VII. Drugs Study

Drug Name Mechasnism of Action

Indication Contraindication

Adverse Effects

Nursing Interventions

Generic Name:

OresolBrand Name:

Pedialyte

Drug Class:• Electrolytes • A07CA - Oral

rehydration salt formulations

Dosage:

250cc every 6 hours PO

Pedialyte are advocated for the treatment of dehydration in viral gastroenteritis, but there is limited evidence to support their use.

To supplement fluid & electrolyte loss due to active play, prolonged sun exposure, hot & humid environment

Intractable vomiting, adyanmic ileus, intestinal obstruction, bowel perforation.

As sole therapy in severe continuing diarrhea. Intractable vomiting. Adynamic ileus. Intestinal obstruction or perforated bowel. Anuria, oliguria, or impaired homeostatic mechanism.

Assess allergic reactions.

Monitor I&O ratio.

Note for the drugs, dosage, time,r oute, client.

Note the side effects of the drugs.

Drug Name Mechasnism of Action

Indication Contraindication

Adverse Effects

Nursing Interventions

Generic Name:

Paracetamol

Brand Name:

Tempra, Biogesic, Bioflu

Drug Class: Anti-pyretic, Non-

opioid analgesic

Dosage:

500mg PO

Decreases fever by inhibiting the effects of pyrogens on the hypothalamic heat regulating centers and by a hypothalamic action leading to sweating and vasodilation.

Relief of mild-to-moderate pain, treatment of fever.

Hypersensitivity, alcohol, table sugar

Drowsiness, nausea, vomiting, abdominal pain and rash.

Assess patient’s fever.

Assess allergic reactions: rash, urticaria; if these occur, drug may have to be discontinued

Drug Name Mechasnism of Action

Indication Contraindication

Adverse Effects

Nursing Interventions

Generic Name:

Cefuroxime

Brand Name:

Ceftin, Zinacef

Drug Class:

Bactericidal/Antibacterial

Dosage:

125 mg, TIV

Inhibits synthesis of bacterial cell wall, causing cell death.

Cefuroxime is indicated to treat infections.

The client’s WBC is elevated and this may indicate infection.

Cefuroxime is indicated for patients with urinary tract infection. The client has cloudy urine that suggest urinary tract infection.

Hypersensitivity to cefuroxime, penicillin/ cephalosporin.

Kidney disease, liver disease and gastrointestinal disease.

Nausea Vomiting Diarrhea Abdominal

pain

Instruct client to report loose stools or diarrhea promptly.

Instruct client to report any signs or symptoms of hypersensitivity.

VIII. Nursing Care Plan

Assessment Nursing Diagnosis

Inference Goal Intervention Rationale Evaluation

Subjective data:-- “ Nakaka12 na syang diaper ngayong araw. Samantalang kahapon mga 6 lang. Madalas din kung sumuka siya.” As verbalized by the mother

Objective data:

-- Loosed bowel movement with yellowish watery stool minimum of thrice a day.

-- Increase bowel sounds/ peristalsis

-- Nausea and Vomiting

Diarrhea r/t infectious processes.

(+)Staphylococcus aureus

secretory diarrhea mediated by cyclic

AMP

Increased production and

secretionof fluids and electrolytes by

the intestinal mucosa

Diarrhea

Short Term:-- After 2-3 hours of nursing interventions, the patient’s mother will gain knowledge about diarrhea.

Long Term:-- After 1-2 days of nursing interventions, the patient will be free of diarrhea.

Independent:1.) Auscultate the abdomen.

2.) Discuss to the mother the different causative factors and rationale for treatment regimen.

3.) Restrict solid food intake.

4.) Provide for changes in dietary intake.

5.) Limit caffeine, high fiber foods and fatty foods.

Dependent:1.) Administer anti-diarrheal medications, as

Independent:1.) For presence. Location and characteristics of bowel sounds.

2.) For the education of the patient’s mother.

3.) To allow for bowel rest and reduce intestinal workload.

4.) To allow foods that precipitates diarrhea.

5.) To prevent gastric irritation.

Dependent:1.) To decrease GI motility and

Short Term:-- After 2-3 hours of nursing interventions, the patient’s mother shall gain knowledge about diarrhea and verbalized understanding of causative factors of diarrhea and rationale for treatment regimen.

Long Term:-- After 1-2 days of nursing interventions, the patient shall be free of diarrhea as evidenced by re-established and maintained normal bowel movement, reduced in frequency of stools and stool returned to its normal consistency.

-- Abdominal cramping

indicated.

2.) Administer medications, as ordered.

minimize fluid losses.

2.) To treat infectious process, decrease motility and/or absorb water.

Assessment Nursing Diagnosis

Inference Goal Intervention Rationale Evaluation

Subjective: Poor

Fluid volume

Increased Short Term: Briefly explain the To establish rapport and gives the patient

Short Term:

breastfeeding and hygienic techniques.

Mother lacks knowledge.

Client is sleepy.

The client is lethargic and has sunken eyeballs.

The mother was not able to breastfeed well her child.

Objective: Diarrhea in 3

days. Acute

gastroenteritis.

E.coli found in the stool.

2-3 se capilliary refill and PR: 120 bpm.

PA: loss 1 kg body weight, gray skin color, poor skin elasticity,

deficit related to excessive secretion of watery stools.

production and secretionof fluids and electrolytes

Diarrhea

Fluid volume deficit

After 2-3 hours of nursing interventions the mother’s patient will verbalize understanding of disease processes, possible complications

Long Term:

After 1-2 days of nursing interventions the client will feel comfortable and safeand will achieve wellness.

disease condition.

Inform the significant other the

procedures to be made

Assess vital signs

Note physical signs of Dehydration

Keep fluid with in reach and encourage frequent intake as possible.

Maintain accurate I&O

Change position frequently

Bathe every other

a secured feeling

Promote cooperation on the part of the patient and significant other

To ascertain status and note progress

To evaluate degree of fluid deficit

Gives convenience to the patient’s parent.

To ascertain status and note progress

Promote ventilation and cooling of body surface

To prevent injury

After 2-3 hours of nursing interventions the mother’s patient verbalized understanding of disease processes, possible complications

Long Term:

After 1-2 days of nursing interventions the client was comfortable and safeand achieved wellness.

very dry mucous membrane, oliguria.

day, promote skin care, provide oral and eye care

Provide safety measure if the patient is confused or weak

Monitor Vital signs and 1& O

Assist patient’s parent to learn to measure ownI & O

Discuss factors related to dehydration

Review medications and side effects

Note signs and symptoms indicationg need for

from dryness

To avoid accidents such as falls

To ascertain status and note progress

Increase independence

Promote self-care

Prevent injuries due to medication side effects

Promote continuity of care

emergent/ further evaluation and follow-up

Assessment Diagnosis Inference Planning Intervention Rationale Evaluation

Subjective:Patient’s mother verbalized “mainit palagi siya kapag hinahawakan. Siguro dahil sa mainit ditto sa ward”.

Objective: Body

Temperature = 38 °C

Warm to touch skin

RR = 45 bpm

HR = 110 bpm

Body sweating

Seizure precaution

Convulsion

Hyperthermia related to related to dehydration as evidenced by increase in body temperature higher than normal range.

Infectious agents(Pyrogens)

StimulateMonocytes

ReleasePyrogenic cytokines

StimulateAnterior

hypothalamus

results inElevated

thermoregulatory set point

leads toIncreased Heat conservation

(Vasoconstriction/behavior changes)

Increased Heat production

(involuntary muscular contractions)

F E V E R

Short term: After 1-2 hours of nursing intervention client will be in:

Normal in temperature

Decreased seizure activity

Long term: After 1-2 days nursing interventions client’s parents will:

Know and demonstrate how to promote normothermia

Nomal body temperature

Independent: Promote surface

cooling by means of tepid sponge bath.

Wrap extremities with cotton blankets.

Encourage the patient to Increased oral fluid intake

Provide supplemental oxygen.

Encourage SO to clean environment and to provide enough ventilation.

Promote relaxation

- To decrease temperature through evaporation and conduction.

-To minimize shivering.

-To prevent dehydration]

-To offset Increased oxygen demands and consumption.

-To feel comfortable and to decrease temperature through radiation and evaporation.

- To keep patient comfortable.

-To check the effectiveness of the intervention & to prevent complications.

- To decrease body temperature.

Short Term After 1-2 hours of nursing intervention client will be in:

Temperature is normal

No seizure activity at the end of the shift

Long term goal:

Relative know to promote normothermia

Normal in temperature

Skin is not warm to touch

Be free from seizure activity

Monitor vital signs & the intake & output.

Collaborative:

Administer antipyretic as order.

*Paracetamol(5oo mg/tab PRN if T

> 37.8 ®C) or 1 amp PRN if T > 38 0C

Still recurrence of seizure