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
“I don’t know how (P.E.S.) format After 8 hours of nursing
much longer I can go After 8 hours of nursing -Assess patient feelings relative - Help to identify precipitating intervention, the goal was fully
on like this. I’ve been Impaired social intervention, the patient to impaired social interaction. factors/stressors. met. The patient:
down in the dumps interaction rt lack of will be able to:
for years and it isn’t support system. -Assess the pt in terms of -This improvement will stimulate - Identified barriers that
getting any better. - Identify barriers identifying and developing areas her to be in more positive social impair social interaction.
I’ve lost everyone that impair social of personal strength and positive. behavior. - Verbalized willingness to
who has ever meant interaction. be involved with others.
anything to me. I’ve - Verbalize - Identified feelings that
disappointed my son willingness to be  Therapeutic
lead to poor social
to the point that involved with interactions.
he’ll never forgive me. others. -Establish therapeutic nurse-client -Promoting trust, allows client to
I’ve asked God to help - Identify feelings relationship. discuss sensitive matters freely.
me through this, but that lead to poor
it seems that He isn’t social interactions. -Provide the pt. with a calming -fewer stimuli mean lesser
listening. Now my environment with fewer stimuli, distractibility and lesser trigger
wife is telling me that such as an environment with dim for manic episodes.
I have Alzheimer’s. light and soft music.
Nothing is fun and I
don’t believe that life -Provide positive reinforcement -Positive reinforcement enhances
is worth living for client’s voluntary interactions self-esteem and encourages
anymore.” as with others. repetition of desirable behaviors.
verbalized by the
patient.
 Educative
-When less manic, exposing
-Encourage patient to involve patients to social situations helps
themselves in activities that develop his/her social skills.
require social interaction when However, this should be done
Objective: INFERENCE Long Term Goal: less manic. non-competitively as competition Long term Goal Evaluation
(at least 5) Scientific Explanation S.M.A.R.T.+ Evidence stimulates aggressive behavior
(Diagram Form) and may trigger manic episodes. After 7 days of nursing
After 7 days of nursing intervention, the goal was fully
-75 yo white male Lack of support system intervention, the patient met. The client:
-He has significant will be able to: -Encourage solitary activities such -Solitary activities help release
loss in early life when as writing, taking photos, painting stress and minimize triggers for - Verbalized thoughts when
his first wife died from - Verbalize thoughts or walking. manic episodes and distractibility. they become
stroke. when they become uncontrollable.
-Lack of social support uncontrollable. Dependent: - Participated in doing
Can contribute to
and moving from an - Participate in doing  Assessment activities without
emotional and physical
independent lifestyle activities without -To ensure the client’s safety manifesting inappropriate
health which can lead to
to one that is more manifesting Check the doctor’s order upon administering medications. behaviors.
isolation and loneliness
dependent on others: inappropriate - Stated and demonstrated
his current wife does  Therapeutic progress in the
behaviors.
not want him to - Lithium was found be effective resumption of sustaining
- State and
engage with Impairs the ability to -Administer Lithium as in treating acute manic and relationships with friends
demonstrate
neighbors, his son function at work and prescribed. depressive episodes, as well as in and family members.
and family and his ex- interact socially progress in the reducing the recurrence of mood
family. resumption of episodes and minimizing the risk
-Social isolation: he sustaining  Educative of suicidal behaviors
feels like he was relationships with
distancing himself friends and family -Explain to the patient the good
from family and Poor interactions with members. effects and adverse effects of -To have knowledge about the
friends that he had others, inability to form medication. administered medication.
known and loved for meaningful relationships
many years. and poor attention span.
Interdependent/Collaborative
History:
-He has no current  Assessment
non-psychiatric adult -To reveal and prevent any
illnesses and takes no -Review other pertinent further complications.
medications. Impaired Social laboratory data (e.g., ABGs,
-He was diagnosed Interaction complete
with rare eye disorder blood count (CBC)); chest x-rays. -The goal of psychotherapy is to
at age 54. talk through mental health
-He has never been -Assess the patient’s need for concerns and help clients heal,
treated for any therapy such as psychotherapy. grow, and move toward more
psychiatric illnesses. productive, psychologically
-He reports 15-year
healthy lives.
history of many
periods of intense  Therapeutic - By meeting their patients'
sadness, loneliness physiological and emotional
and guilt that have -Provide emotional support to the needs, they also improve the
lasted weeks to patient. healing process and help patients
moths.
feel safe and more empowered
-He has no dietary
with managing their own
restrictions and no
recovery.
surgeries.

VS:  Educative -To help them regarding their

Temp – 37 C mental state.
BP – 120/80 mmHg -Encourage the pt. to seek for
RR – 20 cpm professional help regarding their
CR: 100 bpm mental health.
O2 Sat – 99%
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:

09/07/2022 Impaired Social Interaction - ““I don’t know how much longer I can go on like this. I’ve been down in the dumps
for years and it isn’t getting any better. I’ve lost everyone who has ever meant
anything to me. I’ve disappointed my son to the point that he’ll never forgive me.
I’ve asked God to help me through this, but it seems that He isn’t listening. Now my
0800 wife is telling me that I have Alzheimer’s. Nothing is fun and I don’t believe that life
is worth living anymore.” as verbalized by the patient.
- 75 yo white male
- He has significant loss in early life when his first wife died from stroke.
- Lack of social support and moving from an independent lifestyle to one that is more
dependent on others: his current wife does not want him to engage with neighbors,
his son and family and his ex-family.
- Social isolation: he feels like he was distancing himself from family and friends that
he had known and loved for many years.
- VS: Temp – 37 C, BP – 120/80 mmHg, RR – 20 cpm, CR: 100 bpm, O2 Sat – 99%

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.
- Identified feelings that lead to poor social interactions.
- Stated and demonstrated progress in the resumption of sustaining relationships with
friends and family members.