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7/29/2019 Requirements1&2.POd
1/10
LEARNING
FEEDBACK
DIARY
Submitted by:
Cathleen Joy V. Angeles BSN 3A
Submitted to:
Sir Roy Quito
7/29/2019 Requirements1&2.POd
2/10
DATE: Feb. 18, 2013
My objectives for today is to become familiar in the different facilities in Philippine
Orthopedic Center and services that are being held in this hospital and also to be able to learn
and follow the rules/regulations and policies that is being implemented in the Philippine
Orthopedic Center.
Today, we were only having our orientation in Philippine Orthopedic Center. I have learned
more about the POC. Their history, total bed capacity, different services, the administrators and
the rules and regulations. My exposure in POC will help me to improve my skills in caring for a
patient. This exposure will also give us great experiences that I am sure we will cherish and
keep in our minds.
Actually, I have no specific problem in the first day of duty (orientation). It was just the start
of the clinical exposure so I think, in this day we will just be freshening up about the POC. But
maybe the large number of different colleges makes it difficult for me to listen to the orientation,
included also that the orientation had started late. We waited for about 2 hours for the
orientation
In order for me to catch up in the orientation, I see to it that I was focusing only to the
speaker. No interruptions are being entertained while listening and my eyes are kept open to
prevent sleeping, especially when it was the time to demonstrate to all of us the application and
removal of balance skeletal traction. At the last day of our duty in POC, we are going to perform
BST so I intently observe the two speakers while they teach us the application and removal of
BST to be able to understand the whole procedure. It really makes it easy for me to understand
BST while I was listening attentively.
7/29/2019 Requirements1&2.POd
3/10
DATE: Feb. 19, 2013
OBJECTIVES:
To enhance my interpersonal skills
To be able to identify different types of braces, tractions and casts.
To provide proper nursing care of patient with brace, cast and traction
We have discussed about fractures and the different types of braces, tractions and casts. So
today, I have learned the different classification of fractures and what are the nursing
responsibilities in a patient with fracture. Nowadays, more people are becoming prone to
accidents. Different nursing care of a patient with fracture is being introduced, like the
application of traction, brace or a cast. Tractions are used to correct deformities; braces are
used as a mechanical support for weakened muscles while casts are used for immobilization.
Some types of the brace, cast and traction were not available in POC. So we didnt see
those who were not available. Another problem encountered is that some of the gadgets are not
sufficient, because while we were discussing, another clinical instructor enters in our room to
get some gadgets that were not available in their room. But this kind of problem is lesser only
because almost all gadgets are present in the rooms; just some of the few gadgets were not.
But because of our requirements in POC (pictures of different casts, braces and tractions),
we were able to identify those gadgets that were not available. These pictures really help us to
become more familiarize with the different gadgets. It helps us to be able to memorize quickly
the different types of casts, tractions and braces.
7/29/2019 Requirements1&2.POd
4/10
DATE: Feb. 20, 2013
My objectives for this day are to identify different types of hardware; to be able to learn
how to prioritize my nursing care to my patient and to be able to properly report HNP to my
fellow classmates.
So today, I reported HNP which is also known as slipped disk. Our clinical instructor
also discussed to us different hardwares, so, I learned for today, to identify different types of
hardware including their indications. Hardware is either external or internal. Internal includes
pin, wires, plates and nails etc. while external includes the RAEF, delta frame, ilizarov etc.
Problems encountered were limited time in discussing the hardwares, which is only for
30 minutes and also the unavailability of the other hardware instrument.
The pictures that we have are really helpful for us in studying different gadgets and
hardwares. In case of the unavailable instrument, we can just look in the pictures that we have
research and then we can now identify what is the image of that hardware.
7/29/2019 Requirements1&2.POd
5/10
DATE: Feb. 26, 2013
After this duty I hope I was able:
To master memorizing and familiarizing all the gadgets and hardwares
To improve my interpersonal relationship with my patient
To provide proper nursing care to all of my patient and also to attend all of their needs
To become more responsible as a student nurse
Today, we are assigned in the childrens ward. This was the area that I like the most
because children are fun to take care of. Before we went to the childrens ward, weve also
discussed Potts Disease, which is also known as tuberculosis in the spine. In the childrens
ward, we have two patients with this kind of disease. I have seen that this disease really shows
signs of weight loss because one of our patients is very thin. And patient with this kind of
disease also experiences some signs and symptoms of PTB. We have also observed
application and removal of cast in the OPD section.
Problems, maybe like limited time in providing nursing care to our patient. Sometimes we
were just rendering morning care to our patient. Some of our patient, we were just interviewing
them about the history of their illness and we provide them health teachings and other nursing
responsibilities.
We provide important health teachings to our patients. Sometimes we assist them in
whatever they were doing like maybe in ADLs, to prevent possible injury. Of course, developing
the trust of your patient or rapport is also important so that the patient will be able to tell you all
his/her concerns regarding his/her health.
7/29/2019 Requirements1&2.POd
6/10
CLINICAL CASE ANALYSIS
NAME: Dominador Aquilea
AGE: 46 y/o
SEX: Male
STATUS: Married
DATE ADMITTED: Feb. 8, 2013
DIAGNOSIS: Avulsed of biceps and forearm flexion with ulnar radial artery transection S/P AS
Repair
Nursing History:
2 days prior to admission
Patient had an accident. While cleaning a mixer truck, the left sleeve of his shirt was
caught by the mixer, including also his left arm.
Immediately brought to Makati Medical Center.
Feb. 8, 2013
Patient was transferred here in POC.
Surgical Procedures:
Ulnar radial artery transection
Nursing Responsibilities:
Assess the level of pain associated with musculoskeletal problems.
Encourage the patient to elevate the affected part to help relieve the pain.
Instruct the patient to do finger exercises and moved the affected part through its range
of motion to maintain function or to improve mobility.
Observe the patient for systemic infection, odors from the cast and purulent drainage
staining the cast. Perform regular assessment of neurovascular status.
Monitor the circulation, motion and sensation of the affected extremity and compare
them with the opposite extremity.
Keep the cast dry but do not cover with plastic or rubber which may cause condensation
that will dampen the skin and cast.
7/29/2019 Requirements1&2.POd
7/10
CLINICAL CASE ANALYSIS
NAME: Elena Abella
AGE: 68 y/o
SEX: Female
STATUS: Married
DATE ADMITTED: Feb. 16, 2013
DIAGNOSIS: Fracture Cl. Comp. displaced intertrochanteric femur right
Nursing History:
1 day prior to admission
Patient falls from standing in a chair.
Patient experienced severe pain that leads to consult in POC.
Surgical Procedures:
With balance skeletal traction
Nursing Responsibilities:
Emphasize on the importance of good hygiene.
o Skin care
o Changing of linens or slings
o Provide bedpan/urinal as needed
o Perineal care
Provision of exercises
o ROM exercises with the use of trapeze
o Deep breathing exercise
o Toes pedal exercises.
Encourage the patient to increase intake of foods rich in fiber, protein, vitamin C and
calcium and to also increase fluid intake.
7/29/2019 Requirements1&2.POd
8/10
CLINICAL CASE ANALYSIS
NAME: Sinegunda Subong
AGE: 90 y/o
SEX: Female
STATUS: Married
DATE ADMITTED: Jan. 9, 2013
DIAGNOSIS: Fx. Cl. Comp. displaced intertrochanteric femur right
Nursing History:
3 days prior to admission
Patient falls while standing on a chair.
Consulted to other clinics. Then transferred here in POC.
Surgical Procedures:
Partial Hip replacement arthroplasty right
Nursing Responsibilities:
Encourage to elevate the affected extremity to immobilize.
Note odors around the cast, stained areas, warm spots and pressure areas. Report them
to the physician.
Report broken cast to the physician; do not attempt to fix it yourself.
Encourage the patient to move toes hourly when awake to stimulate circulation.
Thoroughly clean the skin and treat it as prescribed.
Teach the patient with leg cast to push down the knee.
7/29/2019 Requirements1&2.POd
9/10
CLINICAL CASE ANALYSIS
NAME: Dionisio Recafor
AGE: 45 y/o
SEX: Male
STATUS: Married
DATE ADMITTED: Jan. 8, 2013
DIAGNOSIS: Lumbar spinal stenosis
Nursing History:
5 years prior to admission:
Patient strained his back carrying a pump boat. No consult initially.
2 years prior to admission:
Patient started limping due to his low back pain.
Progressive of low back pain lead patient to seek consult at POC and admitted surgical
intervention.
Surgical Procedures:
Posterior Decompression; Posterior Lumbar Interbody Fusion L4-L5, L5-S1
Nursing Responsibilities:
Assess neurovascular status.
Maintain body alignment.
Encourage for early ambulation.
Encourage to wear brace as prescribed.
Assist patient in applying the brace and to protect the skin from irritation and breakdown.
Reassure the patient that minor adjustments of the brace by the orthotist will increase
comfort and minimize problems associated with its long term used.
Gradual increase of daily activities as tolerated.
7/29/2019 Requirements1&2.POd
10/10
CLINICAL CASE ANALYSIS
NAME: Juary Ray Gayos
AGE: 9 y/o
SEX: Male
STATUS: Single
DATE ADMITTED: Jan. 10, 2013
DIAGNOSIS: T/C Acute spinal injury inc. spinal level C6 etiology to be determined
Nursing History:
4 months prior to admission
Patient strained his cervical and lumbar area due to fall in the clothes line. No consult
initially.
3 months prior to admission
Patient experienced numbness of the lower extremities
2 months prior to admission
Patient was unable to walk lead to seek consult at PGH.
Transferred to National Childrens then to POC.
Surgical Procedures:
No surgical procedure done.
Nursing Responsibilities:
Encourage patient to ambulate with assistance. Can move as normally as possible, but
avoid walking on wet, or slippery floors.
Assess neurovascular function.
Emphasize importance of proper hygiene.
Instructed to continue taking medications as ordered.
Gradual increase of daily activities as tolerated.
Encourage toe and finger exercises.
Assist patient o identify areas of self-care deficit and in developing strategies to achieve
independence in ADLs