URDANETA CITY UNIVERSITY

San Vicente West, Urdaneta City, Pangasinan 2428

COLLEGE OF HEALTH SCIENCES

Bachelor of Science in Nursing

DRUG STUDY
Name of Student: BUENCONSEJO, JIRAH Year Level and Group: BSN 3 – GROUP A

Affiliating Agency/Area: ___________________________________________ Month/Year of Exposure: ______________________

DRUG CLASSIFICATION INDICATION SIDE EFFECTS ADVERSE EFFECTS NURSING RESPONSIBILITIES

- Note for the drugs, dosage, time, route of

client.
Generic Name: - Antimanic drug - Lithium is also CNS: lethargy, slurred Cardiac: Bradycardia,
- Note the side effects of the drugs.
prescribed for speech, muscle flattened or inverted T
Carbolith (CAN), - Before starting treatment with lithium, it is
major depressive weakness, fine hand waves, heart block, and
Duralith (CAN), essential to get kidney function tests and
disorder as an tremor. sick sinus syndrome.
Eskalith CR, Lithane thyroid function tests.
adjunct therapy,
(CAN) GI: nausea, vomiting, CNS: Confusion, memory - In patients above 50 years of age, an
bipolar disorder
diarrhea, thirst problems, new or electrocardiogram is also necessary.
Brand Name: without a history
worsening tremor, - Because lithium is associated with weight
of mania,
GU: Polyuria
Lithium hyperreflexia, clonus, gain, it is important to weigh a patient before
treatment of
slurred speech, ataxia, starting treatment. It is also beneficial to
Dosage: vascular
stupor, delirium, coma, determine if the patient has prediabetes,
headaches, and
600 mg and seizures (rarely). diabetes, or dyslipidemia.
neutropenia.
These effects are - It is also important to monitor patients for
Route: MECHANISM OF ACTION CONTRAINDICATIONS theoretically due to dehydration and lower the dose when there
excess action on the are signs of infection, excessive sweating, or
Oral - Mechanism of - Lithium is not
same sites that mediate diarrhea.
Frequency: Lithium is not recommended in - Mental health nurses should be alert to the
therapeutic action.
known; alters patients with signs and symptoms of lithium toxicity and
qAM and qHS sodium transport renal Renal: Nephrogenic report such to the prescriber immediately if
in nerve and impairment. It is diabetes insipidus with these are present. It is essential to maintain
muscle cells; also not polyuria and polydipsia. coordination of care in patients on /lithium
inhibits release of recommended in These side effects are therapy owing to its narrow therapeutic
norepinephrine patients with due to lithium's action on index and potential adverse effects and
and dopamine, cardiovascular ion transport. toxicity
but not disease. Lithium
 serotonin, from causes reversible Hematologic: - Give with caution and daily monitoring of
stimulated T wave changes Leukocytosis and aplastic serum lithium levels to patients with renal or
neurons; slightly and can unmask anemia. CV disease, debilitation or dehydration or
increases Brugada life-threatening psychiatric disorders.
Gastroenterologic:
intraneurons syndrome. A - Give drug with food or milk or after meals.
Diarrhea and nausea
stores of cardiology - Individuals vary in their response to this drug;
catecholamines; consult is Endocrinal: Euthyroid some patients may exhibit toxic signs at
decreases necessary if a goiter or hypothyroid serum lithium levels considered within the
intraneuronal patient goiter therapeutic range.
content of experiences
second unexplained Other: Acne, rash, and
messengers and palpitations and weight gain. Lithium-
may thereby syncope. It is also induced weight gain is
selectively not advisable to more common in women
modulate the consider lithium than in men.
responsiveness for treatment in
of hyperactive children under 12
neurons that years of age.
might contribute
to the manic
state.

Checked by: _________________________________ Date: ____________________

Clinical Instructor’s Name and Signature

URDANETA CITY UNIVERSITY

San Vicente West, Urdaneta City, Pangasinan 2428

COLLEGE OF HEALTH SCIENCES

Bachelor of Science in Nursing

NURSING CARE PLAN (NCP)

Name of Student: BUENCONSEJO, JIRAH Year Level and Group: 2nd YEAR GROUP A

Affiliating Agency/Area: ___________________________________________ Month/Year of Exposure: ________________________

Assessment Nursing Diagnosis Planning Intervention Rationale Evaluation

(at least 10)
Subjective: Problem, Etiology, Short Term Goal: Independent: Short Term Goal Evaluation
Signs S.M.A.R.T. + Evidence  Assessment
“Madali pong mawala (P.E.S.) format After 8 hours of nursing
yung attention ko sa After 8 hours of nursing -Assess patient feelings relative - Help to identify precipitating intervention, the goal was fully
kausap ko, minsan Impaired social intervention, the patient to impaired social interaction. factors/stressors. met. The patient:
nga habang interaction rt the will be able to:
nagsasalita po sila patient’s manic state -Assess the pt in terms of -This improvement will stimulate - Identified barriers that
bigla nalang po ako secondary to imbalances - Identify barriers identifying and developing areas her to be in more positive social impair social interaction.
mananahimik tapos in the patient’s that impair social of personal strength and positive. behavior. - Verbalized willingness to
mamaya magdadaldal biochemical/neurological interaction. be involved with others.
uli ako” as verbalized processes as evidenced - Verbalize
by the patient. by poor interactions with willingness to be  Therapeutic
others, inability to form involved with
meaningful relationships others. -Establish therapeutic nurse-client -Promoting trust, allows client to
and poor attention span. relationship. discuss sensitive matters freely.

-Provide the pt. with a calming -fewer stimuli mean lesser

environment with fewer stimuli, distractibility and lesser trigger
such as an environment with dim for manic episodes.
light and soft music.
Objective: INFERENCE Long Term Goal: Long term Goal Evaluation
(at least 5) Scientific Explanation S.M.A.R.T.+ Evidence -Provide positive reinforcement -Positive reinforcement enhances
(Diagram Form) for client’s voluntary interactions self-esteem and encourages After 2-3 days of nursing
After 2-3 days of nursing with others. repetition of desirable behaviors. intervention, the goal was fully
-31 yr old female. Bipolar Disorder intervention, the patient met. The client:
-She’s on her second will be able to:
marriage.  Educative - Verbalized thoughts when
-Her speech became - Verbalize thoughts -When less manic, exposing they become
impossible to when they become -Encourage patient to involve patients to social situations helps
uncontrollable.
understand. themselves in activities that develop his/her social skills.
Impairs the ability to uncontrollable. - Participated in doing
-She’s having require social interaction when However, this should be done
function at work and - Participate in doing activities without
hallucinations about less manic. non-competitively as competition
interact socially activities without manifesting inappropriate
the movie stars. stimulates aggressive behavior
manifesting behaviors.
and may trigger manic episodes.
inappropriate
History:
behaviors.
-Had episodes of
depression occurred -Encourage solitary activities such -Solitary activities help release
when the pt was a Poor interactions with as writing, taking photos, painting stress and minimize triggers for
junior high school. others, inability to form or walking. manic episodes and distractibility.
-She led to psychiatric meaningful relationships
admissions at 15 and and poor attention span.
19 y/o. Dependent:
-Pt. was treated with  Assessment
antidepressants and
psychotherapy. Check the doctor’s order -To ensure the client’s safety
-She has been in upon administering medications.
Impaired Social  Therapeutic
several detoxification
Interaction
centers for alcohol
abuse. -Administer Lithium as - Lithium was found be effective
-She was diagnosed
with bipolar disorder 6
yrs ago.
-She went to a
terrible depression
after she had her
third baby.
-She’s taking lithium
ever since until now.

VS:
Temp – 37 C
BP – 120/80 mmHg
RR – 20 cpm
CR: 100 bpm
O2 Sat – 99%

prescribed. in treating acute manic and

depressive episodes, as well as in
reducing the recurrence of mood
episodes and minimizing the risk
of suicidal behaviors

 Educative
-To have knowledge about the
-Explain to the patient the good administered medication.
effects and adverse effects of
medication.

Interdependent/Collaborative

 Assessment

-Review other pertinent -To reveal and prevent any

laboratory data (e.g., ABGs,
complete
blood count (CBC)); chest x-rays.
-Assess the patient’s need for
therapy such as psychotherapy.
further complications.
-The goal of psychotherapy is to
talk through mental health
concerns and help clients heal,
grow, and move toward more
Checked by: Date: ___________________

URDANETA CITY UNIVERSITY

San Vicente West, Urdaneta City, Pangasinan 2428

COLLEGE OF HEALTH SCIENCES

Bachelor of Science in Nursing

FDAR CHART

Name of Student: BUENCONSEJO, JIRAH Year Level and Group: 2ND YEAR – GROUP A

DATE/TIME FOCUS DATA, ACTION AND RESPONSE

 DATA:

06/18/2022 Impaired Social Interaction - “Madali pong mawala yung attention ko sa kausap ko, minsan nga habang
nagsasalita po sila bigla nalang po ako mananahimik tapos mamaya magdadaldal uli
ako” as verbalized by the patient.
- 31 yr old female; She’s on her second marriage.
0800 - Her speech became impossible to understand.
- She’s having hallucinations about the movie stars.
- VS: Temp – 37 C, BP – 120/80 mmHg, RR – 20 cpm, CR: 100 bpm, O2 Sat – 99%
- Had episodes of depression occurred when the pt was a junior high school.
- She led to psychiatric admissions at 15 and 19 y/o.
- Pt. was treated with antidepressants and psychotherapy.
- She has been in several detoxification centers for alcohol abuse.
- She was diagnosed with bipolar disorder 6 yrs ago.
- She went to a terrible depression after she had her third baby.
- She’s taking lithium ever since until now.

ACTION:

- Assess patient feelings relative to impaired social interaction.

- Establish therapeutic nurse-client relationship.
- Provide the pt. with a calming environment with fewer stimuli, such as an
environment with dim light and soft music.
- Encourage patient to involve themselves in activities that require social interaction
when less manic.
0004 - Administer Lithium as prescribed.
RESOLUTION:

- The client verbalized thoughts when they become uncontrollable.

- The client participated in doing activities without manifesting inappropriate
behaviors.