Patient: Patient AM, Bed 6 Diagnosis: Obstructive Uropathy S/P E Lumbar Exploration Evacuation of Psoas Abscess Diet: Diet

As Tolerated Drug Generic Name: Metronidazole Brand Name: Flagyl Classification: Anti-infective / Antiprotozoal Dosage: 500 mg / tab, BID Indication Bacterial infections caused by anaerobic microorganisms Contraindication/s Hypersensitivity to metronidazole Use cautiously with CNS diseases, hepatic disease, candidiasis, lactation. Action Side Effects Adverse Effects No adverse effects mainfested by the client. Nursing Considerations Administer with food or milk to minimize GI irritation. Tablets may be crushed for clients with difficulty swallowing. Instruct client to take medication exactly as directed evenly spaced times between dose, even if feeling better. Do not skip doses or double up on missed doses. If a dose is missed, take as soon as remembered if not almost time for next dose. May cause dizziness or lightheadedness. Caution client or other activities requiring alertness until response to medication is known. Inform client that medication may

A direct-acting No side effects trichomonacide manifested by and amebicide the client. that works at both intestinal and extraintestinal sites. It is thought to enter the cells of microorganisms that contain nitroreductase. Unstable compounds are then formed that bind to DNA and inhibit synthesis causing cell death.

cause an unpleasant metallic taste. Inform client that medication may cause urine to turn dark. Administer drug with food to decrease GI upset and enhance absorption. Have vitamin K available in case hypoprothrombine mia occurs. Discontinue if hypersensitivity reaction occurs.

Generic Name: Cefuroxime Brand Name: Ceftin Classification: Antibiotic / Cephalosporin Dosage: 500 mg / cap, BID

Infection caused by Escherichia coli

Hypersensitvity to cephalosporins

Binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

No side effects No adverse manifested by effects the client. manifested by the client.

Generic Name: Tranexamic Acid Brand Name: Hemostan Classification:

Used for the prompt and effective control of hemorrhage in various surgical areas.

Allergic reaction or hypersensitivity Presence or history of blood clots

It is a synthetic No side effects derivative of the manifested by amino acid the client. lysine. It exerts its anti-fibrinolytic effect through the reversible blockade of

No adverse effects manifested by the client.

Unusual change in bleeding patter should be immediately reported to the physician. To control heavy bleeding, the

Antihemorrhagic Dosage: 500 mg / cap

lysine-binding sites on plasminogen molecules. Antifibrinolytic drug inhibits endometrial plasminogen activator and thus prevents fibrinolysis and the breakdown of blood clots. The plasminogenplasmin enzyme system is known to cause coagulation defects through lytic activity on fibrinogen, fibrin and other clotting factors. By inhibiting the action of plasmin (finronolysin) the anti-fibrinolytic agents reduce excessive breakdown of fibrin and effect physiological hemostasis.

medication should only be taken during the menstrual period. Medication can be taken with or without meals. Instruct client to swalow Tranexamic acid with plenty of liquids and not to break, crush, or chew.

Patient: Patient MB, Bed 5 Diagnosis: Indirect Inguinal Hernia S/P Herniotomy (R) Diet: Diet As Tolerated Drug Generic Name: Amoxiclav Brand Name: Augmentin Classification: Broad-spectrum penicillin Dosage: 500 mg / 125 mg, TID Indication Treatment of bacterial infections induced by gram negative and gram positive amoxicillinresistant microorganisms whose resistance is caused by lactamases Contraindication/s Penicillin hypersensitivity History of coamoxiclavassociated or penicillinassociated jaundice or hepatic dysfunction. Action An antibiotic that combines amoxicillin and clavulanic acid. It destroys bacteria by disrupting their ability to form cell walls. Side Effects No side effects manifested by the client. Adverse Effects No adverse effects mainfested by the client. Nursing Considerations Assess bowel pattern before and during treatment as pseudomembranous colitis may occur. Report hematuria or oliguria as high doses can be nephrotoxic. Assess respiratory status. Ensure that the client has adequate fluid intake during any diarrhea attack. Assess client for severe diarrhea and vomiting for dehydration and electrolyte imbalance. Instruct client to avoid potentially hazardous activities.

Generic Name: Mefenamic Acid Brand Name: Ponstan Classification: NSAID Dosage: 500 mg / cap, TID

Short-term relief of mild to moderate pain

Hypersensitivity to drug GI inflammation or ulceration

Anthranilic acid derivative. Like ibuprofen, it inhibits prostaglandin synthesis and affects platelet function.

No side effects manifested by the client.

No adverse effects manifested by the client.

Patient: Patient AM, Bed 6 Diagnosis: Obstructive Uropathy S/P E Lumbar Exploration Evacuation of Psoas Abscess Diet: Diet As Tolerated Assessment Subjective: Nanghihina ako. Ayokong magkikilos, as verbalized by the patient Objective: > (+) limited movement > (+) facial grimace > RR: 28 cpm Nursing Diagnosis Activity intolerance related to fatigue and retention of waste products secondary to obstructive uropathy Inference Inability of urine to drain through the ureter Planning Nursing Interventions 1. Monitor vital signs. Rationale 1. To obtain baseline data regarding the clients health status and to determine effectiveness of nursing care 2. To promote self-esteem. Evaluation Goal partially met. At the end of 8 hours of nursing intervention the client was able to report a decrease in activity intolerance and was able to participate willingly in desired activities, as manifested by: > (+) limited movement > (-) facial grimace > RR: 22 cpm

At the end of 4 hours of nursing intervention the client will be able Urine backs up to report a into the kidney decrease in activity Retention of intolerance and waste products will be able to (urea and toxins) participate willingly in desired Accumulation of activities, as fluids and toxins manifested by: in the > (-) limited bloodstream movement > (-) facial Increased fatigue grimace > RR: < 28 cpm Insufficient energy to perform activities

2. Promote independence in self-care activities as tolerated. 3. Assist with activities. 4. Encourage alternating activity with rest. 5. Assist client to learn and demonstrate appropriate safety measures. 6. Encourage client to use relaxation techniques.

3. To protect from injury. 4. To prevent overexertion. 5. To prevent injury.

6. To promote relief from possible pain and to enhance sense of wellbeing.

Subjective: Wala akong ganang kumain. Wala akong gusting kainin, as verbalized by the patient. Objective: > BMI: 14.8 kg/m2 (underweight) > (-) presence of subcutaneous fats/muscle mass

Imbalanced nutrition, less than body requirements related to decreased oral intake secondary to obstructive uropathy

Inability of urine to drain through the ureter Urine backs up into the kidney Retention of waste products (particularly urea) Accumulation of urea in the bloodstream (uremia) Upset stomach Loss of appetite

At the end of 8 hours of nursing intervention, the patient will be able to verbalize understanding of the importance of proper diet and will be able to demonstrate behavior changes to regain weight.

1. Determine ability to chew, swallow, or taste.

2. Discuss eating habits, including food preferences and intolerance. 3. Emphasize importance of well-balanced, nutritious diet.

1. To determine that factors that affect ingestion and/or digestion of nutrients. 2. To appeal to client likes and desires.

3. To provide understanding of proper nutrition and dietary practices. 4. Promote intake 4. To promote of protein-rich nitrogen foods such as balance eggs and meats. needed for growth and healing.

Goal met. At the end of 8 hours of nursing intervention, the patient was able to verbalize understanding of the importance of proper diet and was able to demonstrate behavior changes to regain weight.