Unciano Colleges Inc.
Circumferential Road, Antipolo City
A Case Study on
In partial fulfillment of the requirements in
NURSING CARE MANAGEMENT 103
Group 3 Section III-C
Sabado, Dante Jr. N.
Salazar, John Fritz M.
San Luis, Katrina F.
Sarsona, Adelaida A.
Sevilla, Kenneth John M.
Sibayan, Shirley D.
Suva, Pepito S.
Verastigue, Allan G.
Yim, Roxanne V.
Ms. Ruby Mendez RN
May 14, 2010
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II. TABLE OF CONTENTS
Table of Contents 4
Background of the Study 6
Patient‟s Profile 8
Nursing History 9
Anatomy & Physiology 21
Laboratory & Diagnostics 27
Drug Study 29
Nursing Care Plan 31
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We, the Bachelor of Science in Nursing 3rd year students, group C-3 of Unciano Colleges,
Antipolo City, would like to extend our deepest gratitude to the following people and the
institution. The completion of the case study was made possible through our invaluable
contribution of the following to whom we convex our sincerest gratitude:
To Angono General Hospital for giving us the opportunity to have our related learning
experience in hospitals.
To the doctors and staff nurses of Angono General Hospital for accommodating and
permitting us to see our client‟s chart and to assess our patients.
To our clinical instructor Ms. Mendez, RN, who professionally and obligingly performed her
responsibilities as our guide through the nursing related experience based on hospital setting.
And above all, to God Almighty, who saw all the sacrifices we‟ve made and He who gave us
intellect. He continues to inspire and guide us in everything we do, whatever we have
accomplished could not have been possible without Him.
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Nursing in general is the process of caring or nurturing for another individual who needs
health care services. This function is expected or should be carried as a science, profession,
and service. Exposing to a hospital area will let nursing students learn and practice more than
lecture can do.
Nursing case studies are conducted because of three aspects, learning, familiarizing with the
case of the patient and involvement. These aspects will help nursing students to practice the
nursing process efficiently and effectively. And it would also help the patient to promote
their health and wellness.
We chose to take the case of baby M.F., who has been diagnosed with Pneumonia because of
the following criteria: cooperativeness, uniqueness of his condition, status of admission, and
the significant others‟ willingness and learning contents of the case.
The client‟s family are also willing to have him as our case study. Prior to that, his
significant others were very accommodating and cooperative during our interaction.
And it is very challenging for us to take this case.
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Background of the study
Hypersensitivity is a term that is used to identify situations in which some type of substance
or medication triggers an unusually strong and adverse reaction from the immune system. In
some instances, hypersensitivity reactions can be extremely uncomfortable, cause permanent
damage, or even result in death. There are four commonly accepted types of this condition,
with variations of these four supported by different schools of medical thought.
Allergies are normally classified as Type 1 hypersensitivity. These involve allergic reactions
that produce an almost immediate effect. The individual may begin to have difficulty
breathing, experiencing what amounts to an asthma attack. In more extreme situations,
anaphylaxis may occur.
An antibody-dependent or cytotoxic reaction defines define Type 2 situations. Within this
category, the hypersensitive reaction manifests with the development of particular conditions
such as Goodpasture‟s Syndrome, Myasthenia Gravis, or Graves disease. A Type
2 hypersensitivity type has more long range implications.
Type 3 hypersensitivity is classified as an immune complex disease. Within this category,
conditions such as Arthus reaction or Serum sickness occur. Along with Type 2, patients
diagnosed with Type 3 often require ongoing monitoring in order to keep the triggered
condition under control.
DTH, or delayed type hypersensitivity, is known as Type 4. Within this category, patients
may develop various dermatological issues that are extremely uncomfortable, experience
fluctuation in T-cell levels, and possibly develop conditions such as multiple sclerosis. As
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With other hypersensitivity types, it is important to identify the substance or medication
causing the hypersensitive reaction and prevent any further ingestion of that substance.
One of the best ways to get an idea of how painful hypersensitivity can be is to consider the
momentary sharp pain that is often experienced when extremely cold beverages come in
contact with a tooth filling. The sudden and intense wave of pain created can often seem
unbearable for a brief moment before leveling off. For people with hypersensitive reactions
to medicine, food, or some factor in their environment, that level of pain does not subside
within a moment, but can last for an extended period of time.
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Food allergies are more common in children than adults. About 7 out of 100 kids have them.
Only about 3 to 4 out of 100 adults do.1 Children often outgrow their food allergies. But if you
have a food allergy as an adult, you will most likely have it for life.
To be able to:
-Establish rapport with the client and his significant others.
-Apply and improve our assessment skills using the 13 areas of assessments
-Review the anatomy and physiology of digestive system.
-Identify the actual potential and health problem of the client.
-Study the pathophysiology of Typhoid fever.
-Formulate appropriate nursing interventions.
-Review medications prescribed to our client and know the nursing considerations when
- Evaluate the effectiveness of the Nursing Care Plan‟s and impart appropriate health teachings
on promoting client‟s health recovery.
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HOSPITAL CASE NO.: 116- 64974
AGE: 8 years old
DATE OF BIRTH: November 23, 2001
RELIGION: Roman Catholic
ETHNIC GROUP: Filipino
RESIDENCE: , Binangonan, Rizal
ROOM: Pediatric Ward
CHIEF COMPLAINT: Rashes all over his body
DATE & TIME OF May 10, 2010; 12:53pm
ADMITTING DIAGNOSIS: Hypersensitivity Reaction
ATTENDING PHYSICIAN: Dr. Cerda
DATE & TIME OF May 11,2010; 11:00am
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“May mga pantal siya sa katawan at nilalagnat ” as verbalized by the client‟s father.
History of Present Illness
Five days before confinement, M.F‟s family had a Chicken Adobo for their dinner. M.F ate a
lot of it and few hours M.F suffered from intermittent fever and rashes all over his body.
According to according to his father M.F also complained itchiness that time. To relieve the
fever his father decided to gave him 5ml of biogesic syrup. After that his father rushed him
to Angono General Hospital for an initial check up. When check up is done, the residence on
duty prescribed Perphenhydramine for his allergy and Paracetamol syrup for fever. The
symptoms are still present to M.F. After 2 days the rashes all over his body get worst and his
fever doesn‟t subside so his father brought him again to Angono General Hospital via
jeepney dated May 10, 2010 at around 11am. They arrived at the Emergency Room and was
seen and examined by the Resident on Duty of the Hospital who is Dr. Cerda. Vital signs are
taken as follows: Body Temperature of 37.8 oC, Pulse Rate of 143 bpm and Respiratory Rate
of 46 cpm. The doctor request for confinement together with his order of IVF D5 0.3 NaCl
500cc x 12o at his right metacarpal vein, Hypersensitive 25mg TIV q 8o, and
Perphenhydramine ½ ampule TIV q 8o. Was then requested for some laboratory
examinations such as; Hematology and. He was admitted at the Pediatric Ward bed #1.
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History of Past Illness
According to his father, M.F‟s usual illness was fever, cough and colds. It was only his first
time of confinement.
During our assessment his father told us that their family has a history of hypertension and
diabetes while his wife has a history of Asthma.
M.F‟s father is a barber shop in their place. He earns almost P12, 000.00 every month. On the
other hand his mother is presently living in Singapore for work. She is a factory worker and
earns P15, 000.00 a month but only half of it was given to them due to her personal expenses.
His father will be the one to pay all his bills in the hospital.
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13 AREAS OF ASSESSMENT
I. SOCIAL STATUS
The patient is 8 years old. He was baptized as a Roman Catholic but he is not an active
participant to any religious or social organization. He is currently studying at his 2nd grade. They
live in Binangonan Rizal. There are 3 siblings and he is a second sibling of his parent. He was
born on November 23 2001. According to him he loves to stay at their house and he seldom go
out with friends. His favorite pastime is playing with his friend and watching TV.
He belongs in the stage of Industry vs. Inferiority. Industry here refers to purposeful or
meaningful activity. It's the development of competence and skills, and a confidence to use a
'method', and is a crucial aspect of school years experience. Erikson described this stage as a sort
of 'entrance to life'. A child who experiences the satisfaction of achievement - of anything
positive - will move towards successful negotiation of this crisis stage. A child who experiences
failure at school tasks and work, or worse still who is denied the opportunity to discover and
develop their own capabilities and strengths and unique potential, quite naturally is prone to
feeling inferior and useless. Engaging with others and using tools or technology are also
important aspects of this stage. It is like a rehearsal for being productive and being valued at
work in later life. Inferiority is feeling useless; unable to contribute, unable to cooperate or work
in a team to create something, with the low self-esteem that accompanies such feelings.
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II. MENTAL STATUS
We asked our patient if he is aware where he is, he replied to us that he is in Hospital.
We asked him if he is still studying, he replied “Yes”. We asked him what is the full name of his
mother, which is currently with him to assess his awareness to person, he answered correctly. His
mother told us that he is now in his 2nd grade. He speaks and answers our questions but when he
answers our questions, he uses „Tagalog‟ dialect fluently. Also during the interview, he doesn‟t
maintain eye contact and seems to be very shy. We also asked the last event that he participated
in his school, and he said “Christmas party”. We also asked him what his favorite song is, he
replied “Nobody”. Our findings are confirmed by his mother.
III. EMOTIONAL DEVELOPMENT
Our client was calm but he is a shy person, when we are talking to him there is a time that we
need to repeat our question twice or thrice before he answer this sometimes he remain silent,
He felt sad because of his condition, because he experiences failure to play with his friend.
IV. SENSORY PERCEPTION
We asked M.F. to sit on the side of the bed before starting our assessment. We started our
assessment by inspecting his external eye structures. Eyebrows were thick, black and evenly
distributed. It was symmetrically aligned and equal in movement. Eye lashes were equally
distributed and straight. Eyelids close symmetrically. Our client had 18 involuntary blinks
per minute. His eyes were symmetrical in size. There were no discharges noted in the inner
and outer cantus of both eyes. His pupils were black in color and equal in size about 5-6mm
with the use of pattern in G&A notes and observable flat and round iris.
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We assessed his papillary reflex with the use of the penlight. We passed the light
approximately 3-4 mm on the level of his eyes from the outer cantus to the inner cantus of his
right eye. His pupils constricted about 1mm when the light passes then return to normal after
the light had passed. We did the same test on his left eye and it had the same reaction. We
notice that our client has a dark circle under his eyes.
While the client was still in sitting position, we continued our assessment. Auricles were
symmetrical in size, uniform in color and aligned with outer cantus of his eyes. We can
notice some dirt both in his left and right external auditory opening. We palpate the auricles
for the texture, elasticity and areas of tenderness. We gently pulled the auricle upward,
downward and backward. And it was mobile, firm and not tender.
We asked the client that we would perform some hearing test to determine the function of
CN VIII (auditory). We performed the Weber‟s Test. By using the tuning fork, we activated
it by pinching the tuning fork on the end corner and placed it on the top of his head. We
asked him on which ear he could hear the vibration and he stated he could hear the vibration
on both ears. (WEBER NEGATIVE)
Lastly, we performed the Rinne‟s Test. We instructed the client to listen on the ringing sound
and tell us if he can no longer hear the ringing sound. We tested first his right ear. By using
the tuning fork, we activated it by pinching the tuning fork on the end corner. We held the
handle of the activated tuning fork on the mastoid process of his right ear until he can no
longer hear the sound. When he stated that he can no longer hear the sound, we immediately
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placed the still vibrating tuning fork in front of his right ear canal approximately 2-3 cm
away. We asked him if he can now hear the sound and he said yes. We also tested his left ear.
We activated the tuning fork and hold the handle of the activated tuning fork on the mastoid
process of his left ear until he stated that he can no longer hear the sound. Then we
immediately placed the still vibrating tuning fork in front of his left ear canal and he said that
he could now hear the sound. The tuning fork vibrations conducted by air are normally heard
longer. Air-conducted (AC) hearing was greater than bone-conducted (BC) hearing. AC>BC
Client‟s external nose was assessed to check for any deviations in shape, size and color. Nose
was symmetrical and uniform in color. No discharges seen on his nose. We also assessed the
patency of both nasal cavities. We asked the client to close the mouth, exert pressure on the
nares and breathe through the opposite nares. Air moves freely as the client breathe through
the nares. Smelling taste was preformed, we prepared perfume and calamansi and instructed
the client to identify the different kind of odor by having his eyes blindfolded and smell it
while the other nostril is occluded. We first let his smell the perfume 1-2 inches away from
the nostril and he recognized it as pleasant smell and able to distinguish it was perfume. The
same thing with the calamansi, the client was able to tell us that it was calamansi with an
unpleasant smell. We did those things bilaterally.
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M.F.s tongue is pinkish in color and also his gums, when we asked him to open his mouth.
Upon inspection there is no a lesion or discharge seen inside his mouth. Upon assessing the
client we prepared taste test using sugar (for sweet), salt (salty), calamansi (for sour) and
coffee (for bitter). We instructed the client to have his eyes blindfolded. We let him taste
these by giving him a pinch of it, using a tongue depressor and put it on his tongue. The
client was able to distinguish and differentiate the sour from salty and sweet from bitter. We
did the test by giving first the less offending to the most offending taste. We let the client to
drink water to prevent after taste right after each procedure.
Tactile: We assessed his sense of touch with his eyes blindfolded and he was still in sitting
position. We performed our assessment on both upper and lower extremities and anterior and
posterior part of his body. We let our client identify between sharp and dull.
First, we let him feel the pointed part of the percussion hammer on his right palm, right arm,
left leg (gastrocnemius), right foot (sole) and chest. He felt the pointed object and said that it
was sharp. Then we let him feel the blunt end of the percussion hammer on its handle. We
put it on his left palm, left arm, right leg (gastrocnemius), left foot (sole) and back. He felt it
and identified it as dull. We repeated the procedure bilaterally and alternately on his upper
and lower limbs, anterior and posterior portion of his body and it had the same result.
Next, we let our client identify between soft and hard. We let him feel a cotton ball on his
right arm. We rubbed the cotton ball smoothly on his right arm and he identified it as soft.
Then, we let him feel the handle of the percussion hammer on his left arm. We pressed the
handle of the percussion hammer on his left arm and he identified it as hard. The procedure
was done on both arms and both legs alternately and had the same result.
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We let our client identify between smooth and rough. We let our patient touch the head of
percussion hammer over her left hand and he identified it as smooth. Then we let him touch
the handle of percussion hammer over his right hand and he identified it as rough. The
procedure was done alternately both on upper and lower limb and it had the same result.
We also let our client identify between cold and warm. We rubbed ours hands (hand friction)
to make it warm then we touch the left arm of our client and he identified it as warm. After
that, we placed a cold bottle of mineral water on his right arm and he identified it as cold. We
repeated the procedure again but on alternate arms and had the same result. Same procedure
was done on his lower limbs and had the same result.
V. BODY TEMPERATURE STATUS
The body temperature was 38.2°C, febrile, taken via right axilla for 3minutes at around 11am .
M.F. can ambulate without assistance when we asked him to take few steps (5 steps) and we
also saw him going to the rest room by himself. We asked the client to walk across the room
(5 steps) to assess his gait; we observed that he has upright posture and steady gait with
opposing arm swing and walks unaided. Range of motion was tested by flexion, extension,
abduction, adduction and rotation on client‟s upper and lower extremities. Active range of
motion was noted both on his right and left upper and lower extremities.
To test his muscle grading, we asked the client to resist the gravity that we are
making with the use of our hand pushing against his upper and lower extremities. His
right and left arms resisted the gravity made by hands while he is on sitting position.
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We noted that his right and left arm has a muscle grading of 5/5. On his lower extremities, we
asked him to lie down on his bed. Lower right and left thigh resisted the gravity made by
hands. Grading muscle strength was 5/5 movements against gravity and against full
resistance both on his lower right and left extremities since both right and left lower
extremities resisted the gravity made by hand. Then we asked him to sit on the side of his
We also tested his patellar reflex by asking the client to relax his lower extremities and
deliver a gentle blow using a percussion hammer on his right kneecap (patella) and it moved
freely and we observed the normal extension or kicking out of the leg. Same procedure was
done on his left knee and had the same result. The functional level noted in the reflex is +2 or
His functional level is 5 since he doesn‟t need assistance from his significant others and
assistive devices in performing his activities of daily living.
As we assess MF‟s nutritional status, we observed the external portion of the mouth using a
penlight. We asked the client to open his mouth and we observed that the client‟s gums,
tongue and mucous membrane are pinkish in color and intact. He has no dental carries, but he
has 1 missing tooth on his upper and 2 missing on his lower teeth. According to him he
seldom brushes his teeth. He eats 3x a day with a snack between meals. Their daily menu
usually includes fish, meat, rice and vegetables.
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He has no allergies on any kind of food or even experience difficulty in swallowing. He has
an IV Fluid of D5 0.03 NaCl 500cc x 12o ,41-42 mgtts/min. He was 66 inches in height and
66 kilograms in weight.
We asked MF how often he voids per day. He said that before his confinement, he defecates
once and urinates 5 times daily. According to him, his urine is approximately ¼ of a drinking
glass or equivalent to 63 ml per void. With that data, we estimated that our client voids at
about 315 ml/day before his confinement. On the day of our assessment, MF had never been
defecated since the start of his confinement, urinated 10 times, the color was light yellow and
has a faint odor. We asked the amount per void and he told us that it is approximately ¼ of a
drinking glass or 63 ml/void.
MF was not yet been circumcise.
STATE OF PHYSICAL REST AND COMFORT:
At home, he usually sleeps at 10 pm to 7 am with a total of 9 hours of sleep. He does not
experience any difficulty in sleeping. He takes a nap every afternoon. During hospitalization,
he doesn‟t experience any difficulty in falling asleep. He was able to sleep for a total of 8
hours but not in consecutive hours, he was disturbed by the noise and taking his vital signs as
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STATE OF SKIN AND APPENDAGES
MF has a trimmed hair and black in color. His hair is evenly distributed. There is no infection
or infestation presence in the hairline or even in his scalp. The hairs of his eyebrows, ears and
nostrils are thin.
The client‟s skin has brown in color. But his skin losses its elasticity. Moisten skin is more
prominent over his extremities. We also check his skin turgor by pinching his skin over his
sternum, the skin springs back to its previous state within 1 second.
MF‟s nails grow thin with a smooth texture. We noticed the presence of dirt in his
nails both hands and feet. As we inspect the tissue surrounding nails there is an intact
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ANATOMY AND PHYSIOLOGY
Hair shafts grow from hair follicles situated in the dermis and hypodermis. Every hair
consists of a root, the part that lies under the skin, and a shaft, the part that extends from the
follicle above the skin.
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Sweat pore The funtion of a sweat pore is when you hot your body has to find a way tto cool
you off.So when your sweating your cooling off.
Dermal papilla Any of the superficial projections of the corium or dermis that interlock with
recesses in the overlying epidermis, contain vascular loops and specialized nerve endings,
and are arranged in ridgelike lines most prominent in the hand and foot. Also called papilla
-The dermal papillae nourishes all hair follicles and bring food and oxygen to the lower
layers of epidermal cells.
Epidermis The upper or outer layer of the two main layers of cells that make up the skin.
The epidermis is mostly made up of flat, scale-like cells called squamous cells.
-acting as the body's major barrier against an inhospitable environment.
Dermis The dermis is the middle layer of your skin. It holds most of the glands and nerve
endings. For example, your sweat gland and your oil glands are located on this level. You
feel hot, cold, touch and several others through your dermis.
Hypodermis The outermost cell layer of the cortex, also called the exodermis, of plants. The
hypodermis may produce substances that act as a barrier to the entry of pathogens, and in
some plants it may function in the absorption of water and the selection of ions that enter the
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Pacinian corpuscles detect gross pressure changes and vibrations and are rapidly adapting
(phasic) receptors. Any deformation in the corpuscle causes action potentials to be generated,
by opening pressure-sensitive sodium ion channels in the axon membrane.
Sweat glands also referred to as sudoriferous glands are exocrine glands, found under the
skin of all mammal species, that are used for body temperature regulation. In humans a
system of apocrine - and merocrine sweat glands is the main method of cooling.
Blood and lymph vessels in vertebrates is a network of conduits that carry a clear fluid
called lymph ( Latin for clear water). It also includes the lymphoid tissue and lymphatic
vessels through which the lymph travels in a one-way system in which lymph flows only
toward the heart.
The retinal nerve fiber layer (nerve fiber layer, stratum opticum, RNFL) is formed by the
expansion of the fibers of the optic nerve; it is thickest near the porus opticus, gradually
diminishing toward the ora serrata.
As the nerve fibers pass through the lamina cribrosa sclerae they lose their medullary sheaths
and are continued onward through the choroid and retina as simple axis-cylinders.
Papilla of hair The papilla is the very bottom portion of the hair follicle that contains the
blood supply and the matrix. The matrix consists of cells that actually form the hair shaft.
A hair follicle is a part of the skin that grows hair by packing old cells together. Attached to
the follicle is a sebaceous gland, a tiny sebum-producing gland found everywhere except on
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the palms, lips and soles of the feet. The thicker the density of the hair, the more the number
of sebaceous glands that are found.
The sebaceous glands are microscopic glands in the skin which secrete an oily/waxy matter,
called sebum, to lubricate the skin and hair of mammals.Sebum acts to protect and
waterproof hair and skin,
Arrector pili: A microscopic band of muscle tissue which connects a hair follicle to the
dermis. When stimulated, the arrector pili will contract and cause the hair to become more
perpendicular to the skin surface
The Stratum germinativum (or basal layer, stratum basale) is the deepest layer of the 5
layers of the epidermis, which is the outer covering of skin in mammals. The stratum
germinativum is a continuous layer of cells. It is often described as one cell thick, though it
may in fact be two to three cells thick in glabrous (hairless) skin and hyperproliferative
epidermis (from a skin disease).
The pigmented layer of retina or retinal pigment epithelium (RPE) is the pigmented cell
layer just outside the neurosensory retina that nourishes retinal visual cells, and is firmly
attached to the underlying choroid and overlying retinal visual cells.The retinal pigment
epithelium is involved in the phagocytosis of the outer segment of photoreceptor cells and it
is also involved in the vitamin A cycle where it isomerizes all trans retinol to 11-cis retinal.
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The stratum corneum is the outermost layer of the epidermis, composed of large, flat,
polyhedral, plate-like envelopes filled with keratin, which is made up of dead cells that have
migrated up from the stratum granulosum.
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Precipitating Factors: Predisposing Factors:
o Food o Underlying gastrointestinal pathology.
Non-immunologic food intolerance Underlying gastrointestinal pathology.
Response to exclusion diet
Reactions may be immediate (1-2 hours)
or delayed (several days)
Multiple food allergies are more common
in gastrointestinal disease
Type I hypersensitivity.
Anaphylactoid reaction due to presence of
Immunological activity threshold is
breached, allergic breakthrough.
Removal of exposure to one of inciting
allergens may be sufficient to produce
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An uncommon disease. True food allergy does exist but is clinically indistinguishable from
non-immunologic food intolerance. Diagnosis of adverse response to food usually confirmed
through response to exclusion diet. Reactions may be immediate (1-2 hours) or delayed
(several days).Food allergies affecting skin are often caused by a single food whereas
multiple food allergies are more common in gastrointestinal disease (Guilford 1994).Very
little known about pathophysiology of food allergy. Most commonly accepted theory is Type
I hypersensitivity. Anaphylactoid reaction due to presence of histamine may be one
mechanism. Food allergy response in dogs is typically delayed (Rosser 1993). Antigenic
exposure gives rise to histamine-releasing factors which remain active some time after
antigen is removed. This may explain the lag between introduction of a hypoallergenic diet
and clinical improvement. Allergic response may only become apparent when
immunological activity threshold is breached, allergic breakthrough. This is when a small
increase in allergen load may provoke an allergic response, similarly removal of exposure to
one of inciting allergens may be sufficient to produce clinical
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LABORATORY AND DIAGNOSTIC FINDINGS
Hematology May 4, 2010
Test Result Normal Values Clinical Significance
Hemoglobin 9.9 M=4-18g/dL Within the normal values
Hematocrit 30 M=40-54% Due to infection
WBC Count 4.4 5.0-10.0 Due to infection
Neutrophil 66 50-70 Within the normal values
Lymphocyte 34 25-40 Within the normal values
Monocyte 0.03 0.00-0.06 Within the normal values
Platelet Count 262 150-450 Within the normal values
Pathologist: Demetric L. Valle Jr.MD.FPSP
Urinalysis May 4, 2010
test result NORMAL VALUES Clinical significance
color Light yellow Yellow Normal
transparency clear Clear Normal
Ph(reaction) 5.0 Acidic A pH below 7
indicates acidity and a
pH in excess of 7
Specific gravity 1.010 1.015-1.025 Normal
glucose negative Negative Normal
Protein (albumin) negative Negative Normal
Pathologist: Bernadette Espiritu, MD
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After 32 hours of exposure in Angono General Hospital, ward, we, the 3rd year students
of Bachelor of Science in Nursing, section C, group 3 of Unciano Colleges - Antipolo, City
acquired proper attitude in communicating with the patients and the staffs in the hospital, we
gained much knowledge and competencies in our clinical area, and we applied our classroom
acquired skills in actual hospital setting.
We established rapport with the client and its significant others. We learn more about the
anatomy and physiology of the patient‟s digestive system and we were able to gain more
knowledge about the medications given to our patient. We were able to enhance our assessment
skills using the 13 Areas of Assessment. We were able to formulate an effective nursing care
plan about the patient‟s condition.
We were able to establish rapport with our client as well as his family and helped them
recognize and gave importance on their health and personal development.
We were able to identify and analyze present health problems of our client that might
place him at risk and we were able to use our nursing skills to help him.
We were able to review our knowledge about anatomy and physiology of the Digestive
system as well as the pathophysiology of Typhoid Fever.
We were able to formulate and plan appropriate nursing interventions that lessen the
health problems of our client, by involving him as well as the members of our group.
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We were able to impart necessary knowledge regarding health maintenance to our client
that guided him to achieve a healthy life.
We were able to evaluate the effectiveness of our nursing care plan.
XV. PROGNOSIS, DISCHARGE PLANNING & HEALTH TEACHING
The infant shows good prognosis towards full recovery and resumption of activities of
daily living, as manifested by being able to eat and sleep better, as well as in resuming his play
and his attempt to walk around. Our client's family, especially the mother, was open-minded and
accepted our health teachings and nursing interventions.
XVIII. DISCHARGE PLAN\
Guidelines from reputable health agencies suggest some steps parents can take to reduce their
child's chances of having food and other allergies, although there are no guarantees of success. If
either or both parents have a personal or family history of allergy, for example, asthma, eczema,
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hay fever, perennial allergic rhinitis (allergy to animals, dust mites, or molds) the following is
Avoid common allergenic foods, in particular peanuts and tree nuts, during pregnancy
and while nursing -- peanut protein, as well as components of cow's milk, eggs, and
wheat, are secreted into breast milk
Breast-feed exclusively -- give your baby only breast milk for the first 6 months of life
using hypoallergenic formulas to supplement breastfeeding if necessary.
Not all studies agree on exclusive breast-feeding. The latest and largest study investigating the
relationship between breast-feeding and allergies, particularly asthma, suggests that breast-
feeding in the early months of life can prevent allergies until your child is 2 years old.
Since delaying foods allows the child's gastrointestinal tract to mature, the following strategies
may be helpful:
Delay giving your infant solid food until 6 months of age.
Delay giving your child common allergenic foods as follows: dairy until age 1 year; eggs
until age 2 years; peanuts, nuts, and fish until 3 years.
If an allergy develops, carefully avoid the offending food.
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