Age- For Submission

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URDANETA CITY, PANGASINANCOLLEGE OF NURSING

Submit ted by :

MALLAR, ADRIAN GBSN 3/GROUP 4

Submit ted to:

Mrs.Emy Lyn Unson

Clinical Instructor



PATIENT ASSESSMENT DATA BASE

A. GENERAL DATA

Patient’s Name: L.F

Address: San Nicolas, Pangasinan Age: 35 Sex: Male Birth Date: January 1, 1978 Rank in the family: Father Nationality: Filipino Civil Status: Married Date of Admission: August 5, 2013 @ 12:30 pm Order of admission: TPR every shift, BRAT, CBC, Creatinine, Urinalysis, Fecalysis, BUN, PNSS 1L for 6 hours, , Paracetamol

500mg 1 tab every 4 hours PRN, Cefuroxime 750mg SIVP every 8 hours, Hyosine NBB IVP every 8 hours Attending Physician: Dr. Campus

B.

CHIEF COMPLAINT

With the chief complaint of diarrhea.

C. HISTORY OF PRESENT ILLNESS

Prior to admission, the patient experienced 3 days of diarrhea watery for 3 times ,and abdominal pain with no consultationdone.

D. PAST HEALTH HISTORY/STATUS

1. Childhood Illness: He experienced fever, diarrhea2. Immunization: he completed all his immunizations.3. Major Illnesses: None4. Current Medication: the patient is taking paracetamol 500 mg OD5. Allergies: The patient has no allergies on medications, foods and beverages he is taking.



E. FAMILY ASSESSMENT

Name Relation Age Sex Occupation Educational

Background

A.F Wife 34 F Housewife High schoolUndergraduate

C.F Child 11 F N/A Student

D.F Child 8 m N/A Student

F. SYSTEMS REVIEW – Gordon’s 11 Functional Health Patterns Assessment

HEALTH PERCEPTION – HEALTH MANAGEMENT PATTERN

Mr. L.F. perceived health as “ kapag malayo ako sa sakit.. malayo kame sa gastusin pang ospital” and Mr.LFactively cooperates on medications and treatment being prescribed.

NUTRITIONAL – METABOLIC PATTERN

The thoughts of food can trigger the patient’s appetite. According to Mr. L.F his usual food; he eats 3 times a day

with 2 cups of rice and 1 viand per meal. His usual daily menu is meat, pork and chicken, she drinks 6 – 8 glasses of water per day. He also drinks coffee every morning

ELIMINATION PATTERN

According to Mr.. L.F. he usually defecates 2 times a day, the color of her stool is golden brown, normal odor of stool and formed stool. Mr. L.F. is not using any laxative. he is usually urinates 3 – 4 times a day, the color of his urine isyellow with a transparency of turbid color and it is aromatic.



ACTIVITY – EXERCISE PATTERN

Self – care ability

0 – Feeding 0 – Dressing 0 – GroomingI – Bathing I – Toileting II – Cooking

0 – Bed mobility III – Home maintenance I – Others

Legend:

0 – Full careI – Requires use of equipmentII – Requires assistance or supervision from othersIII – Requires assistance or supervision from another, and equipment and a deviceIV – Dependent; doesn’t participate

COGNITIVE – PERCEPTUAL PATTERN

Upon whispering, the patient can hear the words that are being whispered. According to him he is not using anyhearing aids. The patient’s vision is normal and he can read the words appropriately. Upon applying slight pressure on thehands of the patient, he is responds actively. he can also differentiate two different odors such as perfume and smell of food. In order for the patient to learn, he read magazines and by the use of media.



SLEEP – REST PATTERN

According to Mr. E.M., before sleeping, he watches television programs, and he does not have any alteration inhis sleeping pattern. Usually, Mr. E.M. sleeps at 9 pm to 6 am and he takes afternoon nap about 2 hours. According tohim, he doesn’t exper ience any alterations during his hour sleep; he is not using any sleeping aids.

SELF – PERCEPTION AND SELF – CONCEPT PATTERN

Mr. E.M. says that he is weak and has a limitation in food and movement. According to him, he was proudbecause he knew that having a wife and children was happy, he is responsible father, kind, caring, and loving. he saysthat her strengths and weakness is her family.

ROLE RELATIONSHIP PATTERN

According to Mr. E.M., he establishes a harmonious relationship towards his family and significant others.

SEXUALITY

–

REPRODUCTIVE PATTERN

According to Mr. L.F, they were sexually active before he got sick..

COPING – STRESS TOLERANCE PATTERN

Mr. E.M. perceived stress and problem in life as “ mahirap lalo na kung na e-stress ako dahil sa kalagayan kongayon, lalo naman masakit saka looban ang magkasakit tapos nagkakaproblema ang pamilya ko para lang maghanapng pang gastos sa pang araw araw napangangailangan lalo n angayon may saki tako at wala man lang maitulong kundiangmagpagaling para maging maayos na ang lahat, pero kapag may problema ako tinatawag ko lang ang mga kaibiganko”

VALUE – BELIEF PATTERN

According to Mr. L.F., he regularly attends Sunday mass for him to have good health, to continue to give themblessings from the lord especially his two childrens. he believes in is a roman catholic



G. HEREDO – FAMILIAL ILLNESS

PATERNAL MATERNAL

GRANDFATHER GRANDMOTHER

HYPERTENSION DIABETES MELLITUS

PATIENT L.F

AGE

H. PHYSICAL ASSESSMENT

A. General Survey1. Overall appearance and grooming: Upon assessment, the patient appears untidy and not groomed.2. Actual height and weight vs. ideal body weight: Normal3. Symptoms of distress: The patient has no symptoms of distress.4. Posture and gait: On his condition, he can’t stand and walk independently.

5. Affect and mood: Upon assessment, LF is showing unhappy mood. 6. Vital signs of the day of physical examination

Blood pressure: 90/60 mmhgTemperature: 37.9°C Respiratory rate: 35 breaths per minuteCardiac rate: 84 bpm



B. Regional exam- utilize IPPA technique Hair, head and face

Has normal skull. (normocephalic)

Smooth contour

No nodules or masses

Smooth and uniform consistent Palpebral fissures equal in size and asymmetric facial movement

Hair is evenly distributed, slightly thin, silky and no presence of lice and infestation

Eyes Eyebrows are evenly distributed, intact, symmetrically aligned and equal movement

Eyelashes are equally distributed and curled slightly outward

Eyelids are intact, no discharge and discoloration, close symmetrically

Bulbar conjunctiva is transparent

Capillaries sometimes evident

Palpebral conjunctiva is shiny, smooth and pink in color

No tenderness and masses over lacrimal gland and also on nasolacrimal duct Cornea is transparent, shiny, and smooth

Nose External is symmetric and straight, no discharge and flaring and uniform in color, no tenderness and lesions

Mucosa pink, clear watery discharge, no lesions

Nasal septum intact and in midline

Ears Auricles are same as color of the face, mobile firm, no tender

Pinna recoil after it is folded

Mouth and throat The lips were dry due to dehydration. The throat was functioning well. No dentures. (+) tartar. There is a black

discoloration in the enamel. (+) breath odor.

Neck and lymph nodes Neck muscles equal in size

Head centered

Head moves coordinated, smooth movement with no discomfort

Not palpable enlarged lymph over the entire neck



Nails Fingernail plate shape convex curvature, smooth texture, highly vascular and pink

Intact epidermis

Thorax and lungs

Chest symmetrically aligned Spinal column is straight, right and left shoulders and hips are at the same height

Posterior thorax uniform in color

Skin intact

Chest wall intact, no tenderness, and masses

Mild retraction and crackles present

Cardiovascular Peripheral pulses are on symmetric pulse volume

Limbs no tender

Breast and axilla Skin uniform in color

Skin intact

Round areola and bilaterally the same

Nipples everted and equal in size

No tenderness, masses and nodule

Abdomen The skin of the abdomen is unblemished and uniform in color. Symmetric abdominal contour flattened and rounded.

Audible bowel sounds. Symmetric movements cause by respiration. No tenderness noted.

Extremities Muscle equal in size on both sides of the body

Muscles and tendons have no contractures

Firm muscles while at rest

No deformities, tenderness nodules on joint

Muscles equal in strength on both body size



Genitals Not performed

Rectum and anus Not Performed

I. PERSONAL / SOCIAL HISTORY

Habits / Vices

o Caffeine : the patient drinks 2 cups of coffee a dayo Smoking : the patient is smoking and consume 10 sticks a dayo Alcohol : the patient occasionally drinks alcohol, beer 2 to 3 bottleso Tea : the patient doesn’t drink tea o

Drugs : none

Lifestyle

The patient’s lifestyle is to work in the farm in the morning and goes home in the afternoon

Social Affiliation

The patient hang out with his friends and occasionally to have drinking session

Rank in the Family

Father

Educational Attainment

College Level



J. ENVIRONMENTAL HISTORY

The patient is living with his wife and children Their house is along the street, bungalow and made up of cement. They have vegetable

garden where sometimes they get their food. Health center is 2 km away from their house.

K. INTRODUCTION

Gastroenteritis is a catchall term for infection or irritation of the digestive tract, particularly the stomach and intestine. It is frequently

referred to as the stomach or intestinal flu, although the influenza virus is not associated with this illness. Major symptoms include nausea and

vomiting, diarrhea, and abdominal cramps. These symptoms are sometimes also accompanied by fever and overall weakness. Gastroenteritis

typically lasts about three days. Adults usually recover without problem, but children, the elderly, and anyone with an underlying disease are more

vulnerable to complications such as dehydration.

The majority of cases in children globally are caused by rotavirus, while in adults norovirus is more common, at least in the United States.

Less common causes include bacteria or their toxins, and parasites. Transmission may occur due to improperly prepared foods, contaminated

water or close contact with those who are infectious.

Children infected with rotavirus usually make a full recovery after a few days. Dehydration is a common complication of diarrhea and a

child with mild or moderate dehydration may have a prolonged capillary refill, poor skin turgor and abnormal breathing. In areas with poor

sanitation repeat infections may lead to malnutrition stunted growth and delayed development.

http://medical-dictionary.thefreedictionary.com/Influenza

http://medical-dictionary.thefreedictionary.com/Nausea+and+Vomiting


http://medical-dictionary.thefreedictionary.com/Fever

http://medical-dictionary.thefreedictionary.com/Dehydration

http://en.wikipedia.org/wiki/Rotavirus

http://en.wikipedia.org/wiki/Norovirus

http://en.wikipedia.org/wiki/Dehydration

http://en.wikipedia.org/wiki/Diarrhea

http://en.wikipedia.org/wiki/Capillary_refill

http://en.wikipedia.org/wiki/Skin_turgor

http://en.wikipedia.org/wiki/Malnutrition

http://en.wikipedia.org/wiki/Developmental_disability

http://en.wikipedia.org/wiki/Developmental_disability

http://en.wikipedia.org/wiki/Malnutrition

http://en.wikipedia.org/wiki/Skin_turgor

http://en.wikipedia.org/wiki/Capillary_refill

http://en.wikipedia.org/wiki/Diarrhea

http://en.wikipedia.org/wiki/Dehydration

http://en.wikipedia.org/wiki/Norovirus

http://en.wikipedia.org/wiki/Rotavirus

http://medical-dictionary.thefreedictionary.com/Dehydration

http://medical-dictionary.thefreedictionary.com/Fever



http://medical-dictionary.thefreedictionary.com/Influenza



L. ANATOMY AND PHYSIOLOGY



The human digestive system is a complex series of organs and glands that processes food. In order to use the food we eat, our body has to break

the food down into smaller molecules that it can process; it also has to excrete waste.

Most of the digestive organs (like the stomach and intestines) are tube-like and contain the food as it makes its way through the body. Thedigestive system is essentially a long, twisting tube that runs from the mouth to the anus, plus a few other organs (like the liver and pancreas) thatproduce or store digestive chemicals.

The Digestive Process:The start of the process - the mouth: The digestive process begins in the mouth. Food is partly broken down by the process of chewing and bythe chemical action of salivary enzymes (these enzymes are produced by the salivary glands and break down starches into smaller molecules).

On the way to the stomach: the esophagus - After being chewed and swallowed, the food enters the esophagus. The esophagus is a long tubethat runs from the mouth to the stomach. It uses rhythmic, wave-like muscle movements (called peristalsis) to force food from the throat into thestomach. This muscle movement gives us the ability to eat or drink even when we're upside-down.

In the stomach - The stomach is a large, sack-like organ that churns the food and bathes it in a very strong acid (gastric acid). Food in thestomach that is partly digested and mixed with stomach acids is called chyme.

In the small intestine - After being in the stomach, food enters the duodenum, the first part of the small intestine. It then enters the jejunum andthen the ileum (the final part of the small intestine). In the small intestine, bile (produced in the liver and stored in the gall bladder), pancreaticenzymes, and other digestive enzymes produced by the inner wall of the small intestine help in the breakdown of food.

In the large intestine - After passing through the small intestine, food passes into the large intestine. In the large intestine, some of the water andelectrolytes (chemicals like sodium) are removed from the food. Many microbes (bacteria like Bacteroides, Lactobacillus acidophilus, Escherichia

coli , and Klebsiella) in the large intestine help in the digestion process. The first part of the large intestine is called the cecum (the appendix isconnected to the cecum). Food then travels upward in the ascending colon. The food travels across the abdomen in the transverse colon, goes

back down the other side of the body in the descending colon, and then through the sigmoid colon.

The end of the process - Solid waste is then stored in the rectum until it is excreted via the anus.

Digestive System Glossary:alimentary canal - the passage through which food passes, including the mouth, esophagus, stomach, intestines, and anus.Anus - the opening at the end of the digestive system from which feces (waste) exits the body.Appendix - a small sac located on the cecum.Ascending colon - the part of the large intestine that run upwards; it is located after the cecum.Bile - a digestive chemical that is produced in the liver, stored in the gall bladder, and secreted into the small intestine.



cecum - the first part of the large intestine; the appendix is connected to the cecum.chyme - food in the stomach that is partly digested and mixed with stomach acids. Chyme goes on to the small intestine for further digestion.Descending colon - the part of the large intestine that run downwards after the transverse colon and before the sigmoid colon.Digestive system - (also called the gastrointestinal tract or GI tract) the system of the body that processes food and gets rid of waste.Duodenum - the first part of the small intestine; it is C-shaped and runs from the stomach to the jejunum.Epiglottis - the flap at the back of the tongue that keeps chewed food from going down the windpipe to the lungs. When you swallow, theepiglottis automatically closes. When you breathe, the epiglottis opens so that air can go in and out of the windpipe.Esophagus - the long tube between the mouth and the stomach. It uses rhythmic muscle movements (called peristalsis) to force food from thethroat into the stomach.Gall bladder - a small, sac-like organ located by the duodenum. It stores and releases bile (a digestive chemical which is produced in the liver)into the small intestine.Gastrointestinal tract - (also called the GI tract or digestive system) the system of the body that processes food and gets rid of waste.Ileum - the last part of the small intestine before the large intestine begins.Intestines - the part of the alimentary canal located between the stomach and the anus.Jejunum - the long, coiled mid-section of the small intestine; it is between the duodenum and the ileum.Liver - a large organ located above and in front of the stomach. It filters toxins from the blood, and makes bile (which breaks down fats) and someblood proteins.Mouth - the first part of the digestive system, where food enters the body. Chewing and salivary enzymes in the mouth are the beginning of thedigestive process (breaking down the food).Pancreas - an enzyme-producing gland located below the stomach and above the intestines. Enzymes from the pancreas help in the digestion of carbohydrates, fats and proteins in the small intestine.Peristalsis - rhythmic muscle movements that force food in the esophagus from the throat into the stomach. Peristalsis is involuntary - you cannotcontrol it. It is also what allows you to eat and drink while upside-down.Rectum - the lower part of the large intestine, where feces are stored before they are excreted.Salivary glands - glands located in the mouth that produce saliva. Saliva contains enzymes that break down carbohydrates (starch) into smaller molecules.sigmoid colon - the part of the large intestine between the descending colon and the rectum.stomach - a sack-like, muscular organ that is attached to the esophagus. Both chemical and mechanical digestion takes place in the stomach.When food enters the stomach, it is churned in a bath of acids and enzymes.transverse colon - the part of the large intestine that runs horizontally across the abdomen.

http://www.enchantedlearning.com/subjects/anatomy/lungs/label/

http://www.enchantedlearning.com/subjects/anatomy/lungs/label/



infllamatition of the intestinal tract

irritation of the intestine

ingestion of bacteria

s i g n a n d

s y m p t o m s

diarrhea, nausea and vomiting, and abdominalpain and cramps.

M. . Pathophysiology

•



N. . LABORATORY

Type of Examination: COMPLETE BLOOD COUNT

RESULTS NORMAL VALUES SIGNIFICANCE

Hemoglobin

Hematocrit

WBC

RBC

Lymphocytes

Monocytes

Neutrophils

128

0.38

13.2

5.23

0.53

0.11

0.36

136-175 g/L

0.39-0.52

4.5-10x10g/L

4.5-5.0

.21-0.40

0.00-0.07

0.36-0.66

May indicate erythrocytosis.

My indicate polycythemia.

Increased valus may suggestinfection.

Decreased values may suggestanemia

May indicate immune defiency.

May indicate viral infection.



FECALYSIS

Results Analysis

Physical properties:

Color Light brown Normal

Consistency Watery d/t profuse secretion of

water and electrolytes

Remarks:

No oral intestinal parasite seen



TYPE OF EXAMINATION: URINALYSIS

RESULTS NORMAL VALUES SIGNIFICANCE

COLOR: Yellow

APPEARANCE: CloudypH: 5.0

Specific gravity: 1.026

PROTEIN: +2

GLUCOSE: Negative

Pale yellow

Clear4.6 to 8.0

1.003 to 1.030

0

0

-color is influence by urine concentration and

ingredients.-Bacteria, excessive crystals, or cells cause cloudiness.

-Urine becomes alkaline(pH more than 7) with urinary

tract infection or severe alkalosis.

-Specific gravity is elevated in dehydration as kidney

try to conserve fluid, and decreased in over hydration

as they try to rid the body of fluid.

-Due to inflammation, protein molecules pass into

urine.

-Glucose in urine occurs most frequently as a symptom

of diabetes mellitus.



O. Drug Study

Generic Name:Paracetamol

Brand Name:Biogesic

Drug Classification: Analgesic/ Anti pyreticsDosage:500mg; 1 tab q4°

Indication:For fever

Mechanism of Action Contraindication Adverse Effects Side Effects Nursing Consideration

Paracetamol reducesthe synthesis of prostaglandin whichare responsible for themediation of pain andfever

Contraindicated tohypersensitivity toparacetamol

o Methemoglobin

emia

o Hemolytic

Anemia

o Neutropeniao Thrombocytope

nia

o Pancytopenia

o Urticaria

o Hypoglycemic

coma

o Jaundice

o Nausea& Vomiting

o Minimal GI upset

Report Nausea andVomiting these aresigns of toxicity

Take with food or milkto minimize GI upset

Report pain thatpersists for more than3 – 5 day



Generic Name:CefuroximeBrand Name:KefoxDrug Classification:Cephalosporin second – generationDosage:750mg SIVP q8° ANST ( - )Indication: for bone and joint infections

Mechanism of Action Contraindication Adverse Effects Side Effects Nursing Consideration

Bactericidal: Inhibitssynthesis of bacterialcell wall, causing celldeath.

Contraindicated withallergy tocephalosporin or penicillin

o Erythema

multiforme

o Epidermal

necrolysis

o Nephrotoxicity

o Pseudomembr anous colitis

o Nausea & Vomiting

o Diarrhea

Report Nausea andVomiting these aresigns of toxicity

Tell to client thatdiarrhea is normalbecause it is theresponse tomedication used totreat bacterialinfection.

Avoid alcohol whiletaking this drug andfor 3 days after because severereactions may occur.



P. . List of Identify Problems According to Priority

Acute pain related irritation of the bowel wall. Hyperthermia related to disease process

Fluid volume deficient related to active fluid loss.



ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

S> “Masakit yung

tiyan ko.” Pain scale of 8/10

O> with guarding

behavior

>grimace noted

>irritable at times

>easy fatigability

>Abdominal Pain

>Weak in

appearance

>Limited range of

motion

>Reduced

interaction with

people

>sleep disturbances

Acute pain

relatedirritation of

the bowel

wall.

Within 30

mins – 1 hour of rendering proper

nursing

interventions the

patient will be

able to report

pain is relieved /

controlled by the

pain scale of 8/10

to 4/10.

Perform comprehensive

assessment of pain scale,include location, quality,

severity and duration.

Note the client’s locus of

control.

Observe non-verbal cues

seen by the patient.

Ascertain client’s knowledge

of and expectations about

pain management.

Review client’s previous

experiences with pain and

methods found eitherhelpful or unhelpful for pain

control in the past.

Work with client to prevent

pain. Instruct the client to

report as soon as it begins.

To assess etiology/

precipitatingcontributory factors.

Individuals with external

locus of control may take

a little or no

responsibility for pain

management.

Observations may or

may not be congruent

with verbal reports

indicating need for

further evaluation.

To evaluate client’s

response to pain.

To know what proper

implementations to berendered to the client.

Timely interventions are

more likely to be

successful in alleviating

After 30 mins

– 1 hour of rendering proper

nursing

interventions the

patient will be

able to report

pain is relieved /

controlled by the

pain scale of 8/10

to 4/10.



Provide a quiet

environment, calm activities

to the patient.

Provide comfort measures.

Encourage diversional

activities

Instruct the client the use of

relaxation exercises such as

deep breathing.

Instruct client to avoid foods

such as milk and chocolate.

Indentify way of minimizing

the pain such as; firm

mattress, good body

mechanism.

Administer analgesics to

maintain acceptable level of

pain if not contraindicated

and as prescribed.

Monitor effectiveness of

pain medications

pain.

To promote relaxation.

To provide non-

pharmacologic pain

management.

To alleviate attention

and comfort to relief

pain

Deep breathing exercises

may reduce painsensation.

Milk and chocolate

increases gastric motility.

Helps relieve pain.

To decrease pain.

To promote timely

intervention/ revision of

plan of care




Subjective:

“mainit ang pakiramdam ko” asverbalized by the patient.

Objective:

o Warm to touch

o Nausea o Headache o Vital signs

Temp.: 37.9°c PR: 84

RR: 35bpm BP: 90/60

Hyperthermiarelated to diseaseprocess

After 1 – 2 hoursof nursingintervention, thepatient’stemperaturewilldecreased from37.9°c to 37.3°cand maintain thenormal bodytemperature

Assess theonset of fever

Observation of vital signs (temperature,blood pressure,pulse andrespiration )

Instruct thepatient to drinkplenty of water

Give tepidsponge bath

Advice not towear a thickblanket and

To identifypattern fever patient

Vital signs is areference todetermine thepatient’s generalcondition

Increased bodytemperatureresulting inincreasedevaporation of the body so itneeds to bebalance with alot of fluid intake

Withvasodilation can

increaseevaporationwhich acceleratethe decline inbodytemperature

Thin clothinghelps reduce theevaporation of

After 1 – 2 hours of nursingintervention, thepatient’stemperature wasdecreased from37.9°c to 37.3°cand maintain thenormal bodytemperature



clothing

Give intravenousfluid therapy andmedicationsaccording tophysiciansprogram.

the body

Infusion of fluidis very importantfor patients withhightemperature




S> “Tubig yung taeko.”

O> elimination of

watery stool at 3-5

times a day

>dry lips

>dry skin

>pale and weak in

appearance

>skin turgor of 3-4

seconds>Vomiting

>abdominal

cramping

>nausea

>fatigue

>dry mucous

membrane

Diagnosis:Fluid volume

deficient

related to

active fluid

loss

Within 3-4hours of

rendering proper

nursing

interventions the

client will be

able to replace

fluid volume

loss.

Note possible diagnosis thatmay create a fluid volume

deficient

Monitor Input & Output

Assess skin turgor regularly

Note physical signs of

dehydration.

Note client’s preferences

regarding fluids and foods with

high fluid content.

Maintain adequate

hydration and increase fluid

intake

Keep fluid within the client’s

reach and encourage frequent

intake as appropriate.

Instruct client to have oral

care.

To assess causative/precipitating factors

To ensure accurate fluid

status

To evaluate degree of

fluid deficit

To evaluate degree of

dehydration.

To know what food to be

given by the preference of

the client.

To prevent dehydration

& maintain hydration status

For proper fluid

replacement.

To prevent injury to the

mucosal lining and to

prevent from dryness

After 3-4hours of

rendering proper

nursing

interventions the

client will be

able to replace

fluid volume

loss.



Administer medications as

prescribed by the physician.

Administer Intravenousfluids as prescribed

Restrict solid food intake, as

indicated

Discuss factors related to

occurrence of dehydration.

Recommend restriction of caffeine as indicated

Don’t allow patient to sit or

stand up quickly as long as

circulation is

compromise.

For pharmacological

management.

Young individuals are

quickly affected by fluid

volume deficit

To allow for bowel rest

and to reduced intestinal

workload

To have knowledge

about the disease and know

the prevention.

Caffeine has diuretic. Toprevent more fluid loss.

To avoid orthostatic

hypotension and possible

syncope.



VII. ONGOING APPRAISAL

The patient shows progressive recovery and is responding well to both medical and nursing intervention. Comfort measuresgiven.

VIII. DISCHARGE PLAN

Medication

Instruct the patient to continue the medications if the doctors order

Exercise

Encourage the patient to have exercise daily

Diet

Advice patient to increase fluid intake

Advice the client for BRAT diet Encouraged the patient to eat foods rich in vitamins and minerals

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Age- For Submission