VIII.

DRUG STUDY
DRUG ORDER Cefazolin 500 mg TIV q 8 for 3 days ANST (-) BRAND NAME Ceptaz PHARMACOLOGIC ACTION Bactericidal: Inhibits synthesis of bacterial cell wall, causing cell death. INDICATION/ CONTTRAINDICATION I: Treatment of infections caused by staphylococcus aureus. CI: Contraindicated with allergy to cephalosporins or penicillins. ADVERSE DESIRED REACTION ACTION CNS: headache, To treat dizziness, lethargy infection. GI: nausea, vomiting, diarrhea, anorexia, abdominal pain,flatulence GU: nephrotoxicity NURSING RESPONSIBILITIES Advise relatives to maintain normal fluid intake of the client while using this medication. Advise the relatives to report if severe diarrhea and difficulty of breathing occurs to the client. Instruct relatives to report signs of superinfection: black "furry" tongue, white patches in mouth, foul-smelling stools, vaginal itching or discharge. Advise the relatives to report if severe diarrhea, difficulty of breathing, rashes and mouth sores occur. Advise the relatives to finish entire course of therapy for the client.

Amikacin 100 mg TIV q 12o x 5 days ANST (-) Antibiotic

Bactericidal: Inhibits cell wall synthesis of sensitive organisms causing cell death.

I: Used to initiate treatment when a staphylococci infection is suspected. CI: Contraindicated with allergy to cephalosporins or penicillins.

CNS: lethargy, hallucinations, seizures GI: glossitis, gastritis, stomatitis, sore mouth

To treat infection.

Paracetamol 250 mg/tab q 6o prn for fever temp 37.8 c

Antipyretic

Thought to produce analgesia and reduce temperature by inhibiting synthesis of prostaglandin in CNS.

I: The drug is indicated for increased temperature. CI: Contraindicated in patient hypersensitive to drug.

Hematologic: Hemolytic anemia Leukopenia Neutropenia Hepatic: Jaundice Metabolic: Hypoglecemia Skin: Rash CNS: lethargy, hallucinations, seizures GI: glossitis, gastritis, stomatitis, sore mouth

To decrease temperature

y y

Advise parents that drug is for short term use only. Warn patient that dosages or unprescribed long term use can cause liver damage.

Ibuprofen 200 mg q 8 for pain

It works by blocking the action of a substance in the body called cyclooxygenase.

I: Indicated for relief of mild to moderate pain. CI: Contraindicated to patient s with hypersensitivity to drug.

For relief of mild y pain.

Advise the relatives to report if severe diarrhea, difficulty of breathing, rashes and mouth sores occur. Advise the relatives to finish entire course of therapy for the client.

NURSING CARE PLAN

Assessment

NURSING DIAGNOSIS Acute Pain r/t mechanical injury.

BACKGROUND KNOWLEDGE
It is described as an unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage. In cases of fracture, pain is continuous and increasing until bone fragments are immobilized.

GOALS AND OBJECTIVES After an hour of nursing interventions, the client will be able to show signs of pain relief.

NURSING INTERVENTIONS 1.Accept patients feeling of pain. Acknowledge the pain experience and convey acceptance of patients response to pain 2.Observe nonverbal cues/pain behaviors and other defining characteristics. 3.Monitor skin color/temperature and VS

RATIONALE

EVALUATION

Subjective: Minsan sumasakit pa rin yung sa may bandang bali ng anak ko.as verbalized by the father of the patient Objective: - shifting back and forth - grimace - client reassured by occasional touching

Pain is a subjective experience and cannot be felt by others

Observations may be the only indicator present when client is unable to verbalize

These are usually altered in acute pain which may help in the management of the problem. Promote nonpharmacological pain management To distract attention and reduce tension.

4.Provide comfort measures (touch, parents presence) 5.Provide diversional activities (TV, etc.)

After an hour of nursing interventions, the client has shown signs of pain relief y The client has stopped crying and has stayed calm y Underlyi ng cause of clients hyperthe rmia was attention, thus treated.

6.Administer analgesics, as indicated and as ordered

Analgesics are medications that reduces pain

Subjective: Iyan yung sugat ng anak ko di pa din gumagaling. As verbalized by the father of the patient. Objective: -wound in the right thigh

Impaired skin integrity related to mechanical injury secondary to surgery

Mechanical injury may result into a break in the continuity of skin due to intensity of trauma.

Long Term: After 3-4 days of nursing interventions, the client will show healing of wounds without signs and symptoms of complication

1.Assess skin lesion/wound for size, shape, consistency, texture, temperature, and hydration. 2.Keep the area clean/dry, carefully dress wounds, support incision, prevent infection, and stimulate circulation to surrounding areas. 3.Use appropriate barrier dressings, wound coverings, skin-protective agents. 4.Use appropriate padding devices when indicated.

Provide baseline Goals Met: data helpful in the management After 3-4 days of nursing of wound.
interventions, the client has shown healing of wounds without signs and symptoms of complication

Short term: After 6-8 hrs of nursing interventions of nursing interventions, the client will: y Have reduced risk of further impairment of skin integrity y Patients caregivers will have full understanding & skill in care of wound

This assists bodys natural process of repair.

To protect the wound and/or surrounding tissues. To reduce pressure on/enhance circulation to compromised tissues

After 6-8 hrs of nursing interventions of nursing interventions, the client: y Have reduced risk of further impairment of skin integrity y Patients caregivers had full understandin g & skill in care of wound.

5.Provide optimum nutrition including vitamins and increased protein intake

This provides a positive nitrogen balance to aid in skin/tissue healing and to maintain general good health
To reduce risk for further infection

6.Follow body substance isolation precaution; use clean gloves & clean dressing for wound care. Practicing proper hand washing before & after wound care.

Hematology Hemoglobin mass Hematocrite Leukocyte count Differential count Segmenters Lymphocytes Monocytes Eosinophils Plt.count Components MCV MCH MCHC

11/18/11 81 .24 11.90

11/20/11 88 .26 9.30

11/21/11 103 .31 11.80

Normal Value 110-158g/L .37-.51 4.5-10x109/L

.73 .19 .07 .01 383

.62 .31 .03 0.04 212

.54 .33 .02 .11 285

.50-.70 .20-.40 .00-.70 .00-.07 .00-.05

78 27 35

78 28 34

84 29 33

82-94 28-32 32-38%

Examination: Gram stain Specimen: Wound Result RBC :Few ;WBC :rare; Epithelial cells :rare ;no microorganism seen; no spore forming bacilli seen