DRUG STUDY Name of Patient Initial: N.N.

B Age: 1 year and 10 months old Sex: Male Date of Admission: August 27, 2013 Diagnosis: BFC secondary to AURTI Date Medication Started: August 27, 2013

DRUG(20) Generic Name(2) Cefaclor Brand Name(2) Classification(2) Antibiotic, Cephalosporin Dosage(4) 250/5ml = 5ml Route(3) Oral Frequency(3) q8 Form(2) suspension Color(2) red

MECHANISM OF ACTION(10) Bactericidal: inhibits synthesis of bacterial cell wall, causing cell death.

INDICATION(10) Lower respiratory infections caused by S. pneumonia, S. aureus, E. coli, Klebsiella pneumonia, H. influenza, S. pyogenes Dermatologic infections caused by S. aureus, S. pyogenes, E. coli, K. pneumonia, Enterobacter UTIs caused by E. coli, K. pneumonia Uncomplicated and disseminated

CONTRAINDICATIONS(1 0) Contraindicated with allergy to cephalosporins or penicillins Use continuously with renal failure, lactation, pregnancy

EFFECTS(10)

NURSING RESPONSIBILITIES(40) Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated. Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy may be instituted pending test results. Monitor periodically BUN and creatinine clearance. Inspect IV injection sites frequently for signs of phlebitis. Report onset of loose stools or diarrhea.

Side Effects Diarrhea, stomach upset Difficulty of breathing Anusual tiredness or fatigue Pain at injection site

Adverse Effect CNS: headache, dizziness, lethargy, paresthesias GI: nausea, vomiting, diarrhea, anorexia,

gonorrhea caused by N. gonorrhoeae Septicimia caused by S. pneumonia, S. aureus, E. coli, K pneumonia, H. influenza Meningitis caused by S. pneumoniae, H. influenza, S. aureus, N. meningitides Bone and joint infections due to S. aureus Perioperative prophylaxis Treatment of acute bacterial maxillary sinusitis in patients 3-mo 12yr

abdominal pain, Although flatulence, pseudomembranous pseudomenbran colitis rarely occurs, ouse colitis, this potentially lifehepatotoxicity threatening complication should be GU: ruled out as the cause Nephrotoxicity of diarrhea during and Hematologic: after antibiotic Bone marrow therapy. depression Monitor for Hypersensitivity: manifestations of ranging from hypersensitivity. rash to fever to Discontinue drug and anaphylaxis; report their serum sickness appearance promptly. reaction Monitor I&O rates and Local: pain, pattern: Especially abcess at important in severely ill injection site, patients receiving high phlebitis, doses. Report any inflammation of significant changes. IV site Others: Patient & Family Education superinfection, disulfram- like reaction with Report loose stools or alcohol diarrhea promptly. Report any signs or symptoms of hypersensitivity

Submitted by: Ariane Rose S.Cedron Year& Section Grp. : BSN3-1 Group 3 Date: August 30, 2013

Submitted to: Mr.Rolly Antonio

DRUG STUDY Name of Patient Initial: N.N.B Age: 1 year and 10 months old Sex: Male Date of Admission: August 27, 2013 Diagnosis: BFC secondary to AURTI Date Medication Started: August 27, 2013

DRUG(20) Generic Name(2) Salbutamol Guaifenesin Brand Name(2) Ventolin Classification(2) Expectorant/ Antiasthma Dosage(4) 5ml, 12mg Route(3) Oral Frequency(3) TID Form(2) Syrup Color(2) White

MECHANISM OF ACTION(10) It relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles. The relief from nasal congestion and bronchospasm is made possible by the following mechanism that takes place when Salbutamol is administered. First, it binds to the beta2adrenergic receptors in the airway of the smooth muscle which then leads to the activation of the adenyl cyclase and increased levels of cyclic- 35-

INDICATION(10) To control and prevent reversible airway obstruction caused by asthma or chronic obstructive pulmonary disorder (COPD) Quick relief for bronchospasm For the prevention of exercise-induced bronchospasm Long-term control agent for patients with chronic or persistent bronchospasm

CONTRAINDICATIONS(10) Hypersensitivity to adrenergic amines Hypersensitivity to fluorocarbons

EFFECTS(10) Nervousness Restlessness Tremor Headache Insomnia Chest pain Palpitations Angina Arrhythmias Hypertension Nausea and vomiting Hyperglycemia Hypokalemia

NURSING RESPONSIBILITIES(40) Assess lung sounds, PR and BP before drug administration and during peak of medication. Observe fore paradoxical spasm and withhold medication and notify physician if condition occurs Administer PO medications with meals to minimize gastric irritation. Extended-release tablet should be swallowed-whole. It should not be crushed or chewed. If administering medication through inhalation, allow at least 1 minute between

adenosine monophospha te (cAMP). When cAMP increases, kinases are activated. Kinases inhibit the phosphorylati on of myosin and decrease intracellular calcium. Decreased in intracellular calcium will result to the relaxation of the smooth muscle airways.

inhalation of aerosol medication. Advise the patient to rinse mouth with water after each inhalation to minimize dry mouth. Inform the patient that Albuterol may cause an unusual or bad taste.

Submitted by: Ariane Rose S.Cedron Year& Section Grp. : BSN3-1 Group 3 Date: August 30, 2013

Submitted to: Mr.Rolly Antonio

DRUG STUDY

Name of Patient Initial: N.N.B Age: 1 year and 10 months old Sex: Male

Date of Admission: August 27, 2013 Diagnosis: BFC secondary to AURTI Date Medication Started: August 27, 2013

DRUG(20) Generic Name(2) Paracetamol Brand Name(2) Calpol Classification (2) Analgesic, Non- opioid Antipyretic Dosage(4) 250mg/ 5ml= 1.5ml Route(3) P.O Frequency(3) q4 for temp 37.8 C Form(2) Suspension Color(2) orange

MECHANISM OF ACTION(10) Decreases fever by a hypothalamic effect leading to sweating and vasodilation Inhibits pyrogen effect on the hypothalamicheat-regulating centers Inhibits CNS prostaglandin synth esis with minimal effects on peripheral prostaglandin synthesis Does not cause ulceration of the GI tract and causes no anticoagulant action

INDICATION(10) Control of pain due to headache, earache,dysmen orrhea, arthralgia, myalgia, musculoskeletal pain, arthritis, immun izations, teething, tonsillectomy Reduce fever in viral and bacterial inf ections As a substitute for aspirin in upper GI disease, bleeding disorders clients in anticoagulant therapy and gouty arthritis

CONTRAINDICATIONS (10) Anemia, cardiac & pulmonary disease. Hepatic or severe renal disease. Liver toxicity (hepatocyte necrosis) may occur with doses not far beyond labeled dosing.

EFFECTS(10)

NURSING RESPONSIBILITIES(40) Do not exceed 4gm/24hr. in adults and 75mg/kg/day in children. Do not take for >5days for pain in children, 10 days for pain in adults, or more than 3 days for fever in adults. Extended-Release tablets are not to be chewed. Monitor CBC, liver and renal functions. Assess for fecal occult blood and nephritis. Avoid using OTC drugs with Acetaminophen . Take with food or milk to minimize GI upset. Report N&V. cyanosis, shortness of breath and abdominal pain as these are signs of toxicity.

Side Effects Minimal GI upset,methemogl obinemia,hemoly tic anemia, neutropenia, thrombocytopeni a, pancytopenia, leucopenia,urtica ria, CNS stimulation, hypoglycemic coma, jaundice, glissitis, drowsiness, liver damage

Adverse Effect Allergic skin reactions & GI disturbances.

Report paleness, weakness and heart beat skips Report abdominal pain, jaundice, dark urine, itchiness or clay-colored stools. Phenmacetin may cause urine to become dark brown or winecolored. Report pain that persists for more than 3-5 days This drug is not for regular use with any form of liver disease.

Submitted by: Ariane Rose S.Cedron Year& Section Grp. : BSN3-1 Group 3 Date: August 30, 2013

Submitted to: Mr.Rolly Antonio

NURSING CARE PLAN Name of Patient Initial: N.N.B Age: 1 year and 10 months old Sex: Male ASSESSMENT NURSING DIAGNOSIS Risk for imbalanced nutrition less than body requirements related to inadequate nutritional intake due to decreased appetite. SCIENTIFIC RATIONALE When a person get sick, all his/ her senses are affected, even the sense of taste, and some have an after taste with the medication. Thats the reason why people loss their appetite when sick. OBJECTIVE NURSING INTERVENTION 1. Assess nutritional history, including a preferred food. 2. Observation and record the patient's food intake. Date of Admission: August 27, 2013 Diagnosis: BFC secondary to AURTI Surgery (if any): None SCIENTIFIC RATIONALE EVALUATION

Subjective cues: Wala ako masyadong ganang kumain, halos mga isang lingo na po. As verbalized by the client. Objective cues: Loss of appetite for a week Anorexia Thin body frame

After 8hrs of nursing intervention the client will identify the importance of eating nutritious foods that will help his body to recover.

1. Identify deficiencies, suspect the possibility of intervention 2. Observing caloric intake / lack of quality food consumption.

The patient identifies the importance of eating nutritious food. The patient shows behavior to improve his eating habits.

3.

Measure body weight per day (if possible).

3. Observing weight loss / observe the effectiveness of the intervention. 4. Little food can reduce vulnerabilities and increase input also prevent gastric distention.

4. Give food a little but often and or eat between meals.

5.

Give and Help oral hygiene.

6. Avoid foods

5. Increased appetite and

that stimulate and gassy. Rational:

oral input. 6. Lowering distention and gastric irritation.

Submitted by: Ariane Rose S.Cedron Year& Section Grp. : BSN3-1 Group 3 Date: August 30, 2013

Submitted to: Mr.Rolly Antonio

NURSING CARE PLAN Name of Patient Initial: N.N.B Age: 1 year and 10 months old Sex: Male ASSESSMENT NURSING DIAGNOSIS Ineffective Airway Clearance related to thick tenacious secretions and airway obstruction as manifested by shallow respiration, tachypnea and fever. SCIENTIFIC RATIONALE OBJECTIVE NURSING INTERVENTION 1. Monitor VS every 2 hrs. 2. Encourage patient to position in high-Fowlers or semi-Fowlers positon. 3. 3. turn patient every2 hrs and prn. 4. teach client to maintain adequate hydration by drinking at least 8-10 glasses of fluid/day ( if not contraindicated) 5. teach andsupervise effective coughing techniques.. 6. perform Chest Physical therapy 7. instruct on splinting abdomen with pillow during coughing efforts.. 8. monitor airway for patency Date of Admission: August 27, 2013 Diagnosis: BFC secondary to AURTI Surgery (if any): None SCIENTIFIC RATIONALE EVALUATION

Subjective: Nahihirapan siyang huminga, kaya naka oxygen siya. As stated by the mother Objective: inability to cough effectively shallow respiratio ns febrile T= 38.1 anxiety restlessne ss adventitio us breath sounds use of accessory muscle while brea thing tachypnea

After 8 hours of nursing intervention, the client will be able to cough effectively andclear own secretions.

1. to assess baseline data. 2. promotes maximal lungfunction. 3. repositioning pro motes drainage o f pulmonary secretions and enhances ventilation to decrease potential of atelectasis. 4. to help thin secretions. 5. To conserve energy and to reduce airway collapse. 6. CPT techniques utilizes forces of gravity and motionto facilitate secretion removal

After 8hours of nursing intervention, the client had beenable to cougheffectively andclear own secretions. Goal was met

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and provide artificial airways as warranted. administer bron chodilators as ordered. instruct client/family to notify nurse if the client is experiencing shortness of breath or air hunger instruct client/family regarding medications, effects, side effects and symptoms of adverse effects to nurse or physician promotes increased expiratory pressu re.8.requires if patient cannot maintain airway patency. to improve ventilation and maximizes air exchange. may indicate bronchial tubes are blocked with mucus, leading tohypoxia andhypoxemia. promotes prompt

identification of potential adverse reaction to facilitate timely intervention

Submitted by: Ariane Rose S.Cedron Year& Section Grp. : BSN3-1 Group 3 Date: August 30, 2013

Submitted to: Mr.Rolly Antonio

NURSING CARE PLAN Name of Patient Initial: N.N.B Age: 1 year and 10 months old Sex: Male ASSESSMENT NURSING DIAGNOSIS Hyperthermia related to BFC secondary to AURTI SCIENTIFIC RATIONALE A fever occurs when t he body sets the core temperature to a higher temperature, through the action of the pre-optic region of the anterior hypothalamus. For example, in response to a bacterial or viral infection, the body will raise its temperature, much like raising the temperature setting on a thermostat. OBJECTIVE NURSING INTERVENTION Provide tepid sponge bath. Assess fluidloss & facilitate oral intake. Promote bed rest. Provide cool circulating air usinga fan. Assist patient in changing into dry clothing. Provide oral hygiene. Monitor vital signs. Maintain IVfluids as orderedby physician. Administer antipyretic as ordered. Administer antibiotic as ordered. Interdepende nt: Monitor Date of Admission: August 27, 2013 Diagnosis: BFC secondary to AURTI Surgery (if any): None SCIENTIFIC RATIONALE Enhances heat loss by evaporation& conduction. Increases metabolic rate &diaphoresis. Reduces body heat Production. Dissipates heat by convection. Increases comfort. Prevents herpetic lesions of the mouth. Notes progress & changes of condition. Prevents de hydration. Reduces fever. Treats underlying cause. EVALUATION

Subjective cues: Baba, taas ang lagnat nang anak ko hanggang ngayon as stated by the patients mother. Objective cues: Warm to touch Drooping eyes Irritability Mild eyes redness Dry lips Flashed skin V/S T= 38.1C CR= 144 RR= 44

After 8 hours of nursing intervention, the patient temperature will lower downto37.5 C

After 8 hours of nursing intervention, the patient as a temperature of 37C

hematologic test &other pertinent lab records Discuss condition of the patient withother members of the health care team.

Indicates presence of infection &dehydration. Ensures continuous intervention

Submitted by: Ariane Rose S.Cedron Year& Section Grp. : BSN3-1 Group 3 Date: August 30, 2013

Submitted to: Mr.Rolly Antonio