Arellano University

College of Nursing
Legarda – Pasay - Pasig
Competency Appraisal 1 / COURSE AUDIT 1 / CAA 1
DLP

Nursing Care Management 103 B (MS 2)

NAME: CHARISSA M. DE LEON BRANCH: LEGARDA

INSTRUCTIONS. Answer the following questions. Write your answers neatly and clearly with complete
citation of reference used (with pages). 25 pts

Situation: Amanda is a 37 year old who has had a esophageal surgery for carcinoma. She is receiving
250 ml of liquid nutrition over a 15 minute period every 4 hours through a nasogastric tube.

1. Amanda tells the nurse that she is experiencing diarrhea. The nurse suspects that the client is
suffering from dumping syndrome:
a. What is a dumping syndrome? (1pt)
- dumping syndrome refers to an unpleasant set of vasomotor and GI symptoms that sometimes occur
in patients who have had gastric surgery or a form of vagotomy. It may be the mechanical result of
surgery in which a small gastric remnant is connected to the jejunum through a large opening.

b. What may cause the dumping syndrome? (1pt)

- rapid gastric emptying in which the food moves rapidly from the stomach to the duodenum

c. What are the manifestations of dumping syndrome? Give at least 3 symptoms (3pts)
- sensation of fullness
- weakness
- diaphoresis
(REFERENCE: Brunner and Suddarth’s Textbook of Medical-Surgical Nursing,10th Edition, Volume 1, Page 1026)

Situation: Andrew, a 15 year old is admitted at the hospital with a possible diagnosis of appendicitis.
He had been symptomatic for several days before admission:
1. What is the possible cause of appendicitis? (1pts)
- obstruction of the appendix and is particularly vulnerable to infection

2. What are the positive indicators of appendicitis? Give at least 3 (1pts)

- vague epigastric or periumbilical pain
- low-grade fever
- Loss of appetite
- Local tenderness is elicited at McBUrney’s point when pressure is applied
 3. What is rebound tenderness? (1 pt)
- production or intensification of pain when pressure is released.

4. What is the common site where pain is elicited upon palpation? (1pt)
- Right lower quadrant

5. What is the major complication of Appendicitis? (1 pt)

- The major complication of appendicitis is perforation of the appendix, which can lead to peritonitis or an
abscess.

6. When does perforation usually occurs? (1pt)

- Perforation generally occurs 24 hours after the onset of pain.

Situation: Diabetes is one of the leading causes of pathologic conditions which often leads to mortality
of the individual.
1. Differentiate Type 1 DM from Type 2 DM (8pts)

Type 1 DM Type 2 DM

Age of Onset Early, before 30 years old Type 2 diabetes occurs most
commonly in people older than
30 years who are obese.

Body Built People with type 1 diabetes are A metabolic disorder

often thin to normal weight and
often lose weight prior to
diagnosis
characterized by the relative
deficiency of insulin production
and a decreased insulin action
and increased insulin
resistance. Also called non-
insulin dependent or adult
onset.

Description A metabolic disorder Hyperglycemic Hyperosmolar

characterized by an absence of Non- ketotic coma
insulin production and secretion
from autoimmune destruction of
the beta cells of the islets of
Langerhans in the pancreas.
Also called insulin-dependent or
juvenile.

Acute Complication Diabetic ketoacidosis

REFERENCE: Brunner and Suddarth’s Textbook of Medical-Surgical Nursing 10th Edition, Volume 2, Page 1150-1154
2. Differentiate Hypoglycemia from Hyperglycemia (4pts)

Hypoglycemia Hyperglycemia

Blood Sugar Level Low blood glucose level, less Fasting level greater than 110
than 50- 60 mg/dl mg/dl

Causes --Too much insulin or oral --Insufficient insulin

hypoglycemic agents --Increased food or alcohol
--Too little food intake
--Excessive physical activity

REFERENCE: Brunner and Suddarth’s Textbook of Medical-Surgical Nursing10th Edition, Volume 2, Page 1178 - 1186