VII.

Drugs Study

Drug Name

Mechasnism of Action

Indication

Contraindication

Adverse Effects

Nursing Interventions

y Pedialyte are advocated for  Oresol the treatment Brand Name: of dehydration in viral  Pedialyte gastroenteritis, but there is Drug Class: limited Electrolytes evidence to  A07CA - Oral support their use. rehydration salt formulations Dosage:  250cc every 6 hours PO

Generic Name:

y To supplement fluid & electrolyte loss due to active play, prolonged sun exposure, hot & humid environment

y Intractable vomiting, adyanmic ileus, intestinal obstruction, bowel perforation.

As sole therapy in severe continuing diarrhea. Intractable vomiting. Adynamic ileus. Intestinal obstruction or perforated bowel. Anuria, oliguria, or impaired homeostatic mechanism.

y Assess allergic reactions. y Monitor I&O ratio. y Note for the drugs, dosage, time,r oute, client. y Note the side effects of the drugs.

Drug Name

Mechasnism of Action

Indication

Contraindication

Adverse Effects

Nursing Interventions

Generic Name:  Paracetamol

Brand Name:  Tempra, Biogesic, Bioflu

Drug Class:  Anti-pyretic, Nonopioid analgesic Dosage:  500mg PO

y Decreases fever by inhibiting the effects of pyrogens on the hypothalamic heat regulating centers and by a hypothalamic action leading to sweating and vasodilation.

y Relief of mildto-moderate pain, treatment of fever.

y Hypersensitivit y, alcohol, table sugar

y Drowsiness, nausea, vomiting, abdominal pain and rash.

Assess patient s fever. Assess allergic reactions: rash, urticaria; if these occur, drug may have to be discontinued

Drug Name

Mechasnism of Action

Indication

Contraindicatio n y Hypersensitivit y to cefuroxime, penicillin/ cephalosporin. y Kidney disease, liver disease and gastrointestin al disease. y y y y

Adverse Effects Nausea Vomiting Diarrhea Abdominal pain

Nursing Interventions y Instruct client to report loose stools or diarrhea promptly. y Instruct client to report any signs or symptoms of hypersensitivity.

Generic Name:  Cefuroxime

y Inhibits synthesis of bacterial cell wall, causing cell death.

Brand Name:  Ceftin, Zinacef

y Cefuroxime is indicated to treat infections. The client s WBC is elevated and this may indicate infection. y Cefuroxime is indicated for patients with urinary tract infection. The client has cloudy urine that suggest urinary tract infection.

Drug Class:  Bactericidal/Antib acterial

Dosage:  125 mg, TIV

VIII. Nursing Care Plan

Assessment

Nursing Diagnosis Diarrhea r/t infectious processes.

Inference

Goal

Intervention

Rationale

Evaluation

Subjective data: -- Nakaka12 na syang diaper ngayong araw. Samantalang kahapon mga 6 lang. Madalas din kung sumuka siya. As verbalized by the mother

(+)Staphylococcus aureus secretory diarrhea mediated by cyclic AMP Increased production and secretionof fluids and electrolytes by the intestinal mucosa Diarrhea

Objective data:

-- Loosed bowel movement with yellowish watery stool minimum of thrice a day.

-- Increase bowel sounds/ peristalsis

2.) Discuss to the mother the different causative factors and 2.) For the Long Term: education of the rationale for -- After 1-2 days of nursing treatment regimen. patient s mother. interventions, the patient will be free of diarrhea. 3.) Restrict solid food 3.) To allow for intake. bowel rest and reduce intestinal 4.) Provide for workload. changes in dietary intake. 4.) To allow foods that precipitates 5.) Limit caffeine, diarrhea. high fiber foods and fatty foods. 5.) To prevent gastric irritation. Dependent:

Short Term: -- After 2-3 hours of nursing interventions, the patient s mother will gain knowledge about diarrhea.

Independent: 1.) Auscultate the abdomen.

Independent: 1.) For presence. Location and characteristics of bowel sounds.

Short Term: -- After 2-3 hours of nursing interventions, the patient s mother shall gain knowledge about diarrhea and verbalized understanding of causative factors of diarrhea and rationale for treatment regimen. Long Term: -- After 1-2 days of nursing interventions, the patient shall be free of diarrhea as evidenced by reestablished and maintained normal bowel movement, reduced in frequency of

-- Nausea and Vomiting -- Abdominal cramping

1.) Administer antidiarrheal medications, as indicated. 2.) Administer medications, as ordered.

Dependent: 1.) To decrease GI motility and minimize fluid losses. 2.) To treat infectious process, decrease motility and/or absorb water.

stools and stool returned to its normal consistency.

Assessment

Nursing Diagnosis
Fluid volume deficit related to excessive secretion of watery stools.

Inference

Goal

Intervention

Rationale

Evaluation

Subjective: y Poor breastfeeding and hygienic techniques. y Mother lacks knowledge. y Client is sleepy. y The client is lethargic and has sunken eyeballs. y The mother was not able to breastfeed well her child. Objective: y Diarrhea in 3 days. y Acute gastroenteriti s. y E.coli found in the stool. y 2-3 se capilliary refill and PR: 120 bpm.

Increased production and secretionof fluids and electrolytes Diarrhea

Short Term:
After 2-3 hours of nursing interventions the mother s patient will verbalize

Briefly explain the disease condition.

To establish rapport and gives the patient a secured feeling

Short Term:
After 2-3 hours of nursing interventions the mother s patient

understanding of Fluid volume deficit disease processes, possible complications

y y

Inform the significant other the procedures to be made

Promote cooperation on the part of the patient and significant other

verbalized understanding of disease processes, possible complications

Assess vital signs

Long Term:
After 1-2 days of nursing interventions the client will feel comfortable and safe and will achieve wellness. y Note physical signs of Dehydration y

To ascertain status and note progress

Long Term:
After 1-2 days of nursing interventions the client was comfortable and safe and achieved wellness.

To evaluate degree of fluid deficit

Keep fluid with in reach and encourage frequent intake as possible.

Gives convenience to the patient s parent.

Maintain accurate I&O

To ascertain status and note progress

PA: loss 1 kg body weight, gray skin color, poor skin elasticity, very dry mucous membrane, oliguria.

Change position frequently

Promote ventilation and cooling of body surface

Bathe every other y day, promote skin care, provide oral and eye care

To prevent injury from dryness

Provide safety measure if the patient is confused or weak

To avoid accidents such as falls

Monitor Vital signs and 1& O

To ascertain status and note progress

Assist patient s parent to learn to measure own I&O

Increase independence

Discuss factors related to dehydration

Promote self-care

y y Review medications and side effects

Prevent injuries due to medication side effects

y y Note signs and symptoms indicationg need for emergent/ further evaluation and follow-up

Promote continuity of care

Assessment

Diagnosis

Inference

Planning

Intervention

Rationale

Evaluation

Subjective: Patient s mother verbalized mainit palagi siya kapag hinahawakan. Siguro dahil sa mainit ditto sa ward .

Hypertherm ia related to related to dehydration as evidenced by increase in body temperature higher than normal range.

Infectious agents (Pyrogens) Stimulate Monocytes Release Pyrogenic cytokines Stimulate Anterior hypothalamus results in Elevated thermoregulatory set point leads to Increased Heat conservation (Vasoconstriction /behavior

Short term: After 1-2 hours of nursing intervention client will be in: y Normal in temperat ure Decreased seizure activity

Independent: y Promote surface cooling by means of tepid sponge bath. y Wrap extremities with cotton blankets. y Encourage the patient to Increased oral fluid intake y Provide supplemental oxygen. y Encourage SO to clean environment and to provide enough ventilation.

- To decrease temperature through evaporation and conduction. -To minimize shivering. -To prevent dehydration] -To offset Increased oxygen demands and consumption. -To feel comfortable and to decrease temperature through radiation and evaporation. - To keep patient comfortable. -To check the effectiveness of the

Short Term After 1-2 hours of nursing intervention client will be in: y Temperature is normal y No seizure activity at the end of the shift

Objective: y Body Temperat ure = 38 C y Warm to touch skin RR = 45 bpm HR = 110

Long term: After 1-2 days nursing interventions client s parents will: y Know and demonstr ate how

Long term goal: Relati ve know to prom

bpm y Body sweating Seizure precautio n

changes)

Increased Heat production (involuntary muscular contractions)

to promote normothe rmia y Nomal body temperat ure Skin is not warm to touch Be free from seizure activity

y Promote relaxation y Monitor vital signs & the intake & output.

intervention & to prevent complications.

ote norm other mia

- To decrease body temperature.

y Normal in temperature y Still recurrence of seizure

y Convulsio n FEVER y Collaborative: yAdminister antipyretic as order. *Paracetamol (5oo mg/tab PRN if T > 37.8 C) or 1 amp PRN if T > 38 0C