NCM 112 LEARNING PACKET ON RELATED LEARNING EXPERIENCE

RLE FOCUS UNIT: CARE OF CLIENTS WITH PROBLEMS ON

CELLULAR ABBERATION
COURSE CODE: NCM 112
COURSE TITLE: CARE OF CLIENTS WITH PROBLEMS IN INFECTIOUS
INFLAMMATORY & IMMUNOLOGIC RESPONSE, FLUIDS &
ELECTROLYTES, OXYGENATION, CELLULAR ABERRATION,
ACUTE & CHRONIC
YEAR LEVEL, ACADEMIC YEAR: LEVEL 3, 2nd SEMESTER SY 2021-2022
CLINICAL AREA OF ASSIGNMENT: ONCOLOGY WARD
DATE OF CLINICAL EXPOSURE:
NO. OF HOURS: 48

MODULE OVERVIEW
Nursing is a profession that requires intensive training on both theoretical and clinical
perspective. The course NCM 112 deals with the Concepts, Principles and Theories of Human
Behavior and the Care of the sick client across the lifespan with emphasis on Infectious
Inflammatory & Immunologic Response, Fluids & Electrolytes, and Oxygenation & Cellular
Aberration in varied settings.
For this module, you will be providing nursing care to adult and elderly clients with medical
conditions related to fluid and electrolyte imbalances.
Having gone through the theoretical inputs in the NCM 112 lecture, the next step that you need
to learn is on the application of these principles and techniques in the nursing care of these
clients.
For this 48- hour related learning experience, you will be catered to flexible
clinical learning experiences through this self-instructional module.
Prepared by: RELATED LEARNING EXPERIENCE ROTATION

MELCHIE L. PULIDO MEDICAL-SURGICAL NURSING

CLINICAL INSTRUCTOR
Remember, this might not be a substitute for the actual clinical experience, but this can help
you navigate through your patient care experiences in this alternative learning platform. This
module has the following parts:

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

MELCHIE L. PULIDO MEDICAL-SURGICAL NURSING

CLINICAL INSTRUCTOR
 LEARNING MAP

(LEARNING ACTIVITIES SHOULD ALWAYS BE REFLECTED BY LEARNING OUTCOMES IN

LEARNING MAP.)
At the end of this 48 - hour related learning exposure, you are expected to:
1. Utilize the nursing process in the care of patient;
2. Perform a holistic health assessment based on the case scenarios provided;
3. Utilize assessment information to formulate a patient-centered plan of care;
4. Explain appropriate nursing interventions per problems identified;
5. Apply bioethical concepts/principles, core values and nursing standards in the care of
clients;
6. Document the care rendered to assigned patient in the simulated health care record
accurately.

FIRST STEP TO ACHIEVE YOUR OBJECTIVE

You had your discussion on the pathophysiology of cancer, epidemiology, prevention,

screening and detection, cancer diagnosis and staging, therapies, medical and nursing care
considerations of these patients with these concerns. Let’s have a review of these concepts and
see how much do you recall.
Let us check on which patient statement alerts you to a warning sign of cancer? Select all that
apply. Put a check (/) if it is a risk factor and cross (x) if it is not.

______ Patient Loreto was admitted to the ER experiencing BM every 4 days

______ Patient Maui has a wart on her finger that lasted for 2 weeks
______ Patient Breton complaining of blister on his toe that never seems get well
______ Patient Mena who has a history of dysplastic nevi
______ Patient Paloma who had a chronic bladder infection
______ Patient Frankie has tenesmus and rectal pain

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

MELCHIE L. PULIDO MEDICAL-SURGICAL NURSING

CLINICAL INSTRUCTOR
 You are now on duty in the Oncology Ward of Lorma Medical Center. In this
48 hour duty, you are expected to handle and manage the care of patients in
the oncology ward. You are assigned to take care of at least 1 patient. You will
be performing the following nursing responsibilities:
 Vital Signs Monitoring
 Bedside Care
 Patient History taking
 Continuous Patient Assessment and monitoring
 Preparation and Administration of Medications
 Intake and output Monitoring (I&O)
 Special Nursing Procedure: (identify which procedure will be
emphasized)
 Planning of Nursing Care Plans
 Patient Care Documentation

In your provision of the nursing care, you are reminded of the following behaviors:

 Professional behaviors – engage appropriate legal and ethical behaviors;

 Communication – communicate effectively with your patient, SO and the health team
 Clinical Decision-Making – develop critical thinking skills to make responsible decisions
related to assessing the patient;
 Caring Interventions – maintaining a safe environment for the patient, including
assessing social, cultural and spiritual influences
 Teaching and Learning – provide health education to patient and SO
 Collaboration – collaborate with patient and SO

As you start with this module, you are free to consult and coordinate with your assigned clinical
instructor. Be sure to get his/ her email address and contact number for collaboration and
assistance. Just keep going, you can do it!

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

MELCHIE L. PULIDO MEDICAL-SURGICAL NURSING

CLINICAL INSTRUCTOR
 THE BIG LEAP

You are now ready to meet your patient for this clinical experience.

CASE SCENARIO:
At 10am of September 15, 2021, B.V is a 58 – year – old woman came to the emergency
department with a 2 day history of fever, chills, and shortness of breath and non-productive cough and
have nausea and vomiting. On arrival, she is disoriented and agitated. Vital signs are 86/43, 119, 28,
39.8°C (103.6°F), SaO2 85% on room air. Chest x-ray demonstrates diffuse infiltrates in the left lower lung.
Her chem 14 is WNL, with the exception of BUN 28 mg/dL, creatine 1.6 mg/dL, and lactic acid 2.4 mg/dL.
She came for a routine mammogram showed a 2.3 x 4.5 cm lobulated mass at the 3:00 position in
her left breast. B.V underwent a stereotactic needle biopsy and was diagnosed with infiltrating ductal
carcinoma that was both estrogen and progesterone receptor positive. The staging work – up was
negative for distant metastasis.
Her final staging was stage IIB. She had a modified radical mastectomy with lymph node
dissection. The sentinel lymph node and 11 of 16 lymph nodes were positive for tumor cells. An implanted
port was placed during surgery. She is prescribed a chemotherapy regimen of six cycles of CAF
(cyclophosphamide {Cytoxan}, Fluorouracil {5-FU}, and doxorubicin {Adriamycin}). Hooked on 0.9% sodium
Chloride 1000 mL for 8 hours.
B.V has now completed three cycles of CAF. Her last treatment with (cyclophosphamide {Cytoxan},
Fluorouracil {5-FU}, and doxorubicin {Adriamycin}) was approximately 12 days ago. Her vital signs are
85/50, RR 28, Temp 39.5, SaO2 85% on room air.
Chart View: Complete Blood Count
WBC 2000/mm³; Neutrophils 34%; Segmented (Polys) 28%; Bands 4%; Lymphocytes 60%; Monocytes 3%;
Eosinophil’s and Basophils 2%; Hct 24.9%; Hgb 8.7 g/dL; Platelets 85,000/mm³

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

MELCHIE L. PULIDO MEDICAL-SURGICAL NURSING

CLINICAL INSTRUCTOR
 TASKS: To immerse yourself in the care management of your patient, let’s take note of the detailed
description of your patient care tasks.
ARRIVAL Using the Case Scenario assigned to you, you are expected to
CHECK
perform the following:

 Interpret Diagnostic Results: Normal range + Patients Diagnostic result + significance

– Oral recitation with Clinical Instructor.
 In groups of 3, create an Infographics about breast cancer relative to your patient’s
condition which shall include the following: a) description of disease b) causes c)
clinical features/manifestations d) medical/surgical interventions e) nursing
interventions
 Formulate a Nursing Care Plan for you patient based on 2 prioritized problems using
the Lorma College of Nursing NCP Form. Integrate your nursing care interventions
significant to bioethical and legal standards in patient care.
 Prior to administering the patient’s medications, you are required to make a drug
study of all medications required by your patient in oral or parenteral form and
document it. Use the Lorma Colleges Drug Study Format for your documentation.
 SBAR is an acronym for Situation, Background, Assessment, and Recommendation; a
technique that is used to promote immediate referral communication. Call your CI
via messenger/zoom and simulate a referral communication between a nurse and a
physician using SBAR format. Role play thru Zoom/Google meet/ FB messenger on
how to endorse and refer your patient with Neutropenia to a doctor (CI). Please see
attached format as your guide.

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

MELCHIE L. PULIDO MEDICAL-SURGICAL NURSING

CLINICAL INSTRUCTOR
You will be graded based on your output:

EVALUATION PARAMETERS (please see portfolio)

Diagnostic Results Interpretation 30pts 25%

Infographics 30pts 20%
Nursing Care Plan 15pts 20%
Drug Study Report 10 pts/drug 10%
SBAR Simulation 30 pts 25%

TOTAL 100%

REFLECTION TIME

In the study of Catherine Paterson et al (2020). “Nurses are key stakeholders in developing and
implementing policies regarding standards of care during the COVID-19 pandemic. This pandemic poses
several challenges for oncology services. Oncology nurses are providing a pivotal role in the care and
management of the novel COVID-19 in the year landmarked as the International Year of the Nurse.” In
the challenges that you anticipate in your future clinical immersion and care for your patients, what
inspiration can you draw out of this beautiful conclusion?

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

MELCHIE L. PULIDO MEDICAL-SURGICAL NURSING

CLINICAL INSTRUCTOR
 MODULE EVALUATION

Before we move on to the next topic, I would want to listen to your feedback for this RLE
learning packet. Kindly rate each area with a scale of 1-5 with 1 as the lowest and 5 as the
highest.

EVALUATION RATING
1. Comprehensive Content
2. Relevance of Content
3. Clarity of the text and the message
4. Alignment of the assessment activities to learning outcomes

REFERENCES:
Palompon, Daisy (2020) Developing Self-Learning Modules for flexible Learning in the Related Learning
Experience, ADPCN Webinar August 3, 2020.

Paterson, Catherine et.al (2020) Oncology Nursing during a Pandemic: Critical Reflections in the context
of COVID – 19
Harding Marian et al., (2013) Critical Thinking Cases in Nursing 5th Edition

Prepared by: RELATED LEARNING EXPERIENCE ROTATION

MELCHIE L. PULIDO MEDICAL-SURGICAL NURSING

CLINICAL INSTRUCTOR