DRUG STUDY

Name of Drug Generic (Brand) Bisacodyl (Dulcolax) Date Ordered Classification Dose/ Frequency Mechanism of Action Specification (Why Drug is ordered for patient) y Surgery ContraIndications Side Effects/ Toxic Effect Abdominal Discomfort y Nursing Considerations

06/16/11

Laxatives

30 mg/day Stimulant laxative single that increases dose peristalsis, probably by direct effect on smooth muscle of the intestine, by irritating the muscle or stimulating the colonic intramural plexus. Drug also promotes fluid accumulation in colon and small intestine.

y y y y y y y

Hypersensitivity y Rectal bleeding Gastroenteritis Intestinal obstruction Abdominal pain Nausea Vomiting

Advise patients that laxatives should be used only for short term therapy. Advise patient to swallow entericcoated tablet whole to avoid G.I irritation. Instruct him not to take within 1 hour of milk or antacid. Tell patient to report adverse effects to prescriber. Teach patient to take drug with a full glass of water or juice.

Name of Drug Generic (Brand) Cefuroxime (Zinnat)

Date Ordered

Classificatio n

Dose/ Frequency

Mechanism of Action

Specification (Why Drug is ordered for patient) y Decrease or control the infection. y

ContraIndications

Side Effects/ Toxic Effect y y y y y Nausea y Anorexia Vomiting Diarrhea Hypersensiti y vity reactions

Nursing Considerations

06/16/11

Antiinfectives, Cephalospor ins

500mg 1 tab BID

Second generation cephalosporin that inhibits cell wall synthesis promoting osmotic instability; usually bactericidal.

Hypersensitive to other cephalosporins and penicillin.

Before giving drug, ask patient if he is allergic to penicillins or cephalosporins. Obtain specimen for culture sensitivity tests before giving first dose. Therapy may begin while awaiting results. Absorption of oral drug is enhanced by food. Tell patient to take drug as prescribed even after he feels better. Instruct patient to notify prescriber about rash or evidence of superinfection.

Name of Drug Generic (Brand) Clindamycin (Clindal)

Date Ordered

Classificatio n

Dose/ Frequency

Mechanism of Action

Specification (Why Drug is ordered for patient) y Prevent infections caused by sensitive staphyolococci , streptococci, bacteroides, and other sensitive aerobic and anaerobic organisms y

ContraIndications

Side Effects/ Toxic Effect y y y y y y y y y Headache y Abdominal pain Anorexia Tarry tools Constipation Diarrhea y Dysphagia Nausea Hypersensiti vity reactions y

Nursing Considerations

06/19/11

Antiinfectives

150mg 1 cap TID

Inhibits bacterial protein synthesis by binding to 50s subunit of ribosome. Hinders or kills susceptible bacteria.

Contraindicate in patients hypersensitive to drug or lincomycin Use cautiously in patients with renal or hepatic disease, asthma, history of G.I disease, or significant allergies

Obtain specimen for culture and sensitivity tests before giving first dose. Therapy may begin pending results. Monitor renal, hepatic and hematopoietic functions during prolonged therapy. Observe patient for signs and symptoms of superinfection Advise patient to take capsule form with a full glass of water to prevent esophageal irritation. Instruct patient to notify prescriber of adverse reactions (especially diarrhea).

Name of Drug Generic (Brand)

Date Ordered

Classification

Dose/ Frequency

Mechanism of Action

Specification (Why Drug is ordered for patient) y Prophylaxis in elective hysterectomy or vaginal repair y y y y

ContraIndications

Side Effects/ Toxic Effects y y y y y Hypersensitivity y Irritability Drowsiness y Dyspareunia Dryness of y vagina and vulva

Nursing Considerations

Metronidazole 06/16/11 Anti-infective, (Dazomet) Antiprotozoal

500 mg 1 tab TID

It enters the cell of microorganisms that contain nitroreductase unstable compounds are then formed that contain nitroreductase unstable compounds are then formed and inhibit synthesis, causing cell death.

Liver disease Alcoholism Blood dyscrasias Active CNS disease

Give oral form with meals to minimize G.I upset. Instruct patient in proper hygiene. Tell patient that metallic taste and dark or red-brown colored urine may occur. Tell patient to void alcohol or alcoholcontaining drugs during therapy and for at least 3 days after therapy is completed.

Name of Drug Generic (Brand) Paracetamol (Biogesic)

Date Ordered

Classification

Dose/ Frequency

Mechanism of Action

Specification (Why Drug is ordered for patient) Mild fever y

ContraIndications

Side Effects/ Toxic Effects y y y y y Chest pain Dyspnea Rash Fever Acute kidney failure Jaundice Hepatic toxicity and failure y

Nursing Considerations

06/19/11

Nonopiod analgesics and antipyretics

500mg 1 tab TID

Reduces fever by acting on the hypothalamus to cause vasodilation and sweating.

Allergy to acetaminophen or any component. Use cautiously with impaired hepatic function, chronis alcoholism, and pregnancy lactation.

y y

Warn patient that high doses or unsupervised long term use can cause liver damage. Advise patient not to take drug longer than 10 days unless directed by health care professional. Advise patient to consult health care professional if discomfort or fever is not relieved by routine doses of this drug or if is greater than 39.5 0 C or last longer than 3 days.

Name of Drug Generic (Brand)

Date Ordered

Classification

Dose/ Frequency

Mechanism of Action

Specification (Why Drug is ordered for patient) y Moderately severe pain y y y y

ContraIndications

Side Effects/ Toxic Effects y y y y y y Dizziness y Headache Nausea Vomiting Dry mouth Diarrhea y

Nursing Considerations

Tramadol 06/18/11 Hydrochloride (Tramal)

Narcotic and Opiod Analgesics

500mg 1 tab TID

It is thought to bind to opioid receptors and inhibit reuptake of norephinephrine and serotonin.

Hypersensitivity to drug Kidney disease Liver disease History of alcohol or drug dependence

Monitor CV and respiratory status. Withhold dose and notify physician if respirations decrease or rate is below `12 breaths per min. Monitor bowel and bladder function. Anticipate need for laxative.

NURSING CARE PLAN

Cues S:Sakit pa ako samad labaw na if molakaw ko. Hinay2x lng ko ug lakaw kung 10 ang pinakasakit, naa sa 7 ang sakit kung molakaw ko O: -vervalized a pain scale at 5 and 7 when ambulate or moving, in a scale of 1-10 with 10 as the most painful. -sighing and moaning noted. -slowed movement. -guarding behavior. -positioning to avoid pain. Nursing Diagnosis Acute pain related to surgical incision in the abdomen. Objectives/ Evaluation Criteria Within an 4 hours of nursing intervention, the patient will verbalize a pain scale of 2-3 and increased comfort. Nursing Interventions INDEPENDENT: 1. Monitor vital signs regularly. Rationale Evaluation Goal Met. After 4 hours of nursing intervention, the patient was able to verbalized a pain scale of 4, increased relief and comfort. Patient also demonstrated breathing techniques to minimize pain. She also participated in conversations to divert her attention which minimize pain.

2. Evaluate pain regularly noting characteristic. 3. Identify specific activity limitations. 4. Encouraged to void freely.

5. Encourage of relaxation technique like deep breathing exercise. 6. Reposition as indicated. 7. Provide adequate rest and sleep. 8. Instructed S.O to provide diversional activities to patient such as conversations. 9. Tell patient to intake food rich in protein such as meat. DEPENDENT: 1. Administer Tramadol 500mg TID

To provide baseline data and Changes in vital signs may be used for rough estimate of pain. Provide information about need for or effectiveness of intervention. Prevents undue strain on operative site. This promotes healing by reducing basal metabolic rate and allowing oxygen and nutrients to be utilized for tissue growth, healing and regeneration. Relieves muscle and emotional tension. May relieve pain and enhance circulation. To facilitate pain relief To help patient focus on non-pain related matters. To facilitate faster wound healing. To relieve mold or moderately severe pain.

Cues S: O: - Horizontal incision in the hypogastric region of the abdomen with dressing and abdominal binder noted. - Redness of surrounding skin noted.

Nursing Diagnosis Risk for infection related to surgical incision.

Objectives/ Evaluation Criteria Within an hour of nursing intervention the patient will identify interventions to prevent/ risk for infection.

Nursing Interventions INDEPENDENT: 1. Observe for localized signs of infection at sutures or surgical incision wound. 2. Note signs of symptoms of sepsis; fever, chills, diaphoresis. 3. Teach patient and S.O how to cleanse incision site daily and remind them to change dressings as needed. 4. Encourage early ambulation and deep breathing, coughing and position change. 5. Instructed patient the necessity of taking antibiotics as directed. 6. Advised patient to intake food rich in Vitamins C such as orange. 7. Told patient to intake food rich in Protein such as meat. 8. Demonstrate to patient and S.O the proper way of hand washing DEPENDENT: 1. Administer Cefurixime 1 tab 500mg BID -

Rationale To check for any signs of infection.

Evaluation Goal Met. After an hour of nursing intervention. The patient mentioned the importance of hygiene, medication compliance, proper wound dressing and early ambulation to prevent infection.

Clindamycin 1 cap 150mg TID Metronidazole 1 tab 500mg TID COLLABORATIVE: 1.Stress Aseptic or proper hand washing technique by all caregivers

To give necessary interventions. To facilitate wound healing and prevent infection by minimizing growth and spread of microorganisms. Ambulation stimulates lower extremity circulation. Premature discontinuation of medication may result in return of infection. To enhanced immune system. To facilitate faster wound healing. To avoid cross contamination of microorganisms. Infections cause by streptococci and other aerobic and anaerobic microorganisms. Uncomplicated UTI Prophylaxis To avoid contamination of microorganisms.

Nursing Diagnosis S: Dili na regular Constipation ako paglibang. related to Sukad tong niaging anatomical bulan kay mga obstruction of the tagtulo o upat ka rectum and adlaw ko ayha inadequate intake malibang. Usahay of fluids and bulk. galisod pud ko ug libang. Seldom eat vegetables as verbalized by the patient. - Intake of 4-6 glass of water a day as verbalized by the patient. O: -Bowel sounds at 6 -hard dry and formed stool in minimal amount as verbalized by the patient.

Cues

Objectives/ Evaluation Criteria Within an hour of nursing intervention, the patient will verbalize understanding of etiology and appropriate interventions for individual situation.

Nursing Interventions INDEPENDENT: 1.) Monitor patients fluid intake and output. 2.) Note color, odor, consistency, amount, and frequency of stool. 3.) Auscultate bowel sounds. 4.) Encourage activity/ exercise within limits of individuals ability. 5.) Instruct on a diet of balanced fiber and bulk and fiber supplements. 6.) Promote adequate fluid intake, including high-fiber fruit juices; suggest drinking warm stimulating fluids. 7.) Tell patient to avoid dehydrating liquids such as soda, coffee and tea. 8.) Promote regular bowel movements. DEPENDENT: 1. Administer Bisacodyl 30mg Single dose COLLABORATION 1. Consult with dietitian to provide well balance diet high in fiber and bulk.

Rationale

Evaluation Goal Met. After an hour of nursing interventions, the patient was able to verbalize her understanding of the etiology and appropriate interventions; and verbalized the relation of diet to her constipation. She also verbalized the significance of increasing consumption of high-fiber foods such as fruits and vegetables and increasing intake of fluids of 8-10 glasses per day.

To evaluate patients hydration status. Provides a baseline for comparison, promotes recognition of changes. Bowel sounds are generally decreased in constipations. To stimulate contractions of intestines. To improve consistency of stool and facilitate passage through colon. To promote passage of soft stool.

To prevent constipation.

To facilitate urge in defecation. Relieve constipations

Fiber resists enzymatic digestion and absorbs liquid in its passing along and thereby producing bulk.