URDANETA CITY UNIVERSITY

COLLEGE OF HEALTH SCIENCES

San Vicente West, Urdaneta City, Pangasinan

In Partial Fulfilment of Requirements for RLE 107N

“UTERINE LEIOMYOMA ”

A Case Study

Presented To:
College of Health Sciences

Submitted By:
AGSAOAY, GLENDA

AGUNDAY, AISHA

APONIO, BRYAN

BASUEL, REDEN

BERGONIA, MICHAEL

BRAGA, CHRISTIAN

BUENCONSEJO, JIRAH

CACONDANGAN, MARIA RICA

CARBILLON, ANGELENE

CEREZO, LOWELL

DE PERALTA, RACHELLE

DELA CRUZ ARIANE

DELMENDO, HANNAH CAMILLE

DION, CELINE

DISOMA, DIAMOND

ESPILLO, KISHA

FLORES, ARA JESSA

FORTES, ANGELICA

GALAANG. ZORROW
 GALANG, MA. ALYSSA

GROUP A of N158
TABLE OF CONTENTS

OBJECTIVES 2

INTRODUCTION 4

BACKGROUND OF THE STUDY 5

NURSING PROCESS 9

Nursing Health History-A

Nursing Health History-B

PHYSICAL EXAMINATION 14

ANATOMY AND PHYSIOLOGY 20

ETIOLOGY/PREDISPOSING/RISK FACTORS 26

PATHOPHYSIOLOGY 28

SIGNS AND SYMPTOMS/CLINICAL MANIFESTATIONS WITH ANALYSIS 29

LABORATORY/DIAGNOSTICS WITH NORMAL VALUES/RESULT ANALYSIS 30

PHARMACOLOGIC INTERVENTIONS WITH ANALYSIS 35

MEDICAL MANAGEMENT WITH ANALYSIS 37

SURGICAL MANAGEMENT WITH ANALYSIS 39

NUTRITIONAL MANAGEMENT WITH ANALYSIS 41

COMPLEMENTARY, ALTERNATIVE AND INTEGRATIVE MEDICINE 43

NURSING MANAGEMENT WITH ANALYSIS 44

NURSING CARE PLAN 45

BIBLIOGRAPHY/REFERENCES 53

RESUME OF PRESENTERS 55

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 OBJECTIVES

GENERAL OBJECTIVES

This case study aims to know and understand the disease process: the causes, effects,

management, treatment, and possible preventions as well as the concept of Uterine Myoma. This

presentation also tends to help client promote and prevent complications of such condition

through the application of nursing skills.

STUDENT-NURSE CENTERED

 KNOWLEDGE

1. Review the proper physical assessment (IPPA) and how to do them efficiently.

2. Understand the disease process: the causes, effects, management, treatment, and

possible preventions.

3. Determine why certain management and medications are given and provided for

the condition.

4. Understand how and why certain diagnostic tests are done for the condition.

5. Review the concepts about the anatomy and physiology with regards to the

condition.

 SKILLS

1. Efficiently perform the physical assessment (IPPA) to the patient.

2. Thoroughly perform health history from patient and significant others.

3. Actively participate in the course of care of patient.

4. Provide health teachings to the patient about certain interventions in the

maintenance of health care.

 Attitudes

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 1. Establish rapport and therapeutic interaction with the patient and significant

others to obtain necessary information and positive compliance to care being

provided.

2. Provide care and health teachings necessary for the betterment of the

condition of the patient.

3. Share the learning acquired to co-student-nurses to increase awareness and

help them if ever they will encounter patient with the same condition.

PATIENT-NURSE CENTERED

At the end of this case study, the patient will be able to:

 KNOWLEDGE

1. Explain Uterine Myoma in own words.

2. Identify possible risk factors for Uterine Fibroids.

3. Identify the importance of the treatments and preventions.

 SKILLS

1. Modify the need for a healthy lifestyle to improve condition

2. Communicate effectively and respectfully with patients and families

3. Work as members of health care team

 ATTITUDES

1. Express awareness on the needs and condition of her present status.

2. Develop the family’s support system and distinguish their respective roles in

improving her health status.

3. Show involvement in promoting on her general health.

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 INTRODUCTION

Uterine Leiomyoma or just myoma is a condition where there is a benign growth or

tumor of smooth muscle in the wall of the uterus (womb). The said growth is made up of fibrous

tissue; hence it is often called a fibroid tumor. Fibroids are almost always benign that can grow

as a single tumor, or there can be many of them in the uterus that may range in size from 1 mm

to more than 20 cm in diameter. Uterine fibroids can be present and be in apparent. Fibroids

vary in size, number and are most often slow-growing and usually cause no symptoms. Myomas

are the most frequently diagnosed tumor of the female pelvis, and the most common reason for

hysterectomy. Although they are often referred to as tumors, they are not cancerous.

Not all women with fibroids have symptoms. Women who do have symptoms often find

fibroids hard to live with. Some have pain and heavy menstrual bleeding. Fibroids also can put

pressure on the bladder, causing frequent urination, or the rectum, causing rectal pressure. Most

myomas develop in women during their reproductive years and are most common in women ages

from 40s and early 50s. Myomas do not develop before the body begins producing estrogens.

Myomas tend to grow very quickly during pregnancy when the body is producing extra estrogen.

Once menopause as begun, the myoma generally stops growing and may begin to shrink due to

the loss of estrogen. Fibroids may be removed if they cause discomforts or if they are associated

with uterine bleeding. Approximately 25% of myomas will cause symptoms and need medical

treatment. No one knows for sure what causes fibroids but it is associated with risk factors, it

could be: Hormonal (affected by estrogen and progesterone levels) and Genetic (runs in

families).

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 BACKGROUND OF THE STUDY

GLOBAL

The majority of women with uterine fibroids are asymptomatic, consequently get less

clinical attention and fibroid tumors often remain undiagnosed . Symptomatic women typically

complain about abnormal uterine bleeding, specifically in terms of heavy and prolonged

bleeding. According to the study of Wegienka et al. (2004) women with myomas were more

likely to report a "gushing"-type of bleeding and high pad/tampon use than women without

myomas. Additionally, women with uterine fibroids may suffer more often from dyspareunia and

non-cyclic pelvic pain. Although bleeding and pelvic pain symptoms are frequently reported in

literature as main symptoms related to uterine fibroids, the number of systematic studies on

fibroid symptoms is limited.

Therapeutic options to treat these symptoms include medical therapy, surgical

interventions and uterine artery embolization . Medical treatments used to manage bleeding

symptoms are oral contraceptives or progestins, although there is no evidence for their efficacy

in treating myomas

The self-reported prevalence in this study ranged from 4.5% in UK to 9.8% in Italy.

These results suggest that uterine fibroids are quite common among women in reproductive age,

considering that the study population only includes diagnosed women with myomas, while the

number of undiagnosed women remains uncertain.

In 2009 the Uterine Bleeding and Pain Women's Research Study (UBP-WRS) was

conducted interviewing 21,479 women across 8 countries in order to gain patient-based

prevalence data on uterine pain and bleeding indications and investigate uterine symptoms and

women's treatment experiences. This article shows relevant results of the study for the indication

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uterine fibroids providing data on self-reported prevalence, symptomatology and management of

uterine fibroids.

2,500 women (USA: 4,500 women) in each country (Brazil, Canada, France, Germany, Italy,

South Korea, the UK, the USA) completed an online survey. Women included were in their

reproductive age (age group 15-49 years; USA: 18-49 years) and had ever experienced menstrual

bleedings.

The survey directly recorded the experiences relating to uterine bleeding and pain of

more than 21,000 women from diverse regional and demographic groups worldwide. This wealth

of data has allowed the identification of various trends, specifically relating to the prevalence,

symptoms and management of uterine fibroids.

An Italian study found that in a non-care-seeking population women with uterine fibroids

were more likely to report moderate or severe dyspareunia and moderate or severe non-cyclic

pelvic pain than women without uterine fibroids, but not moderate to severe dysmenorrhea. The

research studies on pain during sexual intercourse are inconsistent.

NATIONAL

Uterine fibroids (i.e., leiomyomata) are common benign smooth muscle tumors of the

uterus. The etiology is not well understood, and a variety of factors including race/ethnicity,

parity, and age at menarche have been examined. By age 49, more than 70 percent of white

women and 84 percent of African American women have fibroids documented by imaging or

surgical records. In the United States, an estimated 26 million women between the ages of 15 and

50 have uterine fibroids. Fibroids may be asymptomatic, or can produce health effects that

include profound bleeding and anemia, pelvic pressure or pain, urinary frequency, abnormal

bowel function, pain with intercourse, as well as effects on fertility and pregnancy outcomes.

More than 15 million US women will experience associated symptoms or health concerns. A

disproportionate number of black women have symptoms in part due to earlier age at onset of

fibroids with larger and more numerous tumors. Black women are also more likely to have

surgical interventions for fibroids.

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 Symptoms from fibroids can result in considerable personal and societal costs including

diminished quality of life, disruption of usual activities and roles, lost work time, and substantial

healthcare expenditures. Across types of interventions, direct annual healthcare costs in the

United States are projected to exceed $9.1 billion. Lost wages, productivity, and short-term

disability are estimated to total another $5 to $17 billion annually, with roughly $4,624 in costs

per woman in the first year of diagnosis.

Leiomyosarcomas are rare: an average of 1,600 new cases occur in the United States each

year However, they have poor outcomes with an average 5-year survival of 36 percent if cancer

has spread to the pelvis and not isolated to the uterus.

Symptoms from fibroids can result in considerable personal and societal costs including

diminished quality of life, disruption of usual activities and roles, lost work time, and substantial

healthcare expenditures.

Asymptomatic fibroids do not require intervention. Discussion of management options

for symptomatic fibroids is among the most frequent conversations in gynecology and primary

care and is the most common reason for gynecologic surgery. These discussions are shaped by

future reproductive goals treatment options differ in fundamental aspects such as cost,

invasiveness, recovery time, risks, likelihood of long-term resolution of symptoms, need for

future care for fibroids, and influence on future childbearing. Thus, synthesis of available

evidence is crucial to assist women and their care providers in making well-informed and

personalized decisions.

In any given year, a greater proportion of women with symptomatic fibroids receive

medical therapy than surgery. Though no medications have been specifically cleared by the U.S.

Food and Drug Administration (FDA) for fibroid treatment, several medications are used off-

label for fibroid symptoms.

LOCAL

Uterine fibroids (leiomyomas) are the most common gynaecological tumours affecting

premenopausal women. They are benign, hormonally dependent tumours arising from the

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myometrial layer of the uterus. Prevalence of fibroids ranges between 3.3 and 77% and varies

with age and ethnicity.

Although most women with fibroids are asymptomatic, fibroids are a major source of

gynaecological morbidity and have a substantial impact on women’s health and quality of life.

The most common symptoms are menorrhagia (heavy menstrual bleeding) and dysmenorrhoea

(menstrual pain). The current management of fibroids includes medical therapy (e.g. ulipristal

acetate), minimally invasive procedures (e.g. uterine artery embolisation) and surgery (e.g.

myomectomy, hysterectomy). Despite the range of treatment options, surgery remains the

mainstay of therapy. Fibroid tissue is comprised mainly of extracellular matrix and characterised

by a low mitotic index and is usually considered slow growing. However, some fibroids can

grow very large—up to 30 cm3.

It is well known that fibroids are sensitive to oestrogens, which may act to grow or

maintain their size. Oestrogen, progesterone and epidermal growth factor (EGF) are considered

essential to the formation of fibroids. Due to their hormonal nature, it was originally thought that

uterine fibroids would develop after puberty, continue to grow in a consistent manner during

reproductive life and shrink after the menopause. Despite recent advances in imaging, our

understanding of the natural life cycle of fibroids remains poor, which makes counselling

difficult.

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 NURSING PROCESS
Nursing Health History-A
i. Demographic Data:

 Age: 57 years old

 Gender: Female

 Education: Highschool Graduate

 Occupation: None

 Marital status: Married

 Religion: Catholic

ii. Chief Complain: Vaginal Bleeding

iii. Diagnosis:

o Initial diagnosis: Submucous Myoma

iv. History of Present Illness: Mrs. Myoma had noticed that she had begun having vaginal

bleeding for about a year. She asked neighbors and friends about this, and because they

had told her it was a normal occurrence which may happen as a result of menopause, she

sought no further treatment. The bleeding, she explained to student nurses, was not

painful, so she believed that it was not really a concern. After telling her children about

her condition, her daughter kept insisting that she seek medical advice, however, she

refused because of the high costs which comes from hospitalization. After sometime, the

bleeding began to increase, and the patient finally listened to the advice of her children.

She left Pangasinan to go to Manila about a week prior to her hospitalization, in which

the doctor referred her to one of the hospital in Manila.

v. Past Illness History: Mrs. Myoma did not have any previous hospital stays. She had only

consulted a doctor two years ago, because she noticed that she often had headaches. Upon

the assessment with her doctor in Pangasinan, they found that Mrs. Myoma had

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 hypertension. To treat this, Mrs. Myoma took aspirin and an anti-hyper medication to

which she could not recall the name of.

FAMILY HEALTH-ILLNESS HISTORY

Hereditary disease in the family is Uterine Myoma and Hypertension which her mother, 1
sister and the patient had herself possessed. This shows that Uterine Myoma and Hypertension
are evident in their family and are hereditary.
GENOGRAM

Paternal Side Maternal Side

Legend:

Mrs. Santos Pancreatitis Male

Dead Heart Disease

Female
Penile Enlargement Vehicle Accident

Myoma Hypertension

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Nursing Health History-B (13 areas of assessment)

 Psycho-Social Evaluation

o The client describes herself as a hardworking and contented woman.

o The client claimed that knowing about her illness saddened her.

o The client also claimed that she always thought of the negative things that might

happen to her.

o The client has a negative outlook on how things are going.

 Mental & Emotional Status

o The client says she had experienced low mood, feelings of hopelessness, crying,

decreased or increased appetite, and loss of interest in previously pleasurable

activities.

o The client says she had emotional trauma, depression and anxiety such as

restlessness, irritability, and sleep disturbance because of fear for fibroids.

o The client also says that in some instances she was not aware of her surroundings and

she can only focus in one thing in such that, even though someone was asking she

wasn’t listening thoroughly and eventually changes her mood with no particular

reasons.

 Environmental

o The client says she had no exposure to any chemicals.

 Sensory perception

o Visual Status: The patient’s both eyes are normal, she can read without using

eyeglasses, and can respond by opening and closing of the eyelids; pupils are

reactive to light and equally round. The patient can perform 6 gaze of field but

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 there is an alternating slow movement of his eyes. Spontaneous eye opening was

noted.

o Auditory: The patient can distinguish voice even from a distance; near or far, loud

or soft; no corrective auditory deficit and no auditory device noted being used by

the patient.

o Olfactory status: The patient was able to discriminate an odor from the other. We

use an alcohol and coffee in assessing in this status.

o Gustatory status: The patient was able to discriminate sweet, sour, salty and bitter

tastes from each other by letting him eat candy, fruits like grapes, and the like.

o Tactile Status: She was able to determine that the patient is able to discriminate

sharp and dull, light and firm touch, able to perceive heat, cold, pain in proportion

to stimulus, able to differentiate common object by touch.

 Motor Stability

o The client says she had no history of stroke.

o The client demonstrates a right posture of the body.

o The client says her body is stable.

 Nutritional Status

o The client says she eats 3 times a day.

o Client says she eats vegetables, fish and meat whenever they have extra money and

she seldom eat fruits.

o The client says that she consumes at an average of 5-6 glasses of water per day.

 Elimination Pattern

o Client says she defecates once a day with a brownish stool.

o Client says she voids 3-5 times a day with amber colored urine in small amount.

Client urinates not more than 1000ml per void.

 Respiratory

o The client has no history of smoking

o No past history of PTB or other lung related problems.

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 o She has no history of lung cancer and has no family history of lung cancer,

asthma, or PTB.

 Body Temperature

o The client describe that she’s not feeling hot.

o The client’s temperature is 37°C, which means the client’s body temperature is

normal because it fits in the normal range of body temperature.

o The client says she has no history of convulsions or febrile seizures related to

hyperthermia.

 Sleep rest-pattern
o The client always wake up in different intervals.

o The client had stated that she experienced sleep difficulties.

 Fluid & Electrolytes

o No history of fluid and electrolyte imbalance.

 Circulatory
o Has been taking anti-hypertensive medication (which she cannot recall the name

of) and aspirin for two years.

 Integumentary
o For her hair, the client takes baths at least once or twice a day. She uses any

available shampoo her daughter at home also uses, and this typically includes

Sunsilk, Dove, or Palmolive.

o Cleans nails at least once a week using cuticle remover.

o Client does not make use of styling products for the hair.

o Client says she has no history of other skin problems such as lesions, drainage or

swelling.

o Does not feel pain upon light or deep palpation.

o The client and his family have no history of skin allergies or skin cancer.

o Does not have any birthmarks or tattoos.

o No problems with perspiration or odor.

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 o Has no current history of excessive hair loss, infestations, or change and

appearance in the hair (such as excessive dryness or brittleness).

o Client does not sunbathe, and is not constantly exposed to chemicals which may

harm the skin such as paint, weed killers, insect repellents, and bleach.

PHYSICAL EXAMINATION

(by body system & focus on complaining area)

Head to Toe Examination 3. Height and weight:

1. General Examination Height: 5’4

a) Body type: obese Weight: 85

b) Posture: normal sitting and 4. Integument

standing posture a) Skin

c) Gait: steady gait. walked i. Color: Skin is dark

smoothly with arms brown in color and even

swinging freely at the sides in distribution.

and the movements are ii. Moisture: Skin is

coordinated smooth without lesions

d) Activity: body movements or scars; no visible

are purposeful, there are no masses or evidence of

signs of tremors and all the ecchymosis.

mobile parts can be moved iii. Texture: Fine scaling of

2. Vital signs dry skin on lower

a) Temperature: 37 C inferior portion of legs

b) Pulse: 80 bpm and on outer portion of

c) Respiration: 16 bpm arms.

d) Blood pressure: 140/90 iv. Turgor: With a Skin

mmHg turgor of 3 seconds.

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 v. Vascularity: not visible b) Eyes

vi. Lesions: Presence of i. Position and alignment:

fissuring of skin on ii. Eyebrows:

inferior portion of the symmetrically aligned.

feet Equally distributed,

b) Hair and scalp slightly curled outward.

i. Distribution: hair is iii. Eyelids: The lower

even in distribution. eyelids are upright.

ii. Color: hair is black. iv. Lacrimal ducts:

iii. Appearance: hair is fine. normally non palpable

iv. Scalp: Scalp is clean v. Conjunctiva: Upper and

and dry. lower palpebral

c) Nails conjunctiva are free of

i. Color: nails are pale swelling or lesions.

pink in color. vi. Sclera: White sclera is

ii. Thickness: normal nail seen around the iris.

thickness. vii. Cornea: Cornea is

iii. Shape: round shape transparent with no

5. Head and Neck opacities. Oblique view

a) Head shows a moist overall

i. Position: Head is round, surface.

symmetric, erect, viii. Pupils: Pupils are

proportional, and equally rounded and

midline to the client’s respond to light and

body; no presence of accommodation.

visible lesions. Head is ix. Lens:  transparent and

held still and upright. uniform in density.

Face is symmetric with x. Visual acuity: able to

an oval appearance. read newsprint with

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 20/20 vision on snellen iii. Gums: Gums are pink in

chart. color.

c) Ears iv. Teeth: Teeth have a

i. Auricles: Ears are equal yellowish discoloration.

in size bilaterally. The v. Tongue: pink in color,

auricle aligns with the moist, no lesions,

corner of each eye. tenderness and nodules.

ii. Ear drums: light-gray Tongue is on the

color or a shiny pearly- middle. Client was able

white to move tongue from

iii. Hearing acuity: normal side to side, up and

voice tones audible. down.

d) Nose vi. Palate: whitish in color,

i. External nares: with a firm texture and

ii. Mucosa: Nasal mucosa irregular transverse

is pink, moist, and free rugae

of exudates. vii. Pharynx: –No swelling,

iii. Discharge: there's no bleeding, lesions, or

sign of discharge masses

iv. Sinuses: Sinuses do not f) Neck

appear enlarged or i. Neck muscles: Neck is

swollen. symmetric with head

e) Mouth and pharynx centered and without

i. Lips: Lips are cracked bulging masses. Thyroid

and dark brown in cartilages move

color. symmetrically as the

ii. Mucosa: With moist client swallows. Neck

pale-pink buccal movement is smooth

mucosa. and controlled.

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 ii. Lymph nodes: No vi. Percussion: Resonance

swelling or tenderness is heard throughout all

of the lymph nodes; lung fields.

lymph nodes are not vii. Auscultation: Clear

enlarged. breath sounds noted.

iii. Thyroid glands: Thyroid b) Anterior thorax

gland is not palpable. i. Thoracic muscles: No

iv. Trachea: Trachea is muscle retraction when

midline. Breathing

6. Thorax and lungs ii. Fremitus: over the

a) Posterior thorax: mainstem bronchi in

i. Contour: Skin is even in front and between the

color. scapulae in the back of

ii. Intercostal spaces: there the chest.

is no bulging within the iii. Percussion: normally

intercostals spaces when the rest of the lungs are

breathing resonant.

iii. Rhythm of breathing: iv. Auscultation: clear, no

inspiratory volume and vesicular breath sounds

depth of chest c) Heart

movement are i. Inspection: Jugular

maintained, with equal venous pulse is not

expansion and normally visible when

symmetry. the client sits upright,

iv. Thoracic muscles: Side Apical impulses are not

to side symmetric chest visible.

shape. ii. Palpation: Carotid

v. Fremitus: Equal tactile artery pulses are equally

fremitus noted. strong. Radial and

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 apical pulses are i. Inspection: unblemished

identical. No pulsations skin, uniform in color.

or vibrations are Flat, rounded,

palpated at the apex and symmetric contour.

the base of the heart. Symmetric movements

iii. Auscultation: With a BP caused by respiration.

of 140/90 mmHg. With Clean umbilicus.

a pulse rate of 80 beats ii. Palpation: bladder not

per minute. No palpable. Liver no

murmurs or extra heart enlargement, not

sounds are heard. S1 and palpable.

S2 sounds are clearly iii. Percussion: Size-10 cm

heard. in R midclavicular line

iv. Heart rate: With a heart iv. Auscultation: bowel

rate of 80 beats per sounds: audible bowel

minute. No signs of sounds, normal = 4 per

fluttering sensation in minute.

the chest area or the f) Musculoskeletal System

skipping of a heart beat. i. Inspection: upper

d) Breast extremities: equal size

i. Inspection: no masses on both sides. Lower

and lumps extremities equal on

ii. Nipple: size is both sides.

proportional, no ii. Palpation: upper

discharged or extremities: equal in

secretions. strenght, coordinated

iii. Palpation: no masses movement. Able to

and lumps. tolerate wide range of

e) Abdomen motion. No difficulty

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 upon bending and left after hitting the

stretching. Lower tricep tendons, Patellar

extremities: able to – knee jerk happened

tolerate wide range of after the brisk tap,

motion. No difficulty Achilles – the foot

upon bending and jerked after hitting the

stretching. No lesions, Achilles.

no scars and no

deformity.

iii. Range of motion: wide

range of motion.

iv. Muscle tone and

strength: Muscle tone

and strength are normal

and function well

g) Neurological System

i. Level of consciousness:

the patient is concious

ii. Behavior: cooperative

iii. Cranial Nerve function:

each cranial nerves are

functioning well

iv. Deep tendon reflexes

(biceps, triceps, patellar,

Achilles): biceps – the

hand jerked after hitting

the thumb placed on her

bicep tendon, Triceps –

her hand move to the

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 ANATOMY AND PHYSIOLOGY

The female reproductive system

consists of the ovaries, uterine tubes (or

fallopian tubes), uterus, vagina, external

genitalia, and mammary glands. The internal

reproductive organs of the female are located

within the pelvis, between the urinary

bladder and the rectum. The uterus and the

vagina are in the midline , with an ovary to

each side of the organ. The internal

reproductive organs are held in place within the pelvis with ligaments. The most conspicuous is

the brad ligament, which spreads out on both sides of the uterus and to which the ovaries and the

uterine tubes attach.

Ovaries
The ovaries are small, oval-shaped, and grayish in color,

with an uneven surface. The actual size of an ovary

depends on a woman’s age and hormonal status; the

ovaries, covered by a modified peritoneum, are

approximately 3-5 cm in length during childbearing years

and become much smaller and then atrophic once

menopause occurs. A cross-section of the ovary reveals

many cystic structures that vary in size. These structures

represent ovarian

follicles at different

stages of development and degeneration. The ovaries are

the female pelvic reproductive organs that house the ova

and are also responsible for the production of sex

hormones. They are paired organs located on either side of

the uterus within the broad ligament below the uterine

(fallopian) tubes. The ovary is within the ovarian fossa, a

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space that is bound by the external iliac vessels, obliterated umbilical artery, and the ureter. The

ovaries are responsible for housing and releasing ova, or eggs, necessary for reproduction. At

birth, a female has approximately 1-2 million eggs, but only 300 of these eggs will ever become

mature and be released for the purpose of fertilization.

Uterine Tubes

The uterine tubes, also known as

oviducts or fallopian tubes, are the female

structures that transport the ova from the

ovary to the uterus each month. In the

presence of sperm and fertilization, the

uterine tubes transport the fertilized egg to

the uterus for implantation. The uterine

tubes are uterine appendages located bilaterally at the superior portion of the uterine cavity.

These tubes exit the uterus through an area referred to as the cornua, forming a connection

between the endometrial and peritoneal cavities. Each uterine tube is approximately 10 cm in

length and 1 cm in diameter and is situated within the mesosalpinx. The mesosalpinx is a fold in

the broad ligament. The distal portion of the uterine tube ends in an orientation encircling the

ovary. The primary function of the uterine tubes is to transport sperm toward the egg, which is

released by the ovary, and to then allow passage of the fertilized egg back to the uterus for

implantation.

A uterine tube contains 3 parts. The first segment, closest to the uterus, is called the

isthmus. The second segment is the ampulla, which becomes more dilated in diameter and is the

most common site for fertilization. The final segment, located farthest from the uterus, is the

infundibulum. The infundibulum gives rise to the fimbriae, fingerlike projections that are

responsible for picking up the egg released by the ovary. The arterial supply to the uterine tubes

is from branches of the uterine and ovarian arteries; these small vessels are located within the

mesosalpinx. The nerve supply to the uterine tubes is via both sympathetic and parasympathetic

fibers. Sensory fibers run from thoracic segments 11-12 (T11-T12) and lumbar segment 1 (L1).

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Uterus

The anatomy of the uterus consists of the following 3

tissue layers: The inner layer, called the endometrium, is

the most active layer and responds to cyclic ovarian

hormone changes; the endometrium is highly specialized

and is essential to menstrual and reproductive function.

The middle layer, or myometrium, makes up most of the

uterine volume and is the muscular layer, composed

primarily of smooth muscle cells. The outer layer of the

uterus, the serosa or perimetrium, is a thin layer of tissue

made of epithelial cells that envelop the uterus. The uterus is a dynamic female reproductive

organ that is responsible for several reproductive functions, including menses, implantation,

gestation, labor, and delivery. It is responsive to the hormonal milieu within the body, which

allows adaptation to the different stages of a woman’s reproductive life. The uterus adjusts to

reflect changes in ovarian steroid production during the menstrual cycle and displays rapid

growth and specialized contractile activity during pregnancy and childbirth. It can also remain in

a relatively quiescent state during the prepubertal and postmenopausal years.

Vagina

The vagina is the female organ of

copulation and functions to receive the penis

during intercourse. It also allows menstrual

flow and childbirth. The vagina extends from

the uterus to outside the body. The superior

portion of the vagina is attached to the sides of

the cervix so that a part of the cervix extends

into the vagina.

The wall of the vagina consists of an outer muscular layer and an inner mucous layer.

The muscular layer is smooth muscle and contains many elastic fibers. Thus the vagina can

increase in size to accommodate the penis during intercourse, and it can stretch greatly during

22 | P a g e
childbirth. The mucous membrane is moist stratified squamous epithelia that forms a protective

surface layer. Lubricating fluid passes through the vaginal epithelium into the vagina.

In young females, the vaginal opening is covered by a thin mucous membrane known as

the hymen. The hymen can completely close the vaginal orifice in which case it must be

removed to allow menstrual flow. More commonly, the hymen is perforated by one or several

holes. The openings of the hymen are usually greatly enlarged during the first sexual intercourse.

The hymen can also be perforated during a variety of activities including strenuous exercise. The

condition of the hymen is therefore not a reliable indicator of virginity.

The External Genitalia

The external female genitalia, also called

the vulva, or pudendum, consists of the vestibule and its surrounding structures. The vestibule is

the space into which the vagina and urethra open. The urethra opens just anterior to the vagina.

The vestibule is bordered by a pair of thin, longitudinal skin folds called the labia minora. A

small erectile structure called the clitoris is located in the anterior margin of the vestibule. The

two labia minora unite over the clitoris to form a fold of skin known as the prepuce. The clitoris

consists of a shaft and a distal glans. Like the glans penis, the clitoris is well supplied with

sensory receptors, and it is made up of erectile tissue. An additional erectile tissue is located on

either side of the vaginal opening.

On each side of the vestibule, between the vaginal opening and the labia minora, are openings of

the greater vestibular glands. These glands produce a lubricating fluid that helps maintain the

moistness of the vestibule. Lateral to the labia minor are two prominent rounded folds of skin

called the labia majora. The two labia majora unite anteriorly at the elevation of tissue over the

pubic symphysis called the mons pubis. The lateral surfaces of the labia majora and the surface

of the mons pubis are covered with coarse hair. The medial surfaces of the labia minora are

covered with numerous sebaceous and sweat glands. The space between the labia minor is called

the pudendal cleft. Most of the time, the labia minora are in contact with each other across the

midline , closing the pudendal cleft and covering the deeper structures within the vestibule. The

region between the vagina and the anus is the clinical perineum. The skin and muscle of this

region can tear during childbirth. To prevent such tearing, an incision called an episiotomy is

sometimes made in the clinical perineum. Traditionally, this clean, straight incision is thought to

23 | P a g e
result in less injury, and less trouble in healing, and less pain. However, many studies indicate

that there is less injury and pain when no episiotomy is performed.

Menstrual Cycle

Menstruation is the shedding of the lining of the uterus (endometrium) accompanied by

bleeding. It occurs in approximately monthly cycles throughout a woman's reproductive life,

except during pregnancy. Menstruation starts during puberty (at menarche) and stops

permanently at menopause. The menstrual cycle begins with the first day of bleeding, which is

counted as day 1. The cycle ends just before the next menstrual period. Menstrual cycles

normally range from about 25 to 36 days. Only 10 to 15% of women have cycles that are exactly

28 days. Usually, the cycles vary the most and the intervals between periods are longest in the

years immediately after menarche and before menopause.

Menstrual bleeding lasts 3 to 7 days, averaging 5 days. Blood loss during a cycle usually

ranges from ½ to 2½ ounces. A sanitary pad or tampon, depending on the type, can hold up to an

ounce of blood. Menstrual blood, unlike blood resulting from an injury, usually does not clot

unless the bleeding is very heavy. The menstrual cycle is regulated by hormones. Luteinizing

hormone and follicle-stimulating hormone, which are produced by the pituitary gland, promote

ovulation and stimulate the ovaries to produce estrogen and progesterone stimulate the uterus

and breasts to prepare for possible fertilization. The cycle has three phases: follicular (before

release of the egg), ovulatory (egg release), and luteal (after egg release).

Menopause

When a woman is 40-50 years old, the menstrual cycles become less regular and

ovulation does not consistently occur during each cycle. Eventually, the cycles stop completely.

The cessation of menstrual cycles is called menopause, and the whole time period from the onset

of irregular cycles to their complete cessation is called the female climacteric. The major cause

of menopause is age-related changes in the ovaries. The number of follicles remaining in the

ovaries of menopausal women is small. In addition to this, the follicles that remain become less

sensitive to the stimulation of FSH and LH. As the ovaries become less responsive to stimulation

by FSH and LH, fewer mature follicles and copora lutea are produced. Gradual changes occur in

women in response to the reduced amount of estrogen and progesterone produced by ovaries.

24 | P a g e
 During the climacteric, some women experience “hot flashes,” irritability, fatigue,

anxiety, temporary decrease in libido, and occasionally severe emotional disturbances. Many of

these symptoms can be treated successfully with hormone replacement therapy, which usually

consists of small amounts of estrogen or progesterone. A potential side effect of HRT is a

slightly increased possibility of the development of breast cancer, uterine cancer, heart attacks,

strokes, and blood clots. HRT does slow the decrease in bone density that can become sever in

some women after menopause and decreases the risk of developing colorectal cancer.

Estrogen and progesterone stimulate the development of the endometrium and

preparation of the uterine lining for implantation of a zygote. If pregnancy does not occur, the

drop in FSH and LH causes the corpus luteum to disintegrate. The drop in hormones also causes

the sloughing off of the inner lining of the uterus by a series of muscle contractions of the uterus.

ETIOLOGY/PRE-DISPOSING/RISK FACTORS

Etiology

25 | P a g e
1. Age - is a risk factor in the disease process of uterine leiomyoma. This is due to the

differences of estrogen and progesterone levels in females as they get older and undergo the

processes of menopause.

2. Race – Although an actual connection between the disease process and race have yet to been

validated and affirmed, many studies have shown that particular races such as American and

African Americans are more susceptible to tumor growth in the endometrial lining among

premenopausal women (Marshall, 1997).

3. Heredity – Women who’s mothers have had myoma themselves are more susceptible to

getting the disease than those who have no family history of the disease. (Faerstein, 1997)

4. Early Menarche and Nulliparity – Studies have suggested that an early start of menarche (less

than the average age of 13) and nulliparity contribute to the development of a uterine leiomyoma,

however, how this connection or relationship between the risk factor and the disease processes

are still unknown (Faerstein, 2001). It is believed that these factors are precipitated because of

the estrogen and progesterone levels in the body.

Precipitating Factors

1. High Fat Diet & Obesity – is also considered a source of estrogen whereas diets rich in fiber

and low in fat decreases estrogen reabsorption. Fat has an enzyme that converts adrenal steroids

to estrogen. The higher the fat intake, the higher the conversion of fat to estrogen. Overeating is

the norm in developed countries. A population from such countries, especially in the Western

hemisphere where a large part of the dietary calorie is derived from fat, has a much higher

incidence of menopausal symptoms. Studies have shown that estrogen and progesterone levels

fell in women who switched from a typical high-fat, refined-carbohydrate diet to a low-fat, high-

fiber and plant-based diet even though they did not adjust their total calorie intake. Plants contain

over 5,000 known sterols that have progestogenic effects.

2. Anxiety/ Stress – The stress levels of the individuals can influence the production of estrogen

and progesterone in the body. Stress causes adrenal gland exhaustion as well as reduced

progesterone levels. This tilts the estrogen to progesterone ratios in favor of estrogen. Excessive

estrogen in turn causes insomnia and anxiety, which further taxes the adrenal glands. This leads

to a further reduction in progesterone output and even more estrogen dominance. After a few

26 | P a g e
years in this type of vicious cycle, the adrenal glands become exhausted. This dysfunction leads

to blood sugar imbalance, hormonal imbalances, and chronic fatigue.

3. Oral Contraceptives or HRT - Oral contraceptives promote estrogen dominance and eventually

influence the growth of the cells in the uterus. This increases the level of estrogen in the body.

Premarin, an estrogen-only drug commonly used in the past 40 years, is the mainstay of estrogen

replacement therapy (ERT). It is a patented, chemicalized hormonal substitute that is different

than the natural estrogen in your body. It contains 48% estrone and only a small amount of

progesterone, which is insufficient to have an opposing effect. The indiscriminate and over-

prescription of Premarin to many who may not need it is the problem. Symptoms include water

retention, breast swelling, and fibrocysts in the breast, depression, headache, gallbladder

problems, and heavy periods. The excessive estrogen from ERT also lead to increased chances of

DNA damage, setting a stage for endometrial and breast cancer

4. Luteal Insufficiency - Leiomyoma formation is also possible because of hyperestrogenism due

to progesterone deficiency that is caused by luteal insufficiency

5. Caffeine or Coffee intake - Increase in coffee consumption. Caffeine intake from all sources is

linked with higher estrogen levels regardless of age, body mass index (BMI), caloric intake,

smoking, alcohol, and cholesterol intake. Studies have shown that women who consumed at least

500 milligrams of caffeine daily, the equivalent of four or five cups of coffee, had nearly 70%

more estrogen during the early follicular phase than women who consume no more than 100 mg

of caffeine daily, or less than one cup of coffee. Tea is not much better as it contains about half

the amount of caffeine compared to coffee. The exception is herbal tea like chamomile, which

contains no caffeine.

Pathophysiology (Schematic Diagram)

27 | P a g e
 Predisposing Precipitating Factors:
Factors: -High fat diet
-Age -Obesity
-Race -Anxiety/Stress
Etiology:
-Heredity -Oral Contraceptives or
Unknown
-Early Menarche -Hormone replacement therapy
& Nulliparity -Luteal Insufficiency
-Coffee/ Caffeine intake
Estrogen Dominance or
increase in Estrogen
production

Proliferation of cells
in uterus S/sx:
Classified according -Swelling of breasts
to area of growth: -Depression
intramural, -Loss of sex Drive
Overgrowth of the
submucous, & -Dysmenorrhea
myometrial lining
subserous

Myoma:
Development of
uterine fibroid

Uterine Cavity S/sx:

begins to stretch or -Pain
-Increased pelvic Pressure
increase in size

Interference in the
vascular supply

Degeneration of the S/sx:

-hypermenorrhea
fibroid -Abnormal bleeding

28 | P a g e
 SIGNS & SYMPTOMS/CLINICAL MANIFESTATIONS

1. Swelling of breasts – Enlargement of the breast and tenderness results from a fluctuation of the

hormones progesterone and estrogen.

2. Depression – Due to imbalanced levels of estrogen in the body.

3. Loss of Sex Drive – Due to imbalanced levels of estrogen in the body.

4. Dysmenorrhea – Due to imbalanced levels of estrogen in the body.

5. Pain – Due to the stretching of the uterus and the proliferation of cells which damages the

endometrial wall.

6. Increased pelvic pressure – Due to the growth of the tumor.

7. Hypremenorrhea and Abnormal Bleeding – Due to the growth of the tumor as well as the

deterioration of the surrounding tissues which may come from the ischemia due to the tumor’s

growth.

29 | P a g e
 LABORATORY/DIAGNOSTIC WITH NORMAL VALUES/RESULT ANALYSIS

COMPLETE BLOOD COUNT

Diagnostic Indications or Date Ordered Normal Analysis and
Results
Procedure Purpose & Released Values interpretation
HGB (g/dL) To measure the August 10, 140 120-160 Normal.
hemoglobin 2019 g/dl Patient was
able to
compensate
with
decreased of
oxygen
carrying
capacity and
availability of
oxygen
increased.
HCT (%) To aid August 10, 43.1 36.0 – Normal. The
diagnosis of 2019 47.0 ratio of solid
abnormal states particles in
of hydration, the blood of
polycythemia the patient is
and anemia and in proportion
to the liquid
aids in
part of the
calculation of
blood
erythrocyte signifying
indices that the blood
is neither too
diluted nor
too
concentrated.
Platelet Count To evaluate August 10, 246 150 – 400 Normal. It
platelet 2019 means that
(x10 9/L) the
production
coagulation
capacity and
clotting factor
of the patient
is functioning
well.

WBC (x10 To determine August 10, 9.1 4.8 – 10.8 Normal

9/L) for presence of 2019 count. It
for further tests means the
such as WBC patient’s
differential immune
infection and function is
intact and
also for
functioning in
determination
its optimum.
count Proximity of
the WBC
count to the
high limit
score means
the body is
trying to fight

30 | P a g e
 present
developing
infection or
there is
presence of
bleeding in
some parts of
the body.
Differential To provide a August 10, 40 55-65% The result is
Count: numeric 2019 below normal
estimate of the range
Segmenters (%) indicating the
client’s
immune status. possible
presence of a
viral
infection.
Lymphocytes To check for August 10, 48 25-35% The result is
(%) immune 2019 above normal
responses range
indicating
infection.

Eosinophils To determine August 10, 05 2-4% The result is

(%) presence of 2019 above normal
multicellular range
parasites and indicating the
certain presence of a
infections parasitic
infection.

Monocytes (%) To determine August 10, 07 2-6% The result is

presence of 2019 above normal
Chronic range. It
inflammatory means
disease, macrophages
Parasitic are activated.
infection, Viral
infection

COMPLETE BLOOD COUNT

NURSING RESPONSIBILITIES BEFORE, DURING, AND AFTER PROCEDURE

Before the Procedure

 Explain the procedure to the pt. and why it is indicated
 Inform the patient that fluid and food restriction is not required
 Inform the patient that a blood sample will be taken.
 Tell the patient that he may experience transient discomfort from the needle puncture
 Fill up laboratory request form properly and send it to the laboratory technician during
the collection of sample/specimen.
During the Procedure

31 | P a g e
  Inform the patient that pain may be felt through prick in the needle
 Instruct the patient to calm down to avoid uneasiness.
After the Procedure
 Apply brief pressure to prevent bleeding
 Apply warm compress if Hematoma will develop at the venipuncture site.

PELVIC ULTRASOUND
Diagnostic Indications or Date Ordered Analysis and
Results
Procedure Purpose & Released interpretation
Pelvic Visualization of August 9, 2019 Uterus: Size 6.1 x 4.9 Central mass
Ultrasound the organs of x 5.9 cm, Anteverted, (3.2 x 3.8 x 3.9
homogenous, No
the pelvis, intermural/ subserous
cm) suggestive
including the myomatous growth of endometrial
uterus, polyp v.
Cervix: Size: 2.6 cm
fallopian tubes, Submucous
x 2.5 cm.
and ovaries. Abnormalities: No myoma.
This study is Focal lesions
done to detect
Endometrium:
any masses or Endometrium is not
obstructions in delineated. There is a
the region of round hyperechoic
the pelvis. mass noted measuring
3.2 x 3.8 3.9 cm
suggesting endo
metrial polyp vs.
Submucous myoma
Ovaries (Right) 1.7 x
2.4 x 2.4 cm lateral
(Left) 2.1 x 2.0 x 2.6
cm
Abnormalities: No
pathologic ovarian
lesion noted

PELVIC ULTRASOUND
NURSING RESPONSIBILITIES BEFORE, DURING, AND AFTER PROCEDURE
Before the Procedure
 Explain the procedure to the pt. and why it is indicated
 Instruct the patient to be placed on NPO for 8-12 hours post midnight
 Acquire a confirmed and informed consent prior to the procedure.
 Inform patient that the gel and the apparatus to be used may feel cold and uncomfortable
as it will be placed on the skin to visualize the organs.
During the Procedure
 Provide privacy
 Advise patient to remain still while the procedure is being informed
After the Procedure
 Document that the procedure has been performed
 Inform physician when findings are available.

32 | P a g e
 BLOOD CHEMISTRY

Diagnostic Indications or Date Ordered & Normal Analysis and

Results
Procedure Purpose Released Values interpretation

Glucose ; RBS To measure the August10, 2019 101 <140 Normal count.
amount of mg/dl It means the
glucose in the amount of
blood right at glucose in the
the time of blood is
sample sufficient for
energy
collection
production and
also not
excessive to
cause
hyperglycemia.
Indicated
insulin
(pancreatic)
function is
functioning to
its optimum.
Creatinine To evaluate August 10, 2019 0.8 0.4-1.4 Normal. It
kidney mg/dl means toxic
function. substances in
the body are
maintained in
normal amount
and signifies
the kidneys are
functioning
normally with
accordance to
its filtration
and excretion
of toxic
substances.
Result also
indicate
normal pH of
blood is
maintained.

Potassium To detect August 10, 2019 3.82 3.4 - 5.3 Normal /

concentrations mmol/l within normal
that are too range. It means
high electrolyte
(hyperkalemia) supply in the
or too low body is
sufficient to
(hypokalemia).
meet hydration
needs.

BLOOD CHEMISTRY
NURSING RESPONSIBILITIES BEFORE, DURING, AND AFTER PROCEDURE

Before the Procedure

33 | P a g e
  Explain the procedure to the pt. and why it is indicated
 Inform the patient that fluid and food restriction is not required
 Inform the patient that a blood sample will be taken.
 Tell the patient that he may experience transient discomfort from the needle puncture
 Fill up laboratory request form properly and send it to the laboratory technician during
the collection of sample/specimen.
During the Procedure
 Inform the patient that pain may be felt through prick in the needle
 Instruct the patient to calm down to avoid uneasiness.
After the Procedure
 Apply brief pressure to prevent bleeding
 Apply warm compress if Hematoma will develop at the venipuncture site.

34 | P a g e
 Pharmacological Management

Generic Name Dates Indication or General Action Clients

(Brand Name) Purposes Response to
Treatment

Brand Name: Date ordered: 1g/IV q 8 First generation The patient

Ancef ANST x 1 more cephalosporin verbalizes
8/11/2019 dose anti-infective understanding of
Generic Name: drug that inhibits taking this
Cefazolin Date performed: cell-wall medication
Sodium synthesis,
8/11/2019 promoting
osmotic
instability;
usually
bactericidal.

Brand Name: Date ordered: 10 mg / amp Opioid The patient

PRN analgesics. Binds verbalizes relief
Nubain 8/11/2019 with opiate from pain
Receptors in the
Generic Name: Date performed: CNS, altering
perception of
Nalbuphine 8/11/2019 and emotional
Hydrochloride response to pain.

Date ordered: Antianginals.

Brand Name: Inhibits calcium The patient
Amlodipine 8/12/2019 ion influx acriss verbalizes
Besylate cardiac and understanding of
5 mg / tab OD smooth- muscle taking this
cells, dilates medication
Generic Name: Date performed: coronary arteries
and arterioles,
Norvasc 8/12/2019 and decreases
blood pressure
and myocardial
oxygen demand.

Brand Name: Date ordered: 75 mg/deep IM Nonsteroidal

ANST (-) anti- The patient
Voltaren 8/12/2019 inflammatory verbalizes
drug, may inhibit understanding of
Generic Name: Date performed: prostaglandin taking this
synthesis, to medication
Diclofenac 8/12/2019 produce anti-
Sodium inflammatory,
analgesic and
anti-pyretic
effects.

Nursing Responsibilities for All Drugs

Before the administration of drug:

 Verify Doctor’s order

35 | P a g e
  Remember the 10R’s of Drug administration
During the administration of drug:

 Verify patient’s identification

 Inform the patient with regards to drug administration
 Clean the IV port prior to administration of the drug
After the administration of drug:

 Monitor patient for adverse effects

 Inform patient that easy bruising may occur
 Caution patient not to stop taking drug abruptly without first consulting prescriber

MEDICAL MANAGEMENT

36 | P a g e
 INTRAVENOUS FLUID THERAPY

Medical Date Ordered General Indication or Clients

Management Description Purposes Response to
Treatment

5% Dextrose in DO: August 10, Hypertonic  To replace No adverse

Lactated 2019 Solution fluids and reactions or IV
Ringer’s A solution electrolytes complications
Solution containing loss noted
(30gtts/min) sodium chloride,  To increase
DC: August 13, potassium vascular/
2019 chloride, calcium plasma
chloride and volume
sodium lactated necessary
in distilled water, during
referred to bleeding or
Lactated blood loss
Ringer’s solution  To replenish
calories from fluid loss of
dextrose the body,
maintain
nutritional
intake when
patient is
unable to
tolerate
feedings, also
serves as
medium for
administratio
n of
medications.
INTRAVENOUS THERAPY
NURSING RESPONSIBILITIES BEFORE, DURING, AND AFTER
Before the Procedure
 Check the doctor’s order regarding to what type of IVF to be used and also its volume
and rate.
 Explain the procedure to the patient.
 Gather all materials needed for the insertion of IVF to save time and not to waste time for
looking for other materials.
 Wash hands before and after the procedure to prevent contamination from insertion site.
During the Procedure
 Place patient in a comfortable position to facilitate easy insertion of IV line and to
decrease patient’s fear about the procedure.
 Make sure that we give the proper IV fluid and drop rate accurately because patient may
experience fluid overload or dehydration.
 Check for its patency by observing the backflow of blood upon insertion.
After the Procedure
 Press the site where the needle was inserted and secure it with micropore.
 Check the site of hand where the needle is inserted if bulging is not visible. If so,
reinsertion is to be undertaken.

37 | P a g e
  Advice patient to avoid scratching the site less movement of the hand where the needle
was inserted to keep it in place.
 Instruct patient and significant others to inform the nurse on duty if bulging of the site is
visible, if there is back flow of blood of if IVF is not infusing well.
 Observe the IV site at least every hour for signs of infiltration or other complications
fluid or electrolyte overload and air embolism.
 IVF regulation should be checked and monitored upon receiving patient.
 Always check the doctor’s order for new orders regarding the IVF supplement of the
patient.
 Always check if the IVF is infusing well and intact.
 Monitor the patient’s skin integrity.
 Provide comfort for the patient.
 Remove and dispose used items.
 Report and record as appropriate.
 Place IV tag

SURGICAL MANAGEMENT

38 | P a g e
TOTAL ABDOMINAL HYSTERECTOMY

 Total abdominal hysterectomy is utilized for benign and malignant disease where

removal of the internal genitalia is indicated. The operation can be performed with the

preservation or removal of the ovaries on one or both sides. In benign disease, the

possibility of bilateral and unilateral oophorectomy should be thoroughly discussed with

the patient. Frequently, in malignant disease, no choice exists but to remove the tubes and

ovaries, since they are frequent sites of micrometastases.

 In general, the modified Richardson technique of intrafascial hysterectomy is used.

 The purpose of the operation is to remove the uterus through the abdomen, with or

without removing the tube and ovaries.

 Physiologic Changes. The predominant physiologic change from removal of the uterus is

the elimination of the uterine disease and the menstrual flow. If the ovaries are removed

with the specimen, the predominant physiologic change noted is loss of the ovarian

steroid sex hormone production.

 Points of Caution. The predominant point of caution in performing abdominal

hysterectomy is to ensure that there is no damage to the bladder, ureters, or rectosigmoid

colon.

 Mobilization of the bladder with a combination of sharp and blunt dissection frees the

bladder from the lower uterine segment and upper vagina. This reduces the incidence of

damage to the bladder.

 By exercising extreme care in management of the uterine artery pedicle, the surgeon may

minimize the risk of injury to the ureter. The same is true of the management of the

cardinal and uetrosacral ligament pedicles.

 If the vaginal cuff is left open with the edges sutured, the incidence of postoperative

pelvic abscess is dramatically reduced.

 Instruments Used:

- Self-retaining retractors

- Moist Gauze packs

- 0 synthetic absorbable suture

- Clamps

-Straight Ochsner Clamp

39 | P a g e
 -Curved Ochsner clamps

-Metzenbaum Scissors

-Scalpel

NUTRITIONAL MANAGEMENT WITH ANALYSIS

LOW SALT, LOW FAT DIE

40 | P a g e
 General Indication or Clients Response
Type of Diet Date Ordered
Description Purposes to Treatment
Low Salt, Low Reduced sodium To prevent risk August 10, 2019 Client has been
Fat diet. and cholesterol for other complying with
Upon admission
content of food complications the diet and was
which may arise able to maintain
from blood pressure
hypertension. within normal
limits for most
days.

LOW SALT, LOW FAT DIABETIC DIET

NURSING RESPONSIBILITIES BEFORE, DURING, AND AFTER

Before the Procedure

 Check the doctor’s order.
 Check the right client.
 Be sure that the diet is properly instructed.
During the Procedure
 Monitor if the client complies with the given diet.
 Be sure patient is taking or eating food he can tolerate
After the Procedure
 Assess for patient’s condition; how he responds to the diet

Active and Passive Range of Motion Exercises

General Indication or Clients Response

Type of Activity Date Ordered
Description Purposes to Treatment
Active and Range of motion To prevent any Aug. 11, 2019 The client was
Passive Range of (ROM) exercises aggravations of able to comply
After Surgery
Motion Exercises are ones in which complications of with the activity;
a nurse or patient immobility such therefore
move each joint as thrombus thrombus
through as full a formation. formation had
range as is been prevented.
possible without
causing pain.

ACTIVE AND PASSIVE RANGE OF MOTION EXERCISES

NURSING RESPONSIBILITIES BEFORE, DURING, AND AFTER

Before the Procedure

 Check the doctor’s order.
 Check the right client.
 Be sure that the activity is properly instructed.

41 | P a g e
  Ensure that the patient understands why this type of activity is being prescribed.
During the Procedure
 Monitor if the client complies with the given activity
 Be sure patient is taking or eating food he can tolerate
After the Procedure
 Assess for patient’s condition; how he responds to the activity

Turning, Coughing, And Deep Breathing

General Indication or Clients Response

Type of Activity Date Ordered
Description Purposes to Treatment
Turning, A type of To assist in Aug. 11, 2019 The client was
Coughing, And exercise which is loosening and able to comply
After Surgery
Deep Breathing educated prior to expectoration of with the activity
the surgery and mucous as evidenced by
implemented clear breath
soon after the sounds.
effects of
anesthesia have
worn off which
includes
activities such as
coughing and
deep breathing
with the use of a
splint.

TURNING, COUGHING, AND DEEP BREATHING

NURSING RESPONSIBILITIES BEFORE, DURING, AND AFTER

Before the Procedure

 Check the doctor’s order.
 Check the right client.
 Be sure that the activity is properly instructed.
 Ensure that the patient understands why this type of activity is being prescribed.
During the Procedure
 Monitor if the client complies with the given activity
 Be sure patient is taking or eating food he can tolerate
After the Procedure
 Assess for patient’s condition; how he responds to the activity.

COMPLEMENTARY, ALTERNATIVE AND INTEGRATIVE MEDICINE

42 | P a g e
 Complementary and alternative medicine (CAM) is broadly defined as systems of

medicine that fall outside of mainstream care and are external to the politically dominant health

system practices. In this definition, both complementary and alternative medicines are used

interchangeably.

 Gui Zhi Fu Ling Tang Ramulus cinnomomi and Poriae cocos decoction

The most commonly used traditional Chinese medicine (TCM) formula to treat uterine

fibroids is Gui Zhi Fu Ling Tang (GFLT). This formula is effective in the treatment of

dysmenorrhea either as a stand-alone treatment or in combination with progesterone receptor

modulator such as mifepristone. The combination GFLT mifepristone therapy was shown to be

more effective than using mifepristone alone. Three of the herbs used are known to be anti-

proliferative and are involved in tumour cell apoptosis and induction of follistatin, Mu Dan Pi

(Cortex Moutan), Chi Shao (Radix Paeoniae Rubra), and Tao Ren (Semen Persicae).

 Genistein
The isoflavone genistein has a number of properties involved in the inhibition

atherosclerosis. Genistein is an anti-inflammatory and modulates vascular inflammation.

Genistein also inhibits tyrosine kinases, enzymes involved in cellular growth and proliferation

signal cascade; blocks platelet aggregation; and modulates genes related to cell cycle and

apoptosis. In addition, genistein also modulates nuclear factor-kappa B (NFkB). As a result,

genistein may also be able to mediate uterine fibroid growth.

 Acupuncture
Acupuncture acts on a variety of therapeutic targets associated in the pathogenesis and

symptomatology of fibroids. It is effective treatment for dysfunctional bleeding and chronic

pelvic inflammatory disease and dysmenorrhea.

Nursing Management for Uterine Myoma

43 | P a g e
  The nurse determines what the experience means to the patient and encourages her to

verbalize her concerns.

 Explanations are given about physical preparations and procedure that are performed.

 The nurse needs to approach and evaluate each patient individually in light of these

factors.

 The nurse assesses the intensity of the patient’s pain and assists the patient with analgesia

as prescribed.

 Nurse helps the patient to ambulate early in the postoperative period.

 Intake and Output char is monitored

 Explain the patient about follow up visit.

 Encouraging verbalization of feelings

 Monitor active fluid loss from wound drainage, bleeding

 Encourage patient to drink prescribed fluid amount.

 Encourages client to increase fluid intake

 Observations of changes in mental status, behavior or level of consciousness.

 Note the catheter patency was settled (when using catheter)

 Assess nutritional status, including weight, history of weight loss and serum albumin.

 Encourage intake of protein and calorie-rich foods.

 Help in developing effective coping strategies.

NURSING CARE PLAN

ASSESSMENT NURSING PLANNING INTERVENTION RATIONALE EVALUATION

44 | P a g e
 DIAGNOSIS
Subjective: Deficient fluid Short term goal: Independent: Short term:
volume related to
“Dinudugo ako blood loss as After 2 days of Assessment Fluid replacement After 2 days of
higit isang taon” evidence by nursing intervention needs are based on nursing
as verbalized by vaginal bleeding the patient will : Monitor urinary correction of intervention, the
the patient. for over a year output. Measure or current deficits and patient was able
ago.  Experience estimate fluid losses ongoing losses. A to:
adequate from all sources such decreased urinary
fluid as gastric losses, output may Goal met. Patient
INFERENCE: volume and wound drainage, and indicate experience
electrolyte diaphoresis insufficient renal adequate fluid
Predisposing balance prefusion or volume and
factor hypovolemia, or electrolyte
(57 years old  Will be polyuria can be balance as
female, gravida 2, able to present, requiring evidence by urine
Objective: more aggressive output greater
genetic identify
predisposition) some fluid replacement. than 30 ml/hr,
Temp –37 °C normal vital signs
managemen
PR - 80 bpm and normal skin
t to
RR -16 cpm turgor.
maintain
BP -140/90
Formation of health. To determine any
mmHg Monitor vital signs Goal met. The
tumor in the cause or be the
muscle of uterus for changes effects of patient was able
dehydration. to understand the
importance of
taking
supplements
Presence of especially iron
vaginal bleeding Long term goal: and eating
Elevated nutritious foods.
After 1 week of Monitor serum hemoglobin and
nursing intervention electrolytes and urine elevated blood urea
Blood loss the patient will osmolality and report nitrogen (BUN)
demonstrate abnormal values. suggest fluid
behaviors or lifestyle deficit. Urine-
changes to prevent specific gravity is Long term goal:
development of fluid likewise increased.
Deficient fluid After 1 week of
volume volume deficit.
nursing
intervention the
Therapeutic
Activity increases patient was able:
Maintain bedrest, intrabdominal
pressure and can be Goal met. The
schedule activities to
predispose to patient will
provide undisturbed
further bleeding. demonstrate
rest period. behaviour or
lifestyle changes
to prevent
development of
Educative fluid volume
deficit.
Oral fluid
Encourage patient to replacement is
drink prescribed fluid indicated for mild
amounts. fluid deficit.

Dependent:

Assessment

Note the client’s To evaluate the

level of ability to express
consciousness and needs.
mentation

Therapeutic

45 | P a g e
 Administer
medications as To stop or limit
appropriate (e.g., fluid losses
antiemetics,
antidiarrheals, or
antipyretics)

Educative
Review and instruct To alert to potential
in medications. complications and
ways to manage.

Interdependent/
Collaborative

Assessment

Assist the physician

with insertion of a This allows more
central venous line effective fluid
and arterial line as administration and
indicated monitoring.

Therapeutic

Assist with
identification and Refer to listing of
treatment of predisposing or
underlying cause. contributing factors
to determine
treatment needs.
Note: Dehydration
is the most
common fluid and
electrolyte
imbalance in older
adults
Educative

Encourage the
client/caregiver to To determine
maintain a diary of replacement needs.
fluid intake, number
and amount of
voidings, and
estimate of other
fluid losses (e.g.,
wounds or liquid
stools), as necessary

46 | P a g e
 NURSING CARE PLAN
ACTIVITY INTOLERANCE
ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective: Activity Short Term Goal Independent: Short Term Goal

intolerance related Evaluation:
 ”Di pa to generalized  After 6 hours Assessment
masyadong weakness as of effective To enhance Goal met partially
makagalaw, manifested by nursing Provide positive met because after
learning
ang hirap” discomforts, interventions atmosphere 6 hours of
weakness and the patient effective nursing
facial grimace. will be able
To ensure the interventions, the
Assess mobility level patient does not
to do the prior to exercise, patient is able to
ADL’s alone injure or over-stress do ADL’s but
stretching or other
and to interventions
himself/herself. with minimal
participate in assistance and
Objective:
self-care participate in self-
Therapeutic
activities. To promote care activities.
 With facial INFERENCE:
grimace. Provide adequate rest healing.
Long Term Goal
 Appears Post-Surgical periods.
Evaluation:
weak with Procedure To know if there is
verbal Long Term Goal Assess physical mobility any changes on
reports of patient’s condition Goal fully met
status
discomforts.  After 2 days because after 2
Pain and Stress specifically on
 with limited of effective days of effective
physical aspects. nursing
range of nursing
motion interventions interventions, the
Immobility the patient Instructed SO to use To provide safety patient is able to
 Cannot
perform will be able side rails, overhead maintain activity
ADL’s alone to maintain and pillows in level within
Thrombus activity level changing the position capabilities as
VITAL SIGNS: Formation within of the patient. evidenced by
capabilities To maximize full normal vital signs
as evidenced Assist to do active strength. during activity, as
- Bp 140/90
by normal range of motion well as absence of
- Pulse 80 bpm Activity weakness, pain,
vital signs exercise like flexing of
- Temp 37 Intolerance and difficulty
during
- Respi 16 bpm both extremities. accomplishing
activity, as
- SO2 98 well as
To provide comfort tasks.
absence of Provide non- by altering
weakness, pharmacologic psychological
pain, and management. responses to pain.
difficulty
accomplishin Educative
g tasks. Minimized
Encourage alternating exhaustion and
activity with rest helps balance O²
supply and demand.

Explain importance of Bedrest is

bed rest in treatment maintained to
decrease metabolic
Dependent demands thus
conserving energy.
Assessment:

Assess emotional and It might be a result

psychological factors of stress and
affecting the current depression that can
situation increase the effects
of an illness.
Therapeutic:

Instructed SO to
reposition the patient
To provide safety
every 2 hours with
proper assistance

Collaborative

47 | P a g e
 Consult with physician
or occupational Prescription of
therapist. medicine and
useful of
formulating
exercises.

NURSING CARE PLAN

OBESITY

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

48 | P a g e
Subjective: Obesity related to Short Term Goal Independent: Independent: Short Term
lesser physical Goal
“Medyo activity than the After 1 week of Assessment Assessment Evaluation:
nahihirapan ako recommended for effective nursing -Monitor vital signs. -To obtain a
gumalaw” as gender and age as interventions the -Introduce self and baseline data and Goal Met
verbalized by the evidenced by the patient will be able to; intention during the current data After 1 week of
patient. results of the BMI first phase of comparison. effective nursing
- Participate in interaction. -This will help the interventions the
development of, and patient was be
- Obtain weight history client build her
commit to, a personal able to;
-Assess risk and trust with the nurse
weight loss program. presence of factors or -This will serve as
Objective: INFERENCE: - Participate in
conditions associated guide for
development of,
with obesity interventions and commit to, a
Height: 5’4 High Fat Intake, -Calculate body mass -To determine
High intake of Long Term Goal personal
Weight: 85 kg index treatments and
simple weight loss
BMI: 32.2 interventions that
carbohydrates, and program.
After 6 months of Therapeutic may be indicated in
VITAL SIGNS: Deficient Fiber effective nursing addition to weight
-Interact with the client Long Term
Intake interventions the in a slow pace, using a management. Goal
- Bp 140/90 patient will be able to; - To estimate
low firm tone. Evaluation:
- Pulse 80 bpm ↓
-Do not hurry client percentage of
- Temp 37 - Demonstrate
into an interaction, body fat. Goal Met
Low energy appropriate changes in
- Respi 16 bpm instead maintain a After 6 months
expenditure lifestyle and
- SO2 98 reassuring and Therapeutic of effective
behaviors,
including eating therapeutic - This will promote nursing
↓
patterns, food atmosphere. a positive and interventions the
quantity/quality, and trusting patient was be
Less than
exercise Educative environment with able to;
recommended
physical activity program. - Discuss normalcy of the client.
ups and downs of - Sometimes clients - Demonstrate
- Attain desirable weight loss may have some appropriate
↓ changes in
body weight with -Discuss myths emotional outbursts
optimal maintenance client/SO may have or hesitancy in lifestyle and
Obesity behaviors,
of about weight and sharing their
health. including eating
weight loss thoughts. So it is
patterns, food
best to not rush
quantity/quality,
them and exercise
program.
Educative
-This prevents - Attain desirable
discouragement body weight with
when progress optimal
stalls. maintenance of
- To address health.
misconceptions and
possibly enhance
motivation for
needed behavior
changes.

Dependent:
Dependent:
Assessment
Assessment - For benefits or
- Review prescribed adverse side effects
drug regimen and drug
-Calculate calorie interactions.
requirements based on -Reducing calorie
physical factors and intake is essential
Activity for weight loss
Therapeutic Therapeutic
-Provide positive -This enhances
reinforcement and commitment to
encouragement for the program and
efforts enhances the
as well as actual person’s sense of
weight loss. selfworth.
Educative

49 | P a g e
 - Provide information Educative
regarding specific -Reducing portion
nutritional needs. size and following
a balanced diet
along
with increasing
exercise is often
what is needed to
improve
health.

Collaborative Collaborative
Assessment
Assessment -To develop and
- Collaborate with implement
physician and comprehensive
nutritionist weight-loss
program that
Therapeutic includes food,
-Recommend weighing activity, behavior
only once/week, same alteration, and
time and support.
clothes, and graph on
chart Therapeutic
-To track progress
Educative while focusing
- Encourage more on the
involvement in idea of being health
planned activity conscious and
program of client’s responsible than on
choice and within what the scale may
physical abilities. reveal.
-Provide contact
number for Educative
dietitian/nutritionist -To facilitate
and/or audiovisual weight control.
materials - To address
ongoing nutritional
needs and dietary
changes

Assessment Nursing Planning Intervention Rationale Evalua

Diagnosis

50 | P a g e
 Short Term Goal: Short T
Subjective: Independent: Goal
Decreased After 4 hours of nursing  Assessment Evaluat
“Mataas po ang Cardiac Output intervention the patient’s
BP ko at mabilis related to vascular blood pressure will Monitored and To established baseline After 4
ako mapagod” as constriction as decrease to less than recorded patient’s data. hours of
verbalized by the manifested by a 140/90 but not lower vital signs. nursing
patient. BP of 140/90 and than 100/70. interven
easy fatigability. , the blo
Long Term Goal:  Therapeutic pressure
the patie
To promote healing of the will low
INFERENCE At the end of 8-hour Promote adequate patient and to lower heart down to
Nursing Interventions, rest. rate. 120/80.
Objective: Occlusion in the theclient will be ableto:
artery  met.
-easy fatigablity
 Demonstrate
 Educative
hemodynamic Long te
stability (Blood Goal
VITAL SIGNS: Decreased blood Encourage relaxation
pressure and To lessen the anxiety Evaluat
supply techniques such as
cardiac output)by which may cause increase
- Bp 140/90 31%-80% as listening to music. in blood pressure. After 8
- Pulse 80 bpm revealed in the hours of
- Temp 37ºC cardiac monitor nursing
- Respi 23 bpm Decreased interven
- SO2 98 venous return the patie
Psychoeducational
programs including demonst
information on stress stability
Educate patient the management and health blood
Decreased amount need for and how to education have been pressure
of blood expelled incorporate lifestyle shown to reduce long term revealed
byventricles changes. mortality and recurrence of cardiac
myocardial infarction in monitor
heart patients. Goal me
Dependent:
The pati
Decreased  Assessment remains
cardiac output of side
Closely monitor fluid In patients with decreased effects f
intake including IV the
cardiac output, poorly
lines. Maintain fluid functioning ventricles may medicat
restriction if ordered. use to
not tolerate increased fluid
volumes. achieved
adequate
cardiac
output.

 Therapeutic Fluid restriction decreases

extracellular fluid volume
For patients with and reduces demands on
increased preload, the heart
limit fluids and
sodium as ordered.

Administer Depending on etiological

medications as factors, common
prescribed, noting medications include
side effects and digitalis therapy, diuretics,
toxicity. vasodilator therapy,
antidysrhythmics,
angiotensin-converting
enzyme inhibitors, and
inotropic agents..

51 | P a g e
  Educative

Educate family and Early recognition of

patient about the symptoms facilitates early
disease process, problem solving and
complications of prompt treatment.
disease process,
information on
medications, need for
weighing daily, and
when it is appropriate
to call doctor.

Interdependent/
Collaborative

 Assessment
Routine blood work can
Monitor laboratory provide insight into the
tests such as complete etiology of heart failure
blood count, sodium and extent of
level, and serum decompensation. A low
creatinine. serum sodium level often
is observed with advanced
heart failure and can be a
poor prognostic sign.
Serum creatinine levels
will elevate in patients
with severe heart failure
because of decreased
perfusion to the kidneys.
Creatinine may also
elevate because of ACE
inhibitors.

52 | P a g e
REFERENCES

Kempson RL, Hendrickson MR: Smooth muscle, endometrial stromal, and mixed
Müllerian tumors of the uterus. Mod Pathol. 2000, 13 (3): 328-342.
10.1038/modpathol.3880055.

Rein MS, Barbieri RL, Friedman AJ: Progesterone: a critical role in the pathogenesis of
uterine myomas. Am J Obstet Gynecol. 1995, 172 (1 Pt 1): 14-18.

Black, J.M., Hawks, J. H. (2009). Medical-surgical nursing: clinical management for

positive outcomes. Vol.2. New York. Saunders.

Blanchard, R., Loeb, S. (2004) Blanchard & Loeb publishers nurse’s drug handbook.
Michigan. Blanchard & Loeb.

Fleischer R, Weston GC, Vollenhoven BJ, Rogers PA. Pathophysiology of fibroid

disease: angiogenesis and regulation of smooth muscle proliferation. Best Pract Res Clin Obstet
Gynaecol. 2008;22(4):603–614. [PubMed] [Google Scholar]

Okolo S. Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin
Obstet Gynaecol. 2008;22(4):571–588. [PubMed] [Google Scholar].

Fischbach, F.T., Dunning, M.B. (2008). A manual of laboratory and diagnostic tests.
Springhouse, PA. Lippincott, Williams, & Wilkins.

Gutierrez, K. J., Peterson, P.G. (2007). Saunders sursing survival guide pathophysiology.
2nd Edition. New Orleans Louisiana. Saunders & Elsevier.

Hole, J.W. (1993). Human anatomy and physiology. 6th edition. Dubuque, IA. Wm C.
Brown Publishers, inc

Huether, S.E., McCance, K.L. (2000). Understanding pathophysiology.2nd edition.

Singapore: Elsevier Science.

Karch, A. M. (2000). Lippincott’s nursing drug guide 2000. University of Michigan.

Lippincott, Williams, & Wilkins.

Keogh, J. (2009). Nursing laboratory and diagnostic tests demystified. Boston. McGraw-
Hill Professional.

McCann, J. A., Holmes, H. N., Robinson, J.M., et al. (2003). Professional guide to
pathophysiology. Springhouse, PA. Lippincott, Williams, & Wilkins.

Nicoll, D., McPhee, S.J., Pignone, M., Chuanyi, M.L. (2007). Pocket guide to diagnostic
tests: Lange clinical science series. Springhouse, PA. McGraw-Hill.

Porth, Carol M., (2005). Pathophysiology: Concepts of altered health states. 7th Edition.
Boston: Lippincott, Williams, & Wilkins.

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 Stockley, R. A. (2007). Chronic obstructive pulmonary disease. Chicago, IL. Wiley-
Blackwell.

Spratto, G.R., Woods, A.L. (2004). PDR nurse’s drug handbook. Springfield, IL.
Cengage Learning, inc.

Wallach, J.B. (2007). Interpretation of diagnostic tests: Doody’s all reviewed collection.
Springhouse, PA. Lippincott, Williams, & Wilkins.

Weber, J., Kelley, J. (2007). Health assessment in nursing. 2nd edition. Boston.
Lippincott, Williams & Wilkins.

Marshall, L., Spiegelman D., Barbieri R., Goldman M.B., Manson, J., Colditz, GA,
Willet, W.C., Hunter, D. (1997) Variation in the incidence of uterine leiomyoma among
premenopausal women by age and race. United States National Library of Medicine, National
Institutes of Health. Vol. 90, Issue. 6. Pg: 967-73

Faerstein, E., Szklo, M., Rosenshein, N., (1997) Risk factors for uterine leiomyoma: a
practice-based control study. American Journal of Epidemiology. Vol. 153, Issue 1: pg 1-10.

Lam, M., (2010) Estrogen Dominance: The silent epidemic. The Authority on Natural
Healing. http://www.drlam.com/articles/Estrogen_Dominance.asp. Accessed on September 14,
2010

Shen Y, Wu Y, Lu Q, Ren M. Vegetarian diet and reduced uterine fibroids risk: A case–
control study in Nanjing, China. Journal of Obstetrics and Gynaecology Research. 2016 Jan
1;42(1):87-94. [Cited 30 June 2019]. Available
Cutter E. Food as a Medicine in Cases of Uterine Fibroids. The American Journal of
Obstetrics and Diseases of Women and Children (1869-1919). 1877 Oct 1;10(4):562. [Cited 30
June 2019]. Available
del Rio AI. Uterine Fibroids: The Complete Guide. Journal of the National Medical
Association. 2008 Oct;100(10):1209. [Cited 30 June 2019]. Available

54 | P a g e
 RESUME OF PRESENTERS

55 | P a g e
AGSAOAY, GLENDA G.
Brgy. Samon, Sta. Maria, Pangasinan
[email protected]
09187689427

CAREER OBJECTIVE:
To build a long-term career in healthcare with opportunities for career growth.

EDUCATIONAL ATTAINMENT:

Elementary Level
Samon Elementary School
Samon, Sta. Maria, Pangasinan
S.Y. 2007-2013
Junior High School
Eastern Pangasinan Agricultural College
Sta. Maria, Pangasinan
S.Y. 2013-2017
Senior High School
Eastern Pangasinan Agricultural College
Sta. Maria, Pangasinan
S.Y. 2017-2019
With Honors- HUMSS STRAND
Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -Present
Bachelor of Science in Nursing

WORK EXPERIENCE:

Tayug Family Hospital Volunteer

Year 2019

SPECIAL SKILLS and INTERESTS

 Assessing patient needs, treat and diagnose minor illness and injuries, and provide therapy.
 Able to work and adjust in working with others.

PERSONAL INFORMATION:
Date of Birth : December 01, 2000
Place of Birth : Sta. Maria, Pangasinan
Gender : Female
Age : 19
Height : 5’
Weight : 50 kg
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Ginalyn G. Agsaoay
Father’s Name : Frankly C. Agsaoay

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

AGSAOAY, GLENDA G.
Applicant’s Signature

56 | P a g e
AGUNDAY, AISHA LEE A.
Alibeng Sison, Pangasinan
[email protected]
09095323941

CAREER OBJECTIVE:

To use my skills in patient assessment, planning, evaluation, implementation and document for
optimum patient care.

EDUCATIONAL ATTAINMENT:

Elementary Level
Alibeng Elementary School
Urdaneta City, Pangasinan
S.Y. 2007-2013
Junior High School
Benigno V. Aldana National High School
Urdaneta, Pangasinan
S.Y. 2013-2017
With Pillars
Senior High School
Benigno V. Aldana National High School
Urdaneta City, Pangasinan
S.Y. 2017-2019
With Honors
Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -Present
Bachelor of Science in Nursing

WORK EXPERIENCE:

Pozorrubio RHU Volunteer

Year 2019

SPECIAL SKILLS and INTERESTS

 Detail-oriented with a positive and friendly disposition.

 Ability to respond promptly to medical issues in urgent care and emergency care skills.
 Developed skills in acute medicine/surgery, mental health, long term care

PERSONAL INFORMATION:
Date of Birth : September 7, 2000
Place of Birth : Manila
Gender : Female
Age : 20
Height : 5’2
Weight : 45
Civil Status : Single

Citizenship : Filipino
Mother’s Name : Aloha A. Agunday
Father’s Name : Rustico A. Agunday

57 | P a g e
 I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

AISHA LEE AGUNDAY

Applicant’s Signature

58 | P a g e
APONIO, BRYAN C.
Brgy. Lagasit San Quintin Pangasinan
[email protected]
09458339091

CAREER OBJECTIVE:

Passionate, self-Committed professionals that providing best healthcare to patients in the

role of a Nurse. Where effective communication and intrapersonal skills can be maximized,

EDUCATIONAL ATTAINMENT:

Elementary Level
BAUTISTA ELEMENTARY SCHOOL
Dasmarinas, Cavite
S.Y. 2007-2013
With Honors
Junior High School
DASMARINAS WEST NATIONAL HIGH SCHOOL
Dasmarinas, Cavite
S.Y. 2013-2017
With Honors & TESDA NC II HOUSEKEEPING
Senior High School
SAN QUINTIN HIGH SCHOOL EDUCATIONAL FOUNDATION INC.
San Quintin, Pangasinan
S.Y. 2017-2019
With Honors ABM STRAND
Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -
Bachelor of Science in Nursing

WORK EXPERIENCE:

Rural Health Unit Volunteer

Barangay Health Unit Volunteer
San Quintin, Pangasinan
Year 2020

Municipal Budget Office

San Quintin, Pangasinan
Year 2018

SPECIAL SKILLS and INTERESTS

 Creativity.
 Interpersonal Skills.
 Critical Thinking.
 Problem Solving/ Decision Making
 Teamwork Skills./ Management
 Communication/Active Listening.

PERSONAL INFORMATION:
Date of Birth : June 17, 2001

59 | P a g e
Place of Birth : San Quintin, Pangasinan
Gender : Male
Age : 19
Height : 5’6
Weight : 90
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Merliza C. Aponio
Father’s Name : Joelito B. Aponio

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

BRYAN CORTEZ APONIO

Applicant’s Signature

60 | P a g e
BASUEL

61 | P a g e
MICHAEL ABAN BERGONIA
Brgy. Cabaruan, Urdaneta City, Pangasinan
[email protected]
09562972418

CAREER OBJECTIVE:
Seeking a position as Student Nurse in health care facility where top notch educational
and training achievements can be put to use in addition to interpersonal skills, to provide quality
healthcare to patients.
EDUCATIONAL ATTAINMENT:
Elementary Level
Cabaruan Elementary School
Urdaneta City, Pangasinan
S.Y. 2007-2013
Junior High School
Cabaruan National High School
Urdaneta, Pangasinan
S.Y. 2013-2017
Senior High School
Urdaneta City National High School
Urdaneta City, Pangasinan
S.Y. 2017-2019
Tertiary Level
Urdanea City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -
Bachelor of Science in Nursing

SPECIAL SKILLS AND INTEREST:

Can multitask in handling different kinds of patients
Active listening
Able to communicate well both verbal and nonverbal
Strong analytical and problem-solving skills, with the ability to make well thought out
decisions
PERSONAL INFORMATION:

Date of birth : May 31, 2001

Place of birth : V-Luna Quezon City Hospital
Sex : Male
Civil Status : Single
Citizenship : Filipino
Religion : Roman Catholic
Weight : 57 kg
Height : 5’5”
Languages Spoken : Filipino
Religion : Roman Catholic
Father’s name : Rolando D. Bergonia
Mother’s name : Rosalinda A. Bergonia

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

MICHAEL A. BERGONIA
Applicant’s Signature

62 | P a g e
CHRISTIAN HARRY REYES BRAGA
Brgy. San Jose, Urdaneta City, Pangasinan
[email protected]
09065145307

CAREER OBJECTIVE:

A position as a student nurse in a Health Care facility where I can make the most of my
nursing education in addition to my interpersonal skill to provide the highest level of patient
care

EDUCATIONAL ATTAINMENT:

Elementary Level
Urdaneta I Central School
Urdaneta City, Pangasinan
S.Y. 2007-2013
Graduated with Distinction
Junior High School
Urdaneta City National High School
Urdaneta, Pangasinan
S.Y. 2013-2017
Graduated with Distinction
Senior High School
Pangasinan State University
Urdaneta City, Pangasinan
S.Y. 2017-2019
Graduated with Distinction
Tertiary Level
Urdanea City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -
Bachelor of Science in Nursing

WORK EXPERIENCE:

Tour Coordinator
Kharmela Events Travel and Tours
Urdaneta City
January 2016 - December 2019

SPECIAL SKILLS and INTERESTS

 Possess strong analytical and problem-solving skills, with the ability to make well thought
out decisions
 Able to communicate well both verbal and nonverbal
 Detail-oriented, efficient and organized professional with extensive experience in surgical
procedures
 Can multitask in handling different kinds of patients
 Exceptional skill in assisting general surgeries

PERSONAL INFORMATION:
Date of Birth : December 10, 2000

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Place of Birth : San Jose, Urdaneta City Pangasinan
Gender : Male
Age : 19
Height : 5’7
Weight : 60
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Josefina R. Braga
Father’s Name : Ernesto V. Braga

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

CHRISTIAN HARRY R. BRAGA

Applicant’s Signature

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BUENCONSEJO, JIRAH
Brgy. Inamotan, Manaoag, Pangasinan
[email protected]
09064873966

CAREER OBJECTIVE:

Committed to providing best healthcare to patients in the role of a Nurse and devoted
towards peace and comfort for patients.

EDUCATIONAL ATTAINMENT:

Elementary Level
Messiah Christian Academy
Urdaneta City, Pangasinan
S.Y. 2007-2013
CLASS VALEDICTORIAN
Junior High School
International Colleges for Excellence Inc.
Urdaneta, Pangasinan
S.Y. 2013-2017
CLASS SALUTATORIAN
Senior High School
International Colleges for Excellence Inc.
Urdaneta City, Pangasinan
S.Y. 2017-2019
TOP 1 – STEM STRAND
Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -
Bachelor of Science in Nursing

WORK EXPERIENCE:

PRC Volunteer
Philippine Red Cross Urdaneta Branch
Year 2019

SPECIAL SKILLS and INTERESTS

 People-oriented self-starter; notable communication and customer service

skills. Strong work ethic and clinical skills. Proficient in medical
terminology, process and equipment use. As member of interdisciplinary
team, keeps needs of patients foremost in mind.
 Detail-oriented, efficient and organized professional with extensive
experience in surgical procedures

PERSONAL INFORMATION:
Date of Birth : December 19, 2000
Place of Birth : Seoul, Korea
Gender : Female
Age : 19

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Height : 5’3
Weight : 54
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Rhea A. Buenconsejo
Father’s Name : Jhill R. Napoles

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

JIRAH BUENCONSEJO
Applicant’s Signature

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CACONDANGAN, MARIA RICA M.
Camantiles, Urdaneta City
[email protected]
09958343658

CAREER OBJECTIVE:

Committed to providing best healthcare to patients in the role of a Nurse and devoted
towards peace and comfort for patients.

EDUCATIONAL ATTAINMENT:

Elementary Level
Camantiles Elementary School
Camantiles, Urdaneta City, Pangasinan
S.Y. 2006-2013

Junior High School

St. Michael School by the Sea
Bonuan, Binloc, Dagupan City, Pangasinan
S.Y. 2013-2017

Senior High School

Lyceum-Northwestern University
Dagupan City, Pangasinan
S.Y. 2017-2019

Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 - Present
Bachelor of Science in Nursing

SPECIAL SKILLS and INTERESTS

 Problem-solving
 Time management
 Leadership
PERSONAL INFORMATION:
Date of Birth : July 25, 2000
Place of Birth : Urdaneta City, Pangasinan
Gender : Female
Age : 20
Height : 5’4
Weight : 54
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Estela Mamogay Cacondangan
Father’s Name : Reynaldo Bernardino Cacondangan

I hereby certify that the above information is true and correct to the best of my knowledge and
belief. I also understand that any misinterpretation will be considered reason for withdrawal of
an offer or subsequent dismissal of employed.

Maria Rica M. Cacondangan

Applicant’s Signature

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CARBILLON, ANGELENE S.
Brgy. Bantog, Sitio Bellag, Sta. Maria, Pangasinan
[email protected]
09513520370

CAREER OBJECTIVE:
To provide best patient comfort, companionship and safety.

EDUCATIONAL ATTAINMENT:

Elementary Level
West Central School Poblacion West
Sta. Maria, Pangasinan
S.Y. 2007-2013
Junior High School
Eastern Pangasinan Agricultural College
Sta. Maria, Pangasinan
S.Y. 2013-2017
Senior High School
Eastern Pangasinan Agricultural College
Sta. Maria, Pangasinan
S.Y. 2017-2019
With Honors
Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -Present
Bachelor of Science in Nursing

WORK EXPERIENCE:

Tayug Family Hospital Volunteer

Year 2019
SPECIAL SKILLS and INTERESTS
 Implementing patient care plans with tasks such as preparing the patient for operations or
other wounds treatment.
 Responding ardently to any medical emergency.

PERSONAL INFORMATION:
Date of Birth : September 28, 2001
Place of Birth : Sta. Maria, Pangasinan
Gender : Female
Age : 19
Height : 5’6
Weight : 57
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Julita S. Carbillon
Father’s Name : Arvin V. Carbillon

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

CARBILLON ANGELENE
Applicant’s Signature

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CEREZO, LOWELL JAIRUS P.
#215 Zone 2, Brgy. Pinmaludpod, Urdaneta City
[email protected]

09558931153

CAREER OBJECTIVE:

Committed to providing best healthcare to patients in the role of a Nurse and devoted
towards peace and comfort for patients.

EDUCATIONAL ATTAINMENT:

Elementary Level
Urdaneta I Central School
Urdaneta City, Pangasinan
March 2012

Junior High School

Panpacific University North Philippines- Urdaneta Campus
Junior High School
Urdaneta City, Pangasinan
June 2012- March 2016

Senior High School

ABE International College of Business and Accountancy
Urdaneta Campus
Grade 12- Senior High School-Humanities and Social Sciences
Urdaneta City, Pangasinan
April 30, 2018
Tertiary Level
Urdaneta City University
Bachelor of Science in Nursing
Urdaneta City, Pangasinan
June 20, 2018- Present

SPECIAL SKILLS and INTERESTS

 Proficient in oral and written communication skills

 Excellent in public relation
 Knowledgeable in various computer software, such as MS Office.
 Mentally keen and alert
 Highly cooperative
 Good in decision making
 Fluent in speaking English Language
PERSONAL INFORMATION:
Date of Birth : April 07, 2000
Place of Birth : Olongapo City, Zambales
Gender : Male
Age : 20
Height : 5’7
Weight : 64
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Ma. Luisa P. Cerezo
Father’s Name : Loreto S. Cerezo

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I hereby certify that the above information is true and correct to the best of my knowledge and
belief. I also understand that any misinterpretation will be considered reason for withdrawal of
an offer or subsequent dismissal of employed.

Lowell Jairus P. Cerezo

Applicant’s Signature

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DE PERALTA, RECHELE P.
Guiling Rosales Pangasinan
[email protected]
09159783618

CAREER OBJECTIVE:

Committed to providing best healthcare to patients in the role of a Nurse and devoted
towards peace and comfort for patients.

EDUCATIONAL ATTAINMENT:

Elementary Level
Guiling-Coliling Elementary School
Guiling Rosales Pangasinan
S.Y. 2007-2013

Junior High School

Guiling-Coliling National HighSchool
Guiling Rosales Pangasinan
S.Y. 2013-2017

Senior High School

ABE International Business Colleges
Urdaneta City, Pangasinan
S.Y. 2017-2019

Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -
Bachelor of Science in Nursing

SPECIAL SKILLS and INTERESTS

 Able to communicate to the client

 Management skills
 Have a better understanding in different situation
PERSONAL INFORMATION:
Date of Birth : August 06,2000
Place of Birth : Quezon City general hospital
Gender : Female
Age : 20
Height : 5’1
Weight : 45
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Bernadeth De Peralta
Father’s Name : Nathaniel De Peralta

I hereby certify that the above information is true and correct to the best of my knowledge and
belief. I also understand that any misinterpretation will be considered reason for withdrawal of
an offer or subsequent dismissal of employed.

Rechele De Peralta
Applicant’s Signature

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DELA CRUZ, ARIANE M.
Brgy. Carayacan San Quintin Pangasinan
[email protected]
09103887796

CAREER OBJECTIVE:
To bring my passion for helping people, willingness to learn new skills and advanced education to
a private practice.
EDUCATIONAL ATTAINMENT:

Elementary Level
SISENANDO V. TECSON ELEMENTARY SCHOOL
Burgos St. Pob. Zone I San Quintin Pangasinan
S.Y. 2007-2013
Junior High School
SAN QUINTIN NATIONAL HIGH SCHOOL
Casantamaria-an San Quintin Pangasinan
S.Y. 2013-2017
Senior High School
SAN QUINTIN NATIONAL HIGH SCHOOL
Casantamaria-an San Quintin Pangasinan
S.Y. 2017-2019
Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -
Bachelor of Science in Nursing

WORK EXPERIENCE:

Eastern Pangasinan District Hospital

San Quintin, Pangasinan
Year 2020
SPECIAL SKILLS and INTERESTS

Creatively.
Critical thinking.
Cultural Awereness.
Attention to Detail.
Compassion.
Communication.
PERSONAL INFORMATION:
Date of Birth : October 15, 2000
Place of Birth : San Quintin, Pangasinan
Gender : Female
Age : 20
Height : 5’2
Weight : 60
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Jennifer Dela Cruz
Father’s Name : Aristotle Dela Cruz

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

ARIANE DELA CRUZ

Applicant’s Signature

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DELMENDO, HANNAH CAMILLE GALVEZ
Sitio Aragaag Bantog, Asingan, Pangasinan
[email protected]
09459722921

CAREER OBJECTIVE:

Eager to work as a Registered Nurse and make most of my skills, education,

nursing externship and compassionate nature. Seeking the scope of Nursing Student
Extern to utilize my hands on experience in basic patient care and other clinical
knowledge

EDUCATIONAL ATTAINMENT:

 TERTIARY (August 2019 - )

Urdaneta City University - Urdaneta City
Course: Bachelor of Science in Nursing

 SENIOR HIGHSCHOOL (June 2017 to April 2019)

Eylim Christian Academy
General Academic Strand

 SECONDARY ( June 2013 to April 2017)

Luciano Millan National High School
Asingan, Pangasinan

 VOCATIONAL (June 2014 to April 2017)

Tesda - LMNHS
Cookery NCII

 ELEMENTARY (June 2007 to March 2013)

Asingan North Central School
Asingan, Pangasinan

WORK EXPERIENCE:

Fastfood Crew
Chowking Urduja
Urdaneta City, Pangasinan
February 2018

SPECIAL SKILLS and INTERESTS

 Active Listening
 Communicating Skill

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 Time-Management
 Good people skills in order to develop and sustain relationships
 Influencing and negotiating skill

PERSONAL INFORMATION:
Date of Birth : March 31, 2001
Place of Birth : Poblacion East, Asingan Pangasinan
Gender :Female
Age : 19
Height : 5’3
Weight : 60
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Evelyn G. Delmendo
Father’s Name : Marlon T. Delmendo

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

HANNAH CAMILLE DELMENDO

Applicant’s Signature

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DION, CELINE C
Legaspi, San manuel Tarlac
[email protected]
09486114973

CAREER OBJECTIVE:

To secure a challenging position in a reputable organization to expand my learnings, knowledge,

and skills.

EDUCATIONAL ATTAINMENT:

Elementary Level
Tarong Elementary School
Tarong Madridejos Cebu
S.Y. 2006-2012
CLASS VALEDICTORIAN
Junior High School
San Felipe National Highschool
San Felipe, San Manuel Tarlac
S.Y. 2012-2017
Senior High School
Alternative Learning System
Moncada, Tarlac
S.Y. 2018
Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -
Bachelor of Science in Nursing

SPECIAL SKILLS and INTERESTS

 Good Communication Skills,Computer skills,Customer serviceandInterpersonal skills.

 Management skillsand Problem-solving.
 Openness to Feedbackand Adaptability
PERSONAL INFORMATION:
Date of Birth : December 14, 1999
Place of Birth :Quezon City
Gender :Female
Age : 20
Height : 4'9
Weight : 45
Civil Status : Single
Citizenship : Filipino
Mother’s Name :Dolores C. Dion
Father’s Name :Romeo S. Dion

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

CELINE C. DION
Applicant’s Signature

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DISOMA, DIAMOND S.
Nancayasan, Urdaneta City, Pangasinan
[email protected]
09636038588

CAREER OBJECTIVE:
A highly driven and dedicated nursing student committed to providing best healthcare to patients
in the role of a Nurse and devoted towards peace and comfort for patients

EDUCATIONAL ATTAINMENT:

 TERTIARY (August 2018 - )

Urdaneta City University - Urdaneta City
Course: Bachelor of Science in Nursing
 SENIOR HIGHSCHOOL (June 2016 to April 2018)
Phinma Upang College of Urdaneta
Accountancy and Business Management Strand
 SECONDARY ( June 2012 to April 2016)
Urdaneta City National High School
Urdaneta City, Pangasinan
 ELEMENTARY (June 2006 to March 2012)
Urdaneta 1 Central School
Urdaneta City, Pangasinan

WORK EXPERIENCE:

Helping my parents managing our businesses in different area of Pangasinan and Tarlac

SPECIAL SKILLS and INTERESTS

 Good in health teaching to the clients

 Problem-solving skills
 Hard working
 Active listening skills
 Communication skills
PERSONAL INFORMATION:
Date of Birth : April 24,2000
Place of Birth : Nancayasan, Urdaneta city, Pangasinan
Gender : Female
Age : 20
Height : 5’2
Weight : 60
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Naif D. Disoma
Father’s Name : Namerah S. Disoma

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 I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

DIAMOND S. DISOMA
Applicant’s Signature

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KISHA NICOLE D. ESPILLO
Lanat , San Manuel, Tarlac
0955-772-8828
[email protected]

Objective:

As a Student Nurse I can make most of my skills, education, and compassionate

nature in health care settings.

PERSONAL INFORMATION

Age : 19

Date of Birth : January 04, 2001

Place of Birth : San Manuel

Nationality : Filipino

Religion : Catholic

Civil Status : single

Height : 5’3

Weight : 46kg

Mother’s Name: Remedios Espillo

Father’s Name : Gil Espillo

EDUCATIONAL ATTAINMENT

Tertiary Level: Urdaneta City University

San Vicente West, Urdaneta, Pangasinan

S.Y 2019-

Bachelor of Science in Nursing

Senior High School Lyceum-Northwestern University

Nancayasan, Urdaneta City, Pangasinan

S.Y 2017-2019

Junior High School OLRA College Foundation

Poblacion, San Manuel, Tarlac

S.Y 2013-2017

Elementary school Gabaldon Central Elementary School

Poblacion, San Manuel, Tarlac

S.Y 2007-2013

SPECIAL SKILLS:

 Ability to learn new skills

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  Flexible to work in any shift
 Able to communicate well
 Computer Literate
 Dedicated and willing to be trained
 Can multitask in handling different kinds of patient.
 Time Management

ACHIEVEMENTS

WITH HONORS
Lyceum-Northwestern University
Nancayasan, Urdaneta City, Pangasinan
Accountancy, Business and Management
S.Y 2017-2019

WITH HONORS
OLRA College Foundation
Poblacion, San Manuel, Tarlac
S.Y 2017

I do hereby declare that the above information given by me is true to the best of my knowledge
and belief.

__KISHA NICOLE D. ESPILLO__

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FLORES, ARA JESSA M
#15Asuncion St. Guiset Norte San Manuel, Pangasinan
[email protected]
09656911488

CAREER OBJECTIVE:

To obtain a position as a student nurse where I could render and practice my skills,
develop my personality as a career person that will utilize my education and background to
expend my knowledge and capabilities of good work in healthcare settings.

EDUCATIONAL ATTAINMENT:

TERTIARY: BACHELOR OF SCIENCE IN NURSING

Urdaneta City University
San Vicente West, Urdaneta City, Pangasinan
S.Y. 2019-

BACHELOR OF SCIENCE IN PHYSICAL THERAPY

University of Baguio
Gen. Luna Road Baguio City
S.Y. 2018-2019
SENIOR HIGH SCHOOL:
STEM- HEALTH
PHINMA University College of Urdaneta
Urdaneta City, Pangasinan
S.Y. 2016-2018
JUNIOR HIGH SCHOOL:
St. Mary’s Dominican School
San Manuel, Pangasinan
S.Y. 2012-2016
ELEMENTARY:
Juan C. Laya Memorial School
San Manuel, Pangasinan
S.Y. 2008-2012

SPECIAL SKILLS and INTERESTS

 Active listening
 Compassion
 Professionalism
 Strong leadership skills

PERSONAL INFORMATION:
Date of Birth : February 06, 1999
Place of Birth : San Manuel, Pangasinan
Gender : Female
Age : 21
Height : 5’1
Weight : 55
Civil Status : Single
Citizenship : Filipino

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Religion : Roman Catholic
Mother’s Name : Laila M. Flores
Father’s Name : Jessie O. Flores

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

FLORES, ARA JESSA M.

Applicant’s Signature

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Fortes, Angelica Joy D.
Brgy. Pindangan West, Alcala, Pangasinan
[email protected]
09073380119

CAREER OBJECTIVE:

Patient-focused and empathetic registered nurse seeking a position within medical practice.

Bringing with them experience, care and extensive knowledge to help improve the lives of the
patients.

EDUCATIONAL ATTAINMENT:

Elementary Level
Pindangan West Elementary School
Alcala, Pangasinan
S.Y. 2007-2013

Junior High School

Cauayan City National High School Main Campus
Cauayan City, Isabela
S.Y. 2013-2017

Senior High School

Cauayan City National High School Main Campus
Cauayan City, Isabela
S.Y. 2017-2019

Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -
Bachelor of Science in Nursing

WORK EXPERIENCE:

Cauayan City Health Office I Volunteer

Year 2019

SPECIAL SKILLS and INTERESTS

 Ability to learn new skill

 Ability to work under pressure
 Communication skills
 Critical thinking and problem solving

PERSONAL INFORMATION:
Date of Birth : May 12, 2000
Place of Birth : Cauayan City, Isabela
Gender : Female
Age : 20
Height :5
Weight : 70
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Corazon D. Fortes

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Father’s Name : Eduard P. Fortes

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

ANGELICA JOY D. FORTES

Applicant’s Signature

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GALAANG, ZORROW D.
Alibeng, Sison Pangasinan
[email protected]
09297877662

CAREER OBJECTIVE:

To use my skills in patient assessment, planning, evaluation, implementation and document for
optimum patient care.

EDUCATIONAL ATTAINMENT:

Elementary Level
Alibeng Elementary School
Urdaneta City, Pangasinan
S.Y. 2007-2013
Junior High School
Benigno V. Aldana National High School
Urdaneta, Pangasinan
S.Y. 2013-2017
With Pillars
Senior High School
Benigno V. Aldana National High School
Urdaneta City, Pangasinan
S.Y. 2017-2019
With Honors
Tertiary Level
Urdaneta City University
San Vicente West, Urdaneta, Pangasinan
S.Y. 2019 -Present
Bachelor of Science in Nursing

WORK EXPERIENCE:

Pozorrubio RHU Volunteer

Year 2019

SPECIAL SKILLS and INTERESTS

 Detail-oriented with a positive and friendly disposition.

 Ability to respond promptly to medical issues in urgent care and emergency care skills.
 Developed skills in acute medicine/surgery, mental health, long term care

PERSONAL INFORMATION:
Date of Birth : September 27, 2000
Place of Birth : Negros Occidental
Gender : male
Age : 20
Height : 5’7
Weight : 63
Civil Status : Single
Citizenship : Filipino
Mother’s Name : Ligaya D. Galaang
Father’s Name : Manuel P. Galaang

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 I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

ZORROW D.GALAANG
Applicant’s Signature

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GALANG, MA. ALYSSA ANTONIO
Zone 6 Dilan-Paurido Urdaneta City Pang.
[email protected]
09566181539

CAREER OBJECTIVE:

To obtain a position as a student nurse where I could render and practice my skills,
develop my personality as a career person that will utilize my education and background to
expend my knowledge and capabilities of good work in healthcare settings.

EDUCATIONAL ATTAINMENT:

TERTIARY:
BACHELOR OF SCIENCE IN NURSING
Urdaneta City University
San Vicente West, Urdaneta City, Pangasinan
S.Y. 2019-

BACHELOR OF ELEMENTARY EDUCATION

Phinma University of Pangasinan, Dagupan
Arellano St. Dagupan City, Pangasinan
S.Y. 2018-2019
SENIOR HIGH SCHOOL:
ARTS and DESIGN
Urdaneta City National High School
Urdaneta City, Pangasinan
S.Y. 2017-2018
JUNIOR HIGH SCHOOL:
Urdaneta City National High School
Urdaneta City, Pangasinan
S.Y. 2012-2017
ELEMENTARY:
Urdaneta I Central school
Urdaneta City, Pangasinan
S.Y. 2008-2012

Messiah Christian Academy

Urdaneta City, Pangasinan
S.Y. 2006-2008

WORK EXPERIENCE:

Dance Zumba Instructor

Cb Mall Urdaneta
Urdaneta City, Pangasinan
2016-2018

Facilitator
Data Core Information Development Computer Literacy Program: Microsoft office
(word, excel, power point), Adobe photoshop, and basic PC trouble shooting
AF square

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 Poblacion Urdaneta City, Pangasinan
2015-2017

SPECIAL SKILLS and INTERESTS

 Active listening
 Compassion
 Professionalism
 Strong leadership skills

PERSONAL INFORMATION:
Date of Birth : July 04, 1999
Place of Birth : Urdaneta City, Pangasinan
Gender : Female
Age : 21
Height : 5’0
Weight : 40
Civil Status : Single
Citizenship : Filipino
Religion : Born Again Christian
Mother’s Name : Marilou A. Galang
Father’s Name : Dionisio M. Galang

I hereby certify that the above information is true and correct to the best of my
knowledge and belief. I also understand that any misinterpretation will be considered reason for
withdrawal of an offer or subsequent dismissal of employed.

MA. ALYSSA A. GALANG

Applicant’s Signature

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