Drug Mechanism of Action Contraindication Side Effects Nursing Consideration

Name: Unclear. Reduces
dexamethasone inflammation by suppressing
polymorphonuclear leukocyte
Brand Names: migration, reversing increased
 Apo-Dexamethasone capillary permeability, and
 Dexasone stabilizing leukocyte
 Ozurdex lysosomal membranes. Also
suppresses immune response
Stock Preparation: (by reducing lymphatic
 Intramuscular injection: activity), stimulates bone
6mg q12 x 3 days marrow, and promotes protein,
fat, and carbohydrate
metabolism.
 Hypersensitivity to drug,
benzyl alcohol, bisulfites,
EDTA, creatinine,
polysorbate 80, or
methylparabe
 Systemic fungal infections
 Active or suspected ocular
or periocular infections,
advanced glaucoma
(intravitreal implant)
CNS: headache, malaise, vertigo, psychiatric  Monitor blood glucose level
disturbances, increased closely in diabetic patients
intracranial pressure, seizures receiving drug orally.
 Monitor hemoglobin and
CV: hypotension, thrombophlebitis, potassium levels.
myocardial rupture after recent  Assess for occult blood loss.
myocardial infarction, thromboembolism  Monitor patient for increased
IOP after intravitreal
EENT: cataracts; elevated intraocular injection.
pressure (IOP), conjunctival hemorrhage  Observe for nonverbal signs
(with intravitreal implant) of pain, are like: facial
expression, posture,
GI: nausea, vomiting, abdominal distention, restlessness, crying /
dry mouth, anorexia, peptic grimacing, withdrawal,
ulcer, bowel perforation, pancreatitis, diaphoresis, changes in heart
ulcerative esophagitis rate / breathing, blood
pressure.
Metabolic: decreased carbohydrate tolerance,
hyperglycemia, cushingoid
appearance (moon face, buffalo
hump), decreased growth (in children),
latent diabetes mellitus, sodium
and fluid retention, negative nitrogen
balance, adrenal suppression,
hypokalemic alkalosis

Musculoskeletal: muscle wasting,

muscle pain, osteoporosis, aseptic joint
necrosis, tendon rupture, long bone
fractures

Skin: diaphoresis, angioedema, erythema,

rash, pruritus, urticaria, contact
dermatitis, acne, decreased wound healing,
bruising, skin fragility, petechiae

Other: facial edema, weight gain or

loss, increased susceptibility to infection,
hypersensitivity reactions

VII. Drug Study

VIIA. Dexamethasone

VIIB. Nifedipine
 Drug Mechanism of Action
Name: Inhibits calcium  Hypersensitivity to
nifedipine transport into
myocardial and vascular
Brand Names: smooth muscle cells,
 Tensipine suppressing contractions.
 Valni Dilates main coronary
 Retard arteries and arterioles
and inhibits coronary
Stock Preparation: artery spasm, increasing
 Tablets: 10 mg 2 tabs oxygen delivery to
q6 heart and decreasing
frequency and severity
of angina attacks.
VIII. Nursing Care Plan
Contraindication Side Effects
CNS: headache, dizziness, fatigue,
drug. asthenia, paresthesia, vertigo
CV: peripheral edema, chest pain,
hypotension
EENT: epistaxis, rhinitis
GI: nausea, constipation
GU: urinary frequency, erectile
dysfunction
Musculoskeletal: leg cramps
Skin: flushing, rash
Nursing Consideration
 Monitor vital signs and
cardiovascular status.
 Stay alert for chest pain
and edema.
 Watch for rash.
 Give cold compress on
the head.
 Assess the availability
of toileting facilities.
Assessment Diagnosis Planning Intervention Rationale Evaluation
Subjective: Knowledge After 8 hours of  Advise mother to always wash  To protect child from infection After series of
Patient asks so deficit R/T new nursing hands before touching the interventions, the
many questions born care. intervention, the baby. patient was able to:
regarding on how patient will be able
to care for the to:  Advise for exclusive  Breastmilk is the complete -learn different
baby breastfeed till 6 months and its food for the baby techniques and tips.
-participate in the importance
Objective: learning process. -become independent
The patient looks  Advise to burp the baby for 10  Positioning new born on the on how to perform the
anxious. - show interest and minutes after each feed and lay side reduces risks of aspiration. different interventions.
motivation to learn. baby in right lateral position
after feeding. -plan different
-list resources that methods on how to
can be used for  Parents were informed to  Napkin rash is common properly demonstrate
more information or change diapers. occurring due to prolonged wet each intervention.
support after nappies and may cause perianal
discharge. diseases. Goal was met.

 Advised to come for  Immunization is important and

immunization of the baby at 1- it will prevent infant from
1/2 months and its importance. many diseases.

 Parents are encouraged to

verbalize feelings.  Parents need to recover from
the stressful events surrounding
childbirth.
VIIIA. Knowledge deficit R/T new born care

VIIIB. Ineffective breastfeeding secondary to knowledge deficit

Assessment Diagnosis Planning Intervention Rationale Evaluation
Subjective: Ineffective After 8 hours of  Inform mother about early  Early recognition of infant After series of
“Hindi ko alam breastfeeding nursing infant feeding cues (example: hunger promotes timely/more interventions, the
ang tamang secondary to intervention, the rooting, lip smacking, sucking rewarding feeding experience patient was able to:
paraan, unang knowledge patient will be able fingers/hand) versus late cue for infant and mother.
anak ko pa lang deficit to: of crying. -show the correct ways
kasi ito” as for an effective
verbalized by the -demonstrate  Recommend avoidance or  To avoid lessen of the infant’s breastfeeding.
patient. techniques to overuse of supplemental desire to breastfeed/ increase
enhance feedings and pacifiers (unless risk of early weaning. -become independent
Objective: breastfeeding specifically indicated). on how to perform the
 G1P0 experience. different interventions.
 Advise mother abstinence/  These things may affect milk
- assume restriction of tobacco, caffeine, production and let-down reflex Goal was met.
responsibility for alcohol, drugs, and excess or be passed on to the infant.
effective sugar.
breastfeeding.
 Soak the nipple with warm  To soften nipple and remove
water before attaching infant. dried milk.

 Advise the mother about the  For effective breastfeeding.

proper positioning of the baby
(tummy to tummy, baby’s
nose and chin should be placed
against the breast). Also, make
sure that the baby sucks the
areola not just the nipple,
baby’s top and bottom lip
should be turned out, and
baby’s chin is pressed onto the
breasts.

VIIIC. Situation low self-esteem related to disturbed body image

Assessment Diagnosis Planning Intervention Rationale Evaluation
Subjective: Situation low After 8 hours of  Determine individual factors  To effectively provide a After series of
Patient expresses self-esteem nursing that could contribute to solution and help the patient. interventions, the
negative related to intervention, the diminish self-esteem. patient was able to:
descriptions about disturbed body patient will be able
herself. image to:  Be realistic and positive during  To enhance trust and rapport -show positive attitude
treatments in health teaching between patient and nurse. to oneself.
Objective: -express positive and setting goals within
The patient is self-appraisal. limitations. -demonstrate good
anxious and behaviors and traits on
shows negative - demonstrate  Encourage use of  To promote positive sense of improving her health.
forms of coping. behaviors to restore visualization, guided imagery, self.
positive self-esteem. and relaxation to promote -become independent
positive sense of self. on how to perform the
-participate in different interventions.
treatment regimen  Encourage family interaction  To maintain open lines of
or activities to with each other and with communication and provides Goal was partially
correct factors that rehabilitation team. on ongoing support for patient met.
precipitated crisis. and family.