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LANOXINClassificationInotropics
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Indications:Heart
failure,paroxysmal
supraventricular
tachycardia
DOSA
GE:
0.25mg/ta
b 1/2tab
OD Action:
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Action:
Inhibits sodium-potassium-activatedadenosinetriphosphatase,
promotingmovement of
calcium from
CNS i i
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: CNS: agitation,
fatigue, generalizedmuscle weakness,
hallucinations,
dizziness, headache,
malaise,
paresthesia, stupor,
vertigo
an
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an
caution
s:
Contraindicated in
patientshypersensitive to
drug and thosewith digitalis
induced toxicity,ventricular
fibrillation, or v-
Nursing Considerations:
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Nursing Considerations:
Observe the ten rights in giving
the medication. Teach patient and a responsible
family member about drug action,dosage regimen, how to take
pulse, reportable signs, and
follow-up care.
Tell patient to report pulse less
than 60 beats/min or more than
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PotassiumChloride
Clasification:
Electrolytes andreplacement
solutions
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Patients
dosage:
10 meq x
2 hours x
8 cycle
diluted to
90cc
Indicati
on:Hypok
A i Ad
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Action:
Replaces
potassium and
maintains
Adverse
reaction:
CV:arrhythmia
s, heartblock,
CNS
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effects:
CNS:
paresthesia oflimbs,
listlessness,confusion,
weakness orheaviness of
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and cautions:
Contraindicated in patientswith severe renal
impairment with oliguria oranuria; with untreated
Addison disease; or acutedehydration, heat cramps,
hyperkalemia, hyperkalemic
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es: Observe ten rights in giving the
medication. Monitor ECG and electrolyte levels
during therapy.
Patient may be sensitive to
tartrazine.
Tell patient to take with or aftermeals with full glass of water or fruit
juice to lessen GI distress.
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PTUpropylthiouracil
Classificaation:
Thyroid hormoneantagonist
Indications
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Indications:
Hyperthyro
idism,
Thyrotoxic
crisis
Action:
Inhibits oxidation
of iodine in
thyroid gland,
blocking activity
of iodine tocombine with
Patients
dosage:
50 mg 1
tab 12
Hematologic: Agranulocyto
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reacti
on:
Hematologic: Agranulocyto
, leukopenia,
thrombocytopenia, aplastic
anemia
Hepatic: hepatotoxicity
CNS: Headache, drowsine
vertigo, paresthesia, neuritineuropathies, CNS
stimulation, depression,
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cautions
: Contraindicated
to patientshypersensitive
to drug.
Use cautiously
in patient with
mg and 10
mg
Observe the ten rights in giving
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es: Observe the ten rights in giving
the medication.
Patients older than 40 may
have an increased risk of
Agranulocytosis.
Give drugs with meals to
reduce adverse GI reactions. Watch for hypothyroidism
(mental depression, cold
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Instruct patient to take drugs
with meals Warn patients to report fever,
sore throat, mouth sores, and
skin eruptions
Tell patient to report unusual
bleeding and bruising. Tell patient to ask prescriber
about using iodized salt and
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Methimazole(Tapazole)
Clasification:
Thyroid hormoneantagonists
Availability:Availability:
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Dosage
20mg/tab
1 tab/TID
Dosage
20mg/tab
1 tab/TID
Availability:
Adults: if mild, 15mg P.O. daily. If
moderately severe,
30 to 40 mg daily. Ifsevere, 60 mg
daily. Daily amountis divided into three
equal doses and
-
Availability:
Adults: if mild, 15mg P.O. daily. If
moderately severe,
30 to 40 mg daily. Ifsevere, 60 mg
daily. Daily amountis divided into three
equal doses and
-
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Indicatio
n:
hyperth
yroidism
Action:
Inhibits
oxidation of
iodine inthyroid gland,
blocking withtyrosine to form
T4. Also may
se CNS: headache drowsiness
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reacti
on
CNS: headache, drowsiness,
vertigo, paresthesia, neuritis,
neuropathies, CNS stimulation,depression and fever
GI: diarrhea, nausea, vomiting,
salivary gland enlargement,
loss of taste, epigastric distress
GU: nephritis Hematologic: agranulocytosis,
leucopenia, thrombocytopenia,
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and cautions:
Contraindicated in
patients
hypersensitive to
drug.Availability
Tablet forms: 5 mgand 10 mg
es:es:
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es:es:
Administer mediation
observing the ten rights
in giving the
medication.
Monitor CBC
periodically to detectimpending leupenia,
thrombocytopenia, and
Administer mediation
observing the ten rights
in giving the
medication.
Monitor CBC
periodically to detectimpending leupenia,
thrombocytopenia, and
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Stop drug and notify
prescriber if severe rash orenlarged cervical lymph
nodes develop
Instruct patient to take drug
with meals to adverse GI
reactions. Warn patient to report fever,
sore throat, mouth sores, skin
Stop drug and notify
prescriber if severe rash orenlarged cervical lymph
nodes develop
Instruct patient to take drug
with meals to adverse GI
reactions. Warn patient to report fever,
sore throat, mouth sores, skin
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Omeprazole
(prilosec)
Omeprazole
(prilosec)Classification:
Antiulcer drugs
Classification:
Antiulcer drugs
I di i
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Indication:
Adjuncttreatment
withAzithromyci
n
(dual therapy)
Action:
Inhibits activityof acid (proton)
pump and bindsto hydrogen-
potassium
adenosine
triphosphatase
reacti CNS: headache
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reacti
on:
CNS: headache,
dizziness and
asthenia
GI: diarrhea,
abdominal pain
nausea, vomiting,
constipation andflatulence
Muskuloskeletal:
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es:
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es: Administer medication
observing the 12 rights ingiving the medication.
Instruct patient to swallowtablets or capsules whole
and not to open, crush orchew them.
Instruct patient to take drug
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Propanolol
(Inderal)Classificati
on:
Antiangina
D
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Dosage
10 mg/tab1 tab
OD
Indications:
adjunctivemanagement
ofthyrotoxicosis
and ThyrotoxicSupressess the
convertion of
A ti
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Action: A nonselective
beta blockers that
reduces cardiac
oxygen demand byblocking
catecholamine-induced increases in
heart rate, blood
rea CNS: fatigue lethargy feve
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rea
ction
CNS: fatigue, lethargy, feve
vivid dreams, hallucinations,
mental depression, light
headedness, insomnia
GI: abdominal cramping,
constipation, diarrhea,
nausea, vomiting CV: bradycardia, hypotensi
heart failure,intermittent
cautions:
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cautions:
Contraindicated in patientswith bronchial asthma, sinus
bradycardia, and heart block
greater than first-degree.Cardiogenic shock, and hear
failure (unless failure is issecondary to a
tachyarrhythmia that can be
ions: Administer mediation observing the
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ions:Administer mediation observing theten rights
in giving the medication.
Monitor vital signs especially the
apical pulse before giving the drug. Ifextreme in pulse rates occur, withhold
drug and notify prescriber
immediately. Give or instruct the patient to take the
drug consistently with meals. Food
F id
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Furosemid
e
Classification:
Loop Diuretic
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Action:
A potent drug
that inhibits
sodium andchloride
reabsorptionat the
proximal and
Indicati
on:
Edem
a
Dosage
andAvailabilit
y:
40 mg ivtt
now
Injection:10mg/ml
S i l
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Contraindica
tion:Contraindica
ted inpatients
hypersensiti
ve to drug
and in those
with n ri .
Special
Precaution:Use
cautiously
in patients
with
hepaticcirrhosis
and in
e ec s CNS: Vertigo, headache,
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:CNS: Vertigo, headache,
dizziness, paresthesia,
weakness, restlessness,fever.
CV: Orthostatichypotension
EENT: Transient deafness,blurred or yellowed vision,
tinnitus.
ties:1 Ob 15 Ri ht i i i
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ties: 1. Observe 15 Rights in giving
medications. 2. Monitor weight, blood pressure,
and pulse rate routinely with long-
term use and during rapid diuresis.Use can lead to profound water
and electrolyte depletion.
3. Monitor fluid intake and output
and electrolyte, BUN, and carbon
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Action:
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Action:
Unknown. A
centally acting
synthetic
analgesiccompound not
chemically
related to
opioids.
Thou ht to
Indicatio
n:
Moderate
tomoderatel
y severe
pain.
Avialability:
Contraindicatio Special
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Contraindicatio
n:
Contraindicated
in patients
hypersensitiveto drug or other
opioids.Serious
hypersensitivity
Special
Precaution:
Use cautiouslyin patients at
risk forseizures or
respiratory
depression; in
patients with
Reaction:
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Reaction: CNS; dizziness, headache,
somnolence, vertigo, seizures,anxiety, asthenia, CNS
stimulation, confusion,
coordination disturbance,
euphoria, malaise, nervousness,
sleep disorder. EENT: Visual disturbances
GI: Constipation, nausea,
s:
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1. Observe 15 rights in giving
medications.
2. Reassess patients level of
pain at least 30 minutes afteradministration.
3. Monitor CV and respiratorystatus.
Withhold dose and notify
Azithromyci
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Azithromyci
n
ClassificationMacrolide anti-
infectives
Dosage/
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Dosage/
Availabili
ty
Tablet
forms: 5mg and
10 mgPatients
dru
Indication
Community-
acquired
pneumoniacaused by
Chlamydiapneumonia,
H. influenza,
Action tionand
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Action
Binds to the50S subunit of
bacterial
ribosomes,
blocking
proteinsynthesis,
bacteriostatic
tionand
Cautions Contraindi
cated inpatients
hypersensitive to
drug
Reaction
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CNS: headache, drowsiness,vertigo, paresthesia, neuritis,
neuropathies, CNS
stimulation, depression and
fever
GI: diarrhea, nausea, vomiting,salivary gland enlargement,
loss of taste, epigastric
Reaction
Nursing Management
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Administer mediation observing
the 12 rights in giving the
medication.
Monitor CBC periodically todetect impending leupenia,
thrombocytopenia, and
agranulocytosis; also monitor
hepatic function.
I t t ti t t t k
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Instruct patient to take
drug with meals toadverse GI reactions.
Warn patient to reportfever, sore throat, mouth
sores, skin eruptions,anorexia, itching, right
upper quadrant pain,
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Ambroxol(Ambrolex)
Classificatio
n
Mucolytics
I di tiAction
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Indication
Acute andchronic
disorder ofthe
respiratorytract
associated
Increasesproduction
of
respiratory
tract fluids
to helpliquefy and
Dosage/
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Dosage/
Availability
Tablets:
100mg,
200mg,
400mg Patients
dosage:
Contraindication
Contraindicated in
patientshypersensiti
Reaction
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Reaction
CNS: dizziness,
headache
GI: nausea and
vomiting
SKIN: rash
Management
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Management
Administer mediation observingthe 12 rights in giving the
medication.
Monitor cough type and
frequency.
Inform patient that drug shouldnot be use for chronic or
persistent cough such as with
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Test Result Normal Values Clinical
Significance
SGPT 97.09 kat/L 4.0 36.0
kat/L
hepatocellular
disease,
alcoholic
cirrhosis,
jaundice, biliary
obstruction
SGOT 12. 24 kat/L 8.0 33.0
kat/L
NormaL
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Result Clinical Significance
Ph i l P ti
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Physical Properties
Color Dark Straw Alcohol/caffeine intake
Transparency Hazy Presence of bilirubin
Reaction Acidic Normal
Specific Gravity 1.010 Normal
Chemical Test
Sugar Negative Normal
Protein (Albumin, Globulin) Negative Normal
Other Test
Bile Positive hyperthyroidism, cirrhosis,
hepatitis
Nitrate Positive Indicates UTI
Microscopic Examination
RBC 14 15 (++) Acute inflammatory
disorders
Pus Cells 5 6 (+) Indicative of infection and
inflammatory conditions of
the lower urinary tract
Others
Bilirubin Crystals Positive hyperthyroidism, cirrhosis,
hepatitis
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Result Normal Values Clinical
Significance
Sodium 136.1 135 145 mEq/L Normal
Potassium .1 3.5 5.3 mEq/L alco olism, I
distur ances
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.
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DISCHARGE
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PLAN
Knowledgeabout illnessPersonal
HygieneNutritio
nMedicat
Follow up
Activities ofDaily Living
GENERAL OBJECTIVE
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To provide continuity ofcare and the appropriate
needs to the client athome in the absence of a
professional health caregiver and health care
OBJECTIVES
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1. To provide knowledgethrough health teachingregarding Diffuse ToxicGoiter, its causes, clinicalmanifestations, and its
management. 2. Teach client and folkson good hygienic
4. Discuss to the client the
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importance of proper andhealthy nutrition.
5. Inform client andsignificant others about the
need for compliance to her
prescribed medication as
well as its action and side
KNOWLEDGE ABOUT THE DISEASE
H th idi i th
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Hyperthyroidism is the
second most prevalent
endocrine disorder after
Diabetes Mellitus. The mostcommon type of
hyperthyroidism results froman excessive output of
th roid hormone cause b
The antibodies activate the
receptor and lead to the increase
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receptor and lead to the increase
production of thyroid hormone
and there is usually an increase
in size of the thyroid gland(Goiter). It affects women 8 times
more than men.
It is characterized by weight
It may appear after an
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emotional shock, stress or aninfection, but the exact
significance of the
relationships is not
understood.
Health maintenance andrestoration activities include
monitorin of th roid tumors
PERSONAL HYGIENE
1 Ad i li t t t k b th d il
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1. Advise client to take a bath daily
in order to minimize the
accumulation and spread of
microorganisms.2. Emphasize the importance of
wearing clean and comfortable
cotton clothes, good oral hygiene
and trimming of nails to its
LIVING
Instruct folks to provide client with
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Instruct folks to provide client with
cool environment, comfortable
temperature, and if needed, change
beddings and cotton clothingbecause patient with
hyperthyroidism frequently finds a
normal room temperature warmbecause of an exaggerated
metabolic rate and increased heat
NUTRITION
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Instruct client to increase oralfluid intake 2-3 liters/day or
within cardiac tolerance in
order to restore bowel
movement, to replenish
sensible and insensible fluidloss and to prevent
Avoid consumption of goitrogens
which could be found in raw
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which could be found in raw
vegetables such as cabbage,raddish, soy beans, carrots,
turnips and cassava.
Rationale: Goitrogens inhibit iodide
metabolism by the thyroid gland
and inhibit thyroid hormonesynthesis.
Instruct client to reduce caffeine
MEDICATIONS
E l i l l t th li t d f lk
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Explain clearly to the client and folksthe proper administration of drugsprescribed by the physician includingthe right time, dosage, route and
timing in order to prevent underdosing nor overdosing of medications.
Inform the client or folks about the
mechanisms and actions of drugs, itsindications and side effects so thatthey will be aware of the need andimportance to take the medicine and
Furo +KCL I tab OD x 5 daysLevofloxacin 250 mg OD x 7 days
MTV + Ph h li id I OD
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MTV + Phospholipids I cap OD
Metronidazole 30 mg TID
Omeprazole 40 mg I cap OD x 7days
Propanolol 10 mg/cap ODDigoxin 0.25 mg OD
KCL I tab TID x 5 days
Rationale: to facilitate fasterrestoration of bodily functions and
effective drug regimen.
FOLLOW UP VISIT
Instruct the client to
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Instruct the client to
come back at the
Western Visayas
Medical Center Out
Patient Department
(WVMC OPD) after
one week (September
Follow up laboratory
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request: CBC
UrinalysisChest X-ray PA view
Serum K determinationRationale: to monitor
ro ress and for immediate
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