Case of Mrs. Mercedes

Case of Mrs. Mercedes

Make a nursing care plan using RAM for Mrs. Mercedes


Mrs. Maria Mercedes, is a 35 y/o female, married, who was recently admitted to the Oncology Nursing Unit in UP-PGH for evaluation. She had been experiencing “heaviness” in the pelvic area, and having watery, foul smelling vaginal discharge. Papanicolaou Exam revealed class V cervical cancer. She had undergone TAH-BSO ( total abdominal hysterectomy with bilateral salpingo -oophorectomy).


Her past health history revealed that she does not go for regular physical examinations. She also admitted that she does not perform BSE (breast self examination). She is 5ft 2 inches tall and weighs 90 lbs. She claim that her usual weight was 130 lbs. She had smoked 1 pack of cigarettes per day for the past 15 years. She is Gravida 4 para 4. Her 1st pregnancy was at age of 19, her 2nd pregnancy was at age of 21, her 3rd pregnancy was at age of 25, and her 4th was at age of 29.


Mrs. Mercedes finished 4th year high school. She lives with her husband and 4 children in her parent’s home, which she describes as overcrowded, less than sanitary, with poor ventilation. Her husband has no regular job. She describes him as emotionally distant and physically and verbally abusive at times.


She is having good recovery after surgery, but she is unable to completely empty her urinary bladder. She is having continued postoperative pain and nausea. The physician prescribed that she has to do intermittent self-catheterization at home. She has several medications namely, 1.) Antibiotic, 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. Mercedes is extremely tearful. She verbalizes great concern over her future of her 4 children. She believes that this illness is a punishment for her past life.



Make an ADPIE for the following modes:


1. Physiologic Mode

2. Interdependence Adaptive Mode

3. Self-concept Adaptive Mode

4. Role function Adaptive Mode