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NOTRE DAME OF TACURONG COLLEGE

COLLEGE OF NURSING
Lapu-Lapu St., Tacurong City, Sultan Kudarat, Philippines
Telephone No. : (064) 200-3631 Fax No. : (064) 200-4131

LEARNER'S WORKSHEET 18

Name: Jasmin Angela S. Forro Year/Section: BSN2-B Group: _____Score: ______

Subject: NCM 109 RLE Date : April 18, 2021

TOPIC 18: HIRSCHSPRUNG’S DISEASE

Activity 1

Questions:

1. Based on the scenario, If the patient’s condition will be left untreated, discuss
possible complications that may place the patient’s life at risk. Provide measures
that may aid in preventing this from happening.

Hirschsprung disease (HSCR) is a birth defect. It occurs in approximately one in 5,000

newborns. Children with Down syndrome and other medical problems, such as

congenital heart defects, are at much greater risk (National Institute of Diabetes and

Digestive and Kidney Disease).

According to National Library of Medicine, a few newborn children and

children display with Hirschsprung-associated enterocolitis, which could be a life-

threatening disease of the digestive tract seen in children with Hirschsprung’s illness.

Signs and indications of enterocolitis are loose bowels, fever, stomach distension,

and diminished vitality. These signs and side effects are considered genuine and life-

threatening. If untreated, perforation of the bowel, septic shock, and death can result.

Complications could be further prevent by proper diagnosis, medical management and

intervention. Laboratory results should also be reviewed and vital signs should be

monitored. It is also important that caregivers be provided with enough teaching about

the disease and its management. Proper referral to the physician when irregularities

happen should also be practiced so that complications can be avoided.

Chhabra S, Kenny SE. Hirschsprung disease. Surgery. 2016;34:628–632.

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Loening-baucke V, Kimura K. Failure to pass meconium: diagnosing neonatal intestinal obstruction. Am Fam Physician.
1999;60:2043–2050.

https://www.niddk.nih.gov/health-information/digestive-diseases/hirschsprung-disease

NOTRE DAME OF TACURONG COLLEGE

COLLEGE OF NURSING
Lapu-Lapu St., Tacurong City, Sultan Kudarat, Philippines
Telephone No. : (064) 200-3631 Fax No. : (064) 200-4131

LEARNER'S WORKSHEET

Activity 2

Name of Student:JASMIN ANGELA S. FORRO Date: April 18, 2021 Score: ___
Course/Year/Section/Group: BSN2-B Subject: NCM109 RLE

1. Fill out the IVF Table

Type of IVF Hypertonic Nursing Responsibilities

Solution (at least 5)

Name of IVF D5NSS Check the right name and type of IVF. Follow
the physician's order. Make sure that the IVF
IV Level received 350cc to be administered is the one prescribed by
the doctor.
IV rate cc/hour 12 cc/hour
Rationale: Identifying the right drug/IVF is
IV rate gtts/minute or 12 ugtts/min
done to prevent medication error.
ugtts/min
⦁ Check and identify the patient
IV level to endorse 254cc/hr
Rationale: Identifying the patient allows the
nurse to administer the right IVF to the right
patient.

⦁ Check the right dosage and follow

the prescription of the doctor

Rationale: Following the doctor's order

prevents overdose.

⦁ Inform the patient about the use and

importance of the IVF to be administered.

Rationale: Awareness of the IVF to be

administered helps the patient understand &
cooperate. This can also help in alleviating the
patient's anxiety towards invasive procedures.

⦁ Inform the patient about the side

effects of the IVF.

Rationale: Knowledge about the IVF would

allow the patient to urgently report side effects.

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2. Formulate 3 prioritized nursing diagnosis (based on NANDA using PES format).

PES Format Sample: Activity intolerance related to generalized weakness as evidenced

by patient's verbalization of "gamay ko lang nga ubra kay ginahapo kg ginakapoy na ko".

1. Constipation related to decreased bowel motility as evidenced by chief complaint

of failure to pass a meconium

2. Imbalanced nutrition: less than body requirements related to lack of peristalsis

as evidence by constipation and vomiting

3. Deficient knowledge of caregivers related to the disease process and surgical

procedure as evidenced by caregiver’s verbalization of “Bal.an mo nurse ang iya
pakaduha na operahan man sauna, nahadlok ko kay daw parehas sila
ginabatyag”

3. Formulate a comprehensive nursing care plan. (FDAR)

FOCUS DATA ACTION RESPONSE

(PES) History of Present Implementation and
Priority Illness, Physical Rationale
NANDA Assessment & (at least five (5) nursing
Nursing Diagnostic interventions)
Diagnosis Tests/Procedures
( at least five (5)
assessment findings)

Constipati Objective After 8 hours of

on related Data: nursing intervention,
to 1. Provided upon assessment,
decrease 1. failure health the patient is crying,
d bowel to teaching to seemed irritable and
motility as pass a the vital signs are the
evidenced mecon cargivers following: BP:
by chief ium about the 60/40mmHg, RR:
complaint 2. vomiti disease 50cpm, PR: 135
of failure ng bpm, Temperature:
to pass a 3. Disten Rationale: 36.6 and SPo2 of
meconiu ded to ease 99%
m abdom caregiver’s

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en
4. no air anxiety
in the
rectum
5. gas- 2. Maintained
filled fluid
intesti balance
nes through
proper IV
regulation
as per
doctor’s
order

Rationale:
Accurate
intake and
output
determinatio
ns and
reporting
the
character,
amount, and
consistency
of stools
help
determine
when the
child may
have oral
feedings

3.
Determined
stool color,
consistency,
frequency,
and amount.

Rationale:
Assists in
identifying
causative or
contributing
factors and
appropriate
intervention

4.
Auscultated
bowels
ounds

Rationale:
Bowel
sounds are
generally
increased
inconstipatio

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n.

5.
Recommen
d avoiding
gas forming
foods

Rationale:
Decreases
gastric
distress
and
abdominal
distension.

Evaluation:

Fully Met Partially Met Unmet

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