Introduction
Name: ?
Sex: Female
Address: ?
Nationality: Filipino
Birth Place: ?
Birth Date: ?
Name of Father: ?
Name of Mother: ?
Name of Spouse: ?
III. Developmental Task
Freud theorized that the libido developed in individuals by changing its object,
through the process of sublimation. He argued that humans are born "polymorphous
perverse"[1], meaning that any number of objects could be a source of pleasure. Following
a biological logic, Freud established a rigid model for that "normal" sexual development
of the human being, or the "libido development". Each child passes through five
psychosexual stages. During each stage, the id focuses on a distinct erogenous zone on
the body. . The term "psychosexual infantilism," refers to those who become fixated in
this way and fail to mature through the psychosexual stages into heterosexuality. Freud
related the resolutions of the stages with adult personalities and personality disorders.
Despite their popularity among psychoanalytical psychologists, Freud's
psychosexual theories are commonly criticized as being sexist. For example, Freud stated
that young females develop "penis envy" toward the males during their psychosexual
development. In response, Karen Horney, a German Freudian psychoanalyst, argued that
young females develop "power envy" instead of "penis envy" toward the male.
Genital phase
The genital stage starts at puberty, allowing the child to develop opposite sex
relationships with the libidinal energy again focused on the genital area. According to
Freud, if any of the stages are fixated on, there is not enough libidinal energy for this
stage to develop untroubled. To have a fully functional adulthood, the previous stages
need to be fully resolved and there needs to be a balance between love and work.
Erikson’s theory of psychosocial development is one of the best-known theories
of personality in psychology. Similar to Freud, Erikson believed that personality develops
in a series of stages. Unlike Freud’s theory of psychosexual stages, Erikson’s theory
describes the impact of social experience across the whole lifespan.
One of the main elements of Erikson’s psychosocial stage theory is the develoment of
ego identity. Ego identity is the conscious sense of self that we develop through social
interaction. According to Erikson, our ego identity is constantly changing due to new
experience and information we acquire in our daily interactions with others. In addition to
ego identity, Erikson also believed that a sense of competence also motivates behaviors
and actions.
Each stage in Erikson’s theory is concerned with becoming competent in an area
of life. If the stage is handled well, the person will feel a sense of mastery. If the stage is
managed poorly, the person will emerge with a sense of inadequacy.
In each stage, Erikson believed people experience a conflict that serves as a turning point
in development. In Erikson’s view, these conflicts are centered on either developing a
psychological quality or failing to develop that quality. During these times, the potential
for personal growth is high, but so is the potential for failure.
Psychosocial Stage 6 - Intimacy vs. Isolation
• This stage covers the period of early adulthood when people are exploring
personal relationships.
• Erikson believed it was vital that people develop close, committed relationships
with other people. Those who are successful at this step will develop relationships
that are committed and secure.
• Remember that each step builds on skills learned in previous steps. Erikson
believed that a strong sense of personal identity was important to developing
intimate relationships. Studies have demonstrated that those with a poor sense of
self tend to have less committed relationships and are more likely to suffer
emotional isolation, loneliness, and depression.
1. 1. Selecting a mate
4. 4. Starting a family
5. 5. Rearing children
6. 6. Managing a home
ANATOMY
The Fallopian tubes are paired, tubular, seromuscular organs whose course runs medially
from the cornua of the uterus toward the ovary laterally. The tubes are situated in the
upper margins of the broad ligaments between the round and utero ovarian ligaments
(Fig. 2). Each tube is about 10 cm long with variations in length from 7 to 14 cm. The
abdominal ostium is situated at the base of a funnel-shaped expansion of the tube, the
infundibulum, the circumference of which is enhanced by irregular processes called
fimbriae. The ovarian fimbria is longer and more deeply grooved than the others and is
closely applied to the tubal pole of the ovary. Passing medially, the infundibulum opens
into the thin-walled ampulla forming more than half the length of the tube and 1 or 2 cm
in outer diameter; the isthmus, a round and cord-like structure constituting the medial
one-third of the tube and 0.5-1 cm in outer diameter, succeeds it. The interstitial or conual
portion of the tube continues from the isthmus through the uterine wall to empty into the
uterine cavity. This segment of the tube is about 1 cm in length and 1 mm in inner
diameter.
PHYSIOLOGY
The tubes act as ducts for sperm, oocyte, and fertilized ovum transport, in addition to
being the normal site of fertilization. These functions depend mainly on three factors:
tubal motility, tubal cilia, and tubal fluid.
V. Pathophysiology
Predisposing Factors:
• Sex – women of childbearing age are affected.
• Age – women of childbearing age are affected.
Precipitating Factors:
• Prior pelvic inflammatory disease
• Prior ectopic pregnancy
• Pregnancy in a woman with an intrauterine device (IUD) in place
• Pregnancy achieved by means of in vitro fertilization or fertility drugs
• Prior tubal surgery (reconstruction or tubal coagulation)
• Cigarette smoking
• Increasing age
Schematic Diagram:
Doctor’s Order
- refer to OR department for operation
o to prepare the patient for the operation
- insert D5LR 1liter at 120 gtts/min
- follow PNSS 1liter at KVO rate
o for IVTT medication purpose
- administer Tramadol 50 mg IVTT every 6 hours
o use for management of moderate to moderately severe pain
- administer Ketorolac 30 mg IVTT every 8 hours
o use for short term management of pain
- administer Ranitidine 50 mg IVTT every 8 hours NPO
o use for short term treatment of active duodenal ulcer
- administer Metoclopramide 10 mg IVTT every 8 hours
o use for symptomatic treatment of gastroesophageal reflux
- administer Nubain 3 mg IVTT 8 hours for severe pain (reserve dose)
- monitor I & O
o use to monitor if the intake and output of the patient is equal
- for blood transfusion
o to compensate blood loss
- refer accordingly
Intervention Rationale
1. Review specific pathology and - provides knowledge base from which
anticipated surgical procedure. Verify that patient can make informed therapy choices
appropriate consent has been signed and consent for procedure and presents
opportunity to clarify misconceptions
2. Use resource teaching materials, - specially designed materials can facilitate
audiovisuals as available patients learning
3. Implement individualized preoperative - enhances patient understanding/control
teaching program: and can receive stress related to the
preoperative/postoperative procedures and unknown/ unexpected
dietary considerations.
4. Implement individualized preoperative - helps reduce possibility of post operative
teaching program: preoperative instructions complications and promotes a rapid return
and which medication to take to normal body function.
5. Provide opportunity to practice - enhances learning and continuation of
coughing, deep breathing, and muscular activity postoperatively
exercises.
Intervention Rationale
1. Prepare operative site according to Minimizes bacterial counts and operative
specific procedure sites
2. Examine skin for breaks or irritation, Disruption of skin integrity at or near the
signs of infection operative sites are sources of contamination
to the incision
3. Identify breaks in aseptic technique and Contamination by environmental/personnel
resolve immediately on occurrence contact renders the sterile field unsterile,
thereby increasing the risk for infection
4. Apply sterile dressing Prevents environmental contamination of
fresh wound
5. Administer antibiotics as indicated May be given prophylactically for
suspected infection or contamination
Diagnosis: Acute pain related to disruption of the skin.
Intervention Rationale
1. Provide information about transitory Understanding the cause of the discomfort
nature of discomfort, as appropriate provides emotional reassuarance
2. Reposition as indicated e.g.,semi- May relieve pain and enhances circulation.
Fowlers position
3. Provide additional comfort measures Improve circulation, reduces muscle
tension and anxiety associated with pain.
4. Encourage use of relaxation technique Relieves muscle and emotional tension;
enhances sense of control and may improve
coping abilities
5. Provide oral care, occasional ice Reduces discomfort associated with dry
chips/sips of fluid as tolerated mucous membranes due to anesthetic
agents, oral restrictions.
S “kung mutukar na gani ang kasakit grabe jud,murag dili jud nako
makaya.”, as verbalized by the client.
O Facial grimace
Making a fist
Reports of pain
A Acute pain related to disruption of the skin.
P Long term: At the end of 2 days the pain felt by the client will be lessen.
Short term: At the end of 4 hours the pain felt by the client will be
alleviated.
I 11. Provided information about transitory nature
of discomfort, as appropriate.
12. Repositioned as indicated e.g.,semi-Fowlers
position.
13. Provided additional comfort measures.
14. Encouraged use of relaxation technique.
15. Provided oral care, occasional ice chips/sips
of fluid as tolerated.
E At the end of 2 hours the pain felt by the client was alleviated.
XI. Health Teaching
XIII. Bibliography