BEFORE DURING

HOSPITALIZATION HOSPITALIZATION
HEALTH PERCEPTION AND HEALTH MANAGEMENT:
 Patient’s chief concern
were about facial edema,  During the patient’s
DOB and easy fatigability. hospitalization, he was on
Patient Axel expressed therapy for Furosemide to
concerns abou the feeling decrease the facial edema.
of tightness around his  He was also initially
face and the fullness prescribed with Pen G IV,
around his chest area. He to treat strep infections
said “Mabigat yung  He was prescribed with
pakiramdam ko, banda Captopril, to lower his
dito” while pointing to an blood pressure, Prednisone
Health Education and area close to his heart. He to help with his discomfort
practices also mentioned “Parang regarding DOB
hinihigit din yung mukha  During his stay at the
ko sa sobrang manas”. hospital, Patient Axel
 Patient Axel’s mother mentioned that he felt
expressed the use of relief when he had said to
liniments such as menthol, his mother that the
for pain. tightness around his face
 Before hospitalization, and the heavy feeling
Patient Axel had an initial around his chest were
BP of 140/80 mmHg, a decreased, as medications
noticeable facial edema were started.
and difficulty of breathing
 Patient Axel’s mother said
that Axel had received and
completed his
Immunizations immunizations, he still
does yearly flu shots as
part of his school
requirements
 Patient had visited a doctor
2 months (May 2021) prior
 He was checked by Dr.
to being hospitalized
Santos, who later
where he was diagnosed
confirmed, that Patient
with acute gastritis with
Axel has RHD.
Medical Consultations sore throat
 Dr. Santos had explained
 No alternative
to Patient Axel and his
consultations were done as
mother all the possibilities
the family is more reliant
of acquiring RHD.
to professional medical
help
Overall health approach  Patient expressed the lack  The healthcare team under

NUTRITION-METABOLIC:
 Upon interview with
Daily food intake (quality,
frequency, amount and
quantity)
 He eats mostly junk food
 He prefers salty foods.
ELIMINATION:
 The usual voiding pattern
 As Patient Axel
Bowel movement pattern
(time, frequency and amount)
of trust in the healthcare
system as he said “Hindi
ako nagpapacheck-up, pag
sumakit lang ng todo,
doon palang siguro ako
magpapadoctor.”
Patient Axel, he expressed
that he is fond of sharing
foods with his friends,
eating the same foods as
they eat and drinks on the
same cups that his friends
drink on.
for snacks during time at
school and also drinks
carbonated liquids
occasionally.
of Patient Axel is in the
morning, after waking up,
and only once per day.
remembers, he used to
pass stools for 2-3 times in
a day prior to being
diagnosed to have acute
gastritis. Stools were loose
and they come in very
frequently.
Patient Axel’s care had
educated him and his
mother regarding the
consequences of not
seeing a professional when
it is needed. They also
stressed the possibility of
him getting an RHD was
probably because of the
untreated strep throat that
he had previously.
 Patient Axel demonstrated
his understanding in the
caution of sharing foods
and/or drinks with other
people. He verbalized
“Simula ngayon, hindi na
ako makiki-inom sa hindi
naman sa akin. Hindi narin
ako magooffer ng drinks
or foods sa iba, kase baka
sila naman mahawa
sakin.”
 During his time at the
hospital, he is under DAT,
with no restrictions,
although, it was made sure
that he had a balanced diet
which includes a meat, a
cup of rice, a serving of
vegetables and fruits on
the side.
 No deviations on the
voiding pattern as Patient
Axel still is voiding in the
morning, after waking up,
usually once per day, and
he does not complain of
any pain sensation while at
it.
  Patient Axel passes small  During hospitalization,
Urinary pattern (time, amounts of urine with no urination becomes more
frequency, amount and color) accompanying pain. frequent, still with no pain
felt.
ACTIVITY AND EXERCISE:

Patient is able to do self
care (bathing, toileting,
hygiene) activities
independently, having no
need of assistance.
 While on hospital, Patient
 Patient Axel expressed the
Axel is not able to do
feeling of getting easily
physical activities as he
tired when doing simple
did prior to being
Problems encountered during exercises, such as brisk
admitted. He is now more
a physical activity walking.
on his cellphone browsing
 He is also able to play or on social media, or, if
basketball with his friends, not, he is playing games
and sometimes feel tired through his phone.
when at game. He usually
takes minute breaks and
small sips of water to
combat the feeling of
tiredness.
 No common problems
 As Patient Axel is
(DOB, easy fatigability)
admitted to the hospital, he
were reported during his
Activity tolerance is not able to look after his
participation in household
siblings and is not able to
chores, or taking care of
do chores.
his siblings.
COGNITIVE AND PERCEPTUAL PATTERN:
 No reported hearing and  No reported hearing and
Hearing / Visual Problem
visual problems visual problems
 Oriented to people’s faces,  Time-oriented; No
time and place and no memory lapses were
Changes in Memory
sensory deficits are recorded while being
diminished admitted to the hospital.
 If only mild, he handles it  Expresses severe
Pain Management
himself discomfort to parents
REST AND SLEEP PATTERN:
Feeding  Upon interview, Patient  On hospital admission,
verbalized his likings Patient Axel is on DAT,
towards to-go foods. He with no specific
prefers to choose salty restrictions on diet.
foods, taken with However, junk foods and
carbonated drinks. carbonated drinks are no

 “Mas prefer ko yung salty
foods, para may lasa” as
verbalized by the patient.
 Patient Axel usually
moves his bowel once a
day, every morning. He
has no difficulty in passing
Toileting stools.
 Urination was less
frequent prior to being
admitted to the hospital,
but no pain was reported.

Able to do normal hygiene
independently, such as
Hygiene
bathing, oral care and
voiding.
 Patient Axel usually sleeps
at 10-11:00pm in the
evening and had to wake
up early in the morning, at
around 6-6:30am because
Sleep Concerns of school duties.
 He takes no noon naps as
most of his day time was
spent at school.
 No episodes of dyspnea
were reported.
SELF PERCEPTION AND SELF CONCEPT:
Self-Perception  Appears to be confident
Description of Self 
Appears to be confident

There are noticeable
changes in body due to
Body Image
puberty but does not affect
his self-perception
ROLE RELATIONSHIP PATTERN:
 Patient Axel’s support
Support System
system are his parents
Family Function  As the eldest child, he
performs household chores
and assist in guidance of
longer a part of Patient
Axel’s diet, rather, he was
given fruits and breads for
snacks.
 No changes in toileting
pattern – defecation was
done once a day, usually
after waking up, no
constipation and pain.
Same with urination,
which comes in more
frequently now than
before. Still no pain is
reported.
 Patient Axel continues to
do his hygiene practices
independently without
needing any assistance
 During hospitalization,
Patient Axel is put on a
modified high back rest to
facilitate in better
ventilation, however, he
sometimes reports of sleep
disturbances due to routine
monitoring of nurses in his
room.
 Worried because of being
idle and not being able to
attend school due to
disease
 Anxious
 Appears to be weak due to
the said disease
 Axel’s support system are
his parents
 Father performs Patient
Axel’s responsibilities
while the mother guards

 Sufficient income because
Sufficiency of Income
 Accessible healthcare
Accessibility of Healthcare
and Nutritional Resources
SEXUALITY AND REPRODUCTIVE:
 There are noticeable
First noticeable changes in
voice
COPING AND STRESS TOLERANCE:
 His coping mechanism
Coping Mechanism
Any anger issues that may
 none
affect hospitalization
VALUE BELIEF PATTERN:
 As the mother stated,
Things and personal values
held important
Family and social values that
affect life
Spirituality
younger siblings axel during hospitalization
both parents have jobs that
 Adequate source of
can cater to their
income because they also
children’s needs. Mother is
have health insurance
a nurse, and father is a
health and safety staff
 Accessible healthcare
resources because they resources because they
live in a city and there are live in a city and there are
health center and health center and
pharmacies near pharmacies near
changes in voice in which  The same deep voice,
it deepened, presence of presence of Adam’s apple,
Adam’s apple, and facial and facial hair
hair
 His coping mechanism
with stress while being
with stress is by playing
hospitalized, is only by
computer games
resting
 none
Patient Axel has no
personal values that were
 Since with his age, still
held important to him
follows family values and
since he is still 15 years
beliefs
old. With his age, still
follows family values and
beliefs
 Family or social values
that affect life specifically
in terms of health, Patient
Axel is not familiar with  Focuses more on scientific
albularyo since both views and values when it
parents works in medical comes to health
field. Focuses more on
scientific views when it
comes to health
 As a Christian, Patient  Being hospitalized, Patient
Axel recognizes that there Axel still religiously prays
is a being greater than

Religious practices that affect
hospitalization
himself as he consistently
offers prayer
 Hospitalization did not
 Offers prayer every
affect his usual offering of
morning and every night
prayer every day