Increased salt intake

Increased vascular permeability

Increased circulatory volume

Vasospasm

Vascular Effects

Kidney effects

Interstitial effects

Vasoconstriction

Poor organ perfusion

Decreased glomeruli filtration rate and increased permeability of glomeruli membranes

Diffusion of fluid from bloodsream into the interstitial tissue

Edema Increased blood pressure Increased serum blood, urea nitrogen, uric acid, and creatinine

Decreased urine output and proteinuria

CUES
Subjective: Masakit yung opera ko pag umuubo ako. As verbalized by the patient.

DIAGNOSIS
Pain r/t post partum physiologic changes Secondary to post operative surgery

PLANNING
After 4-6 hours of nursing intervention, the patient will: 1. Identify characteristics of pain and will describe factors that intensify it. 2. Understand and carry out appropriate interventions of pain relief. 3. Expresses comfort and relief from pain.

INTERVENTION
1. Assess patients pain symptoms. 2. As ordered, administer pain medications. 3. Discuss and demonstrate proper usage of surgical girdle. 4. Discuss with patient reasons for her discomfort and its expected duration.

RATIONALE
1. To obtain informatio n and plan appropriat e nursing interventi ons. 2. To provide pain relief. 3. To prevent trauma to the post operative wound. 4. To decrease anxiety and increase complianc e.

EVALUATION
1. Goal met. 2. Goal met. 3. Goal met as evidenced by the patients proper usage of the surgical girdle. 4. Goal met.

Objective: BP: 130/90 -bearable pain Guarding behavior especially at the stomach.

DRUG STUDY

NOMENCLATURE
Generic Name: Magnesium sulfate

ACTION
Cofactor of many enzyme systems involved in neurochemical transmission and muscular excitability; prevents or controls seizures by blocking neuromuscular transmission; attracts and retains water in the intestinal lumen and distends the bowel to promote mass movement and relieve constipation.

INDICATION
Acute nephritis (children) to control hypertension . IV/I M: Preeclampsia or eclampsia PO: shortterm treatment of constipation PO: evacuation of the colon for rectal and bowel examinations To correct or prevent hypomagnes emia in patients on parenteral nutrition

SIDE EFFECTS
CNS: weakne ss, dizzines s, fainting, sweatin g (PO) GI: excessiv e bowel activity, perineal irritatio n (PO)

CONTRAINDICATIONS
Contraindicated with allergy to magnesium products; heart block, myocardial damage; abdominal pain, nausea, vomiting, or other symptoms of appendicitis; acute surgical abdomen, fecal impaction, intestinal and biliary tract obstruction, heapatitis. Do not give during 2hour preceding delivery because of risk of magnesium toxicity in the neonate.

NURSING RESPONSIBILITIES: 1. Use only as a temporary measure to relieve constipation. Do not take if abdominal pain, nausea, or vomiting occurs. 2. You may experience diarrhea with oral use. If this occurs, discontinue drug and consult your health care provider. 3. Report sweating, flushing, muscle tremors or twitching, inability to move extremities.

NOMENCLATURE
Generic Name: Hydralazine hydrochloride

ACTION
Act directly on vascular smooth muscle to cause vasodilation, primarily arteriolar, decreasing peripheral resistance.

INDICATION
ORAL: essential hypertension alone or in combination of other drugs. PARETERAL: severe essential hypertension when drug cannot be given orally or when need to lower BP is urgent.

SIDE EFFECTS
CNS: headach e, dizzines s. CV: palpitati ons, tachycar dia, angina pectoris. GI: anorexia , nausea, vomitin g, diarrhea

CONTRAINDICATIONS
Contraindicated with hypersensitivity to hydralazine, tartrazine (in 100mg tablets marketed as apresoline); CAD, mitral valvular rheumatic heart disease (implicated in MI)

NURSING RESPONSIBILITIES: 1. Take this drug exactly as prescribed. Take with food. Do not discontinue or reduce dosage without consulting your health care provider. 2. Report persistent or severe constipation; unexplained fever or malaise, muscle or joint aching; chest pain; rash; numbness; tingling.

NOMENCLATURE
Generic Name: Ketorolac tromethamine

ACTION
Antiinflammatory and analgesic activity; inhibits prostaglandins and leukotriene synthesis.

INDICATION
Short-term management of pain (up to 5 days) Opthalmic: relief of ocular itching due to seasonal conjunctivitis and relief of post operative inflammation after cataract surgery.

SIDE EFFECTS
CNS: headache, dizziness, somnolence, insomnia. GI: Nausea, dyspepsia, GI pain, and gastric/Duod enal ulcers GU: Dysuria, Renal impairment

CONTRAINDICATIONS
Contraindicated with significant renal impairment, during labor and delivery, lactation. Use cautiously with impaired hearing; allergies; hepatic, CV and GI conditions.

Nursing Responsibilities Every effort will be made to administer the drug on time to control pain; dizziness, drowsiness can occur (avoid driving or using dangerous machinery); burning and stinging on application(ophthalmic) Report sore throat, fever, rash, itching, weight gain, swelling in ankles or fingers; changes in vision; black, tarry stools, easy bruising.

NOMENCLATURE
Bisacodyl

ACTION INDICATION SIDE CONTRAINDICATIONS EFFECTS

Laxatives Short-term relief of constipation; to prevent straining; to evacuate the bowel for diagnostic procedures. Cramps, faintness, stomach discomfort, and dyspenea. Acute surgical abdomen or intestinal obstruction, severe dehydration, fecal impaction, chronic use.

Nursing Considerations 1.Use a temporary measure, swallow tablets whole. Do not take this drug within 1hour of any other drugs report signs of sweating, flushing, muscle cramps, excessive thrist.

NOMENCLATUR ACTION E
Catopril ACE inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. It also inactivates the vasodilator bradykinin and other vasodilatory prostaglandins. ACE inhibitors also increase plasma rennin levels and reduce aldosterine levels. This is due to the suppression of the renninangiotensinaldosterone system resulting in decreased serum concentrations of angiotensin I and aldosterone. The reduction of angiotensin I leads to decreased aldosterone secretion and as a result small increases in serum potassium may occur along with sodium and fluid loss.

INDICATIO N
Hypertensi on Manageme nt of congestive heart failure (CHF) Reduces th e risk of death or developme nt of CHF aftermyoc ardial infarction ( MI) Slows the progressio n of left ventricular dysfunctio n into overt heart failure Used to decreased the progressio n of diabetic neuropath y

SIDE EFFECTS
Dizziness or lighthead edness Fatigue Headache Insomnia Weakness or excessive tiredness Cough Hypotensi on Tachycard ia or fast heart beat Taste disturban ces: salty or metallic taste or decreased ability to taste

CONTRAINDICAT IONS
Hypersensitivity Cross sensitivity among Ace inhibitors Pregnancy Angioedema (hereditary or idiopathic)

Nursing Consideration

1. 2.

3. 4. 5. 6. 7. 8. 9.

Monitor blood pressure and pulse frequently during initial dose adjustment and periodically during therapy. (for patients treated with hypertension) For patients treated with CHF, monitor weight and assess patient routinely for resolution of fluid overload. Signs of fluid overload are: peripheral edema, rales or crackles, dyspnea, weight gain and jugular vein distention. The nurse should keep in mind that Captopril may cause false-positive result for urine acetone. The drug should be administered 1 hour before or 2 hours after meals. It may be crushed if the patient has difficulty swallowing. Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Inform the patient that Captopril tablets may have a slight sulfur odor (like rotten eggs). Instruct the patient to notify the physician immediately when the following manifestations are experienced:

NOMENCLAT URE
multivitamins

ACTIO INDICATI N ON

SIDE EFFECTS
constipation, diarrhe a; nausea, vomiting, heartburn; stomach pain, upset stomach; black or dark-colored stools or urine; temporary staining of the teeth; headache; or unusual or unpleasant taste in your mouth.

CONTRAINDICATI ONS

NOMENCL ATURE
Amoxicillin trihy drate

ACTION
antibiotic (pe nicillinampicillin type)

INDICATION
Infections due to susceptible strains of haemophilus influenza, e.coli, proteus mirabilis, neisserria gonorrhea, streptococcu s pneumonia, enterococcus faecalis, streptococci, non penicillinaseproducing staphylococci . Helicobacter pylori infection in combination with other agents Postexposur e prophylaxis against. Bacillus anthracis

SIDE EFFECTS
lethargy, halluci nations, seizures, glositis, stomatitis, gastritis, sore mouth, furry tongue, black hairy tongue, nausea and vomiting, diarrhea, abdominal pain, bloody diarrhea, entero colitis, pdesudomemeb ranous colitis specific hepatis.

CONTRAINDIC ATIONS
Contraindic ated with allergies to penicilllins, cephalospo rins, or other allergens. Use cautiously with renal disorders, lactation.

Nursing considerations Culture infected area prior to treatment; re-culture area if response is not as expected. Give in oral preparations only; amoxicillin is no taffected by food Continue therapy for at least 2 days after signs of infection have disappeared; continuation for 10 full days is recommended. Use corticosteroids or antihistamines for skin reaction. Report any side effect

NOMENCLAT URE
Mefenamic Acid

ACTION
Infections of the respirator y tract, paranasal sinuses, genitor urinary tract, otitis media, sinusitis, meningiti s, septicemi a

INDICATION SIDE EFFECTS

Prevents bacterial all synthesis during replicati ons Dizziness, fatigue, insomnia, skin rashes, itchy eyes, sore/dry mouth, abnormal taste sensation .

CONTRAINDICATI ONS
Hypersensitivity to penicillin, cephalosporins not used to treat pneumonia, bacteremia, pericarditis during acute stage.

Nursing considerations Obtain patients history of allergy. Assess patient for and s/s of infection. Assess patient sensitivity to penicillin and other cephalosphorins Assess allergic reactions during therapy.

NOMENCLATURE

ACTION INDICATION SIDE CONTRAINDICATIONS EFFECTS