DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS NURSING DIAGNOSIS

GENERIC NAME: Appears to inhibit Relief of mild to moderate pain, Hypersensitivity reaction. Check if the pt. is taking other
Paracetamol prostaglandin synthesis in fever.IV: (Additional) medication.
the CNS and, to a lesser Management of moderate to Advice the pt. not to take alcohol
extent, block pain impulses severe pain when combined while on medication
BRAND NAME: through peripheral action. with opioid analgesia. Evaluate therapeutic response
Biogesic Acts centrally on Make sure to administer
hypothalamic heat regulating prescribed dose
center, producing peripheral Educate pt. that paracetamol can
vasodilation (heat loss, skin be taken on an empty stomach
CLASSIFICATION: erythema, diaphoresis). Educate patient that paracetamol
Analgesic (non-opioid), Therapeutic Effect: Results may be taken by pregnant
and antipyretic in antipyresis. Produces women and has no proven effect
analgesic effect. on breastfeeding
Assess patients fever or pain
Assess if patient has allergic
DOSAGE: reaction to medication
500 mg / tab Educate pato recognize signs of
chronic overdose like bleeding,
CONTRAINDICATIONS ADVERSE EFFECTS bruising, malaise and sore throat
Severe hepatic impairment or Early Signs of Acetaminophen Advice patient to notify if signs of
severe active liver disease Toxicity: Anorexia, nausea, unusualities occur
ROUTE: (Ofirmev). diaphoresis, fatigue within first Monitor CBC, liver and renal
P.O Cautions: Sensitivity to 12–24 hrs. functions
acetaminophen; severe renal Later Signs of Toxicity:
impairment; alcohol Vomiting, right upper quadrant
FREQUENCY: dependency, hepatic tenderness, elevated hepatic
q6H; PRN for fever with impairment, or active hepatic function tests within 48–72 hrs
temp. greater than 38°C disease; chronic malnutrition after ingestion.
and hypovolemia (Ofirmev);
G6PD deficiency (hemolysis
TIMING: may occur). Limit dose to less
8:00 am; 2:00 pm; 8:00 than 4 g/day
pm; 2:00 am

DRUG STUDY
 NURSING CARE PLAN
DEFINING NURSING
SCIENTIFIC ANALYSIS GOALS OF CARE INTERVENTIONS RATIONALE
CHARACTERISTICS DIAGNOSIS
SUBJECTIVE: Impaired Skin Rash in dengue fever is a After 8 hours of nursing INDEPENDENT: INDEPENDENT:
“ Daan nani ang Integrity as maculopapular or macular interventions, the patient will: 1. Assess characteristics 1. Clarifies
rashes miss before evidenced by confluent rash over the face, of rashes, its location intervention
1. Display progressive and severity. needs and
pani nako siya gipa rashes related to thorax, and flexor surfaces,
improvement/ healing priorities.
admit” as verbalized Dengue with islands of skin sparing. of lesions or rashes; 2. Perform routine skin
by the SO The rash typically begins on and inspection and note 2. Provides
day 3 and persists 2-3 days. 2. Be free of signs of changes. information about
infection or rather client’s nutrition
OBJECTIVE: A second rash may occur 1- complications. 3. Assess nutritional and hydration
 No scratching 2 days of defervescence, status and potential for status.
of the delayed healing.
lasting 1-5 days; it is
extremeties 3. Protein- calorie
morbilliform, is 4. Instruct patient not to malnutrition and
noted maculopapular, spares the scratch rashes. deficiency of Vit.
 Presence of
palms and soles, and A, C and zinc
rashes on
occasionally desquamates. may impair
upper DEPENDENT: normal healing
extremeties 1. Administer medication mechanism.
 VS as follow: as prescribed by the
T: 36.8 physician. 4. To avoid further
PR: 86 bpm
complication and
RR: 20 cpm 2. Instruct SO to notify possibilities of
BP: 100/70 health care providers if infection.
O2: 99% the rash hurts.
CRT: <2 secs Sources:
.
Pain Score: https://www.medscape.com/
3. Regulate IVF as DEPENDENT:
0/10 answers/215840- ordered by the 1. Identifies
43504/how-is-rash- physician. medication that
characterized-in-dengue may promote
healing.
COLLABORATIVE:
1. Review laboratory 2. To respond and
results.
 give interventions
2. Notify physician immediately.
immediately if
unusualities occur. 3. Good hydration
promotes faster
3. Instruct SO to keep healing for
patient’s extremeties rashes.
away from untidy
things.
COLLABORATIVE:
1. These studies
may reveal
concerns related
to underlying
condition.

2. To avoid
worsening of the
condition.

3. To avoid
acquiring harmful
pathogens that
may cause
infection.
 NURSING CARE PLAN
DEFINING NURSING NURSING
SCIENTIFIC ANALYSIS GOALS OF CARE RATIONALE
CHARACTERSTICS DIAGNOSIS INTERVENTIONS
SUBJECTIVE: Risk for bleeding In dengue, platelets are one After 8 hours of nursing INDEPENDENT:
“Naguol lagi ko miss secondary to of the major cell intervention, the patient
kay nagkagamay iyaa Thrombocytopenia populations affected by will be able to : 1. Instruct the patient not to 1. To avoid pricking
platelet count” as direct and or indirect use sharp objects to patient’s gums and
verbalized by the SO mechanisms if infection. It 1. Experience no mouth such as lessen the risk of
of the patient is common to observe both signs and symptoms of toothbrush and bleeding.
thrombocytopenia and bleeding or hemorrhage toothpicks.
OBJECTIVE: platelet dysfunction in and
Patient is lying in bed; dengue, both strongly relate 2. To note bleeding
showing discomfort to the clinical outcome. 2. Maintain or 2. Observe for sites where sites and give
through facial Thus, platelets are demonstrate bleeding may/ may have intervention.
grimaces; with the frequently affected in Improvement in occurred.
platelet count of 112 dengue either for alteration laboratory values.
3. To avoid wounding
103/mm3 and 106 of their own functionality,
3. Instruct the SO to keep the pt. and to lessen
103/mm3 on 2 for “ silent transport” of
patient away from sharp risk of bleeding.
consecutive days; with virus , or as an antiviral
objects.
the following vital immune cell.
signs:
DEPENDENT:
T: 36.8 C 1. Instruct SO to increase 1. Dehydration together
PR: 86 bpm oral fluid intake of the pt. with bleeding could
RR: 20 cpm Source: cause fatal risk to pt.
BP: 100/70 mmHg https://www.intechopen.co 2. Increase IV infusion rate
O2: 99% m/b depending on the 2. Proper hydration
CRT: <2 sec. ooks/thrombocytopenia/lavi doctor’s order. could help in RBC
Pain Score: 0/10 ew-of-platelets-in-dengue production and
3. Administer medication lessen thrombo-
as prescribed by the cytopenia.
physician.
3. Medications could
promote healing to
the pt.
COLLABORATIVE:
1. Monitor laboratory 1. To identify the need for
studies especially platelet intervention and to know it’s
count and RBC production. effectivity.

2. Instruct the pt. and 2. It can be mistakenly

SO to avoid choco colored identified as blood in the
foods. stool which is one of the
most important studies in
3. Monitor chargers in dengue.
patient’s laboratory vales.
3. To know effectivity of
4. Refer unusualities to care.
physician.
4. To solve unusualities
immediately and avoid fatal
risks.
 NURSING CARE PLAN
DEFINING NURSING
SCIENTIFIC ANALYSIS GOALS OF CARE INTERVENTIONS RATIONALE
CHARACTERISTICS DIAGNOSIS
SUBJECTIVE: Risk for deficient Recognition of dengue viral After 8 hours of nursing INDEPENDENT: INDEPENDENT:
“ Dili kayo siya mag fluid volume antigen on infected intervention, the pt. will be 1. Assess pt.’s condition. 1. To monitor signs &
inom tubig miss pero related to monocyte by cytotoxic T able to: symptoms.
1. Maintain fluid volume at a 2. Monitor & document vital
wala mn sad siya decreased blood cells results in cellular direct
functional level. signs. 2. Provides baseline for
nalipong or unsa” as volume destruction and infection of assessing and
verbalized by the SO. secondary to red bone marrow precursor 2. Patient explains measures 3. Assess skin turgor & oral evaluating interventions.
altered platelet cells as well as that can be taken to treat or mucous membranes.
production immunological shortened prevent fluid volume loss. 3. Signs of dehydration
OBJECTIVE: platelet survival causing 4. Assess color & amount of are also detected
 Dry skin noted platelet lyses that urine. through the skin and
indicate excessive fluid
 Dry mucous predisposes the host to
DEPENDENT: loss or resultant of
membrane hemorrhage therefore 1. Encourage pt. to increase dehydration.
noted increasing the risk for oral fluid intake.
 Cracked lips deficient fluid volume. 4. Provides information
noted
Successful management of 2. Encourage pt. to eat foods about overall fluid
 VS as follow: with high fluid content such as balance
T: 36.8 severe dengue requires
careful attention to fluid watermelon, grapes and etc.
PR: 86 bpm
RR: 20 cpm management and proactive DEPENDENT:
3. Emphasize importance of
BP: 100/70 treatment of hemorrhage. oral hygiene. 1. Oral fluid
O2: 99% Admission to an intensive replacement is indicated
CRT: <2 secs care unit is indicated for 4. Provide comfortable for mild fluid deficit and
Pain Score: environment. is a cost-effective
patients with dengue shock
0/10 method for replacement
syndrome.
COLLABORATIVE: treatment.
1. Administer parenteral fluids
as prescribed. 2. To promote faster
healing through
2. Educate the pt. and SO rehydration. Addition of
Sources: about the importance of fluid-rich foods can
maintaining proper nutrition enhance continued
https://emedicine.medscape
.com/article/215840- and hydration. interest in eating.
treatment#d9
3. Fluid deficit can
cause a dry, sticky
mouth. Attention to
mouth care promotes
interest in drinking and
reduces discomfort of
dry mucous
membranes.

4. To avoid acquiring
harmful infections and
promote faster healing.

COLLABORATIVE:
1. Parenteral fluid
replacement is indicated
to prevent or treat
hypovolemic
complications.

2. Increasing the
patient’s knowledge
level will assist in
preventing and
managing the problem.