MARY'S COLLEGE NURSING PROGRAM Tagum City A CASE STUDY on HYPERTENSIVE URGENCY, HYERTENSIVE CARIOVASCULAR DISEASE, CORONARY ARTERY DISEASE, LEFT VENTRICULAR HYPERTROPHY, SINUS RHYTHM, NOT IN FAILURE; PROSTATE CANCER STAGE III ___________________________ Presented to: EVIE LUZ S. DOCENA, RN, MN Clinical Instructor In Partial Fulfillment of the Requirements In Related Learning Experience (RLE) __________________________ By: Castillo, Kent John N. Rodriguez, Michael Roy B. Cinco, Romruth C. Sedico, Quenny Lou A. Presores, Gerlie Mae

August 2009

A. Introduction -

B. Objective of the Study C. Assessment -

• Biographic Data • Chief Complaint • History of Present Illness • Past medical and Nursing History • Personal, Social-Economic History D. Patient Need Assessment E. General Survey F. Course in the ward -

G. Laboratories and Diagnostic Examinations H. Review of Anatomy and Physiology I. Symptomatology -

J. Etiology of the disease K. Pathophysiology -

• Written Pathophysiology • Diagram L. Synthesis of clients conditioned status from admission to present -

M.Evaluation of the Objective of the study N. Nursing Care Plan O. Bibliography -

A. INTRODUCTION Heart disease is the leading cause of death for all people in the US, and stroke is the third leading cause of death. Heart disease and stroke are also major causes of disability and significant contributors to increasing health care costs in the US. The mortality rate for cardiovascular disease (heart disease, stroke, and chronic obstructive pulmonary disease) is greater than the combined rate for all leading causes of death (cancer, unintentional injuries, pneumonia/influenza, diabetes, suicide, kidney disease, chronic lever disease and cirrhosis). (US DHHS, 2000). The major risk factors for cardiovascular disease are hypertension, smoking, hypercholesterolemia, high alcohol consumption, and lack of physical activity. (Tamir and Cachola, 1994). In 2001 there were approximately 460,000 indigenous people in Australia, accounting for 2.4% of the population. However persons greater than 40 years old account for proportionately fewer indigenous people, reflecting the fact that indigenous people are much more likely to die before they are old than the general Australian public: men at 56 years; women at 63 years. In addition, death rates are estimated to be four times higher in indigenous than in non-indigenous Australians. In 2002 the leading cause of death in indigenous people was cardiovascular disease (CVD), responsible for 1/3 of all deaths, followed by ischemic heart disease (16%) and stroke (9%). Of indigenous Australians aged 35–44 years, 16% reported a

cardiovascular condition, with the rate increasing to 31% for those aged 45 to 54 years, and to 47% for those aged 55 years and over. The prevalence of cardiovascular disease is greater in remote areas. Coronary heart disease is 3–4 times higher for males and females than in non-indigenous people. Indigenous people are much more likely to die of CVD than non-indigenous people at any age, especially in younger age groups – the death rate among 25–54 year olds was 10 times higher than other Australians. Every hour, nine Filipinos die of cardiovascular or heart diseases. In fact, cardiovascular diseases (CVD) remain the No. 1 cause of death in the Philippines. About one out of four deaths in the country are traced to cardiovascular diseases, according to the Department of Health One out of 20 adults (40 years and older) suffers from coronary/ischemic heart disease. And one out of 10 adults (15 years and older) suffers from hypertension, or high blood pressure. Five out of 100 adults suffer from coronary artery disease. Surveys made by the DOH show that Central Luzon had the highest cases of cardiovascular diseases (225 per 100,000 population). Metro Manila registered the highest mortality rate (99 per 100,000) while the lowest was in Central Mindanao (16 per 100,000). During the past three years, eight of the ten leading causes of morbidity in Davao Region were communicable but highly preventable diseases. In 2002, the illnesses registered were the upper and lower respiratory tract infections, pneumonia, diarrhea, influenza, tuberculosis, malaria and dengue. The non-communicable leading causes of morbidity were hypertensive diseases and genitourinary system diseases. In 20022004, cerebrovascular diseases topped the leading causes of mortality, indicating the need to examine closely the lifestyle of the at-risk population in the region. In 2002, heart diseases ranked second to cerebrovascular diseases. Other leading causes of death among all ages include pneumonia, accidents, malignant neoplasms, tuberculosis, hypertensive diseases, diabetes mellitus, lower respiratory infections and septicemia. Cumulative risk and trends in prostate cancer incidence in Mumbai, India. Information relating to cancer incidence trends in a community forms the scientific basis for the planning and organization of prevention, diagnosis and treatment of cancer. We here estimated the cumulative risk and trends in incidence of prostate cancer in Mumbai, India, using data collected by the Bombay Population-based Cancer Registry

The lowest incidence rate recorded was in Shanghai. The stage distributions of prostate cancer in Asian populations are still unfavorable compared to those of Western developed countries.4% of all cancers) were registered by the Bombay Population-based Cancer Registry. Although Asian people have the lowest incidence and mortality rates of prostate cancer in the world. reflecting a possible improvement of diagnostic efforts and changes of environmental risk factors in Asian immigrants. Nevertheless.7% of all male cancers and 2. Although some of the increases may result from enhanced detection. National Taiwan University Hospital and National Taiwan University College of Medicine. The differences in incidences between native Americans and Asian immigrants are getting smaller. Taipei. China and the highest rates were in Rizal . much of the increased incidence may be associated with westernization of the lifestyle. 50-69 and 70+) also. However. The probability estimates indicated that one out of every 59 men will contract a prostate cancer at some time in his whole life and 99% of the chance is after he reaches the age of 50. In 2000. which may help to reduce prostate cancer incidence in a chemopreventive setting. Methods. Malaysia. Department of Urology.000 person-years) while the incidence in Singaporean Chinese increased 118% from 6. Taiwan. the Philippines and Israel. Singapore. Both genetic and environmental risk factors responsible for elevated risks in Asian people are being identified. the huge variations in incidences among ethnic groups imply that there are important genetic risk factors. the age-adjusted incidence was over 10 per 100000 men in Japan.from the year 1986 to 2000. these rates have risen rapidly in the past two decades in most Asian countries. Taiwan.7 per 100.3-12. Analysis of the trends in age-adjusted incidence rates of prostate cancer during the period 1986 to 2000 showed no statistically significant increase or decrease and the rates proved stable across the various age groups (00-49.4 per 100. During the 15 year period. a trend towards diagnosing cancer with more favorable prognosis is seen in most Asian countries. Prostate cancer has become one of the leading male cancers in some Asian countries. The incidence of prostate cancer has risen by 5-118% in the indexed Asian countries (agespecific and age-standardized) based on incidence and mortality rates data for prostate cancer in Asian countries for 1978-1997. a total of 2864 prostate cancer cases (4. with increasing obesity and increased consumption of fat.000 person-years.6 to 14. Results. Incidence at centers in Japan rose as much as 102% (Miyagi 6.

more and more cases are being seen every year. September 2006. . In the 1990s. According to Local Studies Related to Aerial Spraying regarding Health and Environmental Conditions of People Living in Three Communities of Davao City Where Aerial Spraying of Pesticides is a Common Practice. citing similar symptoms among people living near banana and pineapple plantations in South Cotabato and different parts of Davao city.” he said. Local interest in Prostate Cancer has also been in the spotlight since the last Presidential Elections when Presidential Candidate Raul Roco revealed that he was diagnosed to have advanced disease. bone cancer. Of the 22 cases of cancer: 6 cases (27. 4 cases (18. uterine.3%) –prostate cancer. Davao Del Sur.Province in the Philippines. Quijano did a research in Guihing.1%) – brain. thyroid. “Although other factors — such as malnutrition and the lack of sufficient housing — also contribute. throat. Incidence and death rates vary tremendously among countries. colon.2%) – breast cancer. Prostate Cancer is the fourth most common male malignancy worldwide. however in the Philippines. long pesticide exposure was largely to blame for those diseases. 2 cases each (9.5%) – liver. lung cancer. 1case each (4. although still much lower than those in the United States of America (USA) and many European countries. where he attributed the high incidence of prostate and breast Cancer and other illness there to the patients’ prolonged exposure to pesticide in the nearby banana plantations. leukemia.

HCVD. NIF. CAD. SR.B. LVH. Prostate CA Stage III Be able to review the anatomy and physiology of the affected organs and systems Distinguish the affected system Trace and analyze the pathophysiology of the infirmity Classify the ordered drugs and associate its action or effects to the patient . students will be able to extend and improve their knowledge and understanding with regards to the causes. effects. OBJECTIVES General: After apprehensive case study. Specific: • • • • • • Study the patient’s history of past and present illness Conduct a synoptic physical assessment of patients with Hypertensive Urgency. NIF. Prostate CA Stage III for them to be able to attain a comprehensive and thorough learning experience with regards to their study that would benefit not only them but also for their readers and for the patients that they will be catering in the future with such kind of disease. signs and symptoms and nursing implementation for Hypertensive Urgency. SR. complications. LVH. CAD. HCVD.

B. LVH. SR. inability to walk and loss of appetite . NIF. M. SR. Iloilo Nationality: Filipino Religion: Protestant Occupation: Pastor Name of Spouse: Starscream Admitting Diagnosis: Hypertensive Urgency. NIF. HCVD. Prostate CA Stage III Identify prognosis of the patient Evaluate the client’s condition from the time of admission up to the present C. Sanchez. Chief Complaint Admitted due to dizziness. ASSESSMENT A. HCVD. 1930 Birth Place: Dumangas. Prostate CA Stage III Admitting Physician: Precy Gem T. CAD.• • • • Consider laboratory results and relate it to patient’s condition Construct nursing care plan for patients with Hypertensive Urgency. Biographical Data Name: Megatron Age: 78 years old Gender: Male Civil Status: Married Birthdate: November 11.D. CAD. LVH.

History of Present Illness Megatron experienced dizziness. HCVD. After a year until 70 y/o. Four months after his operation. He had never undergone chemotherapy. Antineoplastic medications and antihypertensive medications were prescribed to him as home medications.3oC RR – 32 cpm Weight – 77 kgs. salty and sweet PR – 89 bpm BP – 170/110 mmhg Height: 5 feet 4inches .VS upon admission: T – 37. where he has diagnosed with Hypertension and prostate CA stage III. Two days after his admission. By the age 18-32 y/o. 2009 & was diagnosed with Hypertensive urgency. CAD. C. Since then. he was admitted due to hematemesis & was diagnosed with gastric ulcer. Since then. has Diabetes Mellitus & is a cigarette smoker and alcoholic drinker during adolescent stage up to adulthood stage. Patient was admitted last July 28. last January & October 2004 at Davao Regional Hospital. D. Patient was fun of eating meaty products. Progressive lower extremity weakness noted after the patient complained of lumbosacral pain. E. patient was fun of smoking everyday and drinking alcoholic beverages almost 4x a week. SR. patient experienced difficulty and painful urination. loss of appetite and inability to walk prior to admission. He has FBC attached to urobag draining a bloody urine. He is hypertensive. result of UXD of prostate released & revealed a Grade 3 prostatic enlargement where patient was suggested for PSA correlation. patient gradually minimized his vices into moderate amount and occasionally. Personal. Patient underwent surgical operation of the prostate twice. last November 2002. PROSTATE CA STAGE III. Family History Megatron belongs to nuclear family and youngest among 9 siblings. LVH. inconstantly and inconsecutively. patient underwent PSA testing quarterly for 5 years. NIF. Abdominal distention and bipedal edema noted. Past Medical History Megatron had undergone surgical operation of the Right eye as out-patient last July 2002 due to cataract.

NIF. LVH.00 monthly as usual income.foods before.000-3.3oC.37. PROSTATE CA STAGE III ARRIVED ON UNIT BY___per stretcher__ ACCOMPANIED BY___wife_and children__ ADMITTING WT/VS: 77 kls. Date/Time____July 28. Her wife is a plain housewife while most of his children now has stable job. 09 8: 00 pm___ ADMITTING MEDICAL DIAGNOSIS: Hypertensive urgency. PATIENT NEED ASSESSMENT Date: July 30. he earned P50.00 – P100. BP. he became then a pastor and receives an honorarium monthly of about P2.000 monthly. 2009 NAME OF PATIENT: Megatron _AGE__78___SEX_M__STATUS_Married___ ADMISSION. For 15 years of being a farmer way back 1964-1979. OXYGENATION FROM_Emergency Room  BP__140/80__ RR 25 cpm____CR___88bpm . Patient has no family history of any type of cancer and diabetes mellitus. D. His father has history of hypertension as well as his siblings. T.170/110mmHg __ CLIENT’s PERCEPTION OF REASON FOR ADMISSION: -Client unable to verbalizeHOW WAS PROBLEM BEEN MANAGED BY CLIENT AT HOME: “Naga-inom ra man siya sa iyang maintenance” – as verbalized by the child of the patient ALLERGIES_____no known allergies______ MEDICINE (at home) Casodex (antineoplastic agent) PHYSIOLOGIC NEEDS I. HCVD. PR-89bpm. CAD. Socio-Economic History Megatron belongs to middle class family. Immediately after being a farmer. RR-32cpm. F. SR.

OF of 1. ’09 on small amount. character. character)__defecated Last June 28. use of accessory muscles noted.(CHARACTER) tachypneic___  LUNGS (per auscultation: character. amount and character) not noted  EATING PATTERN: 3x a day_  INTAKE (IVF. of times and frequency. chest pain. breathing character and pattern):crackles sounds heard upon auscultation. w/ symmetrical chest expansion. in brown color soft stool. vomiting. TEMPERATURE MAINTENANCE TEMPERATURE: 37. flaky. flaky • nasal cannula LIFE SUPPORTING APPARATUS: with O2 @ 3LPM via • OTHER OBSERVATIONS (related) Patient shows discomfort with the nasal cannula by removing it. dry. wrinkled and   not warm to touch_  experience fever anymore_ III NUTRITIONAL FLUID OTHER OBSERVATION (related)_patient did not  HEIGHT/WT 5”4’/77 kg _ AMT. chest pain not noted • seconds_ CAPILLARY REFILL good capillary refill of less than 3 • and wrinkled. II. water = 300cc  Other OBSERVATION (related)\: Skin is dry. . SKIN CHARACTER AND COLOR_skin is brown.  CARDIAC STATUS (per auscultation) sounds. lung sound.8kcal/day  PROBLEM (nausea. has poor skin turgor IV ELIMINATION  Last BOWEL MOVEMENT(frequency.2 oC_ SKIN CHARACTER_Skin is dry. FLUID/WATER: with IVF of PNSS 1L@300cc/hr. amount. FOOD CONSUMED: w/ good appetite. __”Lub-dubb” sound heard with increased intensity per auscultation. no. intercostals retraction noted. symmetry of chest expansion. able to consumed the OF served  PRESCRIBED DIET: LSLF.

) __9__ VIII STIMULATION ACTIVITY MENARCHE__N/A__  WORK: Before: farmer & pastor During: needs assistance in performing activities of  RECREATION/PAST TIME: daily living. sensation)_able to urinate last July 30. thus.  URINATION(Frequency. facial expression. can’t able to verbalize  OTHER observation (related) Patient has difficulty in sleeping due to pain felt VII SEXUALITY REPRODUCTIVE  LMP__N/A__  GRAVIDA/PARITY__N/A__  MENSTRUAL CYCLE__N/A__  EDC__N/A__ AOG__N/A__ PRENATAL__N/A__ GYNECOLOGIC PROBLEM__N/A__  FMILY PLANNING METHOD USE: calendar method  CHILDREN (no. 2009. grimace face and guarding behavior noted on genital area  FREQUENCY_continuos_  CHARACTER can’t able to describe. character. can’t able to sit. and verbal response – makes incomprehensible sounds _____ . amount of sleep)_10-11 hours_ PROBLEM AS VERBALIZED -can’t able to verbalizeOTHER OBSERVATION (related)_Patient can easily be distracted. with FBC attached to urobag. draining a bloody urine @100 cc level  OTHER OBSERVATION (Related)_Bladder is distended per palpation V REST-SLEEP     BED TIME _6-7 pm_WAKING UP__5:30 am_ SLEEP (pattern. diaphoretic)frequent change of position noted. eye opening – to verbal command. a moderate smoker and drinker before SAFETY AND SECURITY  NEURO VS____GCS of 10/15. having difficulty in sleeping back again VI PAIN AVOIDANCE  RATE PAIN_-can’t able to verbalize. motor response –to localized pain.2x a day. episodes of napping &  HOBBIES/VICES: sleeping. NORMAL PATTERN 1. irritable.TIME STARTED__7:30 PM_  LOCATION _genital area__BEHAVIOR (restlessness.

With O2 @ 3LPM via nasal cannula. unresponsive and tachypneic. awake. MN__ CI E. With symmetrical chest expansion. also because he is a friendly type of person and being loved by family members. (+) intercostal retraction. trembling. the ultimate goal of his father is to see his children succeed and become better persons. his children have stable jobs. He has a moderate self esteem. conscious. with NGT @ Right nostril patent and intact. Responsive. able to respond by making incomprehensible sounds  EMOTIONAL PROBLEM (diaphoretic. With IVF of # 5 . GENERAL SURVEY Date of Assessment: July 30. 2009 On bed. Pale conjunctiva of the eye noted. For now. (+) use of accessory muscles. with distal end close. Assessed by: ______A4_________ SN-SMC __Evie Luz Docena. SELF ACTUALIZATION NEED According to one of his children. With isocoric pupils of 2mm less briskly reactive to light and accommodation. restless)_restlessness: frequent change of position due to pain felt________ LOVE BELONGING NEED  CHILDREN (living with?) Patient is loving and supportive as verbalized by her child and  HUSBAND (living with) wife. RN. Due respect and care was given to him SELF ESTEEM NEED He is a good person and a loving father. MENTAL STATUS (Coherent. crackles sound heard per auscultation on both lung fields. husband and pastor. unconscious) conscious.

with distal end close. With NGT at Right nostril patent and intact.2 37. low fat diet.3 37.8 37.2 37. Bladder distention noted. On low salt. On osteorized feeding of 1.1 37.9 37. Vital Signs upon admission and present VITAL SIGNS Date 7/28/09 Shift 7-3 Time 9:35 10:50 11-7 12:10 4:30 7/29/09 7-3 8:45 12:00 3-11 4:00 8:00 11-7 12:30 4:00 7/30/09 7-3 8:00 12:20 3-11 4:00 5:00 6:00 7:00 8:00 9:00 10:00 C.3 37.1 37.3 37. With FBC attached to urobag draining a bloody urine @ 100 cc level.PNSS 1L @ 300cc/hr @ 200 cc level infusing well @ Left metacarpal vein.5 37.3 37. B. Bipedal edema noted. Pale nailbeds noted with capillary refill returns within 3 seconds.8 T 37.1 37 37.4 37 36.9 BP 160/100 150/90 140/80 130/90 170/100 160/90 140/90 150/90 130/90 120/80 140/80 150/100 160/100 150/90 140/80 140/80 150/90 140/80 140/80 RR 32 25 18 20 23 26 26 24 17 19 20 20 26 25 27 25 30 28 29 PR 92 89 83 82 84 89 78 81 83 85 82 80 97 94 89 88 81 85 77 . Nutritional Status Megatron stands 5”4’ and weighs 77 kilos.4 37.7 38.1 36.

With poor skin turgor.kcal/day. Difficulty of hearing sounds noted. Skin loses its elasticity. Dry lips noted. Pale conjunctiva of the eyes noted. Pulmonary System Respiratory rate is above normal range. With IVF of #5 PNSS 1L @ 300cc/hr infusing well at Left metacarpal vein. The skin takes longer to return to its natural shape after being tented between the thumb and finger. Integumentary System Skin is dry. appears thin and translucent. Restlessness: frequent change of position noted. . Presence of parasites not noted. thin and loss of scalp noted. Fingernails slightly long in length. neck. HEEN Head is symmetrically rounded. unclear. Contain moderate amount of waxy secretion. Eyes. A thin. G. uniform in color. flaky and wrinkled. Can’t able to speak out clearly to express feelings and ideas. Bristle-like hairs of the eyebrows noted. The sense of smell markedly diminish. Bilateral on auditory canals noted. F. motor response – to localized pain & verbal – makes incomprehensible sounds. Eyeballs appear sunken. pale and thick. Weight loss noted from 85 kg to 77 kg. Skin folds of the upper lids is more prominent & lower lids sag. hands and legs. Visual acuity is decrease. Flat tan to brown-colored macules noted as large as 1-2 cm on exposed body area such as face. D. arms. Pinna aligned with corner of eye. The eyes appear dry and lusterless. smooth without nodules. eye opening – to verbal command. Ears of equal size and similar appearance noted. grayish white arc or ring appears around the part of the cornea. with an RR of 32 cpm. Lymph nodes non palpable. Neurologic Status Glasgow Coma Scale of 10/15. Shortness of breath & dyspnea as well as use of accessory muscles upon breathing is observed. Neck symmetrical without masses and scars. E. Capillary refill returns within 3 seconds. non-tender & without lesions. Nose is symmetrical & straight. Pupil reaction to light and accommodation is normally symmetrically equal but less brisk. Denies malnutrition during childhood. Hair is gray in color.

watcher verbalized that client has scanty amount of urine about 30-50cc of urine per urination with the absence of blood and bloody urine was noticed after the insertion of the foley catheter. Denies presence of hemorrhoids. With surgical scar noted on left iliac region. Pallor is observed.crackles sounds heard per auscultation on both lung fields. The anteroposterior diameter of the chest widens. I. Gastrointestinal System Abdomen is round. Enlarged border on Right side of abdomen noted upon palpation as well as distention of bladder. With FBC attached to urobag draining a bloody urine @ 100 cc level within the shift. Prior to the insertion of the foley catheter. Urinary elimination normally once a day. Progressive lower extremity weakness noted after the patient complained of lumbosacral pain. Genito-Urinary System No bulging or masses that can be palpated in inguinal area. “Lubb-dubb” sound heard with increased intensity per auscultation. Clubbing of fingers not noted. . K. J. Blood pressure dramatically changes from the lowest taken BP of 140/80 & the highest was 150/100mmHg. Bladder is distended. H. Chest pain not noted. No presence of lesions in the genital area. Unable to verbalize pain upon urination. Use of intercostals retraction upon breathing. Cardiovascular System Cardiac rate plays around 80-90 bpm. Presence of bipedal edema noted. with symmetrical chest expansion. Musculoskeletal System Needs assistance in performing activities of daily living. Bowel movements usually experienced 1-2 times a day with soft and brown color stool on small amount as described by watcher. Scanty amount of pubic hair noted. Has history of hypertension. With O2 @ 3LPM via nasal cannula.


started with IVF of D5NSS 1L @ 120cc/o regulated and infusing well. Seen and examined by Dr.F. with IVF of D5NSS 1L @ 120cc/o. vital signs taken and recorded. watched out for any unusualities. regulated. 73 Soft diet 9:20a IVF D5NSS 1L @ 120cc/hr m RBS start Follow-up PSA .S. conscious. ECG and CXN done. needs attended to. lab exams requested. placed comfortably on bed. watched and cared for. ECG 12 leads. lab exams and medications followed up. diet. DOCTOR’S ORDER Admit under reverse isolation ward under onco/cardio v/s q4  Labs: CBC. and coherent in due to increase BP and body weakness. CXR-PA. COURSE IN THE WARD DATE SHIFT NURSE’S NOTES 07/28/ 09 311 8:00p m Admitted this 78 years old male patient awake. pH. RBS. L. PSA Start IVF with D5NSS 1L @ 120cc/hr Meds: • Captopril 50g now q6hrs if BP > 140/90 • Amlodipine 10g 1tab now OD 6am • Metoprolol 100g 1tab BID PO • Atorvastatin 80g 1tab OD @ HS • Moriamin S2 1tab TID Refer for persistent elevated BP LSLF diet Refer accordingly 9:50p m Received form ER per Tramadol 50mg for pain stretcher. vital signs checked and recorded. BT. U/A. 07/29/ 09 117 Received conscious and 11:00p responsive with IVF of D5NSS m @ 120cc/o – on. awake and q8 PO conscious.followed up labs. Watched out for signs of unusualities. Creatinine..L. Sanchez with new orders made.F. Serum elec. endorsed to NOD. Vital signs checked. needs attended to.

which aids in compensation by producing a base deficit.7 97.45) 45mmHg) 100mmHg) 26mmol/L) mmol/L) (95-100%) 7.8 88. the hyperventilation that causes respiratory alkalosis is followed by an increase in lactate and pyruvate in the blood. LABORATORIES AND DIAGNOSTIC EXAMS ARTERIAL BLOOD GAS 7-30-09 9:00am Ph (7. Bicarbonate reabsorption by kidneys is reduced and bicarbonate is excreted through the urine. RBS 7-29-09 TIME RESULT MED GIVEN REFERRED . compensation occurs by metabolic means.9 -9.2 Interpretation: partially compensated respiratory alkalosis Analysis: When a respiratory acid-base imbalance is present. Occasionally.G.35pCO2 (35PO2 (80HCO3 (22BE (2 O2 sat% 7.3 16. it is compensated for by a physiologically induced-metabolic disturbance. In primary respiratory alkalosis.43 17.

3 RESULT 21. Edar cSS cSS cSS HEMATOLOGY RESULT 116 NORMAL VALUE M: 140170g/L F: 120140g/L 5. Espina Dr.43 Normal Decreased Iron deficiency anemia NORMAL VALUE INTEPRETATION ANALYSIS .55-0. Edgar Dr. hemolytic anemia.34 B(+) RESULT 150400x109/L M: 0.2 32.50 F: 0.35 INTEPRETATION Decreased ANALYSIS Blood loss. bone marrow suppression.02-0.010.5 310.37-0. Concentration Segmenters Eosinophils Lymphocytes 9.7 10units IVTT HR given HR 15units IVTT HR 2units IVTT Dr.40-0.9 0.24 Normal Normal Decreased Adrenal corticosteroids and other immunosuppressive drugs.65 0.25-0.8 286 26.04 0. autoimmune diseases Thrombocyte Number Concentration Erythrocyte Volume Fraction Blood Group 7-30-09 EXAM NAME 257 0.7 470mg/dl 30.2:30pm 10:30pm 2:00pm 5:00pm 11:00pm 7-30-09 TIME 5:00pm 7:00pm 9:00pm 11:00pm 2:00pm 10:00am 7-28-09 EXAM NAME Hemoglobin Mass Concentration 27mmol 32.0x109/L 0. Edar MED GIVEN 10units HR 8units HR 4units HR 6units HR REFERRED Dr.73 0.1mmol/l 33.03 0.9 13. sickle cell anemia Leukocyte No.

04 Increased Decreased Neutrophils Eosinophils 0.2 Sodium Potassium Calcium 156.20 .43 Decreased Blood loss.0x109/L 0. malignant disease Stress and acute infection Associated with congestive heart failure.Hemoglobin Mass Concentration Leukocyte No.27 Color Transparency pH SG URINALYSIS RESULT Light yellow Clear 5.37-0.010.25 1. circulatory disease.01 Lymphocytes 0.25 M: 0.1 5. trauma.50 F: 0.13-1. autoimmune diseases iron deficiency anemia ELECTROLYTES 7-30-09 EXAM NAME Creatinine RESULT NORMAL VALUE M: 53.25-0.02-0. bone marrow suppression.35 Decreased Erythrocyte Volume Fraction 0.79 0. and aplastic and pernicious anemia Adrenal corticosteroids and other immunosuppressive drugs. infectious mononucleosis. sickle cell anemia Acute infection. hemolytic anemia.20 0. Concentration 87 M: 140170g/L F: 120140g/L Decreased Increased 14.0umol/L F: 44.6 3.65 0.0 10.5-5.32mmol/L INTEPRETATION ANALYSIS Increased Associated primarily with renal disease and obstructive urinary tract disease.096. hemorrhage.0umol/L 135-148mmol/L 3.55-0.3115.40-0. Increased Hypernatremia Decreased Hypokalemia Normal 240.0mmol/L 1.

55cm (53gms) and shows irregular borders.1 x 4. Both show normal corticomedullary parenchymal echotexture.7cm. The right kidney measures 9. Bilateral.: 09-1382 Exam: Abdomen and prostate Age: 78 years old Date: 07-30-09 Department: Medicine Service of: Dr.25cm. Hepatic vessels are normal. ANATOMY AND PHYSIOLOGY CARDIOVASCULAR SYSTEM .Pus cells Epithelial cells 0-2 occasional ULTRASOUND Name: Megatron Address: Sto. Spleen and pancreas are unremarkable. Urinary bladder is normal.05 x 4.6 x 5. Wall is not thickened. Intrahepatic ducts & CBD are not dilated. H. Impression: Fatty liver Grade 3 prostatic enlargement suggest PSA correlation Grade 1 hydronephrosis. Cuarte Abdominal UXD: A physiologically distended gallbladder is noted with no calcification within. The liver shows an echogenic but homogenous echotexture with no mass nor defects seen.85cm. Tomas. Prostate is enlarged measuring 4. while the left 9.85cm.1 x 4. With a cortical thickness of 1. Both central echo complexes show mild (Grade1) dilatation with no calcification seen. Dvo del Norte File No. with a cortical thickness of 1.

which separates the aortic vestibule from the lower part of the right atrium and upper part of the right ventricle.A. The right atrium receives deoxygenated blood from the superior vena cava and inferior vena cava. and thus can create the higher blood pressure. Comparing the left and right ventricle. the left ventricle has thicker walls because it needs to pump blood to the whole body. Ventricles have thicker walls than the atria. The greater portion of it is thick and muscular and constitutes the muscular ventricular septum. Heart Chambers The heart has four chambers. On the right side is the atrium that contains blood which is poor in oxygen. Its upper and posterior part. is thin and fibrous. and is curved toward the right ventricle. two atria and two ventricles. The left atrium receives oxygenated blood from the left and right pulmonary veins. . and is termed the membranous ventricular septum. Septum The interventricular septum (ventricular septum. This leads to the common misconception that the heart lies on the left side of the body. The atria are smaller with thin walls. or during development septum inferius) is the thick wall separating the lower chambers (the ventricles) of the heart from one another. and the left ventricle pumps blood into the systemic circulation for the rest of the body. while the ventricles are larger and much stronger. Atrium There are two atria on either side of the heart. The left atrium contains blood which has been oxygenated and is ready to be sent to the body. There are two ventricles: the right ventricle pumps blood into the pulmonary circulation for the lungs. Ventricles The ventricle is a heart chamber which collects blood from an atrium and pumps it out of the heart. The ventricular septum is directed backward and to the right.

are capable of auto regulation to maintain coronary blood flow at levels appropriate to the needs of the heart muscle. The coronary arteries that run on the surface of the heart are called epicardial coronary arteries. As discussed below. Although blood fills the chambers of the heart. the left and right. These arteries. PROSTATE GLAND The prostate is one of the male sex glands. and remove blood from. It lies just below the bladder and surrounds the beginning of the urethra. which is why blockage of these vessels can be so critical. the heart muscle itself. immediately above the aortic valve. is so thick that it requires coronary blood vessels to deliver blood deep into the myocardium. Together these glands secrete the fluids that make up .B. • Right coronary artery. seminal vesicles. when healthy. The other major sex glands are the testicles and semen. while the right coronary artery originates from the right aortic sinus. The vessels that supply blood high in oxygen to the myocardium are known as coronary arteries. In general there are two main coronary arteries. the muscle tissue of the heart. The normal prostate is about the size of a walnut. the left coronary artery originates from the left aortic sinus. The urethra is the tube that runs through the penis. or myocardium. The coronary arteries are classified as "end circulation". causing angina or a heart attack. It carries urine from the bladder and semen from the sex glands. Left coronary artery Both of these arteries originate from the beginning (root) of the aorta. Coronary Artery The coronary circulation consists of the blood vessels that supply blood to. The vessels that remove the deoxygenated blood from the heart muscle are known as cardiac veins. These relatively narrow vessels are commonly affected by atherosclerosis and can become blocked. since they represent the only source of blood supply to the myocardium: there is very little redundant blood supply.

LOCATION & DESCRIPTION Raises and lowers scrotum to help regulate temperature and promote spermatogenesis. The chief male hormone is testosterone. (< 1% of semen) Adjacent to the seminiferous tubules in the testicle. also helps raise and lower scrotum to help regulate temperature Part of the testes and connect Efferent ductules the rete testis with the Ducts for sperm to get to epididymis epididymis Begins at the vas deferens. the Colliculus seminalis. or expansion to Dartos muscle outside the external spermatic increase surface area available to promote heat fascia but below the skin loss. which is produced mostly by the testicles. . Responsible for production of testosterone. During ejaculation. Ejaculatory ducts passes through the prostate. and to help flush urethra. This fluid helps to lubricate the urethra the prostate on either side of the for spermatozoa to pass through. Covers the testes. out any residual urine or foreign matter. its growth is influenced by male sex hormones. semen passes through the ducts and exits the (2) and empties into the urethra at body via the penis. Causes reflex for ejaculation. Closely related to nerves.As the prostate is a sex gland. Voluntary and involuntary contraction. Overview of Male Reproductive System Structure and Function STRUCTURE Bulbourethral glands (2) Cells of Leydig (Interstitial cells of Leydig) Cremaster muscle FUNCTION Secretion of gelatinous seminal fluid called prePea sized organs posterior to ejaculate. Contraction by wrinkling to decrease surface area Layer of smooth muscular fiber available for heat loss to testicles.

Three columns of erectile tissue: two corpora cavernosa and one Male reproductive organ and also male organ of corpus spongiosum. Raise vaginal pH. mucus. Also called the testis from the adluminal "mother cells" or "nurse cells". semen first goes through a clotting process and then becomes more liquid. activated by FSH. and bulbourethral glands. provides both secretory and interstitial blood compartment of structural support. After ejaculation. efferent ducts to vas deferens. outside of body. Contain Convoluted structure attached to proteins. Seminal vesicles vas deferens near the base of flavins. hormones. semen. Seminiferous tubules (2) Long coiled structure contained Meiosis takes place here. and "seminal plasma". Sertoli cells Junctions of the Sertoli cells form the blood-testis barrier. phosphorylcholine and prostaglandins. creation of gametes in the chambers of the testis. a Cells responsible for nurturing and development of structure that partitions the sperm cells . gray or pink (blood stained).Epididymis Penis Tightly coiled duct lying just outside each testis connecting Storage and maturation of sperm. Testes Gonads that produce sperm and male sex Inside scrotum. Prostate gland Scrotum Semen Components are sperm. vitamin C. High fructose concentrations provide nutrient energy for the spermatozoa as they travel through the female reproductive system. Usually white but can be yellow. prostate. enzymes. slightly alkaline fluid the urinary bladder and can be constituting up to one-third of the volume of felt during a rectal exam. Seminal plasma is produced by contributions from the seminal vesicle. Surrounds the urethra just below Stores and secretes a clear. compartment of the seminiferous tubules. Urethra urination. About 65-75% of the seminal fluid in humans originates from the seminal vesicles. (2) the urinary bladder. joins with vas deferens.Production of testosterone by cells of Leydig in the testicles. (sperm). . passes through penis. fructose. Regulates temperature at slightly below body temperature.(25-30% of semen) Pouch of skin and muscle that holds testicles.

The prostate gland is comprised of 30–50 glands arranged in acini. Each tube is about 30 cm long. laterally by the puborectalis muscle. Connects bladder to outside body. Each passes arteries (Gonadal Supplies blood to the testes. and 3) central/periurethral zone. It Testicular is a paired artery. propelling sperm forward. anteriorly by the pubic symphysis. Sperm are transferred from the vas deferens into the urethra. . Muscular tubes connecting the left and right epididymis to the ejaculatory ducts to move sperm. obliquely downward and laterally arteries) behind the peritoneum. and posteriorly by the rectum. inferiorly by the urogenital diaphragm (containing the membranous urethra). Also passage for sperm. and is bounded superiorly by the bladder. collecting fluids from accessory sex glands en route Urethra Vas deferens The prostate is a glandular structure that weighs approximately 20 grams. During ejaculation the smooth muscle in the vas deferens wall contracts.Branch of the abdominal aorta. The prostate can be roughly divided into three different zones of tissue that include the 1) peripheral zone. 2) transition zone. The male reproductive system. Tubular structure that receives urine from bladder and carries it to outside of the body. which empty the prostatic secretion into the prostatic urethra. about 8 inches long.

however. which produce sperm. in the prostate gland of the young adult the peripheral zone is composed of glandular tissue (65%). The testes produce about 5–10 mg of testosterone each day. Negative feedback control . The hypothalamic-pituitary-testicular axis In response to the hormones secreted by the hypothalamus. follicle-stimulating hormone (FSH) and drenocorticotrophin (ACTH). and the central zone (25%). the pituitary gland secretes luteinizing hormone (LH). and subsequently exert their effects on the testes and adrenal glands. Most prostatic carcinomas develop in the peripheral zone. The final target organs in the hypothalamic-pituitary-testicular axis are the male gonads. FSH acts on the seminiferous tubules to promote sperm production. and is the site where benign prostatic hyperplasia tends to occur. while LH acts on the Leydig cells to stimulate production of testosterone. which is particularly sensitive to androgens. Each testis contains a network of seminiferous tubules. These hormones enter the circulation. which are converted into testosterone in peripheral tissues and in the prostate gland. the transition zone (10%). or testes. The growth and maintenance of the prostate gland is critically dependent upon testosterone.The function of these different zones is not clear. About 5% of total plasma testosterone is also produced by the adrenal glands. The central or periurethral zone appears to be most sensitive to estrogen. Between these tubules there is a system of testosterone-producing Leydig cells. ACTH stimulates the adrenal glands to produce the adrenal androgens androstenedione and dehydroepiandrosterone.

and binds to androgen receptors (AR) within the glandular cells. Free testosterone passes through the prostate cell membrane.5 times more potent as a male sex hormone than testosterone. where it is metabolized to dihydrotestosterone (DHT) by the enzyme 5-alpha-reductase. This complex of AR with DHT then targets DNA sequences. The overall effect is to reduce the amount of LH acting on the Leydig cells.Testosterone controls its own release via a negative feedback effect it exerts on the hypothalamic-pituitary-testicular axis. that activate various cell functions. Prostatic cell function Most testosterone (97%) circulates in the bloodstream. DHT is 2. The remaining 2– 3% of testosterone remains unbound. SYMPTOMATOLOGY Prostate Cancer CLINICAL MANIFESTATION • • • • • • Difficulty starting urination Interrupted flow of urine Difficulty in having an erection Painful ejaculation Pain when passing urine Feeling that your ACTUAL SYMPTOMS       Due to the presence of tumor in the prostate gland IMPLICATION . and is bound to one of two proteins. the hypothalamus reduces the secretion of LHRH. known as androgen response elements. and is thought to affect the glandular cells of the prostate gland. either sex hormone binding globulin (SHBG) or albumin. When testosterone levels in the bloodstream are raised. which inhibits the secretion of LH from the pituitary gland. therefore reducing testosterone secretion. I. including growth and proliferation.

• • bladder is not emptying completely when you urinate Nocturia Dysuria   Painful urination due to narrowing. The presence of red blood cells (erythrocytes) in the urine due to tumor. Breathing difficulty in due to compensatory mechanism of the body. • Hematuria  CORONARY ARTERY DISEASE CLINICAL MANIFESTATION • • • • • • • • • • • • Profuse sweating Restlessness Cold and clammy skin Shortness of breath Dizziness Nausea Vomiting A loss of consciousness Abnormal heartbeat Angina Heart murmur Heart attack ACTUAL SYMPTOMS             IMPLICATION Inability to relax or calm oneself due to improper oxygenation. HYPERTENSIVE CARDIOVASCULAR DISEASE CLINICAL MANIFESTATION • • • • Chest pain Confusion Irregular heartbeat Weakness ACTUAL SYMPTOMS     IMPLICATION Inability to exert force with one's muscles to the degree that would be . Impairment in spatial perception and stability due to poor oxygenation. obstruction and trauma to the passageway of the urine.

• • Dizziness Nausea    expected given the individual's general physical fitness due to poor oxygenation in the body. • • • • Abnormal accumulation of fluid beneath the skin. . overwork. Breathing difficulty in due to compensatory mechanism of the body. or in one or more cavities of the body. medication. • Fatigue • • • • • • Shortness of breath Nausea Anxiety Nose bleeds Vomiting Heart palpitations       LEFT VENTRICULAR HYPERTROPHY CLINICAL MANIFESTATION • • • • Chest pain Palpitations Dizziness Fainting Dyspnea Angina Abdominal discomfort Swelling (edema) ACTUAL SYMPTOMS         IMPLICATION Impairment in spatial perception and stability due to poor oxygenation. Breathing difficulty in due to compensatory mechanism of the body. Impairment in spatial perception and stability due to poor oxygenation. Physical and/or mental exhaustion that can be triggered by stress. or mental and physical illness or disease such as Hypertension.

While the exact reasons why one man gets Prostate Cancer and another man does not are unknown. More than 75% of all cases of Prostate Cancer are in men over 65 years of age. called androgens. the most prevalent being testosterone. There are risk factors that have been associated with the incidence of Prostate Cancer in certain populations: • The incidence of Prostate Cancer increases with age more rapidly than any other cancer. This occurs when cancer cells break away from a cancerous tumor and move through the blood and lymph nodes to other areas of the body. The average age of men newly diagnosed with Prostate Cancer is 70. however. • The risk of Prostate Cancer is twice as high for men of African descent as it is for Caucasian men. • . What is known. These abnormal cells can form a malignant (cancerous) tumor. and that the growth of Prostate Cancer is related to the male hormones. is an uncontrolled growth of abnormal cells. ETIOLOGY Prostate Cancer The exact cause of Prostate Cancer is unknown. the cancer can spread (metastasize) to other organs of the body. is that Prostate Cancer. In some cases.J. Family history: a man is more likely to develop Prostate Cancer if he has firstgeneration relatives (such as father or brother) who have been diagnosed with Prostate Cancer. like other cancers.

there are no symptoms caused by the cancer. call your doctor. and medical conditions. and other factors." Other dietary factors that may increase prostate cancer risk include low intake of vitamin E (Vitamin E is found in green. That is. since UV light exposure can increase vitamin D in the body. blood in urine or ejaculate. Autopsy studies of Chinese. omega-3 fatty acids (found in fatty fishes like salmon). and painful urination or ejaculation.Early Prostate Cancer is often asymptomatic. However. Lower blood levels of vitamin D also may increase the risk of developing prostate cancer. German. medical procedures. The primary risk factor is age. lifestyle. in particular trans fats resulting from the hydrogenation of vegetable oils. In the year 2005 in the United States. medications. there were an estimated 230. However. and minerals can contribute to prostate cancer risk. Israeli. the same series of studies showed that men with elevated levels of long-chain ω-3 (EPA and DHA) had lowered incidence. are associated with an increased prostate cancer risk. However.suite101. leafy vegetables).000 new cases of prostate cancer and 30. A long-term study reports that "blood levels of trans fatty acids. Prostate cancer is uncommon in men less than 45. difficulty starting or stopping Swedish. There are also some links between prostate cancer and medications. The average age at the time of diagnosis is 70. genetics. Jamaican. especially at night. Daily use of anti-inflammatory medicines such as .000 deaths due to prostate cancer. and in eighty percent of men in their 70s. A man's risk of developing prostate cancer is related to his age. and Ugandan men who died of other causes have found prostate cancer in thirty percent of men in their 50s. It’s important to note that these symptoms are not limited to Prostate Cancer. and may be indicative of another. and the mineral selenium. vitamins. diet. A study in 2007 cast doubt on the effectiveness of lycopene (found in tomatoes) in reducing the risk of prostate cancer. many men never know they have prostate cancer.cfm/17126/1004/2) The specific causes of prostate cancer remain unknown. Dietary amounts of certain foods. Men with higher serum levels of the short-chain ω-6 fatty acid linoleic acid have higher rates of prostate cancer. more advanced Prostate Cancer can cause symptoms including urination problems: a more frequent need to urinate. such as an infection. condition. race. If you experience any of the above symptoms. non-cancerous. (http://www. This may be linked to lower exposure to ultraviolet (UV) light. but becomes more common with advancing age.

More frequent ejaculation also may decrease a man's risk of prostate cancer. or naproxen may decrease prostate cancer risk. aneurysm (eg. and vasculitis (eg. syphilis). such as decreasing intake of animal fat.html) . ( obesity and elevated blood levels of testosterone may increase the risk for prostate cancer. Prostate cancer risk can be decreased by modifying known risk factors for prostate cancer. ibuprofen.html) Coronary Artery Disease Usually. infection with the sexually transmitted infections chlamydia.blogspot. in Kawasaki disease). Rare causes include coronary artery embolism. Less often. Finally. CAD is due to coronary spasm. In particular. or syphilis seems to increase risk. in gonorrhea. Infection or inflammation of the prostate (prostatitis) may increase the chance for prostate cancer. dissection. CAD is due to subintimal deposition of atheromas in large and mediumsized coronary arteries (atherosclerosis—see Arteriosclerosis). though others have shown no benefit. (http://www.merck. One study showed that men who ejaculated five times a week in their 20s had a decreased rate of prostate cancer. Use of the cholesterol-lowering drugs known as the statins may also decrease prostate cancer risk.

or glandular cancer.blogspot. (http://our-medical-center. a condition known as carcinoma in situ or prostatic intraepithelial neoplasia (PIN). or the tumor cells may develop the ability to travel in the bloodstream and lymphatic system. Prostate cancer most commonly metastasizes to the bones. This invasion of other organs is called metastasis. PATHOPHYSIOLOGY Written (Prostate Cancer) When normal cells are damaged beyond repair. Eventually. Cancer cells avoid apoptosis and continue to multiply in an unregulated manner. and bladder. Initially. they are eliminated by apoptosis. the tumor may grow large enough to invade nearby organs such as the seminal vesicles or the rectum.K. lymph Prostate cancer is classified as an adenocarcinoma. Over time these cancer cells begin to multiply and spread to the surrounding prostate tissue (the stroma) forming a tumor. that begins when normal semen-secreting prostate gland cells mutate into cancer cells. small clumps of cancer cells remain confined to otherwise normal prostate glands. rectum.html) Coronary Artery Disease . The region of prostate gland where the adenocarcinoma is most common is the peripheral zone. Prostate cancer is considered a malignant tumor because it is a mass of cells which can invade other parts of the body.

Rupture exposes collagen and other thrombogenic material. HCVD. which interrupts coronary blood flow and causes some degree of myocardial ischemia. L. actions and different nursing considerations with regards to the administration of the medications. Patient’s Prognosis After some point in time. a development of her present health status is anticipated. It also helped us understood the causes and effects of the diseases that enabled us to determine the predisposing and precipitating factors and traced the pathophysiology of these disorders. which activates platelets and the coagulation cascade. Reasons are unclear but probably relate to plaque morphology. plaque Ca content.Coronary atherosclerosis is often irregularly distributed in different vessels but typically occurs at points of turbulence (eg. SYNTHESIS OF THE CLIENT’S CONDITION/STATUS FROM ADMISSION TO PRESENT A. and plaque softening due to an inflammatory process. NIF. and in the renal arteries. SR. the arterial lumen progressively narrows. As the atheromatous plaque grows. We have also identified and formulated the nursing interventions that we could render to the patient that will help us attain our goal of care to our patient basing from the nursing care plan we have formulated. The degree of stenosis required to produce ischemia varies with O2 demand. This also had given us the knowledge to identify where and when it had started and how the disease progressed and we had also interpreted the laboratory and diagnostic exam results of the client and recognized the implication of it. Continuous administration of medications will result to termination of the signs and . We also identified the different pharmacologic treatments indicated to the condition. Prostate CA Stage III. Conclusion We therefore conclude that the study portrayed its importance and helped us know all about Hypertensive Urgency. considering the effects. B. LVH. It can cause mesenteric ischemia. Occasionally. an atheromatous plaque ruptures or splits. resulting in an acute thrombus. vessel bifurcations). CAD. depend on the location and degree of obstruction and range from unstable angina to transmural infarction. as the medical and the nursing management of the patient is constantly done. collectively referred to as acute coronary syndromes (ACS). resulting in ischemia (often causing angina pectoris). it can cause stenosis leading to hypertension. The consequences of acute ischemia.

3. His prescribed diet is a low-salt. Discharge Plan Medicine . low-fat diet. Client should take his prescribed medications religiously. Have an oral fluid intake with in cardiac tolerance. If you are taking medicine that makes you drowsy. like all other types of cancer. do not drive or use heavy equipment. C. herbs.Keep a written list of the medicines you take. Follow the prescribed diet. he is expected to be discharged. Lifestyle modification is also important in order to prevent the severity of the condition that will further contribute complications such as cessation of smoking and drinking alcoholic beverages. Furthermore. high blood pressure. Take the medications directly as prescribed. 4. prostate cancer. Visit his doctor regularly for constant check-ups and to continuously monitor his condition. D. the following measures are recommended: 1. and palpitations. . vitamins. And most probably after 3-7 days from the day of our interaction with him. is an incurable type of disease. Always take your medicine as directed by caregivers. and when and why you take them. vital signs are expected to stabilize. over-the-counter drugs. weight loss. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. and the form of therapy is only palliative which only alleviates the signs and symptoms of this disease. Learn why you take each medicine. Ask your caregiver for information about your medicine. weakness. 2. Do not skip doses or double up on missed doses. Do not use any medicines. 5. He must create a schedule in order for him to be guided as when to take the medicines and for him not to be able to forget in doing so. Bring the list of your medicines or the pill bottles when you see your caregivers. Recommendations On the basis of the findings of this study. dyspnic. or food supplements without consultation. the amounts. Do not quit taking your medicines until you discuss it with your caregiver.symptoms that was caused by the patient’s disease such as fatigue. However. bipedal edema. therefore client should avoid salty and fatty foods and client must take note that all canned goods are high in sodium even if it says that it is good for the heart.

It is also important to mobilize the client in order to prevent activity intolerance and prevent constipation. The food groups include breads. milk and milk products. ask your caregiver if you should add special drinks or vitamins to your diet. try eating foods that are soft or in liquid form. meat and fish). ask your doctor about ways to lessen the pain. You may need to make diet changes depending on your tolerance.Talk to your caregiver before you start exercising. Stay active. Tell your caregiver if you are nauseated. vegetables. the location of your cancer. Exercising makes the heart stronger. poultry. If pain keeps you from being active. Client should also observe regular hand and body hygiene to decrease the risk of acquiring infection. Your caregiver will tell you how much to take and how often to take it.Good oral hygiene and proper dental care apply to all age groups but the needs of the elderly population can be slightly different than the needs of younger people. Tell caregivers if the pain medicine does not help or if your pain comes back too soon. not only for the client but also for the client’s significant others. Furthermore. But you have hypertensive problems due to presence of a Coronary Artery Disease.0 Liters of liquid . if you have trouble swallowing. Active range of motion exercises are taught to the patient to avoid joint stiffness and promote proper circulation. Few steps and mobilization will help as well. Men 19 years old and older should drink about 3. and protein (beans. thus you should watch out with your diet and have a low sodium and low fat diet. or have other problems eating or digesting your food. Exercise helps keep your bones stronger. vomiting. The medicine may not work as well at controlling your pain if you wait too long to take it. Diaphragmatic breathing and coughing exercises will be demonstrated to lessen feeling of pain sensation and prevent atelectasis.You may be given medicine to take at home to take away or decrease pain. or treatment side effects. Do not wait until the pain is too bad before taking your medicine. Together you can plan the best exercise program for you. Eating healthy foods may help you feel better and have more energy.It is important that you get good nutrition when you have cancer. eggs. Take the medicine exactly as directed by your caregiver. It is best to start slowly and do more as you get stronger. Daily bath is recommended as well as frequent hand hygiene. fruits. lowers blood pressure.Exercise . Hygiene . Eat a variety of healthy foods from all the food groups. Avoid taking non-steroidal antiinflammatory medicines (NSAIDs). and keeps you healthy. Treatment . Diet .

we were also able to have a clearer view on how the disease affects the patient’s body by tracing the pathophysiology of the disease process and identifying the different organs involved by reviewing its anatomy and physiology. nationally and globally. The best liquids to drink have water. These liquids help your body hold in fluid and help prevent dehydration. Ask your caregiver what liquids are best to drink if you are on a low salt or low sugar diet. we were able to trace the history of her disease locally. We have come up with a comprehensive assessment of the patient’s biographical data. Women 19 years old and older should drink about 2. Try to drink enough liquid each day. and salt in them. EVALUATION OF THE OBJECTIVE OF THE STUDY After few days of conducting thorough study about the case of Megatron. By understanding fully the mechanism and effects of the disease to the patient. . we have come up with a discharge plan pertaining to the patient’s early recovery. You should also drink more liquids if you are exercising. M. And lastly. sugar.each day (close to 13 eight-ounce cups).2 Liters of liquid each day (close to 9 eight-ounce cups). these can also be counted in your daily liquid amount. Apart from that. cephalocaudal physical assessment as well as pertinent medical information with regards to the client’s health condition. Drink even more liquids if you will be outdoors in the sun for a long time. and not just when you feel thirsty. We have also identified and traced some medications and how these drugs affect the patient’s physiological functioning. such as coffee. we have interpreted different laboratory results related to her condition. Appropriate therapeutic care was well planned and provided to the client. If you are used to drinking liquids that contain caffeine.

org/HIC/Anatomy/ itemId=2617452&nav=yes.prostateline. Lippincott Williams and 10th Edition Internet 1. 11th Edition. Smeltzer. 2..dirtybananas. 2004 OctDec. 2004 Jun. http://davaotoday. © 2008.texasheartinstitute. et. Volume 1 and 2. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing. al. http://www. 5(4):401-5. 3. 11th Edition 3. Suzanne C.pdf 6. BIBLIOGRAPHY Book 1. 7(2):120-32. 5.cancerline. Davis’ Drug Guide. 7. http://www. http://www. Nurse’s Pocket Guide. Source: Asian Pacific Journal of Cancer Prevention: Apjcp.cfm .N. Source: Aging Male. Changing trends of prostate cancer in Asia. 2. 4.

com/2007/12/prostate-cancer. http://74. (http://our-medical-center.153.dlshsi.blogspot.125.html) 10.html) .8. +Davao+Del+Norte&cd=5&hl=tl&ct=clnk&gl=ph 9. ( Region11-Agenda. http://our-medical-center.cfm/17126/1004/2) q=cache:3MIOUR5r0KAJ:www.suite101.

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