ASSESSMENT Subjective Cues: Nilagyan siya ng brace para daw maitama yung likod niya, sabi ng doctor, as verbalized

by the clients mother. Objective Cues: - Limited range of motion - Difficulty in turning - Presence of Knight Taylor Brace

PLANNING After 4 hours of nursing intervention, the patients mother will verbalize understanding of the situation and treatment regimen and safety measures. -

INTERVENTION Encourage to change position every 2 hours Schedule activities with adequate rest periods Provide regular skin care Provide passive exercises -

EVALUATION To prevent complication (e.g. decubitus ulcer) To reduce fatigue

To promote good hygiene To maintain integrity To maximize production muscle

Encourage adequate intake of fluid and nutritious foods Explain the use of adjunctive devices such as Knight Taylor Brace

energy

To promote knowledge and enhances safety

ASSESSMENT Subjective Cues: Kulang daw siya ng timbang sabi ng doctor eh as verbalized by the clients mother. Objective Cues: - Underweight - Lack of interest in eating nutritious foods

PLANNING After 4 hours of nursing intervention, the client will demonstrate a behavior to achieve appropriate weight -

INTERVENTION Assess weight, age, body build, strength, activity/ rest level Discuss eating habits, including food preferences to the clients SO Administer ordered vitamins as -

EVALUATION To provide comparative baseline

To appeal to the patients likes

To enhance intakes

patients

Encourage and provide for frequent rest periods

To conserve energy, especially in metabolic requirements To maximize nutrient intake without undue fatigue To reduce bad taste left from the medications used in respiratory treatment

Encourage small, frequent meals with foods high in protein and carbohydrates Provide oral care before/ after meals and during bedtime

DRUG Generic name: Ethambutol Brand name: Myambutol, Servambutol Classification: Antituberculotic Dosage: 15 mg/kg PO qDay

MODE OF ACTION Ethambutol is bacteriostatic against actively growing TB bacilli, it works by obstructing the formation of cell wall. Mycolic acids attach to the 5-hydroxyl groups of D-arabinose residues of arabinogalactan and form mycolylarabinogalactanpeptidoglycan complex in the cell wall. It disrupts arabinogalactan synthesis by inhibiting the enzyme arabinosyl transferase. Disruption of the arabinogalactan synthesis inhibits the formation of this complex and leads to increased permeability of the cell wall.

INDICATION Ethambutol eliminates certain bacteria that cause tuberculosis (TB). It is used with other medicines to treat tuberculosis and to prevent you from giving the infection to others.

CONTRAINDICATION Ethambutol hydrochloride is contraindicated in patients who are known to be hypersensitive to this drug. It is also contraindicated in patients with known optic neuritis unless clinical judgemnet determines that it may be used. Ethambutol hydrochloride is contraindicated in patients who are unable to appreciate and report visual side ettects or changes in vision (eg, young children, unconscious patients).

ADVERSE EFFECTS loss of appetite upset stomach vomiting numbness and tingling in the hands or feet optic neuritis blurring of vision

NURSING RESPONSIBILITIES Assess patient for infection (appearance of wounds, sputum, VS, urine and stool and WBC.) at beginning and during therapy. Obtain specimens before initiating therapy. Take drug as indicated. Not to be given to children 6 years below due to optic neuritis Provide supplemental vitamin A. if not contraindicated

DRUG Generic Name: Pyrazinamide

MODE OF ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECTS

Pyrazinamide is used with other medications to Brand Name: treat tuberculosis Tebrazid (Canada) (TB). It is an antibiotic and Classification: works by stopping Antituberculotic the growth of bacteria. This Dosage: antibiotic treats 15-30 mg/kg PO qD only bacterial (max, 2 g/day) or infections. It will 50 to 70 mg/kg 2 not work for viral times/wk. infections (such as common cold, flu). Unnecessary use or misuse of any antibiotic can lead to its decreased effectiveness.

Initial treatment of Severe hepatic active tuberculosis damage; acute gout. in adults and selected children when combined with other antituberculosis agents. After treatment failure with other primary drugs in any form of active tuberculosis.

NURSING RESPONSIBILITIES Malaise Measure baseline serum Nausea uric acid and Vomiting liver function Anorexia prior to the Arthralgia onset of Myalgia therapy and Fever periodically Rash during Itching treatment. Acne Use only if Photosensitivity therapy is Gout essential. Dysuria Appears to be Porphyria well tolerated Thrombocytopenia in children. Hepatotoxicity Use with Interstitial caution, usually nephritis starting at the low end of the dosage range, because of the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant

diseases or other drug therapy. Advise patient to avoid intake of alcoholic beverages and alcoholcontaining products. Emphasize importance of follow-up examinations to monitor effectiveness of therapy and identify adverse reactions.