Table of Contents

I. Objectives

II. Introduction

III. Personal Data

IV. History

V. Physical Assessment

VI. Laboratory Tests/Diagnostic Test

VII. Medication

Case Discussion

a.Definition

b. Causes

c.Risk factors

d. Signs and symptoms

e. Pathophysiology

f. Management

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OBJECTIVES

A. General Objectives

At the end of the Individual Case study, the students will gain a lot and essential knowledge, information, skills and desirable attitudes that will be used by us not only in the clinical area and during duty hours but everywhere and anytime upon discussing the focused disease and other related topics.

B. Specific Objectives

At the end of the Individual Case study, the students will be able to:

♥Knowledge

Define PneumoniaKnow the causes and risk factors of the said diseaseDetermine the signs and symptoms of PneumoniaFamiliarize the diagnostic procedures and treatment of the diseaseFormulate nursing diagnosis to patient with PneumoniaConstruct a plan of care to patient with PneumoniaHave an overview about the underlying abnormalities and physiologic disturbances as by Pneumonia

♥SkillsDeal with patient having Pneumoniacommit to effectively execute or implement nursing care plan for the client, including all nursing interventions suitedevaluate the efficiency of the nursing care provided according to the nursing care plan

♥AttitudesUnderstand the feelings and condition of the patient having Pneumonia Empathize with the patient

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INTRODUCTION

Pneumonia is an inflammation of the lungs caused by an infection. It isalso called Pneumonitis or Bronchopneumonia. Pneumonia can be a serious threat to our health. Although pneumonia is a special concern for older adults and those with chronic illnesses, it can also strike young, healthy people as well.  It is a common illness that affects thousands of people each year in the Philippines, thus, it remains an important cause of morbidity and mortality in the country.

There are many kinds of pneumonia that range in seriousness from mild to life-threatening. In infectious pneumonia, bacteria, viruses, fungi or other organisms attack your lungs, leading to inflammation that makes it hard to breathe. Pneumonia can affect one or both lungs. In the young and healthy, early treatment with antibiotics can cure bacterial pneumonia. The drugs used to fight pneumonia are determined by the germ causing the pneumonia and the judgment of the doctor. It’s best to do everything we can to prevent pneumonia, but if one do get sick, recognizing and treating the disease early offers the best chance for a full recovery.

A case with a diagnosis of Pneumonia may catch one’s attention, though the disease is just like an ordinary cough and fever, it can lead to death especially when no intervention or care is done. Since the case is a toddler, an appropriate care has to be done to make the patient’s recovery faster. Treating patients with pneumonia is necessary to prevent its spread to others and make them as another victim of this illness.

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ASSESSMENT

A. Personal Data

Name: C.K.A.Age: 3 monthsAddress: Poblacion Norte, Sigma, CapizSex: FemaleReligion: Roman CatholicCivil Status: Single

Chief of Complaint: Cough

Attending Physician: Dr. Conlu

Room no. /Unit: Broncho Ward

Date & Time of Admission: September 15, 2009 11:30P.M

Admitting Diagnosis: Pneumonia

B. History

History of Present Illness

C.K.A. had onset of nonproductive cough, (-) fever, (-) LBM/vomiting, (+)gml suck at 2 weeks prior to admission. She was admitted in the Broncho Pedia Ward and was diagnosed with Pneumonia.

Past HistoryImmunization: Not completely immunizedPast Hospitalization: NoneAllergies: YesPrevious diseases: NoneRemedies: None

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Family Genogram

C. Physical Assessment• A 3-month old baby girl• Weigh 3.4 kilograms• Short brown hair

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LEGEND

PNEUMONIA

COMMON COLDS

1984

R A

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1986

M A

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2008

J.R A

1

2009

C K A

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• Rapid shallow breathing noted• Expressed his self through crying • Skin is warm to touch• Irritability noted due to his condition

GeneralC.K.A. is a 3 months female child who appears weak because of

an ambulatory patient and is responsive to any stimuli. He has an IVF at the right plantar vein; have oxygen and have a volume regulator set reads in the IV pole.

Vital Signs

Temperature: 36.6 degree CelsiusRespiratory Rate: 78 bpmCardiac Rate: 155 bpm

Skin, Hair, Head, Ears, Eyes

o Skin- light brown in coloro Hair- fine texture, slightly thick, no infestations and evenly

distributedo Head and face- the skull is normocephalic

General Appraisal

Language: Hiligaynon and a little Tagalog

Hygiene- performs proper hygiene with the help of the mother

Hearing- has good acuity

Mental status- no mental noted

Neurological The patient can able to expressed his self through crying and

smiling.Eye/Vision

Our patient, have pale conjunctiva due to fever. Eyelashes present curving outward. No lesions noted on the eyelid. Pupil equal, round, reactive to light and accommodation.

Ears/Hearing Our patient doesn’t have hearing problem, no discharges,

symmetrical, no swelling and tenderness. Can respond normal voice

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tone. Intact with lesions. the helix of the ears is line up with the outer canthus of the eyes

Nose Our patient doesn’t have nasal problem, any discharges, any

swelling and tenderness noted upon inspection and uniform in color. Nasal septum is in the midline.

Mouth/Tongue/Teeth/ Speech The patient had a pallor lips, reddened gums, without teeth. Thin whitish coating noted in the tongue, it moves freely without lesions.

Throat/Neck Neck is symmetrical with head, can turned head from right to left

gradually, but with resistance, no palpable lymph nodes.

Respiratory System Patient use accessory muscle in order to breathe normally,

presence of wheezing sound is heard upon auscultation and in normal hearing, with respiratory rate of 60-42 cpm., and nebulization was given.

Circulatory/Cardiovascular Patient has a heart rate of 130-160 beats per minute. No edema

and swelling noted. Good capillary refill less than 2sec.

Gastrointestinal Flat abdominal.contour, no tenderness or distention.

Genitourinary Patient had minimal urination, with minimum 350 cc per diaper

Musculoskeletal The patient had normal upper and lower extremities,

symmetrical and no tendernessIntegumentary

The patient's skin was warm to touch, he experience on and off fever, with good skin turgor. Positive rashes on her ears, head of rashes, sores, and lesions.

D. Laboratory Results/ Diagnostic Results

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September 14, 2009 Hematology

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WBC 9.65 10^ 9/L 4.5-11.0 AbnormalRBC 3.61 10^12/L 4.6-6.2 WNL

Hemoglobin 103 g/L 135-180 AbnormalLow hemoglobin indicates hemorrhage, leukemia, dietary deficiency

Hematocrit .31 vol. fr. .40-.54 AbnormalSegmenters 75% 50-70 AbnormalEosinophils 0.0% 0-3 WNLBasophils 0.0% 0-1 WNL

Lymphocytes .50% 20-45 AbnormalMonocytes 3.0% 0-8 WNL

Platelet 364 10^9/L AbnormalRemarks: OPDSeptember 16, 2009 UrinalysisMacroscopic

Color Pale straw Pale straw to amber color

WNL

Transparency Slightly hazy ClearReaction pH 5 4.7-8.0 WNL

Sp. Gravity 1.010 1.0010-1.0030Protein negative WNLGlucose negative negative WNL

MicroscopicA morph U/P occasional

RBC/ hpf 0-2 0-2/ HPF WNLWBC/hpf 2-6 0-2/HPF Abnormal

Pyuria often caused by urinary tract infection and many times bacteria can be seen in sediment preps. Depending on clinical signs,

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pyuria maybe an indication for culture of urine even if no bacteria are seen.

Epithelial cells fewBacteria few few WNL

Radiology Department September 14, 2009X-ray requestChest APL

X-ray FindingsFew hazy ground glass infiltrates with some air Bronchogram are noted at the right perihilar lung area.Both lungs are hyperaerated.There are normal bronchovascular markings.No paratracheal for peribronchial enlarged nodes are

detected.

Cardiac size and configuration is normal.The rest of the visualized chest structures are unremarkable.

Impressions Consider left perihilar air-space pneumonia

Radiology Department September 21, 2009X-ray request

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Chest APL

X-ray Findings

Follow up study done as compared with the previous chest x-ray taken September 14, 2009 shows no significant.Progression or regression of haziness in the right lung base.The trachea is at midline.The cardiac silhouette is not enlarged/The costo phenic sulci are blunted.The umidiaphragms are smooth.The rest of the visualized soft and osseous structure are unremarkable.

Impression Right basal Pneumonia

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E. Medication

Trade Names & Dosage

Generic Name

Classification Action Indication Side Effect Contraindication Nursing Responsibility

Penbritin175 mg IVEvery 12 hoursANST(-6)

Ampicillin Anti-infectivesTherapeutic action:Treatment and prophylaxis of various bacterial infections such as pneumonia

Binds to bacterial cell wall, resulting in cell death

Treatment of patients with lower respiratory tract infection

Inflammation and redness of the tongue; irritation of mouth or throat; mild diarrhea; nausea; second infection; vomiting.Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or

Hypersensitivity to ampicillin, any component of the formulation, or other penicillins;infectious mononucleosis.

• Assess patient for infection (vital signs, sputum, urine, stool, and WBC) at beginning of and throughout therapy.• Obtain a history before initiating therapy to determine previous use and reactions to cephalosporins.

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tongue); bloody stools; severe diarrhea

Persons with a negative history of penicillin sensitivity may still have an allergic response.

• Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue the drug and notify the physician or other health care professional immediately if these occur. Keep

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epinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction

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Paracetamol

0.4 ml q 4hrs. PRN for temperature of 37.8°C and above

Acetaminophen Antipyretic Analgesic

Reduces fever by acting directly on the hypothalamic heal-regulating center to cause vasodilation and sweating which helps dissipate heat.Reduces pain.

Analgesic-antipyretic in patients with aspirin allergy, hemostatic disturbances, and upper GI disease

Common cold, flue, other viral and bacterial infections with pain and fever.

Arthritis and rheumatic disorders involving musculoskeletal pain

Treatment of mild to moderate pain & as an antipyretic; for symptomatic relief of headache, migraine, neuralgia, toothache & teething pains, sore throat, rheumatic aches & pains, flu, feverishness & feverish cold.

Contraindicated with allergy to acetaminophen

-Assess for the history of allergy to acetaminophen, impaired hepatic function, -Do not exceed the recommended dosage-Assess fever; note presence of associated signs (diaphoresis, tachycardia, and malaise)-assess for clinical improvement and relief of pain and fever

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Panaxim100 mg q 5hrrs ANST

Cefuroxime

cephalosporin antibiotic

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus

As for the other cephalosporins although as a second-generation it is less susceptible to Beta-lactamase and so may have greater activity against Streptococcus pneumoniae

-GI disturbances, dizziness, headache,

Vial: Digestive Disorders: Diarrhea, nausea, vomiting. As with some other wide-spectrum antibiotics, some rare cases of pseudomembranous colitis have been reported.

Allergic Reactions:

Hypersensitivity to cephalosporins.

Observe for signs and symptoms of anaphylaxis during first dose; with prolonged therapy, monitor renal, hepatic, and hematologic function periodically; monitor prothrombin time in patients at risk of prolongation during

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inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Maculopapulous rashes, urticaria, pruritus, fever, seric disease, some very rare cases of anaphylaxis, polymorphous erythema and on exceptional occasions, the Stevens-Johnson syndrome, the Lyell syndrome may occur.

Hematologic Reactions: Hypereosinophilia, leucopenia, neutropenia (sometimes severe), thrombocytopenia (sometimes severe)

cephalosporin therapy (nutritionally-deficient, prolonged treatment, renal or hepatic disease)-report immediately any swelling, redness, or pain at injection/infusion site; respiratory difficulty or swallowing; chest pain; or rash.-Maintain adequate hydration (2-3 L/day of fluids) unless instructed

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may also occur.

Thrombophlebitis after IV administration. Pains, discomfort, induration at the site of injection site when administered through IM route.

to restrict fluid intake.

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Claforan 140 mg IV q 12 hrs

cefotaxime Cephalosporin antibiotic Inhibits

bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing

Susceptible bacteremia, septicemia, lower respiratory and genitourinary tracts, skin and skin structure

For lower respiratory tract infection due to S. pneumoniae, UTI’s due to E. coli and skin infection due to S. aureus.

1% to 10%:

Dermatologic: Rash, pruritus

Gastrointestinal: Diarrhea, nausea, vomiting, colitis

Local: Pain at injection site

<1%: Anaphylaxis, arrhythmia (after rapid IV injection via candidiasis, central catheter), BUN increased, creatinine increased, eosinophilia, erythema multiforme, fever,

contraindicated in patients who have shown hypersensitivity to cefotaxime sodium, any component of CLAFORAN, or the cephalosporin group of antibiotics.

-Know if the client are allergic to penicillin or cephalosporins.

- Tell to the S.O to report adverse reactions and signs and symptoms.

Assess moth for white patches on mucus membranes, tongue. Monitor bowel activity/stool consistency carefully; mild GI

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activity of cell wall autolytic enzymes while cell wall assembly is arrested.

headache, interstitial nephritis, neutropenia, phlebitis, pseudomembranous colitis, Stevens-Johnson syndrome, thrombocytopenia, toxic epidermal necrolysis, transaminases increased, urticaria, vaginitis

Reactions reported with other cephalosporins include agranulocytosis, aplastic anemia, cholestasis, hemolytic anemia, hemorrhage,

effects may be tolerable, but increasing severity may indicate onset of antibiotic- associated colitis. Monitor I & O, renal function reports for nephrotoxicity. Be alert for superinfection; severe genital/anal pruritus, abdominal pain, severe mouth soreness, moderate to severe diarrhea

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pancytopenia, renal dysfunction, seizure, superinfection, toxic nephropathy.

overdose include neuromuscular hypersensitivity and convulsions.

E zinc drops 1.0 ml OD helps speed

up the healing process after an injury

reduce the duration and the severity of

Decreasing the length of time the common cold lasts, when taken by mouth as a lozenge.

Promoting

zinc might cause nausea, vomiting, diarrhea, metallic taste, kidney and stomach damage, and

Contraindicated with patients an underfed infants who had a malaria

Routine zinc supplementation is not

Periodic monitoring of plasma levels of zinc,

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cold symptoms weight gain

and improving depression in people with eating disorders such as anorexia nervosa.

Increasing vitamin A levels in underfed children, or in children with low zinc levels.

Preventing and treating pneumonia in undernourished children

other side effects. Using zinc on broken skin may cause burning, stinging, itching, and tingling.

High doses above the recommended amounts might cause fever, coughing, stomach pain, fatigue, and many other problems.

recommended without the advice of a healthcare professional.

zinc nose spray may be unsafe because it may cause loss of ability to smell.

Do not take zinc if:You have HIV (human immunodeficiency virus). Zinc might reduce survival time.

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CASE DISCUSSIONA. Definition

Pneumonia is a lung infection that can make you very sick. You may cough, run a fever, and have a hard time breathing. For most people, pneumonia can be treated at home. It often clears up in 2 to 3 weeks. But older adults, babies, and people with other diseases can become very ill. They may need to be in the hospital.

You can get pneumonia in your daily life, such as at school or work. This is called community-based pneumonia. You can also get it when you are in a hospital or nursing home. This is called hospital-based pneumonia. It may be more severe because you already are ill. This topic focuses on pneumonia you get in your daily life.

B. Causes

Germs called bacteria or viruses usually cause pneumonia. Streptococcus pneumoniae (pneumococcus) and Mycoplasma pneumoniae both are the common bacterium which causes bronchopneumonia in the adults and children.

Pneumonia usually starts when you breathe the germs into your lungs. You may be more likely to get the disease after having a cold or the flu. These illnesses make it hard for your lungs to fight infection, so it is easier to get pneumonia. Having a long-term, or chronic, disease like asthma, heart disease, cancer, or diabetes also makes you more likely to get pneumonia. In people with impaired immune systems, pneumonia may be caused by other organisms, including some forms of fungi, such as Pneumocystis jiroveci (formally called Pneumocystis carinii). This fungus frequently causes pneumonia in people who have AIDS. Some doctors may suggest an HIV test if they think that Pneumocystis jiroveci is causing the pneumonia.

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C.RISK FACTORS

Smoke

Have another medical condition, especially lung

diseases such as chronic obstructive pulmonary

disease (COPD) or asthma

Are younger than 1 year of age or older than 65

impaired immune system

Have a change in mental status (such as confusion

or loss of consciousness) that increases the risk of

breathing mucus or saliva from the nose or mouth,

liquids, or food from the stomach into the lungs

(aspiration )

Drink alcohol

Recently had a cold or the flu

Malnutrition

Have heart disease

Immobilization

Hospital admission

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Long-term Illnesses

D. Signs and symptoms

PNEUMONIA

Manifested by the Textbook Manifested by the PatientCough, often producing mucus (sputum) from the lungs. Mucus may be rusty or green or tinged with blood.

Fever

Shaking, "teeth-chattering" chills

Fast, often shallow, breathing and the feeling of being short of breath.

Chest wall pain that is often made worse by coughing or breathing in.Fast heartbeat Fast heartbeat

Increased respiration rate

Feeling very tired (fatigue) or feeling very weak (malaise)

Nausea and vomiting.

Diarrhea.

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E..PATHOPHYSIOLOGY

Pneumonia is a serious infection or inflammation of your lungs. The air sacs in the lungs fill with pus and other liquid. Oxygen has trouble reaching your blood. If there is too little oxygen in your blood, your body cells can’t work properly. Because of this and spreading infection through the body pneumonia can cause death. Pneumonia affects your lungs in two ways. Lobar pneumonia affects a section (lobe) of a lung. Bronchial pneumonia (or bronchopneumonia) affects patches throughout both lungs.

Bacteria are the most common cause of pneumonia. Of these, Streptococcus pneumoniae is the most common. Other pathogens include anaerobic bacteria, Staphylococcus aureus, Haemophilus influenzae, Chlamydia pneumoniae, C. psittaci, C. trachomatis, Moraxella (Branhamella) catarrhalis, Legionella pneumophila, Klebsiella pneumoniae, and other gram-negative bacilli. Major pulmonary pathogens in infants and children are viruses: respiratory syncytial virus, parainfluenza virus, and influenza A and B viruses. Among other agents are higher bacteria including Nocardia and Actinomyces sp; mycobacteria, including Mycobacterium tuberculosis and atypical strains; fungi, including Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis, Cryptococcus neoformans, Aspergillus fumigatus, and Pneumocystis carinii; and rickettsiae, primarily Coxiella burnetii (Q fever).

The usual mechanisms of spread are inhaling droplets small enough to reach the alveoli and aspirating secretions from the upper airways. Other means include hematogenous or lymphatic dissemination and direct spread from contiguous infections. Predisposing factors include upper respiratory viral infections, alcoholism, institutionalization, cigarette smoking, heart failure, chronic obstructive airway disease, age extremes, debility, immunocompromise (as in diabetes mellitus and chronic renal failure), compromised consciousness, dysphagia, and exposure to transmissible agents.

Typical symptoms include cough, fever, and sputum production, usually developing over days and sometimes accompanied by pleurisy. Physical examination may detect tachypnea and signs of consolidation, such as crackles with bronchial breath sounds. This syndrome is commonly caused by bacteria, such as S. pneumoniae and H. infl

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SCHEMATIC DIAGRAM OF PATHOLOGY OF PNEUMONIA

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Predisposing Factors Age( very young )Exposure ( living )

Precipitating factorsDaily Activities Environment Diet

Pathological Entry (inhalation) of organism:

Bacteria or Viruses

Occurrence of localized inflammation

MUCUS PRODUCTION MANIFESTED BY WHEEZING

Bacteria invades alveolar cell in the

lungsDiminished surfactant production

Formation of Hyaline membrane

SIGNS AND SYMPTOMSFever, cough, chest, pain, rapid, swallow breathing

BRONCHOPNEUMONIAAirway Obstruction

Predisposing Factors Age( very young )Exposure ( living )

NURSING MANAGEMENT:

       Pt will need to have breath sounds monitored q 4 to determine if pneumonia is progressing.

       O2 sats should be done regularly ( at least q4 during acute phase) to make sure that patient is getting adequate perfusion.

       Make sure to give all scheduled antibiotics on schedule so that therapeutic ranges are maintained.

       Any s/s of infection must be monitored and reported to MD.

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NURSING CARE PLAN: 1

ASSESSMENT NURSING DIAGNOSIS

GOALS INTERVENTIONS RATIONALE EVALUATION

Subjective:

“Naluoy ko gni sa akon bata kay nabudlayan sa magginhawa” as verbalized by mother.

Objective: ineffective

cough noted crackles and

wheezing noted upon auscultation

irritability shallow

breathing

Ineffective airway clearance related to accumulation of secretions

Short term:

a) Demonstrate an RR of 50-60cpm, and irritability.

The family will:b) verbalize

understanding of cause (s) and therapeutic management

c) to establish and maintain patent airway for the whole shift

Independent

1. Assess RR every 4 hours.

2. Position the head appropriately (head of bed elevated).

3. Discourage the overfeeding of the baby.

4. Avoid supine position for extended periods.

- to detect early signs of compromise-to prevent vomiting with aspiration into lungs

-to prevent from having difficulty in breathing

-to improve respiratory function

Short- term:

After the intervention, the patient demonstrates the ff: -Decreased of respiratory rate from 74 bpm-She appears relax

The family verbalized:“Mejoh ginpataas ko na ang ulo sakon puya.Mina gli para makaginhawa sa

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cyanosis tachypnea

RR=74bpm5. Encourage

sitting, lateral prone and upright position.

6. Auscultate breath sounds and assess air movement.

Dependent 1. Assist with the use of respiratory devices and treatment (mechanical ventilation)

-to stimulate cough & clear airways

-to enhance mobilization of secretions that interfere with oxygenation

-to enhance lung expansion & ventilation

mayad”,verbalized by the mother.

NURSING CARE PLAN: 2

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ASSESSMENT NURSING DIAGNOSIS

GOALS INTERVENTIONS RATIONALE EVALUATION

Subjective:

“ Naluoy gid ko sa akon puya kay daw nabudlayan gid sa magginhawa”, verbalized by the mother

Objective Irritability (+) Abnormal

Skin Color: Pale & Dusky

Tachypnea w/ RR= 74bpm

Impaired gas exchange related to altered oxygen supply

Short term: After 4 hours of intervention, the family will:

Verbalize understanding of causative factors and appropriate intervention

Independent1.)Monitor

respiratory rate, depth and scale.

2.)Observe color of skin, mucous membranes and nail beds, noting presence of peripheral cyanosis

3.)Elevate head of bed/position client appropriately

-Manifestations of respiratory distress are dependent on/and indicative of the degree of lung involvement and underlying general health status.

- To note respiratory compromise

-To maintain airway and enhance gas exchange

After the intervention, the family:a.)Verbalized understanding of causative factors such as inhaled bacteria and appropriate interventions such as medication compliance and adequate breastfeeding

NURSING CARE PLAN: 3

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ASSESSMENT NURSING DIAGNOSIS OBJECTIVES INTERVENTIONS RATIONALE EVALUATION

Subjective:

“Sang nag 2 weeks na sa wla ko na sya ginpadede kay tungod skon ubra mina ng-untat kag wala na ako kapasuso.”, verbalized by the mother

Objective: Weighs 3. 4 Skinny

Interrupted breastfeeding related to maternal employment as manifested by lack of knowledge and time

Short-term:

After nursing intervention the mother should be aware about the importance of breastfeeding.

Independent:

1. Encourage the mother to eat foods that will sustain her milk production if possible.

2. Educate the mother about the importance of the breastfeeding.

Breastfeeding is the most important factors that mother should provide to their children. So it is really necessary that the baby will get enough nutrition coming from the milk of a mother so as to promote immune system.

After nursing intervention the mother was slightly encourage in trying to provide milk through breastfeeding because her awareness threaten her in terms of the health of the baby.

Nursing Care Plan no. 4

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ASSESSMENTNURSING

DIAGNOSIS OBJECTIVES IMPLEMENTATION RATIONALE EVALUATION

Subjective:

“ Gamay gid yah akon puya mina dali gid sa magmasaki kag exposed gid kami sa mga sapat.”

Objective:Weighs 3.4

Imbalance Nutrition :less than body requirements

Short term: At the end nursing intervention, the mother will be able to:

Verbalize understanding of the risk factors for her child.

Identify interventions to prevent or reduce risk of infection

The baby will develop a strong resistance against diseases. She will able to know the importance of the health of the baby

Independent:1.2. Maintain a germ-

free environment

Emphasize necessity of sustaining the needs of the baby which is the food that should be provided.

Teach the mother maintain the vitamins of the baby

1. To promote healthy condition and to minimize the risk of acquiring such diseases.

To prevent from acquiring dieases and promote more resistance.

Vitamins helps to protect the baby. So baby should take vitamins to promote

At the end of nursing interventions, the mother:

Verbalized understanding of the risk factors for her child

Identified interventions that will prevent or reduce the risk of infection

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Teach the mother about the advantages of being aware in giving right time, amount and quality of milk she must give.

3.

good nutrition and disease free .

2.

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