subjective: Palaging gutomang baby kokaya iyak ngiyak as verbalized by thepatient Objective:>the babydoesnt respondto other comfortmeasures givenby

the mother Breastfeeding,ineffective r/tunsatisfactoryfeeding processInability todemonstrateproper breastfeedingtechnique(STG) After 8 hours of NursingIntervention,the baby will beable to stopcrying ad willshowsatisfactoryresponse tobreastfeedingprocess(LTG) After a coupleof months of NursingIntervention,the baby willgain weight andwill receiveadequateamount of milk supply.(Independent)>Explain the benefitsof breast feeding, themechanisms involvein lactation, theproper breast careand most especiallythe proper breastfeeding position.>Assist thebreastfeeding processas needed> Increase fluidintake>Discuss theimportance of adequate nutritionduring lactation>to promotebreast feedingbecause breastmilk contains allthe necessarynutrients a babyneeds for the first6 months of life>to promotebonding betweenmother and child>Breastfeedingdelays ovulationand therefore thepossibility of anotherpregnancy>Breastfeedinghelps stopbleeding afterdeliveryThe motherunderstands theimportance andbenefits of breastfeeding anddemonstratesproper breastfeeding technique.(The goal wascompletely met)

Routes and Dosage of Ferrous Sulfate

Deficiency
PO: ADULTS, ELDERLY: 2-3 mg/kg/day or 50-100mg elemental iron 2 time/day up to 100mg 4 time/day. CHILDREN: 3 mg/kg/day elemental iron in 1-3 divided doses.

Prophylaxis
PO: ADULTS, ELDERLY: 60-100 mg elemental iron/day. CHILDREN: 1-2 mg/kg/day elemental iron. Maximum: 15 mg elemental iron/day.

Action of Ferrous Sulfate

Ferrous Sulfate is an essential component in the formation of hemoglobin, myoglobin and enzymes. It is necessary for effective erythropoiesis and transport or utilization of oxygen.

Side Effects and Adverse Reactions of Ferrous Sulfate

Side Effects of Ferrous Sulfate
y y y y y

Mild, transient nausea Heartburn Anorexia Constipation Diarrhea

Adverse Reactions of Ferrous Sulfate

y y

Large doses may aggravate peptic ulcer, regional enteritis, and ulcerative colitis. Severe Iron Poisoning:

o o o o o o o

Vomiting Severe abdominal pain Diarrhea Dehydration Hyperventilation Pallor or cyanosis Cardiovascular collapse

Nursing Considerations for Clients Taking Ferrous Sulfate

y y y y y y y y y

Store all forms at room temperature. Give between meals with water but may give with meals if gastrointestinal discomfort occurs. Transient staining of mucous membranes and teeth will occur with liquid iron preparation. To avoid, place liquid on the back of the tongue with dropper or use straw. Avoid simultaneous administration of antacids or tetracycline. Do not crush sustained-release preparations. Eggs and milk inhibit absorption. Monitor serum iron, total iron-binding capacity, reticulocyte count, hemoglobin, and ferritin. Monitor daily pattern of bowel activity and stool consistency. Assess for clinical improvement, record of relief of symptoms (fatigue, irritability, pallor, paresthesia, and headache).

Patient Teachings for Clients Taking Ferrous Sulfate

y y y

Expect stools to darken in color. If gastrointestinal discomfort occurs, take after meals or with food. Do not take within 2 hours of antacids because it rpevents absorption.

Ferrous sulfate
Generic Name: Ferrous sulfate Trade Name: Classification: Iron Preparation Dose, Route, PO freq: BID

MECHANISM OF ACTION

Elevates the serum iron concentration which then helps to form High or trapped in the reticuloendothelial cells for storage and eventual conversion to a usable form of iron. INDICATIONS Prevention and treatment of iron deficiency anemias. Dietary supplement for iron. CONTRAINDICATIONS Hypersensitivity Severe hypotension. ADVERSE EFFECT Dizziness N&V Nasal Congestion Dyspnea Hypotension CHF MI Muscle cramps Flushing NURSING RESPONSIBILITIES Advise patient to take medicine as prescribed. Caution patient to make position changes slowly to minimize orhtostatic hypotension. Instruct patient to avoid concurrent use of alcohol or OTC medicine without consulting the physician. Advise patient to consult physician if irregular heartbeat, dyspnea, swelling of hands and feet and hypotension occurs. Inform patient that angina attacks may occur 30 min. after administration due reflex tachycardia. Encourage patient to comply with additional intervention for hypertension like proper diet, regular exercise, lifestyle changes and stress management.