Name of drug, dose Hydrocortisone (Solu-cortef) 100 mg IV q6 hours (12-6)

and frequency

Action Corticosteroid,

Mechanism of Decrease inflammation, mainly by stabilizing leukocyte lysosomal membrane; suppresses immune response; stimulates bone marrow; and influences
action protein, fat and carbohydrate

Indication Rheumatic disorders, collagen disease,

Severe or intractable allergic states, respiratory distress, nervous system disorders and severe inflammation

Side effects sleep problems (insomnia), mood changes;

acne, dry skin, thinning skin, bruising or discoloration;

increased sweating;

headache, dizziness, spinning sensation;

nausea, stomach pain, bloating.

Contraindication Drug is used with extreme caution in patients with serious infection; may mask sings and symptoms of infection.

Nursing • Determine whether patient’s is sensitive to drug

responsibilities
• Monitor vital signs especially BP

• Monitor regularly for weight changes and fluid and electrolyte imbalances, especially hypokalemia; promote increase intake of high potassium
food

• Monitor patient for cushingoid effect.

Name of drug, dose and PAI with Pulmodual 1 nebule now then q6h
frequency

Action Anti-asthmatic

COPD preparations

Mechanism of action Prevents it from attaching to muscarinic receptors on membranes of smooth muscle cells. By blocking acetylcholine’s effects in bronchi and
bronchioles, it relaxes smooth muscles and causes bronchodilation

Indication Reversible airways obstruction such as asthma & COPD for patients in need of more than a single bronchodilator or who require 2nd
bronchodilator

Side effects Dry mouth, nausea, constipation, headache, fine tremors, nervous tension, muscle cramps and palpitation

Contraindication Hypersensitivity to drug or any other component of ipratropium bromide and salbutamol

Nursing responsibilities • Monitor patient for hypersensitivity reactions that could be life threatening

• Monitor the patient’s respiratory status for development of bronchospasm

• Instruct patient to rinse mouth after each nebulizer or inhaler treatment to help minimize throat dryness and irritation

• Instruct client to avoid respiratory irritants such as smoke, dust and strong cents.
Name of drug, dose and Cefepime (Axera) Ig IV q8hours ANST (3-11-7)
frequency

Action Antibiotics

Mechanism of action Inhibit bacterial cell wall synthesis by binding protein which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial
cell wall, thus inhibiting cell wall synthesis

Indication Treat infections by gram positive and gram negative bacteria. First active cephalosporins are active against infection caused by most gram
positive cocci and certain gram negative bacilli

Side effects injection site reactions (pain, redness, swelling, soreness, or skin rash),stomach pain,

nausea,vomiting,loss of appetite,diarrhea, headache,skin rash or itching,

Contraindication Contraindicated in patient’s hypersensitivity to drug, cephalosporin, beta lactam antibiotics or penicillin.

Nursing responsibilities • Obtain patient’s allergy history before administering drug

• Obtain culture and sensitivity test result, if possible and as ordered, before giving the drug

• Know that an allergic reaction to cephalosporin may occur even in a patient with no history of allergic reactions

• Observe for signs and symptoms of allergic reaction after administering the drug; discontinue drug and notify practitioner if reaction
occur.
Name of drug, Azithromycin (Zenith) 500mg 1 tab OD
dose and
frequency

Action Antibiotics

Mechanism of Inhibits bacterial cell wall synthesis, ultimately causing cell wall destruction; bactericidal
action

Indication Moderate to severe pain from acute and some chronic disorders; COPD, dry, nonproductive cough, pneumonia, sinusitis and bronchitis

Side effects mild diarrhea, vomiting, constipation; stomach pain or upset; dizziness, tired feeling, mild headache; nervous feeling, sleep problems (insomnia);

vaginal itching or discharge; mild rash or itching; ringing in your ears, problems with hearing; or.

decreased sense of taste or smell.

Contraindication Contraindicated in patient’s hypersensitivity to drug components and to any macrolide and ketolide antibiotics.

Nursing Observe 10 rights in giving drug administration

responsibilities
Obtain culture and sensitivity testing before starting drug therapy

• Monitor patient for superinfection. Drug may cause overgrowth of no susceptible bacteria or fungi

• Instruct client to take drug with 8 ounces of water

• Monitor renal function

• Warn patient that abdominal pain and loose watery stools may occur. If diarrhea persists, tell the practitioner

• Explain importance of completing full course of therapy as prescribed.

Name of drug, dose and Omeprazole (Prosec) 40 gm OD Pre BF
frequency

Action Proton pump inhibitor

Mechanism of action Block gastric acid secretion by inhibiting acid pump in gastric parietal cells

Indication Prevent and treat NSAID related gastric ulcer

Side effects fever; cold symptoms such as stuffy nose, sneezing, sore throat; stomach pain, gas; nausea, vomiting, mild diarrhea; or.

headache.

Contraindication Contraindicated in patients with known hypersensitivity to drug

Nursing responsibilities • Observe 10 rights in giving drug administration

• Monitor for diarrhea and abdominal pains

• Administer 1 hour before meals

• Instruct patient to avoid gastric irritants (smoking, alcohol, caffeine and food that cause GI irritation) which may counteract drug effect.

• Advise to notify practitioner immediately about abdominal pain or diarrhea

Name of drug, dose and KChlor 1 tab TID
frequency

Action Electrolytes

Mechanism of action Potassium chloride is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and
skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate
metabolism and gastric secretion.

Indication Hypokalaemia, Prophylaxis of hypokalaemia and mild K deficiency

Side effects mild nausea or upset stomach;

mild or occasional diarrhea;

slight tingling in your hands or feet; or.

appearance of a potassium chloride tablet in your stool.

Contraindication Hyperchloraemia, severe renal or adrenal insufficiency.

Nursing responsibilities • Observe 10 rights in giving drug administration

• Assess for renal function

• Assess nutritional status including dietary recall and anthropometric measure

• Weigh the patient before initiating therapy

• Reinforce instruction on maintaining a well-balanced diet with emphasis on food allowance and restriction

• Urge patient to keep follow up laboratory appointments as directed by prescriber to determine serum level

• Monitor serum levels closely to prevent toxicity

Name of drug, dose and IgCo 1 sachet dissolve in 1 cup of tap/warm water BID
frequency

Action Nutritional supplement

Mechanism of action Combination of Carbohydrates, proteins, minerals and vitamins

Indication Nutritional supplement

Nursing responsibilities • Observe 10 rights in giving drug administration

Name of drug, dose and TMZ MR 35 mg 1 tab BID (8-8)

frequency

Action Antianginal

Mechanism of action Produce vasodilation, decrease preload and afterload and reduce myocardial oxygen consumption

Indication Prophylactic treatment of angina pectoris episodes. Adjuvant symptomatic treatment of vertigo and tinnitus.

Side effects Gastric discomfort, nausea, headache, vertigo.

Contraindication Contraindicated to patient’s hypersensitivity to nitrates and those with early MI, severe anemia, orthostatic hypotension, hypertrophic
cardiomyopathy and cardiac tamponade.

Nursing responsibilities • Monitor BP, preferably just before nest dose to evaluate efficacy.

• Monitor patients for cardiac failure. Discontinue drug in patients who develop cardiac failure.
Name of drug, dose and Sacubitril Valsartan (Entresto) 20 mg 1 tab BID (8-8)
frequency

Action Antihypertensive

Mechanism of action Block the binding of angiotensin II to the angiotensin II receptor, preventing vasoconstriction and aldosterone secreting effect of angiotensin
thus lowering blood pressure

Indication Treat hypertension, manage heart failure.

Side effects drowsiness, dizziness, hypotension or a headache

Contraindication Contraindicated to patient’s hypersensitivity to any angiotensin II receptor blocking agents

Nursing responsibilities • Observe 10 rights in giving drug administration

• Monitor patient’s blood pressure carefully, watch for hypotension

• Instruct patient to maintain fluid intake

• Monitor serum potassium level because drug may elevate potassium level by blocking aldosterone secretion

• Advise client to take the drug exactly as prescribed at the same time each day to maintain therapeutic effect

• Educate patient ways to minimize orthostatic hypotension

• Stress the importance of continuing with nonpharmacological therapies (diet modification, exercise and stress reduction)
Name of drug, dose and Spiriva 18mg 1 puff OD via inhaler
frequency

Action Bronchodilators

Mechanism of action Competitive, reversible inhibition of muscarinic receptors leads to bronchodilation

Indication Maintenance treatment of patients with COPD. Maintenance treatment associated dyspnea, improvement of COPD compromised quality of
life and reduction of exacerbation

Side effects dry mouth,constipation,upset stomach,vomiting,

cold symptoms (stuffy nose, sneezing, sore throat),

nosebleed, or.muscle pain.

Contraindication Contraindicated to patient’s hypersensitivity to atropine, its derivatives, ipratropium or any component of the drug

Nursing responsibilities • Monitor patient’s renal functions, because the drug is excreted mainly by the kidney

• Monitor patients pulmonary function, to evaluate the effectiveness of the drug

• Instruct patient to rinse her mouth after each treatment to help minimize throat dryness and irritation

• Inform patient that drug is for maintenance treatment of COPD and not for immediate relief of breathing problems

• Provide full instructions for the handihaler device or respimat spray inhaler.

• Tell patient not to get any powder or spray into the eyes
Name of drug, dose and Clopidogril 75mg (cloux) OD post lunch
frequency

Action Antiplatelet

Mechanism of action Interfere with platelet aggregation in different drug-specific and dose specific ways, preventing thromboembolic events

Indication Reduce risk of death in patients with previous MI or unstable angina and risk or transient ischemic attacks in men

Side effects chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling; sudden numbness or weakness,
especially on one side of the body; sudden headache, confusion, problems with vision, speech, or balance; pale skin, weakness, fever, or
jaundice

Contraindication Contraindicated to patients with active bleeding, thrombocytopenia, history of hemorrhagic stroke, severe liver impairment, underlying
coagulation disorder

Nursing responsibilities • Monitor for bruising and evidence of bleeding

• Instruct the patient to report signs and symptoms of bleeding immediately.

• Monitor hemoglobin and clotting factors and platelet levels

• Minimize venipuncture and injections; apply pressure to all puncture sites to prevent bleeding
ASSESSMENT NURSING PLANNING EVALUATION
DIAGNOSIS INTERVENTION
Subjective: Ineffective airway After 1 hour Independent: Dependent: Goal met.
“Gainuboako” as clearance r/t of nursing 1.) Position the patient in a 1) Administer Rupafin 10mg 1 tab After 1 hour of nursing intervention
verbalized by the retained secretions intervention, high fowler’s position. OD 12nn as an antihistamine. patient maintained a clear and patent
patient. and the patient  To decreased  Compete with histamine airway.
Objective: bronchoconstriction will maintain pressure on the to bind to H1 receptors
 Chest indrawing airway diaphragm and thought out the body.
 Nasal Flaring patency. enhancing drainage. 2) Administer Montelukast 10mg
 Productive 2). Asses and monitor 1 tab @ HS.
cough with respiration and breathe  Reduces early and late
whitish sticky sounds. phase
secretion.  To ascertain status bronchoconstriction from
 CXR reveals: and note progress. antigen challenge.
Bibasal 3.) Encourage deep 3) Administer via inhaler Spiriva
pneumonia and breathing and coughing 18mg 1 puff OD
pulmonary exercise.  Competitive, reversible
emphysema  To promote lung inhibition of muscarinic
 2nd CXR expansion and to receptors leads to
reveals: left remove secretions. bronchodilation.
pleural 4.) Encourage increase fluid 4) Administer Hydrocortisone
effusion. intake. Solucortef 100mg IV q6h
 Wheezing and  Hydration helps  Decrease inflammation,
rales in both decrease the mainly by stailizing
lungs. viscosity of leukocyte lysosomal
 ABG result: secretions, membrane.
Fully facilitating 5) Administer PAI with
compensated expectoration. Pulmodual 1 nebule now then q6h
respiratory 5.) Provide physio-therapy  By blocking
acidosis. and back tapping. acetylcholine’s effects in
 O2 at 2Lpm via  These techniques bronchi and bronchioles,
nasal cannula. will prevent possible it relaxes smooth muscles
aspirations and
 Inability to prevent any and causes
speak full untoward bronchodilation
sentences complications. 6) Provide supplemental O2 at 2
( have to stop to 6.) Monitor and graph serial LPM via nasal cannula.
breath) ABGs, pulse oximetry, chest  To maximize oxygen
 Needs 2 x-ray. transport to tissues.
pillows to  Establishes baseline
lay down for monitoring
and progression or
breathe regression of
comfortably disease process an
 RR – 24bpm complications.
ASSESSMENT NURSING DIAGNOSIS PLANNING EVALUATION
INTERVENTION
Subjective: Impaired gas After 4hrs of nursing Independent: Dependent: Goal met:
“nabudlayan ako exchange r/t altered intervention, the 1.) Position the • Administer Rupafin 10mg 1 After 4hrs of nursing
mag’ginhawa” as oxygen supply and patient will patient in upright tab OD 12nn intervention the patient
verbalized by the alveoli destruction. demonstrate position. Compete with histamine to bind to respiration decreased from
patient. improve ventilation. Oxygen delivery may H1 receptors thought out the body. 24bpm- 19bpm and
Objective: be improved by • Administer Montelukast demonstrate improved
• RR-24bpm upright position and 10mg 1 tab @ HS. ventilation.
• O2 at 2Lpm breathing exercises Reduces early and late phase
via nasal to decrease airway bronchoconstriction from antigen
cannula. collapse, dyspnea, challenge.
• Productive and work of • Administer via inhaler Spiriva
cough with breathing. 18mg 1 puff OD
whitish sticky 2.) Assess and Competitive, reversible inhibition of
secretion. routinely monitor muscarinic receptors leads to
• Chest xray skin and mucous bronchodilation.
reveals: membrane color. • Administer Hydrocortisone
Bibasal Duskiness and Solucortef 100mg IV q6h
pneumonia, central cyanosis Decrease inflammation, mainly by
pulmonary indicate advanced stailizing leukocyte lysosomal
emphysema hypoxemia. membrane.
and pleural 3.) Asses and record • Administer PAI with
effusion. respiratory rate and Pulmodual 1 nebule now
• Wheezing depth. then q6h
and rales of Useful in evaluating By blocking acetylcholine’s effects in
both lungs the degree of bronchi and bronchioles, it relaxes
upon respiratory distress smooth muscles and causes
auscultation. or chronicity of the bronchodilation
• ABG Results: disease process. • Provide supplemental O2 at 2
Fully 4.) Encourage deep- LPM via nasal cannula.
compensated slow or pursed-lip To maximize oxygen transport to
respiratory breathing. tissues.
alkalosis
• Low R: To promote lung
hemoglobin: expansion and
131 g/L remove secretions.
• Low RBC: 4.3
10x12/L
• (+)chest
indrawing
• Pale
conjunctiva
• Needs 2
pillows to lay
down and
breathe
comfortably
ASSESSMENT
Objective
 The patient is 77 years old,
making him more
immunocompromised
 Chest X-ray results show Bibasal
Pneumonia and Pulmonary
Emphysema
 2nd Chest X-ray results show
Bibasal Pneumonia, pulmonary
emphysema and left pleural
effusion
 CBC results show low
Lymphocytes= 10; low
monocytes= 1; and high
segmenters= 88
 Sputum results reveal presence
of Klebsiella Pneumonia
 Culture and Sensitivity test reveals
presence of Klebsiella Pneumonia
NURSING PLANNING EVALUATION
DIAGNOSIS INTERVENTION
Altered protection After 3 days of Independent: Dependent Goal met.
related to invasion of nursing 1. Monitor sign and symptoms 1. Administer Cefipime
pathogenic organisms intervention, the of infection, like fever (Axera) Ig IV q 8 hours ANST
patient will be free R:Fever indicates presence of (3 -11 -7)
of pathogenic infection R: Cefipime inhibits bacterial
organisms that 2. Assess the color of sputum cell wall synthesis
cause infection R: The color of the sputum is 2. Administer Azithromycin
indicative whether there is (Zenith) 500 mg 1 tab OD
infection or not. R: Azithromycin is
3. Monitor all vital signs. bactericidal
R: Changes in vital signs
values may indicate further
exacerbation of the disease.
4. Perform handwashing and
necessary aseptic techniques
R: To prevent further
contamination
ASSESSMENT NURSING PLANNING EVALUATION
DIAGNOSIS INTERVENTION
Subjective: Disturbed sleeping After 1 day of Independent: Dependent: Goal met.
pattern related to nursing 1.) Assess patient’s sleep pattern and 1) Administer After 1day of nursing
“Nabudlayanakomagtulog physical intervention, the changes. Montelukast 10mg intervention the
kay sigenakoninubo” as discomfort. patient will achieve  Provides information to alleviate 1 tab @ HS. patient reported
verbalized by the patient. and maintain sleep deprivation in relation to age-  Reduces early and improved sleeping
Objective: adequate amount related changes and identify and late phase pattern AEB the pt.
 Productive cough of sleep. establish plan of care. bronchoconstriction verbalized “
with whitish 2).Provide calm, quiet environment. from antigen okaynaakontulog” and
sticky secretion.  Helps to promote conducive challenge. the patient does not
 Weakness and atmosphere for restful sleep. 1) Administer Iterax look weak.
Restlessness 3.) Instruct the patient to practice slow deep 20mg 1 tab OD HS
 Presence of breathing. PRn for
eyebags and dark  Relaxation and deep breathing may sleeplessness.
under eye circles help alleviate the discomfort. Suppresses activity in
Yawning 4.) Instruct patient to avoid stimulants like certain essential regions of
caffeinated drinks, stressful activity prior to the subcortal are of the
sleep. CNS.
 Over stimulation prevents patient
from falling asleep.
5.)Instruct pt. to drink milk before going to
sleep.
 To facilitate the sleep process, as it
contains the amino acid
tryptophan, this helps in increasing
the melatonin level in the body.
ASSESSMENT NURSING DIAGNOSIS PLANNING EVALUATION
INTERVENTION
Subjective: “Di Risk for injury r/t After 24 hours of nursing Independent: Goal met.
nakakitaakonisakamata” as impaired sensory intervention, the patient 1.) Assess he general status of the patient. The patient has remained free from
verbalized by the patient. function will verbalize  This is to determine the patient’s injury throughout his hospital stay.
Objective: understanding about condition that may cause injury.
 Eyes are strabismus. performing necessary 2). Educate the patient about safety ambulation.
 The patient has a hard precautions in order to  Patient’s knowledge about his condition
time recognizing faces remain free from further is vital to his safety.
 Patient often has to injury. 3.) Speak to visually impaired client during care.
take time to properly  To provide auditory stimulation and
register what he is prevent startle reflex.
looking at. 4.) Thoroughly conform patient to surroundings.
 The patient has  The patient must get used to the layout
difficulty locating of the environment to avoid accidents.
objects 5.) Educate him or caregiver to label with bright
colors such as yellow or red significant places in
environment that must be easily located
 Lighting an unfamiliar environment
helps increase visibility if the patient
must get up at night.
ASSESSMENT
Subjective:
“Madalinalangakosubongkapuyon” as
verbalized by the patient.
Objective:
 Exertional dyspnea
 RR=24bpm
 Insufficient sleep
 Fatigue
 Pale skin
 Pale conjunctiva
 Low hemoglobin: 131 g/L
 Low RBC: 4.3 10x12/L
NURSING PLANNING EVALUATION
DIAGNOSIS INTERVENTION
Activity intolerance After 1 day of nursing Independent: Goal met
related to imbalance intervention, the 1.) Assess the physical activity level and mobility of the After 1day of nursing
between oxygen and patient will verbalize patient. intervention the
demand. and use energy-  Provides baseline information for formulating patient was able to
conservation nursing goals demonstrate
techniques. 2). Investigate the patient’s perception of causes of increased activity
activity intolerance. intolerance.
 Determining the cause can help guide the nurse
during the nursing intervention.
3.) Instruct patient in energy conservation technique.
 These measures reduce cellular metabolism and
oxygen demand.
4.) Encourage adequate rest to minimize energy
expenditure and prevent fatigue.
 Sleep deprivation and difficulties during sleep
can affect the activity level of the patient
5.)Measure vital signs immediately after the activity, the
client rest for 3 minutes then measuring the vital signs
again.
 To ensure return to normal a few minutes after
exercising.