University of the Philippines Manila

SCHOOL OF HEALTH SCIENCES

ASCAR
Palo, Leyte

IASIS
Eastern Visayas Regional Medical
Center: Pediatric Ward Wing 1
What is
Ascariasis?
 an infection of the small
intestine caused by Ascaris
lumbricoides, which is a species
of roundworm.
 the most common roundworm
infection.
 most common in places without
modern sanitation.
Ascariasis
HEALTH
HISTORY
Biographical Data
Chief Complaint
History of Present Illness
Past Health History
Family History
Psychological History and Lifestyle
Biographical
Data
Name:
Address:
Age:
Civil Status:
Date of Birth:
Occupation:
Mother:
Father:
Ordinal Position:
Type of Service:
Source of Information:
Attending Physician:
Chief
Complaint

 Vomiting
 Diarrhea
 Abdominal Pain
History of Present
Illness
Past Health
History
Childhood and Infectious Disease: Fever, Cold and Cough
Immunization: Complete
Allergies: No known allergies to food and
drugs
Medication taken: Paracetamol (fever)
Neozep (colds)
Major Surgeries and
Previous Hospitalization: None
Injuries: None
Family History
GRANDFAT GRANDMOTH
FATHER OF MOTHER OF
HER OF ER OF
MARISSA MARISSA
MANUEL MANUEL

FATHER
OF
MANUEL

MANUEL
MARINA
(Patient)
Disease:
Psychological History
and Lifestyle
Alcohol use: Not applicable
Drug Use: Not Applicable
Tobacco Use: Not applicable
Domestic and Partner Violence: Not
applicable
Sexual Practice: Not applicable
Travel History: None
Work Environment: Not applicable
Psychological History
and Lifestyle
Home Environment:
Hobbies and
Leisure Activities:
Education:
Economic Status:
Ethnic Background:
Ascariasis
PHYSICAL
EXAMINATION
General Survey
Vital Signs
Head; Ears; Nose; Mouth and Throat; Neck; Eyes; Chest and Lungs;
Cardiovascular and Peripheral Vascular; Musculoskeletal; Neurologic;
Genito-urinary
General Survey

Appearance: facial
features symmetrical, and
no signs of acute distress.
Body structure: Body parts
equal bilaterally, has
bloated stomach.
Vital Signs
Temperature: 37.1° C
Pulse Rate: 120 bpm
Respiratory Rate: 40 cpm

Skin
Fair skin color, no rashes and lesion,
no bruises or no edema observed, has
scars on the ankle, pallor
Head
 No hair loss, lumps or lesions, facial
features are symmetrical and no
edema and deformity.
Ears
No deformity, redness,
swelling and drainage.

Nose
No deformity, redness, swelling
and drainage.
Mouth and
Throat
No lesions in the mouth and
no enlargement of tonsils,
presence of Oral Thrush.

Neck
No scars, lesions or bruises
Eyes
Cornea dilate, no deformity
or asymmetry, pinkish
conjunctiva
Chest and
Lungs
No scars or lesions
Cardiovascular and
Peripheral Vascular
 Pulse rate-120 bpm (radial) normal rhythm, normal
capillary refill, no clubbing of nails, Cardiovascular
examination revealed normal S1 and S2 with no
murmur, and central nervous system examination
revealed no neurological deficits.

Musculoskelet
al
No rashes, scars, lesions or
deformities observed.
Abdomen
Abdominal examination revealed
abdominal tenderness and rigidity in the
central and mid-abdomen. There was no
organomegaly. Auscultation revealed a
silent abdomen or minimal peristalsis.
Neurologic
No involuntary movement of
extremities

Genito-
urinary
No bulging, swelling or redness
noted
GORDON’S
Ascariasis
FUNCTIONAL
HEALTH PATTERNS
ASSESSMENT
Health Perception/ Health Management I Cognitive-Perceptual Pattern
Nutritional-Metabolic Pattern I Sleep-Rest Pattern
Elimination Pattern I Roles-Relationship Pattern
Activity-Exercise Pattern I Sexuality-Reproductivity Pattern
Self-Perception – Self Concept Pattern I Coping-Stress Tolerance
Pattern
Values-Belief Pattern
Health Perception/ Health
Management
Before hospitalization:
The patient had vitamins and exercises through playing.
 
During hospitalization:
The patient takes her medications as prescribed.

Nutritional-Metabolic
Pattern
Before hospitalization:
The patient has no known allergies. She eats well.
 
During hospitalization:
The patient had a decreased appetite but it slowly
turning back to normal.
Elimination Pattern
Before hospitalization:
The patient had a normal urinary elimination with diaper
changed, 3 or more times per day. She has loose watery stool
with and defecates 5x within 24 hrs.
 
During hospitalization:
The patient still has normal urination, bowel movement has
been reduced with formed stools.

Activity-Exercise
Pattern
Before hospitalization:
The patient plays with her friends with maximum energy.
 
During hospitalization:
The patient plays but at a minimal level due to hospital
Sleep-Rest Pattern
Before hospitalization:
The patient had enough of sleep everyday, with one nap, one in
the afternoon, and sleep at the evening.
 
During hospitalization:
The patient had a disturbed sleep pattern due to hospital
conditions as verbalized by the mother.

Cognitive-Perceptual
Pattern
Before hospitalization:
The patient can see, hear, and smell clearly. She communicates well
with her parents with words and sounds that she can do. She remembers
faces of her relatives and playmates very well.
 
During hospitalization:
The patient can still see, hear, and smell clearly. She still communicates
with her parents with words and sounds that she can do. She also still
remembers faces of her relatives and playmates very well.
Self-Perception – Self-
Concept Pattern
Before hospitalization:
The patient had a good posture, maintains eye contact when relaxed,
and had a normal tone when speaking or making sounds.
 
During hospitalization:
The patient is not cooperative. She is not active and she is weak, cannot
maintain eye contact when relaxed, and had a small tone of when
speaking or making sounds.

Roles-Relationship
Pattern
Before hospitalization:
The patient has a good relationship with her family and playmates and
socializes well with others.
 
During hospitalization:
The patient still has a good relationship with her family and playmates.
Sexuality-Reproductive
Pattern
N/A

Coping-Stress
Tolerance Pattern
N/A
Values-Beliefs Pattern
N/A
Ascariasis
ANATOMY:
Digestive System
Parts
Normal Physiology
Digestive System

The digestive system consists of the

digestive tract, a tube extending from the
mouth to the anus, and its associated
accessory organs—primarily glands located
outside the digestive tract that secrete fluids
into it. The digestive tract is also called the
alimentary tract, or alimentary canal.
Technically, the term gastrointestinal (GI)
tract refers only to the stomach and
intestines, but it is often used as a synonym
for digestive tract.
Regions of Digestive Tract
Oral cavity, or mouth, with the salivary
glands and tonsils as accessory organs
Pharynx, or throat
Esophagus
Stomach
Small intestine, consisting of the
duodenum, jejunum, and ileum, with the
liver, gallbladder, and pancreas as major
accessory organs
Large intestine, including the cecum,
colon, rectum, and anal canal
Anus
Major Functions
 Ingestion is the intake of solid or liquid food into
the stomach
 Mastication is the process by which the teeth chew
food in the mouth
 Propulsion is the movement of food from one end
of the digestive tract to the other
 Swallowing, or deglutition (moves liquids or
a soft mass of food and liquid, called a bolus),
from the oral cavity into the esophagus.
 Peristalsis propels material through most of
the digestive tract. Peristaltic waves are
muscular contractions
 Mass movements are contractions that move
material in some parts of the large intestine
Major Functions
 Mixing back and forth movement within the
digestive tract to mix it with digestive secretions
and help break it into smaller pieces
 Secretion food moves through the digestive tract,
secretions are added to lubricate, liquefy, buffer,
and digest the food
 Digestion is the breakdown of large organic
molecules into their component parts:
carbohydrates into monosaccharides, proteins into
amino acids, and triglycerides into fatty acids and
glycerol
 Absorption is the movement of molecules out of
the digestive tract and into the circulation or into
the lymphatic system
 Elimination is the process by which the waste
Ascariasis
PATHOPYSI
OLOGY
Pathopysiology
Pathopysiology
 Ascaris lumbricoides is the largest of the intestinal
nematodes affecting humans, measuring 15-35 cm
in length in adulthood.
 Infection begins with the ingestion of embryonated
(infective) eggs in feces-contaminated soil or
foodstuffs.
 Once ingested, eggs hatch, usually in the small
intestine, releasing small larvae that penetrate the
intestinal wall.
 Larvae migrate to the pulmonary vascular beds and
then to the alveoli via the portal veins usually 1-2
weeks after infection, during which time they may
cause pulmonary symptoms (e.g., cough,
wheezing).
Pathopysiology
 After migrating up the respiratory tract and being
swallowed, they mature, copulate, and lay eggs in
the intestines.
A fertile egg of Ascaris lumbricoides
 Adult worms may live in the gut for 6-24 months,
where they can cause partial or complete bowel
obstruction in large numbers, or they can migrate
into the appendix, hepatobiliary system, or
pancreatic ducts, and rarely other organs such as
kidneys or brain.
 From egg ingestion to new egg passage takes
approximately nine weeks, with an additional three
weeks needed for egg molting before they are
capable of infecting a new host.
Ascariasis
LABORATOR
Y
Fecalysis
Color: Brown
Ova of Parasites:Positive for Ascaris Lumbricoides ova

Urinalysis
Color: Yellow
Clarity: Clear
pH: 7.5
Special Gravity: 1.0004
Leukocyte: Negative
Pus Cell: 13.50
Red Cells: 2.40
Complete Blood Count
(CBC)
Hemoglobin: 78 g/L Low
Hematocrit: 0.26 L/L Low
RBC: 3.84 x 10ˆ 12/L Low
WBC: 8.56 x 10ˆ 9/L Low
Eosinophils: 0.15 High

Culture and Sensitivity

(Blood)
Result: No growth after 5 days of incubation
Ultrasonography
- Multiple tubular echogenic structures along the
course of the biliary and gallbladder consider
biliary ascariasis
- Minimal ascites
- Normal sonographic evaluation of the liver,
kidneys, urinary bladder, spleen and pancreas
Ascariasis
DRUG
STUDY
 Nystatin/ Triamcinolone
Route Mechanism Indication Contraindicat Adverse Nursing
and of Action ion Effect Responsibility
Dosage and
Classificatio
n of Drug
Oral Antifungal Indicated in the treatment Contraindicated in GI: transient When treating
of cutaneous or patients nausea, vomiting, infants, swab
Intestinal Binds to mucocutaneous mycotic hypersensitive to diarrhea. medication on oral
Candidiasis: ergosterol, a major infections caused by drug. Some nystatin   mucosa. Prescriber
Adults: component of the Candida albicans and other oral suspension GU: irritation, may instruct
500,000 – 1 fungal cell susceptible Candida preparations sensitization, immunosuppressed
million units membrane. When species. These preparations contain sugar and vulvovaginal patients to suck on
present in are not indicated for are unsuitable for burning (vaginal vaginal tablets
Amebic sufficient systemic, oral, intravaginal children with form). (100,000 units)
Liver concentrations, it or ophthalmic use. disaccharide   because this
Abscess: forms pores in the intolerance. SKIN: rash provides prolonged
Children: 30 membrane that   contact with oral
– 50 mg/kg leads to K+ mucosa.
daily in three leakage,
divided doses acidification and
 Nystatin/ Triamcinolone
Route and Mechanis Indication Contraindicat Adverse Nursing
Dosage m of ion Effect Responsibility
Action
and
Classifica
tion of
Drug
ORAL Antifungal Indicated in the treatment Contraindicated in GI: transient When treating
CANDIDIASIS of cutaneous or patients nausea, vomiting, infants, swab
(thrush) mucocutaneous mycotic hypersensitive to diarrhea. medication on oral
Adults and infections caused by drug. Some nystatin   mucosa. Prescriber
children: Candida albicans and other oral suspension GU: irritation, may instruct
400,000 to susceptible Candida preparations sensitization, immunosuppressed
600,000 units species. These preparations contain sugar and vulvovaginal patients to suck on
oral suspension are not indicated for are unsuitable for burning (vaginal vaginal tablets
q.i.d. or 200,000 systemic, oral, intravaginal children with form). (100,000 units)
to 400,000 units or ophthalmic use. disaccharide   because this
lozenges four to intolerance. SKIN: rash provides prolonged
five times daily   contact with oral
up to 14 days. mucosa.
 Metronidazole
Route Mechanism of Indication Contraindicat Adverse Nursing
Action and
and Classification of ion Effect Responsibility
Dosage Drug
Oral Antibiotic Susceptible anaerobic Contraindicated in CNS: fever, Monitor liver
infections, including patients vertigo, headache, functions test
Intestinal It inhibits nucleic intraabdominal, skin and hypersensitive to ataxia, dizziness, results carefully in
Amebiasis: acid synthesis by skin structures, drug or other syncope, confusion, elderly patients.
Children: 30 disrupting the gynecologic, bacterial nitroimidazole irritability,  
to 50 mg/kg DNA of microbial septicemia, bone and joint, derivatives and in depression, Give oral form with
daily in three cells. This CNS, lower respiratory patients in first weakness, meals.
divided doses function only tract, endocarditis. trimester of insomnia, seizures,  
for 10 days occurs when pregnancy. peripheral Observe patient for
metronidazole is neuropathy. edema.
partially reduced
and this reduction GI:
usually happens Abdominal
only in anaerobic cramping or pain,
bacteria and stomatitis,
protozoans. epigastric distress,
nausea and
vomiting, anorexia,
 Metronidazole
Route Mechanism of Indication Contraindicat Adverse Nursing
Action and
and Classification of ion Effect Responsibility
Dosage Drug
Oral Antibiotic Susceptible anaerobic Contraindicated in CNS: fever, Monitor liver
infections, including patients vertigo, headache, functions test
Intestinal It inhibits nucleic intraabdominal, skin and hypersensitive to ataxia, dizziness, results carefully in
Amebiasis: acid synthesis by skin structures, drug or other syncope, confusion, elderly patients.
Children: 30 disrupting the gynecologic, bacterial nitroimidazole irritability,  
to 50 mg/kg DNA of microbial septicemia, bone and joint, derivatives and in depression, Give oral form with
daily in three cells. This CNS, lower respiratory patients in first weakness, meals.
divided doses function only tract, endocarditis. trimester of insomnia, seizures,  
for 10 days occurs when pregnancy. peripheral Observe patient for
metronidazole is neuropathy. edema.
partially reduced
and this reduction GI:
usually happens Abdominal
only in anaerobic cramping or pain,
bacteria and stomatitis,
protozoans. epigastric distress,
nausea and
vomiting, anorexia,
 Piperacillin Sodium and
Tazobactam Sodium
Route Mechanism of Indication Contraindicat Adverse Nursing
Action and
and Classification of ion Effect Responsibility
Dosage Drug
Intravenous Tazobactam Moderate to severe infections Contraindicated in CNS: fever, Monitor patient’s
inhibits beta caused bt pipercillin-resistant, patients headache, sodium intake.
Adults: 3.375 lactamase and piperacillin/tazobactum- hypersensitive to dizziness,
susceptible, betalactamase-
g (3 g prevents the drug or other insomnia, agitation, Obtain specimen
producing strains of
piperacillin/0 destruction of microorganisms in appendicitis penicillin. dizziness, anxiety, for culture and
.375 g pipercillin. (complicated by rupture or   seizures sensitivity tests
tazobactam) Pipercillin kills abcess) and peritonitis cause bt Use cautiously in before giving first
q 6 hours as a bacteria by e.coli, b. Fragilis, b. Ovatus, b. patients with GI: nausea, dose. Therapy may
30-minute. inhibiting the Thetaiotaomicron, b. Vulgatus; bleeding diarrhea, vomiting, begin pending
Duration of synthesis of skin and skin-structure tendencies, uremia, constipation, results
treatment is bacterial walls. It infections by s. Aureus; hypokalemia and dyspepsia, stool
usually 7-10 binds postpartum endometritis or pid other drug allergies, changes, abdominal
caused by e.coli; moderately
days. preferentially to severe community-acquired
especially to pain.
specific-binding pnemonia caused by cephalosporins,
proteins located haemophilus influenzae because of possible
inside bacterial cross-sensitivity.
cell wall.
 Paracetamol
Route Mechanism of Indication Contraindicat Adverse Nursing
Action and
and Classification of ion Effect Responsibility
Dosage Drug
Oral It has a central Has good analgesic and Acute liver failure, Low fever with Check patient if
analgesic effect that antipyretic properties. It is liver problems, nausea, stomach taking any other
is mediated through suitable for the treatment of severe renal pain, and loss of medication
activation of
pains of all kinds. impairment and a appetite; dark urine, containing
descending
serotonergic condition where the clay colored stools; paracetamol.
pathways. There is body is unable to or jaundice.
no known exact maintain adequate Advise to avoid
mechanism however blood flow called drinking alcohol.
debate exists about shock.
primary site of
action: inhibition of
prostaglandin
synthesis or through
an active metabolite
influencing
cannabinoid
receptors.
Ascariasis
NURSING
CARE PLAN
 Risk for Dehydration
  Nursing Rationale to Goals and Nursing Intervention Rationale to Evaluation
Cues Diagnosis Nursing Objective Nursing
Diagnosis Intervention
Subjective: Risk for Continued Long Term -Independent- After 3 days of
“nag sige ra deficient Vomiting and Goal: Monitor Intake and implementation;
siyag sukag Fluid Volume Diarrhea : After 3 days Output  
the patient will
og kalibang related to Note number, Provide The nurse was
Fluid may shift maintain
” as diarrhea and adequate fluid character, and amount information about able to monitors
verbalize by vomiting. from the blood into of stool overall fluid the patient’s
volume, vital
the parent of the digestive tract. Estimate insensible balance, as well intake and
signs and
the patient. balance intake fluid loses guidelines for fluid output
If the loss is and output Observe for oliguria replacement. The patient’s
persistent  
Objective:     vital signs
Temp: 37.1 Short Term Assess Vital signs remain normal
Then intracellular Goal:
Pulse Rate: fluid may decrease
Temp. BP, Pulse rate, Hypotension, No signs of
Monitor Vital
120 signs Respiratory rate tachycardia, and dehydration
Respiratory Risk for deficient Assess for signs fever can indicate were seen
Rate: 40 Fluid Volume. of dehydration Assess for signs of response to fluid Patient
Monitor Intake dehydration loss. weighted
Source: and output. Dry skin and mucus Indicates excessive everyday
Pathophysiology   membranes fluid loss and
For the Health Decrease skin turgor resultant
Risk for Dehydration
  Nursing Rationale to Goals and Nursing Intervention Rationale to Evaluation
Cues Diagnosis Nursing Objective Nursing
Diagnosis Intervention
Weight Daily Indicator of overall
fluid and
nutritional status.
-Dependent- Used to correct
Administer drugs as fluids and
prescribed. electrolytes
imbalances
-Collaborative-
Administer
Intravenous Fluids
and Electrolytes, as
indicated.
 Pain
  Nursing Rationale to Goals and Nursing Intervention Rationale to Evaluation
Cues Diagnosis Nursing Objective Nursing
Diagnosis Intervention
Subjective: Impaired In heavy ascariasis Reduce pain Independent: Goals are met
“Nagsakit sense of infestation, a mass and Assess the extent and as evidenced
of worm can block
We must have a
og taman comfort: discomfort. characteristics of pain; by:
a portion of the detailed baseline so
ang iyahang pain related
to smooth intestine, causing     we not only know Pain was lost or
tiyan, unya severe abdominal  
how to treat
nasuka siya muscle spasm Pain will be  
diminished/
secondary to cramping and appropriately, but client feeling
nga naay vomiting. The
lost or  
migration of also to know if it comfortable.
wati”, as blockage can even diminished.
parasites in has changed.
verbalized perforate the
by the the stomach.
intestinal wall or
mother. appendix, causing Control pain by giving Patients who are in pain
internal bleeding or a warm compress on have trouble
appendicitis. the abdomen and participating in care,
Objective: repositioning.
relaxing, sleeping, and
healing. Do what is
TPR: 37.1C necessary to proactively
treat the patient’s pain,
RR: 40cpm and notify the MD as
PR: 120bpm appropriate of changes
or an inability to provide
Risk for Dehydration
  Nursing Rationale to Goals and Nursing Intervention Rationale to Evaluation
Cues Diagnosis Nursing Objective Nursing
Diagnosis Intervention
Ensure adequate Patients with
hydration. abdominal pain
may have a
diminished
appetite, be NPO,
or not want to
drink fluids.
Record intake and
output. Patients with
abdominal pain
may not be taking
in appropriate
fluids or foods, or
their urinary and/or
bowel output may
be lacking.
Accurate I&O is
essential for
appropriate clinical
Risk for Dehydration
  Nursing Rationale to Goals and Nursing Intervention Rationale to Evaluation
Cues Diagnosis Nursing Objective Nursing
Diagnosis Intervention
Dependent:

Administer analgesics Analgesics helps to

as ordered. relieve the patient
from any forms of
pain.

Collaborative:

Give intravenous Assess and

fluid. promote
appropriate fluid
balance, which
may requirire
notifying the
provider of a
decreased oral
intake and need for
intravenous fluids
 Deficient Knowledge
  Nursing Rationale to Goals and Nursing Intervention Rationale to Evaluation
Cues Diagnosis Nursing Objective Nursing
Diagnosis Intervention
Subjective: Deficient Limited health Long Term Independent: Long Term
“Wa mi knowledge literacy skills are Goal: Provide and review Goal Achieved:
often greater
Provides
kahibalo kung regarding the information regarding
among certain knowledge base
ngano disease etiology of bleeding, After one week
treatment and groups: older from which client of nursing
nagsakit siya After one relationship of
process adults, people with can make informed intervention
ug asa niya week of lifestyle behaviors,
nakuha ine related to limited education, choices and they verbalized,
poor people,
nursing and ways to reduce
nga sakit” as lack of decisions about the mode of
minority intervention risk and contributing
verbalized by interest in future and control transmission, its
population, and the mother factors. Encourage
her mother learning as questions. of health problems. route and the
people with limited and child will
“among balay characterized prevention of
English be able to
duol sa salog by incorrect proficiency.
the disease.
performance verbalize, the
unya pag
mode of Give information with
mukosog ang the use of media. Use Different people
transmission,
ulan mo taas visual aids like take in information
ang tubig” its route and diagrams, pictures,
the prevention in different ways
added by her videotapes,
mother of the disease. audiotapes.
Deficient Knowledge
  Nursing Rationale to Goals and Nursing Intervention Rationale to Evaluation
Cues Diagnosis Nursing Objective Nursing
Diagnosis Intervention
Clients with low Short Term Help patient identify Learning occurs Short Term
literacy skills have Goal: community resources through imitation, Goal Achieved:
less information for continuing so persons who are
about health information and After 2 days of
currently involved
promotion and/or After 2 days support. nursing
management of a in lifestyle changes
of nursing can help the intervention
disease process for they understood
themselves and
intervention learner anticipate
the mother how the
their families adjustment issues. diseases exist.
because they are and the child Community
unable to read the will be able to resources can offer
educational understand financial and
materials. As a how the educational
result, they have diseases exist.
higher rates of
support.
hospitalization than
people with
adequate health
literacy.
Ascariasis

PROGNOSIS
Diseases Ascariasis can
cause:

 There are a number of complications that

may occur with untreated ascariasis.
Following is a list of these complications:
 Bowel obstruction (intestinal blockage)
 Pancreatitis (inflammation of the pancreas)
 Cholecystitis (inflammation of the
gallbladder)
 Peritonitis (inflammation of the abdominal
cavity lining)
Diseases Ascariasis can
cause:
 Intussusception (an intestinal condition in which part of the
intestine is pulled into itself, creating an obstruction)
 Volvulus (abnormal twisting of the intestine)
 Peritoneal granulomas (scar tissue lining the abdomen)
 Hepatic (liver) abscesses
 Pneumonitis (inflammation of the lungs)
 Death
 Organs other than the intestinal tract and lungs may be
occasionally involved; some patients may have allergic reactions
that may become severe. About 11,000 deaths occur each year
worldwide due to intestinal obstructions caused by ascariasis, with
the majority of patients being children.
Prognosis
 The prognosis of ascariasis for appropriately diagnosed and treated
ascariasis is very good. However, the prognosis begins to decline
if the patient develops a high number of worms in the body (worm
burden). This worm burden can lead to more serious complications
such as intestinal obstruction and worsens the prognosis of this
disease. A female worm may reach a length of 14 inches (35cm).

 An interesting additional effect of ascariasis may be increased

fertility in women who have the infection. Researchers in Bolivia
suggest that the worm alters the immune system for its own
protection that results also in allowing females to become pregnant
easier. The mechanism of this enhanced fertility is unknown, but
researchers suggest it could lead to development of fertility-
enhancing drugs.
Thank
you!
Prepared by:

SABULAO, Cedrick James

CABUEÑAS, Roy
REBATO, Kyla Veronica
PICSON, Noreen Joy
BALBUENA, Abigail
REASOL, Roshel Mae
OPALLA, Rhea Diana
DE LEON, Danielle Elaine
ROA, Andrea Rosario