Cebu Institute of Technology

University
N. Bacalso Ave., Cebu City Philippines

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

INDIVIDUAL REQUIREMENTS
DRUG STUDY AND NURSING CARE PLAN

IN PARTIAL FULFILLMENT OF THE COURSE RLE 402

SUBMITTED BY:

DARA SOPHIA N. ENCARGUEZ

BSN IV-N1

SUBMITTED TO:

GIAN PHILIPPE KARLO L. ONCINES, RN, MAN

FACULTY
DRUG STUDY
DOSAGE/FREQ/
NAME OF INDICATIONS/
ROUTE/ CLASSIFICATION MECHANISM OF ACTION SIDE EFFECTS ADVERSE EFFECTS NURSING RESPONSIBILITIES
DRUG CONTRAINDICATIONS
SUPPLIED
GENERIC PATIENT’S DOSE: Antifungal Fluconazole interacts with INDICATIONS: BLOOD AND LYMPHATIC MULTI-SYSTEM: BEFORE:
NAME: 14-demethylase, a  Fluconazole is SYSTEM DISORDERS:  Hepatic 1. Checked and validated the doctor’s order
200mg cytochrome P-450 used to treat  Agranulocytosis toxicity (e.g. and/or medication order prior to the administration
Fluconazole enzyme responsible for serious fungal or  Anaemia cholestasis, of the medication and/or enteral product.
FREQUENCY: catalyzing the conversion yeast infections, hepatocellul 2. Observed the Ten Rights of medication
 Leucopenia
BRAND of lanosterol to ergosterol. including vaginal ar damage, administration.
Once a day (OD)  Thrombocytopenia
NAME: As ergosterol forms a candidiasis, hepatitis, 3. Ensured proper preparation of drugs and took
 Neutropenia
critical part of the fungal oropharyngeal fulminant note of the drugs’ mechanism of action and side
Diflucan ROUTE:
cell membrane, candidiasis GASTROINTESTINAL hepatic effects.
Oral fluconazole inhibits the (thrush, oral DISORDERS: failure) 4. Obtained a history on allergies.
synthesis of ergosterol to thrush),  Nausea  Ventricular
SUPPLIED: increase cellular esophageal arrhythmia DURING:
 Vomiting
permeability. Other candidiasis  Torsade de 1. Identified patient and validated identity by
 Diarrhea
Tablet functions of the (candida pointes checking the bed number and arm band.
medication are to prevent  Abdominal pain 2. Explained what the medication is for as well as
esophagitis),  Stevens-
endogenous respiration other candida  Flatulence its possible side and adverse effects on the body.
Johnson
and the formation of infections  Dyspepsia 3. Took patient’s vital signs.
syndrome
yeasts. It is also (including  Constipation 4. Prepared the medication.
 Toxic
noteworthy to reiterate urinary tract  Dry mouth 5. Informed patient about the route of
epidermal
that the loss of sterols infections, necrolysis administration.
goes parallel with the peritonitis GENERAL DISORDERS 6. Made sure that the patient is aware that he/she
accumulation of 14— [inflammation of AND ADMIN SITE must not exceed the recommended dosage
methyl sterols found in the lining of the CONDITIONS: amount.
fungi and is the primary stomach], and  Fatigue 7. Gave the medication whole with a glass of
cause of the perceived infections that  Malaise water.
fungistatic activity of may occur in  Asthenia 8. Ensured that the patient has swallowed and
fluconazole. different parts of  Fever taken the medication.
the body), or
Mammalian demethylation fungal IMMUNE SYSTEM AFTER:
is less sensitive to (cryptococcal) DISORDERS: 1. Recorded and documented the administration
fluconazole inhibition; meningitis. This  Angioedema of medication.
therefore, using medicine works  Urticaria 2. Evaluated the patient’s therapeutic response.
fluconazole helps the body by killing the 3. Assessed for any hypersensitivity reactions
counteract the causative fungus or yeast, METABOLISM AND (chills, fever).
agents of fungal infection. or preventing its NUTRITION DISORDERS: 4. Instructed SO to report dark urine, pale stool,
Despite this mechanism of growth.  Hypercholesteremi jaundiced skin or sclera of eyes, rash, pruritus.
action, triazoles are Fluconazole is a
considered to be also used to  Hypertriglyceridae
fungistatic against prevent mia
Candida species. candidiasis in  Hyperlipidaemia
patients having  Hypokalaemia
 Microbiologically, bone marrow  Anorexia
fluconazole has activity transplants who
limited to yeasts and some receive cancer
clinical activity against the or radiation MUSCULOSKELETAL AND
endemic fungi, treatment. CONNECTIVE TISSUE
Histoplasma, DISORDERS:
Blastomyces, and CONTRAINDICATIONS:  Myalgia
Coccidioides. Fluconazole  Hypersensitivity
has excellent activity to fluconazole NERVOUS SYSTEM
against Candida species  Concomitant DISORDERS:
and Cryptococcus species use with  Headache
but has less activity astemizole,  Dizziness
against C. glabrata and no cisapride,  Dysgeusia
activity against C. krusei. quinidine,  Paraesthesia
terfenadine,  Tremor
Reference: pimozide,  Vertigo
Govindarajan, A., Bistas, erythromycin.
K. G., & Aboeed, A.
PSYCHIATRIC
(2020). Fluconazole.
DISORDERS:
PubMed; StatPearls
Publishing.  Insomnia
https://www.ncbi.nlm.nih.g  Somnolence
ov/books/NBK537158/
SKIN AND
SUBCUTANEOUS TISSUE
DISORDERS:
 Rash
 Pruritus
 Increased
sweating
 Alopecia

DOSAGE/FREQ/
NAME OF INDICATIONS/
ROUTE/ CLASSIFICATION MECHANISM OF ACTION SIDE EFFECTS ADVERSE EFFECTS NURSING RESPONSIBILITIES
DRUG CONTRAINDICATIONS
SUPPLIED
GENERIC PATIENT’S DOSE: Laxative Osmotic Increases water content INDICATIONS: GASTROINTESTINAL METABOLISM AND BEFORE:
NAME: and softens the stools.  Treatment of DISORDERS: NUTRITION 1. Checked and verified doctor’s order regarding
10mL Lowers the pH of the colon, chronic  Burping gas DISORDERS: the correct dosage, frequency, and route.
Lactulose which inhibits the diffusion constipation  Nausea  Hyperglyce 2. Assessed patient’s history for allergy to
FREQUENCY: of ammonia from the colon mia lactulose, low-galactose diet.
 Cramps
BRAND into the blood, thereby CONTRAINDICATIONS: 3. Assessed patient for abdominal distention,
qhs  Stomach
NAME: reducing blood ammonia  Patients on low- presence of bowel sounds and normal pattern of
discomfort or pain
levels. galactose diets  Belching bowel function.
Lilac ROUTE:
 Distention 4. Prepared the medication as per doctors’ order.
Oral Reference: 5. Checked for the medication expiration date.
 Flatulence
Nursing Central. (n.d.). 6. Practiced the 10 rights of medication
 Diarrhea
SUPPLIED: Lactulose. Retrieved from: administration
https://nursing.unboundme
Syrup dicine.com/nursingcentral/v DURING:
iew/Davis-Drug-Guide/ 1. Introduced self to patient.
51431/all/lactulose 2. Verified patient’s identity.
3. Observed proper hand hygiene.
4. Educated patient on the purpose of the drug to
be administered.
6. Emphasized to the patient the importance of
continuously taking the medication.
7. Administered the drug in a full glass (240 ml) of
water or it can also be mixed with fruit juice to
improve flavor.

AFTER:
1. Recorded and documented the administration
of medication.
2. Assessed color, consistency and amount of
stool produced.
3. Monitored serum electrolytes periodically when
used chronically.
4. Cautioned the patient that this medication may
cause belching, flatulence, or abdominal
cramping. Health care professional should be
notified if diarrhea occurs.

NURSING CARE PLAN

 PLANNING/ NURSING INTERVENTIONS/
ASSESSMENT NURSING DIAGNOSIS CLIENT GOAL PATIENT’S GOAL ACTIONS RATIONALE EVALUATION
SUBJECTIVE CUES: Imbalanced Nutrition: Less After performing SHORT TERM: INDEPENDENT SHORT TERM:
“Gamay ra gyud na Than Body Requirements comprehensive After 6-8 hours of nursing 1. Obtained the patient’s 1. These measurements are After 6-8 hours of
siya’g kaon perme miss Related to the nursing interventions, the patient will height and weight. Weighed required to determine nursing
unya pugsunonon pa Consequences of interventions, be able to: the patient daily at the same nutritional needs. Daily weights interventions, the
gyud kaayo, mura ba’g Chemotherapy Secondary the patient will  Verbalize accurate time with the same clothes provide feedback about patient was able to:
wa siyay gana perme” to Acute Myeloid Leukemia be able to knowledge of before breakfast. whether the treatment plan  Verbalize
as verbalized by the maintain condition and needs adjustments. accurate
patient’s SO. SCIENTIFIC BASIS: adequate understanding of knowledge
Children and adolescents nutritional treatment regimen 2. Recorded a thorough diet 2. This assessment focuses on of condition
OBJECTIVE CUES: with acute myeloid needs. history. Points to consider dietary intake and food and
 Verbalize
 Loss of leukemia experience a are: preferences, allergies, and understandi
commitment to
appetite spectrum of nutrition-  Type of food areas such as the patients’ ng of
mutually agree
 Weight loss related morbidities during preference ability to eat. treatment
upon goals and
 Insufficient and after treatment.  Times of meal intake regimen
treatment plan
muscle tone Additionally, Chemotherapy  Food allergies  Verbalize
 Pale and dry is one of the most LONG TERM:  Food that causes
commitment
skin aggressive cancer After 6-8 weeks of nursing indigestion
to mutually
treatments and may have interventions, the patient will  Taste or chewing 3. Health conditions that affect
 Decreased agree upon
or impose serious adverse be able to: problems the gastrointestinal tract,
activity goals and
effects on one’s nutrition  Demonstrate  Presence of dentures hormones, and acute illnesses
tolerance treatment
and overall health status. appropriate  Appetite changes such as large wounds, surgery,
 S/P plan
Chemotherapy Imbalanced nutrition (less changes in lifestyle or trauma contribute to
3. Considered the patient’s nutritional changes. Being
(2/16/22) and behaviors, LONG TERM:
than body requirements), past medical history, aware of these factors helps
 Vital signs: including eating After 6-8 weeks of
usually occurs as a result comorbidities, and acute create a more targeted
T – 36.2°C patterns, food nursing
of the interaction between situation. treatment plan. Etiological
P – 110 bpm quantity/quality and interventions, the
the host and the disease, exercise program factors for malnutrition need to patient was able to:
R – 22 cpm which results in decreased  Maintain weight at a be identified to guide  Demonstrate
BP – 100/80 mmHg nutrient intake, loss of satisfactory level for appropriate treatment. appropriate
PS – 4 out of 10 appetite, changes in taste,
height, body build, changes in
and food aversion, fear, 4. The reason for not eating lifestyle and
age, and gender 4. Assessed the patient’s
depression, and anxiety. appropriate amounts of food behaviors,
Moreover, imbalanced relationship to food. may be physical, physiological, including
nutrition (less than body or psychological. eating
requirements) in acute 5. A pleasant environment patterns,
5. Provided an inviting
myeloid leukemia or other without distraction, noise, and food
environment and offered
cancer patients has been offensive or medicinal odors quantity/qual
opportunities to socialize
observed to negatively during mealtimes. makes it more enjoyable for the ity and
impact patients’ response patient. In addition, socializing exercise
to therapy, increase the during meal times has patients program
incidence of treatment- looking forward to mealtimes  Maintain
related side effects, and might increase motivation weight at a
interrupt serial treatment to eat. satisfactory
regimens, extend hospital 6. Encouraged nutritional level for
stay, impair performance supplements and healthy 6. Extra snacks and height, body
status, immune function, snacks between meals. supplements, such as build, age,
and quality of life, and nutritional shakes, increase and gender
ultimately affects survival caloric intake. However, advise
status. the patient not to substitute
meals with supplemental
SOURCES: 7. Provided small frequent shakes.
1. Gebremedhin, T. meals instead of three full
K., Cherie, A., 7. If the patient cannot finish
meals.
Tolera, B. D., meals at designated times,
Atinafu, B. T., & offer more mealtimes with
Demelew, T. M. smaller portions. Small,
(2021). Prevalence frequent portions might be
and risk factors of more tolerable and increase
8. Provided nutritional overall calorie intake.
malnutrition among
education about dietary
adult cancer
guidelines and the importance 8. Patients and family
patients receiving
of adequate caloric intake to members need to have
chemotherapy
maintain the desired weight. nutritional knowledge about
treatment in cancer
center, Ethiopia: food groups to maintain
9. Scheduled rest periods adequate and healthy nutrition
cross-sectional before meals and open at home.
study. Heliyon, packages and cut up food for
7(6), e07362. patient. 9. Nursing assistance with
https://doi.org/10.1
activities of daily living (ADLs)
016/j.heliyon.2021.
will conserve the patient’s
e07362
energy for activities the patient
2. Gomes, C. de C., values. Patients who take
Silva, C. C. G. da, DEPENDENT: longer than one hour to
Nascimento, P. R. 1. Administered the complete a meal may require
P. do, Lemos, T. prescribed medication/s assistance.
M. de A. M., and/or vitamins/supplements
1. Vitamins and minerals are
 Marcadenti, A., as ordered by the physician an essential part of a healthy
Markoski, M. M., & before and after meals: diet and play an important role
Fayh, A. P. T.  Vitamin C+Zinc in the body’s immune system.
(2020). Nutritional  Vitamin B Complex Additionally, pain decreases
status and  Vitamin D3 the appetite, thus why patients
appetite-regulating  Tramadol + are given analgesics.
hormones in early Paracetamol
treatment of acute
myeloid leukemia COLLABORATIVE:
among children 1. Collaborated with a
and adolescents: a licensed dietitian regarding 1. Based on lab values,
cohort study. Sao the nutritional status and diet assessment, and other
Paulo Medical planning. indicators, the dietitian can
Journal, 138, 118– determine the patient’s daily
125. caloric and nutritional
https://www.scielo. requirements to increase
br/j/spmj/a/GGJtqP 2. Offered referrals to weight and maintain an ideal
JM3fSFPv6sm8x8 community resources about weight. The dietitian will also
GKL/?lang=en nutrition. consider the patient’s ability
and preferences of food intake.

2. Community resources such

as “Meals on Wheels” can help
patients to maintain food
availability consistently.

REFERENCES:

1. Gebremedhin, T. K., Cherie, A., Tolera, B. D., Atinafu, B. T., & Demelew, T. M. (2021). Prevalence and risk factors of malnutrition among adult cancer patients receiving chemotherapy
treatment in cancer center, Ethiopia: cross-sectional study. Heliyon, 7(6), e07362. https://doi.org/10.1016/j.heliyon.2021.e07362
2. Gomes, C. de C., Silva, C. C. G. da, Nascimento, P. R. P. do, Lemos, T. M. de A. M., Marcadenti, A., Markoski, M. M., & Fayh, A. P. T. (2020). Nutritional status and appetite-regulating
hormones in early treatment of acute myeloid leukemia among children and adolescents: a cohort study. Sao Paulo Medical Journal, 138, 118–125.
https://www.scielo.br/j/spmj/a/GGJtqPJM3fSFPv6sm8x8GKL/?lang=en
3. Govindarajan, A., Bistas, K. G., & Aboeed, A. (2020). Fluconazole. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537158/
4. Nursing Central. (n.d.). Lactulose. Retrieved from: https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/51431/all/lactulose