Drug

Dosage

Action

Indication Short-term treatment of active duodenal ulcer; First-line therapy in treatment of heartburn or symptoms of gastroesophageal reflux disease (GERD); Short-term treatment of active benign gastric ulcer; GERD, severe erosive esophagitis, poorly responsive symptomatic GERD; Long-term therapy: Treatment pathologic

Contraindication

Adverse Effect CNS: >Headache >Dizziness >Asthenia >Vertigo >Insomnia >Apathy >Anxiety >Paresthesias >Dream abnormalities

Nursing Responsibilities >Assessment History: Hypersensitvityto omeprazole or any of its components; pregnancy, lactation.

Omeprazole (losec) Classification:  Proton Pump Inhibitor

40mg IVP q 8

Gastric acidpump inhibitor; Suppresses gastric acid secretion by specific inhibition of the hydrogenpotassium ATPase enzyme system at the secretory surface of the gastric parietal cells; Blocks the final step of acid production.

Contraindicated with hypersensitivity to omeprazole or its components; Use cautiously with pregnancy lactation.

of

Physical: Skin lesions; reflexes, affect; Dermatologic: urinary output, >Rash abdominal exam; >Inflammation respiratory a us >Uritacaria cultation >Pruritus interventions >Alopecia >Dry skin >Administer before meals. GI: Caution patient to >Diarrhea swallow capsules >Abdominal whole, not to open, pain chew, or crush >Nausea them. >Vomiting

hypersecretory conditions (ZollingerEllison syndrome, multiple adenomas, systemic mastocytosis); Eradication of H. pylori with amoxicillin or metronidazole and clarithromycin; Prilose OTC: Treatment of frequent heartburn (2 or more days/week); Unlabeled use: Posterior laryngitis; enhance efficacy of pancreatin for the treatment of steatorrhea in cystic fibrosis.

>Constipation >Dry mouth >Tongue atrophy Respiratory: >URI symptoms, cough, epistaxis Other: >Cancer in preclinical studies >Back pain >Fever

Drug name Cefuroxime Classification:  Antibiotic; Cephalosporin (second generation)

Dosage 750mg IVP q 8

Action Absorbed from the GIT: primarily metabolized in the liver and excreted in the urine. Caution must be used in patient with hepatic or renal condition because either condition could alter drug metabolism and excretion. These drugs cross placenta and enter breastmilk.

Indication Oral (cefuroximeaxetil) >Pharyngitis, tonsillitis caused by Streptococcus pyogenes

Contraindication >Contraindicated with allergy to cephalosporin or penicillin.

>Otitis media caused >Use cautiously with renal failure. by Streptococcus pneumoniae, S. pyogenes ,Haemophilus influenzae, Moraxella catarrhalis >Lower respiratory infections caused by S. pneumonia. Haemophilus para influenzae, >UTIs caused by E. coli, Klebsiella pneumonia >Uncomplicated gonorrhea(urethral and

Nursing management Body as a Whole >Culture infection, :Thrombophlebitis and arrange (IV site); pain, for sensitivity tests burning, cellulitis before and during (IM site); super therapy if expected infections, response is not seen. positive Coombs >Have with Vit K test. available in case hypoprothrombinemia GI: Diarrhea, occurs. nausea, antibiotic- >Discontinue associated colitis. if hypersensitivity reaction occurs. Skin: Rash, >Determine history pruritus, urticaria. of hypersensitivity reactions to Urogenital: cephalosporin, Increased serum penicillin, and history creatinine and of allergies, BUN, decreased particularly to drugs, creatinine before therapy is clearance. initiated. >Report onset of loose stools or diarrhea. Although

Side effect

endocervical) >Skin and skin structure infections, including impetigo caused by Streptococcus aureus, S, pyogenes >Treatment of early Lyme disease

pseudo membranouscolitis. >Monitor I & O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.

Drug Diclofenac sodium Classification: CNS agent; analgesic, antipyretic, NSAID

Dosage 75 mg IVP q 8

Action Although its exact mechanism has not been fully elucidated, it appears to be a potent inhibitor of cyclooxygenase, thereby decreasing the synthesis of prostaglandin.

Indication Treatment of duodenal ulcers, reflux esophagitasis maintenance treatment to prevent relapse, ZollingerEllison syndrome and treatment of NSAIDrelated gastric and duodenal ulcers to prevent relapse.

Contraindication Hypersensitivity to diclopenac, patients in whom asthma, urticaria, angioedema, bronchospasm, severe rhinitis, shock, or other sensitivity reaction is precipitated by aspirin or other NSAID

Side effect CNS: dizziness, headache, drowsiness. Special senses: tinnitus Skin: rash, pruritus. GI: dyspepsia, nausea, vomiting, abdominal pain, cramps, constipation, diarrhea, inflatulence, peptic ulcer CV: fluid rentention Respiratory: asthma

Nursing management >monitor for therapeutic effectiveness. >observe and report signs of bleeding. >monitor BP for hypertension and blood sugar for hyperglycemic >monitor weight and report gains greater than 1kg >monitor for signs and symptoms of GI irritation and ulceration.

Drug name Generic: hyoscine-Nbutylbromide

Classification

Action

Indication Relief of smooth muscle spasm of the GI and in the genitourinary system

Contraindication >glaucoma >myasthenia gravis >paralytic ileus >pyloric stenosis >prostatic enlargement >porphyria

Side effect Side effect includes constipation, dry mouth, photophobia, flushing, skin rash. Buscopan may also cause urinary urgency and urinary retention. Less common side effect includes confusion, nausea, vomiting and dizziness.

Anti cholinergic/ Inhibits anti spasmodic acetylcholine at receptor sites in ANS which Brand: buscopan controls secretions, free Dosage: 1 Tab, acid in the TID stomach: blocks central muscunaric receptors which decrease involuntary movement.

Nursing management >assess for eye pain. Discontinue medication >assess for urinary hesitancy, retention, palpate bladder of retention occurs >assess for constipation >assess for tolerance over long therapy >assess for mental status >instruct patient to avoid alcohol because it may increase central nervous depression.

Assessment

Nursing diagnosis Acute pain related to inflammatory process

Scientific Explanation

Planning

Nursing intervention

Rationale

Evaluation

Subjective: masakit ang tiyan ko as verbalized by the patient. Objective: y Guarding behavior y Facial grimace noted y Irritable y Pain scale of 7/10

Nociceptors are the receptors for pain. These are activated by chemicals such as prostaglandin, serotonin, hiastamine, acetlycholine and bradykinin. Prostaglandins produced at the site of injury act to further enhance the nociceptive response to inflammation by lowering the threshold to noxious stimulation.

After 15-30 mins of nursing intervention the patient will be able to verbalize lessened pain from a pain scale of 7/10 to 5/10.

1. Assess level and location of pain 2. Provide comfort such as restful environment 3. Promote bed rest, allowing to assume position of comfort 4. Implement the use of relaxation techniques such as deep breathing exercise

Intensity of pain indentifies need for pain medication Promote relaxation, reduces muscle tension Bed rest in semi fowlers position reduces pressure Reduces muscle tension and

After 15-30 mins of nursing intervention the patient was able to verbalize lessened pain from a pain scale of 7/10 to 5/10.

Chronic inflammation with nociceptive stimulation is the source of pain.

5. Provide diversional activities such as reading 6. Turn side to side at intervals

promote nonpharmocolo gic pain managemen t To divert or refocus attention

DEPENDENT: 7. Administer medication as prescribed:  Analgesics

Relieves pain and enhances circulation Relieves reflex spasm or smooth muscle contraction and assist with pain managemen

 Anticholinergics

t.  Narcotics Given to reduce severe pain.

Assessment S: O: > presence of surgical incision right upper quadrant of the abdomen. > with slightly soak and intact dressing.

Scientific explanation Risk for Clients infection related undergone to inadequate surgical primary defense procedure that secondary to impairs the body Cholecystectomy first line of defense thereby increasing the risk of being invaded by pathogenic organisms.

Diagnosis

Planning Within 3 days of proper nursing intervention, the patient will be able to identify interventions to prevent or reduce risk for infection.

Intervention 1. Monitor vital sign -

Rationale Elevation in rate may indicate infection

Evaluation Within 3 days of proper nursing intervention, the patient was able to identify interventions to prevent or reduce risk for infection.

2. Observe for localized sign of infection at insertion site of invasive lines, sutures, surgical incision and wounds 3. Change wound dressing as indicated using proper technique for changing or disposing of contaminated materials. 4.emphasize the importance of

Assessing the patient helps determine prioritization of care.

Sterile technique prevent contamination and reduce risk for infection

May reduce the

proper hygiene

risk of infection and spread of microorganism To avoid other complication.

5. Instruct patient in techniques to protect the integrity of skin.

6. Encourage patient to verbalize any changes noted on the operative site, such as redness, swelling and unusual odor changes. Collaborative 7. Administer penicillin g sodium

To allow continuous monitoring and assessment of patient condition.

Serves as prophylactic treatment and prevent bacteria to harbor on operative site.

Assessment S: ano kaya tong sakit ko? Hindi kaya acidic lang ako? At saka ang alam ko sa pagod ito eh O:  Frequently asking question about his condition, treatment and diet  With worried gaze

Diagnosis Deficient knowledge related to condition, prognosis, treatment, self-care, and discharge needs

Scientific explanation There is this presence of knowledge deficit due to some unfamiliar information that causes some confusion to the client that needs to be discussed.

Planning After an hour of nurse-patient interaction the patient will Verbalize understanding of disease process, prognosis, and potential complications.

Intervention 1. Provide explanations of/reasons for test procedures and preparation needed. 2. Review disease process/ prognosis. Discuss hospitalization and prospective treatment as indicated. Encourage questions, expression of concern.

Rationale - Information can decrease anxiety, thereby reducing sympathetic stimulation.

Evaluation After an hour of nurse-patient interaction the patient verbalized understanding of disease process, prognosis, and potential complications.

- Provides knowledge base from which patient can make informed choices. Effective communication and support at this time can diminish anxiety and promote healing.

3. Review drug regimen, possible side effects.

- Gallstones often recur, necessitating long-term therapy.

4. Instruct patient to avoid food/fluids high in fats (e.g., whole milk, ice cream, butter, fried foods, nuts, gravies, pork), gas producers (e.g., cabbage, beans, onions, carbonated beverages), or gastric irritants (e.g., spicy foods, caffeine, citrus). 5. Suggest patient limit gum chewing, sucking on straw/hard candy, or smoking.

- Prevents/limits recurrence of gallbladder attacks.

- Promotes gas formation, which can increase gastric distension/discomfort.

DRUG STUDY AND NURSING CARE PLANS