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The proponents humbly recognize the limitedness of their young minds; thus, they
had to consult different people concerning this case presentation, people who are more
knowledgeable than them. Now the group see this case study printed, they would like to
express their utmost gratitude to their significant others whom have inspired and helped
them dedicate their selves to make the success of this undertaking a reality.
First, to the Almighty God for His unceasing love and blessings; for further
strengthening the proponents spirit and giving them power and fortitude to face the
inherent demands of the tasks assigned to them thereby molding them to become efficient
and effective student nurses and individuals. To God be the Glory!
Second, to their chosen patient and his family, for their willingness to be the
subject for this case study, for being responsive and open to inquiries during the interview
process and for being cooperative in the assessments the group did.
Third, to their Clinical Instructors, Mrs. Maria Minda Escubido, RN, MN, Ms.
Theresa Kintanar, RN, MN, Mrs. Dinna Rose Bayog, RN, MN, Ms. Li Derla, RN, MN,
together with all other clinical instructors, for their invaluable time, knowledge
and effort rendered to the students for them to be able to work at their best as student
nurses, may they all find it in their hearts to keep going and keep teaching the eager
young minds of tomorrow.
Fourth, to the residents-on-duty, staff, and nurses-on-duty at the Southern
Philippines Medical Center Pediatrics Ward for accommodating the group and for being
understanding and patient during the whole time of their duty.

Fifth, to the other patients who made a spot in the proponents hearts; the children
in the Pediatrics ward for motivating them to do more and for pushing them
beyond their limits to help them restore their good physical health, to
appease their restlessness and sometimes to endure their unexplainable combative
Lastly, to their parents and families for their unparalleled love, support and
understanding and for being with them during their hard times, may they remain in the
proponents hearts all through the years as they finish and reach their goals.


The group 3 of Section BSN-3A of the Ateneo de Davao University, conducted an

interview and physical assessment last July 12 to 14, 2012 at the Pediatrics Ward BPN
room of the Southern Philippines Medical Center as part of their case study in relation to
Oxygenation concept. The groups case is about Patient CAP, who was admitted to the
Pediatrics-BPN ward with a medical diagnosis of Pediatrics Community Acquired
Pneumonia C.
The respiratory system, being the biological system of an organism that
introduces respiratory gases to the interior and performs gas exchange, is very vital for
human life. Without it, there will be no supplementation of oxygen and removal of carbon
dioxide in the body. It is an amazing highway that travels through our entire body
connecting all our body cells. But what if the system itself has defect, will we still
The subject of this case study, patient CAP, was one of the patients
admitted at the Pediatrics Ward during the proponents clinical exposure. He was
admitted due to diagnosed Pediatrics Community Acquired Pneumonia C, or simply,
PCAP C. Pediatric community-acquired pneumonia is a common illness that
affects infants and children. Community Acquired Pneumonia, in general, occurs
because the atmosphere or the areas of the lungs which absorb oxygen (alveoli) from
the atmosphere become filled with fluid and cannot work effectively. The term
community-acquired pneumonia (CAP) refers to a pneumonia in a previously healthy

person who acquired the infection outside a hospital. (Pathophysiology: Concepts of

Altered Health States, 6th Edition by Porth)
Streptococcus pneumoniae and viruses are the most common causes in infants
three weeks to three months of age. Viruses are the most frequent cause of pneumonia in
preschool-aged children; Streptococcus pneumoniae is the most common bacterial
pathogen. Mycoplasma pneumoniae and Chlamydia pneumoniae often are the etiologic
agents in children older than five years and in adolescents. (
Based on the study made by the United Nations Children's Fund
(UNICEF), an estimated 3 million children die worldwide from pneumonia annually;
these deaths almost exclusively occur in children with underlying conditions, such as chronic lung disease of
prematurity, congenital heart disease, and immunosuppression. ( According
to the World Health Organization, on 2010, PCAP C was present in 50% of all PCAP
cases; 26% were aged less than 1 year. PCAP occurs throughout the world and is a
leading cause of illness and death in children under 5 years old, having an estimated
1.62.2 million deaths. It is more common in the developing countries like in South Asia
(34%) and Sub-Saharan Africa (28%). ( In the Philippines, it continues
to be a leading cause of morbidity in children under five accounting to about 828.8 per
100,000 population. (Department of Health Field Health Service Information System,
2008). In the statistics in Davao City on 2011, Pediatric Community Acquire Pneumonia
ranks second in the top 10 leading causes of morbidity per 1000 children with a total of
1,178 cases (37.14%). As for mortality, it tops the list with a total of 78 deaths (2.46%).
(Davao City Health Office)

The group chose the case of Patient CAP which is Pediatrics Community
Acquired Pneumonia C primarily because they already have the prior knowledge on this
type of pediatric illness, thus requiring them to apply this knowledge in the actual setting.
This would serve as a good avenue for them to develop their skills in relation to the facts
and information that they have already learned in the university.
As student nurses and future registered nurses, the proponents want to understand
and appreciate more on what is happening to a patient with Pediatric
Community Acquired Pneumonia. PCAP, being one of the most common illnesses
affecting children, they are in a pursuit for knowledge to be able to impart it to others.
Through this, the proponents are hoping that they will be able to find the right
plan of care and sound interventions, not forgetting the patients rights as a person.
All in all, these will help them become efficient and effective nurses in a
competitive future.

Within four-weeks rotation at the Southern Philippines Medical Center, the goal
of the group is to provide holistic nursing care to their patients and to apply the
knowledge they have gained in the university to the actual clinical situation. Furthermore,
the group aims to present a comprehensive case study which explains the condition and
the appropriate medical and nursing management regarding the state of the chosen
patient. The proponents aim to perform the necessary nursing interventions to help
alleviate the patients condition and improve his health. The proponents also aim to
establish a good relationship with the health care team and the patient.

1. Choose a patient whose condition is within the proponents scope.
2. Gather all necessary information regarding him as may be related to this case
3. Trace the clients past and present health history.
4. Trace his genogram or family tree.
5. Distinguish the developmental data of the client using the theories of Robert
Havighurst, Erik Erikson, and Jean Piaget;
6. Define the complete diagnosis of the disease of the client from three reliable
7. Identify and rationalize the signs and symptoms present in the patient.

8. Review the anatomy and physiology of the systems affected in the patients
9. Trace the pathophysiology of the disease process.
10. Analyze the doctors orders by justifying our rationale.
11. Distinguish and determine the clinical significance and diagnostic tests that the
patient has undergone including their implications, normal and abnormal values,
findings for comparison, and specific interventions associated with each
diagnostic procedure.
12. Discuss the drugs given to the client to be able to know the action, dosage, and
frequency of each drug as well as the necessary nursing responsibilities that
should be done.
13. Relate the clients situation to various nursing theories.
14. Synthesize our understanding of the disease process and treatment to come with
comprehensive nursing care plans.
15. Formulate appropriate nursing care plans and correlate them with nursing
16. Validate patients prognosis according to the following categories: onset of illness,
duration of illness, precipitating factors, willingness to take medications and
treatment, age, environmental factors and family support.
17. Make a discharge plan for the client with the use of M.E.T.H.O.D.S.

1. Perform a thorough physical cephalocaudal assessment on client.
2. Anticipate clients health problems and needs and make a nursing care plan of the
problems identified.
3. Provide care based on the various nursing care plans formulated with
consideration to patients safety, comfort, emotional and psychological wellbeing.
4. Apply sound decision-making skills.
5. Select and apply appropriate interventi Porth)ons maximizing available resources.
6. Render health teachings to the client and her significant others to promote health

1. Establish a trusting relationship with our client and his significant others.
2. Establish a professional and friendly relationship with superiors and peers.
3. Actively listen to significant other to be able to know patients concerns and
attend to his needs.
4. Show genuine concern and willingness in serving the client.
5. Develop a caring, non judgmental, and therapeutic attitude towards the patient
and significant others.
6. Encourage a Christ-centered communication with patient to help him deal with
the situation that he is into.
7. Integrate ethico-legal, moral, and spiritual values in dealing with the patients,
their families, and other members of the health team.