VIRGEN MILAGROSA

COLLEGE OF NURSING
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Case Study (Hydatidiform Mole)

I. GENERAL INFORMATION:
Name: L. A. R.
Admission Date: 02/13/2020
Admission Time: 2:13 PM
Admitting Physician: Dr. Callao
Chief Complaint: Vaginal Spotting
Admitting Diagnosis: G1P0 Molar Pregnancy 6 1/7 wks.
Pathophysiology
Hydatidiform mole (also known as molar pregnancy) is a subcategory of diseases
under gestational trophoblastic disease (GTD), which originates from the placenta and
can metastasize. It refers to the abnormal growth of the chorion which is the outermost
vascular membrane that during a normal pregnancy would enclose the embryo and
ultimately give rise to the placenta. In the situation in which the hydatidiform mole
develops, the embryo is usually either absent or dead. The mole, a collection of sacs
(cysts) containing a jellylike substance, resembles clusters of grapes and can attain a
great size. Most of the moles are expelled in about the 20th week of pregnancy.
It is categorized as a complete and partial mole and are usually considered the
noninvasive form of gestational trophoblastic disease. In a “complete mole,” no normal
fetal tissue forms. In a “partial mole,” incomplete fetal tissues develop alongside molar
tissue. Although hydatidiform moles are usually considered benign, they are
premalignant and do have the potential to become malignant and invasive. In extremely
rare instances, hydatidiform moles develop into choriocarcinomas, which are highly
malignant tumors.
The risk to molar pregnancy appears to be higher in pregnant women who are
younger than age 20 or older than age 40 and of Asian heritage. The most common
symptom is vaginal bleeding, especially between the 6th and 16th weeks of pregnancy;
which is sometimes accompanied by a piece of tissue containing grapelike shapes. Other
signs and symptoms include increase level of hCG, marked nausea and vomiting, rapid
increase in fundic height, no FHT, and signs of PIH before 20th weeks of gestation.
Management includes preoperative evaluation which attempts to identify known
potential complications such as preeclampsia, hyperthyroidism, anemia, electrolyte
depletions from hyperemesis, and metastatic disease. The molar pregnancy is usually
terminated by suction curettage or manual vacuum aspiration. Other treatment and
management for molar pregnancy includes prophylactic treatment of methotrexate,
monitoring of hCG levels such as urinalysis for 1 year, and advising the patient to avoid
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becoming pregnant for one year after diagnosis to ensure that the mole has been
completely removed.
II. DEVELOPMENTAL DATA:
The 6th Stage of Erik Erikson's Theory of Psychosocial Development referred to as the
Psychosocial Crisis Stage of Intimacy vs. Isolation that takes place during the life stage of Young
Adulthood between the ages of approximately 18 to 40 years old has been correlated to the
patient’s age who is 20 years old. According to this stage, as youth move even deeper into
adulthood, developing intimate relationships becomes particular salient. In connivance to the
said description, the patient is in the Stage of Young Adulthood indicative that she is in the
psychosocial stage of Intimacy vs. Isolation that is completely determined by interpersonal
relations. Erikson explained this stage also in terms of sexual mutuality - the giving and
receiving of physical and emotional connection, support, love, comfort, trust, and all the other
elements that would typically associate with healthy adult relationships conducive to mating and
child-rearing. People of the other gender are no longer desired solely as sex objects but as people
who are capable of being loved non-selfishly. Love is the virtue that is developed upon resolving
the crisis in this stage. Erikson stated that avoiding intimacy, fearing commitment and
relationships can lead to isolation, loneliness, and sometimes depression which is clearly not
evident on the verbal and non-verbal expressions of the patient while establishing rapport with
her through interviews. The need for friendship and sexual expression gets combined during this
stage; and long-term and intimate relationship becomes the primary focus which is evident to the
patient’s verbalization that she is in a relationship with someone in the opposite sex. The
building of friendship to inner circles and intimate relationship to the opposite sex as verbalized
by the patient is clearly a manifestation of the major developmental focus that is being described
by Erikson in the 6th Stage of his 8 Theory of Psychosocial Development which is the Stage of
Intimacy vs. Isolation in Young Adulthood.
III. HEALTH HISTORY:
A. FAMILY HISTORY
Maternal
(-) DM (+) Alcohol Intake

(-) HPN (-) Smoking

Paternal
(-) DM (+) Alcohol Intake
(+) HPN (+) Smoking
B. PAST MEDICAL HISTORY
(-) Comorbids (-) Smoking (-) Previous CS
(+) Heart Disease (-) Surgical History
(-) Alcohol
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C. PRESENT ILLNESS
2 days prior to admission with vaginal spotting; with palpable mass and
hypogastric pain.
Physical Exam:
Skin: Essentially normal (Normal turgor)
Head: Essentially normal (Normocephalic)
Eyes: Essentially normal (Anicteric sclera)
Nose: Essentially normal (No bleeding)
Neck: Essentially normal (No mass)
Chest: Essentially normal (Symmetrical chest expansion)
Heart: Essentially normal (No murmurs)
Lungs: Essentially normal (No wheezes/crackles)
Abdomen: Uterus is larger than normal, no fetal parts palpable
Genito-Urinary System: Closed cervix
Nervous System: Essentially normal (GCS: 15)
IV. MEDICAL TREATMENT AND MANAGEMENT INCLUDING DIAGNOSTIC
PROCEDURES AND ITS INTERPRETATION TO NURSING
Clinical Diagnosis:
 Admitting Diagnosis: G1P0 Molar Pregnancy 6 1/7 wks.
 Complete Final Diagnosis: G1P0 (0010) Molar Pregnancy Partial
 Other Diagnosis: Anemia, corrected
Principal Operation/ Procedure: Suction Curettage
Urinalysis Result

Performed: 02/13/2020, 12:22 PM

Requesting Physician: Dr. Emelyn Prado

RESULT RESULT
Color: Dark Yellow Pus Cells: /HPF 15-30 (glitter cells)
Transparency: Hazy Red Cells: /HPF 8-10 (dysmorphic)
Reaction/ pH: 7.0 Epithelial Cells: /LPF Many
Specific Gravity: 1.010 Amorphous Urates/ PO4: /LPF Moderate
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Protein: Negative Mucus Thread: /LPF Few

Glucose: Negative Bacteria: /HPF Few
Ketone: Negative Crystal: /LPF
Urinalysis Result

Date: 02/15/2020
Requesting Physician: Dr. Callao

Physical
Color: Yellow
Transparency: Hazy
Microscopic
1. Epithelial Cells: Tubular Squamous Few/ 1 sq.
2. Pus Cells: 15-20
3. Red Blood Cells: 2-5
hpf
4. Bacteria: None
5. Yeast cells:
6. Mucous Threads: Moderate
7. Trichomonas vaginalis:
8. Crystals:
9. Fungi:
10. Amorphous Urates: Few
11. Amorphous Phosphates:
Chemical
Protein:
NEGATIVE (-)
Glucose:
Specific Gravity: 1.010
pH: 6.0
Pregnancy Test:
Nursing Interpretation:
Often, the results of UA give more clues about the content and consistency of the
patient’s urine as it identifies pathology of the urinary tract and may identify metabolic
abnormalities as well. Upon admission, the patient’s UA indicates an appearance of hazy, instead
of the normal clear transparency which may be due to the presence of few bacteria and increased
amount of WBCs/ pus cells with 15-30 (glitter cells) as well as dysmorphic RBCs noted in the
test; and a normal dark yellow-colored urine due to the urochrome. In her subsequent UA, hazy
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transparency and a yellow-colored urine is still seen; however, subsequent microscopic UA exam
showed the absence of bacteria which is indicative of a normal finding, compared to the first test.
A decreased amount of 15-20 pus cells is also noted in the subsequent test compared to the first,
but is still a factor in giving the hazy transparency of the urine.
During the first UA test, red cells/HPF is also dysmorphic with a result of 8-10 which is
higher than the normal result ranging from 0-5 RBCs/HPF; but has been normalized during the
subsequent microscopic UA test with a result of 2-5 RBCs/HPF. Epithelial cells during the
admission (1st test) also reported as “many” are present per LPF which is caused by the patient’s
condition upon admission, but gradually normalized during the subsequent UA test reported as
“tubular squamous few/ 1 sq” from a normal range of 1-5 squamous. Other findings in the UA of
the patient is indicative of a normal result, such as the specific gravity (1.010), pH (7.0 | 6.0),
protein, glucose and ketone (negative). Baseline/normal findings are based from:
 Color: Light yellow-dark amber
 Transparency: Clear
 pH: 4.6 – 8.2
 Specific Gravity: 1.005 – 1.030
 Pus Cells: Male: <4 /HPF | Female: 5-7 /HPF

Hematology
Test Time: 02/13/2020, 3:00 PM
Requesting Physician: Dr. Callao

Parameter Result Unit Ref. Range

RBC L 2.74 10^12/ L 3.50 – 5.50
HGB L 85 g/L 110 – 160
HCT L 25.0 % 37.0 – 54.0
WBC H 13.09 % 4.00 – 10.00
Neu % H 84.7 % 50.0 – 70.0
Lym % L 10.0 % 20.0 – 40.0
Mon % 5.2 % 3.0 – 12.0
Eos % L 0.1 % 0.5 – 5.0
Bas % 0.0 % 0.0 – 1.0
PLT H 361 10^9/ L 150 – 300
MCV 91.2 fL 80.0 – 100.0
MCH 31.0 pg 27.0 – 34.0
MCHC 340 g/L 320 – 360
RDW-CV 12.3 % 11.0 – 16.0
RDW-SD 42.6 fL 35.0 – 56.0
MPV 7.1 fL 6.5 – 12.0
Bleeding mins.
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Clotting mins.
ABO O
RH Positive
ESR
Hematology
Test Time: 02/21/2020, 2:57 AM
Requesting Physician: Dr. Callao

Parameter Result Unit Ref. Range

RBC 4.11 10^12/ L 3.50 – 5.50
HGB 115 g/L 110 – 160
HCT L 35.3 % 37.0 – 54.0
WBC 9.61 10^9/ L 4.00 – 10.00
Neu % 65.9 % 50.0 – 70.0
Lym % 25.4 % 20.0 – 40.0
Mon % 6.8 % 3.0 – 12.0
Eos % 1.9 % 0.5 – 5.0
Bas % 0.0 % 0.0 – 1.0
PLT 163 10^9/ L 150 – 300
MCV 85.8 fL 80.0 – 100.0
MCH 28.0 pg 27.0 – 34.0
MCHC 326 g/L 320 – 360
RDW-CV 15.8 % 11.0 – 16.0
RDW-SD 51.4 fL 35.0 – 56.0
MPV 8.3 fL 6.5 – 12.0
Bleeding mins.
Clotting mins.
ABO
RH
ESR
Nursing Interpretation:
Hematology tests which includes the RBC lab values, along with the indices, are used to
diagnose conditions such as anemia, infection and many other disorders including the severity of
bleeding, through comparison and calculation of lab values for the individual characteristics of
the blood cells.
From the 1st hematology test conducted upon admission, the patient presents with a low
level of RBC (2.74 10^12/L), HGB (85 g/L) and HCT (25.0%) indicative of anemia as part of
the other signs of molar pregnancy. Determining the level of HCT is relevant to the patient’s
condition as it is used to diagnose and monitor anemia and to check the severity of ongoing
bleeding related to the chief complaint of the patient upon admission which is vaginal bleeding.
The patient also presented a high platelet count of 361 10^9/L which indicates anemia. The
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results also presented a high level of WBC count of 13.09% which may be due to the effect of
molar pregnancy and the stress and pain experienced as verbalized by the patient prior to and
upon admission. In terms of WBC differential, low level of Lym (10.0%) and Eos (0.1%) and
high level of Neu (84.7%) has been noted. Low level of lymphocytes and eosinophils as well as
the high level of neutrophils is relative to the immune system’s stress response in regards to the
patient’s condition. The results of the other parameters in hematology test of the patient indicates
a normal result, such as the basophils, monocytes, red cell indices, RDW, and MPV, as seen
from each of their normal reference ranges. The blood type of the patient is also indicated in the
test which is O positive.
The 2nd hematology test performed indicates that the anemia of the patient as diagnosed
by the physician has been corrected as manifested by normal results of almost all of the
parameters of the test as compared to the abnormal findings from the 1 st hematology test.
However, the patient is still having a low hematocrit level of 35.3% based from the normal
values of 37.0-54.0% indicating that the patient may still be experiencing blood loss related to
vaginal bleeding from the time the test was performed.
Complete Blood Count (CBC)

Performed: 02/13/2020, 12:18 PM

Requesting Physician: Dr. Emelyn Prado

TEST RESULT REFERENCE

WBC 11.63 5.00 – 10.00 10^9/L
NEUTROPHIL % 75.0 50.0 – 70.0 %
LYMPHOCYTE % 16.1 20.0 – 40.0 %
MONOCYTE % 8.6 3.0 – 12.0 %
EOSINOPHIL % 0.1 0.5 – 5.0 %
BASOPHIL % 0.2 0.0 – 1.0
RBC 2.78 3.50 – 5.00 10^12 L
HEMOGLOBIN 84 120 – 160 g/L
HEMATOCRIT 23.6 37.0 – 48.0 %
MCV 85.0 82.0 – 95.0 fL
MCH 30.1 27.0 – 31.0 pg
MCHC 354 320 – 360 g/L
PLATELET 322 150 – 450 10^9 L

Nursing Interpretation:
Complete blood count is one of the most basic laboratory examinations to assess the
overall health status of a patient. It can help diagnose infections, autoimmune disorders, anemia,
and other blood diseases. As found in the test upon admission, there is a higher than normal
result of WBC (11.63 10^9/L) and neutrophil (75.0%) which may be a stress response of the
patient’s immune system along with low levels of lymphocytes (16.0%) and eosinophil (0.1%)
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concerning the chief complaint of vaginal bleeding associated with molar pregnancy. Monocytes
and basophils in the WBC differential have a normal result from the test. Manifested also in the
test are the low levels of RBC (2.78 10^12L), HGB (84 g/L), and HCT (23.6%) which is
indicative that the patient has anemia as diagnosed by the physician. Red cell indices and platelet
count of the patient fall from the normal range as seen in each of the reference ranges.
Clinical Chemistry

Performed: 02/13/2020, 12:22 PM

Requesting Physician: Dr. Emelyn Prado

TEST RESULT REFERENCE

FASTING BLOOD SUGAR (FBS) 3.9 to 5.8 mmol/L
CHOLESTEROL <= 5.2 mmol/L
URIC ACID (BUA) 89.25 to 416 µmol/L
MAGNESIUM (Mg ++) 1.3 to 2.5 mEq/L
BUN 3.99 2.5 – 6.3 mmol/L
CREATININE 51.82 35.4 – 132.6 µmol/L
SGPT (ALT) 49.2 Up to 38.0 U/L
SGOT (AST) 25.0 Up to 40.0 U/L

Date: 02/15/2020
Requesting Physician: Dr. Callao

Test Normal Values Result

Glucose 3.60 – 5.83 mmol/L
Total Cholesterol 0.0 – 5.2 mmol/L
High Density Lipoprotein 0.0 – 1.6 mmol/L
Low Density Lipoprotein 0.0 – 3.88 mmol/L
Very Low Density Lipoprotein 0.0 – 0.91 mmol/L
Triglycerides 0.11 – 2.32 mmol/L
Blood Urea Nitrogen 2.5 – 7.1 mmol/L
Creatinine 71 – 133 mmol/L
Total Protein 60 – 80 g/L
Albumin 35 – 50 g/L
Globulin 23 – 35 g/L
A/G Ratio 1.5 – 2.5
Aspartate Aminotransferase
14 – 59 u/L
(AST)
Alanine Aminotransferase
9 – 172 u/L
(ALT)
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Alkaline Phosphatase 38 – 126 u/L

Total Bilirubin 3.4 – 22.0 ummol/L
Unconjugate Bilirubin 0.0 – 19 ummol/L
Direct Bilirubin 0.0 – 7 ummol/L
Blood Uric Acid 207 – 506 mmol/L
Lactate dehydrogenase 313 – 618 u/L
Amylase 28 – 100 u/L
/ Sodium 135 – 148 mmol/L 140.1
/ Potassium 3.5 – 5.3 mmol/L 3.57
/ Chloride 98 – 107 mmol/L 109.1
Calcium 2.10 – 2.54 mmol/L
Phosphorus 0.81 – 1.45 mmol/L

Nursing Interpretation:
Among the clinical chemistry tests done to the patient upon admission (1 st test), Serum
Glutamic-Pyruvic Transaminase is found to be slightly elevated with a result of 49.2 U/L from a
reference of up to 38 U/L compared to the Serum Glutamic-Oxaloacetic Transaminase (25.0
U/L) of the patient indicating a normal finding that is performed along with SGPT. AST and
ALT are considered to be two of the most important tests to detect liver injury, although ALT is
more specific for the liver than AST and is more commonly increased than AST. An AST/ALT
ratio is calculated which may be used to distinguish between different causes of liver damage
and to distinguish liver injury from damage to heart or muscle. The result of the BUN (3.99
mmol/L) and creatinine (51.82 µmol/L) levels of the patient also falls from the normal range of
values which indicates that the patient’s kidneys are functioning as they should.
The 2nd clinical chemistry tests of the patient are focused upon sodium (140.1 mmol/L),
potassium (3.57 mmol/L) and chloride (109.1 mmol/L) which are the serum electrolytes of the
body. Sodium and potassium levels of the patient both resulted to a normal finding; however, the
chloride levels of the patient manifested a slight increase from the normal values.
Blood Chemistry

Date: 02/15/2020
Requesting Physician: Dr. Callao

METHOD RESULT UNIT REF. VALUE REMARKS

ALT 55.2 U/L 0.0 – 34.0 High
AST 56.2 U/L 0.0 – 31.0 High
CREA 41.0 µmol/L 62.0 – 106.0 Low
UREA 1.57 mmol/L 2.80 – 7.20 Low

Nursing Interpretation:
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There is a high level of ALT (55.2 U/L) and AST (56.2 U/L) in the blood of the patient as
seen from the set of reference values. As obtained from the patient during NPI, she has a history
of heart disease, as well as considering also her present condition of molar pregnancy which may
be the reason why these tests have been performed, along with checking for the condition of the
patient’s liver. With heart or muscle injury, AST is often much higher than ALT and levels tend
to stay higher than ALT for longer than with liver injury. A low level of crea (41.0 µmol/L) and
urea (1.57 mmol/L) has also been found as compared to the set of reference values indicated.
Blood Typing

Date: 02/13/2020, 12:18 PM

Requesting Physician: Dr. Callao

PARAMETERS RESULT
Blood Type/ Rh “O” Rh POSITIVE

Nursing Interpretation:
Blood typing is the determination of major blood group a person belongs to. (ABO
system). Blood typing in the ABO system, and others, involves the identification of specific
proteins that are contained in the blood. From the test performed, the patient has an “O” Rh
Positive blood type.
Crossmatching

Date: 02/13/2020
Requesting Physician: Dr. Callao

Patient/Donor’s Blood Type: ABO “O” Crossmatching: Unit Serial No. 2428-09846-5
Rh Positive
Source: PRC
Extraction Date: 1/31/20
Expiration Date: 3/05/20
Result: Compatible
Amount: 1 unit
Blood Report: WB/ PRBC

Date: 02/14/2020
Requesting Physician: Dr. Curiose

Patient/Donor’s Blood Type: ABO “O” Crossmatching: Unit Serial No. 2400-007232-5
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Rh Positive
Source: Philippine Red Cross
Extraction Date: 2/12/20
Expiration Date: 3/18/20

Amount: 1 “u” 250 mL Result: Compatible

Blood Report: PRBC
Crossmatching

Date: 02/15/2020
Requesting Physician: Dr. Callao

Patient/Donor’s Blood Type: ABO “O” Crossmatching: Unit Serial No. 2400-0067 08-5

Rh Positive

Source: PRC

Extraction Date: 1/3/20

Expiration Date: 3/6/20

Amount: Result: Compatible

Blood Report: 1 unit WB

Nursing Interpretation:

Crossmatching is a comparison test performed on whole blood in order to ensure

compatibility of transfused blood. Since there are many known and unknown antibodies in the
blood, crossmatching is done as a final step before transfusing blood. Simply stated, a
crossmatch involves the actual mixing of a sample of the donor’s blood with that of the
recipient’s blood. The mixed samples of blood are then observed for any agglutination which
might occur. The process takes 45 minutes to one hour to watch for a reaction.
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CSF/ Typhidot/ Leptospira/ Dengue Test/ Screening Test

Date: 02/13/2020
Requesting Physician: Dr. Callao

CEREBROSPINAL FLUID DENGUE TEST

Appearance: _________ IgG: _________
CELL COUNT IgM: _________
RBC Count: _________ /cu.mm LEPTOSPIRA TEST
WBC Count: _________ /cu.mm IgG: _________
DIFF. COUNT IgM: _________
Polymorphs: _________ SCREENING TEST RESULT
Lymphocytes: _________ HBsAg: ________
Protein: _________ HCV: ________
Glucose: _________ RPR: ________
Cob Web Formation: _________ HIV: ________
Others: _________
ASO Titer: ________ Todd units
TYPHIDOT
IgG: ________
IgM: ________
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Attending Physician: DR. PALISOC Date: 02/13/2020

LMP: 12-04-19

ULTRASOUND REPORT

TRANSABDOMINAL:

The uterus is anteverted with regular contour and heterogenous echopattern measuring
14.31 x 12.43 x 13.33 cm. The endometrial cavity is dilated containing heterogenous mass with
varied size vesicles and areas suggestive of hemorrhages at the lower uterine segments
measuring 11.7 x 6.20 x 11.41 cm (vol. 413.74 mL) suggestive of molar pregnancy. The
subendometrial halo is intact.
Both ovaries were not visualized.
There is no free fluid in the cul de sac.

IMPRESSION:

ENLARGED ANTEVERTED UTERUS WITH INTRA ENDOMETRIAL CONTENTS

CONSIDER MOLAR PREGNANCY.
PLEASE CORRELATE CLINICALLY AND WITH SERUM B-HCG.

Attending Physician: DR. BORLING Date: 2-15-2020

X-RAY RESULTS

CHEST PA:
Lungs are clear.
The heart is normal in size and configuration.
Pulmonary vascularity and aorta are w/n normal.
Diaphragm and sulci are intact.
Bony thorax is unremarkable.

IMPRESSION:
Normal chest x-ray.
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Medical Management
Preoperative antibiotic prophylaxis to prevent bacterial infections before and after suction
curettage with Cefuroxime sodium and Clindamycin. Managed bowel movements with
Bisacodyl, a laxative drug given before the procedure of suction curettage to help evacuate the
bowel contents.
Administration of Evening Primrose Oil (EPO) 2 capsules every 2 hours intravaginally as
a cervical preparation to soften and dilate the cervix prior to suction curettage to minimize
adverse events, such as cervical laceration or uterine perforation, while the instruments pass
through the cervix. Stimulation of uterine contractions and management of bleeding (to reduce
the likelihood of hemorrhage) with the administration of 10 units of oxytocin intravenously and 1
tablet of Methylergonovine maleate (Methergine) TID, as ordered.
Control of hypogastric pain with nonsteroidal anti-inflammatory drugs such as
mefenamic acid and ketorolac. Prevention and treatment of iron deficiency anemia and iron
supplementation with FeSo4.
Surgical Management
Patients who are diagnosed with molar pregnancy must be evaluated for possible
complications, such as: overactive thyroid, anemia, and toxemia of pregnancy, before suction
curettage is performed. Patients should have a complete examination and laboratory testing.
The patient, diagnosed with molar pregnancy, has been evaluated for having anemia due
to molar pregnancy. Laboratory tests showed that the patient is hemodynamically stable with
correction of preoperative anemia prior to doing the procedure of suction curettage. After the
anemia has been corrected, the principal procedure of suction curettage was performed.
Suction curettage is the method of choice of evacuation, regardless of uterine size, in
patients with partial and complete molar pregnancies.
Nursing Management
Assessed the condition of the patient. Monitored the vital signs and maintain intake-
output chart. Monitored the amount and character of vaginal bleeding. Assessed the uterine
fundus; and the emotional distress that the patient may be experiencing. Considered the ability of
the patient to work and perform ADL.
Immediately reported to the health care provider if there are any abnormalities observed
such as fluctuating vital signs and if experiencing acute abdominal pain, nausea and vomiting,
excessive emotional distress, and passage of large clots of blood or small amounts of tissue/
grape-like vesicles through the vagina.
Administered IV fluids as ordered. Provided emotional support and encouraged
verbalization of feelings regarding condition. Allow one support person at bedside before and
after suction curettage, if desired by patient. Provided and reviewed information about any newly
prescribed medications. Provided written discharge and follow - up instructions as well as health
teachings, more importantly upon refraining from getting pregnant along with the monitoring of
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UA (hCG levels) for 1 year in order to detect if the mole has been completely removed or if there
is a possible recurrence towards the patient.
 V. DRUG STUDY (INCLUDE GENERIC NAME, ACTIONS, SE, AND
CONTRAINDICATION)

Generic Name
Side Effects/ Nursing
(Brand Name) Indications Actions
Contraindications Responsibilities
if any
Parenteral Binds to one or more of Adverse Effects: Assessment:
Cefuroxime the penicillin-binding
 Lower respiratory  CNS: Headache,  History: Hepatic
Sodium proteins (PBPs) which
infections caused dizziness, and renal
inhibits the final
by S. pneumoniae, lethargy, impairment,
Route of transpeptidation step of
S. aureus, E. coli, paresthesias lactation, pregnancy
administration: peptidoglycan synthesis
Klebsiella
IV in bacteria cell wall, thus  GI: Nausea,  Physical: Skin
pneuemoniae, H.
inhibiting biosynthesis vomiting, status, LFTs, renal
influenzae, S.
and arresting cell wall diarrhea, anorexia, function tests,
pyogenes
assembly resulting in abdominal pain, culture of affected
 Dermatologic bacteria cell death. flatulence, area, sensitivity tests
infections caused pseudomembranou
Interventions:
by S. aureus, S. s colitis,
pyogenes, E. coli, hepatotoxicity  Culture infection
K. pneuemoniae, site, and arrange for
 GU:
Enterobacter sensitivity tests
Nephrotoxicity
before and during
 UTIs caused by E.
 Hematologic: therapy if expected
coli, K. pneumoniae
Bone marrow response is not seen.
 Uncomplicated and depression
 Observe 10 rights in
disseminated (decreased WBC,
drug administration.
gonorrhea caused decreased
by N. gonorrhoeae platelets,  Preparation:
decreased Hct) Preparation of
 Septicemia caused
parenteral drug
by S. pneumoniae,  Hypersensitivity:
solutions and
S. aureus, E. coli, Ranging from rash
suspensions differs
K. pneumoniae, H. to fever to
for different starting
influenzae anaphylaxis;
preparations and
serum sickness
 Meningitis caused different brand
reaction
by S. pneumoniae, names; check the
H. influenzae, S.  Local: Pain, manufacturer’s
aureus, N. abscess at directions carefully.
meningitidis injection site, Reconstitute
phlebitis, parenteral drug with
 Bone and joint
inflammation at sterile water for
infections due to S.
IV site injection, D5W,
aureus
0.9% sodium
 Other:
 Perioperative chloride, or any of
Superinfections,
prophylaxis the following, which
disulfiram-like
also may be used for
 Treatment of acute reaction with
further dilution:
bacterial maxillary alcohol
0.9% sodium
sinusitis in patients
Contraindications: chloride, 5% or 10%
3 mo–12 yr
 dextrose injection,
5% dextrose and
0.45% or 0.9%
sodium chloride
injection, or 1/6 M
sodium lactate
injection. Stability of
solutions depends on
diluent and
concentration:
Check
manufacturer’s
specifications.
 Contraindicated in  Infusion: Inject
patients with slowly over 3–5 min
cephalosporin directly into vein for
hypersensitivity. IV administration, or
infuse over 30 min;
Cautions:
may be given by
 Use cautiously in continuous infusion.
patients Give
hypersensitive to aminoglycosides and
penicillin because cefuroxime at
of possibility of different sites.
cross-sensitivity
 Dispose of used
with other beta-
materials properly.
lactam antibiotics.
 Do proper
 Use with caution
documentation.
in breastfeeding
women and Teaching points:
inpatients with
 Avoid alcohol while
history of colitis
taking this drug and
or renal
for 3 days after
sufficiency.
because severe
reactions often
occur.
 Educate patient
about the side
effects, such as
stomach upset or
diarrhea.
 Report severe
diarrhea, difficulty
breathing, unusual
tiredness or fatigue,
pain at injection site.
Clindamycin  Clindamycin is Clindamycin inhibits  Mild rash or Assessment:
indicated in the bacterial protein itching
 History: Allergy to
Time ō treatment of serious synthesis by binding to  Stomach pain, clindamycin, history
Administration infections caused 23S RNA of the 50S nausea of asthma or other
: BID by susceptible subunit of the bacterial allergies, allergy to
 Skin problems,
anaerobic bacteria. ribosome. It impedes tartrazine (in 75- and
such as hives,
 Clindamycin is also both the assembly of the 150-mg capsules);
rash, red,
indicated in the ribosome and the hepatic or renal
shedding, or
treatment of serious translation process. The dysfunction;
peeling skin
infections due to molecular mechanism lactation; history of
susceptible strains through which this  Yellow regional enteritis or
of streptococci, occurs is thought to be appearance of the ulcerative colitis;
pneumococci, and due to clindamycin's skin, nails, or history of antibiotic
staphylococci. three-dimensional whites of the eyes associated colitis
structure, which closely (jaundice)
Interventions:
resembles the 3'-ends of
 Vomiting, severe
L-Pro-Met-tRNA and  Perform culture and
stomach pain, or
deacylated-tRNA during sensitivity tests
diarrhea
the peptide elongation before initiation of
cycle - in acting as a  Signs of low blood therapy.
structural analog of these pressure, ranging
 Administer oral drug
tRNA molecules, from dizziness to
with a full glass of
clindamycin impairs fainting
water or with food to
peptide chain initiation
 Pain or difficulties prevent esophageal
and may stimulate
when swallowing; irritation.
dissociation of peptidyl-
pain behind the
tRNA from bacterial  Take full prescribed
breastbone; newly
ribosomes. course of oral drug.
developed
Do not stop taking
heartburn or acid
without notifying
regurgitation
health care provider.
(signs of
inflammation in  You may experience
your esophagus) these side effects:
Nausea, vomiting
 Vein irritation (if
(eat frequent small
you are receiving
meals);
injections of
superinfections in
clindamycin)
the mouth, vagina
 Fever or body (use frequent
aches hygiene measures;
request treatment if
severe).
 Report severe or
watery diarrhea,
abdominal pain,
inflamed mouth or
vagina, skin rash or
lesions.
Evening  Used as part of Evening primrose oil  Headache Interventions
Primrose Oil over-the-counter presents a content of
 Stomach Upset  Obtain the vital
(EPO) dietary 74% Linolenic acid and
signs of the patient,
9% Gamma-linolenic
 supplements. acid from which the later  Rash especially BP.
Patient’s seems to be the key
 Helps to ease  Nausea  Observe patients
Dosage: 2 cap active ingredient of this
premenstrual ten rights in drug
q2° oil. The therapeutic  Dizziness
symptoms (PMS) administration.
intravaginally activity of evening
e.g., menstrual
primrose oil is attributed  Be alert for adverse
cramps and breast
to the direct action of its  May raise the risk reactions and drug
tenderness.
essential fatty acids on of bleeding among interactions.
 It also aids in immune cells as well as people who take
Teaching Points
easing the to an indirect effect on anticoagulant and
symptoms of the synthesis of antiplatelet  Always seek
menopause due to eicosanoids. The actions medications. medical advice
hormone of highly unsaturated before taking this
 It may also raise
irregularities eg, fatty acids in tissues and supplement during
the risk of seizures
hot flashes. eicosanoids are thought pregnancy as it may
as well as serious
to be implicated in possibly induce
 Initiate cervical nausea and
inflammatory and labor.
ripening – the vomiting for
immunologic
softening and people taking a  Do not take
pathogeneses.
thinning of the class of drugs evening primrose
Evening primrose oil
cervix in known as oil if you have
soft gel capsule contains
preparation for phenothiazines. epilepsy,
linoleic and gamma-
labor and delivery. These drugs are schizophrenia, or a
linolenic acid, which are
used to treat bleeding disorder,
precursors of
schizophrenia and or if you are about
prostaglandins E1 and
other psychotic to have surgery.
E2. They are involved in
disorders. EPO may increase
the biosynthesis of
the risk of seizures
prostaglandin. For this
and bleeding
activity, the main
complications.
involved component is
the Gamolenic acid. The
presence of this essential
fatty acid allows the
synthesis of anti-
inflammatory substances
such as 15-hydroxy-
eicosatrienoic acid and
prostaglandin E1.
Oxytocin  Antepartum: To Synthetic form of an Adverse effects Assessment:
initiate or improve endogenous hormone
 CV: Cardiac  Fetal maturity,
Patient’s dose: uterine contractions produced in the
arrhythmias, presentation, and
10 units to achieve early hypothalamus and stored
PVCs, pelvic adequacy
vaginal delivery; in the posterior pituitary;
hypertension, should be assessed
stimulation or stimulates the uterus,
subarachnoid prior to
reinforcement of especially the gravid
hemorrhage administration of
labor in selected uterus just before
oxytocin for
cases of uterine parturition, and causes  Fetal effects:
induction of labor.
inertia; myoepithelium of the Fetal bradycardia,
management of lacteal glands to neonatal jaundice,  Assess character,
inevitable or contract, which results in low Apgar scores frequency, and
incomplete milk ejection in lactating duration of uterine
 abortion; second women.  GI: Nausea, contractions;
trimester abortion. vomiting resting uterine
tone; and fetal heart
 Postpartum: To  GU: Postpartum
rate frequently
produce uterine hemorrhage,
throughout
contractions during uterine rupture,
administration.
the third stage of pelvic hematoma,
labor and to control uterine  Monitor maternal
postpartum hypertonicity, BP and pulse
bleeding or spasm, tetanic frequently and fetal
hemorrhage. contraction, heart rate
rupture of the continuously
 Lactation
uterus with throughout
deficiency
excessive dosage administration.
 Unlabeled uses: To or hypersensitivity
 This drug
evaluate fetal
 Hypersensitivity: occasionally causes
distress (oxytocin
Anaphylactic water intoxication.
challenge test),
reaction
treatment of breast Intervention:
engorgement  Other: Maternal
 Do not administer
and fetal deaths
oxytocin
when used to
simultaneously by
induce labor or in
more than one
first or second
route.
stages of labor;
afibrinogenemia;  Preparation: Add
severe water 1 mL (10 units) to
intoxication with 1,000 mL of 0.9%
seizures and coma, aqueous sodium
maternal death chloride or other IV
(associated with fluid; the resulting
slow oxytocin solution will
infusion over 24 contain 10
hr; oxytocin has milliunits/mL (0.01
antidiuretic units/mL).
effects)  Infusion: Infuse
via constant
infusion pump to
ensure accurate
control of rate; rate
determined by
uterine response;
begin with 1–2
mL/min and
increase at 15- to
60-min intervals.
Teaching Points
 The patient
receiving parenteral
oxytocin is usually
receiving it as part
 of an immediate
medical situation,
and the drug
teaching should be
incorporated into
the teaching about
delivery. The
patient needs to
know the name of
the drug and what
she can expect after
it is administered.
Bisacodyl  It stimulates the Irritates smooth muscle Common Side
muscles in the wall of intestine and possibly Effects:
 May lead to
of the small colonic intramural
 Abdominal hypokalemia
intestine and colon plexus, thus in turn
cramping
to generate a bowel increasing peristalsis.  May cause
movement. It also  Electrolyte and abdominal pain and
alters water and Increases intestinal fluid fluid imbalance cramps
electrolyte levels in accumulation and
 Excessive diarrhea  Use caution with
intestines, laxation by altering
milk
increasing the level water and electrolyte  Nausea
of fluids which also secretion  Assess for
 Rectal burning
produce a laxative- abdominal distention
like effect.  Spinning sensation and bowel function
(vertigo)
 Bisacodyl is used  Instruct patient to
for temporary relief  Stomach/abdomin drink 1500-2000
of occasional al pain mL/day during
constipation and therapy
 Vomiting
irregularity.
 Monitor fluid and
 Weakness
 It may also be used electrolyte levels
to clean out the Serious Side Effects:
 Instruct patient to
intestines before a
 Persistent take as ordered
bowel
nausea/vomiting/d
examination/surger
iarrhea
y
 Muscle
cramps/weakness
 Irregular heartbeat
 Dizziness
 Fainting
 Decreased
urination
 Mental/mood
changes (such as
confusion)
Methylergono  Routine A partial agonist or Adverse effects Assessment:
vine Maleate management after antagonist at alpha  CNS: Dizziness,
(Methergine) delivery of the receptors; as a result, it headache, tinnitus,
placenta increases the strength, diaphoresis  History: Allergy to
Patient’s Dose: duration, and frequency methylergonovine,
 Treatment of of uterine contractions,  CV: hypertension,
1 tab TID
postpartum atony which shortens the third Hypertension, toxemia, sepsis,
and hemorrhage; stage of labor and palpitations, chest obliterative
subinvolution of the reduces blood loss. pain, dyspnea vascular disease,
uterus hepatic or renal
 GI: Nausea,
impairment,
 Uterine stimulation vomiting
lactation,
during the second
Contraindications pregnancy
stage of labor
following the and cautions
 Physical: Uterine
delivery of the  Contraindicated tone, vaginal
anterior shoulder, with allergy to bleeding;
under strict medical methylergonovine, orientation,
supervision hypertension, reflexes, affect; P,
toxemia, lactation, BP, edema; CBC,
pregnancy. LFTs, renal
function tests; fetal
 Use cautiously monitoring when
with sepsis, used during labor.
obliterative
vascular disease, Interventions:
hepatic or renal
 Monitor postpartum
impairment.
women for BP
changes and
amount and
character of vaginal
bleeding.
Teaching Points:
 This drug should
not be needed for
longer than 1 week.
 The patient
receiving a
parenteral oxytocic
is usually receiving
it as part of an
immediate medical
situation, and the
drug teaching
should be
incorporated into
the teaching about
delivery. The
patient needs to
know the name of
the drug and what
 she can expect after
it is administered.
 Report difficulty
breathing,
headache, numb or
cold extremities,
severe abdominal
cramping
Ferrous  It is used to treat or Elevates the serum iron Adverse effects  Observe proper
Sulfate prevent iron concentration, and is dosage of
(FeSO4) deficiency anemia then converted to Hgb or  CNS: CNS medication.
due to inadequate trapped in the toxicity, acidosis,
Classification:
diet, malabsorption reticuloendothelial cells coma and death  Note other drugs
Enzymatic
pregnancy, and for storage and eventual with overdose that the patient is
mineral and
blood loss. Iron is conversion to a usable  GI: GI upset, taking to avoid
iron
an important form of iron. possible interactions.
preparation anorexia, nausea,
mineral that the vomiting,  To avoid panic,
Route ō body needs to Iron combines with constipation, inform patient that
administration: produce red blood porphyrin and globin diarrhea, dark stools may become
PO cells. chains to form stools, temporary dark, green, or black
hemoglobin, which is staining of the in color.
 Dietary supplement critical for oxygen
Patient’s teeth (liquid
for iron delivery from the lungs  Arrange for periodic
Dosage: 1 cap preparations)
TID  Unlabeled use: to other tissues. Iron monitoring of HGB,
Supplemental use deficiency causes a Contraindications HCT, and iron
during epoetin microcytic anemia due and Cautions levels.
therapy to ensure to the formation of small
proper hematologic erythrocytes with  Contraindicated  Take on an empty
insufficient hemoglobin. with allergy to any stomach to increase
response to epoetin ingredient; sulfite absorption or with
allergy; vitamin c which
hemochromatosis, helps with
hemosiderosis, absorption.
hemolytic
anemias.
 Use cautiously
with normal iron
balance; peptic
ulcer, regional
enteritis,
ulcerative colitis.

Mefenamic  Relief of moderate Anti-inflammatory, Adverse effects Assessment:

Acid pain when therapy analgesic, and
will not exceed 1 antipyretic activities  CNS: Headache,  History: Allergies;
wk. related to inhibition of dizziness, renal, hepatic, CV,
prostaglandin synthesis; somnolence, GI conditions;
 Treatment of exact mechanisms of insomnia, pregnancy; lactation
primary action are not known. fatigue, tiredness,
dysmenorrhea dizziness,  Physical: Skin color
and lesions;
 tinnitus, orientation, reflexes,
ophthalmic ophthalmologic and
effects audiometric
evaluation,
 Dermatologic: peripheral sensation;
Rash, pruritus, P, edema; R,
sweating, dry adventitious sounds;
mucous liver evaluation;
membranes, CBC, clotting times,
stomatitis LFTs, renal function
 GI: Nausea, tests; serum
dyspepsia, GI electrolytes, stool
pain, diarrhea, guaiac.
vomiting, Teaching Points:
constipation,
flatulence, ulcers,  Take drug with food;
GI bleed take only the
prescribed dosage;
 GU: Dysuria, do not take the drug
renal impairment longer than 1 week.
 Hematologic:  Discontinue drug
Bleeding, platelet and consult your
inhibition with health care provider
higher doses, if rash, diarrhea, or
neutropenia, digestive problems
eosinophilia, occur.
leukopenia,
pancytopenia,  Dizziness or
thrombocytopeni drowsiness can
a, occur (avoid driving
agranulocytosis, and using dangerous
granulocytopenia machinery).
, aplastic anemia,
decreased Hgb or  Report sore throat,
Hct, bone fever, rash, itching,
marrow weight gain,
depression, swelling in ankles or
menorrhagia fingers; changes in
vision; black, tarry
 Respiratory: stools; severe
Dyspnea, diarrhea, right upper
hemoptysis, abdominal pain,
pharyngitis, flulike symptoms,
bronchospasm, chest pain.
rhinitis
 Other:
Peripheral
edema,
anaphylactoid
reactions to
 anaphylactic
shock
Contraindications
 Contraindicated
with
hypersensitivity
to mefenamic
acid, aspirin or
NSAID allergy,
and as treatment
of perioperative
pain with
coronary artery
bypass grafting

Ketorolac Ketorolac is used Inhibits synthesis of  Respiratory:  Don’t forget to

short-term (5 days or prostaglandins in body rhinitis, assess first the
less) to treat or for tissues by inhibiting at hemoptysis, patient before
management of least 2 cyclo-oxygenase dyspnea administering this
moderate to severe (COX) isoenzymes, drug: know the
pain. COX-1 and COX-2  GI: GI pain, history (e.g.
May inhibit chemotaxis, diarrhea, allergies, renal
alter lymphocyte vomiting, nausea impairment, etc.)
activity, decrease  CNS: dizziness, and physical
proinflammatory fatigue, condition of the
cytokine activity, and insomnia, patient (reflexes,
inhibit neutrophil headache ophthalmologic and
aggregation; these audiometric
effects may contribute to  Hematologic: evaluation,
anti-inflammatory neutropenia, orientation, clotting
activity. leukopenia, times, serum
Ketorolac works by decreased Hgb or electrolytes, etc.)
reducing hormones that Hct, bone
cause inflammation and marrow  In case of
pain in the body depression hypersensitivity, be
sure that emergency
 Dermatologic: equipment is
sweating, dry available.
mucous
membrane,  Drug vials should be
pruritus protected from light.
 To maintain serum
levels and control
pain effectively,
administer it every
six hours or as
directed.
 Report any signs of
itching, swelling in
the ankles, sore
throat, easy bruising,
etc.
 VI. NURSING INTERVENTIONS AND RATIONALE
Nursing
Assessment Planning Intervention Rationale Evaluation
Diagnosis
Subjective: Acute After 2 hours Independent:
hypogastric ō nsg.
- “Medyo  NPI initiated - To gain trust Goal was met.
pain r/t interventions,
masakit ang and After 2° ō nsg.
interruption ē patient will
puson ko,” cooperation interventions,
of tissue verbalize
as ē pt.
continuity relief from  V/S taken and - To provide
verbalized verbalized
as evidence pain. recorded baseline data
by ē patient. relief from
by self-
- Rated pain pain and rated
reports ō  Encouraged - To evaluate
as 4/10. it as 1/10 from
pain verbalization coping
4/10.
Objective: intensity in of feelings abilities and
- Weak and a pain rating about the to identify
pale in scale ō 4/10. pain. areas of
appearance additional
- V/S taken as concern as
follows: pain is a
subjective
T: 36.2°C experience
P: 84 bpm and cannot
be felt by
R: 21 bpm other.
BP: 120/70  Comfort - To provide
measures comfort and
rendered. reduce
tension.
 Encouraged - To provide
deep comfort and
breathing reduce
exercises and tension as
relaxation well as to
techniques. avoid
fatigue.
 Encouraged
adequate bed
rest.
  Performed
- To identify if
pain
there is an
assessment
improvement
each time pain
in status.
occurs.
Dependent
 Administrati - To control
on of and provide
analgesic by relief from
NOD, as pain.
needed.
Subjective: Deficient After 8 hours Independent Goal was met.
isotonic ō nsg.
Verbalized  NPI initiated - To gain trust After 8° ō nsg.
fluid interventions, interventions,
severe bleeding and
volume r/t ē patient will
every night cooperation. ē patient
active fluid be able to maintained
prior to
volume loss have an  V/S taken - To provide fluid volume
admission.
secondary to adequate and recorded. baseline data. at a functional
“Nanghihina  fluid volume level as
 Advised to - To provide
ako tapos vascularity as evidenced evidenced by
 OFI adequate
nahihirapan ako ōē by controlled adequate
rehydration
gumalaw,” as chorionic bleeding and urinary output
verbalized by villi as normal urine  Record I&O - Determines with normal
the patient. evidence by concentration and urine the degree of urine
vaginal . concentration fluid losses. concentration
Objective:
bleeding,  . and lesser
- ć  RBC RBC count vaginal
(2.74x10^12/  Observed - Reflects the
& dark bleeding extent of bleeding.
L) (Feb. 13, yellow urine
2020) tendencies, blood loss.
concentratio noting the
- Dark yellow n.
colored urine amount and
concentration color of
- Weak in vaginal
appearance discharge.
- V/S taken as
 Encouraged - Bleeding
follows:
adequate bed may stop or
T: 36.2°C
rest. lessen with a
P: 84 bpm
decrease in
R: 21
activity.
breaths/min
BP: 120/70 Dependent
 Administered - To replace
 IVF and and conserve
blood blood
transfusion, volume
as ordered. contrary to
the blood
loss caused
by vaginal
bleeding.
Collaborative:
 Reviewed - To evaluate
laboratory the body’s
data, response to
including UA bleeding/othe
and CBC. r fluid loss
and to
determine
replacement
needs.
Objective: Risk for After 8° ō Independent: Goal was met.
infection nsg.
- Conscious &  NPI initiated. - To gain trust After 8° ō nsg.
related to a interventions, interventions,
coherent and
site for ē pt. will
- Afebrile cooperation. ē pt. remained
organism remain free free from
- ć an IVF ō
invasion from  V/S taken and - To provide infection
D5LR 1L @
secondary to infection recorded. baseline data. before and
around 600 cc
ē invasive before and  Performed after invasive
level regulated
procedure ō after invasive proper procedures
at 10-12
dilatation & procedures handwashing and verbalized
gtts/min
curettage and verbalize before & after - Proper hand understanding
(KVO)
and invasive understandin all contact ć washing is on identifying
- V/S taken as
lines ō IVF g on patient or one of the interventions
follows:
& blood identifying specimen. most to reduce and
T: 36.2°C
transfusion. interventions important prevent risk of
P: 80 bpm
to reduce and means to infection.
R: 19 bpm  Encouraged ē
prevent risk prevent the
BP: 100/70 patient & SO
of infection. spread of
to perform infection.
proper
handwashing
often.
 Maintained - To prevent
sterile the spread of
technique for infection.
 all invasive
procedures
(D&C
instruments,
lines for IV
and blood
transfusion)
 Instructed to - Enforced to
remain NPO prevent any
prior to undigested
D&C. food or fluids
from moving
into the
mouth and
getting to
airway while
under
anesthesia.
 Emphasized - Minimizes
ē importance the entry of
of good harmful
perineal microorganis
hygiene. ms.
 Encouraged - Helps reduce
early stasis of
ambulation, secretions in
deep the lungs and
breathing, the bronchial
and frequent tree.
position
changes.
 Instructed to - This reduces
use perineal ē risk ō
pads and infection and
avoid allows
tampons. tissues to
heal
Dependent:
 Administered - To determine
and effectiveness
monitored of therapy or
medication presence of
 regimen as side effects.
ordered.
Collaborative:
 NOD - D & C is an
coordinated invasive
with the DR procedure &
team to equipment &
ensure that materials
aseptic used during ē
technique operation
will be may be a
maintained possible
during the source ō
entire harmful
procedure of microorganis
D & C. m, hence,
everything
should be
sterile.
 Monitor x̄ - Prompt
signs & recognition
symptoms ō &
infection intervention
inclusive ō of
vital signs & manifestation
post D&C s of infection
CBC count. prevents
progression
into a worse
septic
condition.

VII. NURSING IMPLICATIONS

A. NURSING PRACTICE

This case study aims to furnish important information about the Hydatidiform
Mole; how it starts, what are the causes and what are the signs and symptoms
especially on how to prevent, treat and manage the patient by providing nursing
responsibilities and nursing care which a student nurse is educated about, competent
and has authority to perform. The nursing practice is crucial to excellence in health
care and is underpinned by values that guide the way in which nursing care is
 provided to the said condition. It has an important role in presentation, early
detection, patient education, patient care and rehabilitation for Hydatidiform Mole.
The understanding of knowledge used in nursing practice will give an important role
in contributing to the improvement of educational preparation and in providing
quality health care to the patient.

B. NURSING EDUCATION

Nursing education includes the concepts of health promotion, disease

prevention, health protection, and risk reduction. The nursing education with regards
to Hydatidiform Mole will focus on providing patient education and to provide an
overview on the occurrence and risk factors of Hydatidiform Mole as well as the
diagnostic and treatment options. By having the right education or knowledge, skills
and competence with regards to the patient’s condition, it will enable you as a health
care provider to give high quality of care and in enabling the patient to attain
improved health condition. Nurses do not only provide care but they also educate
their patients. Nursing education is key to preventive care, it helps nurses by
providing them the skills and tools they need to positively impact individual's lives.
The nursing education do not only keep nurses up to date on the latest advances in
care and treatment, but it allows nurses to improve patients’ health as well.

C. NURSING RESEARCH
In nursing research, this case study will function in the provision of additional
and updated knowledge about Hydatidiform Mole. It aims to promote lifelong
professional development of the discipline of nursing and supports the fact that
nursing is a professional discipline. Nursing research improves clinical expertise and
personal knowledge. It also aims to serve motivation for further findings about the
patient’s condition and related cases in order to provide optimum quality of care to
the patient. The nursing research is vital to help health care professionals stay abreast
of the latest medical advances contributing to the optimization of patient care,
advance their field, to expand their knowledge, to gain more information about the
patient’s condition, to remain updated about the findings, to improve their skills and
to offer improved and better patient care as well as to implement changes to provide
excellence in nursing care and helps to locate additional resources.
VIII. REFERRAL AND FOLLOW UP (IF ANY):
Submitted by: [SIGNATURE over PRINTED NAME]

OBUBA, EZINNE SORIANO, ANGELICA JOAN

PALISOC, JEANETTE SORIANO, ARIANE VI

PEREZ, JENNIFER TAMAYO, ARSHEL

RASOS, JIMELLY TERRADO, BRIAN

RECEPCION, MARIELLA VALENCIA, GLAIZA

ROSARIO, CYRINE JOYCE VALLO, MILLE GRACE

SAMPAGA, MARY JOY YANTO, GENIEROSE

SIMEON, MAY ANN ZARATE, MICHEALA

Discussed with student by:

Clinical Instructors:

Merly Cabuang, RN, MAN

Jocelyn Ona, RN, MAN

Ma. Theresa Aguilan, RN, MAN

Certified by:

Ma. Theresa R. Aguilan,

RN, MAN
Dean, College of Nursing