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Generic Name

Rebamipide

Brand Name Classification Suggested dose Mode of Action

Remapride Antiulcerant; Antacids PO Gastritis; Peptic ulcer 100 mg 3 times/day. Rebamipide is a mucosal protective agent and is postulated to increase gastric blood flow, prostaglandin biosynthesis and decrease free oxygen radicals.

Drug Interactions Indication

None noted.   Treatment for peptic ulcer disease Prevention of NSAID-induced gastropathy

Contraindication

Contraindicated with patients who are hypersensitive to the drug, lactating, pregnant, and children.

Adverse Reaction

Rash, pruritus, constipation, diarrhea, dry mouth, dry lips, abdominal distention, constipation.

Nursing Responsibilities

1. Ten Rights. 2. Do not give more than three tablets per day of this

5. Watch out for abdominal distention. 8. 6. Ask the client to take in food which are high in fiber to prevent constipation. 9.medication. Inform the client of the possible side effects. Encourage the client to verbalize relief from hyperacidity. . 7. 10. 4. Monitor intake and output. Instruct the client to report presence of rash. Ask the client to increase fluid intake because the drug may cause dry mouth. Ask the client to wear lip-balm or place a petroleum jelly on the lips to prevent it from cracking since the drug may cause dry lips. 3.

5 g calcium carbonate. An increase in bicarbonate ions and prostaglandins may also confer cytoprotective effects. It is a basic compound that acts by neutralizing hydrochloric acid in gastric secretions.Generic Name Calcium Carbonate Brand Name Classification Suggested dose TUMS Calcium-containing Antacids As Antacid: Chew 2-4 tablets as symptoms occur. or as directed by a physician. Calcium carbonate may also be used as a nutritional supplement or to treat hypocalcemia . Maximum Daily Dose: 15 tablets equivalent to 7. Maximum Daily Dose: 4 tablets equivalent to 2 g calcium carbonate. Subsequent increases in pH may inhibit the action of pepsin. Repeat hourly if symptoms return. As a Calcium Supplement: Chew 2 tablets twice daily with a meal. Mode of Action Calcium carbonate is an inorganic salt used as an antacid.

dyspepsia. Contraindication Patients with prior hypersensitivity reaction. 4. 2. redness diaphoresis. As a source of daily calcium. Nursing Responsibilities 1. Hypotension. throid hormones. hyperacidity. 3. vomiting. hypercalcemia. . Inform the client of the side effects of the drug. nausea. Remomber not to give calcium within two hours of consuming other oral drugs or fiber containing food. Ten rights. flushing. phenytoin tetracyclines: may decrease oral absorption of these drugs Indication Symptomatic treatment of heartburn. hypercalciuria or on a low-phosphate diet. Make sure to give the drug 30 minutes to 1 hour after meals.Drug Interactions Digoxin: may increase risk for arrhytmiasif hypercalcemia occurs Fluroquinolones bisphospanates. feeling of warmth. pain rash. sour stomach and acid indigestion. Adverse Reaction Chalky taste.

7. Monitor the heart rate and blood pressure of the client because the drug may cause hypotension. 9. Ask the client to chew the tablet before swallowing. 10. thus wearing of loose clothing is suggested. Advice the client not to drink water immediately after taking the drug. Remind the client not to swallow the tablet. .5. Inform the client that the drug may cause feeling of warmth. 6. Do not give the more than 15 tablets per day. 8.

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that high blood O N A L M 2 0 1 2  1 day Post Dialysis ®: elevated sugar level temperature is an amount of food indication of infection.Date and Time N O V E M B E   Cues Needs Nursing Diagnosis Goal of Care Nursing Interventions Evaluation Objective:  local pain Impaired tissue N U T R I T I ®: Tissues were broken down upon insertion of IJ shunt. note which has high b) Demonstrated pain. delays wound 4) Assess patient’s level and avoid food healing of discomfort. 2) Assess for purulent 8:00 pm drainage. lifestyle change 3) Assess for elevated understanding such as agreeing to eat the right body temperature. the patient: a) will be able to demonstrate 1) Elicit details of injury GOAL MET and treatment. noted (pain scale: mild) Guarding noted Wound dressing not 4 ®: to know proper 2012 interventions to be done. November 27. soaked with blood care. integrity related to open IJ shunt insertion Within 5 hours of nursing interventions. After 8 hours of R 27. the patient: ®: purulent drainage from incision site willingness for indicates presence of a) Verbalized infection. amounts of sugar no signs of ®: to know how pain to promote affects the client’s rest infection periods that may delay .

®: to reduce pain due to incision. 7) Administer analgesics right where the as prescribed. cleaning . cold at the left upper compress may reduce edema and promote arm to reduce some numbing thereby promoting pressure on the comfort. bleeding to the 6) Apply hot and cold affected area. might cause ®: nutritional status may delay recovery. c) Understood 5) Determine client’s that pressure nutritional status. that BP taking ®: warmth rushes blood to the affected should be done area to promote healing. b) will verbalize understanding of health teachings on proper wound care at home setting. compress just above d) Understood the incision site. I c) will show no C signs of infection such as P A T T E R N increased temperature and abnormal amount discharges.3:00pm E T A B O L healing. 8) Promote optimum nutrition by advising IJ shunt is inserted. the patient to eat right amounts of food. d) will willingness learn show to of recovery of tissues.

11) Assist with exercises. the sleep. ®: to promote blood circulation. to prevent bed sore from prolonged bed rest. ®: to prevent excessive tissue pressure. ®: to limit metabolic demands. 12) Instruct client to note changes condition changes in such in her as pain and characteristics . and meet comfort needs. 10) Promote early mobility. Encourage adequate periods of rest and during teaching process. maximize energy available for healing.techniques participating by 9) ®: to facilitate healing.

®: increased blood sugar delays wound healing. active bleeding may indicate opening of incision.unusual discomfort. reduces potential for complications. ®: secretions may be due to infection. physical ®: promotes early intervention. note amount of secretions. 15) Teach client of proper care of area. minimize . 14) Check wound dressing for signs of active bleeding. 13) Instruct client to avoid eating sweet food/food which may alter blood sugar level.

®: to minimize or prevent bacterial growth. to if tell these signs are felt. 16) Instruct the patient to finish all prescribed antibiotics. 17) Teach client of the early signs of infection such as fever and abnormal instruct physician secretions. ®: early detected infections are easier to cure.paper. ®: adding pressure to the area might cause bleeding. .

and the abdomen. No lesions noted upon inspection. Vital Signs (November 27. Body odor and halitosis not noted. No tenderness noted. No areas of increased vascularity.PHYSICAL ASSESSMENT General Survey Received patient lying on bed awake and responsive with Hep-lock on right cephalic vein and a right IJ shunt. Edema not noted. . ecchymosis. Skin is smooth. or bleeding noted. Client has good body symmetry with no deformity. Rashes noted on both of her arms. Limbs and trunk appear proportional to the body’s height. appears restless. Clothing of choice was appropriate for the weather. it she answers immediately. The skin is moist with a minimum of perspiration.9 °C Skin. Client appears clean and neatly dressed. Body fat is evenly distributed. Hair and Nails Client’s skin is uniformly light brown in color. 2012) BP: 150/90 mmHg PR: 74 bpm RR: 24 cpm Temp: 36. She appears appropriate to the stated chronological age. Good skin turgor noted as evidenced by skin retraction in less than 3 second when pinched at the anterior chest. under the clavicle. even and firm. Client is not irritable. When she is asked.

intact. nontender. The facial features and movements are symmetrical. The scalp is shiny. Hair is thin. Nails are clean and well trimmed with light pink nail beds. close her eyes. No edema. . The muscles of the neck are symmetrical with the head in a central position. The scalp is pale white in color. Hair is shiny and resilient when traction was applied. or involuntary movements noted. The angle of the nail base is approximately 160 degrees. and without lesions or masses. The shape of the face is round. Seborrhea not noted. Capillary refill is two seconds. Head. and without masses or depressions. The patient experienced no discomfort with movement. Surrounding tissues were intact. hair won’t come out in clumps in hands. no lesions or lacerations were observed. The skull is smooth. frown and smile. The muscles are symmetrical without palpable masses or spasms. There are no signs of infestation or lesions. Neck and Regional Lymphatics The head is normocephalic and proportional to body size. The temporomandibular joint articulate smoothly and without crepitus. The patient was able to raise her eyebrows. disproportionate structures. The client is able to move the head through a full range of motion without complaint of discomfort or noticeable limitation.Hair is originally black but has mixture of white hair and evenly distributed. The nail surface is smooth and slightly rounded. and wavy.

She mentioned that she has reading eyeglasses but upon assessment she didn’t wear such. Eyes She could only see clearly the things near to her. The ears are physically symmetrical and are both located in line with the outer canthus of her eyes.Regional Lymphatics No enlargement. Her pinna has no noted deformities. Conjunctiva was pink and moist without foreign bodies. and no discoloration noted. lesions or foreign bodies. enlargement. The client can raise both eyelids symmetrically. swelling. . no large amount of exudates. symmetrical. Auricles are smooth. infections. superficial vessels and without exudates. Eyelashes are evenly distributed and curled slightly outward. There were no abnormalities in her thyroid gland both anteriorly and posteriorly. it is firm and non-tender. There’s no enlargement. Sclera is white with some small. round. or redness noted in her lacrimal apparatus. Upon palpation. Nose. Mouth. masses. Lymph nodes are not palpable. or tumors. and Throat She was able to hear the ticking sound from our watch in both ears. no pain or tenderness noted. Both eyes move smoothly and symmetrically in each of the six fields of gaze and converge on the held object as it moves toward the nose. Pinna recoils after it is being folded. or redness. No swelling. and equal diameter. lesions. ranging from two to six mm. nodules and inflammations. The eyelids appear symmetrical with no dropping. Ears. or tenderness noted on palpation. Skin is intact with no noted scaling and flakiness of skin. Lenses are transparent in color. and minimal tearing. The pupils are deep black. Minimal cerumen in her ear canal was observed. Eyebrows are present bilaterally and are evenly distributed.

The nasal mucosa is pink without swelling or polyps. Wharton’s ducts are patent and without inflammation or lesions. The uvula is midline. Client has 30 teeth. or masses.. There is no evidence of swelling around the nose and eyes. lesions. Breast and Regional Nodes The patient refused to be assessed. The septum is at the midline and without perforation. Halitosis not noted. Nose is located symmetrically in the midline of the face and is without swelling. and lesions. . exudates. The lips are moist. which reveals that she does not have any hearing problems. bleeding.” the soft palate and the uvula rose symmetrically. white and smooth edges. The lips are pink without lipstick. The tongue moves freely. lesions. Nasal flaring not noted. in proper alignment and with no caries noted. Tonsils are not inflamed. Client was asked to speak “yes. There were no swellings or lesions. The hard and soft palates are concave and pink. or bleeding. Both left and right nares were patent. Client experienced no discomfort/tenderness during palpation or percussion. Her breath smells fresh.She was able to repeat a sentence when it was softly said behind her ears. with no discharges. The throat is pink and vascular and without swelling. The tongue is in the midline of the mouth.

Musculoskeletal System She was able to exhibit strong hand grip on both arms. Pulses have regular rhythm. Bowel sounds of 11 per minute were heard upon auscultation. Client was able to extend both arms. Abdominal assessment Surgical wound incision noted at her right upper quadrant due to open cholecystectomy done. Heart and Peripheral Vasculature Murmurs not noted. normal. Opsite dressing noted with no abnormalities and bleeding noted. The thorax rises and falls in unison in the respiratory cycle. Upper and lower extremities were proportional in length. No adventitious breath sounds noted on both left and right lung fields during auscultation. . There is no paradoxical movement. Umbilicus is medially located and shows no sign of inflammation/ abnormal discharges.Thorax and Lungs Patient has a regular and normal breathing pattern with a respiratory rate of 24cpm upon assessment. The abdomen rises with inspirations and falls with expiration. Crepitus not noted. Patient has a cardiac rate of 78bpm. Female Genitalia The patient refused to be assessed. Pain is felt with a pain scale of 4/10. moderate. No hand tremors noted. and it was dry and intact. Point of maximum impulse and beat is auscultated at the 5 th intercostal space midclavicular line. Tactile Fremitus on both lungs are symmetrical. Trachea is at midline. Her pulse rate upon assessment was 74bpm and could be easily felt at her carotid pulse. She has quiet and rhythmic respirations.

Ateneo de Davao University College of Nursing SY 2012 . Leonardo Molina.2013 2nd Semester DRUG STUDY PHYSICAL ASSESSMENT NCP Submitted to. RN MN Submitted by: Toni Anne Virocel BSN – 3A GROUP 2 .