DRUG STUDY

LOSARTAN
Generic Name LOSARTAN
POTASSIUM
Brand Name Cozaar

Classification CARDIOVASCULAR AGENT; ANGIOTENSIN II RECEPTOR

ANTAGONIST; ANTIHYPERTENSIVE
General Action Angiotensin II receptor (type AT1) antagonist acts as a potent
vasoconstrictor and primary vasoactive hormone of the renin–angiotensin–
aldosterone system.
Dose and Route 100mg/1 tab OD PO

Indications or Selectively blocks the binding of angiotensin II to the AT1 receptors found
Purposes in many tissues (e.g., vascular smooth muscle, adrenal glands).
Antihypertensive effect results from blocking the vasoconstricting and
aldosterone-secreting effects of angiotensin II.
Side effects CNS: Dizziness, insomnia, headache.
GI: Diarrhea, dyspepsia.
Musculoskeletal: Muscle cramps, myalgia, back or leg pain.
Respiratory: Nasal congestion, cough, upper respiratory infection, sinusitis.
Contraindications Hypersensitivity to losartan, pregnancy [category C (first trimester),
category D (second and third trimesters)], lactation.
Nursing Assessment & Drug Effects
Responsibilities
● Emphasize the importance of continuing to take as directed, even if
feeling well. Take missed doses as soon as remembered if not almost time
for next dose; do not double doses. Medication controls but does not cure
hypertension.
● Caution patient to avoid salt substitutes containing potassium or foods
containing high levels of potassium or sodium unless directed by health
care professional.

● Caution patient to avoid sudden changes in position to decrease

orthostatic hypotension. Use of alcohol, standing for long periods,
exercising, and hot weather may increase orthostatic hypotension.

● May cause dizziness. Caution patient to avoid driving or other activities

requiring alertness until response to medication is known.

● Advise patient to notify health care professional of all Rx or OTC

medications, vitamins, or herbal products being taken and to consult with
health care professional before taking other medications.

● Instruct patient to notify health care professional if swelling of face,

eyes, lips, or tongue or if difficulty swallowing or breathing occur.

● Emphasize the importance of follow-up exams to evaluate effectiveness

of medication.

● Hypertension: Encourage patient to comply with additional interventions

for hypertension (weight reduction, low-sodium diet, discontinuation of
smoking, moderation of alcohol consumption, regular exercise, stress
management). Medication controls but does not cure hypertension.

● Instruct patient and family on proper technique for monitoring BP.

Advise them to check BP at least weekly and to report significant changes.

● Instruct patient to notify health care professional of medication regimen

before treatment.
Title: Teenage pregnancy worsening in PH
Author: Chito Chavez
Date of Publication: October 29, 2019, 4:57 PM
URL Source: https://news.mb.com.ph/2019/10/29/teenage-pregnancy-worsening-in-ph/

Summary
The Philippines is currently haunted by teenage pregnancy woes as 13.6 percent of girls below
18-years-old got themselves pregnant in 2018. It was also not reassuring that the rate of the
spread of HIV cases was also the highest in the Philippines, where sex has become cheaper as
more and more motels are built in Quezon City, Manila, Pasay and other cities in the National
Capital Region (NCR.) Every day, 576 babies are delivered by Filipino teenage mothers, for a
total of 210,240 babies annually, with the Davao Region, from where President Duterte holds
court, notching 17.9 percent, followed by Northern Mindanao with 14.7 percent. Concerned
about the impact of teen pregnancies on the national population, poverty situation and the
possibility of minors contracting HIV, Perez and Philippine Legislators’ Committee on
Population and Development (PLPCD) executive director Rom Dongeto and other concerned
individuals like noted Filipino rock star Skarlet Brown (who is also known as Myra Ruaro)
launched the “No More Children Having Children” campaign at the Park Inn by Radisson at SM
North Edsa on October 23.

Reaction
Teenage pregnancy may seem as a minor issue but it poses problems and threats not only to the
teenage mother, but to the society as well, thus this issue must be solved and be given notice
(Osotimehin, 2013). Assessing the situation of the Philippines when it comes to teenage
pregnancy, it can be seen that the issue is pressing. Considering that most numbers come from
the bottom of the pyramid, it increases poverty incidence: first, since they come from poor
families, it will be hard for them to sustain the needs of their child thus, increasing infant
mortality rate as well; and second, it will be hard for them to look for jobs. Considering that the
Philippines is heavily influenced by the Catholic church, teenage pregnancy is expected to be not
as rampant. However, the problem lie with the media, which showcases sex – may it be in
magazines, TV shows, movies, songs, etc. as if there’s nothing wrong with it. The culture
nowadays is that sex is a “normal” thing for teenagers, which explains why the number of youth
engaging in premarital sex or any other sexual activities continues to increase. Given this culture,
it can be said that it is almost unavoidable. However, education could prevent all this.There
should be safe sex education given to the youth especially to those in poorer sectors. However,
sex education must be given in the right age or should be age appropriate. We cannot solely
blame the youth or the teenage mothers for their actions. Yes, they should take part in the
responsibility, because somehow it was their choice. However, lack of education and poverty is
still to blame. By simply spreading awareness and information there is a probability that teenage
pregnancy could be lessened.
ARTICLE

Teenage pregnancy worsening in PH

The Philippines is currently haunted by teenage pregnancy woes as 13.6 percent of girls below
18-years-old got themselves pregnant in 2018.

Worse, nine percent of girls aged between 15 and 19 have already given birth or are pregnant,
the Philippine Statistics Authority (PSA) said in 2017.

Compounding the problem is that 17 percent of females aged 15 to 49, the period of fecundity,
want to use family planning methods, but are not doing so or have no access to such methods.

The Philippines has become the topnotcher in teen pregnancies among the six major economies
of the Association of Southeast Asian Nations (ASEAN), with the rate in the Philippines
increasing while the same rate was reported to be sinking in the other member-states.

It was also not reassuring that the rate of the spread of HIV cases was also the highest in the
Philippines, where sex has become cheaper as more and more motels are built in Quezon City,
Manila, Pasay and other cities in the National Capital Region (NCR.)

Every day, 576 babies are delivered by Filipino teenage mothers, for a total of 210,240 babies
annually, with the Davao Region, from where President Duterte holds court, notching 17.9
percent, followed by Northern Mindanao with 14.7 percent.

The National Demographic and Health Survey (NDHS) conducted in 2014 showed that the
frequency of early child-bearing was higher in the rural areas with endemic poverty and afflicts
families with more members.

“We are not even talking of teen pregnancies due to incest, or among minors forced to become
commercial sex workers (CSWs) like those recruited to work in night clubs and white slavery
rings the favor virgins for moneyed local clients,” the study said.

Studies conducted by government agencies, Health Undersecretary Juan Antonio “Jeepy” Perez,
executive director of the Commission on Population and Development (Popcom) showed that
teenage mothers were more likely to have premature and underweight babies, suffer chronic
poverty and unlikely to achieve higher educational attainment.

Concerned about the impact of teen pregnancies on the national population, poverty situation and
the possibility of minors contracting HIV, Perez and Philippine Legislators’ Committee on
Population and Development (PLPCD) executive director Rom Dongeto and other concerned
individuals like noted Filipino rock star Skarlet Brown (who is also known as Myra Ruaro)
launched the “No More Children Having Children” campaign at the Park Inn by Radisson at SM
North Edsa on October 23.
“Bills seeking to address teenage pregnancies have been filed in the 17th Congress but never
reached the sponsorship stage and thus were doomed to sleep the sleep of the dead in the plenary
while similar proposals reached third reading in the Senate,’’ Perez and Dongeto said.

Versions of the Prevention of Teenage Pregnancy Bill are pending in the two Houses of
Congress—House Bill 2297 in the Lower House and Senate Bill 161 in the Upper Chamber.

Briefly, the proposals call for the crafting of a program of action and an investment plan to
prevent teenage pregnancy and the establishment of a national information campaign to educate
minors and their parents about the adverse impacts of early motherhood.
 PHYSICAL ASSESSMENT

Physical assessment of the Patient was done at the SPMC Family Planning Center,

February 11, 2020, while patient was sitting comfortably. The Patient was oriented to time, place

and person. She displayed a good attention span and was very cooperative throughout the whole

physical assessment. She displayed no involuntary movements and was logical throughout the

interview. Both nonverbal and verbal responses were appropriate. The patient is currently on her

2nd pregnancy. She has a record of G2T1P0A0L1 at her 29th week of gestation. Her current

weight is 64kg from 50kg, current height is 172 which is a BMI of 22.7 (normal).

Vital Signs

 BP 180/100 mmHg

 PR 114

 RR: 29

 TEMP: 37

 02 Saturation: 99%

SKIN

 brown skin generally uniform in color except in areas exposed to the sun

 skin temperature uniform and within the normal range (37°C)

 when pinched, skin readily springs back to previous state

 moist skin folds

 nails with smooth texture

 nail beds pink

  prompt capillary refill time (2 seconds)

 bipedal non-pitting edema

HEAD

 absence of nodules or masses

 symmetric facial features and movements

 symmetric nasolabial folds

 evenly distributed black hair

 no infestations

EYES

 eyebrows symmetrically aligned with equal movement

 eyelashes equally distributed and curled slightly outward

 skin of eyelids intact with no discoloration

 lids close symmetrically

 bilateral blinking exhibited

 no discharge, edema or tearing

 white sclera

 pink palpebral conjunctiva

 iris black in color

 pupils equal in size with smooth borders

 illuminated pupils constricts

 pupils converge when near object is moved toward the nose

  when looking straight ahead, the client can see objects in the periphery

 both eyes coordinated, move in unison with parallel alignment

EARS

 color same as facial skin

 symmetrically aligned

 pinna immediately recoils after it is folded

 pinna is not tender

 no lesions or discoloration

 dry cerumen, grayish-tan color

 normal voice tones audible

 able to hear ticking of a watch in both ears

NOSE

 symmetric and straight

 no discharge or flaring

 absence of lesions and tenderness

 nasal septum intact and in the midline

MOUTH AND THROAT

 outer lips uniform pink color with symmetric contour, soft and moist

 buccal mucosa is of uniform pink color

  gums are pink

 tongue pink, moist, at central position

NECK

 head centered

 lymph nodes not palpable

BREAST

 firm

 generally symmetric in size

CARDIOVASCULAR

 BP 180/100 mmHg

 PR 114

 reported palpitations

 symmetric pulse strength

RESPIRATORY/CHEST

 chest symmetric

 chest wall intact, no tenderness, no masses

 symmetric chest expansion and excursion

 RR: 29 breaths per minute

GASTROINTESTINAL/ABDOMEN

 striae present at hypogastric and iliac regions

 linea nigra present

 no tenderness

 presence of surgical incision

URINARY

 absence of nocturia, dysuria, urgency, hesitancy,

 light yellow urine

REPRODUCTIVE

 Refused to be assessed

 G2T1P0A0 L1

MUSCULOSKELETAL/EXTREMITIES

 muscle equal size on both sides of the body

 no bone deformities

 no tenderness

NEUROLOGIC

I. Olfactory

Patient was able to identify the smell of the alcohol and the cologne.
II. Optic

Peripheral field intact upon confrontation

III. Oculomotor

Eyes exhibit PERRLA

IV. Trochlear

Both eyes exhibit purposeful movements and as necessary

V. Trigeminal

Facial sensations are intact and can be felt equally and bilaterally. Patient can frown

and smile at will and jaw strength was equally bilateral.

VI. Abducens

Both eyes show coordinated, voluntary and purposeful movement

VII. Facial

Patient reported that he could taste his previous meal. Patient can frown, smile, wink

both eyes and purse lips

VIII. Vestibulocochlear

Patient can hear words at different distances.

IX. Glossopharyngeal

Patient was able to swallow without pain and difficulty

X. Vagus

Uvula rises at the midline and patient can swallow without difficulty

XI. Accessory

Patient can move neck both left and right, front and back without pain and difficulty.

Patient can shrug shoulders one by one and at the same time without difficulty.
XII. Hypoglossal

Patient can protrude tongue at the midline without difficulty and can pronounce

various words properly

 School of Nursing

In Partial Fulfillment of Requirements in

Intensive Nursing Practicum

Submitted by:

Mr. Aubrey Unique M. Evangelista

BSN 4-A

Submitted to:

Ms. Grace E. Guitguiten, RN, MN

Date:

February 12, 2020

What did I do today?

In our 3 days of clinical exposure in the Family Planning Center, I was given a chance to

perform Leopold’s Maneuver and was apt to recognize and count fetal heart rate. Also, I was

given the occasion to give a lecture to mothers and parents about family planning, the various

methods, the benefits for the mother, child, father, and the whole family. I took vital signs,

measured the weight and height and most importantly was able to counsel some mothers about

the pertinence of family planning through one on one interview.

What did I learn?

I learned that raising awareness among men and women, couples, families about all the

methods of contraception and having nurses skilled to address their questions, can expel myths

and help to reduce the large numbers of unintended pregnancies. Good sexual and reproductive

health is key to protecting and improving the health and wellbeing of the nation.

What do I need to do now?

For future, I would try to do the in depth assessment of the needs of a client by involving

spouse as well. Moreover, I would try to get the expert opinion regarding family planning

counseling by integrating different approaches of family planning counseling. This would

enhance my knowledge about family planning counseling skills. Additionally, I would try to

discuss such sensitive issues with the client by having enough knowledge about the family

planning methods.