XIII.

HEALTH TEACHING PLAN 46

Medication Exercise Treatment Hygiene Outpatient Diet

Furosemide

C: Loop Diuretic

H: Inhibits reabsorption  Upon arrival  The nurse  Client and S/O were told  Client is advised to  Patient was put on low salt
of sodium and chloride patient was assigned to take a bath everyday come back if the low fat diet to decrease
at proximal and distal lying on bed instructed the to maintain proper physician requires and fluid retention.
tubule and in the loop of awake, client to take the hygienie. follow up check up
Henle consicous medicine and report any
and alert. prescribed to her  The client was also abnormalities are  Ask client to avoid foods
E: 40 mg; IVTT;q8h She can by the asked to change her observed.
clean clothes, if possible such as:
C: nephrotic syndrome, move physician.
independtly one size bigger to  Smoked, cured, salted or
ascites, hypertension . provide comfort.
without any  Make the client and canned meat, fish or
K: assistance  Health teaching S/O understand why poultry including bacon,
 Assess signs of needed cold cuts, ham,sausage,
metabollic acidosis, was given to the maintaining
hypokalemia,  The patient client about the  The use of lotions, oils , environmental sardines,
treatments given and moisturizers was cleanliness needs to be  Frozen breaded meats
Weight, I&O daily was taught
to determine fluid by the doctor also encouraged by the observed in order to
passive student nurse to
loss; effect of drug
range of which in cludes reduce infections. Also  Salted nuts
may be decreased if dietary changes maintain skin integrity. ensure that the client
used daily. motion by  Beans canned with salt
the student and medicines. feels safe and
added
 In AM to avoid nurse to comfortable.
 Dental care was also
 47

interference with promote  Monitoring of reinforced by the student  Bread and rolls with salted
sleep if using drug circulation to oral fluid intake nurse in charge, client tops
as a diuretic the and output was was told to brush teeth  Tell patient to have her
 Potassium BP regularly checked  Quick breads, self-rising
extremities also ordered by 2-3 times a day with a
replacement if to monitor her health flour, biscuit, salted
potassium < 3  the physician. soft bristle tooth brush,
The student to avoid gum bleeding. status. crackers
mg/dl
nurse also Proper perineum care
reinforced  Prepackaged, processed
Atorvastatin was also taught by the mixes for potatoes and rice
C:Antilipidemic teachings student nurse to the  Advise client comply
H: Inhibits HMG-CoA about client to help ward off with the medications
reductase enzyme, elevating the perscribed by the
infection and bad odor.
which reduces feet of the physician.
cholesterol synthesis client where
E:40 mg/tab 1 tab  Client and S/O to
bipedal
ODHS  SO and Client was also incooperate more frsh fruit
C:As an adjunct in edematous
advised to change the and vegtables into patients
primary hyper- can be seen,
bed linens to promote diet.
cholesterolemia, to increase
venous clean and comfortable
dysbetalipoproteinemia, environment.
elevated triglyceride return to
levels, prevention of CV heart and
decrease
disease by reduction of  Patient was on limited oral
heart risk in those with edema.
fluid intake (LOFI) of one
mildly elevated  Ask client liter per day. MIO was
cholesterol and S/O to strictly reinforced

K: plan periods
of rest, sleep,
 Assess diet, obtain and activities
 48

diet history, for the client

including fat, to decrease
cholesterol in diet stress.
 Assess cholesterol
triglyceride levels  S/O was
periodically during asked to also
treatment; check
provide
lipid panel 6 wk
after changing dose assistance to
 Renal studies in client with
patients with ambulating
compromised renal or
system: BUN, I&O positioning,
ration, creatinine if needed to
  for muscle pain,
avoid slips or
tenderness, obtain
CPK baseline and if falls.
these occur, drug
 The student
may need to be
discontinued nurse also
 Teach patient to minimized
stay out of the sun, any
or use sunscreen environment
protective clothing al stress and
to prevent
noises to
photosensitivity
(rare) provide
comfort to
Ceftriaxone the client.

C: Broad-spectrum
 49

antibiotic
H: Inhibits bacterial cell
wall synthesis,
rendering cell wall
osmotically unstable,
leading to cell death
E:2g IV x3h drip q24h
C:Streptococcus
pyogenes,
Staphylococcus aureus;
serious lower respiratory
tract, urinary tract, skin,
gonococcal,
intraabdominal
infections, septicemia,
K:
Assess:
 Sensitivity to
penicillin, other
cephalosporins
  Nephrotoxicity:
increased BUN,
creatinine; urine
output: if
decreasing, notify
prescriber; may
indicate
nephrotoxicity
 Blood studies: AST,
ALT, CBC, Hct,
bilirubin, LDH, alk
 50

phosphatase,
Coombs’ test
monthly if patient is
on long-term
therapy
 Electrolytes: K, Na,
Cl monthly if
patient is on long-
term therapy
 Bowel pattern daily;
if severe diarrhea
occurs, drug should
be discontinued;
may indicate
pseudomembranous
colitis
 IV site for
extravasation,
phlebitis; change
site q72h
  anaphylaxis:
rash, urticaria,
pruritus, chills,
fever, joint pain,
angioedema; may
occur few days after
therapy begins
 Bleeding:
ecchymosis,
bleeding gums,
hematuria, stool
 51

guaiac
  overgrowth of
infection: perineal
itching, fever,
malaise, redness,
pain, swelling,
drainage, rash,
diarrhea, change in
cough, sputum

Losartan

C:Antihypertensive
H: Inhibits bacterial cell
wall synthesis,
rendering cell wall
osmotically unstable,
leading to cell death
E: 50mg/tab 1 tab BID
C: Hypertension, alone
or in combination,
nephropathy in type 2
diabetes, hypertension
with left ventricular
hypertrophy
K:
Assess:
 BP with position
changes, pulse q4h;
note rate, rhythm,
quality
 52

 Electrolytes: K, Na,
Cl
 Baselines in feet,
legs daily
 Skin turgor, dryness
of mucous
membranes for
hydration status

Teach patient/family:
 To avoid sunlight or
wear sunscreen if in
sunlight;
photosensitivity
may occur.
 To notify prescriber
of mouth sores,
fever, swelling of
hands or feet,
irregular heartbeat,
chest pain
 That excessive
perspiration,
dehydration,
vomiting, diarrhea
may lead to fall in
blood pressure;
consult prescriber if
these occur

Clopidogrel
 53

C:Platelet aggregation
inhibitor
H: Inhibits first and
second phases of ADP-
induced effects in
platelet aggregation
E: 75 mg/tab 1 tab OD
C:Inhibits first and
second phases of ADP-
induced effects in
platelet aggregation
K:
Assess:
 For symptoms of
stroke, MI during
treatment
 Hepatic studies:
AST, ALT,
bilirubin, creatinine
(long-term therapy)
 Blood studies:
CBC, Hct, Hgb, PT,
cholesterol (long-
term therapy)

Teach Patient/Family:
 That blood work
will be necessary
during treatment
 54

 To report any
unusual bruising,
bleeding to
prescriber; that it
may take longer to
stop bleeding
 To take with food
or just after eating
to minimize GI
discomfort
 To report diarrhea,
skin rashes,
subcutaneous
bleeding, chills
fever, sore throat
 To tell all health
care providers that
clopidogrel is used;
may be held 3-7
days before surgery