Drug Lab Result

8/11/2019 Drug Lab Result

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VII. LABORATORY RESULT

Diagnostic/LaboratoryProcedure

Date Results Indications/Purposes Results Normal Values(units used in the hospital)

Analysis /Interpretation of Results

Hematology

ClinicalChemistry

Date Results:August 7, 2014

August 7, 2014

Specimens of venous blood aretaken for a CBC which includesHemoglobin and Hematocritmeasurements, RBC indices anddiferential white cell count.

Laboratory tests demonstratingthe presence of physiologicallysignificant substances in theblood, urine, tissue, and bodyfluids with application to thediagnosis or therapy of disease.

Hemoglobin: 126

Hematocrit:38

WBC count: 12.8

RBC count: 4.36

Platelet count:200

Lymphocytes:0.30

Monocytes:0.4

Segmenters:0.66

Cretinine:87.2

SGPT/ALT:15.9

120-180 g/L

37-47 volume %

5-10 x 109g/L

4.3-6.1x10x12

g/L

150-450x109/L

0.25-0.50

0.2-0.15

0.50-0.80

35.40-150.30 umol/L

> Normal

> Normal

>high due to presence of infection orinflammation

>Normal

>Normal

> Normal

>Normal

>Normal

> Normal


2/12

4-41 U/L >Normal

Diagnostic/

LaboratoryProcedures

Date Ordered

and dateResult/s In

Indication/s or

Purposes

Result/s Normal Values (Units used

in the Hospital)

Analysis and Interpretation of

results

Nursing

Implication

Urinalysis Sept. 16, 2009Result:Sept. 17, 2009

> To determine thepresence of microorganism, the type oforganism, and theantibiotics to which theorganism aresensitive.

> Assess the color,odor, and consistency

of the urine and thepresence of clinicalsigns of UTI. (frequency, urgency,dysuria, hematuria,flank pain, cloudyurine with foul odor.

Color: yellow

Appearance:

SlightlyTurbid

Pus cells:

1-2

RBC:

1-3

Epithelial cells:

Color:

straw amber transparent

Appearance:

Amber transparent

Pus cells:

0/HPF

RBC:

Red blood cells: 02/HPF

Epithelial cells:

None to few

Normal

Normal

Not Normal, pus cells are present.

Normal

Not Normal, moderate epithelial cells a

Before:

>Explain the purpose of the specimcollection and the procedure forcollection of the specimen. Client mexperience anxiety about theprocedure, especially if it is perceiveas being intrusive or if they fearunknown to the result. A clearexplanation will facilitate cooperatioon the part of the client.

>Provide proper instruction if client be the one to collect the specimen.

During:

>Provide client comfort, privacy andsafety. Client may experiencedembarrassment or discomfort whenproviding a specimen.>The nurse needs to be judgementand sensitive to possible socio cultubeliefs that might affect clientscondition.>Use the correct procedure forobtaining the specimen.

Aseptic technique should be use incollection to prevent contaminationthat can cause inaccurate results.


3/12

moderate

Mucus threads:

many

Specific gravity:

1.005

Albumin:

-

Glucose:

negative

None

Specific gravity:

1.010-1.020

Albumin:

Negative

Glucose:

Negative

Not Normal, mucus threads arepresent.

Normal

Normal

Normal

>Note relevant information on thelaboratory requisition slip likemedications the client is taking thatcan affect the result of the specime>As much as possible collect thespecimen at the first void in themorning.

After:

>Make sure that the specimen labeand the laboratory requisition carry correct information.>Attach the label securely.>Transport the specimen to thelaboratory promptly. Fresh specimeprovide more accurate results.>Report abnormal laboratory finding

Procedure date result Impression

Chest AP Suppine

>reserved for very illpatients who cannotstand erect.

August 7,2014 no definite active lung infiltrate The heart is not grossly enlarge,

undilated aorta the mediastinum, diaphragm, costophrenic sulci and visualized bones show no findings

of note.

No significant chest

finding.


4/12

PELVIC ULTRA SOUND A pelvicultrasound

uses sound waves to

make a picture of the

organs and structures

in the lower belly

(pelvis).

A pelvicultrasound looks at

thebladder and:

Theovaries,uterus,

cervix,andfallopian

tubes of a woman

(female organs ).

August 7,2014 Transabdominal sonogram at 32 and 3/7 postmenstral weeks shows a single NONVIABLEintrauterine fetus in breech presentation,

No cardiac activity or somatic motion is demonstrated.No vascular flow is demonstrated in the fetal circulation and heart on color flow mapping.

Fetal Growth Parameters:

measurement Sonographic ageBPD = 69mm 20W ODHC = 256mm 27W 5DFL = 51mm 27W 1D

AC = 232mm 27W 3D

Composite age:Amniotic fluid index = 2.3 + 1+1.9+0.7= 5.8cm (n=6 cm and above)

Diminished amniotic fluid

Fundal and posterior placenta

Single intrauterine fedemise

IX. DRUG STUDYUniversity of LuzonCollege of Nursing

Dagupan City

Patients Name: Anisah Lumna Age: 33 Ward/Area:Obstetrics & Gynecology Hospital: Luzon medical Center

Chief Complain: Nape pain/ DOB Diagnosis Impression: Attending Physician: Dra. Pastoral

D R U G S T U D Y
http://www.webmd.com/hw-popup/ultrasoundhttp://www.webmd.com/hw-popup/ultrasoundhttp://www.webmd.com/hw-popup/ultrasoundhttp://www.webmd.com/a-to-z-guides/what-is-an-ultrasoundhttp://www.webmd.com/hw-popup/bladderhttp://www.webmd.com/hw-popup/ovarieshttp://www.webmd.com/hw-popup/uterushttp://www.webmd.com/hw-popup/cervix-8243http://www.webmd.com/hw-popup/fallopian-tubeshttp://www.webmd.com/hw-popup/fallopian-tubeshttp://www.webmd.com/women/structures-pictured-by-pelvic-ultrasound-femalehttp://www.webmd.com/women/structures-pictured-by-pelvic-ultrasound-femalehttp://www.webmd.com/hw-popup/fallopian-tubeshttp://www.webmd.com/hw-popup/fallopian-tubeshttp://www.webmd.com/hw-popup/cervix-8243http://www.webmd.com/hw-popup/uterushttp://www.webmd.com/hw-popup/ovarieshttp://www.webmd.com/hw-popup/bladderhttp://www.webmd.com/a-to-z-guides/what-is-an-ultrasoundhttp://www.webmd.com/hw-popup/ultrasound


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GenericName

BrandName

Dosage,Route, &

Frequency

Indication action AdverseReaction

Interactions Contraindication

NursingImplications

PatientTeaching

HydrazalineHydrochloride

Apresoline,

10mgvia IVevery 8hours

To reduceafter load insevere CHF (withnitrates); andsevere

essentialhypertension(parenteral tolowerbloodpressurequickly).

Directlyrelaxesarteriolarsmoothmuscle.

No adversereactions noted,such as;>head ache>vomiting

No interactionwith other drug

Not contra-indicated to thepatient

>Monitor patients Vital signsand body weight frequently.>Some clinicians combinehydralazine therapy withdiuretics agents to decreasesodium retention and

tachycardia, and to preventanginal attacks.>Watch patient closely forsigns of lupus erythematosus-like syndrome (sore throat,fever, muscle and joint aches,skin rash).

>Teach patient abhis disease andtherapy. >Explain importance of takithis drug asprescribed, even w

hes feeling w>Inform the patienorthostatic hypotecan be minimized rising slowly andavoiding suddenposition Changes

Generic

Name

Brand

Name

Dosage,

Route, &Frequency

Indication action Adverse

Reaction

Interactions Contraindicatio

n

Nursing

Implications

Patien

Teachi

MagnesiumSulfate

Sulfamag 2.5 mg deep IMon each buttocks

Prevention orcontrol ofseizures inpreeclampsiaoreclampsia

May decreaseacetylcholinereleased bynerve impulses,but itsanticonvulsantmechanism isunknown..

No adversereaction noted.

No druginteraction noted

Notcontraindicatedto the patient

>Use cautiously inimpaired renal function,myocardial damage,and heart block, and inwomen in labor.>I.V. use: Monitor vitalsigns every 15 mins>Monitor I & O. urineoutput should be 100mlor more in 4 hr periodbefore each dose.

Inform

patientabout

short-

term nefor drug

andaddress

anyquestio

or

concern


6/12

GenericName

BrandName

Dosage,Route, &

Frequency


Interactions Contraindication NursingImplications

PatieTeach

Cefuroxime Zinacef 500mg1ta every12hours

Gynaecologic

InfectionsInterferes with

bacterial cell

wall, causing

cell to die.

No adversereaction noted.

No druginteraction noted


>Explain the action and scientific

explanation of drugs to the patient and

family members

>Assess pts condition at starting

therapy & regularly thereafter to

monitor the drugs effectiveness.

>Monitor patient closely for toxicity

such as tremor, palpitations, increased

heart rate, decreased BP, seizures,

hypokalemia, muscle cramps, headache,

and hyperglycemia.

>Proper disposal of syringe and other

waste materials

>Check for infiltrations and

thrombophlebitis

Advise

patien

take w

meals

enhan

absorp

n. If

tablet

must b

crushe

mix wi

food o

bevera

.

GenericName

BrandName

Dosage,Route, &

Frequency


Interactions Contraindicat

ion

NursingImplications

PatientTeaching

Ketorolac Toradol 30mg> via IV

Ketorolac isindicated forshort-termmanagement ofpain (up tofive daysmaximum).

The primary mechanism of actionresponsible for ketorolac'santiinflammatory,antipyretic andanalgesic effects is the inhibition ofprostaglandin synthesis by competitiveblocking of the the enzyme cyclooxygenase(COX). Like mostNSAIDs, ketorolac is a non-selectiveCOX inhibitor.

As with other NSAIDs, themechanism of the drug is associatedwith the chiral S form. Conversion of

Noadversereactionnoted.

No druginteractionnoted

Notcontraindicated tothepatient

>Document indications for therapy,onset, location, pain intensity/level,and characteristics of the symptoms

>If given on p.r.n. basis, base thesize of a repeat dose on duration ofpain relief from previous dose. If thepain returns within 3-5 hours, the

next dose can be increased by up to50% (as long as the total daily doseis not exceeded). If the pain does notreturn for 8-12 hr, the next dose canbe decreased by as much as 50% or

> inform thepatient thatKetorolacmay causesome peopto becomedizzy ordrowsy


7/12

the R enantiomer into the S enantiomer hasbeen shown to occur in the metabolism ofbuprofen; it is unknown whether it occurs inthe metabolism of etorolac.

the dosing interval can be increasedto q 8-12 hr.

GenericName

BrandName

Dosage,Route, &

Frequency



NursingImplications

PatientTeaching

NicardipineDrip

Cardene 1D5W90ml + 10mL

antihypertensives foressentialhypertension.

Inhibits the transportof calcium intomyocardial andvascular smoothmuscle cells,resulting in inhibitionof excitation-contraction couplingand subsequentcontraction.Therapeutic Effects:Systemicvasodilation

resulting indecreased bloodpressure. Coronaryvasodilationresulting indecreasedfrequency andseverity of attacks ofangina.

No adversereaction notedsuch as;dizziness,shortness ofbreath

No interactionnoted withcefuroxime

Notcontraindicated tothepatient

>Establish baseline data beforetreatment is started including BP,pulse, and lab values of liver andkidney function.

>Monitor BP during initiation andtitration of dosage carefully.Hypotension with or without anincrease in heart rate may occur,especially in patients who arehypertensive or who are alreadytaking antihypertensive medication.

>Avoid too rapid reduction in eithersystolic or diastolic pressure duringparenteral administration.

>Discontinue IV infusion ifhypotension or tachycardia develop.

>Observe for large peak and troughdifferences in BP. Initially, measureBP at peak effect (12 h after dosing)and at trough effect (8 h after dosing).

>Advise patient toavoid grapefruit andgrapefruit juice duringtherapy.

> Caution patient tochange positions slowto minimize orthostatichypotension

>Record and report aincrease in frequencyduration, and severity

of angina wheninitiating or increasingdosage. Keep a recorof nitroglycerin use anpromptly report anychanges in previousanginal pattern.Increased incidenceand severity of anginahas occurred in somepatients usingnicardipine.

Generic Brand Dosage, Indicatio action Adverse Interactions Contraindicatio Nursing Patient


8/12

Name Name Route, &Frequency

n Reaction n Implications Teaching

Metronidazole

noritade

500mgvia IVevery*hours

Amebicide in themanagement ofamebicdysentery

>DisruptsDNA andproteinsynthesisinsusceptibleorganisms

>Bactericidal, oramebicidalaction

Noadversereactionnoted

Nointeractionnoted withcefuroxime

Notcontraindicatedwith the patient

>assess pts. Infection

>watch carefully for edema

because it may cause

sodium retention

>assess skin for severity

areas of localadverse

reactions>record number and

character of stools

>assess pts and familys

knowledge of drug therapy

r>instruct pt. to take oral form with

meals to minimize reactions

>instruct to complete full course o

therapy

>tell pt. not to use alcohol or drug

that contain alcohol

.>tell pt. that metallic taste and

dark or red brown urine may occu

>may cause dizziness/ light

headedness

Generic

Name

Brand

Name

Dosage,

Route, &Frequency

Indication action Adverse

Reaction

Interactions Contraindication Nursing

Implications

Patient

Teaching

Clindamycine

Cleocin

HCl,1 capsuleevery 8hours

Treatingseriousinfectionscausedby certainbacteria

used to treata widevariety ofbacterialinfections.Itis anantibiotic thatworks bystopping thegrowth of

bacteria.

No adversereactionnoted suchas;Nausea,vomiting,ordiarrhea

no interactionnoted

not contraindicatedto the client

Administer oral drug with afull glass of water or with foodto prevent esophagealirritation. Do not give IM injectionsof more than 600 mg; injectdeep into large muscle to avoidserious problems. Do not use for minorbacterial or viral infections. Monitor renal and liverfunction tests, and blood

counts with prolonged therapy.

>inform patient that shemay experience theseside effects: Nausea,vomiting (eat frequentsmall meals);superinfections in themouth, vagina (usefrequent hygienemeasures; requesttreatment if severe).> tell patient to Reportsevere or watery diarrhea

abdominal pain, inflamedmouth or vagina, skin rasor lesions.
http://www.webmd.com/a-to-z-guides/bacterial-and-viral-infectionshttp://www.webmd.com/a-to-z-guides/bacterial-and-viral-infectionshttp://www.webmd.com/digestive-disorders/digestive-diseases-nausea-vomitinghttp://www.webmd.com/digestive-disorders/digestive-diseases-nausea-vomitinghttp://www.webmd.com/a-to-z-guides/bacterial-and-viral-infectionshttp://www.webmd.com/a-to-z-guides/bacterial-and-viral-infections


9/12

GenericName

BrandName

Dosage,Route, &

Frequency



PatientTeaching

Mefenamic Apo-Mefenamic

500mg1 capsuleevery 6

hours

Relief of

moderate

pain when

therapy will

not exceed 1

wk

Anti-

inflammato

ry,

analgesic,

and

antipyretic

activities

related to

inhibition of

prostaglan

din

synthesis

No adverse

reaction

noted such

as ;Rash,

pruritus,

sweating,

dry mucous

membranes

no interaction

notedNot

containdicated to

tha patient

>Give with milk or food

to decrease GI upset.

>Arrange for periodic

ophthalmologic

examination during long-

term therapy.

>Institute emergency

procedures if overdose

occurs: gastric lavage,

induction of emesis,

supportive therapy.

Advice patient to:>Take drug with food; take only t

prescribed dosage; do not take th

drug longer than 1 wk.

>Dizziness, drowsiness can occu

(avoid driving or the use of

dangerous machinery).

>Report sore throat, fever, rash,

itching, weight gain, swelling in

ankles or fingers; changes in

vision; black, tarry stools; severe

diarrhea.

GenericName

BrandName

Dosage,Route, &

Frequency



NursingImplications

PatientTeaching

Acedofenac clanra 100Mgevery 12

hours

It eases pain

and reduces

inflammation.

Some prostaglandins

are produced at sites

of injury or damage,

and cause pain and

inflammation. By

blocking the effect of

COX enzymes, fewer

prostaglandins areproduced, which

means pain and

inflammation are

No adverse

reaction noted

such as;Diarrhea, nausea,

headache,

indigestion,

heartburn,

abdominal pain,flatulence, feeling

sick, dizziness and

rash.

No

interaction

with other

drug

Not

contraindicated

to the patient

tell patient to

>Taking Preservex with

food and drink

>Preservex must be

taken preferably with o

after food.


10/12

eased.

GenericName

BrandName

Dosage,Route, &

Frequency



NursingImplications

PatientTeaching

dulcolaxBisacodyl 1suppository

NOW

Bisacodyl isused for thetemporaryrelief ofoccasionalconstipationand irregularbowelmovements.

It works by stimulatingthe bowel muscles andalso accumulates waterin the intestines. Thishelps to soften the stooland produce a bowelmovement more quickly.The tablets should betaken at bedtime toproduce a bowelmovement the nextmorning. Thesuppositories usually

take about 15 minutes to1 hour to work

No adversereactionnoted.

No drugintertionnoted

Notcontraindicated to the patient

>Evaluate periodicallypatient's need forcontinued use of drug;bisacodyl usuallyproduces 1 or 2 softformed stools daily.

>Monitor patientsreceiving concomitantanticoagulants.

>Indiscriminate use oflaxatives results in

decreased absorptionof vitamin K.

Inform the client :>Add high-fiberfoods slowly toregular diet toavoid gas anddiarrhea.>Adequate fluidintake includes aleast 68glasses/d.?Do not breast

feed while takingthis drug withoutconsultingphysician.

GenericName

BrandName

Dosage,Route, &

Frequency



NursingImplications

PatientTeaching

Nifedipine adalatgitz

1 tabonce a day

hypertension causes blood-pressureloweringthroughperipheralvasodilation. Itcan cause anuncontrollabledecrease in


No druginteractionnoted


> Monitor BP andpulse beforetherapy, duringdose titration andperiodically duringthe therapy.

>Adalat shouldnever be

>instruct patient on techniqufor monitoring pulse. If heartrate is below 50 beats perminute

>Instruct the patient to avoidconcurrent use of alcohol orOTC medications and naturor herbal products especiall


11/12

blood pressure,reflextachycardia,and a stealphenomenon incertain vascularbeds.

administered withgrapefruit juice.

As it can increasethe level of themedicine in theblood and thusincrease its effecton the bloodpressure.

cold preparations, withoutconsulting the doctor.hephysician should be notified

>Advise patient to takemedication exactly asdirected. Missed dosesshould be taken as soon asremembered unless almosttime for next dose.

GenericName

BrandName

Dosage,Route, &

Frequency



PatientTeaching

Nebirolol Nebilet 5mg1 tab,once a day

hypertension Blocks beta receptors.Factors that may beinvolved in mechanismof action includedecreased heart rateand myocardialcontractility, diminishedtonic sympatheticoutflow to the peripheryfrom cerebralvasomotor centers,suppressed reninactivity, and decreasedperipheral vascularresistance. Lacksintrinsicsympathomimeticactivity attherapeutically relevantdoses.

No adversereaction noted

Interted with

nifedipineNotcontraindicated tothe patient

Closely monitorpatients receivinganesthetic agentsthat depressmyocardialfunction. Whendiscontinuation ofnebivolol isplanned, carefullyobserve patientsand advise them tominimize physicalactivity. Closelymonitor patientssuspected ofdevelopingthyrotoxicosis whennebivolol therapy isto be withdrawn.

>Advise patients

that this medicine

may be taken wit

or without food.

>Caution patien

to avoid sudde

position change

to preve

orthostatic

hypotension.


12/12

GenericName

Brandname

Dosage,Route, &

Frequency



NursingImplications

PatientTeaching

bromocriptine

Parlodel 2.5mg1 tab3 times aday

mTo stop milk

production after

an abortion or

miscarriage or in

women after a

delivery who

should not

breastfeed for

medical reasons.

Bromocriptineblocks the releaseof a hormonecalled prolactinfrom the pituitarygland. Prolactin

affects themenstrual cycleand milkproduction.


No drugintertionnoted

Notcontraindicated to thepatient

>Monitor vital signsclosely during the firstfew days andperiodically throughouttherapy.

>Lab tests: PeriodicCBC, liver functionsand renal functionswith prolonged therapy.

Inform patient that>takingbromocriptine tosuppresspostpartumlactation may have

temporary reboundbreast enlargemenand pain followingdrug withdrawal.

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Date: Date:

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Drug Lab Result