HCVD COVID 19 SUSPECT

SEVERE PNEUMONIA

CARDIOMEGALY

CHF NYHA 4C
SINUS TACHYCARDIA WITH
LATERAL WALL ISCHEMIA
 MEMBERS:

• INDANAN, MA. CHARIS ANNE

• MANILA, MARY HOPE
• MATA, LARAHBELLE
• MATULAC, JEANETTE
• MORIA, MORRIS
• NUEVO, KEITH
GENERAL AND SPECIFIC
OBJECTIVES
• GENERAL OBJECTIVE:
• AFTER ___ DAYS OF EXPOSURE AT SOUTHWESTERN UNIVERSITY MEDICAL CENTER , BEING AIDED WITH THE
CONCEPT OF , __________________________________________ WE WILL BE ABLE TO GAIN EXACT KNOWLEDGE ,
ENHANCE MY SKILLS AND DEVELOP POSITIVE ATTITUDE TOWARDS THE CARE OF THE CLIENTS.
• SPECIFIC OBJECTIVES :
• ADHERE TO CONFIDENTIALITY OF PRINCIPLES , INTEGRITY , AND CONSENT OF A CLIENT.
• DISPLAY RESPECT , CARE , COMPASSION , POSSIBILITY AND WARM RELATIONSHIP WITH THE CLIENT.
• BUILD A STRONG RELATIONSHIP AND COLLABORATION WITH CO - STUDENT NURSES.
• DEMONSTRATE PROPER DOCUMENTATION AND ATTENTIVE LISTENING SKILLS.
• DEMONSTRATE SENSITIVITY TO CULTURE , AGE , GENDER , AND DISABILITY ISSUES.
• DEVELOP PROPER TEACHING SKILLS.
• DEMONSTRATE THE PRACTICE OF ETHICAL PRINCIPLES IN RELATION TO PATIENT CARE.
• EXHIBIT PROPER ASSESSMENT , DIAGNOSIS , PLAN , IMPLEMENTATION AND EVALUATION.
• ANTICIPATE THE NEEDS OF THE CLIENT.
• IDENTIFY THE BEST PRACTICE PATTERNS TO FACILITATE CARE FOR CLIENT.
BIOGRAPHIC DATA
• PATIENT F.A.B , IS 80 YEARS OLD MALE , WHO WAS BORN ON SEPTEMBER 18 , 1939 IN
CEBU CITY. HE IS MARRIED AND CURRENTLY RESIDING AT GUANDALAJARA , CEBU CITY . HE IS A
FILIPINO AT BIRTH AND ROMAN CATHOLIC BY RELIGION. BOTH PARENTS ARE DECEASED. THE
PATIENT CAME TO ER ACCOMPANIED BY HIS WIFE ON AUGUST 11, 2020 AT 3:53 PM , WITH A
CHIEF COMPLAINT OF COUGH AND DYSPNEA. PATIENT’S BASELINE VITAL SIGNS ARE AS
FOLLOWS: BP : 130/90MMHG , HR : 121BPM , RR: 36 RPM, TEMP: 36.7 DEGREE CELCIUS , O2
SAT : 75%. THE PATIENT WAS ASSESSED BY THE PHYSICIAN DR FERNANDEZ AT THE IM
DEPARTMENT.
ANATOMY AND
PHYSIOLOGY
COVID-19
CARDIOMEGALY
SEVERE PNEUMONIA
HCVD
CHF NYHA 4C
PATHOPHYSIOLOGY
COVID 19
LABORATORY AND
DIAGNOSTIC
URINALYSIS

• PATIENTS URINALYSIS IN CHEMICAL EXAMINATION REPORTED THAT THE ALBUMIN WAS AT 3+

AND ALSO THE BLOOD 3+, MODERATE IN AMORPHUS URATES AND ABUNDANT IN BACTERIA.
PATIENT’S OTHER RESULT WAS IN NORMAL RANGE.
IMMUNOLOGY

• PATIENT’S IMMUNOLOGY EXAMINATION HAS A RESULT OF QCRP >160 MG/DL (NORMAL VALUE
<10), THE INCREASE OF IT INDICATES THAT THERE IS INFLAMMATION IN THE PATIENT’S BODY
CAUSED BY SOME INFECTION. PATIENT ALSO UNDERGONE COVID-19 RAPID ANTIBODY TEST
(QUALITATIVE) AND THE RESULT WAS POSITIVE IN THE EXAMINATION.
CLINICAL CHEMISTRY

• PATIENT’S FAST BLOOD SUGAR RESULT WAS 142.00 MG/DL (REF. RANGE: 70-100).HIS
TRIGLYCERIDES WAS 221.8 MG/DL (REF. RANGE: 25-148).
BLOOD GAS ANALYSIS
• PATIENT’S BLOOD GAS ANALYSIS HAS RESULT OF A DECREASED PCO2 LEVEL OF 18.5MMHG
(NORMAL VALUE 35-45), PO2 WAS 115MMHG (NORMAL VALUE 80.0-100.0), HCO3 WAS 10.8
MMOL/L (NORMAL VALUE 22.0-26.0).
LDH OR LACTATE DEHYDROGENASE
• PATIENT’S EXAMINATION FOR LDH OR LACTATE DEHYDROGENASE HAS DRASTICALLY INCREASED
WITH THE RESULT OF 1560. 09 (NORMAL VALUE <480), THIS INDICATES THAT THERE IS TISSUE
DAMAGE ON THE PATIENT. THE PATIENT WAS ALSO POSITIVE FOR TROPONIN-1 WITH A RESULT
OF 521.30 NG/L. PATIENT'S SODIUM LEVEL WAS 137 MMOL/L, POTASSIUM LEVEL WAS 3.30
MMOL/L, CREATINE WAS INCREASED 2.00 (REF. RANGE: 0.51-0.95), BUN WAS INCREASED 27.6
(REF. RANGE: 6.0-20.0), BUA WAS ALSO INCREASED WITH A RESULT OF 8.70 (REF.RANGE: 2.4-5.7)
AND LASTLY THE ALT (SGPT) OF THE PATIENT WAS ALSO INCREASED WITH A RESULT OF 26.60
(REF.RANGE: 0-41).
HEMATOLOGY

• PATIENT’S PROTHROMBIN TIME RESULT WAS 17.4 SECONDS AND HAS AN INTERNATIONAL
NORMALIZED RATIO (INR) OF 1.37 SECONDS. THE PERCENTAGE ACTIVITY HAS DECREASED INTO
72.99% THAN THE NORMAL RANGE. PATIENT'S PLATELET RESULT WAS 110X 10/MM3 AND IS
MUCH DECREASED THAN THE NORMAL RANGE.
DRUG STUDY
 Name of the Drug Mechanism Of Action
Works by inhibiting
the mucopeptide synthesis
Generic Name: in the bacterial cell wall. The beta-
lactam moiety of Ceftriaxone binds to
Ceftriazone carboxypeptidases, endopeptidases,
and transpeptidases in the bacterial
Brand Name: cytoplasmic membrane. These
enzymes are involved in cell-wall
Forgram synthesis and cell division. By binding
to these enzymes, Ceftriaxone results
Classification: in the formation of defective cell
walls and cell death
3rd generation cephalosporin
Dosage:
2 gm
Indication/s Side Effects/Adverse Reactions Nursing Responsibilities
Indicated in patients with neurologic Assess patient’s Previous Sensitivity Reaction to
complications, carditis and arthritis. Pain penicillin or
It is also effective in Gram negative Other cephalosphorins.
infections; Meningitis, Gonorrhea. It
is also for Bone and joint infections, Induration Assess patient for
Lower respiratory tract infections, signs and symptoms of infection before and
middle ear infection, PID, Septicemia during the treatment
and Urinary Tract infections. Phlebitis
Obtain C&S before beginning drug therapy to
identify if correct treatment has been initiated.
Rash
Report signs such as petechiae, ecchymotic
areas, epistaxis or other forms of unexplained
Contraindication/s
Diarrhea bleeding.
Hypersensitive to cephalosporins,
penicillin’s and related antibiotics. Monitor hematologic, electrolytes, renal and
Thrombocytosis hepatic function.

Route: Assess for possible supper infection: itching

Leucopenia fever
IV

Frequency: Glossitis

Q24H
Respiratory
Timing: Super
infections

ANST
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Nursing Responsibilities
Azithromycin blocks Treatment of lower respiratory Reactions
transpeptidation by binding to 50s infections: Acute bacterial Mild to moderate nausea, vomiting, Culture site of infection before therapy.
Generic Name: ribosomal subunit of susceptible exacerbations of COPD. abdominal pain, dyspepsia,
organisms and disrupting RNA- flatulence, diarrhea, cramping; angio Administer on an empty stomach 1hr before
Azithromycin dependent protein synthesis at the Treatment of lower respiratory edema, cholestatic jaundice; or 2–3hr after meals. Food affects the
chain elongation step. infections:Streptococcal pharyngitis and dizziness, headache, vertigo, absorption of this drug.
Brand name: tonsillitis due to Streptococcus pyogenes somnolence; transient elevations
in those who cannot take penicillins of liver enzyme value. Prepare Zmax by adding 60 mL water to
Zenith bottle, shake well.
Treatment of uncomplicated skin
infections due to Staphylococcus aureus, Counsel patients being treated for STDs about
Classification: S. pyogenes, Streptococcus agalactiae appropriate precautions and additional
therapy.
Macrolide

Contraindication/s
Dosage:
• Contraindicated with hypersensitivity
to azithromycin, erythromycin, or any
500 mg/cap
macrolide antibiotic.

Route:
• Use cautiously with gonorrhea or
syphilis ,pseudomembranous colitis,
PO
hepatic or renal impairment, and
lactation.
Frequency:
OD

Timing:

8:00AM
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Reactions Nursing Responsibilities
Anti-inflammatory and Specific: CNS: euphoria, insomnia, psychotic 1.Determine whether patient is sensitive to
immunosuppressive effects Adjunctive treatment in bacterial behavior, pseudotumor cerebri, other corticosteroids
Generic Name: of dexamethasone are meningitis. vertigo,headache, paresthesia,seizures, 2.Most adverse reactions to corticosteroids
approximately 30 times more General: depression. are dose-or duration-dependent.
Dexamethasone potent than cortisol. Anti- Cerebral edema. Allergic and 3.For better results and less toxicity, give once
inflammatory effects are complex, inflammatory conditions, Shock, CV: hypertension, daily dose in morning.
Brand Name: but primarily via inhibition of Tuberculosis meningitis. edema,arrythmias,thromboembolism. 4.Give oral dose with food when possible.
inflammatory cells and Patient may need drugs to prevent GI
Dexasone, suppression of expression of EENT: cataracts, glaucoma. irritation.
Diodex or Hexadrol inflammatory mediators. 5.Give I.M injection deeply into gluteal muscle.
GI: peptic ulceration, GIirritation, Rotate injection nsites to preven tmuscle
Classification: increased appetite, pancreatitis, atrophy. Avoid subcutaneous injection
nausea,vomiting. because atrophy and sterile abscesses may
Anti-inflammatory; Glucocorticoid occur.
GU: increase urine glucose,and calcium 6.Always adjust to lowest effective dose
Dosage: levels 7.Monitor patient weight, blood pressure, and
electrolyte levels.
6mg Metabolic: hypokalemia,hyperglycemia 8. Monitor patient for cushingoid effects,
Contraindication/s including moon face, buffalo hump, thinning
Route: >Active. Musculoskeletal: muscleweakness of hair.
>Untreated tuberculosis.
IVTT >Inactive tuberculosis. Skin: Delayed wound healing
>Herpes simplex infection of the eye.
Frequency: >A herpes simplex infection. Other: Susceptibility toinfection
an infection due to a fungus.
OD intestinal infection caused by the
roundworm Strongyloides.
Timing: a condition with low thyroid hormone
levels.
1ST Dose now
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Reactions Nursing Responsibilities

Colchicine is a classical anti-mitotic  It is used to treat gout attacks. More common Monitor for early signs of colchicine toxicity
drug which blocks mitotic cells in  It is used to prevent gout  Diarrhea including weakness, abdominal discomfort,
Generic Name: metaphase. It binds to soluble tubulin attacks.  nausea anorexia, nausea, vomiting, and diarrhea,
to form tubulin-colchicine complexes  It is used to treat familial  stomach pain regardless of administration route.
Colchicine in a poorly reversible manner, which Mediterranean fever.  vomiting
then binds to the ends of  It may be given to you for other Rare Report to physician. To avoid more serious
Brand Name: microtubules to prevent the reasons. Talk with the doctor.  Black, tarry stools toxicity, drug should be discontinued
elongation of the microtubule  Take with or without food.  blood in the urine or stools promptly until symptoms subside.
Colcrys polymer.  burning, "crawling", or tingling
feeling in the skin
Classification:  difficulty with breathing when
exercising
Anti-gout agents  fever with or without chills
 headache
Dosage:  large, hive-like swellings on the face,
eyelids, mouth, lips, or tongue
0.5 g/tab  muscle weakness
Contraindication/s  numbness in the fingers or toes
Route: Contraindicated in patients with renal (usually mild)
or hepatic impairment.
PO
Who are taking a P-gp inhibitor or a
Frequency: strong CYP3A4 inhibitor.

BID

Timing:

8AM-6PM
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Reactions Nursing Responsibilities

Generic Name: The secretion of melatonin Insomnia and improving sleep in Headache
increases in darkness and decreases different conditions. Short-term feelings of depression Daytime  Monitor for and report worsening
Melatonin during exposure to light, thereby sleepiness insomnia and cognitive or behavioral
regulating the circadian rhythms of Timing of your circadian rhythms. Dizziness changes.
Brand Name: several biological functions, Stomach cramps,  Monitor for S&S of decreased
including the sleep-wake cycle. In and Irritability. testosterone levels (e.g., loss of libido)
Methxytryptamine particular, melatonin regulates the or increased prolactin levels
sleep-wake cycle by chemically (galactorrhea).
Classification: causing drowsiness and lowering  Instruct patient to take at bedtime as
the body temperature. directed. Causes drowsiness.
Acetamides  Caution patient to avoid driving and
other activities requiring alertness
Dosage: until response to medication is
known.
3mg/tab Contraindication/s  Caution patient to avoid concurrent
use of alcohol or other CNS
It can cause some side effects
Route: depressants.
including headache, short-term
PO
feelings of depression, daytime
sleepiness, dizziness, stomach cramps,
and irritability.
Frequency:
BID
Do not drive or use machinery for four
to five hours after taking melatonin.
Timing:
8AM-6PM
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Nursing Responsibilities
Reactions
Competitively inhibits action of Short-term treatment for duodenal CNS: headache, dizziness, fever, Assess patient for abdominal pain. Look for blood
histamine on the H2 at receptor sites ulcer. malaise, paresthesia, vertigo. inemesis, stoolor gastricaspirate.
Generic Name: of parietal cells, decreasing gastric
Famotidine acid sectretion. Short-term CV: flushing, palpitations. Oral suspension must be reconstituted and shaken
treatment for benign gastric before use.
ulcer. EENT: orbital, edema, tinnitus.
Brand Name: Store reconstituted oral suspension below
Pepcid Treatment of gastroesophageal reflux G.I.: anorexia, constipation, diarrhea, 86oF(30oC).Discard after 30 days.
disease (GERD). dry mouth, taste perversion.
Using one dose a day, administer drug at bedtime.
Classification: Pathological hypersecretory Musculoskeletal: bone & muscle pain.
H2 blockers conditions. Decrease doses with renal failure.
Skin: acne, dry skin.
Relief of heartburn, acid indigestion, Arrange for administration of concurrent antacid
Dosage: and sour stomach. Other: transient irritation at I.V. therapy to relieve pain.
20mg/tab site.

Contraindication/s
Route:
General Information
PO

H2-blocker hypersensitivity
Frequency:
Gastric cancer
2tabs OD

Infection
Timing:
Hepatic disease, QT prolongation,
8PM
renal disease, renal failure, renal
impairment.
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Reactions Nursing Responsibilities

Inhibits the action of histamine at A Skin Rash Instruct patient not to take new medication
Generic Name: theH2 receptor site located primarily Treatment and prevention w/o consulting physician
in gastric parietal cells, resulting in of heartburn, acid indigestion, and Constipation
Ranitidine inhibition of gastric acid secretion. sour stomach. Instruct patient to take as directed and do
Diarrhea not increase dose
Brand Name: Has some antibacterial action against
H.pylori Prophylaxis of GI hemorrhage from Dizziness Allow 1 hour between any other antacid and
Zantac stress ulceration. ranitidine
Drowsiness
Classification: Assess patient for epigastric or abdominal
Headache pain and frank or occult blood in the stool,
H2 Blockers emesis, or gastric aspirate
Nausea
Dosage: Nurse should know that it may cause false-
Stomach Cramps positive results for urine protein; test with
150mg/tab sulfosalicylic acid
Vomiting
Route: Inform patient that it may cause drowsiness
or dizziness
PO
Contraindication/s
Inform patient that increased fluid and
Pregnancy
Frequency: fiber intake may minimize constipation

Lactation (excreted in breastmilk)

1tab BID Advise patient to report onset of black, tarry
stools; fever, sore throat; diarrhea;
Geriatric patients (more susceptible
Timing: dizziness; rash; confusion; or hallucinations
to adverse CNS reactions)
to health care professional promptly
8AM-6PM
Renal impairments
Inform patient that medication may
temporarily cause stools and tongue to
Cirrhosis
appear gray black.
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Reactions Nursing Responsibilities

Tocilizumab, which is a humanized Treatment of CAR T-cell–induced Respiratory tract infections Tocilizumab may be administered alone or in
Generic Name: anti-IL-6R monoclonal antibody, can severe or life-threatening cytokine combination with corticosteroids
bind to both mIL-6R and sIL-6R and release syndrome (CRS) in adults and Headache
Tocilizumab Drip then inhibit classical and trans-signals. pediatric patients aged two years or Tocilizumab should not be administered to
This may be its potential mechanism older Hypertension patients with an active infection, including
Brand Name: for the treatment of cytokine storm in localized infections.
COVID-19. Treatment of active systemic juvenile Elevation in liver test
Actemra idiopathic arthritis in patients aged Avoid use of live vaccines while on
two years or older Reactions of injection site (rash, redness, tocilizumab.
Classification: swelling, itching)
Treatment of active polyarticular Patients should be evaluated for risk and
Humanized interleukin-6 receptor- juvenile idiopathic arthritis in patients Associated serious infection (tuberculosis, tested for latent tuberculosis (TB) prior to
inhibiting monoclonal antibody aged two years or older sepsis, fungal infection) starting.

Dosage: Treatment of giant cell arteritis in Educate patients about signs and symptoms
adult patients of infection.
400mg in 100cc PNSS
Communicate the reason for laboratory
Contraindication/s
Route: Active tuberculosis monitoring while on tocilizumab.

IV Inactive tuberculosis Instruct patients to inform their provider

immediately if they develop a fever,
Frequency: Bacterial infection persistent stomach pain, or a change in
bowel habits.
Run for 2 hours Opportunistic fungal infection
Educate patients on signs of hypersensitivity
Timing: Pneumonia with a fungus reaction and to report symptoms to the
nurse immediately.
- infection that lasts a long time.
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Nursing Responsibilities
Reactions

Reduces fever by acting directly on the Temporary reduction off ever, temporary CNS: headache Do not exceed the recommended
Generic Name: hypothalamic heat-regulating center to relief of minor aches and pains caused by dosage.
cause vasodilation and sweating, which common cold and influenza, headache, CV: chest pain, dyspnea, myocardial
Paracetamol helps dissipate heat. sore throat, toothache, backache, damage when doses of 5-8g/day are Reduce dosage with hepatic
menstrual cramps, etc ingested daily for several weeks or when impairment.
Brand Name: doses of 4g/day are ingested for 1yr
Avoid using multiple preparations
Tylenol/ Biogesic GI: hepatic toxicity and failure, jaundice containing acetaminophen. Carefully
check all OTC products.
Classification: GU: acute renal failure, renal tubular
necrosis Give drug with food if GI upset occurs.
Analgesic (Nonopioid);
Antipyretic Hematologic: methemoglobinemia- Discontinue drug if hypersensitivity
cyanosis; hemolytic anemia-hematuria, reactions occur.
Dosage: anuria; neutropenia, leukopenia,
pancytopenia, thrombocytopenia, Treatment of overdose: Monitor
300mg hypoglycemia; serum levels regularly, N-
acetylcysteine should be available as
Contraindication/s
Route: a specific antidote.
Contraindicated with allergy to
Hypersensitivity: rash, fever.
acetaminophen.
IVTT

Frequency:
Use cautiously with impaired hepatic
function, chronic alcoholism, pregnancy,
30 Minutes prior to Tocilizumab Drip
lactation.

Timing:

30 Minutes before Tocilizumab Drip

 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Reactions Nursing Responsibilities

Temporary symptomatic relief of

Significant anticholinergic activity. various allergic conditions. Constipation Monitor cardiovascular status especially with
Generic Name: Competes for H preexisting cardiovascular disease.
1-receptor sites on effector cells, thus Treat or prevent motion sickness, Diarrhea
Diphenhydramine Hydrochloride blocking histamine release. Effects in vertigo,and reactions to blood or Monitor for adverse effects especially in
parkinsonism and drug-induced extra plasma in susceptible patients. Dizziness children and the older adult. Supervise
Brand Name: pyramidal symptoms are apparently ambulation and use side-rails as necessary.
related to its ability to suppress Also used in anaphylaxis as adjunct to Drowsiness
Benadryl central cholinergic activity and to epinephrine and other standard If pt is having acute allergic reaction, obtain
prolong action of dopamine by measures after acute symptoms have Dry mouth history of recently ingested foods, drugs,
Classification: inhibiting its reuptake and storage been controlled. environmental exposure, emotional stress.
Nose/Throat
Anti-histamine In treatment of parkinsonism and Monitor B/P, rate, depth, rhythm, type of
drug-induced extra pyramidal Excitability respiration; quality, rate of pulse.
Dosage: reactions.
Headache Assess lung sounds for rhonchi, wheezing,
50mg As a nonnarcotic cough suppressant; rales.
As a sedative-hypnotic. Loss of appetite
Route: Avoid tasks that require alertness, motor skills
Nausea until response to drug is established.
IVTT Contraindication/s
Hypersensitivity reactions (eczema, Nervousness Dry mouth, drowsiness, dizziness may be an
Frequency: pruritus, rash, cardiac disturbances, expected response of drug.
photosensitivity) may occur. Restlessness
30 minutes prior to Tocilizumab Drip Avoid alcohol
Overdose symptoms may vary from Trouble sleeping
Timing: CNS depression (sedation, apnea,
hypotension Vomiting
30 minutes before Tocilizumab Drip
Severe allergic reactions (rash; hives;
itching; trouble breathing; tightness in the
chest; swelling of the mouth, face, lips, or
tongue)
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Reactions Nursing Responsibilities

give dose no later than 5 pm to minimize

Furosemide is a potent loop diuretic
Generic Name: that works to increase the excretion
of Na+ and water by the kidneys by
Furosemide inhibiting their reabsorption from
the proximal and distal tubules, as
Brand Name: well as the loop of Henle. It works
directly acts on the cells of the
Lasix nephron and indirectly modifies the
content of the renal filtrate.
Classification:
Indicated in adults and pediatric
patients for the treatment of edema
associated with congestive heart
failure, cirrhosis of the liver, and
renal disease, including the
nephrotic syndrome. LASIX is
particularly useful when an agent
with greater diuretic potential is
desired.
CNS: dizziness, encephalopathy,
headache, insomnia, nervousness.
EENT: hearing loss, tinnitus.
CV: hypotension.
Peeing more than normal
Feeling thirsty with a dry mouth.
disruption of sleep cycle.
PO May be taken with food or milk to
minimize gastric irritation.
Tablets may be crushed if patient has
difficulty swallowing.
Do not administer discolored solution or
tablets.

Loop Diuretics Headaches. Instruct patient to take furosemide as

directed. Take missed doses as soon as
Dosage: Feeling confused or dizzy. possible; do not double doses.
Contraindication/s
Diabetes.
40mg Muscle cramps, or weak muscles. Advise patient to contact health care
Low amount of magnesium in the
professional if weight gain more than 3 lbs
blood.
Route: in 1 day.
A type of joint disorder due to excess
uric acid in the blood called gout.
IVTT Advise patient to contact health care
Low amount of calcium in the blood.
professional immediately if rash, muscle
Low amount of sodium in the blood.
Frequency: weakness, cramps, nausea, dizziness,
Low amount of potassium in the
numbness, or tingling of extremities occurs.
blood.
OD
Low amount of chloride in the blood.
Heart attack.
Timing:

8AM
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Reactions Nursing Responsibilities

Generic Name: Nitrates are drugs that act directly on Prevention and treatment of Angina (CNS) Headache, dizziness, and Instruct patient to take medication as
the smooth muscle to cause Pectoris due to coronary artery myasthenia. directed, even if feeling better.
Isosorbide Mononitrate (ISMN) relaxation and to depress muscle disease in Adults.
tone. (GI) N & V and incontinence. Take missed doses as soon as remembered;
Brand Name: doses of isosorbide dinitrate should be taken
A nitrate that dilates (widens) blood ( CV) Hypotension. at least 2 hrs apart.
IMDUR vessels, making it easier for blood to
flow through them and easier for the (SKIN) Flushing pallor sweating and Do not double doses.
Classification: heart to pump. increased perspiration, Temporary Redness
Of Face And Neck. Do not discontinue abruptly
Anti-anginal drugs
Caution patient to
Dosage: make position
changes slowly to
60mg/tab minimize orthostatic
hypotension
Route:
Contraindication/s
PO
The presence of any allergies to
Frequency: nitrates. These drugs are also
contraindicated in the following
OD conditions: Severe anemia, head
trauma or hemorrhage, pregnancy
Timing: and lactation

8AM
 Name of the Drug Mechanism Of Action Indication/s Side Effects/Adverse Reactions Nursing Responsibilities

Assess for hypersensitivity to Trimetazidine.

Trimetazidine is a cellular acting anti - This drug is recommended in long-
Generic Name: ischaemic agent. It has 3 main
properties by which it acts as a
Trimetazidine cytoprotective agent. It inhibits the
anaerobic glycolysis and fatty acid
Brand Name: metabolism, thus allowing only
aerobic glycolysis. This action helps to
Vastarel restore the energy balance in the cell.
It inhibits acidosis and free radical
Classification: accumulation in the cell. All these
action help the cell to restore the
Anti ischemic; anti-anginal normal ionic and metabolic balance.
Dosage:
Rare causes of GI disorders
term treatment of coronary Use cautiously in patients with heart failure
insufficiency; angina pectoris. or hypertension and in elderly patients.
nausea and vomiting
If one dose is missed, immediately take next
dose.
Fever
Do not stop medication even when feeling
better if doctor has not stopped prescription.
Rash
Encourage patient to continue efforts at
smoking cessation.
Respiratory illness
Provide safety measures if lethargy occurs.

35mg/tab anemia

Route: Contraindication/s
Contraindicated in patients with
PO Parkinson disease, Parkinsonian
symptoms, tremors, restless leg
Frequency: syndrome, and other related
movement disorders
OD

Timing:

8AM
 DRUG NAME MECHANISM OF INDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
ACTION

 Do not administer undiluted due to potential for

Generic Name: Zinc Sulfate
Brand Name: Orazine
Characteristic: Mineral & Electrolyte
replacement
Participates in synthesis and 
stabilization of proteins and
nucleic acids in subcellular and
membrane transport system.
Prevention of individual trace 
element deficiencies inpatients 
receiving long term total
parenteral nutrition.
Nausea phlebitis.
Vomiting  Provide blanket and warm clothing to increase
comfort.
 Assess for allergic reaction.
 Monitor history of drug allergy.
 Advise patient not to miss any doses.
 Encourage increase diet high in protein,
vitamins and minerals.

Dosage: 2ml
CONTRAINDICATION ADVERSE EFFECT

 Hypersensitivity or allergy to  Gastric irritation (oral user only)

Route: PO, IV
any components in formulation
 Pregnancy or lactation

Frequency: OD

Timing: AM

Wilson, B.A (2007). Nurses

Drug Guide 2007. Upper Saddle
River, NJ: Prentice hall
 DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS NURSING RESPONSIBILITIES

 Monitor vital signs

Generic Name: Atorvastatin Calcium Inhibits HMG- COA reductase, 
Brand Name: Lipitor
Characteristic: Lipid Lowering
Agent/ HMG-CoA Reductase
Inhibitor
which catalyzes first step in
cholesterol synthesis; this
action reduces concentration of
serum cholesterol and low
density lipoprotein (LDLs) linked
to increases the risk of coronary
artery disease.
Adjunct to diet for controlling  Nausea  Determine allergens
LDL total cholesterol, apo-  Nocturia  Review patient medication/physicians order
lipoprotein B.  Dysuria  Monitor for muscle weakness
 Urinary Retention  Advise patient to report immediately if there is
 Anemia any unusuality observed.

Dosage: 40mg/tab

CONTRAINDICATION ADVERSE EFFECT

Route: PO  Active liver disease, which may  Rectal Hemorrhage

include unexplained persistent  Erectile dysfunction
elevations in hepatic  Thrombocytopenia
transaminase levels.  Hepatic failure
Frequency: OD  Hypersensitivity to any  Hyperglycemia
component of this medication.  Muscle pain

Timing: 8am

Patricia D. Shulll (2013), Nurse’s

Drug Handbook, McGraw-Hill
Education, LLC.
 DRUG NAME MECHANISM OF
ACTION
Generic Name: Multivitamins This product is especially
formulated for adults to help
ensure optimum energy and
increase body resistance against
Brand Name: Enervon infections. It also has Vitamin C,
an antioxidant which helps the
body's natural defense against
free radicals and help boost
Characteristic: Vitamins immune function.
Dosage:
Route: PO
Frequency: OD
Timing: AM
INDICATION
A nutritional supplement to help
promote increased energy and enhance
the immune system. For the treatment
of Vitamin B-complex deficiencies and
Vitamin C deficiencies.
CONTRAINDICATION
 If the patient is allergic to any
ingredient of the product.
SIDE EFFECTS NURSING RESPONSIBILITIES
 Asses for allergic reaction
 Bone pains,
 Advise patient not to take couple of tablets daily
 hyperesthesia
 Encourage patient to eat healthy and nutritious
 Muscle weakness
foods
 numbness on the limbs and face
 Avoid overdosing
ADVERSE EFFECT
 Vitamin C: Prolonged intake of
Ascorbic Acid (Vitamin C) in
excess of 2 grams per day may
lead to nausea, abdominal
cramps, diarrhea, and nose
bleeds.
NURSING CARE PLAN
FDAR
DISCHARGE PLAN
DATE FOCUS TIME DAR
8/12/20 Discharge instructions 4:50pm D: With discharge order from attending physician
Dr.Fernandez
A: Activity : Instructed patient to avoid crowded
places, dusty and smoke area, and any strenuous
activities, encouraged to have adequate resting
period, emphasized the importance of hand
washing/alcohol sanitation.
Medication: Teach the patient about the
importance of taking the medications given by
the doctor by knowing its name, action, purpose,
dose, route of administration and side effects of
each drug that he is taking for his illness.
Environment: Instructed patient and SO to make
sure that the environment is quiet, clean, and free
from irritants. Do not allow someone smoking
inside your house.
Treatment: Encouraged patient to have a healthy
diet, drink plenty of fluids and to follow
instructions on his treatment. Advised patient to
avoid smoking. Make sure that the family and
client knows the purpose and action of their
treatment.
Health Teaching: Educated patient, including
the family members regarding pneumonia and
covid. Isolation for about 14 days upon arrival.
Teach them about the proper hand washing or use
of alcohol based hand rub and the proper
coughing and sneezing to prevent droplets from
spreading..
Outpatient Referral: Instructed patient to strictly
comply to follow-up check ups. The patient will
have available telephone numbers of referred
physicians and agencies. A written discharge will
be provided.
Diet: Advised patient to consume food that are
rich in protein such as nuts, beans, fish and other
nutritious food. Encouraged patient to have
adequate fluid intake and avoid carbonated
drinks.
BIBLIOGRAPHY
• DIOTTI, R.A (2020) THE PATHOGENESIS OF CORONAVIRUS DISEASE 2019 (COVID-19): EVALUATION AND PREVENTION RETRIEVED NOVEMBER 17,2020
FROM HTTPS://WWW.NCBI.NKM.NIH.GOV/PMC/ARTICLES/PMC7352127/PDF/JIR2020-1357983.PDF

• BLACK, J. M., & HAWKS, J. H. (2009). MEDICAL-SURGICAL NURSING: CLINICAL MANAGEMENT FOR POSITIVE OUTCOMES (VOL. 1). A. M. KEENE (ED.).
SAUNDERS ELSEVIER.

• A. PAN, L. LIU, C. WANG, ET AL.ASSOCIATION OF PUBLIC HEALTH INTERVENTIONS WITH THE EPIDEMIOLOGY OF THE COVID-19 OUTBREAK IN WUHAN,
CHINA

• J AM MED ASSOC, 323 (19) (2020), PP. 1915-1923, 10.1001/JAMA.2020.6130

• CROSSREFVIEW RECORD IN SCOPUS

• WILSON, B.A (2007). NURSES DRUG GUIDE 2007. UPPER SADDLE RIVER, NJ: PRENTICE HALL

• PATRICIA D. SHULLL (2013), NURSE’S DRUG HANDBOOK, MCGRAW-HILL EDUCATION, LLC.

• HODGSON, B., KIJIOR, R. (2014), NURSES DRUG HANDBOOK, ELSEVIER SAUNDERS

• DOMINGO, JENNIFER (2020), RANITIDIEN DRUG STUDY. RETREIVED NOVEMBER 18, 2020 FROM:
HTTPS://WWW.SCRIBD.COM/DOC/52673160/RANITIDINE-DRUG-STUDY
• SANTOS, CHRISTEL (2020), DRUG STUDY - DEXAMETHASONE. RETREIVED NOVEMBER 18, 2020 FROM:
HTTPS://WWW.SCRIBD.COM/USER/33640557/CHRISTEL-SANTOS
• PORRAL, BIANCA (2020), DRUG STUDY CEFTRIAXONE. RETRIEVED NOVEMBER 18, 2020 FROM:
HTTPS://WWW.SCRIBD.COM/DOC/125842910/DRUG-STUDY-
• WAYNE, GIL (2017), IMPAIRED GAS EXCHAGE NURSING CARE PLAN.. RETRIEVED NOVEMBER 18, 2020
FROM: HTTPS://NURSESLABS.COM/IMPAIRED-GAS-EXCHANGE/
•