BENIGNO, NATHANIEL B. Section 315/Group 17 NURSING CARE PLAN Patient s Name: Ms. Rocelyn V.

Odieta Age : 23 Status : Single ASSESSMENT Subjective: Client verbalized a moderate pain on her lower abdomen. Objective: Rated pain as 6 out of 10. Sleepy eyes noted. PR=85 RR=23 BP=110/70 NURSING DIAGNOSIS Altered comfort pain r/t increased uterine contraction. PLANNING INTERVENTIONS RATIONALE EVALUATION

After 4 hours of Independent: nursing y Monitor vital signs interventions, the client will y Assess contraction be able to: patterns, bloody show y Verbalize and the degree of pain within pain and its tolerable characteristics, limits. location, severity, y Perform duration and acceptable frequency. level of comfort. y Gain knowledge y Provide comfort about measures: breathing  Encourage technique. comfortable y Gain position knowledge  Position the client in a left side lying about signs of labor. position

After 4 hours of y To obtain baseline nursing interventions, the data y This is to monitor client was able to: the progress of y Provide labor and the evidence for condition of both improved the mother and comfort the baby. Helps to compared to identify areas of baseline. chief concern, providing baseline y Maintain an acceptable level for future of comfort interventions. when possible. y Left lateral position y Learned the increases venous importance of return and breathing enhances placental technique. circulation. Position y Determine the changes promote comfort, reduce signs of labor whether false muscle tension,

 Encourage client to assume different positions and change them regularly y Teach proper breathing technique.

relieve pressure and promote fetal descent.

signs of labor or true signs of labor.

y Inspect the client s suprapubic area and palpate for bladder distention. Encourage the client to void. y Provide information and update client on labor progress. Dependent: y Give analgesics as doctor s ordered, evaluating effectiveness and observing for any signs and symptoms of untoward effects.

y Proper breathing technique can prevent exhaustion, therefore preventing prolonged delivery of the fetus and prolonged pain. y A full bladder contributes to discomfort and impedes fetal descent. y Helps alleviate any anxiety and fears that may exacerbate pain. y Analgesic helps relieve pain.

BENIGNO, NATHANIEL B. Section 315/Group 17

NURSING HISTORY

I.

Biographical Data: y y y y y y y Name:Rocelyn V. Odieta Address:Blk 4 Lot 114 Southville 8-C Housing Proj. San Jose Rizal, Montalban Age: 23 Birthday: February 14, 1987 Occupation: Housewife Marital Status: Single Religion: Roman Catholic

II.

Chief Complaint: Prenatal Check-up

III.

Present Illness: During pregnancy the client had a previous history of fever last June 8, 2010 accompanied by nausea and vomiting. She was also diagnosed of UTI of the same date. As of to date, the client is experiencing a moderate pain on her lower abdomen.

IV.

Past Illness: The client had a normal delivery of her child (1st baby) with no complications. During her first pregnancy the client stated that she experienced depression due to unexpected pregnancy at her early age. She also noted of her asthma during her childhood but didn t complicate her pregnancy.

V.

Family Illness: The client has a history of anemia on her father s side.

VI.

Functional Activities: 1) Nutritional Metabolic: 2 cup of rice with fish; 1 bowl of noodles; 1 glass of water 2) Elimination: Irregular bowel (dependent on food intake) 3) Activity Exercise: Morning exercise 4) Sleep rest: No problem at sleeping, able to sleep anywhere and anytime provided that there is comfort. 5) OB History: Gravida-2; Term-1; Living Child-1 6) MIDAS: The client s menarche was at age 14 (Nov. 10, 2001) with regular interval and duration of 3-5 days of menstruation. She consumes 6 napkins/pads during stressful activities while 4 napkins/pads during at rest or free from stress. She noted that pimples on her face, moody and a hot feeling are signs that her menstruation is approaching. 7) Sexual History: Her coitarche was at age 18. The client stated that she experienced 2 partners on sexual intercourse, one from the past whereas her first boyfriend and one at present whereas her live-in partner. She also noted that she never experienced and pain during coitus.

JOURNAL

Newly Identified Gene Mutations May Prompt 10% Of Ovarian Cancers Thursday, September 9, 2010 at 8:48AM Scientists at the University of British Columbia have found gene mutations that may cause an estimated 10% of ovarian cancers, a finding that could help them develop new treatments and better understand which women are at high risk for the disease. In the United States, ovarian cancer ranks as the fifth deadliest cancer among women. Of the several subtypes of epithelial ovarian cancer, high-grade serous carcinomas are the most common, accounting for approximately 70% of all cases of epithelial ovarian cancer in North America. Although ovarian clear-cell carcinoma is the second most common subtype in North America (accounting for 12% of cases and an even higher percentage in Japan) and is the second leading cause of death from ovarian cancer, it is relatively understudied. Although ovarian clear-cell carcinoma does not respond well to conventional platinum taxane chemotherapy for ovarian carcinoma, this remains the adjuvant treatment of choice, because effective alternatives have not been identified. Both ovarian clear-cell and endometrioid carcinomas are associated with endometriosis. The genetic events associated with the transformation of endometriosis into ovarian clear-cell carcinoma and endometrioid carcinoma are unknown. Ovarian clear-cell carcinomas have a low mitotic rate, therefore grow more slowly, are genetically stable, and do not exhibit the complex genetic instability of the other ovarian high-grade serous carcinomas that may contribute to their lack of sensitivity to platinum-based chemotherapy. Although ovarian clear-cell carcinoma does not respond well to conventional platinum taxane chemotherapy for ovarian carcinoma, this remains the adjuvant treatment of choice, because effective alternatives have not been identified. Both ovarian clear-cell and endometrioid carcinomas are associated with

endometriosis. The genetic events associated with the transformation of endometriosis into ovarian clear-cell carcinoma and endometrioid carcinoma are unknown. In study published in the New England Journal of Medicine September 2010 issues, researchers at the University of British Colombia, and other universities examined the frequency of a particular gene mutation ADID1A in ovarian cancer. ARID1A mutations were seen in 55 of 119 ovarian clear-cell carcinomas (46%), 10 of 33 endometrioid carcinomas (30%), and none of the 76 high-grade serous ovarian carcinomas. ARID1A mutations were evident in the tumor and contiguous atypical endometriosis but not in distant endometriotic lesions. These data implicate ARID1A as a tumorsuppressor gene frequently disrupted in ovarian clear-cell and endometrioid carcinomas. Since ARID1A mutation can be seen in the early cancer (preneoplastic) lesions, the researchers speculate that this is an early event in the transformation of endometriosis into cancer. Website: http://www.cancerwebmed.com/cancerwebmed/2010/9/9/newly-identified-genemutations-may-prompt-10-of-ovarian-can.html

REACTION PAPER This discovery would be a great help especially to those who suffer much of the ovarian cancer. It will give them treatments and will give better understanding of which women are at high risk of the ovarian cancer. Through this newly discover will enable the doctors to lower the number of victims suffering the cancer and will prevent the patients who are at risk of ovarian cancer to increase. Also, it will give new knowledge of its connection to other cancer cells aside from ovarian cancer. So far the scientist doesn t give much attention yet but it is good to hear that they are looking into it. We hope that it may soon be improved so that it can be used as a treatment once drugs were developed and help the doctors to treat cancer. They may provide opportunities for developing new biomarkers and therapies that target those genes.