Generic/Trade Name Generic name: haloperidol Brand name: Haldol

Dosage/ Frequency 5 mg/ml

Classification Antipsychotics

Action Alters the effects of dopamine in the CNS Also has anticholinergic and alphaadrenergic blocking activity. Diminished signs and symptoms of psychoses

Indication Organic Psychoses acute psychotic symptoms Relieve hallucinations, delusions, disorganized thinking severe anxiety seizures

Contraindication seizure disorder glaucoma elderly clients

Adverse Effects CNS: extrapyramidal symptom such as muscle rigidity or spasm, shuffling gait, posture leaning forward, drooling, masklike facial appearance, dysphagia, akathisia, tardive dyskinesia, headache, seizures. CV: tachycardia, arrhythmias, hypertension, orthostatic hypertension. EENT: blurred vision, glaucoma GI: dry mouth, anorexia, nausea, vomiting, constipation, diarrhea, weight gain. GU: urinary frequency, urine

Nursing Consideration Assess mental status prior to and periodically during therapy. Monitor BP and pulse prior to and frequently during the period of dosage adjustment. Observe patient carefully when administering medication. Monitor I &O ratios and daily eight. Assess patient for signs and symptoms of dehydration. Monitor for development of neuroleptic malignant syndrome Advise patient to take medication as directed.

retention, impotence, enuresis, amenorrhea, gynecomastia Hematologic: anemia, leucopenia, agranulocytosis Skin: rash, dermatitis, phtosensitivity

Generic/Trade Name Generic name: diphenhydramine Brand name: Benadryl

Dosage/ Frequency 50g

Classification Antiparkinsonian drug

Action Antagonizes the effect of histamine at H1 receptor sites; does not bind or inactivate histamine

Indication parkinsonism or drug-induced extrapyramidal effects

Contraindication cardiac disease or hypertension glaucoma gastric or duodenal ulcers

Adverse Effects CNS: headache, fatigue, anxiety, tremors, vertigo, confusion, depression, seizures, hallucinations CV: tachycardia, palpitations, orthostaic hypotension, heart failure EENT: blurred vision GI: dry mouth, nausea, vomiting, constipation, flatulence GU: urinary hesitancy or frequency, urine retention Hematologic: leukopenia Skin: photosensitivity, dermatitis

Nursing Consideration Caution the client that the medication may cause drowsiness, creating difficulties or hazards or other activities that require alertness. Tell the client to take the medication with food to decrease GI upset. Explain to the client that arising quickly form a lying or sitting position may cause orthostatic hypotension. When taking these medications, the client needs to have blood cells counts, renal function, hepatic

function, and blood pressure monitored. Adverse effects of these drugs occur more commonly in elderly clients. Explain to the client that use of these drugs in warm weather may increase the likelihood of heatstroke.

Generic/Trade Name Generic Name: Biperiden Brand Name: Akineton

Dosage/ Frequency 2g tab

Classification Anti cholinergic drug

Action Synthetic anticholinergic dru g blocks cholinergic responses in the CNS

Indication Parkinsonian syndrome especially to counteract muscular rigidity and tremor; extrapyramidal symptoms

Contraindication -Untreated narrow angle glaucoma -intestinal stenosis or obstruction -mega colon -prostatic hypertrophy - life threatening -tachycardia

Adverse Effects -CNS and peripheral effects - skin rashes -dyskinesia -ataxia -twitching -impaired speech micturition difficulties Fatigue -dizziness at higher doses -restlessness -agitation anxiety -confusion

Nursing Consideration Assess for Parkinsonism, EPS. *Assess for mental status. *Assess patient response if anti cholinergics are given. *Assess for tolerance over long term therapy , dosage may have to be increased or changed. *Avoid activities that require alertness, may cause dizziness, drowsiness and blurring of vision.

Generic/Trade Name Generic Name: Amoxicillin Brand Name: Amoxil, Polymox

Dosage/ Frequency 250 mg

Classification Non-narcotic anal gesic, Antipyretic, Antibiotic

Action This drug is a semi-synthetic broad spectrum penicillin closely related to Ampicillin. It binds to Penicillinbinding proteins in the cytoplasmic membranes of bacteria, thus inhibiting cellwall synthesis. It also inhibits cell growth and cell division. It is better absorbed than Ampicillin.

Indication Ear, nose, and throat infections due to Streptococcus species. GU Infections due to Escherichia coli, Proteus miribalis, Enterococcus facecalis. Skin infections due to Streptococcus, S. pneumonia, Staphylococcus, or H. haemophilus Acute uncomplicated gonococcal infections due to Neisseria gonorrhoeae. In combination with omeprazole or lansoprazole to treat duodenal ulcers by eradicating Helicobacter pylori.

Contraindication -Hypersensitivity -Use of the 875mg tablet in clients with a GFR less than 30mL/minute.

Adverse Effects

Nursing Consideration -Note for any hypersensitivity reaction -Instruct clients that therapeutic regimen must be completed even if symptoms subside. -Childs dose should not exceed maximum adult dose. -Clients with GFR of 10-30 mL/min should receive 250500mg q12h. -Monitor CBC, renal and liver function tests. May be taken with food. -Antibiotic resistance may occur if used without practitioner consultation as

white patches or sores inside your mouth or on your lips; fever, swollen glands, rash or itching, joint pain, or general ill feeling; severe blistering, peeling, and red skin rash; pale or yellowed skin, yellowing of the eyes, dark colored urine, fever, confusion or weakness; severe tingling, numbness, pain, muscle

weakness; or easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

duration of therapy may not be completed. -Report: bleeding, sore throat, rash, diarrhea, worsening of symptoms, lack of response.

Cues Subjective: nalulungkot ako kasi dinala nila ako dito gusto ko na kasi lumabas. Objective: -poor eye contact -Low voice tone -Flat affect

Nursing Diagnosis Ineffective Coping related to Situational crisis as evidenced by poor eye contact and flat affect

Analysis Inability to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or inability to use available resources. (p.227 Nurses Pocket Guide 11th edition)

Planning Goal: After 8 hours of nursing intervention the client will be able to identify and manage effective coping patterns Objective: After 4 hours of nursing intervention the client will be able to meet psychological needs as evidenced by appropriate expression of feelings. After 4 hours of nursing intervention the client will be able to provide for meeting psychological

Intervention -Provide an atmosphere of acceptance

Rationale -Establishing a rapport is essential to a therapeutic relationship and supports the client in self- reflection. Recognizing thoughts and feeling is best brought about in atmosphere of warmth and trust. -To identify successful techniques that can be used in current situation -Open, nonthreatening discussions facilitate the identification of causative and contributing factors -May help client to express emotions, grasp

Evaluation

-Determine previous methods of dealing with life problems -Encourage verbalization of feelings, perceptions and fears.

-Devote time for listening

needs. -Encourage to identify her own strengths and abilities

situation, and feel more in control. -To develop strategies for coping based on personal strengths and previous experiences. Improves selfconcept and sense of ability to manage stress. -enhances therapeutic relationship.

-Provide meaningful conversation

Cues

Nursing Diagnosis

Analysis

Planning

Intervention

Rationale

Evaluation

Subjective: Gusto ko na sana lumabas para pag labas ko magtatrabaho na ako para makabawi naman sa mga magulang ko at makapag asawa narin. Objective: Actions are congruent with expressed feelings and thoughts

Readiness for Enhanced SelfConcept

A pattern of perceptions or ideas about the self that is sufficient for wellbeing and can be strengthened (p.583 Nurses Pocket Guide 11th edition)

Goals: After 8 hours of nursing intervention the client will be able to demonstrate behaviors changes to promote positive selfesteem. Objectives: After 4 hours of nursing intervention the client will be able to verbalize understanding of own sense of selfconcept. After 4 hours of nursing intervention the client will be able to participate in programs and activities to enhance self-

-Determine availability /quality of family/SO (S) support.

-Presence of supportive people who reflect positive attitudes regarding the individual promotes a positive sense of self. -Individuals who have a sense of their own selfimage and are willing to look at themselves realistically will be able to progress in the desire to improve -Promotes trusting situation in which client is free to be open and honest with self and others -Avoids threatening existing self-

-Note willingness to seek assistance/ motivation for change.

-Develops therapeutic relationships. Be attentive, maintain open communication. -Accept clients perceptions/view of current status.

esteem

-Encourage client to progress at own rate

esteem and provides opportunity for client to develop realistic plan for improving selfconcept. -Adaptation to a change in selfconcept depends on its significance to the individual and disruption to lifestyle. -Enhances sense of well-being/can help to energize client. -Provides opportunity for learning new information/skills that can enhance feelings of success, improving selfesteem.

-Involve in activities program of choice, promotes socialization -Encourage participation in activities that clients enjoys or would like to experience