Republic of the Philippines

ISABELA STATE UNIVERSITY

City of Ilagan Campus

FOOD POISONING
PATHOPHYSIOLGY
PREDISPOSING FACTORS:

PRECIPITATING FACTORS:

1
Jomari Jimenez BSN 3-C
 Republic of the Philippines
ISABELA STATE UNIVERSITY
City of Ilagan Campus

DISEASE PROCESS WITH SIGNS AND SYMPTOMS

Contaminated food handling or storage

Warmth, moisture, time

Classic bacterial food poisoning Increased multiplication of bacteria or virus Less common causes of food poisoning

Ingestion of preformed bacterial toxins Ingestion of bacteria

Meat, salad, cream Fried rice, milk Meat, gravy Canned food
Poultry, Milk Seafood, Produce

Staphylococcus Aureus Bacillus cereus Clostridium Clostridium

Perfringens Botulinum
Campylobacter Shigella
Enterotoxin Emetic Diarrhea Enterotoxin Botulinum
secretions toxin toxin secretions neurotoxin

Non-invasive Secretion Intracellular

Acetylcholine bacteria of
Toxin stimulation of vagus Disruption of ß barrels in invasion of
blockage on
nerve endings in stomach epithelial cell epithelial cell adhere to cytolethal intestine
peripheral nerve
tight junctions membrane synapses. intestinal wall distending
toxin
Increased medullary
center stimulation Increased fluid in +/- Shiga toxin
Diplopia,
intestinal lumen Epithelial damage secretion
Dysphagia,
Dyspnea,
Nausea, Vomiting
Abdominal cramps, Diarrhea Weakness,
Death Fever, Bloody Diarrhea
2
Jomari Jimenez BSN 3-C
 Republic of the Philippines
ISABELA STATE UNIVERSITY
City of Ilagan Campus

Nursing Care Plan

Assessment Diagnosis Planning Intervention Rationale Evaluation

3
Jomari Jimenez BSN 3-C
 Republic of the Philippines
ISABELA STATE UNIVERSITY
City of Ilagan Campus

Assessment Diagnosis Planning Intervention Rationale Evaluation

4
Jomari Jimenez BSN 3-C
 Republic of the Philippines
ISABELA STATE UNIVERSITY
City of Ilagan Campus

Drug Study
Drug Name Action Dosage/Route Indication/Uses Contraindication Adverse Reaction Nursing Management

Generic: May inhibit PO RA, osteoarthritis, Contraindicated in patient CNS: dizziness, Black Box Warning Drug
Ibuprofen prostaglandin Capsule: 200 mg arthritis hypertensive to drug and in headache, nervousness. can cause potentially
synthesis, top Oral drops: those with angioedema, Cv edema, fluid fatal arrhythmias. Only
Mild to moderate pain:
Brand: advil, produce anti- 40mg/mL, 50 syndrome of nasal polyps, or retention. skilled personnel trained
moderate to severe pain
advil liquid-gel, inflammatory, mg/1.25mL bronchospastic EENT: tinnitus. in identification and
as an adjunctive to
caldolor, analgesics, and Oral suspension: reaction to aspirin or other GI: abdominal pain, treatment of acute
opioid analgesics: fever
children’s advil, antipyretic 40mg/mL, NSAIDs. bloating, constipation, ventricular arrhythmias,
reduction in children.
children’s effects. 100mg/5ml Black Box Warning: decreased appetite, particularly polymorphic
motrin Jr Tablets: 100mg, Mild to moderate pain, Contraindicated for the diarrhea, dyspepsia, ventricular tachycardia,
strength, 200mg, 400mg, fever treatment of perioperative epigastric distress, should give drug.
ibuprofen, Tablets (chewable) Reliefs of signs and pain after CABG surgery.  flatulence, heartburn,
infants, advil 50 mg, 100mg symptoms of juvenile Black Box Warning: NSAIDs nausea, non- Before therapy, correct
concentrated arthritis can increase risk of heart necrotizing hypokalemia and
drops, junior Injection: attack or stroke in patients enterocolitis, vomiting. hypomagnesemia to
strength dvil, 800mg/8mL Migraine with or without heart disease GU: acute renal failure, reduce risk of
Nono-profen (100mg/mL) in Clinically significant or risk factors for heart azotemia, cystitis, proarrhythmic.
pms-ibuprofen. single dose vials. patent ductus arteriosus disease. hematuria.
(PDA). Hematologic: Black Box Warning
Therapeutic Black Box Warning: Risk of agranulocytosis, Patients with atrial
class: NSAID’s heart attack or stroke can aplastic anemia, fibrillation lasting longer
Pharmacologic occur as early as the first leukopenia, than 2 to 3 days must be
class: NSAID’s weeks of using an NSAID. neutropenia, adequately
Risk appears greater at higher pancytopenia, anticoagulated, generally
doses. Use lowest effective thrombocytopenia, over at least 2 weeks.
dose for shortest duration anemia, prolonged
possible. bleeding time. Monitor ECG
Metabolic: continuously during
Black Box Warning: NSAIDs hypokalemia, administration and for at
may increase risk of serious hypoglycemia. least 4 hours afterward or
GI adverse events, including Skin: pruritus, rash, until QTc interval returns
bleeding, ulceration, and injection site irritation to baseline; drug can

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Jomari Jimenez BSN 3-C
 Republic of the Philippines
ISABELA STATE UNIVERSITY
City of Ilagan Campus

perforation of the stomach or induce or worsen

intestines, which can be fatal.
These events can occur at any
time during use and without
warning symptoms. Elderly
patients are at greater risk for
serious GI events.
ventricular arrhythmias.
Longer monitoring is
required if ECG shows
arrhythmia or patient has
hepatic in-sufficiency.

·Ibuprofen lysine injection is Don't give class IA or

contraindicated in preterm other class III
infants with significant renal antiarrhythmics with
impairment, proven or infusion or for 4 hours
suspected un-treated infection afterward.
or necrotizing enterocolitis,
thrombocytopenia, PATIENT TEACHING
coagulation defects, active
bleeding, and congenital heart Tell patient to report
disease in whom patency of adverse reactions
the ductus arteriosus is promptly.
necessary for satisfactory
pulmonary or systemic blood Instruct patient to alert
flow. nurse of discomfort at
injection site.
Alert: NSAIDs increase risk
of HF.
·Use cautiously in elderly
patients and in patients with
GI disorders, history of pep-
tic ulcer disease, hepatic or
renal disease, cardiac
decompensation, HTN,
asthma, or intrinsic
coagulation defects.
·Long-term NSAID use may
result in renal papillary
necrosis and other renal
6
Jomari Jimenez BSN 3-C
 Republic of the Philippines
ISABELA STATE UNIVERSITY
City of Ilagan Campus

injury.

May increase risk of aseptic

meningitis, with fever and
coma, particularly in patients
with SLE and related
connective tissue dis-ease. If
signs or symptoms of
meningitis occur, consider
whether they're related to
ibuprofen therapy.

Overdose S&S: Abdominal

pain, nausea, vomiting,
lethargy, drowsiness,
headache, tinnitus,
nystagmus, CNS depression,
seizures, hypotension,
bradycardia, tachycardia,
atrial fibrillation, metabolic
acidosis, coma, acute renal
failure, hyperkalemia,
respiratory depression and
failure.

Drug Name Action Dosage/Route Indication/Uses Contraindication Adverse Reaction Nursing Management

Generic: Anastrozole A selective PO First-line treatment of Contraindicated in CNS: headache, PREGNANCY-

nonsteroidal postmenopausal women patients hypersensitive asthenia, pain, LACTATION-
Brand: Arimidex aromatase Adults: 1 mg PO with hormone receptor- to drug or its dizziness, depression, REPRODUCTION
inhibitor that daily. positive or hormone components. paresthesia, anxiety,  Drug can cause fetal

7
Jomari Jimenez BSN 3-C
 Republic of the Philippines
ISABELA STATE UNIVERSITY
City of Ilagan Campus

Therapeutic Class: significantly receptor-unknown insomnia, stroke. harm.

Antineoplastics lowers estradiol AVAILABLE locally advanced or Use cautiously in CV: hot flashes,  Contraindicated in
levels, which FORMS metastatic breast cancer patients with thromboembolic women who are or
Pharmacologic Class: inhibits breast Tablets:1 mg preexisting ischemic disease, chest pain, may become
Aromatase inhibitors cancer cell Advanced breast cancer heart disease peripheral edema, pregnant.
growth in in postmenopausal HTN, vasodilation,  Women of
postmenopausal women with disease cardiac ischemia. childbearing
women. progression after EENT: cataracts, potential should use
tamoxifen therapy pharyngitis, sinusitis. effective
GI: nausea, vomiting, contraception during
Adjunctive treatment of diarrhea, constipation, therapy and for at
postmenopausal women abdominal pain, least 3 weeks after
with hormone receptor- anorexia, dry mouth, final dose.
positive early breast dyspepsia.  It isn't known if drug
cancer GU: vaginal dryness, appears in human
pelvic pain, UTI. milk. Patient
Risk reduction for breast Metabolic: weight shouldn't breastfeed
cancer in gain, increased ap during therapy and
postmenopausal women petite. for 2 weeks after
Musculoskeletal: bone final dose.
pain, back pain, NURSING
arthritis, arthralgia, CONSIDERATIONS
osteoporosis, fractures.  Give drug under
Respiratory: dyspnea, supervision of a pre-
bronchitis, cough. scriber experienced
Skin: rash, sweating. in use of
Other: lymphedema, antineoplastics.
flulike symptoms.  Patients with
hormone receptor-
negative disease and
patients who didn't
respond to previous
tamoxifen therapy
rarely respond to
anastrozole.

8
Jomari Jimenez BSN 3-C
 Republic of the Philippines
ISABELA STATE UNIVERSITY
City of Ilagan Campus

 For patients with

advanced breast
cancer, continue
anastrozole until
tumor progresses.
 Monitor bone
mineral density
because drug can
decrease bone
mineral density.
 Use drug only in
postmenopausal
women.
 Rule out pregnancy
before starting drug.
PATIENT TEACHING
 Instruct patient to
report adverse
reactions, especially
difficulty breathing,
chest pain, or skin
lesions or blisters.
 Tell patient to take
medication at the
same time each day.
 Stress needs for
follow-up care.
 Counsel female
patient about risks of
pregnancy during
therapy and advise
her to use effective
contraception during
therapy and for at
least 3 weeks after
9
Jomari Jimenez BSN 3-C
 Republic of the Philippines
ISABELA STATE UNIVERSITY
City of Ilagan Campus

final dose.
 Advise patient not to
breastfeed during
treatment and for 2
weeks after final
dose.
 Tell patient that drug
lowers estrogen
level, which may
lead to decreased
bone strength and
increased risk of
fractures.

NURSING CONSIDERATIONS

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Jomari Jimenez BSN 3-C