NURSING HEALTH HISTORY

FAMILY HEALTH HISTORY According to the patients wife, the patient is the eldest child in the ordinal position of the family. He had other seven siblings, 6 were boys, and 1 girl. Both his parents have hypertension. His mother died on year 1999 and his father died the following year due to the aforementioned disease. His younger sibling who is still alive is also experiencing hypertension, wherein, two of them also have a diabetes mellitus. The patient belongs to a family where strong ties exist, supporting each other in times of distress and adversities, as evidence of an in-depth care provided to him and continuous follow-up in his condition through visiting him.

PERSONAL AND SOCIAL HISTORY The patient is the bread winner of the family. He was a tenant and works before as a bus conductor. But when he experienced hypertension, he preferred to work as a tricycle driver. During his free-days, he spends his time with his family, chatting and watching television with them. The patient rarely does household chores and often drinks liquor with their neighbors. He was satisfied and has no difficulties doing this job except when he began experiencing the signs and symptoms of the disease. He stops working as his illness began to complicate.

PAST HEALTH HISTORY During the childhood years of the patient, he experience having chicken pox. He did not encounter any accident or injury and does not have any allergies to drugs, food and other environmental agent. The patient received the complete dose of prescribed childhood immunization. If he experienced fever, coughs and colds he usually takes over the counter drugs.

PRESENT HEALTH HISTORY According to the patient wife it was three years ago when the patient was diagnosed of diabetes mellitus but before he was identified to have this kind of disease, he already experience having hypertension due to too much drinking of alcohol, smoking and being fond of eating fatty foods. He has been admitted to the hospital many times because of several occurrence of stroke. Prior to his present admission to the hospital, the patient experience stroke or CVA for the 4th time. This incident initiates his family to admit the patient to MDH immediately. The patient has a chief complain of body weakness and entered the hospital via wheelchair. According to the his wife, they think that the reason why he experiences this attack is because of too much eating of

jack fruit, which they believe cause the increase of his blood sugar level. After the recent attack, his left body already became paralyzed. DRUG STUDY Name of the drug Allopurin ol Classificatio n Antigout drug Action Inhibits xanthin oxidase, an enzyme involved for the conversi on of purines to uric acid thus reducing the productio n of uric acid with a decrease in serum and sometim es in urinary acid levels, relieving the signs and symptom s of gout. indication Management of the signs and symptoms of primary and secondary gout. Management of patients with malignancies that result in elevations of serum and urinary uric acid. Adverse effects CNS: headache, drowsiness, peripheral neuropathy, neuritis, paresthesics; DERMATOLOGI C: rashesmaculopapular, scaly or exfoliativesometimes fatal; CI: nausea, vomiting, diarrhea, abdominal pain, gastritis, hepatomegaly, hyperbilirubinemi a, cholestatic jaundice GU: exacerbation of gout and renal calculi, renal failure. HEMATOLOGIC: anemia, luekopenia, agranulocytosis, thrombocytopenia, aplastic anemia, bone marrow depression. Nursing responsibilities Administe r drug following meal. Avoid over the counter medicatio n, check with your health care provider. Assess for side effects. Assess rash and report rash; unusual bleeding or bruising: fever, chills: gout attack; numbness or tingling; flank pain, skin rash. Check urine alkalinityurates crystallize

Amlodipi ne besylate

Antianginal, antihyperten sive

Inhibits hypertension influx of calcium ions across cell membran es to produce relaxatio n of coronary vascular smooth muscle, decrease periphera l vascular resistanc e of smooth muscle and increases myocardi al oxygen.

CNS: headache, fatigue, somnolence CV: edema, dizziness, flushing, palpitations. GI: nausea, abdominal pain, dyspepsia

in acid urine; sodium bicarbona te or potassium citrate may be ordered to alkalinize urine. Arrange for regular medical follow-up and blood tests. Assess patients blood pressure or angina before therapy and regular thereafter. Monitor patient carefully for pain. Be alert for adverse reaction. Advice patient to comply in all areas of method regimen: diet, exercise, stress reduction,

Ciproflox acin

Antibacterial Inhibits fluoroquinol bacterial one DNA gyrase thus preventin g replicatio n in susceptib le bacteria.

Sepsis, infection, or imminent risk of infection in patient whose immune system has been weakened

CNS: headache, dizziness, insomnia, fatigue, somnolence, depression, blurred vision, hallucination, antaxia, nightmares. CV: arrhythmias, hypotension, angina EENT: dry eye, eye pain, keratopathy, GI: nausea, vomiting, dry mouth, diarrhea, abdominal pain GU: renal failure HEMATOLOGIC: elevated BUN, AST, ALT, serum creatinine and alkaline phosphatase; decrease WBC, nuetrophil count, Hct OTHER: fever, rash

smoking cessation and drug therapy. Assess patients and familys knowledg e of drug therapy. Assess patient for previous sensitivity reaction Assess patient for signs and symptoms of infection before and during treatment: fever, earache, characteri stics of wounds, sputum, urine, stool and WBC>10, 000/mm3. Assess for allergic reaction and anaphylax is Epinephri ne and resuscitati on

glipzide

Antidiabetic drugs

Stimulate s insulin release from the pancreati c beta cells and reduces glucose output from the liver; insulin sensitivit y is increased at periphera l target sites.

Non-insulin dependent diabetes mellitus not controlled by diet alone. Maturity-onset diabetes mellitus.

CNS: dizziness, drowsiness, headache CV: facial flushing GI: nausea, vomiting, constipation HEMATOLOGIC: agranulocytosis, thrombocytopenia, aplastic anemia HEPATIC: cholestatic jaundice METABOLIC: hypoglycemia SKIN: rash, pruritus.

citicoline

Central Citicolin nervous e is a system drugs derivativ e of choline and cytidine involved in biosynth esis of lecithin.

CVA in acute and recovery phase. Symptoms and signs of cerebral insufficiency i.e., dizziness, headache, poor concentration, memory loss, disorientation,

Shock, hypersensitivity, hypotension, insomnia, excitement. Stimulates parasympathetic action and fleeting and discreet hypo tensor effect.

equipmen t should be available for anaphylac tic reaction. Assess for possible adverse reaction. Assess glucose level before starting therapy and regularly thereafter. Be alert for adverse reactions and drug interactio n. Assess patients family knowledg e of drug therapy. Assess patient condition and evaluate patient medical history. Monitor blood pressure, pulse and

metformi n

Antidiabetic drugs

It is claimed to increase blood flow and oxygen consump tion in the brain. Decrease s interstitia l absorptio n of glucose and hepatitis glucose productio n.

etc.

heart rate. Assess allergic reaction like gastrointe stinal disturbanc es. Monitor patient,s hematolo gic status. Closely monitor patient in times of stress such as infection, surgery or trauma. Advice patient that drug must be continued on daily basis to control symptoms and prevent complicat ions. Assess nutrition: fat, protein, carbohydr ates; nutritional analysis should be

Non-insulin dependent diabetes mellitus.

simvastati Antihyperlip n emic

Inhibits HMGCOA reductase enzyme, which reduces cholester ol

Heterozygous familial hypercholestero lemia

CNS: headache, asthenia, sleep disturbance. GI: abdominal pain, constipation, diarrhea, dyspepsia, flatulence, nausea. HEPATITIC:

synthesis .

cirrhosis, hepatitis, hepatic necrosis. MUSCULOSKEL ETAL: myalgia RESPIRATORY: upper respiratory tract infection.

completed by dietician before treatment is initiated. Be alert for adverse reactions and drug interactio n. Assess knowledg e/ teach patient proper use, possible side effects/ appropriat e interventi ons, and adverse symptoms to report. Tell patient or the s.o. to notify the physician if adverses reactions occur, particularl y muscle aches and pains.