Mrs. X, is a 36 yrs old female.

Married who was recently admitted to the Oncology Nursing Unit in the ABC hospital for evaluation. She had been experiencing heaviness In the pelvic area and having watery, foul, smelling vaginal discharge. Papanicolaou exam revealed class IV cervical cancer. She had undergone TAH-BSO (Total Abdominal Hysterectomy with Bilateral Salphingo Oopherectomy). Her past health history revealed that she does seek for regular physical examination. She also admitted that she does not perform breast self-examination (BSE). She is five feet two inches tall and weighs 90 lbs. She claimed that her usual weight was 130 lbs. She had smoked pack of cigarettes per day for the past 15 years. She is gravid 4 para 4. Her first pregnancy was at age 19, her second pregnancy was at age 21, her third pregnancy at age 25, and her fourth pregnancy at age 29. Mrs. X finished 4th yr high school she lives with her husband and four children in her parents home, ehich she describes as overcrowded, less than sanitary, with poor ventilation. Her husband has no regular job. She describes has emotionally distant and abusive at times, physically and verbally. She is having good recovery after surgery, but she is unable to completely empty her urinary bladder. She is having continued post-op pain and nausea. Physician described that she has to do intermittent self catheterization at home. She has several medication namely, 1. Anti biotic 2. An Analgesic as needed for pain 3. An antiemetic as needed for nausea. In addition, the physician recommended radiation therapy on an outpatient basis. Mrs. X is extremely tearful. She verbalizes great concern over her future and future of her four children. She believes that this illness is a punishment for her past life. **Apply Nursing care of Mrs. X with Roys model Living physiologic Adaptive Model, Interdepence adaptive moods, Role function Adaptive moods and use Roys Nursing Process, (Assessment of Behavior of Stimuli, Nursing Diagnosis, Good Settling, Intervention, Evaluation. Case II History of Miss Padua Miss Padua, a 25 year old female had consulted the health center because of her fever since three days ago. This is accompanied by loss of appetite to eat, body malaise, headache, abdominal pains, dizziness. Her vital signs are as follows: T-38.7C, PR-86, VF-21/min, BP-90/60mmHg. Miss Padua claims that she has lost weight because of her fever and loss of appetite to eat. She lives in a crowded community which is constantly submerged in water due to floods. These cause severe problems in sanitation and source of water supply. Laboratory test and physical examination revealed dengue hemorrhagic fever (DHF). Miss Padua is extremely worried because she had a neighbor who dies because of DHF few months ago. In addition, she is concerned over financial expenses for her illness and her absence from her job as a saleslady.

Use the following format for applying nightingales philosophy of environment. A. Nursing the sick 1. Assessment 2. Plan B. Physical Enironment 1. Home, Community/ neighborhood and 2. Home, community, neighborhood and workplace plan C. Physiological Environment 1. Assessment and plan D. Nutrition 1. Assessment and Plan