III.

MEDICAL MANAGEMENT
a. DIAGNOSTIC AND LABORATORY PROCEDURES
DIAGNOS GENERAL INDICATIO NORMA ANALYSIS NURSING
TIC/ DESCRIPTI N OR L AND RESPONSIBI
LABORAT ON PURPOSE VALUES INTERPRE LITIES
ORY TATION
PROCEDU
RES
Hemoglobin A hemoglobin The The The patient is Maintain
test determines hemoglobin normal considered to monitoring of
the quantity of test is used to value for have anemia the platelet
hemoglobin in screen for hemoglabi because the count and
the blood. low or high n is 11–14 results, monitoring vital
Hemoglobin is amounts of g/dL which is 7.2 signs, and look
a protein that red blood g/dL, are for any
contains the cells; considered to abnormalities.
majority of red however, the be lower than
blood cells test is most the normal Provide the
(erythrocytes). frequently value. This I client with the
Hemoglobin used to detect because of blood or blood
includes iron, anemia the excessive products that
which enables (levels of of Mrs. Lili were ordered.
oxygen hemoglobin Valiente
binding. that are lower since Take
Hemoglobin than normal). delivery. precautions to
permits red Also use for prevent
blood cells to monitoring bleeding, such
transport blood loss as avoiding
oxygen from and blood intramuscular
the lungs to the replacement injections, to
rest of the response. prevent trauma.
body's organs
and tissues. It is important
to make the
client take any
medications
that have been
prescribed, and
a diet analysis
should be done
to identify
items such as
those high in
iron and
vitamin K.
Mean cell The mean It is used to The Mrs. Lili Monitor vital
volume corpuscular assess the normal Valiente signs
volume average size value is results is 99.0
(MCV), also of red blood 74.4–95.6 fL, which is Maintain
known as the cells in a fL higher than monitoring of
mean cell given blood the normal the platelet
volume, is a sample. Red value. count
value that is blood cells
measured in a are important Take
laboratory to for delivering precautions to
determine the oxygen prevent
typical throughout bleeding, such
proportions the body in as avoiding
and volume of order to intramuscular
a red blood maintain the injections, to
cell. It is useful health and prevent trauma
in assisting in function of
the organs and During times of
determination tissues. acute blood loss
of the cause of or transfusion,
anemia. it is important
to carefully and
thoroughly
review the
results of a
CBC.
White cell The white Done to The The white Antibiotics, IV
count blood count is identify the normal cell count for fluids, and
performed to root cause of value of Mrs. Lili other medicines
assess bacterial a high WBC the white Valiente was should all be
and viral count like cell count determined to given according
infections, as infection and for be 3.2 109/L, to the doctor's
well as to aid inflammation pregnant which is orders.
in the . Also, a women is considered to
diagnosis of typical type 6–16 be lower than Always
leukemic of test that is 109/L the normal maintain a close
illnesses and utilized in the value. watch on the
track their diagnosing patient vital
progression. and signs
monitoring of
a broad range Check the white
of health blood cell count
problems. and look for
any changes.

Vitamins A and
C, as well as
 zinc, are
necessary for
replenishing
body resources
lost by
combating
diseases.
Provide
information on
the significance
of adhering to
the specified
diet, including
specific vitamin
and mineral-
rich food
sources.
Platelets To assist in -Confirm an 150–400 131 109/L -Monitor and
diagnosing and elevated 109/L normal trend platelet
evaluating platelet count count.
treatment for (thrombocyto -Monitor blood
blood sis), which pressure, and
disorders can cause dizziness.
such as increased Check skin
thrombocytosis clotting. temperature for
and warmth, assess
thrombocytope - Confirm a capillary refill,
nia and to low platelet assess pedal
evaluate count pulses, and
preprocedural (thrombocyto monitor level of
or preoperative penia), which consciousness.
coagulation can be -Instruct
associated patients to
with bleeding consume a
variety of foods
- Provide within the basic
screening as food
part of a groups,
complete maintain a
blood count healthy weight,
(CBC) in a be
general physically
physical active, limit salt
examination, intake, limit
especially alcohol intake,
upon and avoid the
admission to
 a healthcare use of tobacco.
facility.
Internationa
l normalized
ratio (INR)
Activated To assist in • Evaluate 30–45 s 39 s Observe for
partial assessing response to Normal symptoms of
thromboplas coagulation anticoagulant altered
tin disorders and therapy with coagulation
Time monitor the heparin or such as
(APTT) effectiveness warfarin bruising,
of therapeutic derivatives bleeding
interventions. gums, or blood
Identify the in urine,
possible sputum, or
cause of stool.
abnormal
bleeding : Monitor blood
pressure; assess
• Identify extremities for
individuals skin
who may be temperature,
prone to color, and
bleeding warmth; assess
capillary refill
and pedal
pulses. Monitor
for dizziness,
numbness,
tingling,
hyperesthesia,
or hypoesthesia.
Monitor and
trend PT and
INR.

Sodium
Potassium
Urea
Creatinine

b. IVF, O2 THERAPY, NEBULIZATION, NGT

TYPE OF GENERAL INDICATION OR NURSING
MEDICAL DISCRIPTION PURPOSE RESPONSIBILITIES
MANAGEMENT
 c. MEDICATIONS
NAME GENERAL INDICATI ROUTE OR SIDE NURSING
OF DESCRIPTIO ON OR ADMINISTRA EFFECT RESPONSIBILI
THE N/ PURPOSE TION, AND TIES
DRUG CLASSIFICA DOSAGE AND ADVER
GENE TION PREQUENCY SE
RIC OF REACTI
NAME ADMINISTRA ON
BRAN TION
D
NAME
Generic Iron -RDA R- PO CV: -maintain the
Name; supplements, A- 600 mcg peripheral vital signs
Folic F- daily vascular checking and
Acid Hematinic - thrombosi report any
Megaloblas R- PO, IM or s, heart abnormalities.
Brand tic or subcutaneous failure. - obtain
Name; macrocytic A- up to 0.8 mg GI: sensitivity test
FA-8 anemia F- daily diarrhea history before
from folic Respirato administration
acid or ry: - avoid IV
other pulmonar administration
nutritional y edema because faster
deficiency, Skin: systemic
hepatic itching elimination will
disease, reduce
alcoholism, effectiveness of
intestinal vitamin.
obstruction - don’t mix
or parenteral
excessive preparation in
hemolysis. R- PO same syringe
A- 0.4 to 0.8 mg with other drugs.
-to prevent F- daily
neural tube
defects
during
pregnancy.

d. DIET
TYPE OF DIET GENERAL INDICATION NURSING
DESCRIPTION OR PURPOSE RESPONSIBILITIES
Diet as tolerated Diet as tolerated refers It indicates that the Give the client the
to the requirement that patient is free to following instructions
a patient must be able consume any foods to follow out:
to consume meals she desires so long - Take in lots of
from one diet stage as those foods do fluids,
before moving on to not result in any especially
the next diet stage. adverse effects on water
Also, used to describe her health. A diet - Constipation
a situation in which the that can be can be avoided
gastrointestinal tract is maintained over by eating foods
able to tolerate food time. The purpose that are high in
and is prepared for the of the DAT diet for fiber, such as
next step of treatment. Mrs. Mrs. Lili fruit and whole
Valiente is to grains
provide her body - Consume meat,
with sufficient particularly
nourishment so she darker meats
is able to such as beef, as
breastfeed her they contain the
babies. It is largest iron.
necessary for her to - Combining the
consume foods that iron
are high in supplement
calcium, protein, with vitamin C
and other nutrients is
to get enough milk. recommended.
- Make sure that
the client eats
enough foods
that are high in
iron, protein,
and calcium.
Lentils, cereals
that have been
fortified with
iron, vegetables
with dark green
leaves, peas,
and dried fruits
like raisins are
all good
sources of iron.
- Consuming
meals high in
iron along with
foods high in
vitamin C, such
 as citrus fruits,
will assist the
body in
absorbing iron
from the foods
that the client
eat.
- Advised the
client to take
foods that have
a source of
protein, plant-
based foods
like soy
products and
meat
alternatives,
legumes,
lentils, nuts,
seeds, and
whole grains
are good
options. Eggs
and dairy
products are
two additional
food choices.
- Educate the
client that dairy
products and
vegetables with
a dark green
color are both
excellent
providers of
calcium.

e. ACTIVITY
TYPE OF GENERAL INDICATION OR NURSING
ACTIVITY DESCRIPTION PURPOSE REPONSIBILITY

f. SURGICAL MANAGEMENT (applicable to patients who had surgery)

i. Definition of the operation
ii. Procedure (preoperative, intraoperative and postoperative period)
iii. Instruments/ equipment and machines / materials needed (provide
pictures/illustration)
iv. Responsibilities of the Nurse
- Before the procedure
**special physical preparation
- During the procedure
- After the procedure