MEDICATION

DRUG

DOSAGE

CLASSIFICATION

MECHANISM OF ACTION -Inhibits of activity of acid (proton) pump and binds to hydrogenpotassium adenosine triphosphatase at secretory surface of gastric parietal cell to block formation of acid.

INDICATION

CONTRAINDICATION

ADVERSE REACTION to -diarrhea -abdominal pain -N/V -constipation

NURSING CONSIDERATIONS -Tell pt.to swallow tablets or capsule whole not open, crush or chew on them. -Take 30 mins.before meal

Omeprazole

40g TSIV OD

G.I.T Ulcer

drugs/

Anti-

-GERD -Erosive esophagitis -Duodenal ulcer.

-Patient hypersensitive drug and its component.

-Patient with metabolic alkalosis and hypocalcemia.

Mupirocin Ointment

On affected arm. TID

Topical drugs/ Local Anti-Inffective

-Unknown -Inhbits bacterial CHON and RNA synthesis.

-Traumatic skin lesion.

-Patient hypersensitive to drug and its component. -Use cautiously in patient the burns or large open wound, impaired renal failure.

-headache -rhinitis, or stinging when use.

-Cautious patient not to use other products. -Notify physician if the condition doesnt improve or worse in 3-5 days.

Chloramphenicol

1 tab q6

Anti-Infective/ Miscellaneous Infective drug

Anti-

-Inhibits bacterial protein synthesis by binding to the 50S subunit of the ribosome, bacteriostatic.

-Meningitis -Bacteremia -Gram-negative organism.

- Patient hypersensitive to drug. - Patient with impaired hepatic or renal function. -Acute intermittent polyuria.

-headache -mild depression -confusion -delirium -peripheral neuropathy with prolonged therapy. -aplastic leukemia. -jaundice

-Obtain specimen for C/S test before giving first dose. -Obtain drug level of measurement and maintain level at 5 to mcg/ml. -Monitor CBC, iron level and platelet 2 days during therapy. Stop drug and notify prescriber immediately if anemia, leucopenia. -Monitor pt. for S/SX of superinfection.

DRUG

DOSAGE

CLASSIFICATION

MECHANISM OF ACTION

INDICATION

CONTRAINDICATION

ADVERSE REACTION

NURSING CONSIDERATIONS -Dont stop abruptly, because it may worsen seizure. -First withdrawal symptoms occur within 8-12 hrs. and includes anxiety, muscle twitching, tremors of hands and fingers, progressive weakness, dizziness, visual distortion, N/V. -Convulsions and delirium may occur within 16hrs. and last up to 5 days after abruptly stopping the drug.

Phenobarbital

60g q12

CNS drugs Anticonvulsant

-Unknown -As barbiturate, probably depress CNS and increase seizure threshold. As sedative, may interfere with transmission of impulses from thalamus to cortex of the brain.

-Anticonvulsant -Febrile seizure -Sedation

-Patients hypersensitive to barbiturates and those with history of manifest or latent porphyria. -Patients with hepatic or renal dysfunction, respiratory disease with dsypnea or obstruction and nephritis.

-drowsiness -lethargy -paradoxical excitement in elderly patient. -changes in EEG pattern. -bradycardia. -Steven-Johnson syndrome.

Ceftriaxone

1g TSIV q12 (-) ANST

Anti-infective/ Cephalosporins

-Third generation cephalosporin that inhibits cell wall synthesis, promoting osmotic instability; usually bacteriacidal.

-Bacteremia -Septicemia -skin and skin structure infection.

- Patients hypersensitive to drug and other cephalosporin.

-fever -transient neutopenia, Thrombocytopenia -dyspnea.

-Obtain C/S test before giving first dose. -Monitor symptoms of infection.

Paracetamol

Q6 for T- >37.8 C

CNS drugs/ Non Opioid analgesics and antipyretics.

-Unknown -produce analgesia by blocking pain impulses by inhibiting synthesis of prostaglandin in the CNS or other substances that sensitize pain .

-Mild fever.

pain

or

- Patients hypersensitive to drug.

-neutropenia -hypoglycemia

-Advise that the drug is only for short term use -Do not exceed five doses in 24 hours.

Intravenous Fluid D5NM (Dextrose 5% in Normosol M Solution)

Type of Solution Hypertonic

Mechanism of Action When administered intravenously, Normosol-M and 5% Dextrose Injection provides water and electrolytes (with dextrose as a readily available source of carbohydrate) for maintenance of daily fluid and electrolyte requirements, plus minimal carbohydrate calories. The electrolyte composition approaches that of the principal ions of normal plasma (extracellular fluid).

Indication D5NM is indicated for parenteral maintenance of routine daily fluid and electrolyte requirements with minimal carbohydrate calories from dextrose.

Contraindication Hypersensitivity to any of the components.

Nursing Responsibilities Do not administer unless solution is clear and container is undamaged. Caution must be exercised in the administration of parenteral fluids, especially those containing sodium ions to patients receiving corticosteroids or corticotrophin. Solution containing acetate should be used with caution as excess administration may result in metabolic alkalosis. Discard unused portion. Properly label the IV Fluid Observe aseptic technique when changing IV fluid

D5LR (5 5 Dextrose in Lactated Ringers)

Hypertonic

Administration of this fluidincreases thesoluteconcentrationof plasma,allowingwater out thecell and intothe extracellular compartmentto restoreosmoticequilibrium,t he cell willshrink

For replacementof fluids andelectrolytesto promoterehydrationstatus topatient hasfree water,salt andcalories

Hypersensitivity to any of the components. - Contraindicated to patientswho havecongestiveheart failure(CHF),pulmonarye dema, urinaryobstruction,steroid therapyand diabeticcoma

Do not administer unless solution is clear and container is undamaged. Caution must be exercised in the administration of parenteral fluids, especially those containing sodium ions to patients receiving corticosteroids or corticotrophin. Solution containing acetate should be used with caution as excess administration may result in metabolic alkalosis.

Discard unused portion. Properly label the IV Fluid Observe aseptic technique when changing IV fluid

PLR (Plain Lactaed Ringers)

Isotonic

Rehydration from the water in a Lactated Ringer's solution is vital, as the total weight of the body is about 70 percent water.

Lactated Ringer's is given intravenously to a patient to replace fluids and electrolytes lost from illness or injury. The concentration of electrolytes and water is designed to mimic the composition of the blood plasma. This solution may be prescribed along with a sugar solution (typically dextrose) to provide a source of calories. Lactated Ringer's may also be used in conjunction with a variety of intravenous medications in order to dilute the medication.

Hypersensitivity to any of the components.

Do not administer unless solution is clear and container is undamaged. Caution must be exercised in the administration of parenteral fluids, especially those containing sodium ions to patients receiving corticosteroids or corticotrophin. Solution containing acetate should be used with caution as excess administration may result in metabolic alkalosis. Discard unused portion. Properly label the IV Fluid Observe aseptic technique when changing IV fluid

DISCHARGE PLAN MEDICATION S AT HOME -Acyclovir (Zovirax) -- treats encephalitis caused by HSV, VZV, and EBV EXERCISE TREATMENT HEALTH TEACHNG Wash hands frequently and thoroughly with soap and water, particularly after using the restroom and before and after meals. Don't share tableware and beverages. OUT PATIENT FOLLOW-UP Call the Doctor if you have: DIET SEXUAL ACTIVITY -Use a latex condom for sexual intercourse -Limit your number of sexual partners

-The need for movement and exercise: if there is weakness of the training exercise, -Ganciclovir positive motion. (Cytovene) -Efforts joint treats encephalitis movement: if caused by there is muscle cytomegalovirus atrophy in and HSV1 malnourished patient then do -Anticonvulsant passive medications -exercises prevent and treat according ROM seizures that may happen with Source: encephalitis http://garest.net/ nursing-care-Vitamin C, 500 - plan-for1,000 mg one to encephalitis-atthree times daily, children.html as an antioxidant and to boost the - Avoid immune system. activities where having a seizure. -Probiotic supplement (containing

-a neuropsycholo gist a specialist in brain injury and cognitive rehabilitation -an occupational therapist they can identify problem areas in a person's everyday life and help work out practical solutions a physiotherapi st a therapist who uses physical methods, such as massage, manipulation and exercise

-Seizures more often, or when they have been controlled for a long period

-Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).

-Side effects from medications

Teach to practice good hygiene and to avoid sharing utensils at home

-Unusual behavior that was not present before

Source: http://www.mayo clinic.com/health/

-Weakness, problems with seeing, or balance problems that are new

-Be aware that nonoxynol-9, the -Avoid refined foods, chemical such as white breads, spermicide used in pastas, and especially gel and foam sugar. contraceptive products and some -Eat fewer red meats lubricated and more lean meats, condoms, does not cold-water fish, tofu protect against any (soy, if no allergy), sexually or beans for protein. transmitted Use healthy oils in diseases foods, such as olive oil or vegetable oil. Source: -Avoid caffeine, http://umm.edu/hea alcohol, and tobacco. lth/medical/reports/ Drink 6 - 8 glasses of articles/herpesfiltered water daily. simplex -Omega-3 fatty acids, such as fish oil, one to three times daily, to help

Lactobacillus acidophilus), 5 10 billion CFUs (colony forming units) a day, for digestive and immune system health. If you are taking antibiotics, taking probiotics as well may help you avoid some side effects such as diarrhea. People with autoimmune diseases, such as rheumatoid arthritis or psoriasis, should ask their doctor before taking probiotics.

There should always be a lifeguard or buddy present when go swimming.

- a speech and language therapist they use specialist techniques to improve all aspects of communication http://www.nhs.u k/Conditions/Enc ephalitis/Pages/C omplications.aspx

encephalitis/DS0 -Sudden fever 0226/DSECTION -Other symptoms =prevention of encephalitis -Comfort measures to reduce headache include dimming the lights, limiting noise and visitors. -Seizures and altered LOC require care directed at injury prevention and safety. -Describes strategies to avoid infection (eg, avoid touching lesions during an outbreak)

Source: http://www.nlm. nih.gov/medline plus/ency/patien tinstructions/000 128.htm

Source: http://www.nlm.ni h.gov/medlineplus /ency/patientinstru ctions/000128.htm

decrease inflammation and boost the immune system. Fish oil may increase the risk of bleeding, especially if you take bloodthinners such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin. Source: http://umm.edu/healt h/medical/altmed/con dition/viralencephalitis

Source: http://umm.edu/h ealth/medical/alt med/condition/vir al-encephalitis -Antibiotics -- if the infection is caused by certain bacteria

-Supportive care, as well as antiviral therapy with a drug such as acyclovir. Other treatments may be used to lower fever, provide hydration, treat seizures if they develop, and reduce any pressure in the skull.

Source: Medical Surgical in Nursing (Brunner and Suddarth) 12th edition Volume 2

-Anti-seizure medications (such as phenytoin) -to prevent seizures -Sedatives -- to treat irritability or restlessness -Acetaminophen - for fever and headache Source: http://www.nlm.n ih.gov/medlinepl us/ency/article/00 1415.htm

Source:http://ww w.webmd.com/ato-zguides/understand ing-encephalitistreatment