The Passion of Human Caring

You will never be bored
You will always be frustrated
You will be surrounded by challenges.
So much to do and so little time
You will carry immense responsibility
And limited authority.
You will step into people’s lives
And you will make a difference.
Some will bless you,
Some will curse you.
You will see people at their worst
And at their best.
You will never cease to be amazed
At people’s capacity for
Love, courage, and endurance.
You will experience resounding triumphs
And devastating failures.
You will cry a lot.
You will laugh a lot.
You will know what it is to be human
And to be humane.

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CLEFT LIP AND CLEFT PALATE

Incomplete closure of the lip and palate or root of the mouth.

Etiology: The exact cause of the lip and palatal clefting is not known, but most experts feel that it is due to both genetic and environmental factors.

Related Causes: Genetic; Folic acid deficiency; steroid, exposure to TORCH.

Common problems:

• feeding difficulty

• infections - upper respiratory and ear

• speech defect (cleft palate)

• dental defect (nasal twang)

• altered normal body image

• respiratory distress

Treatment: Surgery

1. Cleft Lip: CHEILOPLASTY

2. Cleft palate: PALATOPLASTY - done before speech development.

Preoperative care:

• proper positioning especially during and after feeding - upright positioned

• burp or bubble the newborn more often

• feed the baby with the use cross cut large holed nipple or Breck feeder technique

• observe for signs of complication: Otitis Media

• For dental defects: Orthodontic exercise and surgery

• speech therapy

Postoperative care:

• Proper positioning: CL- supine or side lying; CP: prone

• Apply elbow restraint and release every 2 hours

• Give feeding with rubber tipped medicine dropper for cleft lip and paper cups and soup spoons for cleft palate

• Cleanse the wound with hydrogen peroxide

• Give post operative medications which include analgesic and antibiotic

• Avoid sucking, suctioning, blowing, pointed and sharp objects (spoon, fork, and straw)

• Make sure baby does not suck the LOGAN’S BAR OR BOW

Feeding an Infant with a Cleft:

Feeding an infant is important not only in providing nourishment, it also provides an intimacy and closeness for both the parent and the child. Infants with a cleft lip seldom have problems either by bottle or breast.

In babies with clefts of the hard palate, the opening in the roof of the mouth often causes difficulty in creating adequate pressure on the nipple, thus creating an inability to suck well enough to get adequate nourishment. Feeding the infant takes patience and practice.

During my school days, we recommended the use of soft squeezable plastic bottle like Mead Johnson with an orthodontic nipple such as Nuk. You can increase the flow by gently squeezing or putting pressure on the bottle. It is important to feed the infant before he/she becomes too hungry. Position the infant in an upright position with the head tilted back slightly. This position allows the milk to flow down into the throat and less into the nose. Infants with clefts do swallow more air and need to be burped frequently. At first, it may take extra time, but this will steadily decrease. Feeding time of the newborn varies from 20-30 minutes. When feeding takes longer than 45 minutes, the infant may be burning up calories necessary to gain weight.

Breast feeding the newborn with a cleft palate is often unsuccessful. Generally the infant cannot produce enough negative pressure to obtain ample breast milk to provide adequate nourishment. Using a breast pump to extract the milk and feeding the infant breast milk from squeezable bottle is recommended.

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POWERHOUSE TRAINING & REVIEW CENTER  Offers. . .   LOCAL BOARD (NLE) REVIEW FOR NURSES

Features . . .

• Test drills and simulations
• With updated review materials
• Intensive lecture with UST Reviewers
• FREE Online Review
• Free practice tests and kit
• Free exam application processing
• With big discount if honor graduate
• 50% discount in case of failure
• With Powerhouse Membership which entitles a reviewee to have 50% discount in CGFNS, NCLEX-CAT & IELTS review
• With personalized services by fellow nurses

For Inquiries, call (032) 4163224 or visit them at Rm. 307/309 3rd Floor JSP Bldg, Cor. Gen Maxilom Ave. & Echavez St., Cebu City

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RANK NAME SCHOOL RATING (%)

1 AIRA THERESE SALAMANCA JAVIER UNIVERSITY OF SANTO TOMAS 86.00

2 ALRIN FLORES FALGUI FAR EASTERN UNIVERSITY - NICANOR REYES MEDICAL FOUNDATION 85.80

3 KRISTINE MARAVILLA MENDOZA REMEDIOS TRINIDAD ROMUALDEZ MEMORIAL SCHOOL 85.60

JOANNA JACOB QUIRANTE UNIVERSITY OF SANTO TOMAS 85.60

4 ANA RICA CHAN GUTIERREZ UNIVERSITY OF SANTO TOMAS 85.40

DALFON SILVIO BABULAR NAVAJA CEBU INSTITUTE OF TECHNOLOGY 85.40

MARIA ALYSSA YEE POLICARPIO UNIVERSITY OF SANTO TOMAS 85.40

AILEEN GRACE YU SOTYCO UNIVERSITY OF SANTO TOMAS 85.40

5 MICHELLE CRUZ AMOROSO UNIVERSITY OF THE PHILIPPINES-MANILA 85.20

MA. REGINA BASA ANG OUR LADY OF FATIMA UNIVERSITYVALENZUELA 85.20

MICHELLE JOYCE CHEUNG ENCARNACION UNIVERSITY OF SANTO TOMAS 85.20

LYKA ABALAJON GEDE-Y RIVERSIDE COLLEGE 85.20

JASON ALBIA GO UNIVERSITY OF SANTO TOMAS 85.20

KATHERINE ROSE RODRIGO RAQUEL DE LA SALLE UNIVERSITY-DASMARIÑAS HEALTH SCIENCE CAMPUS 85.20

6 REGINA KRYS VILLAFLOR CABANILLA CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE) 85.00

ASTER ANNIE DE JESUS CALMA UNIVERSITY OF THE PHILIPPINES-MANILA 85.00

TRACY MICHELLE BUAN CATACUTAN CENTRO ESCOLAR UNIVERSITY-MANILA 85.00

DIANA JUSTO CUPINO UNIVERSITY OF SANTO TOMAS 85.00

RACHEL MAE TABUENA DAIGDIGAN MINDANAO STATE UNIVERSITY-MARAWI CITY 85.00

KAREN MARIE GALVEZ FLORES TRINITY UNIVERSITY OF ASIA (TRINITY-QC) 85.00

ELAINE ESTHER SALDUA FUNTANAR CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE) 85.00

MARION DELOS SANTOS LLAUDER UNIVERSITY OF SANTO TOMAS 85.00

KEVIN BRYAN UY LO UNIVERSITY OF SANTO TOMAS 85.00

ANNE LORRAINE TRINIDAD LORENZO UNIVERSITY OF PERPETUAL HELP RIZAL LAS PIÑAS 85.00

LOUIE JHON ERRACHO LUNARIA UNIVERSITY OF THE PHILIPPINES-MANILA 85.00

JOANNA ROXAS MAALA OUR LADY OF FATIMA UNIVERSITYVALENZUELA 85.00

PATRICK PARAS MEJIA UNIVERSITY OF SANTO TOMAS 85.00

KRISTINE VALINO PICADIZO UNIVERSITY OF PERPETUAL HELP RIZAL LAS PIÑAS 85.00

EIREN ORO REBUTE WEST VISAYAS STATE UNIVERSITY-LA PAZ 85.00

RIZZA ARMAS TAMAYO COLEGIO DE DAGUPAN (COMPUTRONIX COLL) 85.00

ANNA MAE MAQUILING TRINIDAD MINDANAO STATE UNIVERSITY - MARAWI CITY 85.00

JENNIFER LAGGAD UGALDE DR. CARLOS S. LANTING COLLEGE-Q. C. 85.00

7 MA. LEONOR GALVAN BARBOSA MINDANAO SANITARIUM & HOSPITAL COLLEGE OF MED 84.80

JENNIFER BAGUIO GAIT VELEZ COLLEGE 84.80

ARIANE CASTAÑARES LLEVARES CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE) 84.80

NEIL ANTHONY ESMILLA MANZANO OUR LADY OF FATIMA UNIVERSITYVALENZUELA 84.80

OLIVER NAVAL MENDOZA SAINT BERNADETTE COLLEGE OF HEALTH AND SCIENCES 84.80

MARICOR CORTEZ MONTALBO UNIVERSITY OF THE PHILIPPINES-MANILA 84.80

TARA PATAWARAN PATAWARAN DR. CARLOS S. LANTING COLLEGE-Q. C. 84.80

ROGER CARLO PAYAWAL PINEDA DR. YANGA’S FRANCISCO BALAGTAS COLLEGE 84.80

BARTOLOME ARTHUR MARCAIDA QUINCINA DR. CARLOS S. LANTING COLLEGE-Q. C. 84.80

MARION KATRINA LARA RAGUINI FAR EASTERN UNIVERSITY-MANILA 84.80

8 MA CRISTINA DIESTA ARROYO UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEM. MEDICAL CENTER 84.60

LANCE LAMBERT GATDULA AYSON BULACAN STATE UNIVERSITY (BULACAN COLL. OF ARTS & TRADES) 84.60

CARLA EMILLE DALANGIN BARBON UNIVERSITY OF THE PHILIPPINES-MANILA 84.60

ROSAURO CRUZ BRIONES MANUEL S. ENVERGA UNIV. FOUNDATIONLUCENA CITY 84.60

JAN PAOLO SANTIAGO CAPARAS DE LA SALLE UNIVERSITY-DASMARIÑAS HEALTH SCIENCE 84.60

SOZEIN SOLIEL BACENA BUSTAMANTE UNIVERSITY OF SANTO TOMAS 84.60

LOURDES CLAIRE RODRIGUEZ DAVID UNIVERSITY OF SANTO TOMAS 84.60

ANA JOY ALMIE CRUZ DIZON UNIVERSITY OF SANTO TOMAS 84.60

LORRAINNE YU EMBAY UNIVERSITY OF THE VISAYAS-MANDAUE CITY 84.60

KRISTINE MARIE LEE INDIONGCO PERPETUAL HELP COLLEGE OF MANILA 84.60

IMEE LOREN CHAN LIM UNIVERSITY OF SANTO TOMAS 84.60

SIM PAMA PANIZA WEST VISAYAS STATE UNIVERSITY-LA PAZ 84.60

ROCHELLE-ANNE ORDINANZA PRIMAVERA UNIVERSITY OF SANTO TOMAS 84.60

RAICHEL FAYE MALLARI RINGOR UNIVERSITY OF SANTO TOMAS 84.60

ROXAN SALVADORA ROMAN OUR LADY OF FATIMA UNIVERSITY VALENZUELA 84.60

CZARINA ANN ARELLANO SEVILLA UNIVERSITY OF SANTO TOMAS 84.60

JEFFREY DE JUSTO SILVA SAINT PAUL UNIVERSITY-ILOILO 84.60

ZYENA JOYCE PALINES UNTALASCO UNIVERSITY OF THE PHILIPPINES-MANILA 84.60

PAOLA SARONA YOUNG UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEM. MEDICAL CENTER 84.60

9 BLAKE WARREN COLOMA ANG CEBU DOCTORS’ UNIVERSITY 84.40

TRISHA CARMELLI GONZALES BAUTISTA UNIVERSITY OF THE PHILIPPINES-MANILA 84.40

DANICA BIANCA BERNAD CAGALAWAN SAINT MICHAEL’S COLLEGE-ILIGAN CITY 84.40

JANNA BIANCA ALBANO CAJIGAL UNIVERSITY OF SANTO TOMAS 84.40

KATHRYN KAYE AQUINO CARPIO UNIVERSITY OF SANTO TOMAS 84.40

GLYNNIS DOREEN OLEGARIO CORPUZ CAPITOL MEDICAL CENTER SCHOOL OF NURSING 84.40

KATRINA RAE LIMJOCO DAZA UNIVERSITY OF SANTO TOMAS 84.40

JEAN DAISY CAMACHO DE GUZMAN UNIVERSITY OF THE PHILIPPINES-MANILA 84.40

FRITZIE PRAXIDIO DELA CRUZ UNIVERSITY OF PERPETUAL HELP SYSTEMLAGUNA 84.40

WILLENBURGH WONG DUCUSIN MANILA CENTRAL UNIVERSITY-CALOOCAN CITY 84.40

GWEN ATIENZA LEGASPI SAINT PAUL UNIVERSITY-MANILA 84.40

JOHN PHILIP TECSON LIM UNIVERSITY OF SANTO TOMAS 84.40

STEPHANIE ANNE CHAN LOPEZ DE LOS SANTOS-STI COLLEGE,INC-(DELOS SANTOS S.N.) 84.40

MYRON MARCO MIRANDA MARIANO UNIVERSITY OF SANTO TOMAS 84.40

JOHN VINCENT LIM OMO HOLY NAME UNIVERSITY (DIVINE WORDTAGBILARAN) 84.40

MARIA WELLA BALBONA PICHON UNIVERSITY OF THE VISAYAS-CEBU CITY 84.40

MAY STEPHANIE GO PUA NAGA COLLEGE FOUNDATION 84.40

DARYLE JOIE MASOCOL RAGASA MANILA DOCTORS’ COLLEGE 84.40

GIRLIE LAZARO REPUYAN UNIVERSITY OF SANTO TOMAS 84.40

MELUDEE JOY MADRIGAL ROCHE CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE) 84.40

MARIA AILEEN CUSTODIO SANTIAGO DR. CARLOS S. LANTING COLLEGE-Q. C. 84.40

ARTHUR MICHAEL ARIS CAMU SUNICO FAR EASTERN UNIVERSITY-MANILA 84.40

JOHN HIROGIE ABAD TOKU TRINITY UNIVERSITY OF ASIA (TRINITY-QC) 84.40

ANGELA SOLAYAO TIU VELEZ COLLEGE 84.40

CATHERINE DASMARIÑAS UY SOUTHEAST ASIAN COLLEGE (UDMC) 84.40

10 ROMINA PAULA PARREÑO BARRAMEDA UNIVERSITY OF SANTO TOMAS 84.20

JOHN ROBERT RAZOTE BAUTISTA TRINITY UNIVERSITY OF ASIA (TRINITY-QC) 84.20

JERIEL BAYHONAN BESAGAS CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE) 84.20

MARIENNE SUNGCAD BRAVO STI COLLEGE CEBU, INC 84.20

EVELYN CUARES CASEÑAS UNIVERSITY OF BOHOL 84.20

BRIDGEL AVILA GALORIO CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE) 84.20

MA. BERNADETTE VALDIVIA LOPEZ-DEE UNIVERSITY OF SANTO TOMAS 84.20

MAY FLOR LLEGO MARCOLINO LARMEN DE GUIA MEMORIAL COLLEGE 84.20

KRISTIAN SANTOS NOCHE CENTRO ESCOLAR UNIVERSITY-MANILA 84.20

DIANNE MAE LAGMAN NOTARIO OUR LADY OF FATIMA UNIVERSITYVALENZUELA 84.20

KRISTINE ANN TAGUPA PANAL MOUNTAIN VIEW COLLEGE 84.20

MARNELA KATHLEEN VELUYA PASAMBA SACRED HEART COLLEGE OF LUCENA CITY, INC. 84.20

RUBY JOMA FADRI RAFANAN ADVENTIST UNIVERSITY OF THE PHILIPPINES 84.20

RAZEILLE KRISTINE ASISTIO RAZON UNIVERSITY OF SANTO TOMAS 84.20

DARRA MAY RAPADA RIANO FAR EASTERN UNIVERSITY-MANILA 84.20

JOMAR PACLEB RONQUILLO COLUMBAN COLLEGE-OLONGAPO CITY 84.20

JEFFREY RAMOS SALAZAR UNIVERSITY OF THE PHILIPPINES-MANILA 84.20

FREDERICK ABAD SAMPANG UNIVERSITY OF SANTO TOMAS 84.20

MARNELEE GRACE RIVERA SEMILLA TRINITY UNIVERSITY OF ASIA (TRINITY-QC) 84.20

JANELLE GRACE TEO SIA UNIVERSITY OF SANTO TOMAS 84.20

JEANETTE MARTINEZ VILLAR WEST VISAYAS STATE UNIVERSITY-LA PAZ 84.20

NOTHING FOLLOWS———————-

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PHILIPPINE HOSPITAL INFECTION CONTROL SOCIETY (PHICS), INC

EASTERN VISAYAS CHAPTER

PRESENTS A SEMINAR IN CELEBRATION WITH THIS YEAR’S NURSE’S WEEK:

THEME:

“Moving Towards New Heights in Infection Control”

Cebu Grand Convention Center

August 22, 2008 - 8:00am - 5:00pm

REGISTRATION FEE:

500.00

TOPICS:

• Evolution and Treat of Emerging Pathogens in Healthcare Setting

• MDRO Detection: Its Role in Surveillance and Outbreak Investigation

• CDC’s New Guideline on Isolation Precaution: Making “Standard Precaution” a Way of Life

• Ventilator-Associated Pneumonia (VAP)

• Blood Stream Infection (BSI)

• Infectious Waste Management in the Community

• Surveillance on Needlestick Injuries (NSI) and Body Fluids

 

For reservations, please contact Naomi - 09228244171 / 09163171273

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Sample Nurse Practice Tests 2 

1. Cells in the pancreas that secrete glucagon and insulin are which of the following?

• a.  A and B cells
• b.  acinar cells
• c.  D cells 
• d. pancreatic D1 cells
• e. pancreatic polypeptide cells

2. A 57-year-old female patient has suffered a major stroke and as a result is in a coma. The attending neurologist is very concerned because the patient is developing ataxic breathing. The pneumotaxic center and apneustic centers of the brain are located in which of the following?

• a. diencephalon
• b. midbrain 
• c.  pons
• d.  spinal cord
• e.  telencephalon

3. A 14-year-old boy presents with weight loss and diarrhea. His tongue becomes sore and blistery after eating oatmeal or rye bread, which leads to the diagnosis of celiac disease. The boy and his parents are advised to be sensitive to symptoms of tetany and paresthesias, since they can occur as a consequence of malabsorption of which of the following?

• a. calcium
• b. carbohydrates
• c. fat
• d. iron
• e. water

4. Lack of oxygen (hypoxia) will cause reflex vasoconstriction in the circulation supplying which of the following organs?

• a. brain
• b. heart muscle
• c. kidney
• d. lungs
• e. skeletal muscle

5. A patient with newly diagnosed schizophrenia is given chlorpromazine. It is a drug that has amongst other effects moderate anticholinergic activity. As a consequence, which of the following is an expected side effect of this medication?

• a. bradycardia
• b. decreased GI sphincter tone
• c.  dry mouth
• d.  emptying of urinary bladder
• e. increased GI motility

6. Which of the following statements concerning total body energy storage is correct?

• (A) Most of the body’s energy store is held as carbohydrate.
• (B) Most of the body’s energy store is held as lipid.
• (C) Most of the body’s energy store is held as plasma glucose.
• (D) Most of the body’s energy store is held as protein.
• (E) Total body’s energy storage approximately equals resting metabolic rate.

7. Heparin is a rapidly acting, potent anticoagulant that has many important clinical uses.Which of the following is an action of heparin?

• (A) activates prothrombin
• (B) acts with antithrombin to inhibit thrombin activity
• (C) decreases prothrombin time
• (D) inhibits calcium action
• (E) promotes vitamin K activity

8. Following an automobile accident a patient suffers a pelvic fracture and significant internal blood loss resulting in hemorrhagic shock. Which of the following organs has the largest specific blood flow (blood flow per gram of tissue) under resting conditions and is especially vulnerable during the shock phase?

• (A) brain
• (B) heart muscle
• (C) kidneys
• (D) skeletal muscle
• (E) skin

9. A 68-year-old woman presents with sleep disturbances and memory loss. After careful analysis, she is diagnosed with early stages of Alzheimer’s disease. Her pharmacological treatment plan includes acetylcholine esterase inhibitors. One week after starting treatment, the woman’s daughter calls in, reporting that her mom has developed new symptoms that might be related to her new medicine. Which of the following is a likely side effect of the drug?

• (A) dry mouth
• (B) forgetting to urinate
• (C) muscle weakness
• (D) nausea and diarrhea
• (E) vertigo

10. A 52-year-old woman has had rheumatoid arthritis for many years. She now comes to you complaining of the development in the past few months of redness, burning, and itching of her eyes and a dry mouth, making swallowing difficult. This newly developing condition gives the patient a greatly increased risk for which of the following?

• (A) esophageal carcinoma
• (B) leukemia
• (C) lymphoma
• (D) melanoma
• (E) pleomorphic adenoma

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Case Study Psychiatric Nursing 101

A 29-year-old man is brought to the emergency center in a drunken stupor. He is accompanied by his wife, who states that he hasn’t been himself at all for the past few months. According to his wife, he was evaluated for depression by his personal physician about 3 months ago and started on an SSRI. He responded quite well to this therapy over the subsequent 2 months. He started feeling so good and so energetic that he stopped taking his medication. He found that he needed less and less sleep, to the point where he is now only sleeping 2-3 hours a day. He has been showering his wife with very expensive gifts and has hit the maximum limit on all of their credit cards. He has been extremely romantic and more interested in sexual relations than at any time before. He has also started drinking heavily and has passed out drunk more than once. His work has suffered, and his boss said that he is in danger of being fired if things don’t straighten out. Other than being drunk, his physical examination and blood tests are normal. He is admitted to the psychiatric unit with a diagnosis of bipolar disorder and started on lithium.

• What is the mechanism of action of lithium?
• What are the common side effects of lithium?
• What is the mechanism of lithium-induced polyuria?

Mechanism of action of lithium: Not entirely known but may be related to inhibition of membrane phospholipid turnover with a reduction in key second messengers, important in the overactivity of catecholamines thought to be related to mood swings characteristic of bipolar disorder.

Common side effects of lithium: Nausea, vomiting, diarrhea, tremor, edema, weight gain, polydipsia, and polyuria.

Mechanism of lithium-induced polyuria: Renal collecting tubule becomes resistant to antidiuretic hormone.

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ß-Blockers

• Examples:  Propranolol, metoprolol, atenolol, nadolol, timolol, pindolol, esmolol, labetalol

•  Toxicity: Impotence, exacerbation of asthma, cardiovascular adverse effects (bradycardia, AV block, Congestive Heart Failure), CNS adverse effects (sedation, sleep alterations)

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