Drugs Stuy(2)

8/14/2019 Drugs Stuy(2)

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8/14/2019 Drugs Stuy(2)


8/14/2019 Drugs Stuy(2)


D. History of Past Illnesses

She remembers having vaccines as a kid but she doesn't know what it is. She received tetanus toxoid in her pregnancy but can¶t remember how she have received the vaccine. She also had chicken pox and mumps when still a kid. She frequently has colds and cough. She also have hypertens

currently taking medications to lower blood pressure.

Obstetric History:

Name: CPLAge: 29 years old

Menarche: 3nd

yr high schoolTPAL: G3P3 (3003)

Last Menstrual Period: 2nd

week of March 2009Age of Gestation: 38 weeks

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E. Family Health Illness History

MP-85

+

FP -88

+

FP-60 MP- 58 FP- 56

MP+

- 53

MP-51

FL-81

+ RL + -

71

RL-54

+ S

RL-53

BL-47 YL-41

CL-33

CL ()-29

CL-30 CL-27

CL ()«client+«««.dead

«««... high bloodS«««

. stroke

«««. heart attack«««male

««.. female

BL-51 RL-45 TL-40

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The client¶s age is 29 years old. She has three siblings. Her father died at 51 years old because of stroke. Her mother is still alive

experiencing high blood pressure. Her father has seven siblings, four of them also experiencing high blood pressure. Her mother has fou

The second sibling died because of heart attack. And the elder brother is experiencing high blood pressure. The client¶s grandparents of

already died because of old age except for her grandmother on her mother side who is also experiencing high blood pressure.

F. Functional Health Pattern

Functional Health Pattern Prior to Hospitalization During Hospitalization

Health Management

Pattern

She does self medication when she has fever, cough &colds. She also uses herbal medicines like sambong,

oregano and lagundi.

She didn't take a bath in the hospital.

Nutritional Metabolic

PatternBreakfast Lunch Dinner

3 pandesal w/

mayonnaise, 1glass juice

- ginisang

monggo, 2 cuprice, 2 glasses

of water

adobong baboy,

1 cup rice, 2glasses of water

3 pandesal with pancit canton1cup coffee

1 glass water

ginataanglangka, 1 cuprice, 2 baso

tubig

menudo, 2 cuprice, 2 glassesof water

pandesal andcoffee

1 fried tilapia,1cup rice, 2

glasses of water

greenvegetables,

bangus fillet, 1cup rice 2

Breakfast Lunch Dinner

- - -NPO (admission)

-1 cup sotanghonflavored noodles

-2 glasses of water

-1 cup rice-1 pritong isda

-2glasses of water

-1 cup rice-1 cup sinigng nab

boy withkangkong

-2glasses of water

-1 nissin cup

noodles bulalo-2 glasses of

water

- 1cup rice

- 1platitongmenudo

-2 glasses water

-discharged

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glasses of water

Elimination Pattern

Characteristics Stool Urine

Frequency 1x a day 4x a day

Consistency formed Clear

Odor Foul No odor

Color brownish Orange

yellow

Discomfort None None

Characteristics Stool Urine

Frequency 1st

2nd

3rd

0 0 1

1st

2nd

3rd

0 4 2

Consistency formed Clear

Odor foul No odor

Color brownish Orange yellow

Discomfort None N

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Activity/ Exercise Pattern ADL:

Feeding-0Bed mobility-0General mobility-0

Bathing-0Dressing-0

Toileting-0Grooming-0

1st day 2nd Day 3rd Day

ADL:

Feeding-0Bed mobility-

0General

mobility-0

Bathing-0Dressing-0Toileting-0

Grooming-0

ADL:


0General

mobility-2


Grooming-0

ADL:


0General

mobility-0


Grooming-0

Sleep/ Rest Pattern

Our patient has a sleeping pattern of 9 pm to 6 am , with

9 hours of sleep. Whenever she wants to take rest, shewatches tv and sometimes chat with her neighbors and

takes a nap in the afternoon, usually 1 hour.

She had irregular sleep pattern because she finds it hard to

sleep in the hospital. She usually sleeps at 10 pm and wakes at6 am.

Cognitive PerceptualPattern

She's thinking of having eyeglasses because at times she

finds it hard to read newspapers because her eyes become blurred. She told us that she got teary-eyed when

expose too long to TV.

Still the same.

Self Perception/ Self Concept Pattern

She thinks herself as healthy because she has no vicesand eats all kinds of vegetables.

She feels tired/ stressed out after the delivery. She told us thateven though she already had two kids before she still feels

uneasy carrying them and cleaning their cord. She felt like shewas hurting them every time she wipes the cotton in their

umbilical cord.

Role Relationship Pattern She have a good relationship with her community. Her friends and neighbors visit her whenever they have their

free time. With her partner, they are both happy and havean open communication. Her husband accompany her

She have more time with her baby. Her friends and neighborsin their community visit her and the baby.

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during her discharged with her mother-in- law.

Sexuality ReproductivePattern

She and her partner stopped engaging themselves in

sexual act, 4 month of her pregnancy because of theenlargement of her abdomen. G3P2(2002)

She thinks of having family planning, due to difficult

pregnancy and delivery. Also, because it is already their thirdchild given that she have hypertension. G3P3(3003)

Coping Stress ToleranceShe usually solves her family problems by talking withthe family member. She seeks console from her friends

and elder family members for advice and opinions for

some matters and also asks some affirmation from her husband.

She thinks that with her mother-in-law and husband with her,she can live a happy life and can pass any obstacle, especially

now that she already have three kis.

Values Belief Pattern

She believes in "hilot", the people who heals bone

sprains. She also believes in myths about pregnancy, likeit is not healthy for a pregnant to stay long outside the

house at night. She believes in µbalis¶. She also usesherbal medicines such as oregano, sambong at bayabas.

She doesn¶t take a bath yet because of lack of facilities in the

hospital but is willing to. She believes in ³balis´ and ³hilot´.

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DRUG STUDY

Generic Name Route/ Dosage/

Frequency

Indications/

Purposes

Contrainications Sideffects Adverse Reactions Nursing Respons

Mefenamic

Acid

Route: Oral

Dosage: 500mg,i tab

Frequency:TID

This medication

relieves pain andreduces

inflammation. It isused to treat

headaches,menstrual cramps,

muscle aches,dental pain and

athletic injuries.

y liver or kidney

diseasey blood disorders

y ulcersy heart disease

y

alcohol usey high blood

pressurey eye disease

y allergies(especially drug

allergies)

y Stomach

upsety Nausea

y loss of appetite

y

dizzinessy drowsiness

y diarrheay headache

y yellowing of the eyes

y fever with or without chills

y visionchanges

y black stools

y persistentstomach/

abdominal pain

y

vomit thatlooks like

coffeegrounds

y allergicreactions:

(symptoms)rash, itching,

swelling,severe

dizziness,trouble

breathing

Instruct client to:

y Take withmilk to mi

stomach uy Most effec

relieving m pain if tak

earliest sigy Take this m

with 6 to 8(180-240m

water.y Do not lie

at least 30after takin

drug.y This shoul

taken for m7 days at a

y Report imif any sign

symptomsallergic re

occur.

Ferrous sulfate Route: OralDosage: 250mg,

i tabFrequency:OD

It is used to treatiron deficiency

anemia (a lack of red blood cells

y iron overloadsyndrome

y hemolyticanemia (a lack

y constipation;y upset

stomach;y black or dark-

y signs of anallergic

reaction:hives;

Instruct client to:y Take ferro

on an empstomach, a

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caused by having

too little iron in the

body).

of red blood

cells)

y porphyria (agenetic enzymedisorder that

causessymptoms

affecting theskin or nervous

system)

y thalassemia (agenetic disorder of red blood

cells)y if you are an

alcoholicy if you receive

regular blood

transfusions

colored

stools; or

y temporarystaining of theteeth.

difficulty

breathing;

swelling of your face,lips, tongue,

or throat.

hour befor

hours after

Avoid takiantacids oantibiotics

hours befotaking ferr

sulfate.y Take this m

with a full

water.y Do not cru

break, or o

extended-rtablet or c

Swallow twhole.

y Shake the

suspensionwell just b

measure ay Use this m

exactly as on the labe

prescribeddoctor. Do

in larger afor longer

recommeny Avoid tak

medicationhour befor

hours after

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fish, meat

whole gra

"fortified"cereals.

y Report im

if any signsymptoms

allergic reoccur.

Metronidazole Route: OralDosage: 500mg,

i tabFrequency:TID

It is an antibioticthat is used to treat

a variety of infections.

y liver problemsy seizure

disordersy any allergies

y should not beused during the

first 3 months

of pregnancyand used withcaution during

the last 6months

y It is excretedinto breast milk

and using itwhile breast-

feeding is notrecommended.

y Dizzinessy headache

y diarrheay Nausea

y stomach painy change in

taste sensationy dry mouth

y Seizuresy loss of

consciousness

y tingling of hands or feet

y unsteadinessy mood/mental

changesy rash

y Itchingy sore throat

y Fever y severe

stomach painy vomiting

y vaginalirritation.

Instruct client to;y It should b

with food glass of w

milk to prestomach u

y Antibiotic

best whenamount ofin your bo

at a constaDo this by

medicationspaced int

throughouand night.

to take thimedication

full prescramount is

even if symdisappear

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days.

y Avoid alco

beveragesy Report im

if any sign

symptomsallergic re

occur.

Cefuroxime Route: Oral

Dosage: 500mg,

i tabFrequency:BID

It is used to treat

many kinds of

bacterialinfections,including severe or

life-threateningforms.

y allergic to any

drugs

(especially penicillin)

y liver or kidney

diseasey diabetes

y heart failure,cancer

y a stomach or

intestinaldisorder

y malnourishment

y pregnanty breastfeeding

mothers

y nausea,

vomiting,

diarrhea,stomach pain;

y headache,

dizziness;y fussiness or

crying (inchildren);

y sleep

problems(insomnia); or

y vaginal

itching or discharge.

y diarrhea that

is watery or

bloody;y fever, sore

throat, and

headachewith a severe

blistering, peeling, and

red skin rash;y seizure

(black-out or convulsions);

or y jaundice

(yellowing of the eyes or

skin).

Instruct client to:

y Take this m

exactly as prescribed

y Take cefur

tablets witwithout m

y Use this mfor the ent

of time pre

by your doy Report im

if any sign

symptomsallergic re

occur.

Captopril Route: Oral

Dosage: 25mg, itab

Frequency:BID

It is used to treat

high blood pressure

(hypertension),congestive heart

failure, kidney

y Do not use this

medicationwithout telling

your doctor if you are

pregnant or

y cough;

y loss of tastesensation, loss

of appetite;y dizziness,

drowsiness,

y feeling light-

headed,fainting;

y urinatingmore or less

than usual, or

Instruct client to:

y Take this mexactly as

prescribedy Take each

a full glass

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problems caused

by diabetes, and to

improve survivalafter a heart attack.

planning a

pregnancy.y

kidney disease(or if you are ondialysis)

y liver diseasey heart disease or

congestive heartfailure

y diabetes;

y a connectivetissue diseasesuch as Marfan

syndrome,Sjogren's

syndrome,lupus,

scleroderma, or

rheumatoidarthritis.

headache;

y sleep

problems(insomnia);

y dry mouth,

sores in themouth or on

the lips;y nausea,

diarrhea,

constipation;or

y mild skin

itching or rash.

y

not at all;

y fever, chills,

body aches,flusymptoms;

y pale skin,easy bruising

or bleeding;y fast,

pounding, or

unevenheartbeats;

y chest pain; or

y swelling,rapid weight

gain.

y It is usuall

hour befor

Follow yoinstruction

y Your bloo

should be on a regul

know theeffectiven

drug.

y Avoid drinalcohol.

y Do not use

substitutes potassium

supplementaking cap

unless you

has told yoy Report im

if any signsymptoms

allergic reoccur.

Aldazide Route: Oral

Dosage: 25mg, itab

Frequency:BIDx 3days

postpartum

Essential

hypertension,oedema and ascites

of congestive heartfailure, cirrhosis of

the liver, thenephrotic

syndrome,idiopathic oedema.

y cute renal

insufficiencyy significant renal

compromisey Addison¶s

diseasey significant

hypercalcaemia,hyperkalaemia

y Gynaecomasti

a may developin association

with the useof

ALDAZIDE.Development

of gynaecomasti

y Gastro-

intestinaldisorders

y Skin andappendages:

rash, pruritis,dermatitis

y Nervoussystem

Instruct client to:

y Taken witmilk to pr

upset.y Taken earl

day so incurination w

distub sleey Arrange to

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y hypersensitivity

to

spironolactone,thiazidediuretics or to

other sulfonamide-

derivedmedicines

y Safety in

pregnancy hasnot beenestablished

y Lactation.

a is related to

both dose and

duration of therapy.Gynaecomasti

a is usuallyreversible

whenALDAZIDE

is

discontinuedy breast

enlargement

may persist.

disorders:

dizziness,

headache, paraesthesia.

y Psychiatric

disorders:impotence.

y Neoplasm: breast

neoplasm,

y Metabolicandnutritional

disorders:electrolyte

disturbances. y Haematologi

cal disorders:

thrombocyto penia.

y Other adverse

reactionsreported with

the use of ALDAZIDE

include pancreatitis

andcholestatic

jaundice.

serum, ele

hydration

function dterm thera

y Weigh you

regula basif there is

weight gaireport it to

physician

immediatey Report im

if any sign

symptomsallergic re

occur.

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HEALTH TEACHING

Goals and

Objectives

Learning Content Methodology Venue/ Time/ Date Resources Evalu

Goal:y To teach the

mother inmanaging

breast

engorgement

pain due tonot

breastfeedin

g relate totaking

captopril.

*

Objectives:y To relieve

mothers breast pain.

y To promote

mother an baby

bonding

even if the

baby is not breastfeedin

g.

Contents:y Explanations why the mother cannot continue

breastfeeding.

- captopril is a drug that lowers the blood

pressure. This drug can be passed through

breastmilk and is harmful if ingested by the baby.

y Suctioning of the mothers breasty Bottle feeding techniques

-choose an appropriate nipple size for your

child, use milk formulas according to doctorsadvice or something that fills up the baby¶snutritional needs. Also, remember to sterilized

the baby¶s things before an after using them by boiling it for 5mins.- Put a bib on your baby and have a cloth ready

to clean any spit-up milk or formula. Now,cradle your baby with his head a bit higher thanthe rest of his body. Hold the bottle; don't prop

it up by itself. This can help prevent choking,

extra gas, tooth decay, and provide bondingtime. It¶ll also help you better judge when he's

finished eating. If your baby slows his eating,try burping after every 2 oz.

y Burp method- Your baby needs a burp during or after

feeding and this is how you do it:Hold her on your lap or rest her on your shoulder. Gently pat or rub baby's back. You

can also lay baby tummy-down on your lap,

y Discussion andteaching why theclient cannot

breastfeed.

y Teaching and

demonstration of proper breastsuctioning,

effective bottlefeeding and burp

method.

Venue: OB-wardTime:2:00pm

Date: January 16, 2010

Manpower Bottle

Goal

The cto dem

prope breas

technsuctio

breasof her

The c

able twhy s

contin breas

answequest

correc

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supporting her head, while you pat her back.Your baby may spit up some milk, so have acloth on your shoulder or lap. If she doesn't

burp after a few minutes but seems comfortable,

don't worry. Not every baby burps after every

feeding.

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Drugs Stuy(2)