Generic NamePenicillin G sodium

Brand NameCrystapen

ClassificationPenicillins

IndicationModerate to severe systemic infection

ActionInhibits cell-wall synthesis during bacterial multiplication

Adverse ReactionCNS: seizures, anxiety, confusion, depression, dizzeness,fatigue. CV: heart failure HEMATOLOGIC: leukopenia, thrombocytopenia, agranulocytosis. OTHER: anphylaxis, hypersensitivity reaction.

Contraindication*Contraindicated in patient hypersensitive to drug or other penicillins and in those on sodium restricted diets.

Nursing Consideration

*Before giving drug, ask patient about allergic reactions to penicillins. *Obtain specimen for culture and sensitivity test *Use cautiously in before giving first patients with other dose. drug allergies, *Don't confuse especially to drug with cephalosporins, polycillin, because of possible penicillamine, or cross-sensitivity. the various type of penicillin.

Generic Name

Brand Name

ClassificationAminoglycosides

IndicationTo prevent endocarditis before GI or GU procedure or surgery

ActionInhibits protein synthesis by binding directly to the 30S ribosomal subunit; bactericidal

Adverse ReactionCNS: fever, headache, lethergy, confussion, dizzeness, seizures CV: hypotension EENT: blured vision, tinnitus HEMATOLOGIC: leukopenia, thrombocytopenia,ag ranulocytosis SKIN: rash, urticaria, pruritus, injection site pain.

Contraindication*Contraindicated on patient hypersensitive to drug or other aminoglycosides

Nursing Consideration*Obtain specimen for culture and sensitivity tests before giving first dose. *Evaluate patient hearing before and during therapy. *use preservativefree formulations of gentamicin when intrathecal route is ordered.

Gentamicin sulfate Garamycin

Generic NameInsulin (regular)

Brand NameHumulin R

ClassificationAntidiabetics and glucagon

Indication*Moderate to severe diabetic or hyperosmolar hyperglycemia regular insulin *Mild diabetic ketoacidosis regular insulin *hyperkalemia

ActionIncreases glucose transport across muscle and fat cell membrane to reduce glucose level. Helps convert glucose to glycogen; triggers amino acid uptake and conversion to protein in muscle cells.; stimulates triglycerides formation and inhibits release of free fatty acids from adipoose tissue; and stimulates lipoprotein lipase activity, which converts circulating lipoproteins to fatty acids

Adverse ReactionMETABOLIC: hypoglycemia, hyperglycemia, hypomagnesemia,h ypokalemia SKIN: rash, urticaria,pruritus, sweeling, redness, stinging, warmth at injection site. OTHER: lipoatrophy, lipohypertrophy, hypersensitivity reactions, anaphylaxis

Contraindication*contraindicated in patient with history of systemic allergic reation to pork when porcinederived products are used or hypersensitivity to any component of preparation. *contraindicated during epesodes of hypoglycemia

Nursing Consideration*To mix insulin suspension, swirl vial gently or rotate between the palms or between palm and thigh. Don't shake vigorously. This causes bubbling and air in syringe. *Don't use insulin that are changes in color or becomes clumped or granular in appearance. *Store insulin in cool area. Refrigeration is desirable but not essentia,except with humulin R (concentrated) U-500.

Generic NameGlyburide and metformin hydrochloride

Brand NameGlucovance

ClassificationAnti-diabetics and glucagon

IndicationSecondb line therapy in patients with type 2 diabetes when diet, exercise, and firstline treatment with a sulfonylurea or metformin don't adequately control glucose level.

ActionUnknwon. Glyburide may lower glucose level by stimulating the release of insulin from the pancreas. Metformin decreases hepatic glucose production and intestinal absorption of glucose and improves insulin sensitivity.

Adverse ReactionCNS: headached, dizzeness GI: diarrhea, nausea, vomiting, abdominal pain METABOLIC: hypoglycemia, lactic acidosis RESPIRATORY: upper respiratory tract infection.

Contraindication*Contraindicated in patient hypersensitive to glyburide or metformin and in those with renal disease, renal dysfunction, or metabolic acidosis (including diabetic ketoacidosis)

Nursing Concideration* In elderely patients, monitor renal function regularly. *For patients requiring additional glycemic control, a thiazolidinedione may be added to glucovance therapy. *Monitor patients closely during times of increased stress, such as infection, fever, surgery or trauma; insulin therapy may be needed. Temporarily suspend drug for any surgical procedure that requires restricted intake of food and fluids and don't restart until patients oral intake has resumed.

Generic NameClindamycin Phosphate

Brand NameCleocin Phophate

Classification

Indication

Action

Adverse Reaction Contraindication

Nursing ConsiderationMonitor Bp and pulse in pts receiving drug parentally. Hypertension has occured following IM injection. Advise pt to remain recumbent following drug administration until Bp has stabilized.

Antibiotic

Serious infection when less toxic alternatives are inappropriate.

Semi synthetic derivative of lincomycin with which it shares neuromuscular blocking properties and other actions.

CV: Hypotension, Cardiac arrest GI: Diarrhea, Abdominal pain, flatulence, bloating, N/V, esophageal irritation, lost of taste, medicinal taste, jaundice, abnormal liver function test.

History of Hypersensitivity to clindamycin: History of general enteritis, ulcerative colitis, or antibiotic associated colitis.

CUES S: Masakit pa din ang paa ko as verbalized by the patient O: >(+)facial grimace >Guarding behavior >Pain located on his right foot >Amputated lower foot >Slow mobilization >(+)Blood on the dressing >(+) Swelling on the right foot

NURSING DIAGNOSIS Moderate pain r/t tissue and nerve trauma Secondary to post surgical operation (Metarsal amputation)

SCIENTIFIC RATIONALE Injury (Transduction) By which noxious stimuli tend to electrical activity (Transmission) Transmitting pain Pain impulses from site of transduction over peripheral sensory nerves Terminals in the spinal cord & the network Neurons relay to the brain (Modulation) enhances activity in the primary affarent pain receptors Pain perceive

PLANNING After 2 to 3 days of nursing intervertion, the pateint's scale of 6\10 will be reduced to 1\10, as evidenced by: (-)facial grimace (-) Guarding behavior

NURSING INTERVENTION Independent: >Monitored v/s >performed pain assessment each time pain occurs >Provided comfort measures such as proper positioning. >Encouraged adequate rest period. >Diverted activities such as listening to the radio, etc. >Provided quiet environment >Noted when pain occurs Dependent: >Administered medicines as ordered

RATIONALE >Baseline data >To rule out worsening of underlying condition >To provide non pharmacological pain management >To prevent fatique >To reduced concern on pain >To provide non pharmacological pain management >To medicate prophylactically as appropriate >To maintain acceptable level of pain

EVALUATION After 2-3 days of nursing intervention the patient was relieved from pain (Pain scale was decreased from 6 to 01) As evidenced by: (-)facial grimace (-)Guarding behavior

CUES S:

NURSING DIAGNOSIS Risk for infection r/t surgical operation secondary to DM.

SCIENTIFIC RATIONALE Insulin deficiency Hyperglycemia Excessive loss of fluids and electrolytes due to osmotic diuresis

PLANNING After 2-3 days of nursing intervention the patient will be able to discussed as evidenced by: > Able to know foot care.

NURSING INTERVENTIO Independent: >assessed surgical operation >Promoted hand washing

RATIONALE >Serves as comparative baseline data >To know the importance of hand washing >Reduce risk of cross contamination >To prevent as soon as posible >To avoid cross contamination

EVALUATION After 2days of nursing intervention the patient was able to understood the risk for infection r/t to his disease >The patient was able to enumerate interventions necessary for avoiding infections >The patient also inderstood the importance of foot care and skin care

O: >Metatarsal amputation >traumatized tissue > Broken skin >increased environmental exposure

polyuria ECF/ICF Dehydration Blood viscosity or concentration Sluggish circulation Polyferation of microorganism Infection

>Demonstrated correct proper hand washing >Observed for sign of infection or onflammation >Maintained aseptic technique when chaging dressing >Encouraged adequate diet & >To prevent further fluid intake increased of glucose level >Discussed foot care >To maintain cleanliness >Encourage to clean wound >Early treatment may everyday help to prevent sepsis Dependent: >To inhibitmicrobial >Administered antibiotics as growth ordered

CUES S: hindi na ako gaano makapagtrabaho kasi madali akong mapagod at manghina as verbilized by the patient. O: > weak in appearance > irritable > inability to maintain usual routines > decreased performance

NURSING DIAGNOSIS Fatique related to decreased metabolic energy production secondary to DM

SCIENTIFIC RATIONALE Insulin deficiency

PLANNING

NURSING INTERVENTION >Monitored PR, RR and BP before and after activity > Discussed with patient the need for activity

RATIONALE > Indicates physioological levels of tolerance

EVALUATION After 1 week of nursing intervention, the patient was able to display improved ability to participate in desired activities such as ADL's as evidenced by: (-) weakness (-) irritable > inability to maintain usual routines > increased performance.

After 1-2 weeks of nursing intervention, Glucose cannot move the patient will display into cells improved ability to participate in desired Sugar builds up in the activities such as blood stream ADL's as evidenced by: Blood glucose level rises (hyperglycemia) (-) weakness (-) irritable Cells are deprive of > Ability to maintain glucose usual routines > increased Muscle and organ performance becomes depleted of energy Fatique

> Education may provide motivation to increase activity level > Prevent excessive > Alternated periods of fatique activity with rest, interrupted sleep > To maximize > Plan care to allow participation individually adequate rest periods > Discussed ways if > Patient will be able conserving energy to accomplish more while bathing etc, with a decreased expenditure of energy > Increased confidence level/self-esteem and > Increase patient tolerance level participation in ADL's > Tolerance as tolerated meaningful information > Interviewed care provider regarding specific changes observed

Generic Name Oflaxacin Floxin

Brand Name

Classification Anti-infective: Quinolone Antibiotic

Indication > Chlamydia trachomitis infection, uncomplicated gonorrhea, prostatitis, resp.tract infections: skin to skin structure infections, urinary tract infection, due to susceptable bacteria, superficial occular infections, pelvic inflammatory disease.

Action A fivoroquinolonee antibiotic with a broad spectrum of activity against gram positive aerobic and anaerobic bacteria.

Adverse Reaction CNS: Headache, dizzeness, insomia, hallucinations. GI: N/V, diarrhea, GI discomfort.

Contraindication Hypersensitivity to ofloxacin or other quinolone antibacterial agents pregnancy: lactation.

Nursing Consideration Withhold ofloxacin and notify physician at first sign of a skin rash or other allergic reaction.

Generic Name Tramadol

Brand Name Ultram, Zydol

Classification Opiate agonist

Indication Management of moderately severe pain

Action Centrally acting opiate receptor agonist that inhibits the uptake of morepine phrine and serotonin, suggesting both opioid like effects, but causes less respiratory depresion than morphine.

Adverse Reaction >Sweating, anaphylactic reaction (even with first dose) > Visual disturbance > Urinary retention/ frequency, menopausal symptoms.

Contraindication > Hypersensitivity to tramadol or other opioid analgesic: pts. accutely intoxicated with alcohol, hyprotics, opioids, or psychotropic drugs: pts. on obstetric pre operative medication, lactation.

Nursing Consideration >Monitor V/S & assess for orthostatic hypotension or signs of CNS depresion. > Assess bowel & bladder function: report urinary frequency or retention.

CUES

NURSING DIAGNOSIS

SCIENTIFIC RATIONALE Neuro Cardiovascular Asthenia

PLANNING

NURSING INTERVENTION

RATIONALE

EVALUATION After 3 hours of nursing intervention, the patient have identified necessary health maintenance activities.

S: Ineffective health Hindi ko na naituloy maintenance r/t lack of ang gamot na nareseta materials resources sa akin as verbalized by the patient. O: > Demonstrated lack of knowledge regarding basic health practices > weak > fatique

After 3 hours of nursing intervention, the patient will be able to identify necessary health maintainance Cardiac cachexia activities as evidenced by: > Demonstrated Malnutrition & tissue knowledge regarding wasting basic health practices > Weakness > Fatique

> Developed plan with > Allows for patient for self care incorporating existing disabilities, adopting and organizing care as necessary > Provided time to listen concerns of patient > Provided anticipatory guidance > To build therapeutic communication > To maintain and manage effective health practices during periods of wellness and identify ways client can adopt when progressive illness/ long term health problems occurs > To prevent regression

> Encouraged socialization and personal involvement > Helped patient develop health care goals

> For further reference/ revision as appropriate

CUES S: hindi ko alam yung mga kumplikasyon basta ang alam ko diabetic ako as verbalized by the patient O: > (+)anxious > (+)often asking question

NURSING DIAGNOSIS Knowledge deficit r/t misinterpretation of disease process and familiarity regarding the treatment of the diseases

SCIENTIFIC RATIONALE Lack of specific information necessary for patient and family to make inform choices regarding of condition of treament necessary to maintain health

PLANNING After 1 to 2 hours of nursing intervention the patient will verbalized understanding of condition and disease process and treatment

NURSING INTERVENTION

RATIONALE

EVALUATION After 1 to 2 hours of nursing intervention the patient verbalized understanding of conditionand disease process and treatment

> Deal with the clients > Prevent anxiety anxiety when it is interfering with the clients learning process. > To facilitate learnung > Provided an environment that is conductive to learning > Provide knowledge > Review disease base from which can prosses of prognosis make informed choices and future expectations > Help pt. to learn the proper way of care and >Providing time treatment learning session > To assess the pt awareness abt. His > Asked the patient condition about His present condition > For learning of the patient > Reviewed dse. Process,trearment and predisposing factor of the dse. For easier standing of the patient. > Stated objective clearly in layman's term.