenLlal) or secondarvŦ Þrlmarv
hvperLenslon whlch refers Lo hlah blood pressure
for whlch no medlcal cause can be foundŦ 1he
Secondarv hvperLenslon are caused bv anoLher
condlLlons LhaL affecL Lhe kldnevsţ arLerlesţ hearLţ or
endocrlne svsLemŦ
1|redness
Irregu|ar neartbeat
8|urred V|s|on
Confus|on
neadache
n|gh b|ood pressure
5IGN AND 5¥MÞ1CMť
kI5k IAC1Ck5ť
WD|abetes Me|||tus
WIam||y n|story
WAdvance age
WCbes|ty
W5edentary L|festy|e
W5tress
W5mok|ng
Wn|gh |ntake of Naţ saturated fats
WA|coho|
N0RMAL vALuL RL3uL13
wBC 5-1010 e/L 15.8
RBC 4.2-5.4 x 106uL 5.51
¬eb 12.0-16.0 e/dl 15.8
¬ot 37º-47º 48.6º
Lvmphoovte 20-40º 14º
Monoovte 2º-8º 5º
LA8CkA1Ck¥ kL5UL15
ANA1CM¥
AND
Þn¥5ICLCG¥
1he heartƌs [ob |s to pump b|ood around
the bodyŦ 1he heart |s |ocated |n
between the two |ungsŦ It ||es |eft of the
m|dd|e of the chestŦ
1he ma|n funct|on of the
card|ovascu|ar system |s therefore
to ma|nta|n b|ood f|ow to a|| parts
of the bodyţ to a||ow |t to surv|veŦ
Ve|ns de||ver used b|ood from the
body back to the heartŦ 8|ood |n
the ve|ns |s |ow |n oxygen (as |t has
been taken out by the body) and
h|gh |n carbon d|ox|de (as the body
has un|oaded |t back |nto the
b|ood)Ŧ
A|| the ve|ns dra|n |nto the super|or and
|nfer|or vena cava wh|ch then dra|n |nto the
r|ght atr|umŦ 1he r|ght atr|um pumps b|ood
|nto the r|ght ventr|c|eŦ 1hen the r|ght
ventr|c|e pumps b|ood to the pu|monary
trunkţ through the pu|monary arter|es and
|nto the |ungsŦ In the |ungs the b|ood p|cks
up oxygen that we breathe |n and gets r|d of
carbon d|ox|deţ wh|ch we breathe outŦ
1he b|ood |s becomes r|ch |n
oxygen wh|ch the body can useŦ
Irom the |ungsţ b|ood dra|ns
|nto the |eft atr|um and |s then
pumped |nto the |eft ventr|c|eŦ
1he |eft ventr|c|e then pumps
th|s oxygenŴr|ch b|ood out |nto
the aorta wh|ch then
d|str|butes |t to the rest of the
body through other arter|esŦ
ÞA1nCÞn¥5ICLCG¥
D|abetes Me|||tus
Iam||y n|story
Advance age
Cbes|ty
5edentary L|festy|e
5tress
5mok|ng
n|gh |ntake of Naţ saturated
fats
and a|coho|
k|dney re|ease
kLNIN |nto the
b|oodstream
kLNIN he|ps
convert
ang|otens|n I
|n ||ver
Ang|otens|n I |s
converted to
ang|otens|n II (a
potent
vasoconstr|ctor) |n
|ungs
Ang|otens|n
II
A|dosteroneť
Causes Na and
water
retent|on
keta|ned Na
and Water
Increased
8|ood Vo|ume
Arter|o|ar
constr|ct|on
Increased
Þer|phera|
vascu|ar
res|stance
Increased 8|ood
pressure and vascu|ar
res|stance to
hypertens|on
NUk5ING
CAkL
ÞLAN
NCÞ 1
5UILC1IVLť
"8ak|t kaya mada|as ako mah||o?" as
verba||zed by the pat|entŦ
C8ILC1IVLť
kequest for |nformat|on
Confuse
Inaccurate fo||ow through of |nstruct|ons
V/5ť
1ť 37Ŧ2
Þť 84
kť 18
8Þť 180/110
NUk5ING
DIAGNC5I5
( A )ť Def|c|t know|edge re|ated to |ack of understand|ng
and |nformat|on about the d|seaseŦ
ÞLANNINGť
After render|ng nurs|ng care |ntervent|onsţ
the pat|ent w||| verba||ze understand|ng of
the d|sease process and treatment
reg|menŦ
IN1LkVLN1ICNť
WMon|tored v|ta| s|gn espec|a||y b|ood pressureŦ
WLxp|a|ned hypertens|on and |ts effect on the heartţ b|ood
vesse|sţ k|dneyţ and bra|nŦ
Wke|nforced the |mportance of adher|ng to treatment reg|men
and keep|ng fo||ow up appo|ntmentsŦ
WLncouraged pat|ent to decrease or e||m|nate caffe|ne ||ke |n
teaţ coffeeţ co|a and choco|atesŦ
WÞrov|ded bas|s for understand|ng e|evat|ons of 8Þţ and c|ar|f|es
m|sconcept|ons and a|so understand|ng that h|gh 8Þ can ex|st
w|thout symptom or even when fee||ng we||Ŧ
W5uggested frequent pos|t|on changesţ |eg exerc|ses when |y|ng
downŦ
kA1ICNALLť
WÞrov|des bas|s for understand|ng e|evat|ons of
8Þţ and c|ar|f|es m|sconcept|ons and a|so
understand|ng that h|gh 8Þ can ex|st w|thout
symptom or even when fee||ng we||Ŧ
WLack of cooperat|on |s common reason for fa||ure
of ant|hypertens|ve therapyŦ
WDecreases per|phera| venous poo||ng that may
be potent|ated by vasod||ators and pro|onged
s|tt|ng or stand|ngŦ
WCaffe|ne |s a card|ac st|mu|ant and may adverse|y
affect card|ac funct|onŦ
WCommun|ty resources ||ke hea|th centers
programs and check ups are he|pfu| |n contro|||ng
hypertens|onŦ
LVALUA1ICNť
After render|ng nurs|ng care
|ntervent|onsţ the pat|ent was ab|e to
verba||ze understand|ng of the d|sease
process and treatment reg|menŦ
NCÞ 2
5U8ILC1IVLť
"Nangh|h|na ako at mada||ng mapagod kya
maghapon |ang akong nakah|ga" as verba||zed by
the pat|entŦ
C8ILC1IVLť
W8ody weakness
WIat|gue
WV/5ť
8Þƹ160/100
Þkƹ55 bpm
NUk5ING
DIAGNC5I5
( A )ť
Act|v|ty Into|erance
re|ated to body weaknessŦ
ÞLANNINGť
After render|ng nurs|ng care |ntervent|onsţ the pat|ent w|||
be ab|e to report measurab|e |ncrease |n energy and w|||
part|c|pate |n necessary des|red act|v|t|esŦ
IN1LkVLN1ICNť
WAssessed response to act|v|ty |nc|ud|ng pre/post v/sŦ
WÞrov|ded pat|ent w|th pos|t|ve atmosphereŦ
WLncouraged pat|ent's part|c|pat|on |n p|ann|ng of
act|v|t|esŦ
WAss|sted pat|ent |n carry|ng out se|fŴcare act|v|t|esŦ
WLncouraged pat|ent to carry out ADLsŦ
WÞ|aced pat|ent on a pos|t|on of comfortŦ
kA1ICNALLť
W1o |dent|fy causat|ve factorsŦ
W 1o ass|st ptŦ to dea| w|th manage factors that
contr|bute to fat|gueŦ
W 1o prov|de ptŦ w|th a sense of contro|Ŧ
W1o |mprove mob|||tyŦ
W1o enhance mot|vat|onŦ
W1o ma|nta|n body a||gnmentŦ
LVALUA1ICNť
After render|ng nurs|ng care |ntervent|onsţ the
pat|ent was ab|e to report measurab|e |ncrease
|n energy and was ab|e to part|c|pate |n
necessary des|red act|v|t|esŦ
NCÞ 3
5U8ILC1IVLť
"Nah|h||o at nangh|h|na ako" as verba||zed by
the pat|entŦ
C8ILC1IVLť
Wkest|essnessŦ
W8ody ma|a|seŦ
W8ody weaknessŦ
WV/5ť
Þkƹ55 bpm
NUk5ING
DIAGNC5I5
( A )ť
Decreased card|ac output r/t a|tered stroke
vo|umeŦ
ÞLANNINGť
IN1LkVLN1ICNť
After render|ng nurs|ng care |ntervent|onsţ the pat|ent's card|ac
output w||| become adequateŦ
WMon|tored and recorded v/sŦ
WAssessed rad|a| pu|se
every hour and reported any dev|at|ons from the base||neŦ
Wkeduced stressfu| e|ementsţ such as excess|ve no|se |n the
pat|ent's env|ronmentŦ
WLncouraged the pat|ent to |ncrease f|u|d |ntake and d|etary f|ber Ŧ
WÞrov|ded d|etary
WChanged pat|ent's pos|t|on frequent|yŦ
restr|ct|onsŦ
WDue med|cat|on such as metopro|o| g|venŦ
kA1ICNALLť
W1o estab||sh base||ne dataŦ
W1o mon|tor for arrhythm|asŤ |mpend|ng card|ac arrestŦ
W1o he|p decrease arrhythm|asŦ
W1o avo|d va|sa|vas maneuver dur|ng defecat|onţ wh|ch can
|ncrease heart rate and b|ood pressureţ and decrease card|ac
outputŦ
W1o promote comfort and avo|d tachycard|aŦ
W1o reduce r|sk of card|ac d|seaseŦ
WIt |s a drug |nd|cated for hypertens|onŦ
LVALUA1ICNť
After render|ng nurs|ng care |ntervent|onsţ the
pat|ent's card|ac
output was become adequateŦ
MLDICAL
AND
5UkGICAL
MANAGLMLN1
Life stvle
Lose weieht.
Lxeroise reeularlv.
Lat a diet rioh in fruits, veeetables, and low-fat dairv produots while reduoine total and
saturated fat intake.
Avoid smokine.
Uo not oonsume more than 1 or 2 alooholio drinks per dav.
Keep vour blood suear under oontrol.
1rv to manaee vour stress.
lollow vour health oare provider's reoommendations.
DkUG
51UD¥
GLNLkIC
NAMLť
apLoprll
CLA55IIICA1ICNť
I aaenLŤ A lnhlblLorŤ
anLlPÞn
CCN1kAINDICA1I
CN ť
PlsLorv of
analoedema
relaLed Lo
prevlous A
lnhlblLor useţ
preanancv (aLŦ
u)ţ lacLaLlon
ADVLk5L kLAC1ICNť N30. C0N3lULRA1l0N:
Wlve an hour before mealŦ
WAdvlse cllenL Lo reporL Lo Lhe
phvslclan wlLhouL delav Lhe
onseL of unexplalned feverţ
unusual faLlaueţ sore LhroaL Ǝ
mouLhţ easv brulslna Ǝ bleedlnaŦ
WAdvlse phvslclan prompLlv lf
vomlLlna Ǝ dlarrhea occurŦ
WMonlLor IS ţ poLasslumţ
hemaLoloalcţ renalŦ
WLosL of LasLe mav be experlenceŦ
8kAND
NAMLť
apoLen
MLCnANI5M CI
AC1ICN ť lnhlblLs
analoLenslnŴconverLlna
enzvme resulLlna ln
decreased plasma
analoLensln llţ whlch
leads Lo decreased
vasopressor acLlvlLv and
decreased aldosLerone
secreLlonŦ
5ÞLCIAL
ÞkLCAU1ICNť
use wlLh cauLlon
ln case of
lmpalred renal
funcLlon and
durlna lacLaLlonŦ
Mav cause a
profound drop ln
8Þ followlna Lhe
flrsL dose or lf
used wlLh
dlureLlcsŦ
5IDL LIILC1ť
8ashţ dvsaeuslaţ aasLrlc
lrrlLaLlonţ aphLhous
ulcer/pepLlc ulcerţ
headacheţ dlzzlnessţ
faLlaueţ drowslnessţ
malalseţ nƎIţ dlarrheaţ
drv mouLhţ
DkUG IN1LkAC1ICNť
lndomeLhacln/Nj24Ŵhr
anLlhvperLenslve effecLs
of capLoprll
lron salL/NjapLoprll
blood levelsŤ separaLe
admlnlsLraLlon bv
aLleasL 2 hr
Þrobenecld/NJapLoprll
blood levels
8/1Njrenal excreLlonŦ
CnLMICAL
CCN1LN1ť
1ableLŴ
sLock 23
ma/Lab
INDICA1ICNť
PÞnŤ ln con[uncLlon wlLh
dlalLalls Ǝ dlureLlcs ln
Plţ dlabeLlc
nephropaLhvţ
rheumaLold arLhrlLlsţ
8avnaud's svndromeţ
ldlopaLhlc edemaţ
8arLLer's svndromeŦ
GLNLkIC
NAMLť
nlfedlplne
CLA55IIICA1ICNť
I aaenLŤ a channel
anLaaonlsLŤ
anLlarrhvLhmlc (lass
lI)Ť nonnlLraLe
vasodllaLorŦ
CCN1kAINDICA1I
CNť
PvpersenslLlvlLv
and lacLaLlonŦ
AŦcuLe Ml
ADVLk5L
kLAC1ICNť
N5GŦ CCN5IDLkA1ICNť
WMonlLor 8Þ Ǝ suaar levelŦ nlfedlplne
has dlabeLoaenlc properLlesŦ
WAvold smoklnaŦ
WlnspecL aums evervdav Ǝ seek
prompL LreaLmenL for svmpLoms of
alnalval hvperplasla (easv bleedlna of
Lhe alnalvaţ Ǝ aradual enlaralna of Lhe
alnalval mass)Ŧ
WÞroLecL capsules from llahL and
molsLureŦ
Wan be Laken wlLhouL reaard Lo
mealsŦ
WMalnLaln fluld lnLake of 2Ŵ3L/dav Lo
avold consLlpaLlonŦ
W8rush LeeLh and floss reaularlv Lo
reduce swelllna and Lenderness of Lhe
aumsŦ
Wuo noL crushed or chewed or dlvlded
Lhe susLalned release LableLsŦ
rapefrulL mav cause lncreased serum
drua levelŦ
8kAND NAMLť
alclbloc
MLCnANI5M CI
AC1ICNť
lnhlblLs Lhe lnflux of
calclum Lhrouah Lhe
cell membraneţ
resulLlna ln a
depresslon of
auLomaLlclLv and
conducLlon veloclLv
leadlna Lo a
depresslon of
conLracLlonŦ
5ÞLCIAL
ÞkLCAU1ICNť
use wlLh cauLlon
ln lmpalred
hepaLlc or renal
funcLlon and ln
elderlv cllenLsŦ
lnlLlal lncrease ln
frequencvţ
duraLlonţ or
severlLv of analnaŦ
5IDL LIILC15ť
llushlnaţ
headacheţ
faLlaue/leLharavţ
edemaţ perlpheral
edemaţ weaknessţ
muscle crampsţ
dlzzlnessţ
llahLheadedţ
dlsLurbed
equlllbrlumŦ
u8u
ln18A1lCnť
ulaoxln/NJeffecL of
ulaoxln bv
NjexcreLlon bv
kldnevŦ
Þosslble/ NJeffecL
of LheophvlllneŦ
8arblLuraLes/Njnlfe
dlplne effecLŦ
Ma
sulfaLe/NJneuromu
scular blockade
and hvpoLenslonŦ
CnLMICAL
CCN1LN1ť
SLockŴ
3ma/capŤ 10
ma/cap
INDICA1ICNť
LreaLmenL of
essenLlal PÞnŤ
coronarv
lnsufflclencv wlLh or
wlLhouL analnaŤ
vasospasLlc analnaţ
Lo lncrease hearL raLe
ln slnus bradvcardla
Ǝ slck slnus
svndromeŦ
GLNLkIC NAMLť
nlcardlplne
hvdrochlorlde
CLA55IIICA1ICNť
I aaenLŤ a channel
blockerŤ anLlPÞn
CCN1kAINDIC
A1ICNť
hvpersenslLlvlLvŤ
advanced aorLlc
sLenoslsŤ
lacLaLlonŦ
ADVLk5L LIILC1ť N5GŦ CCN5IDLkA1ICNť
Wlve on MÞ1? sLomachŦ
WMonlLor 8ÞŦ defer lf
Ƽ90/60mmPaŦ
WAssess for Plţ lf beLa
blockers prescrlbedţ
monlLor closelvŦ
W8eporL anv
perslsLenL/boLhersome slde
effecLs such as dlzzlnessţ
chesL palnţ SC8ţ welahL
aalnţ and swelllna of
exLremlLlesŦ
WMalnLaln proper lnLake of
flulds Lo prevenL
consLlpaLlonŦ
WAvold alcohol and llmlL
caffelneŦ
WAvold prolonaed sun
exposureŦ
8kAND NAMLť
ardene
MLCnANI5M CI
AC1ICNť
ModeraLelv lncreases
C and P8 and
slanlflcanLlv decreases
perlpheral vascular
reslsLanceŦ SllahL
lncrease ln C1 lnLerval
and sllahL Lo no
decrease ln
mvocardlal
conLracLlllLvŦ no effecL
on C8S complex or Þ8
lnLervalŦ
5ÞLCIAL
ÞkLCAU1ICNť
SafeLv and
efflcacv ln
chlldren less
Lhan 18 vears of
aae have noL
been
esLabllshedŦ use
wlLh cauLlon ln
paLlenLs wlLh
Plţ lmpalred
llver funcLlonţ
reduced hepaLlc
blood flow or
lmpalred renal
funcLlonŦ
5IDL LIILC1ť
llushlnaţ lncreased
analnaţ hvpoLenslonţ
palplLaLlonţ
Lachvcardlaţ
vasodllaLlonţ anxleLvţ
dlzzlnessţ
llahLheadednessţ
headacheţ nƎIţ
blurred vlslonţ malalseţ
polvurla
DkUG IN1LkAC1ICNť
lmeLldlne/8anlLldlne/
NJ8loavallablllLv of
nlcardlplneNJplasma
levelsŦ
8lfampln/Njnlcardlplne
effecLŦ
vclosporlne
/NJlncreases plasma
levels of cvclosporlne
posslblv leadlna Lo
renal LoxlclLvŦ
PMlAL Cn1n1ť
5tockŴ apsulesţ
xLendedŴreleaseť 30
maţ 43 maţ60 maţŤ
apsulesţ lmmedlaLeŴ
releaseť 20maţ 30
maŤ ln[ecLlonť 2Ŧ3
ma/mlŦ
INDICA1ICNť
chronlcţ sLable(efforLŴ
assoclaLed) analnaŤ
PÞnŤ
GLNLkIC
NAMLť
lonldlne
hvdrochlorlde
CLA55IIICA1ICNť
I aaenLŤ cenLral
acLlna hvperLenslve
analaeslc
CCN1kAINDICA1ICNť
Þreanancvţ lacLaLlonŤ
sclerodermaţ presence
of an ln[ecLlon slLe
lnfecLlonţ paLlenLs on
anLlcoaaulanL Lherapvţ
ln bleedlna dlaLheslsŦ
ADVLk5L LIILC1ť N5GŦ CCN5IDLkA1ICNť
WMonlLor 8Þ closelvŦ
WMonlLor l Ǝ CŦ
WueLermlne wLŦ dallvŦ
WlnsLrucL Lo noL
abrupLlv dlsconLlnue
Laklna Lhls medsŦ
WlnsLrucL Lo noL rake
C1 druasţ alcoholţ or
oLher nS depressanLs
wlLhouL prlor
dlscusslon wlLh
phvslclanŦ
Wxamlne slLe when
Lransderm paLch ls
removedŦ
W8eporL lf ervLhemaţ
rashţ lrrlLaLlon or
hvperŴplamenLaLlon
occursŦ
8kAND NAMLť
aLapres
MLCnANI5M CI
AC1ICNť
SLlmulaLes alphaŴ
adreneralc recepLors
on Lhe nSţ resulLlna
ln lnhlblLlon of Lhe
svmpaLheLlc
vasomoLor cenLers
and decreased nerve
lmpulsesŦ
5ÞLCIAL ÞkLCAU1ICNť
use wlLh cauLlon
durlna lacLaLlon and ln
Lhe presence of severe
coronarv lnsufflclencvţ
recenL Mlţ chronlc
renal fallureţ
cerebrovascular
dlseaseŦ
5IDL LIILC15ť
urv mouLhţ drowslnessţ
dlzzlnessţ sedaLlonţ
consLlpaLlonţ headacheţ
faLlaueţ malalseţ anxleLvţ
lnsomnlaţ resplraLorv
depresslonţ loss of llbldoţ
nocLurlaţ nƎIŦ
DkUG IN1LkAC1ICNť
Alcohol/NJdepressanL
effecLsŦ
MlrLazaplne/ Loss of 8Þ
conLrolljanLaaonlsm of
alphaŴ2 adreneralc
recepLorsŦ
1olazollne/ 8locks
anLlhvperLenslve effecLŦ
Ierapamll/ NJ8lsk of AI
block and severe
hvpoLenslonŦ
narcoLlc analaeslcs/
ÞoLenLlaLlon of clonldlne
hvpoLenslve effecLŦ
CnLMICAL
CCN1LN1ť
5tockŴ 73
ma/LabŤ 130
ma/LabŦ
INDICA1ICNť
PvperLenslonţ
psvchosls ln
schlzophrenlaţ
ulceraLlve collLlsţ
epldurallv ad[uncL
Lherapv for severe
palnţ aLLenLlon deflclL
hvperŴacLlvlLv
dlsorderţ llles de la
1oureLLe's svndromeŦ
GLNLkIC
NAMLť
Pvdralazlne
hvdrochlorlde
CLA55IIICA1ICNť
I aaenL Ť nonnlLraLe
vasodllaLorŤ anLlPÞnŦ
CCN1kAINDICA1ICNť
oronarv arLerv
dlseaseţ mlLral
valvular rheuŴmaLlc
hearL dlseaseţ Mlţ
Lachvcardlaţ SLŦ Safe
use durlna preanancv
(caLeaorv ) or
lacLaLlon ls
esLabllshedţ
hvpersenslLlvlLvŦ
ADVLk5L LIILC1ť N5GŦ CCN5IDLkA1ICNť
WueLermlne anLlnuclear
anLlbodv LlLer before
lnlLlaLlon of Lherapv Ǝ
perlodlcallv durlna
prolonaed LherapvŦ
WMonlLor 8Þ and P8
closelvŦ
WMonlLor l Ǝ C when alven
parenLerallv Ǝ ln Lhose
wlLh renal dvsfuncLlonŦ
WMonlLor welahLţ check for
edemaŦ
WMake poslLlon chanaes
slowlv and Lo avold
sLandlna sLlllţ hoL
baLhs/showersţ sLrenuous
exerclse and excesslve
alcohol lnLakeŦ
Wuo noL drlveŦuo noL
breasLfeed whlle Laklna
Lhls druaŦ
8kAND NAMLť
Apresollne
MLCnANI5M CI
AC1ICNť
uecreases perlpheral
reslsLance buL
concurrenLlv elevaLes
cardlac ouLpuLŦ AcLs
dlrecLlv on smooLh
muscle of blood
vesselsŦ
5ÞLCIAL
ÞkLCAU1ICNť
use wlLh cauLlon ln
lmpalred hepaLlc or
renal funcLlon and ln
elderlv cllenLsŦ lnlLlal
lncrease ln
frequencvţ duraLlonţ
or severlLv of analnaŦ
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DkUG IN1LkAC1ICNť
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W2008 Ldition PUR Nurse's Urue ¬andbook
0eoree R. 3pratto, Adrienne L. woods.
WBrunner & 3uddarth's 1extbook of Medioal-3ureioal Nursine 11
th
Ldition. volume 1
WLmereenov drues. ( own ).
lL was mv flrsL Llme ln AMP 8 area wlLh MrŦ !avlerŦ AL flrsL Lhls dav was an
manlc dav for meţ because we all Lhouah LhaL our Llme of duLv was 6Ŵ2ţ we are all
ln school aL exacL 4ť30 amţ afrald of belna laLeŦ 8uL when we arrlved aL APM Lo
meeL Mam Llmţ we LhouahL LhaL she was our l for LhaL dav and she sald LhaL she
ls noL our lţ her Llme ls 10Ŵ6Ŧ We are all dlsappolnLed for LhaL clrcumsLancesţ
because none of Lhem lnform us LhaL our duLv was 2Ŵ10Ŧ Well anvwavţ l don'L
blame anvoneŦ When we meL slr !avler he rushed us for preparlna our paraŴ
phernalla LhaL should be use lnslde Lhe 8Ŧ l have a feellna LhaL we were so busv
lnslde Lhe 8ţ and l'm rlahLŦ When l enLered l alreadv mv paLlenLţ we were
accldenLallv asslaned aL Þedla areaŦ MeeLlna wlLh mv paLlenL helps me a loL when
provldlna care Lo LhemŦ l learned from Lhe flrsL dav of mv duLv LhaL paLlenL ls a
musL and lmporLanLţ alLhouah all of us know lLŦ l also experlenced alvlna 1S8 on
mv paLlenLŦ l learned LhaL vou should noL be affecLed of Lhe condlLlon Lhev haveŦ
And vou should puL vourself on Lhe shoes of vour paLlenLŦ ?ou should acL llke whaL
who Lhev areţ be humble and never lanore Lhem when Lhev need vour helpŦ
MC11Cť
l also aoL Lhe chance Lo observe a procedure Lo a one of Lhe paLlenL ln Þedla
who ls newbornŦ 1he newborn should have an oroaasLrlc Lube (C1)Ŧ lL was a
aood experlence for meŦ
We all have dreamsŦ 8uL ln order Lo make dreams lnLo reallLvţ lL Lakes an
awful loL of deLermlnaLlonţ dedlcaLlonţ selfŴdlsclpllneţ and efforLŦ
May 13ţ 2010
GLAMn
Lk
2Ŵ10 ÞM
MkŦ IAVILk
AkCUI2Aţ LDLLINA IŦ
85N 3C GkCUÞ 1
1hls was Lhe lasL dav of our duLv and we are busv aaalnŦ l have so manv
experlenced and learnlna lnslde Lhe 8Ŧ l have a paLlenL who fallen from a
Lree and l experlence alvlna hlm a wound careŦ l also experlenced alvlna skln
LesL and an lnLramuscular ln[ecLlon Lo hlm for anLl LeLanusŦ l learned noL ln
alvlna care buL also parLlclpaLlna ln Lhe oLher member of Lhe sLaff ln Lhe 8
sLaLlonŦ l also aoL Lhe chance Lo observe lnserLlna a caLheLer ln a male paLlenL
wlLh Lhe aulde and supervlslon of our ŦlŦŦAnd be alerL aL all Lhe LlmesŦ ven ln
a slnale quesLlon vou should provlde an answer Lo Lhem and Lhere's no
problem lf vou don'L know Lhe answer [usL Lell Lhem LhaL vou don'L knowŦ
never acL llke vou're Lhe besL ln Lhe worldŦ
MC11Cť
lew Lhlnas ln Lhe world are more powerful Lhan a poslLlve
pushŦ A smlleŦ A world of opLlmlsm and hopeŦ A vou can do lL
when Lhlnas are LouahŦ
May 14ţ 2010
GLAMn
Lk
2Ŵ10 ÞM
MkŦ IAVILk
AkCUI2Aţ LDLLINA IŦ
85N 3C GkCUÞ 1
THANK YOU SIR JAVIER!!! LOVE
YOU!!!
God b|ess!! thanks for gu|d|ng us dur|ng our duty at LkŦ
Ior shar|ng the know|edge that you haveŦ Ior trust|ng us
and for g|v|ng us a chance to exper|ence a fee||ng of be|ng
reg|stered nurseŦ 5ana mag|ng CŦIŦ po nam|n kayo u||tŦ
A|ways take care s|rŦ mua *

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