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DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Classification
Mechanism of Action
Indications
Contraindications
Nursing Responsibilities
Cefuroxime sodum
CNS: Headache, dizziness, lethargy, paresthesia GU: Nephrotoxicity Local: pain at the injection site, inflammation at IV site
Avoid alcohol intake while taking this drug and for 3 days after because of severe reactions often occur. Report immediately if experience severe diarrhea, difficulty of breathing, fatigue, pain at injection site.
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES PUERTO PRINCESA CITY
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident
Name of Drug Classification
Ward: SURGICAL
Indication
Contraindication
Side effects
Nursing responsibilities
Paracetamol
Antipyretic, analgesic
Exhibits analgesic action by peripheral blockage of pain impulse generation. It produces antipyresis by inhibiting the huypothalmic heat-regulating centre. Its weak anti-inflammatory activity is related to inhibition of prostaglandin synthesis in the CNS.
It is also used to bring Hypersensitivity to CNS: Headache down a high acetaminophen GU: acute kidney temperature. failure, renal For this reason, tubular necrosis paracetamol can be Hematologic: given to children Hemolytic anemia, after vaccinations to hematuria, prevent postneutropenia, immunisation pyrexia leukopenia (high temperature). Hypersensitivity: -is often included in rash, fever cough, cold and flu remedies
Report rash, unusual bleeding or bruising, yellowing of skin and eyes, changes in voiding patterns
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES PUERTO PRINCESA CITY
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident
Name of Drug Classification
Ward: SURGICAL
Indication
Contraindication
Side effects
Nursing responsibilities
Metronidazole
500mg IV q 8
Bactericidal: Prophylaxis for Inhibits DNA patients undergoing synthesis in abdominal surgery specific (obligate) anaerobes, causing cell death; antiprotozoaltrichomonacidal, amebicidal: Biochemical mechanism of action is not known.
Contraindicated with hypersensitivity to metronidazole,; pregnancy (do not use for the first trimester). Use cautiously with hepatic disease, CNS diseases, candidiasis (monoliiasis), blood dyscrasias, lactation
CNS: Headache, dizziness, ataxia, fatigue GU: Dysuria, incontinence, darkening of the urine Local: Redness, burning, dryness and skin irritation
The urine may be a darker color than usual Report dizziness, unusual fatigue or weakness, fever and chills
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Name of Drug
Classification
Mechanism of Action
Indications
Contraindications
Nursing Responsibilities
Ranitidine
50 g IV q 8 hr
Competitively inhibits action of h2 at receptor sites of the parietal cells, decreasing gastric acid secretion
of Contraindicated CNS: Headache, malaise, acid with allergy to dizziness, somnolence, sour ranitidine, lactation insomnia, vertigo CV: Tachycardia, Use cautiously with bradycardia, PVCs ( impaired renal or rapid IV administration) hepatic function Dermatologic: Rash, alopecia Local: pain at injection site, local burning or itching at IV site
Assess patients GI condition before starting the therapy. Be alert for adverse reactions and drug interactions. Urge patient not to smoke; smoking, may increase gastric acid secretion and worsen disease.
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Classification
Mechanism of Action
Indication
Contraindication
Side effects and Adverse Reaction CNS: Headache, dizziness, somnolence, insomnia, fatigue, tinnitus Dermatologic: Rash, pruritus, sweating, dry mucous membranes GU: renal impairment, dysuria Respiratory: Dyspnea, hemoptysis, pharyngitis, bronchospasm, rhinitis
Nursing Responsibilities
Short term Contraindicated with management of significant renal pain (up to 5 impairment days). Use cautiously with allergies; and GI conditions
Administer drug on time to control pain; dizziness, drowsiness can occur (avoid driving or using dangerous machinery). Report itching, weight gain, swelling of ankles or fingers.
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Classification
Mechanism of Action
Indication
Contraindication
Side effects and Adverse Reaction CNS: Headache, dizziness, somnolence, insomnia, fatigue, tinnitus Dermatologic: Rash, pruritus, sweating, dry mucous membranes
Nursing Responsibilities
Analgesic NSAID
Analgesic and anti- Management inflammatory activites acute pain related to inhibition of the COX 2 enzyme, which is activated in inflammation to cause the signs and symptoms associated with inflammation does not affect the COX 1 enzyme, which protects the lining of the GI tract and has blood clotting and renal failure
of Contraindicated with allergies to sulphonamides, celecoxib, NSAIDs or aspirin; significant renal impairment Use cautiously with impaired hearing, hepatic and CV conditions
Take only the prescribed dosage You may experience these side effects: Dizziness, drowsiness Report fever, rash, itching, weight gain, swelling in ankles or fingers; changes in vision
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Name of Drug
Mannitol
Classification
Mechanism of Action
Indication
Contraindication
Nursing Responsibilities
Osmotic, Diuretic
Elevate the osmolarity of the glomerular filtrates, thereby hindering the reabsorption of water and leading to a loss of water, sodium chloride (used for diagnosis of glomerular filtration rate); creates an osmotic gradients in the eye between plasma and ocular fluids, thereby reducing IOP; creates an osmotic effect, leading to decreased swelling in posttransurethal prostatic resection.
Reduction of intracranial pressure and treatment of cerebral edema; of elevated IOP when the pressure cannot be lower by other means.
Contraindicated with anuria due to severe renal disease. Use cautiously withpulmonary congestion, active intracranial bleeding (except during craniotomy), dehydration, renal disease and CHF.
You may experience this side effects: increase urination; GI upset (suck sugar less lozenges); blurred vision, (used caution when moving, ask for assistance). Report difficulty of breathing, pain at the IV site, chest pain.
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Name of Drug
Mannitol
Classification
Mechanism of Action
Indication
Contraindication
Nursing Responsibilities
Osmotic, Diuretic
Elevate the osmolarity of the glomerular filtrates, thereby hindering the reabsorption of water and leading to a loss of water, sodium chloride (used for diagnosis of glomerular filtration rate); creates an osmotic gradients in the eye between plasma and ocular fluids, thereby reducing IOP; creates an osmotic effect, leading to decreased swelling in posttransurethal prostatic resection.
Reduction of intracranial pressure and treatment of cerebral edema; of elevated IOP when the pressure cannot be lower by other means.
Contraindicated with anuria due to severe renal disease. Use cautiously withpulmonary congestion, active intracranial bleeding (except during craniotomy), dehydration, renal disease and CHF.
You may experience this side effects: increase urination; GI upset (suck sugar less lozenges); blurred vision, (used caution when moving, ask for assistance). Report difficulty of breathing, pain at the IV site, chest pain.
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Name of Drug
Amlodipine Besylate
Classification
Mechanism of Action
Indication
Contraindication
Nursing Responsibilities
Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; Inhibits transmembrane calcium flow which results in the depression of impulse formation in specialized cardiac pacemaker cells, slowing the velocity of conduction of cardiac impulse, depression of myocardial contractility, and dilation of coronary arteries, and arterioles, and peripheral arterioles; this effects lead to decrease cardiac work,
Angina pectoris due to coronary artery spasm (printzmetals variants. Chronic stable angina, alone or in combination with other agents. Essential hypertension, alone or in combination with other hypertensive.
Contraindicated with allergy to amlodipine, impaired or hepatic renal function, sick sinus syndrome, heart block nd rd (2 or 3 degree). Use cautiously with CHF.
Take with meals if GI upset occurs. You may experience this side effects; nausea, vomiting (eat frequent small meals); headache, (adjust lighting, noise, temperature; medication maybe ordered). Report irregular heartbeat, shortness of breath, swelling of hands or feet, pronounced dizziness, constipation.
decrease cardiac oxygen consumption, and in patients with vasospastic (printzmetals) angina, increase delivery of the oxygen to cardiac cells.
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Name of Drug
Simvastatin
Classification
Mechanism of Action
Indication
Contraindication
Nursing Responsibilities
Take drug in the evening. Do not take grape fruit juice while using this drug. You may experience this side effects: nausea (eat frequent small meals); headache, muscle and joint aches and pains (may lessen); sensitivity to light (use a sunscreen and wear protective clothing). Report severe GI upset, changes in vision, unusual bleeding, or bruising, dark urine and dark colored stools, fever, muscle pain or soreness.
Inhibits HMGCoA reductase, the enzyme that catalyzes the first step in the cholesterol synthesis pathways, resulting in a decrease in serum cholesterol, serum LDLs, and either an increase or no change in serum HDLs.
Adjunct to diet in the treatment of elevated total cholesterol and LDL cholesterol with primary hyper cholesterolemia (type II A and II B), in those unresponsive to dietary restriction of saturated fat and cholesterol and other non pharmacologic measures. To reduce the risk of coronary disease, mortality, in CV events, including stroke.
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Name of Drug
Lanzoprozole
Classification
Mechanism of Action
Indication
Contraindication
Nursing Responsibilities
Gastric acid-pump inhibitor: suppresses gastric acid secretions by specific inhibition of the hydrogen-potassium ATP ase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production.
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Name of Drug
Amikacin Sulfate
Classification
Mechanism of Action
Indication
Contraindication
Nursing Responsibilities
Aminoglycoside antibiotic
Bactericidal: Inhibit protein synthesis in susceptible strains of gram-negative bacteria, and the functional integrity of bacterial cell membrane appears to be distracted, causing cell death.
Contraindicated with allergy to any aminoglycosides, renal or hepatic disease. Use cautiously with elderly patients, with diminished hearing-, decreased hearing, decreased renal function dehydration, neuro muscular disorders.
This drug is only available for IM or IV use. You may experience this side effect: headache, dizziness (reversible; safety measures may need to be taken if severe) nausea, vomiting. Report pain of injection site, severe headache, dizziness, difficulty of breathing, rash or skin lesions.
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Name of Drug
Ceftazidime
Classification
Mechanism of Action
Indication
Contraindication
Nursing Responsibilities
Dermatologic infections caused by P-aeruginosa S. Aureus, E. Coli, Serratia, Proteus, Klebsiella, H. Influenzae, Enterobacter, S. Pyogens. CNS infection caused by H. Influenzae, N. Meningitides.
with to or
Avoid alcohol while taking this drug and for three days after because severe reactions often occur, You may experience these side effect: stomach upset, diarrhea. Report severe diarrhea, difficulty of breathing, unusual tiredness or fatigue, pain at injection site.
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Name of Drug
Ceftazidime
Classification
Mechanism of Action
Indication
Contraindication
Nursing Responsibilities
Dermatologic infections caused by P-aeruginosa S. Aureus, E. Coli, Serratia, Proteus, Klebsiella, H. Influenzae, Enterobacter, S. Pyogens. CNS infection caused by H. Influenzae, N. Meningitides.
with to or
Avoid alcohol while taking this drug and for three days after because severe reactions often occur, You may experience these side effect: stomach upset, diarrhea. Report severe diarrhea, difficulty of breathing, unusual tiredness or fatigue, pain at injection site.
DRUG STUDY
Name: F.S Diagnosis: MPI 2 vehicular accident Age: 20 years old Physician: Dr. Tucay Ward: SURGICAL
Name of Drug
Ceftazidime
Classification
Mechanism of Action
Indication
Contraindication
Nursing Responsibilities
Dermatologic infections caused by P-aeruginosa S. Aureus, E. Coli, Serratia, Proteus, Klebsiella, H. Influenzae, Enterobacter, S. Pyogens. CNS infection caused by H. Influenzae, N. Meningitides.
with to or
Avoid alcohol while taking this drug and for three days after because severe reactions often occur, You may experience these side effect: stomach upset, diarrhea. Report severe diarrhea, difficulty of breathing, unusual tiredness or fatigue, pain at injection site.
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
RESULT
Impressions: Infarct with edema: Left frontal, temporal and parietal lobes Subfalcine Herniation to the Right Infarct: Posterior lobe of the Right cerebellar hemisphere
RATIONALE
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City LABORATORY STUDY NAME OF PATIENT: F.S AGE: 21years old WARD: Surgical Ward (ONP)
URINALYSIS DATE LABORATORY EXAMINATIONS
Color Transparency Hazy None
RESULT
Dark Yellow
NORMAL VALUES
Straw- Amber
INTERPRETATION
Indicates that the urine color of the patient is concentrated and it can be altered by drugs or food s she is taking. There is a presence of bacteria, WBC or PUS in the urine.
SIGNIFICANCE
It is done to determine if there is a presence of infection or a damage kidney. To determine if there is a presence of infection or inflammation in the kidneys. It is done to determine if the patient is hypertensive or not.
Albumin
(-)
Not Present
Specific Gravity
1.015
1.010-1.017
The result is within normal range that indicate that there is no presence of chronic nephritis or diabetes insipidus Within normal range that indicates that there is no presence of infection or UTI An abnormal result that may be an indicative of bacterial infection.
To determine how concentrated the urine is and to determine presence of diseases To determine if there is a pus in the urine It is done to determine whether the bladder mucosa is shredding normally due to infection.
Pus Cells
3.9/hpf
0-5hpf
Bacteria
Few
Not Present
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City LABORATORY STUDY NAME OF PATIENT: CHIEF COMPLAINT:
DATE
CBC January 24, 2011 Hemoglobin 134 grams/liter 135-180 grams/liter
F.S
LABORATORY EXAMINATIONS
RESULT
NORMAL VALUES
INTERPRETATION
Hemoglobin count is within the normal range that indicates a blood-oxygen carrying capacity of the cells into the tissues and all throughout the body
SIGNIFICANCE
Important in blood carrying oxygen to tissues and the body.
Hematocrit
39.9 vol %
40-54%
WBC
9.03 x 10 /L
5.0-10.0 x 10 /L
Within normal range that indicates a normal level of RBC concentrated in the blood cells The WBC is above the normal range that may be an indicative of infection, inflammation or tissue injury Above normal level that indicates a bodys capacity to fight against infection Below normal range that indicates a infection present in the body either bacterial or viral.
This shows the percentage of RBCs in the total blood volume Transports oxygen bound to hemoglobin molecules throughout the body cells. This is for crucial body defense against infection To determine variation in WBCs that may signifies infection or suppression of immune system or response. Takes residence in the lymphatic tissues where they play an important role in immune response
6.5
24-40%
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DATE
LABORATORY EXAMINATIONS
ELECTROLYTES Potassium
RESULT
NORMAL VALUES
INTERPRETATION
SIGNIFICANCE
January 24 , 2011
3.8
January 14,2011
Sodium
143
Potassium
3.8
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DATE
LABORATORY EXAMINATIONS
BLOOD CHEMISTRY
RESULT
NORMAL VALUES
INTERPRETATION
SIGNIFICANCE
BUN
9.9
Uric Acid
448
Creatinin
150
Cholesterol
5.23
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
DATE
LABORATORY EXAMINATIONS
BLOOD CHEMISTRY
RESULT
NORMAL VALUES
INTERPRETATION
SIGNIFICANCE
Triglycerides
1.55
HDL
1.23
LDL
3.29
VLDL
0.70
PALAWAN STATE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES Puerto Princesa City
RESULT
RATIONALE
X- ray ultrasound