Embed Size (px)
Citation preview
OUR LADY OF FATIMA UNIVERSITY #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student: Angelique B. Espiritu _______________________________________________________________________________________ Name and Address of School: Our Lady of Fatima University #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City__________________Accreditation Level (if any): PACUCOA Level II Year Granted: April 10 ,2002Date School/Program was Recognized: April 25, 2001________________Number: 033 ________________________Year: 2001____________First Course (if any): NOT APPLICABLE_________________ School Graduated From: NOT APPLICABLE_________ Year: NOT APPLICABLE____Year of Admission in the Bachelor of Science in Nursing Program: June 2008_______________________________________________________Year Graduated (BSN Program): November 2011_______________________________________________________________________________
I. Major Operations
No.Date of
OperationCase No.
Name of Patient
Diagnosis Operation PerformedType of
AnesthesiaName of Surgeon
Name of HospitalSupervised by
Qualified CISignature of Qualified CI
1.July 28.
20102010-
002988Leticia Cortez
Post appendectomy Adhesion
Adhesiolysis SpinalDr. Shakya
SudipFatima University Medical Center
Mrs. Secinia I.Tallo,
RM,RN,MAN
2.July 29,
20102010-
087660Milagros Rubio Breast Carcinoma
Modified Radical Mastectomy
Spinal Dr. Celso FidelFatima University Medical Center
Mrs. Secinia I.Tallo,
RM,RN,MAN
3.January 1,2011
141837Leah P.
Meneses,
Gravida3 Parity 2 Pregnancy Uterine Full
Term, Previous Cesarean section
Repeat Lower transverse Cesarean
sectionSpinal
Dr. Priscilla Quiambao
Calumpit District Hospital
Mr. Marcellus Belisario RN,MAN
4.February 6,2011
2011-09462
Emmanuel RullIncarcerated Inguinal
Hernia, RightMesh herniorrhaphy,
RightLocal
AnesthesiaDr. James
BañezFatima University Medical Center
Mrs. Secinia I.Tallo,
RM,RN,MAN
5.February 14,2011
2011-000810
Golda Swing Oliverio
Gravida2 Parity1 Pregnancy Uterine Full
Term, Previous Cesarean section
Repeat Lower transverse Cesarean
sectionSpinal
Dr. Jennalyn Delos Reyes
Fatima University Medical Center
Mrs. Secinia I.Tallo,
RM,RN,MAN
Prepared by:
Angelique B. Espiritu Signature over printed Name of StudentSupervised by: _______________Signature over printed name of FacultyDate Signed: ____________Degree: ________________a.) PRC NO: __________
Valid Until: ________b.) PNA NO: ___________ Valid Until:_________
Noted by:
Secinia I TalloSignature over printed name of Clinical Coordinator Date Signed: __________Degree: RM, RN, MANa) PRC NO: 196915
Valid Until: November 29,2011b.) PNA NO: 18696
Valid Until: Life time
Concurred by: Elsa Pacheco
Signature over printed name ofChief Nurse
Date Signed: ___________Degree: BSN, RN,MAN__a.) PRC NO: 01257229Valid Until: October 13,2014b.) PNA NO: 070626
Valid Until: October 2011
Approved by:
Nelia R. Capulong, RN, MAN Signature over printed name of Dean Date Signed: ____________Degree: BSN, RM, MAN_____ a.) PRC NO: 0041904______ Valid Until: July 31, 2012b.) PNA NO: 18698_________
Valid Until: Lifetime____c.) ADPCN NO: 0627_______ Valid Until: Life time
OUR LADY OF FATIMA UNIVERSITY#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student: Angelique B. Espiritu _______________________________________________________________________________________ Name and Address of School: Our Lady of Fatima University #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City________________Accreditation Level (if any): PACUCOA Level II Year Granted: April 10 ,2002Date School/Program was Recognized: April 25, 2001________________Number: 033 ________________________Year: 2001____________First Course (if any): NOT APPLICABLE_________________ School Graduated From: NOT APPLICABLE_________ Year: NOT APPLICABLE__Year of Admission in the Bachelor of Science in Nursing Program: June 2008______________________________________________________Year Graduated (BSN Program): November 2011_______________________________________________________________________________
II. Minor OperationsNo. Date of
OperationCase No. Name of Patient Diagnosis Operation
PerformedType of
AnesthesiaName of Surgeon Name of Hospital Supervised by
Qualified CISignature of Qualified CI
1. July 28. 2010
2010-102737 Federico Alejo Rectal Mass Colonoscopy with Biopsy
Local Anesthesia
Dr. Roberto Lopez Fatima University Medical Center
Mrs. Secinia I.Tallo, RM,RN,MAN
2. August 18,2010
OPH 081210-02
Conigonda Boroc Barandino
Mature Senile cataract, Right Eye
Phacoemulsification with Posterior Chamber Intraocular Lens, Right eye
Local Anesthesia
Dr,Guillermo Loja Fatima Eye and Rehab Center
Mr. Arvin A. Avaculanan.RN
3. November 4,2010
124909 Maria Dulce Domanillo
Gravida3 Parity3 Multiparity
Bilateral Tubal Ligation
Local Anesthesia
Dr. Priscilla Quiambao
Calumpit District Hospital
Mr. Marcellus Belisario RN,MAN
4. February 14,011
2011-114607 Isidro Magaling Antral,Ulcer, Duodenitis
Gastroscopy and Pyloric Testing
Local Anesthesia
Dr. Roberto Lopez Fatima University Medical Center
Mrs. Secinia I.Tallo, RM,RN,MAN
5. February 17,2011
164732 Cecilia M. Garcia Abnormal Uterine Bleeding
Endometrial Polypectomy
Local Anesthesia
Dr. Lorna Fernando Calumpit District Hospital
Mr. Marcellus Belisario RN,MAN
Prepared by:
Angelique B. Espiritu Signature over printed Name of StudentSupervised by: _______________Signature over printed name of FacultyDate Signed: ____________Degree: ________________a.) PRC NO: __________
Valid Until: ________b.) PNA NO: ___________ Valid Until:_________
Noted by:
Secinia I TalloSignature over printed name of Clinical Coordinator Date Signed: __________Degree: RM, RN, MANa) PRC NO: 196915
Valid Until: November 29 ,2011b.) PNA NO: 18696
Valid Until: Life time
Concurred by: Elsa Pacheco
Signature over printed name ofChief Nurse
Date Signed: ___________Degree: BSN, RN,MAN__b.) PRC NO: 01257229Valid Until: October 13,2014b.) PNA NO: 070626
Valid Until: October 2011
Approved by:
Nelia R. Capulong, RN, MAN Signature over printed name of Dean Date Signed: ____________Degree: BSN, RM, MAN_____ a.) PRC NO: 0041904______ Valid Until: July 31, 2012b.) PNA NO: 18698_________
Valid Until: Lifetime____c.) ADPCN NO: 0627_______ Valid Until: Life time
OUR LADY OF FATIMA UNIVERSITY#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student: Angelique B. Espiritu _______________________________________________________________________________________ Name and Address of School: Our Lady of Fatima University #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City________________Accreditation Level (if any): PACUCOA Level II Year Granted: April 10 ,2002Date School/Program was Recognized: April 25, 2001________________Number: 033 ________________________Year: 2001____________First Course (if any): NOT APPLICABLE_________________School Graduated From: NOT APPLICABLE_________Year: NOT APPLICABLE__Year of Admission in the Bachelor of Science in Nursing Program: June 2008______________________________________________________Year Graduated (BSN Program): November 2011_______________________________________________________________________________
III. Actual Deliveries No. Case
No.Diagnosis Name of
MotherAge Date of
DeliveryTime of Delivery
Gender of Baby
Name of Hospital Type of Delivery Supervised by: Signature of Qualified C.I.
1. 319-10 Pregnacy Uterine Full Term Gravida 1 Parity 038 weeks Age of Gestation
Millete Arvin 20 years old
August 23, 2010
6:28am Male Camarin Health Center and Lying in
Normal Spontaneous Delivery
2. 325-10 Pregnacy Uterine Full Term Gravida 3 Parity 239 weeks Age of Gestation
Eva Rojo Reyes
34 August 26, 2010
7:30am Male Camarin Health Center and Lying in
Normal Spontaneous Delivery
3. 330-10 Pregnacy Uterine Full Term Gravida 3 Parity 242 weeks Age of Gestation
Cristina Nabong
31 August 27, 2010
3:45pm Male Camarin Health Center and Lying in
Normal Spontaneous Delivery
4. 332-10 Pregnacy Uterine Full Term Gravida 2 Parity 139 weeks Age of Gestation
Princess Lalu 23 August 28, 2010
8:15am Female Camarin Health Center and Lying in
Normal Spontaneous Delivery
5. 343-10 Pregnacy Uterine Full Term Gravida 4 Parity 338 weeks Age of Gestation
Emma Belgica 29 September 7,2010
5:20pm Male Camarin Health Center and Lying in
Normal Spontaneous Delivery
Prepared by:
Angelique B. Espiritu Signature over printed Name of Student
Supervised by: _______________Signature over printed name of FacultyDate Signed: ____________Degree: ________________a.) PRC NO: __________
Valid Until: ________b.) PNA NO: ___________ Valid Until:_________
Noted by:
Imelda N. VillegasSignature over printed name of Clinical Coordinator Date Signed: __________Degree: RN, MAN_______a) PRC NO: 69342
Valid Until: November 11, 2013b.) PNA NO: 2011 037405
Valid Until: October 2011
Concurred by:
Norma A. Manere RM, RN, MANSignature over printed name of
Chief NurseDate Signed: ___________Degree: RM, RN, MANa.) PRC NO: 0082296Valid Until: May 23, 2014b.) PNA NO: 3805
Valid Until: Life time
Approved by:
Nelia R. Capulong, RN, MAN Signature over printed name of Dean Date Signed: ____________Degree: BSN, RM, MAN_____ a.) PRC NO: 0041904______ Valid Until: July 31, 2012b.) PNA NO: 18698_________
Valid Until: Lifetime____c.) ADPCN NO: 0627_______ Valid Until: Life time
OUR LADY OF FATIMA UNIVERSITY#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student: Angelique B. Espiritu _______________________________________________________________________________________ Name and Address of School: Our Lady of Fatima University #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City________________Accreditation Level (if any): PACUCOA Level II Year Granted: April 10 ,2002Date School/Program was Recognized: April 25, 2001________________Number: 033 ________________________Year: 2001____________First Course (if any): NOT APPLICABLE_________________School Graduated From: NOT APPLICABLE_________Year: NOT APPLICABLE__Year of Admission in the Bachelor of Science in Nursing Program: June 2008______________________________________________________Year Graduated (BSN Program): November 2011_______________________________________________________________________________
IV. Deliveries Assisted No. Case
No.Diagnosis Name of
MotherAge Date of
DeliveryTime of Delivery
Gender of Baby
Name of Hospital Type of Delivery Supervised by: Signature of Qualified C.I.
1. 388308 Pregnacy Uterine Full Term Gravida 2 Parity 138 weeks Age of Gestation
Hannah Calderon
23 February 2, 2010
8:20am Female Macabebe District Hospital
Normal Spontaneous Delivery
2. 317-10 Pregnacy Uterine Full Term Gravida 2 Parity 039 weeks Age of Gestation
Jededia Pakiding
21August 23, 2010
4:10pm Female Camarin Health Center and Lying in
Normal Spontaneous Delivery
3. 321-10 Pregnacy Uterine Full Term Gravida 2 Parity 139 weeks Age of Gestation
Ma. Jinky Nualla
17 August 24, 2010
3:20pm Male Camarin Health Center and Lying in
Normal Spontaneous Delivery
4. 323-10 Pregnacy Uterine Full Term Gravida 2 Parity 137 weeks Age of Gestation
Thiel Noquita 27 August 25, 2010
9:30am Male Camarin Health Center and Lying in
Normal Spontaneous Delivery
5. 335-10 Pregnacy Uterine Full Term Gravida 4 Parity 338 weeks Age of Gestation
Riza Villanueva
21 September 1,2010
7:55am Female Camarin Health Center and Lying in
Normal Spontaneous Delivery
Prepared by:
Angelique B. Espiritu Signature over printed Name of StudentSupervised by: _______________Signature over printed name of FacultyDate Signed: ____________Degree: ________________a.) PRC NO: __________
Valid Until: ________b.) PNA NO: ___________ Valid Until:_________
Noted by:
Imelda N. VillegasSignature over printed name of Clinical Coordinator Date Signed: __________Degree: RN, MAN_______a) PRC NO: 69342
Valid Until: November 11, 2013b.) PNA NO: 2011 037405
Valid Until: October 2011
Concurred by: Norma A. Manere RM, RN, MAN
Signature over printed name ofChief Nurse
Date Signed: ___________Degree: RM, RN, MANa.) PRC NO: 0082296Valid Until: May 23, 2014b.) PNA NO: 3805
Valid Until: Life time
Approved by:
Nelia R. Capulong, RN, MAN Signature over printed name of Dean Date Signed: ____________Degree: BSN, RM, MAN_____ a.) PRC NO: 0041904______ Valid Until: July 31, 2012b.) PNA NO: 18698_________
Valid Until: Lifetime____c.) ADPCN NO: 0627_______ Valid Until: Life time
OUR LADY OF FATIMA UNIVERSITY#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student: Angelique B. Espiritu _______________________________________________________________________________________ Name and Address of School: Our Lady of Fatima University #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City________________Accreditation Level (if any): PACUCOA Level II Year Granted: April 10 ,2002Date School/Program was Recognized: April 25, 2001________________Number: 033 ________________________Year: 2001____________First Course (if any): NOT APPLICABLE_________________School Graduated From: NOT APPLICABLE_________Year: NOT APPLICABLE__Year of Admission in the Bachelor of Science in Nursing Program: June 2008______________________________________________________Year Graduated (BSN Program): November 2011_______________________________________________________________________________
V. Cord Dressing No. Case No. Date Performed Name of Baby Gender of Baby Name of Mother Age Name of Hospital Supervised by: Signature
of Qualified C.I.1. 154770 Feruary 24,2010 Baby Boy Paraiso Male Flordeliza Paraiso 35 years old Calumpit District Hospital
2. 310-10 August 17,2010 Baby Boy Labawan Male Maila Labawan 25 years old Camarin Health Center and Lying in
3. 318-10 August 23,2010 Baby Girl Itable Female Lovely Itable 23 years old Camarin Health Center and Lying in
4. 342-10 Septeber 6,2010 Baby Boy Ceneza Male Edelina Ceneza 17 years old Camarin Health Center and Lying in
5. 156191 October 26,2010 Baby Girl De Sagun Female Kristel De Sagun 26 years old Calumpit District Hospital
Prepared by:
Angelique B. Espiritu Signature over printed Name of StudentSupervised by: _______________Signature over printed name of FacultyDate Signed: ____________Degree: ________________a.) PRC NO: __________
Valid Until: ________b.) PNA NO: ___________ Valid Until:_________
Noted by:
Imelda N. VillegasSignature over printed name of Clinical Coordinator Date Signed: __________Degree: RN, MAN_______a) PRC NO: 69342
Valid Until: November 11, 2013b.) PNA NO: 2011 037405
Valid Until: October 2011
Concurred by: Norma A. Manere RM, RN, MAN
Signature over printed name ofChief Nurse
Date Signed: ___________Degree: RM, RN, MANa.) PRC NO: 0082296Valid Until: May 23, 2014b.) PNA NO: 3805
Valid Until: Life time
Approved by:
Nelia R. Capulong, RN, MAN Signature over printed name of Dean Date Signed: ____________Degree: BSN, RM, MAN_____ a.) PRC NO: 0041904______ Valid Until: July 31, 2012b.) PNA NO: 18698_________
Valid Until: Lifetime____c.) ADPCN NO: 0627_______ Valid Until: Life time
