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Submitted by: Cathleen Joy V. Angeles Submitted to: Sir Roy Quito BSN 3A

2013 My objectives for today is to become familiar in the different facilities in Philippine Orthopedic Center and services that are being held in this hospital and also to be able to learn and follow the rules/regulations and policies that is being implemented in the Philippine Orthopedic Center. I have learned more about the POC. included also that the orientation had started late. I see to it that I was focusing only to the speaker. At the last day of our duty in POC. total bed capacity. the administrators and the rules and regulations. especially when it was the time to demonstrate to all of us the application and removal of balance skeletal traction.DATE: Feb. we were only having our orientation in Philippine Orthopedic Center. It really makes it easy for me to understand BST while I was listening attentively. It was just the start of the clinical exposure so I think. This exposure will also give us great experiences that I am sure we will cherish and keep in our minds. Today. But maybe the large number of different colleges makes it difficult for me to listen to the orientation. No interruptions are being entertained while listening and my eyes are kept open to prevent sleeping. Actually. My exposure in POC will help me to improve my skills in caring for a patient. I have no specific problem in the first day of duty (orientation). in this day we will just be freshening up about the POC. we are going to perform BST so I intently observe the two speakers while they teach us the application and removal of BST to be able to understand the whole procedure. We waited for about 2 ½ hours for the orientation In order for me to catch up in the orientation. 18. different services. Their history. .

more people are becoming prone to accidents. . braces and tractions). braces are used as a mechanical support for weakened muscles while casts are used for immobilization. These pictures really help us to become more familiarize with the different gadgets. But because of our requirements in POC (pictures of different casts. I have learned the different classification of fractures and what are the nursing responsibilities in a patient with fracture. To provide proper nursing care of patient with brace. like the application of traction. tractions and casts. So today. Tractions are used to correct deformities. tractions and casts. Some types of the brace. 2013 OBJECTIVES:    To enhance my interpersonal skills To be able to identify different types of braces. brace or a cast. Different nursing care of a patient with fracture is being introduced. because while we were discussing. 19. cast and traction were not available in POC. So we didn’t see those who were not available. tractions and braces. we were able to identify those gadgets that were not available. Another problem encountered is that some of the gadgets are not sufficient. But this kind of problem is lesser only because almost all gadgets are present in the rooms. cast and traction We have discussed about fractures and the different types of braces. another clinical instructor enters in our room to get some gadgets that were not available in their room. It helps us to be able to memorize quickly the different types of casts.DATE: Feb. just some of the few gadgets were not. Nowadays.

20. wires. Problems encountered were limited time in discussing the hardwares. while external includes the RAEF. so. Our clinical instructor also discussed to us different hardwares. I learned for today. to identify different types of hardware including their indications. In case of the unavailable instrument. which is only for 30 minutes and also the unavailability of the other hardware instrument.DATE: Feb. Hardware is either external or internal. ilizarov etc. I reported HNP which is also known as “slipped disk”. plates and nails etc. . to be able to learn how to prioritize my nursing care to my patient and to be able to properly report HNP to my fellow classmates. The pictures that we have are really helpful for us in studying different gadgets and hardwares. Internal includes pin. we can just look in the pictures that we have research and then we can now identify what is the image of that hardware. delta frame. 2013 My objectives for this day are to identify different types of hardware. So today.

. maybe like limited time in providing nursing care to our patient. to prevent possible injury. And patient with this kind of disease also experiences some signs and symptoms of PTB. Sometimes we were just rendering morning care to our patient. Problems. we’ve also discussed “Pott’s Disease. we have two patients with this kind of disease. 26. In the children’s ward.DATE: Feb. Before we went to the children’s ward. This was the area that I like the most because children are fun to take care of. 2013 After this duty I hope I was able:     To master memorizing and familiarizing all the gadgets and hardwares To improve my interpersonal relationship with my patient To provide proper nursing care to all of my patient and also to attend all of their needs To become more responsible as a student nurse Today. Some of our patient. Sometimes we assist them in whatever they were doing like maybe in ADLs. we were just interviewing them about the history of their illness and we provide them health teachings and other nursing responsibilities. We provide important health teachings to our patients.” which is also known as tuberculosis in the spine. developing the trust of your patient or rapport is also important so that the patient will be able to tell you all his/her concerns regarding his/her health. Of course. We have also observed application and removal of cast in the OPD section. we are assigned in the children’s ward. I have seen that this disease really shows signs of weight loss because one of our patients is very thin.

2013 Patient was transferred here in POC. . Instruct the patient to do finger exercises and moved the affected part through its range of motion to maintain function or to improve mobility. Immediately brought to Makati Medical Center. 2013 DIAGNOSIS: Avulsed of biceps and forearm flexion with ulnar radial artery transection S/P AS Repair Nursing History:  2 days prior to admission Patient had an accident.  Feb. Encourage the patient to elevate the affected part to help relieve the pain. odors from the cast and purulent drainage staining the cast. including also his left arm. the left sleeve of his shirt was caught by the mixer.CLINICAL CASE ANALYSIS NAME: Dominador Aquileña AGE: 46 y/o SEX: Male STATUS: Married DATE ADMITTED: Feb. motion and sensation of the affected extremity and compare them with the opposite extremity. 8. Monitor the circulation. Keep the cast dry but do not cover with plastic or rubber which may cause condensation that will dampen the skin and cast. 8. Perform regular assessment of neurovascular status. Surgical Procedures:  Ulnar radial artery transection Nursing Responsibilities:        Assess the level of pain associated with musculoskeletal problems. Observe the patient for systemic infection. While cleaning a mixer truck.

16. protein. vitamin C and calcium and to also increase fluid intake. Comp. displaced intertrochanteric femur right Nursing History:  1 day prior to admission Patient falls from standing in a chair.CLINICAL CASE ANALYSIS NAME: Elena Abella AGE: 68 y/o SEX: Female STATUS: Married DATE ADMITTED: Feb.  Encourage the patient to increase intake of foods rich in fiber. o o o o  Skin care Changing of linens or slings Provide bedpan/urinal as needed Perineal care Provision of exercises o o o ROM exercises with the use of trapeze Deep breathing exercise Toes pedal exercises. 2013 DIAGNOSIS: Fracture Cl. . Surgical Procedures:  With balance skeletal traction Nursing Responsibilities:  Emphasize on the importance of good hygiene. Patient experienced severe pain that leads to consult in POC.

Surgical Procedures:  Partial Hip replacement arthroplasty right Nursing Responsibilities:   Encourage to elevate the affected extremity to immobilize. Consulted to other clinics. Encourage the patient to move toes hourly when awake to stimulate circulation. Note odors around the cast.     Report broken cast to the physician. stained areas. do not attempt to fix it yourself. . Cl.CLINICAL CASE ANALYSIS NAME: Sinegunda Subong AGE: 90 y/o SEX: Female STATUS: Married DATE ADMITTED: Jan. Then transferred here in POC. Comp. displaced intertrochanteric femur right Nursing History:  3 days prior to admission Patient falls while standing on a chair. 2013 DIAGNOSIS: Fx. Report them to the physician. Thoroughly clean the skin and treat it as prescribed. warm spots and pressure areas. 9. Teach the patient with leg cast to “push down” the knee.

Assist patient in applying the brace and to protect the skin from irritation and breakdown. Reassure the patient that minor adjustments of the brace by the orthotist will increase comfort and minimize problems associated with its long term used. Encourage for early ambulation.  2 years prior to admission: Patient started limping due to his low back pain. Progressive of low back pain lead patient to seek consult at POC and admitted surgical intervention. Surgical Procedures:  Posterior Decompression. 8. Maintain body alignment. 2013 DIAGNOSIS: Lumbar spinal stenosis Nursing History:  5 years prior to admission: Patient strained his back carrying a pump boat. L5-S1 Nursing Responsibilities:       Assess neurovascular status.CLINICAL CASE ANALYSIS NAME: Dionisio Recafor AGE: 45 y/o SEX: Male STATUS: Married DATE ADMITTED: Jan.  Gradual increase of daily activities as tolerated. No consult initially. . Posterior Lumbar Interbody Fusion L4-L5. Encourage to wear brace as prescribed.

Assist patient o identify areas of self-care deficit and in developing strategies to achieve independence in ADL’s . spinal level C6 etiology to be determined Nursing History:  4 months prior to admission Patient strained his cervical and lumbar area due to fall in the clothes line. Nursing Responsibilities:        Encourage patient to ambulate with assistance. but avoid walking on wet. Can move as normally as possible.   3 months prior to admission Patient experienced numbness of the lower extremities 2 months prior to admission Patient was unable to walk lead to seek consult at PGH. Emphasize importance of proper hygiene. Encourage toe and finger exercises.CLINICAL CASE ANALYSIS NAME: Juary Ray Gayos AGE: 9 y/o SEX: Male STATUS: Single DATE ADMITTED: Jan. 10. Instructed to continue taking medications as ordered. No consult initially. or slippery floors. Surgical Procedures:  No surgical procedure done. Transferred to National Children’s… then to POC. Gradual increase of daily activities as tolerated. 2013 DIAGNOSIS: T/C Acute spinal injury inc. Assess neurovascular function.