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HILTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Name of Student: MONTECILLO CLARISSA IBARRIENTOS __ _ Name and Address of School: OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.,HILLTOP MANSION HEIGHTS, LAGRO,QUEZON CITY Accreditation Level (if any): PACUCOA LEVEL II___________________ Year Granted: APRIL 10, 2002________________________________________ Date School/Program was Recognized: APRIL 25, 2001 Number: 033 Year: 2001 First Course (if any):NOT APPLICABLE ___School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE ___ Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2006 Year Graduated (BSN Program): MARCH 2010 I. Major Operations
No .
1.
Date of Operation October 31 2008 November 20, 2008 February 03, 2009 January 31, 2010 February 17, 2010
Diagnosis Pregnancy uterine 33 weeks age of gestation transverse in labor gravida 3 para 2 Cataract senile mature left eye
Type of Anesthesia Spinal Anesthesia Monitored Anesthesia care Monitored Anesthesia care General Anesthesia Spinal Anesthesia
Name of Surgeon Dr. Imelda Carreon Dr. Ronaldo fernando Dr. Ronaldo Fernando Dr. James Hernandez Dr. Imelda Carreon
Name of Hospital United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation
Supervised by Qualified CI Wilowena Angeles RN, MAN PRC No. 304439 PNA No. 2011-061316 Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316
2.
01503
Cataract extraction
3.
01634
Cataract extraction
4.
02142
5.
02166
Lorena Dionisio
Prepared by: Montecillo Clarissa I. Signature over printed Name of Student Supervised by: Wilowena Angeles RN,MAN Signature over printed Name of Faculty Date Signed: ________ Degree: BSN MAN a.) PRC NO: 304439 Valid Until: February 12, 2015 b.) PNA NO: 2012-826680 Valid Until: December 2012
Noted by: LIza May B. Jecino RN,MAN Signature over printed Name of Clinical Coordinator Date Signed: _________ Degree: BSN MAN a.)PRC NO: 164056 Valid Until: January 25, 2013 b.) PNA NO: 2011-17397 Valid Until: Lifetime
Concurred by: Lorna Punongbayan Diano RN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: RN a.) PRC NO: 0260345 Valid Until: March 21, 2013 b.) PNA NO: 2011-087335 Valid Until: October 2011
Approved by: Nelia R. Capulong RN,RM,MAN Signature over printed Name of Dean Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0041904 Valid Until: July 31,2012 b.) PNA NO: 18698 Valid Until: Lifetime c.) ADPCN NO: 0627 Valid Until: December 2011
OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST., HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Name of Student: MONTECILLO CLARISSA IBARRIENTOS Name and Address of School: OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Accreditation Level (if any): PACUCOA LEVEL II Year Granted .APRIL 10 2002 Date School/Program was Recognized: APRIL 25, 2001 Number: 033 ____Year: 2001 First Course (if any):NOT APPLICABLE School Graduated From: NOT APPICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2006 Year Graduated (BSN Program): MARCH 2010 II. Minor Operations
No. 1. Date of Operation September 28, 2008 November 5, 2008 November 5, 2008 January 26, 2010 Case No. 89470 Name of Patient Nathan Dumantang Melita D. Naing Diagnosis Lacerated wound 2nd digit left hand Hypogastric pain Operation Performed Suturing Type of Anesthesia Local Anesthesia Local Anesthesia Spinal Anesthesia Local Anesthesia Name of Surgeon Dr. Asis Name of Hospital United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation United Balagtas Doctors Hospital Corporation Ospital ng Sampaloc Supervised by Qualified CI Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 . Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 . Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 Carmelita S. Vitug RN,RM,MAN PRC No. 266517 PNA No. 18470 Marcellus Belisario RN, MAN PRC. No. 0349993 PNA No. 19636 Approved by: Nelia R. Capulong RN,RM,MAN Signature over printed Name of Dean Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0041904 Valid Until: July 31,2012 b.) PNA NO: 18698 Valid Until: Lifetime c.) ADPCN NO: 0627 Valid Until: December 2011 Signature of Qualified CI
2.
01479
Colonoscopy
3.
00363
4.
678500
5.
155015
Nenita Agustin
Incomplete abortion
Intravenous Sedation
Prepared by: Montecillo Clarissa I. Signature over printed Name of Student Supervised by: Wilowena Angeles RN,MAN Signature over printed Name of Faculty Date Signed: ________ Degree: BSN MAN a.) PRC NO: 304439 Valid Until: February 12, 2015 b.) PNA NO: 2012-826680 Valid Until: December 2012
Noted by: LIza May B. Jecino RN,MAN Signature over printed Name of Clinical Coordinator Date Signed: _________ Degree: BSN MAN a.)PRC NO: 164056 Valid Until: January 25, 2013 b.) PNA NO: 2011-17397 Valid Until: Lifetime
Concurred by: Lorna Punongbayan Diano RN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: RN a.) PRC NO: 0260345 Valid Until: March 21, 2013 b.) PNA NO: 2011-087335 Valid Until: October 2011
Concurred by: Minerva Espino RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0090530 Valid Until: October 10, 2012 b.) PNA NO: 19638 Valid Until: Lifetime
Concurred by: Grace D. Zaldua RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0142514 Valid Until: May 26, 2012 b.) PNA NO: 15062 Valid Until: Lifetime
OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST., HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Name of Student: MONTECILLO CLARISSA IBARRIENTOS ___ ___________________________________________________________________________________________________________________________________ Name and Address of School: OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.,HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY __ Accreditation Level (if any): PACUCOA LEVEL II Year Granted: APRIL 10 2002 Date School/Program was Recognized: APRIL 25, 2001 _ Number: 033 __ __Year: 2001 _ First Course (if any): NOT APPLICABLE _ School Graduated From: Year: NOT APPICABLE _ _ _ Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2006 ____ Year Graduated (BSN Program): MARCH 2010 ___ III. Actual Deliveries
No. 1.
Diagnosis Pregnancy uterine full term cephalic in labor gravida 4 para 4 Pregnacy uterine full term cephalic in labor gravida 1 para 0 Pregnancy uterine full term cephalic in labor gravida 2 para 1 Pregnancy uterine 40 weeks age of gestation cephalic in labor gravida 1 para 0 Pregnancy uterine 39 weeks age of gestation cephalic in labor gravida 2 para 1
Age 34
Date of Delivery June 01, 2009 March 04,2009 March 20, 2009 March 17, 2010 March 17, 2010
Name of Hospital Camarin health center and Lying-in Camarin health center and Lying-in Camarin health center and Lying-in Bulacan Maternity and Childrens Hospital Bulacan Maternity and Childrens Hospital
Type of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery
Supervised by: Qualified C.I. Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Emelita Bulos RM, RN, MAN PRC No: 192498 PNA No: 026809 Emelita Bulos RM, RN, MAN PRC No: 192498 PNA No: 026809 Approved by: Nelia R. Capulong RN,RM,MAN Signature over printed Name of Dean Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0041904 Valid Until: July 31,2012 b.) PNA NO: 18698 Valid Until: Lifetime c.) ADPCN NO: 0627 Valid Until: December 2011
Signature of Qualified CI
2.
068-9
20
8:40 am
Female
3.
078-09
Nenita Yape
20
8:00 am
Female
4.
153169
Glenda Arellano
28
10:10 am 9:20 am
Male
5.
152672
28
Female
Prepared by: Montecillo Clarissa I. Signature over printed Name of Student Supervised by: Imelda Villegas RN, MAN Signature over printed Name of Faculty Date Signed: ________ Degree: BSN MAN a.) PRC NO: 69342 Valid Until: November 11, 2013 b.) PNA NO: 2012- 023957 Valid Until: December 2012
Noted by: LIza May B. Jecino RN,MAN Signature over printed Name of Clinical Coordinator Date Signed: _________ Degree: BSN MAN a.)PRC NO: 164056 Valid Until: January 25, 2013 b.) PNA NO: 2011-17397 Valid Until: Lifetime
Concurred by: Norma A. Manere RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0082296 Valid Until: May 23, 2011 b.) PNA NO: 3805 Valid Until: Lifetime
Concurred by: Minerva Espino RN MAN Signature over printed Name of Chief Nurse Date Sugned:_________ Degree: BSN MAN a.) PRC NO: 0090530 Valid Until: October 10, 2012 b.) PNA NO: 19638 Valid Until: Lifetime
OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST., HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Name of Student: MONTECILLO CLARISSA IBARRIENTOS ___ Name and Address of School: OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.,HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY ____ Accreditation Level (if any): PACUCOA LEVEL II Year Granted: APRIL 10 2002 _____ Date School/Program was Recognized: APRIL 25, 2001 Number: 033 Year: 2001 ____ First Course (if any): NOT APPLICABLE School Graduated From: NOT APPLICABLE Year: NOT APPLICABLE Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2006 ____ Year Graduated (BSN Program): MARCH 2010______________________________________________________________________________________ IV. Deliveries Assisted
No. 1.
___
Diagnosis Pregnancy uterine full term premature rupture of membrane gravida 1 para 0 Pregnancy uterine full term cephalic in labor gravida 2 para 1 Pregnancy uterine full term cephalic in labor gravida 1 para 0 Pregnancy uterine full term cephalic in labor gravida 2 para 1 Pregnancy uterine full term cephalic in labor gravida 2 para 1
Age 21
Name of Hospital Gregorio H. Del Pilar hospital Camarin health center and Lying-in Camarin health center and Lying-in Camarin health center and Lying-in Camarin health center and Lying-in
2.
074-09
27
1:45 am
Male
3.
075-09
20
11:44 am
Female
4.
076-09
30
1:05 am
Female
5.
153339
Teresita Humanoy
21
1:05 pm
Male
Type of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery
Supervised by Qualified C.I. Cecile F. Guevarra, RN, MAN PRC No. 293775 PNA No. 18471 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531
Prepared by: Montecillo Clarissa I. Signature over printed Name of Student Supervised by: Imelda Villegas RN, MAN Signature over printed Name of Faculty Date Signed: ________ Degree: BSN MAN a.) PRC NO: 69342 Valid Until: November 11, 2013 b.) PNA NO: 2012- 023957
Noted by: LIza May B. Jecino RN,MAN Signature over printed Name of Clinical Coordinator Date Signed: _________ Degree: BSN MAN a.)PRC NO: 164056 Valid Until: January 25, 2013 b.) PNA NO: 2011-17397 Valid Until: Lifetime
Concurred by: Norma A. Manere RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0082296 Valid Until: May 23, 2011 b.) PNA NO: 3805 Valid Until: Lifetime
Concurred by: Minerva Espino RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0090530 Valid Until: October 10, 2012 b.) PNA NO: 19638 Valid Until: Lifetime
Concurred by: Arlene Galang-Generosa RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO:152240 Valid Until: October 19, 2014 b.) PNA NO: 18248 Valid Until: Lifetime
Approved by: Nelia R. Capulong RN,RM,MAN Signature over printed Name of Dean Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0041904 Valid Until: July 31,2012 b.) PNA NO: 18698 Valid Until: Lifetime c.) ADPCN NO: 0627 Valid Until: December 2011
OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST., HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Name of Student: MONTECILLO CLARISSA IBARRIENTOS Name and Address of School: OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST.,HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY Accreditation Level (if any): PACUCOA LEVEL II Year Granted: APRIL 10 2002 Date School/Program was Recognized: APRIL 25, 2001 __Number: 033 _ Year: 2001 _ First Course (if any): NOT APPLICABLE _ School Graduated From: NOT APPLICABLE Year: NOT APPICABLE _ Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2006 Year Graduated (BSN Program): MARCH 2010 V. Cord Dressing
No. 1. Case No. 00371 Date Performed November 20, 2008 Name of Baby Baby girl Galvez Gender of Baby Female Name of Mother Arlene Galvez Age 27 Name of Hospital United Balagtas Doctors Hospital Corporation Supervised by Qualified C.I. Wilowena Angeles, RN, MAN PRC No. 304439 PNA No. 2011-061316 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Imelda Villegas, RN, MAN PRC No. 69342 PNA No. 2011-041531 Emelita Bulos RM, RN, MAN PRC No: 192498 PNA No: 026809 Concurred by: Lorna Punongbayan Diano RN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: RN a.) PRC NO: 0260345 Valid Until: March 21, 2013 b.) PNA NO: 2011-087335 Valid Until: October 2011 Approved by: Nelia R. Capulong RN,RM,MAN Signature over printed Name of Dean Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0041904 Valid Until: July 31,2012 b.) PNA NO: 18698 Valid Until: Lifetime c.) ADPCN NO: 0627 Valid Until: December 2011 Signature of Qualified C.I.
2.
070-09
Male
Elma Leguani
3.
071-09
Female
Abegail Odon
4.
077-09
Female
Sheryl Quesada
5.
151014
Male
Marilou Caparas
21
Prepared by: Montecillo Clarissa I. Signature over printed Name of Student Supervised by: Imelda Villegas RN, MAN Signature over printed Name of Faculty Date Signed: ________ Degree: BSN MAN a.) PRC NO: 69342 Valid Until: November 11, 2013 b.) PNA NO: 2012- 023957 Valid Until: December 2012
Noted by: LIza May B. Jecino RN,MAN Signature over printed Name of Clinical Coordinator Date Signed: _________ Degree: BSN MAN a.)PRC NO: 164056 Valid Until: January 25, 2013 b.) PNA NO: 2011-17397 Valid Until: Lifetime
Concurred by: Norma A. Manere RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0082296 Valid Until: May 23, 2011 b.) PNA NO: 3805 Valid Until: Lifetime
Concurred by: Minerva Espino RN MAN Signature over printed Name of Chief Nurse Date Signed:_________ Degree: BSN MAN a.) PRC NO: 0090530 Valid Until: October 10, 2012 b.) PNA NO: 19638 Valid Until: Lifetime