Professional Documents
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NCP and Drug Study For Case in Sle
NCP and Drug Study For Case in Sle
Nursing diagnosis
Rationale
Predisposing
Nursing diagnosis:
Gender: Female
Race: Asian
Impaired tissue
Precipitating
integrity related to
Infection: UTI ,
inflammation, altered
Pneumonia
circulation as
evidence by malar
rash on the face,
Unknown etiology
discoid skin rashes
on hands, scalp and
defective immune
thighs, oral mucous
regulatory
membrane ulcers and
mechanism
presence of alopecia.
Nanda definition:
Damage to mucous
membranes, corneal,
integumentary or
subcutaneous tissues
Source:
Doenges, et al.
Nurses Pocket
Guide (12 Ed.). F.A.
Davis company.
2010
Desire outcome
Nursing intervention
After 32 hours of
nurse-client
interaction the client
will be able to:
excess T cell,
defective B cell
suppression and
shifting of T helper 1
to Th2 immune
responses
b cell hyperactivity
production of
pathogenic
Evaluation
After 32 hours of
nurse-client
interaction the client
will be able to:
Independent:
1. Verbalize
understanding of
condition and
causative factors.
1.
a. identify underlying
condition or
pathology involved
in tissue injury
Loss of immune
tolerance
increase antigenic
load
Justification
-serves as baseline
data and will
suggests treatment
options, as well as
clients desire and
ability to protect self,
and potential for
recurrence of tissue
damage
-determines the
extent or
25
slightly decreased
>history of
Rheumatoid Arthritis
(2004)
>history of UTI
(March2011)
Weakness:
>Poor immune
system
>gender: female
>poor hygiene
>does not cooperate
in treatment
>does not exercise
Strengths/wellness:
>strong support
system
>strong financial
support
autoantibodies
involvement of
injury
immune complexes
complement
activation
c. inspect skin on
daily basis,
describing wound
lesions and rashes
characteristics
observed
-promotes timely
intervention and
revision of plan of
care
d. encourage
adequate periods of
rest and sleep
3. Maintain optimal
nutrition and
physical well-being.
3.
a. maintain
appropriate moisture
environment for
particular wound
-to minimize
condition and
promote healing
b. reposition client,
-to enhance
involving client in
understanding and
reasons for and
cooperation
decisions about times
and positions
c. encourage early
ambulation or
mobilization
-promotes circulation
and reduces risk
associated with
immobility and
prevent excessive
tissue pressure
26
4. identify measure
in preventing and
treatment regimens
to enhance healing
d. provide optimum
nutrition and
increased protein
intake
4.
a. emphasize
importance of
adequate nutritional
and adequate fluid
intake
b. assist client in
understanding and
following medical
regimen and
developing program
of preventive care.
-enhances
cooperation and
optimizing outcomes
c. discuss importance
of health as well as
measures to maintain
proper skin
functioning
- for changes
indicative of healing
or presence of
infection,
complications.
5. Review laboratory
results pertinent to
causative factors
Collaborative:
1. Monitor and
administer
medications as
27
Ordered such as,
Lasix, Predisone,
Cozar, Norvasc,
Merrem, Calvit and
KCl.
or cumulative effects
3. Assist with
diagnostic
procedures
-May be necessary to
determine extent of
impairment.
4. Assist in
identifying ongoing
treatment needs and
rehabilitation for the
individual like
physical and
occupational therapy.
Source:
Doenges, et al.
Nurses Pocket
Guide (12 Ed.). F.A.
Davis company.
2010
Source:
Doenges, et al.
Nurses Pocket
Guide (12 Ed.). F.A.
Davis company.
2010
28
ASSESSMENT
NURSING
DIAGNOSIS
Fatigue related to
immune system
pathology as
evidenced by
patients appearance
of weakness and
tiredness, lethargy,
inability to perform
activities
independently, poor
muscle strength, Hgb
result of 115 g/L and
104 g/L (normal:
120-160 g/L) last
November 15 and
November 17 lab
result, Serum sodium
results of 130
(normal: 137-143
mEq/dL) and serum
potassium result of
2.60 (normal: 3.6-5.1
mg/dL) on November
15 lab result
Definition: An
overwhelming
sustained sense of
exhaustion and
decreased capacity
for physical and
RATIONALE
Predisposing
Gender: Female
Race: Asian
Precipitating
Infection: UTI ,
Pneumonia
Unknown etiology
Female estrogen
hormones
Manifestations of
heightened levels of
estrogen during
puberty and
pregnancy
Unknown cause of
estrogen influencing
the immune
response of the HLA
system in
chromosome 6
Human Leukocyte
DESIRED
OUTCOME/
NURSING GOALS
After 32 hours of
nursing interventions,
the client will be able
to:
NURSING
INTERVENTIONS
JUSTIFICATION
Independent Nursing
Interventions:
EVALUATION
After 32 hours of nursing
interventions, the client was
able to:
1. Report improved
sense of energy
a. Note patients
belief of what is
causing the fatigue
and what relieves it
-to assess
contributing factors
b. Evaluate aspect of
learned
helplessness that
may be manifested
by giving up
-can perpetuate a
cycle of fatigue,
impaired functioning,
and increased anxiety
and fatigue
c. Accept reality of
patients report of
fatigue and do not
underestimate effect
on the quality of life
the client
experiences
d. Instruct methods
to conserve energy
(e.g. plan steps of
activity before
beginning so that all
29
of 2.60 (normal: 3.6mental work at usual
5.1 mg/dL) on
work level
November 15 lab
result
Vebal reports of Indi
ko pagsamuka anay,
nakapoy ko.
With health history of
easy fatigability and
body weakness 7
months prior
admission and with
decreased Hgb, Hct,
potassium and sodium
results of lab tests after
consultation to
physician.
Source: Doenges, et
al. Nurses Pocket
th
Risk Factors/Weaknesses: Guide (9 ed.). F.A.
Davis
Poor appetite
Episodes of joint pain Company.2004. p
232.
Noncompliance to
some medical
interventions and
laboratory tests
Hospital environment
(too warm and noisy)
Sleep deprivation
Poor financial support
Knowledge deficit of
disease process and
treatment
Fewer or defective
macrophages in the
body
2. Perform activities
of daily living and
desired activities at
level of ability
Defective clearance
of early apoptotic
cells
Secondary necrosis
of the cells
Release of nuclear
fragments as
potential
autoantigens
Impaired membrane
integrity of dendritic
cell
Induced maturation
of dendritic cells
3. Participate in
recommended
treatment program
e. Provide
environment
conducive to relief
of fatigue
( e.g.provide electric
fan, etc.)
-temperature and
level of humidity are
known to affect
exhaustion
f. Provide means to
decrease
environmental noise
(e.g. earplugs, etc.)
g. Provide
diversional
activities. Avoid
overstimulation/und
erstimulation
(cognitive and
sensory)
-when sleep
deprivation is
present, it adds to
fatigue
-impaired
concentration can
limit ability to block
competing
stimuli/distractions
h. Discuss routines
to promote restful
sleep (e.g.
uninterrupted
periods of rest,
longer sleep periods
at night, etc.)
a. Determine ability
to participate in
activities/ level of
mobility
-helpful in
30
Wellness/strengths:
Good emotional
support for the family
Willingness to
follow nursing
interventions
Have strong faith
in God
Various
autoantibody
productions
patterns
determining
pattern/timing of
activity
c. Interview
significant others
regarding specific
changes observed on
patient
-to assess
contributing factors
d. Establish realistic
activity goals with
the patient
-enhances
commitment to
promoting optimal
outcomes
-to maximize
participation
f. Involve patient
and significant
others in schedule
planning
-to increase
awareness of the
treatment and
rehabilitation to
patient and
significant others
-to manage patient
within their limits of
ability
Fatigue
g. Encourage to do
whatever is possible
(e.g.self-care, sit up,
etc.)
Appearance of
tiredness and
Production of
antinuclear antibody,
anti-phospholipid
and other specific
autoantibodies
Anti-erythrocyte
antibody activation
Formation of
defective immune
complex
Hemolysis
Reduced RBC count
Decrease in oxygen
available for cellular
uptake
31
inability to perform
activities of daily
living independently
Source:
Smeltzers S.C, et,al.
Brunner &
Suddarths Textbook
of Medical
Surgical Nursing.
Lippincott Williams
and Wilkins. 12th ed.
assist in ambulation
as indicated
a. Discuss the
disease process
relevant to patient
-understanding the
disease can help the
client understand the
treatment regimen
b. Discuss therapy
regimen relating to
individual causative
factors
-to encourage
participation of
patient and
significant others in
health management
of patient
d. Instruct patient in
ways to monitor
responses to activity
and significant signs
and symptoms
e. Promote overall
health measures (e.g.
nutrition(High CHO,
Normal CHOn, low
Fat), adequate fluid
-presence of
anemia/hypoxemia
reduces oxygen for
available cellular
uptake and
32
intake of 1.5-2L/day, contributes to fatigue
appropriate intake of
vitamins and
minerals as
prescribed especially
iron, etc.)
Collaborative
interventions:
a. Administer
-to promote wellness
medications related
of patient
to patients condition
(e.g. pain relievers,
antimalarials, etc.)
b. Assist with
medical procedures
as indicated
c. Administer blood
transfusions properly
as indicated. Report
any allergic
reactions.
Source: Doenges, et
al. Nurses Pocket
Guide(9th ed.). F.A.
Davis
Company.2004. pp
232-234.
RISK NCP
33
Assessment
Abnormal cues:
>easy fatigability and
weakness
>Patient is not oriented to
time and place, forgetful
>Photosensitivity
>presence of alopecia
>Malar or "butterfly" rash
on the face
>Discoid skin rash on
hands, thighs and scalp
>oral mucous membrane
ulcers
>joint pain
>sunken eyes
>poor appetite
>dependent in her ADL
>poor muscle tone
Vital signs:
RR=24 cpm
Temp= 36.5C
Nursing diagnosis
Nursing diagnosis:
Predisposing
Gender: Female
Risk for injury
Race: Asian
related to tissue
Precipitating
damage, autoimmune Infection: UTI ,
dysfunction,
Pneumonia
abnormal blood
profile ,
disorientation and
Unknown etiology
altered mobility as
evidence by malar
immune system
rash on the face,
activation
discoid skin rashes
on hands, scalp and
thighs, oral mucous
altered immune
membrane ulcers and
response
presence of alopecia,
weakness,
disoriented to time
soluble mediators
and place,
(cytokines)
photosensitivity.
Nanda definition:
Laboratory results:
-Antinuclear Anti Body
result is 7.
-HGB, HCT, RBC, platelet
are decreased
-WBC is increased
-serum sodium slightly
decreased
Rationale
At risk of injury as a
result of
environmental
conditions
interacting with the
individuals adaptive
and defensive
resources.
Desire outcome
Justification
After 32 hours of
nurse-client
interaction the client
will be able to:
Evaluation
After 32 hours of
nurse-client
interaction the client
will be able to:
Independent:
1. Verbalize
understanding of
individual factors
that contribute to
possibility of injury
Endothelial / cellular
response
Autoimmunity
Tiisue or organ
involvement
Nursing intervention
2. Modify
environment as
indicated to enhance
1.
a. Perform thorough
assessment regarding
safety issues when
planning for client
care and/or preparing
for discharge from
care.
-failure to accurately
assess and intervene
or refer these issues
can place the client
at needles risk and
creates negligence
issues for the
healthcare
practitioner.
-affects clients
ability to protect self
and/or others, and
influences choice of
interventions and
teaching
c. assess clients
muscle strength,
gross and fine motor
coordination
2.
a. provide healthcare
within culture of
safety
2. Goal met.
The patient was able
to encourage how to
protect herself and
enhance her
34
>history of Rheumatoid
Arthritis (2004)
>history of UTI
(March2011)
Weakness:
>Poor immune system
>gender: female
>lack of patients
cooperation
>poor hygiene
>does not cooperate in
treatment
>does not exercise
.poor environmental
sanitation
Strengths/wellness:
>strong support system
>strong financial support
>strong religious belief
Source:
Doenges, et al.
Nurses Pocket
Guide (12 Ed.). F.A.
Davis company.
2010
3. Display behaviors,
lifestyle changes to
reduce risk factors
and protect self from
injury.
c. inform client
regarding all
treatment and
medication
d. encourage use of
techniques to reduce
or manage stress and
vent emotions
3.
a. encourage and
assist in frequent
range-of-motion
exercises
-exercises promote
good circulation to
the body. Thus,
improving the body
to be more health
and prevent from
further injury
-to monitor patients
condition.
-to prevent patient
from at risk for falls.
awareness and
knowledge about
safety things and
necessary precaution
to be done to prevent
her to be at risk for
injury.
35
d. stress importance
of monitoring
conditions and risk
that may contribute
to occurrence of
injury
Collaborative:
1. Assist in
treatments and
provide information
regarding clients
disease/condition.
2. Administer
medications such as;
Lasix, Predisone,
Cozar, Norvasc,
Merrem, Calvit and
KCl as ordered using
the 10 rights to
medication
-to alleviate
itchiness, and to
correct fluid and
electrolyte balance
and also to regulate
blood pressure.
Source:
Doenges, et al.
Nurses Pocket
Guide (12 Ed.). F.A.
Davis company.
2010
Source:
Doenges, et al.
Nurses Pocket
Guide (12 Ed.). F.A.
Davis company.
2010
36
Treat hypertension
37
coronary arteries and arterioles.
XIV. DRUG STUDY
38
Treat hypertension
39
40
41
Suppresses immune
response; stimulates bone
marrow
42
C
43
Relieve moderate to
moderately severe pain
44
45
C
Generic name:
levofloxacin
Brand name:
Levaquin
Classification:
Antibiotic, florquinolone
Bactericidal: interferes with
DNA by inhibiting DNA gyrase
replication in susceptible gramnegative and gram-positive
bacteria, preventing cell
reproduction
H
treats bacterial infection
E
Administer without regards to
meals with a glass of water;
given twice a day per Orem
C
Instruct patient to drink plenty
of fluids while taking this drug
Instruct to report rash, visual
changes, severe GI problems,
weakness, tremors
K
Arrange for culture and
sensitivity tests before
beginning therapy
Ensure patient is well hydrated
Administer oral drug without
regard to meals with a glass of
water; separate oral drug from
other cation administration,
including antacids by at least 2
hours
Discontinue at any sign of
hypersensitivity (rash,
photophobia) or at complaint of
tendon pain, inflammation or
rupture
46
47
K
C
Generic name:
Potassium Chloride
Brand name:
Potassium Chloride
Classification:
Electrolyte
Principal intracellular cation of
most body tissues, participates
in a number of physiologic
processesmaintaining
intracellular tonicity,
transmission of nerve impulses,
contraction of cardiac, skeletal
and smooth muscle,
maintenance of normal renal
function; also plays a role in
carbohydrate metabolism and
various enzyme reaction
48
49
C
Generic name:
Eperisone
Brand name:
Eperisone
Classification:
Antispasmodic
Eperisone acts by relaxing both
skeletal muscles and vascular
smoothmuscles, and
demonstrates a variety of
effects such as reduction
of myotonia, improvement of
circulation, and suppression of
the pain reflex.The drug
inhibits the vicious cycle of
myotonia by decreasing
pain,ischaemia, and hypertonia
in skeletal muscles, thus
alleviating stiffnessand
spasticity, and facilitating
H
Treats muscle spasm
E
Should be taken with food;
given three times a day per
Orem
C
Report fever, erythema,
blistering, itching, ocular
congestion or stomatitis
50
muscle movement.
51
C
Generic name:
Multivitamins with Buclizine
Brand name:
Multivitamins with Buclizine
Classification:
Multivitamins supplement
Buclizine is a piperazine
antihistamine with
antimuscarinic and moderate
sedative properties. It is used
mainly for its antiemetic action
and in the treatment of
migraine in combination with
analgesics.
H
Treats nausea, vomiting and
dizziness
E
Should be taken with food.
(Take within hr before
meals.) Given once a day
C
Avoid over the counter drugs;
may contain ingredients that
cause serious reactions with
drug
Avoid alcohol; serious sedation
could occur
Report difficulty breathing;
hallucinations, remors, loss of
coordination; visual
disturbances, irregular heart
beat
K
Assess orientation, reflexes,
affects; visual examinations; P,
BP;RR, adventitious sounds;
bowel sounds, normal GI
output, normal urinary output
52
C
Generic name:
Potassium Chloride
Brand name:
Potassium Chloride
Classification:
Electrolyte
Principal intracellular cation of
most body tissues, participates
in a number of physiologic
processesmaintaining
intracellular tonicity,
transmission of nerve impulses,
contraction of cardiac, skeletal
and smooth muscle,
maintenance of normal renal
function; also plays a role in
carbohydrate metabolism and
various enzyme reaction
H
prevent and correct potassium
deficiency
E
Not affected by meals
C
Caution patient not to use salt
substitutes
53
54
Exercise
Exercise plays its part in
the treatment of lupus. It
is very important to keep
muscles & joints active
C: Loop Diuretic
for a variety of reasons.
Muscles need to be
H: Treat hypertension
toned in order to
function adequately. The
E: Not affected by meals. size of the muscle & its
blood circulation depend
It is given every twelve
on its function (where
hours (q12h) IVTT.
the muscle is & what it
C: Advise patient to stand does). Physical therapy
is very beneficial to the
slowly to prevent
patient who is trying to
dizziness, not to drink
maintain muscle
alcohol and to minimize
integrity & tone. Joints
strenuous exercise in hot
depend on tendons & the
weather
calcification of bones.
These in turn depend on
K: Monitor weight,
continued movement.
peripheral edema, breath
Significant bone loss
sounds, blood pressure,
through osteoporosis
fluid intake and output,
occurs when bones are
and electrolyte, glucose,
not used regularly.
BUN, and carbon dioxide Encourage significant
levels.
other to do passive ROM
(Range of motion)
exercises for the client.
2. Generic name:
Treatment
Hygiene
The goal for the treatment For maintaining skin
of systemic lupus
integrity:
erythematosus
1. Keep skin clean while
relieving itching and
1.Dietary regulationdryness.
alcohol restriction.
2. Treatment of associated
condition.
Monitor intake and
output to identify the
output and fluid
replacement needs.
Vital signs taking every
hour to assess any
changes on health
status
Encourage fluid intake
to replace fluid and
blood loss and to
maintain blood
pressure and renal
function
Administer medications
as ordered to prevent
infections
Encourage and assist
significant other to turn
Sponge bath
Mild soap added to
water to moisturize the
skin.
2. Keep nails short and
trimmed to prevent
excoriation.
3. Keep hair clean and
moisturized.
Outpatient
Adherence to
pharmacological and
non-pharmacological
interventions.
Stress to patient and
family the importance of
follow-up examinations
and treatment because of
changing physical status.
Allowing monitoring of
symptoms, disease
activities, and treatment
of side effects.
Refer patient for
continuous physical
therapy for the
improvement of the
condition..
Diet
Suggested diet is
DASH diet (high in
fruits and
vegetables,
moderate in low-fat
dairy products, and
low in mimimal
protein, has a
substantial amount
of plant protein from
legumes and nuts
Promote intake of
vegetable-value
protein foods: soy
protein, broccoli
55
Prednisone
Brand name: Prelone
C: Corticosteroids
H: Suppresses immune
response; stimulates bone
marrow
1. Musculoskeletal
activity (designed to
enhance flexibility &
mobility)
Types of Activities:
Passive ROM Exercises
Duration:
E: Given orally with food 10-15 minutes
if possible to reduce GI
irritation. It is given once Frequency:
Prescribed medications:
Everyday, 2-4 hours
a day every am and once
NSAIDs: For people
every pm.
with joint or chest pain
2. Stretching Exercises
or fever, drugs that
(to specifically target
C: Teach patient signs and
joint weakness)
decrease inflammation,
symptoms of adrenal
called nonsteroidal
insufficiency: fatigue,
Types of Activities:
anti-inflammatory
muscle weakness, joint
Chin-to-chest. Raise the
pain, fever, anorexia,
drugs (NSAIDs), are
back of the person's head
nausea, shortness of
often used. Although
up from the bed. Gently
breath, dizziness, fainting.
some NSAIDs, such as
tip his chin toward his
ibuprofen and
chest. Try to rest the
K: Monitor for
person's chin on his
naproxen, are available
Cushingoid effects: moon chest if possible.
over the counter, a
face, buffalo hump,
doctors prescription is
Head turns. Put one hand
central obesity, thinning
necessary for others.
on each side of the
hair, hypertension and
NSAIDs may be used
increased susceptibility to person's face. Turn the
alone or in
person's head toward the
infection.
right as if he were
combination with other
looking over his right
types of drugs to
shoulder.
Then
slowly
3. Generic name: losartan
control pain, swelling,
turn the person's head so
Brandname: Cozaar
and fever. Even though
he is looking over his
some NSAIDs may be
left shoulder. Turn the
periodontal disease.
Mucous membrane
ulcers can be treated
with hydrogen
peroxide gargle,
buttermilk gargle, or
steroid impregnated
gel.
5. Proper food
preparation
alcohol, alcohol
restriction is a must
because of clients
condition.
The client should
consume amounts of
necessary calories to
maintain moderate
body weight. Fat
intake should be
limited to 30% of
the total calories
Instruct patient to
limit fluid intake to
500-600 ml/day.
Include foods rich in
zinc. These foods
include oysters,
meats, seafood,
poultry and eggs.
Include rich sources
of iron in your diet.
To increase
absorption, consume
with an acidcontaining food or
one with vitamin C.
Sources of iron
56
C: antihypertensives,
angiotensin II receptor
antagonists, Management
of hypertension
4. Generic name:
Amlodipine besylate
Brandname: Norvasc
purchased without a
prescription, it is
important that they be
taken under a doctors
direction.
Antimalarials:
Antimalarials are
another type of drug
commonly used to treat
lupus. These drugs
were originally used to
treat malaria, but
doctors have found that
they also are useful for
lupus. A common
antimalarial used to
treat lupus is
hydroxychloroquine
(Plaquenil1). It may be
used alone or in
combination with other
drugs and generally is
used to treat fatigue,
joint pain, skin rashes,
and inflammation of
the lungs.
Corticosteroids: The
mainstay of lupus
treatment involves the
use of corticosteroid
include cream of
wheat, liver, beef,
lamb, pork, chicken,
turkey, eggs, fish,
beans baked with
molasses, prunes,
prune juice, apricots,
green peas, enriched
breads, and cereals
Take medications
with food to
decrease the
irritating effect on
the stomach and
small intestine.
Foods and drugs
taken together also
increase the time
available for the
absorption of the
drug.
Include foods rich in
Vitamin D. These
include foods
primarily of animal
origin: eggs, butter,
milk, fish oils,
cereals, margarines
and breads. This
57
C: Cardiovascular agent;
calcium channel blocker;
antihypertensive agent
H: Treat hypertension
E: Not affected by meals.
It is given once a day.
C: Report shortness of
breath, palpitations,
irregular heartbeat,
nausea, or constipation to
physician
K: Special Precautions for
patients w/ impaired
hepatic & renal function,
CHF. Elderly. Pregnancy
& lactation.
5. Generic name:
Meropenem
Brand name: Merrem IV
C: Miscellaneous antiinfectives
H: Prevent complicated
skin and skin structure
infections
E: Not affected by meals.
It is given every eight
hours (Q8h).
the foot.
Ankle bends. Push the
person's foot so his toes
point up toward the
ceiling. Then put your
hand on top of the foot
and push the foot down
again.
Ankle rotation. Hold the
ankle with one hand.
Hold the person's upper
foot with your other
hand. Gently turn the
foot and ankle in circles.
Toe bends. With your
palm on top of the
person's foot, curl the
toes down toward the
sole (bottom) of the foot.
Then straighten and
stretch the toes.
Toe spreads. Use your
fingers to spread the toes
apart one at a time. Then
bring them together
again.
Intensity:
Gradually increasing
from soft to moderate
pressure.
Duration:
2-3 Sessions, 15-20
minutes a day
hormones, such as
prednisone
(Deltasone),
hydrocortisone,
methylprednisolone
(Medrol), and
dexamethasone
(Decadron, Hexadrol).
Corticosteroids are
related to cortisol,
which is a natural antiinflammatory hormone.
They work by rapidly
suppressing
inflammation.
Immunosuppressives:
For some patients
whose kidneys or
central nervous
systems are affected by
lupus, a type of drug
called an
immunosuppressive
may be used.
Immunosuppressives,
such as
cyclophosphamide
(Cytoxan) and
mycophenolate mofetil
(CellCept), restrain the
overactive immune
58
C: Tell patient to report
adverse effects if drug or
signs and symptoms of
superinfection.
K: Obtain specimen for
culture and sensitivity
before giving first dose.
6. Generic name:
Tramadol + Paracetamol
Brand name: Ultram
C: Analgesic
H: Relieve moderate to
moderately severe pain
E: Not affected by meals.
It is given thrice a day
(TID).
Frequency:
2-4 times a week.
Consultation must be
done first before
engaging to any exercise
programs. This is to
ensure the safety and
limitations of exercises
intended for end stage
renal disease patients.
Encourage significant
other (wife) to do ROM
(range of motion)
exercises on the time
required to prevent
immobility of the patient.
59
+Vit D
Brandname: Calvit
C: Dietary supplements
H: improve and
strengthen bones and
joints
E: Should be taken with
food, swallow whole and
do not chew.
C: Monitor blood
pressure, ECG, renal
function, magnesium,
phosphate, potassium,
serum, and urine calcium
concentrations.
K: Avoid using two (2)
hours prior to or until four
(4) hours after taking
other medications
8. Generic name:
Levofloxacin
Brand name:
C: Antibiotic,
florquinolone
H: treat fatigue, joint pain,
skin rashes, and
inflammation of the lungs.
E: With or without meals
60
with a glass of water
Skin Biopsy
Kidney Biopsy
K: Discontinue at any
sign of hypersensitivity
(rash, photophobia) or at
complaint of tendon pain,
inflammation or rupture
9. Generic name: KCL
Brand name:
C: Electrolyte
H: Replaces potassium
and maintains potassium
level
E: Taken with or after
meals with full glass of
water or fruit juice
C: Report toughing of the
hands or feet unusual
tiredness or weakness,
feeling of heaviness in
legs, severe nausea,
vomiting, abdominal
pain,black or tarry stools,
pain at IV injection site
K: Monitor IV injection
sites regularly for
61
necrosis, tissue sloughing
and phlebitis
10. Generic name:
Eperisone
Brand name:
C: antispasmodic
H: Relaxation of
hypertonic skeletal
muscles, Improves
intramuscular blood flow,
Reduction of muscle
spindle sensitivity via
motor neurons,
Vasodilatation and
augmentation of blood
flow.
E: After meals
C: Report symptoms such
as fever, erythema,
blistering, itching, ocular
congestion or stomatitis,
etc
K: Monitor symptoms
such as redness, itching,
urticaria, or edema of the
face and other parts of
the body,dyspnoea etc,
treatment should
be discontinued and
appropriate measures
62
taken
11. Generic name:
Multivitamins with
Buclizine
Brand name:
Multivitamins with
Buclizine
C: Antihistamines &
Antiallergics
H: Relieved Motion
sickness, migraine,
nausea, pruritic skin
disorders
E: Should be taken with
food. (Take within hr
before meals.)
C: Report signs of
hypersensitivity.
K: Make sure it is taken
after meals to prevent GI
disturbances.
63