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Anthonys College
NAME: O. JN.S. San Jose, Antique
AGE: 19 yrs. old Nursing Department
Dr.: Dr. A
CC: Abdominal pain
NURSING CARE PLAN
CUES NURSING
RATIONALE PLANNING INTERVENTION RATIONALE EVALUATION
DIAGNOSIS
SUBJECTIVE: Acute pain related Gastritis is a GENERAL: INDEPENDENT: After 2 hours of
Nabudlayan to series of After 2 hours of Assess for signs/symptoms of > Early recognition of signs and symptoms nursing
ako maginhawa irritation/inflammat condition that nursing pain of pain allows for prompt intervention and intervention, the
hay sa ubo ko, ion of gastric present with intervention, the improved pain control patient was
as verbalized by mucosa as inflammation of patient will be Position for comfort and > When patients are comfortable their pain relieve from
the patient. evidenced by the gastric relieve from pain provide additional comfort may be diminished pain.
recurrent mucosa. Usually measures as needed
abdominal pain stems from Note for the location, scale, >To determine the nursing care to be given
ingestion of a SPECIFIC: intensity and onset of pain to the patient.
corrosive, 1.) After 30 Maintain a calm and quite >To minimize stimulus that could aggravate
erosive, or minutes of environment. the condition of the patient
OBJECTIVE: infectious intervention, the Teach Patient the use of and > Non-pharmacological pain management
Facial grimace substance client would be assist patient with non- can help decrease pain by promoting
Restlessness able to have normal pharmacological approaches to relaxation. It is believed that most of these
Patient verbalize breath respiration, pain management such as interventions are effective because they
of moderate pain and have easier heat/cold application, stimulate the closure of the gating
with scale of breathing. distraction techniques, mechanism in the spinal cord and can thus
5/10 relaxation breathing, block the transmission of pain
2.) After 45 visualization, and/or listening to
V/S as follows: minutes of nursing music
T- 38 C intervention, the Teach patient to avoid spicy > Avoiding a diet with excess fat will help
P- 88 bpm client would be foods and to implement a diet the gastric mucosa heal and help with
R- 24 cpm able to mobilize low in fat inflammation
BP- 110/ 70 secretions. DEPENDENT:
mmHg Administer analgesic pain > Administering analgesics helps control a
medication per physician patients pain by blocking the pain receptors
orders.
> to assure that the body receives accurate
Regulate IVF as ordered
amount of fluids and electrolytes
St. Anthonys College
NAME: O. JN.S. San Jose, Antique
AGE: 19 yrs. old Nursing Department
Dr.: Dr. A
CC: Abdominal pain
DRUG STUDY
Name of Drug
Classification and Mechanism Indication and Side Effects or Adverse
(Dosage, Route, Frequency, Nursing Responsibilities
of Action Contraindication Reactions
Timing)
Timing:
(7 -7)
Name of Drug
Classification and Mechanism Indication and Side Effects or Adverse
(Dosage, Route, Frequency, Nursing Responsibilities
of Action Contraindication Reactions
Timing)
Diarrhea Check the physicians order
Generic Name: Classification: Indication: Soft stools Follow 14 rights of
Nausea medications
Biodiastase 2000 III, Lipase I, Digestants Dyspepsia, anorexia, overeating, Vomiting Check the chart if the patient
Panprosin Ss , Pancellasess, promotion of digestion, gastric Difficulty in breathing is hypersensitive to the drug
Pancreatin Enteric Coated distention due to indigestion & Palpitations.
Granules, Ursodeoxycholic Acid, abdominal distention due to post- Give the drug after meal and
Simethicone op surgery, meteorism, should be taken with food
aerophagy, nausea, vomiting &
300 mg tablet degassing. Report if any of the adverse
effects is present
Brand Name:
Bearse Monitor the vital signs
Dosage: Mechanism of Action: Contraindication:
1 tab
Pancreatic enzymes are enteric- Hereditary problems eg.
coated to minimize destruction galactose intolerance, Lapp
or inactivation in gastric acid. lactase deficiency or glucose-
Route: Pancreatic enzymes are not galactose mal absorption.
Oral absorbed from the
gastrointestinal tract in Childn <7 yr..
appreciable amounts.
Frequency:
TID
Timing:
(8 4 - 8)
Name of Drug
Classification and Mechanism Indication and Side Effects or Adverse
(Dosage, Route, Frequency, Nursing Responsibilities
of Action Contraindication Reactions
Timing)
Headache Check the physicians order
Generic Name: Classification: Indication: Constipation Follow 14 rights of
Omeprazole. Abdominal pain medications
40 mg capsule Antacids, Antireflux Agents & Treatment of duodenal ulcer, Nausea Monitor the vital signs
Antiulcerants gastric ulcer, H. pylori-associated Vomiting Assess knowledge/teach
Brand Name: PUD, reflux esophagitis & appropriate use of this
Risek Zollinger-Ellison syndrome. medication, interventions to
GERD, maintenance of healed reduce side effects, and
Dosage: erosive esophagitis, NSAID- adverse symptoms to report.
1 capsule associated ulcer, acid aspiration. Give medication before meals
and the patient should
swallow capsule whole
Encourage patient to avoid
Route: Contraindication: alcohol, aspirin products,
Oral Mechanism of Action: ibuprofen, and foods that may
Hypersensitivity to any of the increase gastric secretions
It inhibits secretion of gastric components of Risek or to during therapy.
acid by irreversibly blocking the substituted benzimidazoles.
Frequency: enzyme system of
OD hydrogen/potassium adenosine
triphosphate (H+/K+ ATPase),
the proton pump of the gastric
parietal cell. This effect is dose-
Timing: related and leads to inhibition of
(7 am) both basal and stimulated acid
secretion irrespective of the
stimulus.