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Hypertension is one of the most common complex disorders.

It is a chronic medical
condition in which the BP is elevated. Accelerated hypertension is associated with
headache, somnolence, confusion, visual disturbances and nausea and vomiting.
Essential hypertension is the form of hypertension that by definition has no identifiable
cause, but there are many ris factors such as sedentary lifestyle, obesity, alcohol
intae, salt !sodium" sensitivity, and vitamin # deficiency. It also related to aging and
some inherited genetic mutations.
#iabetes $ellitus type % also called non&insulin&dependent #$ is a disorder that is
characteri'ed by high blood glucose in the context of insulin resistance and relative
insulin deficiency. (hile it is often initially managed by increasing exercise and dietary
modification. Early symptoms may be nothing more than chronic fatigue, generali'ed
weaness, and malaise !feeling of unease", excessive urine productive, excessive thrist
and increase fluid intae, blurred vision, unexplained weight loss, itching of external
genetalia and excessive bowel movement.
)raditionally considered a disease of adults, type % diabetes is increasingly
diagnosed in children in parallel to rising obesity rates due to alterations in dietary
patterns as well as in life styles during childhood.
OBJECTIVES
*ur general ob+ective is to determine diseases that are applicable in our $edical&
,urgical -ursing concept.
*ur specific ob+ectives are. to provide care to the patient/ to enhance patient0s ability
to participate in daily activities/ to decrease his suffering from the illnesses/ to enhance
patient0s health status/ also, to enhance my ability for patient care, to gain nowledge
and enhance sills, and to fulfill my re1uirement in -2$345%4%.
SCOPE AND LIMITATIONS
)his care study is limited only to metabolic and endocrine concept/ it is also limited
to client who have illnesses that is applicable in the concept/ it is limited to patient in the
medical ward only/ the care is only limited for 6 days.
Patients Profile
Name: Patient 78
Date of Birth: $ay 59, %454
Age: 35 years old
Sex: $ale
Ciil Stat!s: $arried
"eight: 3 ft. and 6 inches
#eight: :4 gs.
Mother: $rs. 7
O$$!%ation: Houseeeper
&ather: $r. 8
O$$!%ation: ;etired employee
A''ress: #abatian ,t., 2armen 2agayan de *ro 2ity
(eligion: ;oman 2atholic
Allergies: -o nown allergies
Date A'mitte': <anuary =5, %454
Time A'mitte': 45.34 pm
A'mitting Diagnosis: Hypertension, anemia with pulmonary congestion
Atten'ing Ph)si$ian: #r. Hinampas
According to the patient it is a heredo&familial disease. His father also suffered from
hypertension and his mother also from a chronic heart disease.
According to patient he rarely drins alcohol. It is only when there is family gathering
and friend invitation.
"ealth "istor)
)he patient has a history of smoing, and alcohol intae. >ast year he also admitted
due to increase blood pressure. He was in a regular chec&up of his blood pressure and
sugar level at ?erman clinic.
Chief Com%laints an' "istor) of Present Illness
Body weaness and pallor = days prior to admission. Body weaness with craving of
food, with fever and cough for @ wees. Presence of bipedal edema.
According to Eri Erison, during this age also called maturity stage which he ccalled
this stage as Ego integrity vs. #espair. In this stage he said that a person accepts
responsibility for one0s self and life. In this case patient 78 shows some signs of despair
due to inability to do some self&activity and prolonged hospitali'ation. According also to Eric
#igest, he categori'ed this age group as older adult. According to him at this group
retirement in each career is the most common but after retirement they are engaged to a
new career in their life. *thers remain in the wor force, either voluntarily or because they
do not have sufficient resources to allow them to retire. Patient 78 wants to continue his +ob
as a private employee but because of his illness he is unable to wor that much and that
maes him have a decision to voluntarily retire, but he added that if given a chance and if
his health restored he will want to bac to wor to fulfill his duty.
5&=5&54
)P; 1 6 hour& to monitor vital signs to prevent complications.
>ow salt, low fat diet& diet is one factor that can mae the condition more
severe.
>ab !2B2"& to determine the presence of anemia.
Arinalysis& to determine presence of protein in urine to determine for the
presence of diabetes mellitus.
2hest 7&ray& for visuali'ation of the heart to determine for the presence of
atrophy.
E2? 5% leads& to determine abnormal activity or contractility of the heart.
BB,& to determine level of blood sugar.
#3( at %4 gttsCmin.& to maintain proper hydration.
#rugs. ,pironolactone 5 tab tid, etosteril 5 tab tid, furosemide 64 mg,
duavent 5 neb every 6 hours.
%&55&54
Berrous sulfate 5 cap. Bid
Bactroban apply to area Bid
*+ra)+ there is minimal accumulation of fluid in both scrotums. Both testicles are normal in
si'e with no masses noted. Impression. hydrocele, bilateral.
Altrasound DAB& both idneys are within normal in si'e and appear hyperechogenic. -o
lithiasis nor pelvocaliectasis noted. Arinary bladder is distensible. Impression/
pyelonephritis.
2hest PA& fibroha'ed density in the right infraclavicular area. Patchy ha'iness in the right
lung base. Heart is enlarged transversely. )rachea is in midline obliteral. ;ight
costrophrenic angle. Impression. P)B, right with undetermined activity basal pneu. ;ight
minimal plural/ effusion. ;ight cardiomegaly >E form.
Anatom) of Pan$reas
)he pancreas is located in the upper abdomen, has endocrine and exocrine
functions.
)he islets of >angerhans, the endocrine part of the pancreas, are collections of cells
embedded in the pancreatic tissue. )hey are composed of alpha, beta, and delta
cells.the hormone that produced by the beta cells is called insulin/ the alpha cells
secrete glucagons and the delta cells secrete somatostatin.
I-,A>I-& A ma+or action of insulin is to lower blood glucose by permitting entry of
glucose into the cells of the liver, muscle and other tissues, where it is either stored as
glycogen or used for energy. Insulin also promotes the storage of fat in adipose tissue
and the synthesis of proteins in various body tissues. In the absence of insulin, glucose
cannot enter the cells and is excreted in the urine. High levels of glucose in the blood
can diagnose this condition, called diabetes mellitus.
?>A2A?*-& the effect of glucagon is chiefly to raise the blood glucose by converting
glycogen to glucose in the liver.
PAT"OP",SIOLO-,
Pre'is%osing fa$tor: genetic, age !63 above", gender !male"
Pre$i%itating fa$tor: lifestyle !smoing", diet !excess fat, salt and sugar in diet"
-ame. Patient 78 #ate. Bebruary 56, %454
Eital ,igns. Pulse. 544 BP$ ;;. =4 2P$ )emp. =F.:G2 Height. 306H (eight.:4 gs.
EE-).
I7J impaired vision I J blind
I J pain I J reddened I J drainage
I J gums I7J hard of hearing I J deaf
I J burning I J edema I J lesion I J teeth
Assess eyes, ears, nose, throat
Bor abnormality IJ no problem
;E,PI;A)*;8
I J asymmetric IxJ tachypnea
I J apnea I J rales IxJ cough I J barrel chest
I J bradypnea I J shallow I J rhonchi
IJ sputum I J diminished I7J dyspnea
I J orthopenea I J labored IJ whee'ing
I J pain I J cyanotic
Assess resp.rate, rhythm, depth, pattern
Breath sounds, comfort I J no problem
2A;#I*EA,2A>A;
I J arrhythmia I7J tachycardia I J numbness
I7J diminished pulses I7J edema I J fatigue
I J irregular I J bradycardia I J murmur
I J tingling I J absent pulses I J pain
Assess heart sounds, rate, rhythm, pulse, bp,
circulation, fluid retention, comfort IJ no problem
?A,);* I-)E,)I-A> );A2)
I J pain I J urine color I J vaginal bleeding
I J hematuria I J discharge I J noctoria
Assess urine fre1., control, color, odor, comfort C
?yn&bleeding, discharge IxJ no problem
-EA;*
I J paralysis I J stuporous I J unsteady I J sei'ures
I J lethartic I J comatose I J vertigo I J tremors
I J confused I J vision I J grip
Assess motor function, sensation, >*2, strength,
?rip, gait, coordination, orientation, speech Ix J no problem
$A,2A>*,DE>E)A> and ,DI-
I J appliance I J stiffness I J itching I J petechiae
I J hot I J drainage I J prosthesis I J swelling
I J lesion I J poor turgor I7J cool I J deformity
I J wound I J rash I J sin color I J flushed
I J atrophy I J pain I J eccymosis
I J diaphoretic I J moist
Assess mobility, motion, galt, alignment, +oint functionC
,in color, texture, turgor, integrity IJ no problem
2hest pain
!occasional"
Blurred vision
Hard of hearing
Scrotal swelling
danruff
BP 180/90
Edema (+2
Edema (+2
N!rsing Assessment II
,AB<E2)IEE *B<E2)IEE
Comm!ni$ation:
I7J hearing loss I7J visual changes
IJ denied
2omments. dili na kaayo ko kadungog ug
kakita
I7J glasses I J language
I J contact lens I J hearing aide
; >
Pupil si'e . = mm
;eaction. ;eactive to light and
accomodation
I J speech difficulties
Ox)genation:
I7J dyspnea
I7J smoing history
IxJ cough IJ sputum
I J denied
2omments. Klisod iginhawa labi na kung
musakit akong dughan
;espiratory IxJ regular IJ irregular
#escribe.fast, shallow breathing
;. no abnormal breathing sounds notedC
> . heared
Cir$!lation:
I7J chest pain I J leg pain
I J numbness of extremities
IJ denied
2omments. sige sakit akong dughan
Heart ;hythm IJ regular I7Jirregular
Anle Edema. presence of edema !L%"
Pulse 2ar. ;ad. #P. Bem.M
; L L N
> L LNNNNNNNNNNNN
2omments. Pulse in the specified area is
palpable but diminished in the lower
extremeties.
N!trition: lo. salt/ lo. fat/ lo. s!gar 'iet
2haracter
IxJ recent change in weight, appetite
I J swallowing difficulty IJ denied
2omments: nagniwang jud ko,lahi ra tong
niagi as verbalized by the patient
I7J dentures IJ none

Bull Partial (ith Patient
Apper I J I7J I J
>ower I J I7J I J
Elimination:
Asual bowel pattern Arinary fre1uency
0x a 'a) 10x a 'a)
constipation remedy I J urgency
-*-E I J dysuria
#ate of last B$ I J hematuria
Bebruary %, %454 I J incontinence
#iarrhea character I7J polyuria
-ot applicable I J foley in place
IJ denied
Bowel sounds. -ormal bowel sounds
Abdominal #istention
Present I J yes IxJ no
ArineM !color, consistency, odor"
Mif they are in place
2omments. Patient don0t have foley bag
catheter .
Management of "ealth an' Illness:
I7J alcohol IJ denied
!amount, fre1uency" occasional
Briefly describe the patient0s ability to follow
treatments !diet, meds, etc." for chronic
2omments. -ot applicable
I J ,BE >ast Pap ,mear. -ot applicable
>$P. -ot applicable
health problems !if present".
Patient is continuously taing his medication
at the right time and was to consumed small
amount of his meal.
NURSING CARE PLAN
-ame of Patient. Patient 78
2AE, -ursing
#iagnosis
*b+ectives Interventions ;ationale Evaluation
,ub+ective.
Kmaglisod o ug
ginhawa
usahayH as
verbali'ed by
the patient.
*b+ective.
Odyspnea
Otachypnea with
rr of =4 cpm
Odecreased Hgb
54.= gmCdl
Opulmonary
congestion
Impaired gas
exchange related
to altered oxygen&
carrying capacity
of blood.
At the end of
the shift patient
will be able to
demonstrate
improve
ventilation and
ade1uate
oxygenation.
O;emonitor respiratory
rate, depth and effort.
Oposition client in high
fowlers position
OEncourage and assist
in deep breathing
exercise
Oturn patient fre1uently
Oadminister oxygen as
ordered
Oalveolar hypoventilation
and associated
hypoxemia lead to
respiratory failure
Oto promote lung
expansion
Oimproving lung
ventilation
Oreduce and prevent lung
obstruction associated
with accumulation of
mucus
Oprevents hypoxemia and
pulmonary hypertension
After the dependent
and independent
nursing careC
intervention goal
met.
,AB<E2)IEE *B<E2)IEE
S2in Integrit):
IxJ dry IJ itching I J other IJ denied
2omments.murag uga akong paminaw sa
akong pamanit
IxJ dry I7J cold I7J pale I J flushed
IJ warm I J cyanotic
Mrashes,ulcers, decubitus !describe si'e,
location, drainage" none
A$tiit)3 Safet):
I J convulsion I J di''iness
I J limited motion of +oints
>imitation inability to.
I7J ambulate I J bathe self
I J other I J denied
2omments. Kdili kaayo ko makalakaw o
makalihok kung walay mualalay
>*2 and orientation.
Patient is highly conscious and oriented to
time and place.
?ait. I J waler I J cane I7J other
I Jsensory and motor losses in face or
extremities
I J;*$ limitations. patient is unable to do
some degree of mobility.
Comfort3 Slee%3 A.a2e
I7J pain !location, fre1uency, remedies"
I J nocturia
I J sleep difficulties IJ denied
2omments:usahay di ko makatulog ug
mamayo tungod sa sakit akong dughan ug
sige ihi-ihit
.
I7J facial grimaces
IJ guarding
IJ other signs of pain. facial grimaces
IJ siderail release form signed ! F4 L years "
-*-E
Co%ing:
*ccupation. none
$embers of household. = members
$ost supportive person. the wife and
daughter
*bserved non& verbal behavior. wea,
)he person and his phone number that can
be reached any time. none
Special Patient Information
NNNNN:4 gs NN#aily weight NNNNNNNNNP)C*)NNNNNNNNN
NNNN180110NNBP 1 shift NNNNNNNNNIrradiation
NNNnoneNNNNN-euro vCs NNnormalNArine testNNNNNNNNN
NNnoneNNNNN2EPC,?. ;eading NNNNNNNNN%6 hr. urine collection
#ate
ordered
#iagnosticC
laboratory exams
#ate done
#ate
ordered
I.E BluidsC blood #ate #isc.
5&=5&54 2B2 %&6&54 5&=5&54 #3w
5&=5&54 Arinalysis 5&=&54 %&%&54 P-,, 5 >
5&=5&54 E2? P BB, %&6&54
5&=5&54 2hest x&ray 5&=5&54
NURSING CARE PLAN
-ame of Patient. Patient 78
2AE, -ursing
#iagnosis
*b+ectives Interventions ;ationale Evaluation
,ub+ective.
*b+ective.
Oincreased heart
rate
Oincreased
blood pressure
Odiminished
peripheral
pulses
Ocool sin
Oedema in the
lower extremities
Ochest pain
#ecreased cardiac
output related to
altered myocardial
contractility
At the end of 5
wee patient
will be able to
participate in
activity that
reduce cardiac
worload.
O;eauscultate apical
pulses
O monitor urine output
Oencourage rest
Oprovide bedside
commode
Oelevate legs, avoiding
pressure under nee
Otachycardia is usually
present to compensate for
decrease ventricular
contractility
Oidney respond to
reduce cardiac output by
retaining water and
sodium
Oto improve efficiency of
cardiac contraction
Odecrease wor of getting
to bathroom
Odecrease venous stasis
After the dependent
nursing careC
intervention goal
met. Patient was
able to tolerate light
activities such as
combing his hair.
NURSING CARE PLAN
-ame of Patient. Patient 78
2AE, -ursing
#iagnosis
*b+ectives Interventions ;ationale Evaluation
,ub+ective.
Ksige o ug ihi&
ihiH as
verbali'ed by
the patient
*b+ective.
Oincreased
urinary output to
%44 ccChr.
Oweaness
Osudden weight
loss from :9 ls.
)o :4 gs.
#eficient fluid
volume related to
osmotic diuresis
from
hyperglycemia.
At the end of 5
wee patient
will be able to
demonstrate
ade1uate
hydration.
O;emonitor temp., sin
colorCmoisture
Oreassess peripheral
pulses and capillary
refill
Omonitor intae and
output.
Omaintain fluid intae
atleast %,344 >Cday or
within cardiac tolerance
Oweight daily
Odry sin may reflect
dehydration
Oindicates level of
hydration, ade1uacy of
circulating volume.
Oprovides ongoing
estimate of volume
replacement needs
Omaintain hydration
Oprovide the best
assessment of current
fluid status and ade1uacy
of fluid replacement.
After the dependent
nursing careC
intervention goal
met. Patient0s output
are at the same
level or almost the
same amount in his
intae.
NURSING CARE PLAN
-ame of Patient. Patient 78
2AE, -ursing
#iagnosis
*b+ectives Interventions ;ationale Evaluation
,ub+ective.
Ksait aong
dughanH as
verbali'ed by the
patient
*b+ective.
Oreports of pain
characteri'ed as
burning pain
Oincreased
respiratory rate
rr&=4 cpm
O Bp changes
Acute pain related
to increased
cardiac worload.
At the end of
shift patient will
report decrease
episode of
pain.
Oplace client at
complete bed rest
during chest pain
Oelevate head of the
bed
Oprovide light meals
Oprovide supplemental
oxygen as ordered
Oadminister antianginal
medications as ordered.
Oreduces myocardial
oxygen demand to
minimi'e ris of tissue
in+ury
Ofacilitate gas exchange
to decrease hypoxia
Odecrease myocardial
worload associated with
wor of digestion,
reducing ris of chest
pain
Oincrease oxygen
available for myocardial
uptae
Oreducing coronary
vasospasm and reducing
cardiac worload
After the dependent
and independent
intervention goal
partially me.
NURSING CARE PLAN
-ame of Patient. Patient 78
2AE, -ursing
#iagnosis
*b+ectives Interventions ;ationale Evaluation
,ub+ective.
Kdili o
maalaaw ong
walay
motabangH as
verbali'ed by
the patient
*b+ective.
Oweaness
Opallor
Odyspnea
Activity intolerance
related to
imbalance
between oxygen
supply.
At the end of 5
wee patient
will achieve
measurable
increase in
activity
tolerance,
evidenced by
reduced
weaness.
Orechec vital signs
before and after activity
Oevaluate accelerating
activity intolerance
Oprovide assistance
with self care activities
O with help of other
health care team,
implement activity
program
Oto prevent orthostatic
hypotension can occur
with activity
Omay denote increase
cardiac decompensation
Omeets client0s personal
care needs without undue
myocardial stress
Ostrengthens and
improves cardiac function
under stress
After the
independent and
dependent nursing
intervention goal
partially met.
A$t!al N!rsing Management
S
K $aglisod o ug ginhawa usahayH as verbali'ed by the patient
O
O#yspnea O#ecreased Hgb 54.= gmCdl
O)acypnea rr&=4 cpm OPulmonary congestion
A
Impaired gas exchange related to altered oxygen&carrying capacity
of the blood.
P
!ong term " #t the end of 1$wee% &atient will demonstrate ade'uate
o()genation through increase Hg*+
,hort term Q At the end of the shift patient will demonstrate
improved ventilation.
I
Independent.
5. Encouraged deep&breathing exercise& improving lung e!pansion
%"Positioned in high&fowlers position& #or lung e!pansion
=.)urned patient fre1uently& redu$e and prevent airway obstru$tion
6. Provide ade1uate rest
#ependent.
3. Administered oxygen P;-
E
After nursing intervention patient reported of better ventilation
therefore goal met.
A$t!al N!rsing Management
S
O
OIncrease H; 544 O2ool sin
Oincrease BP 594C5%4 OEdema on both legs !L%"
Odiminished peripheral pulses
A
#ecreased cardiac output related to myocardial contractility.
P
>ong term Q At the end of 5&wee patient will participate in
activities that reduce cardiac worload.
,hort term Q At the end of the shift pt. BP and pulse rate will
decrease to normalC acceptable rate.
I
Independent.
5. Encouraged rest& to improve e##i$ien$y o# $ardia$ $ontra$tion
%"Elevated legs& to de$rease venous stasis
=.Positioned in left lateral position or position of comfort
#ependent.
6. Administered antidiuretic drug& to relieve edema
3. Administered antihypertensive drug as ordered.
E
After nursing intervention goal partially met. Patient0s BP and
pulses decreases but not in acceptable rate 5F4C554
A$t!al N!rsing Management
S
K,ige o ug ihi&ihiH as verbali'ed by the patient
O
OIncrease urinary output %44 ccChr. O #ry sin
Oweaness O sudden weight loss from :9&:4 gs.
A
Bluid volume deficit related to osmotic diuresis from hypergycemia.
P
>ong term Q At the end of 5&wee patient will be able to
demonstrate ade1uate hydration.
,hort term Q At the end of the shift patient0s intae and output will
be at the same amt.
I
Independent.
5. $onitored intae and output
%"$aintained fluid intae atleast %,344 mlCday or within cardiac
tolerance.
=.Encouraged rest
6. Advised for volume per volume replacement.
E
After nursing intervention goal met. Patient0s intae and output are
almost at the same level.
A$t!al N!rsing Management
S
K,ait aong dughan. as verbali'ed by the patient.
O
O;eport of pain!burning pain"
OIncrease respiratory rate
OBP changes
A
Acute pain related to increase cardiac worload.
P
>ong term Q At the end of 5&wee patient will report no more pain.
,hort term Q At the end of the shift patient will report decrease
episodes of pain.
I
Independent.
5. Placed patient at complete bed rest during episode of chest
pain.
%. Elevated head part
=.Provided light meals
6. Provided supplemental oxygen as indicated
3. Provide a 1uite environment to rest
E
At the end of nursing intervention patient verbali'ed a decrease in
the episode of chest pain.
#;A? ,)A#8
?eneric
name of the
ordered drug
Brand
name
#ate
ordered
2lassification #oseCfre1uencyC
route
$echanism of action ,pecific
indication
2ontraindication ,ide effects -ursing
precautions
,pironol
actone
5&=5&54 Potassiu
m&
sparing
diuretic
%3 mg. 5
tab tid
2ompetitively
blocs the
effects of
aldosterone in
the renal tubule,
causing loss of
sodium and
water and
retention of
potassium.
Oad+unctive
therapy in
edema
associated
with 2HB
OEssential
hypertensi
on with
combinatio
n of other
drug.
OHypersen
sitivity to
drug and
its
component
Owith renal
disease
Oanuria
O#i''ine
ss,
headach
e
Odrowine
ss,
fatigue
Ocrampin
g, dry
mouth,
thirst,
vomiting
Ogive drug
in the
morning so
that increase
urination on
does not
intae with
sleep.
Oavoid
giving foods
rich in
potassium
Omeasure
and record
regular
weight to
monitor
mobili'ation
of fluid.
#;A? ,)A#8
?eneric
name of the
ordered drug
Brand
name
#ate
ordered
2lassification #oseCfre1uencyC
route
$echanism of action ,pecific
indication
2ontraindication ,ide effects -ursing
precautions
$etformi
nhydroc
hloride
$etfor
min
hydroch
loride
5&=5&54 Anti&
diabetic
344 mg. 5
tab BI#
P.*
Possibly
increase
utili'ation of
glucose,
decrease
hepatic glucose
production and
alters intestinal
absorption of
glucose.
Oad+unct to
diet to
lower
blood
glucose
with type %
#$.
Ocontraindi
cated with
allergy to
drug
component
O2HB
Osevere
infections
Oserious
hepatic
impairment
.
O#i''ine
ss, light&
headedn
ess
OArrhyth
mias
Onausea
and
vomiting
Oconstipa
tion
Oavoid
alcohol
Oreport fever
.report
unusual
bleeding
#;A? ,)A#8
?eneric
name of the
ordered drug
Brand
name
#ate
ordered
2lassification #oseCfre1uencyC
route
$echanism of action ,pecific
indication
2ontraindication ,ide effects -ursing
precautions
Amino
acids
Detoste
ril
%&5&54 Protein
substrate
5 tab )I# Essential and
nonessential
amino acids
provided in
various
combinations to
supply calories
and proteins
and provide a
protein building
and protein&
sparing effect
for the body.
Oprovide
nutrition to
patient
when
health can
be
improved
or restored
by
replacing
lost amino
acids.
Onutrition
support of
uremic
patient
when oral
nutrition is
not
feasible.
Owith
alleegy to
drug
component
Osevere
electrolyte
imbalance
Odecrease
circulating
blood
volume
Obleeding
abnormaliti
es
O#i''ine
ss,
headach
e
Ohyperte
nsion
Onausea
and
vomiting
Opulmon
ary
edema
Oweight
patient daily
to monitor
nutritional
status
Oreport for
presence of
side effects.
#;A? ,)A#8
?eneric
name of the
ordered drug
Brand
name
#ate
ordered
2lassification #oseCfre1uencyC
route
$echanism of action ,pecific
indication
2ontraindication ,ide effects -ursing
precautions
Albuterol
,ulfate
#uaven
t
%&5%&54 Bronchod
ilator
5 nebule
every 6
hours
In low doses,
acts relatively
selectively at
beta%&
adrenergic
receptors to
cause
bronchodilation
and
vasodilation.
O)reatmen
t of acute
attacs of
bronchosp
asm.
Owith
alleegy to
drug
component
Otachyarrh
ythmias,
tachycardi
a
Ohypertens
ion
Ohistory of
stroe
Orestless
ness,
anxiety
O2-,
stimulatio
n
Ocardiac
arrhythmi
as,
tachycard
ia and
palpitatio
ns
Onausea
and
vomiting
Omaintain a
beta&
adrenergic
blocer on
standby in
case cardiac
arrhythmias
occurs
O do not
exceed
recommend
ed dose.
#;A? ,)A#8
?eneric
name of the
ordered drug
Brand
name
#ate
ordered
2lassification #oseCfre1uencyC
route
$echanism of action ,pecific
indication
2ontraindication ,ide effects -ursing
precautions
2iproflox
acin
%&5%&54 Antibacte
rial
344 mg. 5
tab BI# p.o
Interferes with
#-A replication
in susceptible
bacteria
preventing cell
production.
OBor
treatment
of
infections
O)reatmen
t of
uncomplica
ted A)I
O2ontraind
icated with
allergy to
drug
component
Ouse
cautiously
with renal
dysfunction
Osei'ures
Oheadac
he,
di''iness
Oinsomni
a
Oblurred
vision
Ohypoten
sion
O#o not cut,
crush and
chew
Ogive
antacids
atleast %
hours after
dosing
Odrin plenty
of water
while taing
this drug
#;A? ,)A#8
?eneric
name of the
ordered drug
Brand
name
#ate
ordered
2lassification #oseCfre1uencyC
route
$echanism of action ,pecific
indication
2ontraindication ,ide effects -ursing
precautions
Aspirin Aspirin %&5&54 Anticoag
ulant
5 tab once
every after
meal
Inhibition of
platelet
aggregation is
attributable to
the inhibition of
platelet
synthesis of
thromboxane
A%, a potant
vasoconstrictor
and inducer of
platelet
aggregation.
O;eduction
of ris of
recurrent
)IAs or
stroe in
males with
history of
)IA due to
fibrin
platelet
emboli.
O2ontraind
icated with
allergy to
drug
component
Ohemophili
a
Obleeding
ulcer
Ohyperpn
ea,
tachypne
a
Ohemorrh
age
.
confusion
Onausea
Odi''ines
s
Ovomiting
Ogive drug
with food or
after meals
Odo not
crush, and
ensure that
the patient
does not
chew the
preparation.
#;A? ,)A#8
?eneric
name of the
ordered drug
Brand
name
#ate
ordered
2lassification #oseCfre1uencyC
route
$echanism of action ,pecific
indication
2ontraindication ,ide effects -ursing
precautions
Potassiu
m
2hloride
supplem
ent
Dalium
#urale
%&5&54 Electrolyt
e
5 )ab )I# Principal
intracellular cat&
ion of most body
tissue,
participates in a
number of
physiologic
process
maintaining
intracellular
tonicity,
transmission of
cardiac, seletal,
and smooth
muscle
maintenance of
normal renal
function/ also play
role in 2H*
metabolism P
various en'ymatic
reactions
Ocorrection
of
potassium
deficiency
O2ontraind
icated with
allergy to
drug
component
Oallergy to
aspirin,
tetra'ine
Osevere
renal
impairment
with
oliguria
Oheat
cramps
O?I
disorders
Ohypera
lemia
OE2?
changes
OAbdomi
nal
discomfor
t
O?I
bleeding
Onausea
Ovomiting
OArrange for
serum
potassium
levels before
and after
therapy
.Administer
after meals
or with food
and a full
glass of
water to
decrease ?I
upset
O#o not
crushC chew
the tablet
#;A? ,)A#8
?eneric
name of the
ordered drug
Brand
name
#ate
ordered
2lassification #oseCfre1uencyC
route
$echanism of action ,pecific
indication
2ontraindication ,ide effects -ursing
precautions
Burosem
ide
%&55&54 >oop
diuretic
64 mg. 5
tab
Inhibits the
reabsorption of
sodium and
chloride from
the ascending
limb of the loop
of Henle,
leading to
sodium&rich
diuresis.
OEdema
associated
with 2HB
Hypertensi
on
O2ontraind
icated with
allergy to
drug
component
Oanuria
Osevere
renal
failure
Ouse
cautiously
with gout
O #$
O#i''ines
s, vertigo
Oparesthe
sias,
weaness,
headache
.
drowsines
s
Oblurred
vision
Ocardiac
arrhythmia
s
Onausea
and
vomiting
Oconstipat
ion
Opolyuria,
nocturia
Oanemia
OAdminister
with food or
mil to
prevent ?I
upset
O?ive early
in the day so
that increase
in urination
will not
disturbed
sleep
O$easure
and record
regular
weight.
#;A? ,)A#8
?eneric
name of the
ordered drug
Brand
name
#ate
ordered
2lassification #oseCfre1uencyC
route
$echanism of action ,pecific
indication
2ontraindication ,ide effects -ursing
precautions
Berrous
,ulfate
%&55&54 Iron
preparati
on
5 cap. BI# Elevates the
serum iron
concentration,
which then
helps to form
Hgb or trapped
in the
reticuloendotheli
al cells for
storage and
eventual
conversion to a
usable form of
iron
O)reatmen
t of iron
deficiency
anemia
O2ontraind
icated with
allergy to
drug
component
Owith
peptic
ulcer
Oregional
enteritis
Oulcerative
colitis
O2-,
toxicity
acidosis
O?I
upset
OAnorexi
a
O-ausea
and
vomiting
O2onstip
ation
Odar
stool
O?ive drug
with meals
!avoid mil,
eggs, coffee,
and tea" for
?I upset
OInstruct
patient that
stool may be
dar or
green
OArrange for
periodic
monitoring
of Hct and
Hgb levels.
#;A? ,)A#8
?eneric
name of the
ordered drug
Brand
name
#ate
ordered
2lassification #oseCfre1uencyC
route
$echanism of action ,pecific
indication
2ontraindication ,ide effects -ursing
precautions
$upiroci
n
Bactrob
an
%&5=&54 Antibiotic BI# apply
to affected
area
Interferes with
bacterial cell
wall synthesis,
causing cell
death in
susceptible
gram negative
bacteria,
ineffective
against gram
positive and
anaerobic
bacteria.
OAse to
treat
impetigo
caused by
staphyloco
ccus
aureus.
O2ontraind
icated with
allergy to
drug
component
Oitching
on the
affected
area
Oinflamm
ation.
O$onitor for
signs of
superinfectio
n.
Patient 78 is advised to see his doctor for chec&ups to determine his health status and
to monitor blood pressure and blood sugar.
(ith Prompt and proper diagnosis, the treatment for patient 78 can easily be carried out.
As for Bebruary 5F, %454 our last duty in <;B Hospital, 780s health condition was improving.
780s vital signs for this time were as follows.
)emperature =F.:G2
Pulse ;ate 9: beatsCmin
;espiratory ;ate =5 cyclesCmin
Blood pressure 564C554 mmHg
(ith this, our nursing interventions were carried out successfully through out our 5F hours duty
on the said hospital. 2ompliance of maintenance medication was encouraged for him to comply
with it and health teaching was also imparted to 78 with emphasis on increase fluid intae and
proper nutrition. )hough it was a tough for us to handle such illness because it needs to have a
close monitoring and extra care should be given to mae sure that the patients health condition
is monitored.
)he >ippincott $anual of -ursing, :
th
edition, >ippincott (illiams P (ilins,pp %:F&%95.
,melt'er, ,. 2. P Bare, B.?., Brunner P,uddarth0s )extboo of $edical ,urgical -ursing,
54
th
edition, >ippincott (illiams P (ilins, pp3%4&3=%.
)aylor, 2.$. P ;alph, ,.,., -ursing #iagnosis ;eference $anual, F
th
edition, >ippincott
(illiams P (ilins, pp. =9:&=99,659& 6%5, 6%F&6%@,
>ippincott0s -ursing #rug ?uide, %44@. pp :%,54:, 596.