Xavier University Prc Or

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XAVIER UNIVERSITY – ATENEO DE CAGAYAN Corrales Avenue, Cagayan de Oro City, Philippines School Code: 0839 Name of Student: PAULA HELENA ROJAS ABA Name & Address of School: Xavier University – Ateneo de Cagayan, Corrales Avenue, Cagayan de Oro City Accreditation level: (If any) None Date School / Program was Recognized: June 9 Number: 008 Year: 1992 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: 2005 Year Graduated (BSN Program): 2009

Year Granted:

Not Applicable

I. MAJOR OPERATIONS N umbe r

Date of Operati on

Case Numbe r

Name of Patient

Diagnosis

Operation Performed

Type of Anesthesia

Name of Surgeon

Name of Hospital

Name of Operating Room Scrub Nurse

1

Decembe r 19, 2007

480465

Gina Dagunot

Cholelithiasis with cholecystolithiasis, gangrenous gallbladder with adhesion

Cholecystectomy Lavage and Drainage

Spinal Anesthesia – Epidural Anesthesia

Dr. Elmer Zalsos

Northern Mindanao Medical Center

Pilarlita Mae S. Pagaray, BSN, RN

2

Decembe r 20, 2007

352552

Francisco Canaya

Nodular Non-toxic goiter with neck metastasis probably malignant

Total Thyroidectomy with Radical Neck Dissection, Right

General Anesthesia

Dr. Bernabe Mendoza

Northern Mindanao Medical Center

Pilarlita Mae S. Pagaray, BSN, RN

3

April 24, 2008

507532

Eddie Yap

Healed Fracture Radius Middle Third, Right; Refracture Medial Third Ulna, Right

Removal of Implant Radius, Right; Replating of the medial third ulna, Right

General Anesthesia

Dr. Justiniano Aquilino Cyril Pimentel

Northern Mindanao Medical Center

Leni I. Gestuveo, BSN, RN

507732

Leonila Villaruel

Phylloides Tumor, Left

Simple Mastectomy, Left

General Anesthesia

Dr. Riman Ricardo

4

April 24, 2008

Prepared by: April 23, 006679 5 2009 PAULA HELENA ROJAS ABA__ Name of Student

Supervised by: Noted by: Clemente Incarcerated Inguinal Herniorrhapy, Right Salarda Hernia ___MRS. IVY R. GO_ MRS.CHRISTY G. DABLO __ . Clinical Instructor Clinical Coordinator Date Signed: Date Signed: _________________________________ __ . Degree: BSN, RN, MAN Degree: BSN, RN, MN, MAN . . a.) PRC No.: 0222293 a.) PRC No.: 0222342 . . Valid Until: April 21, 2010 Valid Until: November 22, . 2010 . b.) PNA No.: 066616 b.) PNA No.: 066620 . . Valid Until: December 31, 2009 Valid Until: December 31, . 2009 .

Concurred by: Local Dr. Joel Anesthesia Babanto DR. DOROTHEA N. ROQUE . Chief Nurse Northern Mindanao Medical Center Date Signed: . Degree: BSN, RN, MAN, Ed D. . a.) PRC No.: 0041397 . Valid Until: February 6, 2010 . b.) PNA No.: 018604 . Valid Until: December 31, 2009 . c.) ANSAP No.: 05047 . Valid Until: December 31, 2009 .

Signature of Operating Room Scrub Nurse

Northern Almer Jan L. Zalsos, BSN, Mindanao RN Medical Center Concurred by: Approved by: Gingoog Fe T. Teope, BSN, RN District MRS. JULIANA L. JAVIER DR. RAMONA HEIDI C. . Hospital PALAD . Chief Nurse Dean College of Nursing Gingoog District Hospital Xavier University-Ateneo de Date Signed: Cagayan Date Signed: . Degree: BSN, RN . a. ) PRC No.: 0077182 . Valid Until: December 10, 2010 . b.) PNA No.: 80212 . Valid Until: December 31, 2009 .

. Degree: BSN, RN, MAN, MAEd, PhD . a.) PRC No.: 0053722 . Valid Until: August 31, 2012 . b.) PNA No.: 11836 . Valid Until: Lifetime . c.) ADPCN No.: 0063 . Valid Until: October 31, 2010 .

XAVIER UNIVERSITY – ATENEO DE CAGAYAN Corrales Avenue, Cagayan de Oro City, Philippines School Code: 0839 Name of Student: PAULA HELENA ROJAS ABA Name & Address of School: Xavier University – Ateneo de Cagayan, Corrales Avenue, Cagayan de Oro City Accreditation level: (If any) None Date School / Program was Recognized: June 9 Number: 008 Year: 1992 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: 2005 Year Graduated (BSN Program): 2009

Year Granted:

Not Applicable

II. MINOR OPERATIONS N umbe r

Date of Operati on

Case Numbe r

Name of Patient

Diagnosis

Operation Performed

Type of Anesthesia

Name of Surgeon

Name of Hospital

Name of Operating Room Scrub Nurse

1

Decembe r 19, 2007

480457

Hazel Jane Malinay

Sacrococcygeal Mass

Excision of Sacrococcygeal Teratoma

General Anesthesia

Dr. Dures Fe Tagayuna

Northern Mindanao Medical Center

Lydia L. Labitad, BSN, RN, MN

Mother’s House, Xavier University – Community Health Care Center Mother’s House, Xavier University – Community Health Care Center

2

February 8, 2008

2008601

Nilda Adoremos

Multiparity

Bilateral Tubal Ligation

Local Anesthesia

Dr. Maria Corazon Cuaycong

3

March 19, 2008

2008615

Judith Baterna

Multiparity

Bilateral Tubal Ligation

Local Anesthesia

Dr. Maria Corazon Cuaycong

4

April 17, 2008

259

Howard Wyne Llesis

Phimosis

Circumcision

Local Anesthesia

Dr. Melodee Zamora

City Health Office -Tablon Health Center

Iryn L. Salcedo, BSN, RN

5

April 17, 2008

260

Howard Miles Llesis

Phimosis

Circumcision

Local Anesthesia

Dr. Melodee Zamora

City Health Office -Tablon Health Center

Iryn L. Salcedo, BSN, RN

Grace L. Llevares, BSN, RN

Grace L. Llevares, BSN, RN

Signature of Operating Room Scrub Nurse

Prepared by:

Supervised by:

Noted by:

PAULA HELENA ROJAS ABA___ Name of Student

MRS. IVY R. GO ___ Clinical Instructor Date Signed:

___ MRS.CHRISTY G. DABLO_____ Clinical Coordinator Date Signed:

. Degree: BSN, RN, MAN . a.) PRC No.: 0222293 . Valid Until: April 21, 2010 . b.) PNA No.:066616 . Valid Until: December 31, 2009 .

. Degree: BSN, RN, MN, MAN . a.) PRC No.: 0222342 . Valid Until: November 22, 2010 . b.) PNA No.: 066620 . Valid Until: December 31, 2009 .

Concurred by: _

__DR. DOROTHEA N. ROQUE_____ Chief Nurse Northern Mindanao Medical Center Date Signed: . Degree: BSN, RN, MAN, Ed D. . a.) PRC No.: 0041397 . Valid Until: February 6, 2010 . b.) PNA No.: 018604 . Valid Until: December 31, 2009 . c.) ANSAP No.: 05047 . Valid Until: December 31, 2009 .

Concurred by:

Concurred by:

Approved by:

__ MRS. EVA R. LLENO________ Chief Nurse Xavier University – Community Health Care Center Date Signed:

______MS. IRYN L. SALCEDO______ Public Health Nurse III City Health Office Date Signed:

____DR. RAMONA HEIDI C. PALAD___ Dean College of Nursing Xavier University-Ateneo de Cagayan Date Signed:

. Degree: BSN, RN, MHA . a. ) PRC No.: 0091662 . Valid Until: August 9, 2012 . b.) PNA No.: 18586 . Valid Until: Lifetime . c.) ANSAP No.: 090011 . Valid Until: Lifetime .

. Degree: BSN, RN, MPH . a.) PRC No.: 0148109 . Valid Until: January 11, 2012 . b.) PNA No.: 79897 . Valid Until: December 31, 2009 .

. Degree: BSN, RN, MAN, MAEd, PhD . a.) PRC No.: 0053722 . Valid Until: August 31, 2012 . b.) PNA No.: 11836 . Valid Until: Lifetime . c.) ADPCN No.: 0063 . Valid Until: October 31, 2010 .

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