HYDROCORTISONE 250 MG IV NOW THEN 100 MG Q6

:Kanina po ay bingyan kayo ng gamot ng ating staff nurse na itinurok po sa inyong swero.
Nasabi po ba sainyo kung para saan ito?
Patient:
:Ang gamot po na iyon ay tinatawag na Hydrocortisone. Ginagamit po ito para mabawasan ang
inflammation o pamamaga sa inyong katawan. Maaari po kayong makaranas ng pananakit ng
ulo, hirap sa pagtulog, pagduduwal, pamamawis, at pananakit ng tiyan. Pakireport na lamang po
sa amin kung nakakaranas po kayo ng mga ito.

AZITHROMYCIN 500MG 1TAB OD X 3 DAYS

: Ma’am, ito pong gamot na ito ay Azithromycin. Ito po ay antibiotic kung saan ginagamot po
nito yung bacterial infection. Pinipiglan po nito ang paglaki o pagdevelop ng bacteria sa loob ng
inyong katawan. Ang mga side effects po nito ay kawalan ng gana sa pagkain, malambot na
dumi, pagduduwal, o pagsusuka, pananakit ng ulo at pagkahilo. Maaari niyo po iyong ireport sa
nurse’s station o sa amin kung makakaranas po kayo ng mga ito. Pakisabi rin po sa amin kung
nakakaramdam po kayo ng pagbilis ng tibok ng puso ninyo, at pangangati. Pwede nyo po ito
inumin kahit walang laman ang inyong tyan pero mas maigi na rin po na nakakain na po kayo
bago po kayo uminom nito para maiwasan po ang pagsakit ng inyong tyan.

HYPERTENSION HEALTH TEACHING

: Magbibigay po ako ng mga ilang paalala at mga dapat gawin para po bumaba ang inyong BP.
Una po, pwede po natin itaas yung ulunan ni Nanay para po bumaba yung dugo na bumabalik sa
puso nya. Sa ganitong kalagayan po, matutulungan nito na bumaba ang BP niya. Sa kanyang
pagkain naman po, mas maigi po na pakainin sya ng malalambot na prutas at gulay katulad na
lamang po ng saging, steamed o nilagang gulay katulad ng carrots, kangkong. Iwasan din po
yung maaalat na pagkain at paninigarilyo. Mayroon po tayong tinatawag na relaxation therapy
para po mabawasan ang inyong stress at bumaba ang inyong BP. Kasama po dito yung “guided
imagery” ang gagawin po natin dito ay pipikit at mag iisip po tayo ng bagay na nagpapakalma sa
atin at nagbibigay ng positibong pananaw. Halimbawa po ay pag iisip na kayo ay nasa tahimik
na lugar katulad ng dagat, o kabukiran. Maaari rin po kayong makinig sa music para po gumaan
ang inyong pakiramdam.
INTERVENTIONS FOR SIDE EFFECTS OF AZITHROMYCIN

 feeling sick (nausea) - stick to simple meals and do not eat rich or spicy food while you're
taking this medicine.
 diarrhoea or being sick (vomiting) - drink lots of fluids such as water or squash to
avoid dehydration. Take small, frquent sips if you're being sick. Signs of dehydration
include peeing less than usual or having strong-smelling pee. Do not take any other
medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor.
 losing your appetite - eat when you would usually expect to be hungry. If it helps, eat
smaller meals more often than usual. Snack when you're hungry. Have nutritious snacks
that are high in calories and protein, such as dried fruit and nuts.
 headaches - rest and drink plenty of water. Ask your pharmacist to recommend a
painkiller if you need one. Talk to your doctor if the headaches last longer than a week or
are severe.
 feeling dizzy or tired - if you feel dizzy when you stand up, try getting up very slowly or
stay sitting down until you feel better. If you begin to feel dizzy, lie down so you don't
faint, then sit until you feel better. Do not drive or use tools or machines if you feel dizzy
or tired. Do not drink alcohol as it may make you feel worse.

RECITE TO CI:
Hydrocortisone 250 Mg IV now then 100 mg q6
Drug Name: Hydrocortisone
Drug Class: Corticosteroids
MOA: act against inflammation and are used to help control many different inflammatory
diseases. Corticosteroids affect numerous steps in the inflammatory pathway, which enhance
their utility. To exert an effect, the steroid molecule diffuses across cell membranes and binds to
glucocorticoid receptors, which causes a conformational change in the receptor.
Indication: to treat inflammation, status asthmaticus, acute and chronic adrenal insufficiency.
Contraindication:

 hypersensitivity

 inactive tuberculosis

 herpes simplex infection of the eye

 an infection due to a fungus

 intestinal infection caused by the roundworm Strongyloides

  pheochromocytoma

 a condition with low thyroid hormone levels

 diabetes

 insufficiency of the hypothalamus and pituitary gland

 low amount of potassium in the blood

 psychotic disorder

 brain injury

 a disease with shrinking and weaker muscles called myopathy

 increased pressure in the eye

 wide-angle glaucoma

 clouding of the lens of the eye called cataracts

 high blood pressure

 chronic heart failure

 an ulcer from too much stomach acid

 diverticulitis

 surgical joining of two parts of the intestine

Side Effects:
 headache
 increased sweating
 trouble sleeping
 unusual hair growth on your face or body
 upset stomach
 increased appetite
 nausea
 weight gain
 skin changes, such as:
o acne
o rash
o dryness and scaliness
Nursing Responsibilities:

 Monitor signs of thrombophlebitis (lower extremity swelling, warmth, erythema,

tenderness) and thromboembolism (shortness of breath, chest pain, cough, bloody
sputum). Notify physician or nursing staff immediately, and request objective tests
(Doppler ultrasound, lung scan, others) if thrombosis is suspected.

 Monitor and report signs of peptic ulcer, including heartburn, nausea, vomiting blood,
tarry stools, and loss of appetite.

 Monitor signs of hypersensitivity reactions or anaphylaxis, including pulmonary

symptoms (tightness in the throat and chest, wheezing, cough, dyspnea) or skin reactions
(rash, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions
occur.

 Assess any muscle or joint pain. Report persistent or increased musculoskeletal pain to
determine presence of bone or joint pathology (aseptic necrosis, fracture).

 Assess signs of increased intracranial pressure in children, including changes in mood

and behavior, decreased consciousness, headache, lethargy, seizures, and vomiting.
Notify physician immediately of these signs.

 Assess muscle strength periodically to determine degree of muscle wasting during long-
term use.

 Measure blood pressure periodically and compare to normal values Report a sustained
increase in blood pressure (hypertension) to the physician.

 Assess peripheral edema using girth measurements, volume displacement, and

measurement of pitting edema Report increased swelling in feet and ankles or a sudden
increase in body weight due to fluid retention.

 Monitor personality changes, including depression, euphoria, restlessness, hallucinations,

AZITHROMYCIN 500MG 1TAB OD X 3 DAYS

Drug Name: Azithromycin
Drug Class: macrolide antibiotics
MOA: by binding to a specific subunit of ribosomes (sites of protein synthesis) in susceptible
bacteria, thereby inhibiting the formation of bacterial proteins. In most organisms this action
inhibits cell growth; however, in high concentrations it can cause cell death.
Indication: widely used to treat chest infections such as pneumonia, infections of the nose and
throat such as sinus infection (sinusitis), skin infections, Lyme disease, and some sexually
transmitted infections.
Contraindication:
 Hypersensitivity to azithromycin, erythromycin, or other macrolide anti-infectives;
 History of cholestatic jaundice or hepatic dysfunction with prior use of azithromycin;
 QT interval prolongation, hypokalemia, hypomagnesemia, or bradycardia;
 Concurrent use of quinidine, procainamide, dofetilide, amiodarone, or sotalol.

Side Effects:
 diarrhea/loose stools
 loss of appetite
 Nausea
 Vomiting
 Headache
 dizziness

Nursing Responsibilities:
 Assess patient for infection (vital signs; appearance of wound, sputum, urine, and stool;
WBC) at beginning of and throughout therapy.
 Observe for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema,
wheezing). Notify health care professional immediately if these occur.
 Assess patient for skin rash frequently during therapy. Discontinue azithromycin at first
sign of rash; may be life-threatening. Stevens-Johnson syndrome or toxic epidermal
necrolysis may develop. Treat symptomatically; may recur once treatment is stopped.
 Advise patient to report symptoms of chest pain, palpitations, yellowing of skin or eyes,
or signs of superinfection (black, furry overgrowth on the tongue; vaginal itching or
discharge; loose or foul-smelling stools) or rash.
 Instruct patient to notify health care professional if fever and diarrhea develop,
especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea
without advice of health care professional.
 Can be taken with or without food

NURSING RESPONSIBILITIES FOR INFECTION:

 Maintain strict asepsis 
 Wash hands or perform hand hygiene before having contact with the patient. Also, impart
these duties to the patient and their significant others and know the instances when to
perform hand hygiene or “5 moments for hand hygiene”:
1. Before touching a patient.
2. Before clean or aseptic procedure (wound dressing, starting an IV, etc.).
3. After body fluid exposure risk
4. After touching a patient
5. After touching the patient’s surroundings.
 Encourage intake of protein-rich and calorie-rich foods and encourage a balanced diet.
Vit C and Green leafy
 Encourage coughing and deep breathing exercises; frequent position changes.
Helps reduce the stasis of secretions in the lungs and bronchial tree. When stasis occurs,
microbial infection of the respiratory tract occurs and may lead to pneumonia.