DRUG STUDY

NAME OF DRUG CLASSIFICA TION INDICATION DOSAGE / PREPARA TION 2 months (single 60mg dose). 3 months1 year, 60 120mg; 1 5 years, 120 250mg; 612 years, 250 500mg; all four- to six-hourly as required, max 4 doses in 24 hrs. MECHANISM OF ACTION ADVERSE REACTION NURSING RESPONSIBILITY

Paracetamo l

Non-narcotic analgesics, antipyretics

Relief of pain and fever

Antipyretic: it inhibits the synthesis of cyclooxygenase (COX), which is responsible for the metabolism of arachidonic acid to prostaglandin. This leads to a reduced amount of prostaglandin thus lowering the hypothalamic set point in the thermoregulatory center. Analgesic: modulates the endogenous cannabinoid system wherein paracetamol is metabolized to AM404 that inhibits the uptake of endogenous cannabinoid/ vanilloid anandamide by neurons. Uptake of it would result in the activation of the pain main receptor (nociceptor) of the body.

rarely, rash, blood disorders. Hypotension following infusion

Liquid form for children and patients with difficulty swallowing In children, dont exceed 5 doses in 24 hours Advise patient that it is only use for a short-term use and consult physician if it will be given to children for 5 days or to adults for 10 days.

NAME OF DRUG Cefuroxime

CLASSIFICATION INDICATION Antibiotic Cephalosporin (second generation Lower respiratory infections caused by S. pneumonia, S. aureus, E. coli, Klebsiella pneumoniae, H. influenza, S. pyogenes Dermatologic infections caused by S. aureus, S. pyogenes, E. coli, K. pneumoniae, enterobater UTIs caused by E. coli, K. pneumoniae

DOSAGE / PREPARATION Tablets: 125, 250, 500 mg; Suspension: 125mg/5ml, 259mg/5ml; Powder for injection: 750mg, 1.5g; Injection: 750mg, 1.5g

MECHANISM OF ACTION Bactericidal: inhibits synthesis of bacterial cell wall, causing cell death

ADVERSE REACTION >CNS: headache, dizziness, lethargy >G.I.: nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence

NURSING RESPONSIBILITY Reporting severe diarrhea with blood, pus or mucus, rash, difficulty breathing, unusual tiredness, fatigue, unusual bleeding or bruising, and unusual itching or irritation

NURSING CARE PLAN

NAME OF DRUG Salbutamol CLASSIFICATION INDICATION DOSAGE / PREPARATION MECHANISM OF ACTION Salbutamol is a direct-acting sympathomimetic with adrenergic activity and selective action on 2 receptors, producing bronchodilating effects. ADVERSE REACTION >CNS: tremor, nervousness, dizziness, insomnia, headache, weakness, malaise. >CV: tachycardia, palpitations, hypertension NURSING RESPONSIBILITY >Assess lung sounds and pulse rate before drug administration. >If administering medication through inhalation, allow at least 1minute between inhalation of aerosol medication. >do back tapping after nebulization. >Adminster P.O. medication with meals to minimize gastric irritation.

Bronchodilator

Salbutamol is a neb direct-acting sympathomimetic with adrenergic activity and selective action on 2 receptors, producing bronchodilating effects.

NAME OF DRUG

CLASSIFICA TION

INDICATION

DOSAGE / PREPARATION

MECHANISM OF ACTION

ADVERSE REACTION

NURSING RESPONSIBILITY

Vitamin A

Tretinoin

effective for the treatment of vitamin A deficiency

50,000 USP Units (15 mg retinol/mL)

Vitamin A is Vitamin A effective toxicity for treatment of conditions such as acne orlung diseases, or for treatment of eye problems, wounds, or dry or wrinkled skin

Teach the family about the Vitamin A toxicity Caution pregnant pati ent about the taking of vitamin A Teach patient that over consumption of vitamin A can cause nausea, irritability and blurred vision. Teach patient that Vitamin A must be avoided from direct sunlight exposure Instruct patient/family that if there is a sign of over dosage of vitamin A, it must be reported immediately to the physician.

ASSESSMENT
S > Inuubo siya as verbalized by the SO O > with unproductive cough >heard crackles upon auscultation > with high respiratory rate, 37 bpm > frequent coughing noted > facial grimace noted > weak in appearance > dry lips noted

DIAGNOSIS
Ineffective airway clearance related to retained secretions in the bronchi

PLANNING
After 4 hours of nursing intervention, the patient demonstrate reduction of cough

INTERVENTION
Establish and maintain rapport to the pt. Provide therapeutic environment such as: Changing of bed linens Proper ventilation Monitor respiration and breath sounds

RATIONALE
To get the trust and cooperation

EVALUATION After 4 hours of nursing intervention, the cough of pt. was lessen

To provide comfort

Evaluate clients cough reflex

To know if the pt. is suffering from respiratory distress To determine ability to protect own airway To avoid alleviation of cough To liquefy the secretions. To help in relieving cough.

Instruct the SO to keep the back of the pt. dry at all times Instruct the patient to increase fluid intake Encourage the patient to eat fruits that are rich in Vit. C

ASSESSMENT S-Medyo nahihirapan akong huminga as verbalized by the patient . O>Presence of wheezes. >Ineffectivecough. >V/S taken asfollows: T: 35.7 CR: 103bpm R: 32

NURSING DIAGNOSIS Ineffective airway clearance related to excessive, thickened mucous secretions

PLANNING After 4 hours of nursing interventions the patient will have an effective breathing pattern.

INTERVENTION >Assess respiratory rate, depth. Note use of accessory muscles, pursed lip breathing, Inability to speak. >Elevate head of the bed, assist patient assume position to ease work of breathing. Encourage deep slow or pursed lip breathing as individually tolerated or indicated. >Routinely monitor skin and mucous membrane color.

RATIONALE >Useful in evaluating he degree or respiratory distress and chronicity of the disease process >Oxygen delivery may be improved by upright position and breathing exercises to decrease airway collapse, dyspnea and work of breathing

EVALUATION After 4 hours of nursing interventions the patient experience an effective breathing pattern.

>Cyanosis may be peripheral in nail beds or central in lips or earlobes .Duskiness and central cyanosis indicate advanced hypoxemia.

>Encourage expectoration of sputum; suction when indicated

>Thick, tenacious, copious secretions are major source if ineffective airways. Deep suctioning may be required when cough is ineffective for expectoration of secretions.

>Evaluate level of activity tolerance. Provide calm and quiet environment.

>During severe or acute respiratory distress, patient maybe totally unable to perform basic self care activities because of hypoxemia and dyspnea. >Multiple external stimuli and presence f dyspnea may prevent relaxation and inhibit sleep.

>Evaluate sleep patterns, note report of difficulties and whether patient feels well rested.

ASSESSMENT

NURSING DIAGNOSIS Altered body temperature related to bacterial invasion in the lungs

PLANNING

INTERVENTION

RATIONALE

EVALUATION

S>Nilalagnat nap o ang anak ko,ang init nya as verbalized by the mother. O>febrile >moist skin >tachypnea v/s: T: 38.7 P:108bpm R:35bpm

After 2 hours nursing intervention the patients temperature will decrease from 38.7C to normal range of 36.537.5C

>Monitor patients temperature every 1 hour Record all sources of fluid loss such as urine, vomiting and diarrhea.

>to determine if the temperature is above the normal range To monitor or potentiates fluid and electrolyte loses. >allows the patient to regain physical strength >to maintain hydration status and helps lower body temperature >To decrease temperature by means through evaporation and

After 2 hours of nursing intervention the patients temperature had decreased from 39.6C to 37.4C

>Provide adequate rest periods

>Encourage patient to increase fluid intake

>Promote surface cooling by means of tepid sponge bath.

conduction. >Wrap extremities with cotton blankets. >Instruct the SO to: >do tepid sponge bath and also teach the significant others on how to do the proper TSB >To minimize shivering.

>promotes return of body temperature to normal