PHINMA University of Pangasinan

Report of Clinical and Case Studies Development

Presented To
Ma’am Maria Rowena Via Lucena
Ma’am Arlene Dacanay
Ma’am Kathrina Luiza Menor
Ma’am Violeta Castillo Gutierrez
Ma’am Angelie Grace Ballesteros Bartolome

TEAM MEMBERS
Aguinaldo, Maria Casandra M.
Amago, Jhulliana Cassandra Joy S.
Aritcheta, Mae Louise G.
Bandong, Krizandra Xia F.
Cabasag, Maebelyn M.
David, Dheserie V.
Dela Cruz, Cassandra Grace M.
Erasquin, Kristel B.
GROUP 1 CASE STUDIES: VERSIONS
Mrs. Teresita Aquino a 31 years old pregnant woman at 36 weeks gestation
admitted to the hospital. The woman is known for having a twin pregnancy and
throughout her pregnancy, she had experienced significant nausea and vomiting.
On examination her blood pressure is 110/80, pulse rate is 80 bpm, respiratory
rate is 18 bpm and fundal height is 41 cm. Ultrasound reveals a concordant
growth of the twin, twin pregnancy with dividing membranes with adequate
amniotic fluid, twins are presenting vertex to vertex, and lastly ultrasound
finding shows consistent with vasa previa.
INTRODUCTION
Good Afternoon, Ma’am. We are the Group 1 and we would like to present to
you for today is our NCP’s and Drug Studies. Before presenting, I’ll begin by
explaining the patient’s profile and our case study. Followed by our NCP’s and
Drug Studies.
PATIENT’S PROFILE
NAME: Teresita Aquino DATE OF ADMISSION: Feb. 22, 2021
AGE: 31 yrs. old TIME OF ADMISSION: 2:00 pm
ATTENDING PHYSICIAN: Dr. Claridad
GENDER: Female
DATE OF BIRTH: Jan. 15, 1990
MARITAL STATUS: Married
ADDRESS: Dagupan City, Pangasinan
OCCUPATION: House wife
RELIGION: Roman Catholic
HOBBIES: Cooking and reading books
7 NCP’s
NCP 1
NURSING
ASSESSMENT NURSING DIAGNOSIS PLANNING INTERVENTIONS RATIONALE EVALUATION
ANALYSIS
 
Impaired tissue perfusion Vasa previa may lead to Short Term: Independent: Independent: Short Term:
Subjective Data: decrease perfusion due After 8 hours of nursing
related to decreased blood
to the umbilical cord’s intervention, the client will 1. Advise the client to have a 1. Reduces the risk of bleeding After 8 hours of nursing
“Nakakaramdam po ako ng flow
blood vessel being be able to verbalize pelvic rest which means and infection. And that it will intervention, the client was
pagkahina “ as verbalized by keep the client’s higher-risk able to verbalized
the patient compressed by the understanding of risk factors no sexual intercourse or
pregnancy as safe as possible understanding of risk factors or
presenting part of the or condition, therapy pelvic exam
  fetus. regimen and when to contact condition, therapy regimen,
healthcare 2. This is to examine the side effects of medications, and
2.  Encourage client to go to
Objective Data: clinic for ultrasound developing of the fetus and when to contact healthcare
  looks for other birth detects
 V/S taken as follows: as well as the problems  
BP: 110/60 mmHg Long Term: with the mother Long Term:
HR: 80 bpm After 72 hours of nursing 3. Check vaginal discharge for After 72 hours of nursing
intervention, the client will 3. Dark colored blood means intervention, the client was
FHR: 160 to 180 any signs of bleeding
be able to comply with fetal hemorrhage—less able to comply with prenatal
bpm
prenatal check-ups and oxygen from the baby check-ups and follow doctor’s
follow doctor’s advice to advice to allow the pregnancy
allow the pregnancy to 4. Encourage health teaching 4. To allow pregnancy to to progress and to increase
progress and to increase such as bed rest and follow progress and to increase chances for fetal survival
chances for fetal survival up check up chances for fetal survival
Dependent: Dependent:
5. Betamethasone can help
5. Administer steroids such as speed up fetal lung maturity
Betamethasone as prescribed
by doctor
 

BANDONG, KRIZANDRA XIA F.

 NCP 2
ASSESSMENT NURSING DIAGNOSIS NURSING ANALYSIS PLANNING INTERVENTIONS RATIONALE EVALUATION

Subjective:
  Risk for fetal Vasa previa is an incredibly rare,
  hemorrhage related to but severe, complication of
  vasa previa pregnancy. In vasa previa, some
Objective: of the fetal umbilical cord blood
  vessels run across or very close to
BP: 110/70 mmHg the internal opening of the cervix.
PR: 80 bpm These vessels are inside the
RR: 18 bpm membranes, unprotected by the
Fundal height: 41 cm umbilical cord or the placenta. As
such, they are at risk of rupturing
when the membranes break.
Short term goal: 1. Assess the vital signs 1. Assess wellbeing of the
 After implementing
nursing intervention, 2. Monitor fetal heart rate
the baby will be free
from any signs of 3. Pelvic rest is suggested
distress or hemorrhage 2. Detect abnormal
  4. Deliver the baby before
  rupture of the membrane
Long term goals:
 After implementing 5. Administer antenatal 3.
corticosteroids
nursing intervention,
the baby will deliver
safely 6. Planned cesarean delivery
  between 34-37 weeks of
gestation 4.
7. Negative blood should be
available 5.
 
 
  6.
Short term goal:
mother and detect  After implementing
nursing intervention,
underlying health
the baby is now free
problems from any signs of
hemorrhage
 
responses which indicate  
hypoxia or distress Long term goals:
 After implementing
It is often suggested nursing intervention,
which means that the baby is now
nothing should be delivered safely
placed in vagina
 
This can cause the baby
to lose a lot of blood
Helps the baby’s lungs
in case need to be
delivered early
In order to prevent the
rupturing of fetal blood
vessel

7. In case of severe
anemic neonate
 
 

AMAGO, JHULLIANA CASSANDRA JOY S.

NCP 3
ASSESSMENT NURSING DIAGNOSIS NURSING ANALYSIS PLANNING INTERVENTIONS RATIONALE EVALUATION

         
Subjective data: “Bigla na Impaired fetal gas exchange r/t Placenta previa is the After 8 hours of nursing Independent: Provides baseline data on
lang ako dinugo” as development of placenta in the   maternal blood loss. After 8 hours of nursing
altered blood flow and interventions, the patient will
vervbalized by the patient lower uterine segment, •Assess vital signs (pulse,   interventions, the patient was
decreased surface area of gas verbalize understanding of able to verbalize understanding
  exchange at site of placental partially or completely causative factors and respirations, and blood • Systemic rest is mandatory
Objective data: covering the internal cervical pressure every 15minutes). and important throughout all of causative factors and
detachment. appropriate Interventions. appropriate interventions
  os. The cause is unknown, but   phases of disease to reduce
VS: a possible theory states that the •Maintain bed rest or chair rest fatigue, and improve strength.
BP: 110/70 embryo will implant in the when indicated. Provide  
PR: 80 bpm lower uterine segment if the frequent rest periods and •Provide objective evidence
RR: 18 bpm deciduas in the uterine fundus uninterrupted night time sleep. of bleeding.
FUNDAL HEIHGT: 41 cm is not favorable. Complications    
CERVIX: 4cm are immediate hemorrhage •Monitor amount and type •To promote placental
FHR: 140 bpm shock, and maternal death; of bleeding. perfusion.
fetal mortality; and postpartum    
hemorrhage. •Position mother on her left •Prevent stearing of placenta
side. if placenta previa is the cause
  of bleeding.
•Restrict vaginal examination.  
   
•Monitor uterine contractions •Assess whether labor is
and fetal heart rate by external present and fetal status and
monitor. external system avoids cervical
  trauma.
•Maintain positive attitude  
toward about fetal outcome. •Supports mother and child
bonding.
 
•Provides adequate fetal
oxygenation despite of lowered
maternal circulating volume

DAVID, DHESERIE V.
NCP 4
ASSESSMENT NURSING DIAGNOSIS NURSING ANALYSIS PLANNING INTERVENTIONS RATIONALE EVALUATION

Subjective: “ Nurse, I feel
Nauseous and Thirsty” as
stated by the Mother
Objective:
VS are taken as follows:
BP: 110/70 mmHg
RR: 18bpm
PR: 80bpm
Fundal Height: 41cm
Deficient Fluid Volume as Deficient Fluid Volume
evidenced by Nausea and (also known as Fluid
Vomiting Volume Deficit (FVD),
hypovolemia) is a state or
condition where the fluid
output exceeds the fluid
intake. It occurs when the
body loses both water and
electrolytes fro m the ECF
in similar proportions.
Common sources of fluid
loss are the gastrointestinal
tract, polyuria, and
increased perspiration.
After a 4 hours of Nursing INDEPENDENT:
Intervention, the Patient will 1. Monitor and document vital
be able to:
LONG TERM: 2.
1. Demonstrates lifestyle
changes to avoid
progression of
dehydration
3.
2. Patient verbalizes
awareness of causative
factors and behaviors 4.
essential to correct fluid
deficit.
3. Patient explains measures 5.
that can be taken to treat
or prevent fluid volume
loss. 6.
4. Patient describes
symptoms that indicate
the need to consult with
health care provider.
signs, especially BP and HR.
Monitor active fluid loss from
wound drainage, tubes,
diarrhea, bleeding, and
vomiting; maintain accurate
input and output record.
Urge the patient to drink the
prescribed amount of fluid.
Assess skin turgor and oral
mucous membranes for signs
of dehydration.
Note the presence of nausea,
vomiting, and fever.
Monitor BP and HR for
orthostatic changes
1. A decrease in circulating blood
volume can cause hypotension
and tachycardia. Alteration in HR
is a compensatory mechanism to
maintain cardiac output. Usually,
the pulse is weak and irregular if
electrolyte imbalance also
occurs. Hypotension is evident in
hypovolemia.
2. Fluid loss from wound drainage,
diarrhea, bleeding, and vomiting
cause decreased fluid volume and
can lead to dehydration.
3. Oral fluid replacement is
indicated for mild fluid deficit
and is a cost- effective method
for replacement treatment.
4. Signs of dehydration are also
detected through the skin.
5. 5.These factors influence intake,
fluid needs, and route of
replacement.
6. A common manifestation of fluid
loss is postural hypotension. It is
manifested by a 20-mm Hg drop
in systolic BP and a 10 mm Hg
drop in diastolic BP.
After a 4 hours of Nursing
Intervention, the Patient has:
1. Demonstrated lifestyle
changes to avoid
progression of dehydration
2. Patient verbalized
awareness of causative
factors and behaviors
essential to correct fluid
deficit.
3. Patient explained
measures that can be taken
to treat or prevent fluid
volume loss.
4. Patient described
symptoms that indicate the
need to consult with health
care provider.

ARITCHETA, MAE LOUISE G.

NCP 5
ASSESSMENT NURSING DIAGNOSIS NURSING ANALYSIS PLANNING INTERVENTIONS RATIONALE EVALUATION

Subjective data: Deficient Fluid Volume r/t Placenta Previa refers to the Short term goal: Independent: To obtain baseline data Patient will able to
“Bigla na lang sumakit ang Active Blood Loss Secondary to presence of placental tissue that  Administer Tocolytics to delay   Provides information about understand the cause of
tiyan ko” as vervbalized by the Disrupted Placental your delivery for a short time Monitor Vital Signs active bleeding versus old blood, bleeding and the both
extends over the internal tissue loss and degree of blood
patient Implantation cervical os. Because this can and Plan for C- Section and alsoAssess color, odor, consistency mother and baby are normal 
loss
  lead to severe antepartum, Decreased Bleeding and amount of vaginal bleeding;  
Objective data: intrapartum, and/or postpartum weigh pads Assessment provides
Woman present with a known Long term goal:   information about possible 
bleeding, placenta Previa is
twin gestation and ultrasound Upon discharge the patient will  Assess baseline data and note infection, placenta previa or
associated with high risks for changes. abruption. Warm, moist, bloody
finding consistent with Vasa be free from bleeding and
preterm birth and maternal and normal examination result   environment is ideal for growth
Previa, where a fetal vessel fetal/neonatal morbidity. of microorganisms.
Patient will maintain fluid Dependent/ collaborative:
overlies the internal cervical os volume at a functional level    
VS: possibly evidenced by adequate Monitor lab. Work as obtained:
BP: 110/70 Lab Work provides information
urinary output and stable vital Hgb & Hct, Rh and type, cross about degree of blood loss;
PR: 80 bpm signs. match for 2 units RBCs, prepares for possible
RR: 18 bpm urinalysis, etc. transfusion. Ultrasound provides
FUNDAL HEIHGT: 41 cm Scheduled for ultrasound as info about the cause of bleeding
CERVIX: 4cm ordered. Intervention increases available
EFFACED: 90%   O2 to saturate decreased
PRESENTING PART: Provide supplemental O2 as hemoglobin
VERTIX ordered via face mask or nasal
AFTER 2 HRS OF LABOR, cannula @ 10-12 L/min. 
THE PATIENT DILATES TO  
6 cm  
FHR: 140 bpm BASELINE
AND THEN INCREASES TO
170 bpm
 

ERASQUIN, KRISTEL B.
NCP 6
NURSING NURSING
ASSESSMENT PLANNING INTERVENTIONS RATIONALE EVALUATION
DIAGNOSIS ANALYSIS

Subjective: Risk of Uterus does not Short term goal: Independent:  For baseline data and to monitor the changes of vital Short term goal:
“Ilang araw na simula Postpartum contract strongly after 1-2 hours of  Monitor and record vital signs. signs After 1-2 hours of nursing
noong nanganak ako Hemorrhage enough nursing intervention, intervention, the goal met.
pero malakas pa rin related to Vasa   the patient will:  Assess and record the type, amount, and  The amount of blood loss will help to determine the  The patient was able to
ang pagdudugo ko” Previa.   site of the bleeding; Save all perineal pads appropriate replacement need of the patient. maintain blood pressure of at
Objective: Breaking of uterine  Maintain blood used during bleeding and weigh them to least 100/60 mm Hg.
 Confusion blood vessels pressure of at determine the amount of blood loss.  The degree of the contractility of the uterus will  The patient was able to
 Irritablity   least 100/60 measure the status of the blood loss. Placing one hand maintain a normal respiratory
Vital signs:   mm Hg.  Assess the location of the uterus and just above the symphysis pubis will prevent possible and heart rate.
B/P: 110/70 mm Hg  Maintain a degree of the contractility of the uterus/ uterine inversion during a massage. . The patient was able to
HR: 80 bpm Bleeding normal Massage boggy uterus using one hand and have a balanced 24-
RR: 18 bpm respiratory and place the second hand above the symphysis   hour intake and output
heart rate. pubis.  This will help in determining the management of the  
 Have a situation thus preventing further complications. Long term goal: After 3
balanced 24-  Review the records and note certain weeks of nursing intervention
hour intake conditions such as retained placental  This will help in determining the fluid loss. A urine the goal met.
and output. fragments, any laceration, abruptio placenta, output of 30-50 ml/hr or more indicates an adequate  The patient was able to
etc. circulating volume. identify behaviors and
  lifestyle changes to enhance
 Measure a 24-hour intake and output. The position increases venous return, making sure a recovery
Long term goal: greater availability of blood to the brain and other vital
After 1 week of Maintain a bed rest with an elevation of organs. Bleeding may be decreased with the bed rest.
nursing intervention, the legs by 20-30° and trunk horizontal.
the patient will:  Treatment options include drugs to increase muscle
Dependent: contraction. It is suggested that prophylactic
Identify be  Administer prescribed medication. administration of a uterotonic will help to reduce blood
haviors and loss and blood transfusion. Also, drugs to help with
lifestyle  Notify other healthcare providers. blood clotting.
changes to
enhance Nurses and other healthcare workers must be aware
recovery. of the typical physiologic and psychological changes
that occur in women's bodies and minds
following birth in order to offer comprehensive care
throughout this time.

CABASAG, MAEBELYN M.
NCP 7
NURSING NURSING
ASSESSMENT PLANNING INTERVENTIONS RATIONALE EVALUATION
DIAGNOSIS ANALYSIS
SUBJECTIVE:     Short term: After 1-2 INDEPENDENT:   Short term:
“Nurse, bigla na lang Risk for fetal Vasa previa occurs hours of nursing The goal met
akong dinugo pero death related to when fetal blood intervention, the 1) Monitor the vital signs of the twin fetus. 1. To obtain baseline status of fetal well-being. Assess the  
hindi ko naramdaman. the presence of vessels that are following must be Auscultate and report FHR; note degree of fetal hypoxia. Initial response of a fetus to Short term: After 1-2 hours of
Masyadong mapula na vasa previa unprotected by the attained: bradycardia or tachycardia. Note change in decreased oxygenation is tachycardia and increased nursing intervention, the
may halong itim ang umbilical cord or hypoactivity or hyperactivity. movements. A further deficit will result in bradycardia and following was attained:
kulay ng nailabas placenta run through  Plan for decreased activity. Non-reassuring findings need
the amniotic immediate 2. Assess the condition of the twin fetus and immediate intervention.  Had an emergency
kong dugo” as do a prenatal monitoring.
membranes and Cesarean Section Cesarean Section.
verbalized by the traverse the cervix. 2. Assessing the conditions may help to identify the
patient.  The babies will 3. Observe for the possible complications  The babies are safely
These vessels may be delivered contributing factors. Prenatal monitoring may help to delivered.
  rupture if the that might occur in the condition of vasa detect cord compression and determine whether the fetus
safely. previa (such as fetal bleeding, prolapsed  There were no
OBJECTIVE: membranes break, is in distress.
 There will be no cord, fetal distress etc). Record the findings indicators of fetal
The woman has a resulting in fetal indicators of fetal and report it immediately to the physician. 3. Early observation could be beneficial to recognize the distress for the
known twin gestation bleeding,
distress for the possible risk that might complicate the condition of the newborns.
and has an ultrasound exsanguination, or
possibly death. newborns 4. Encourage the mother to do an early and twin fetus. Reporting the findings may help to formulate a
findings with vasa Long term:
previa. frequent ultrasound examination. good care plan.
Long term: After 3-4 The goal met.
  days of nursing 5. Do a complete physical exam to the  
4. To assess the fetus, detect certain abnormalities and
VITAL SIGNS intervention, the neonates after birth for signs of problems or Long term: After 3-4 days of
determine the possible complications early.
BP- 110/70 mmHg following must be complications. nursing intervention, the
PR- 80 bpm attained: 5. Assessing the neonates after birth is relevant to identify following was attained:
RR- 18 bpm DEPENDENT: their well-being. Finding any problems could help the
Fundal Height: 41 cm  Upon discharge, healthcare provider to plan the best possible care.  Upon discharge, the
the newborns’ 5. Administer corticosteroids. newborns’ examination
Cervix: 4 cm and after
2 hours of labor, examination 6. Pelvic rest may be advised (avoiding sex 5. Steroids may help to mature the baby’s lungs in case findings were normal
dilates to 6 cm findings will be or putting anything in your vagina). they need to be delivered early.
normal.  
Effacement: 90%
COLLABORATION: 6. Pelvic rest may help to avoid risks and complications.
Presenting Part:
 
Vertex/vertex 7. Vaginal delivery can pinch the blood vessels which cuts
7.) Perform immediate Cesarean Section
FHR: 140 bpm   off the blood flow to the baby. Cesarean Section is
delivery.
increases to 170 bpm preferred to help the woman avoid dangerous delivery-
    room situations and can be a lifesaver in an emergency.

   

DELA CRUZ, CASSANDRA GRACE M..

6 DRUG STUDIES
DRUG STUDY 1
         
NAME OF DRUG MECHANISM OF ACTION CONTRAINDICATIONS SIDE EFFECTS/ADVERSE EFFECTS NURSING RESPONSIBILITIES
 
Antenatal betamethasone Hypersensitivity, active infection or The most common side effects of Celestone 1. Explain to women the potential benefits of
primarily used to speed up systemic fungal or acute infections. Soluspan include: corticosteroid administration to the pre term
lung development in neonate
 headache,
GENERIC NAME: preterm fetuses. It
stimulates the synthesis  depression, 2. Explain that drug cannot prevent or lessen
and release of surfactant the severity of all complication of
BETHAMETHASONE which lubricates the lungs  mood swings, prematurity
allowing the air sacs to  sleep problems (insomnia),
BRAND NAME: slides against one another 3. If they have diabetes explain more frequent
without when the infant  numbness, blood glucose testing needed
breathes. tingling,
CELESTONE SOLUSPAN 
4. Assess serum electrolyte levels for sodium
 burning pain, and potassium imbalances

CLASSIFICATION:  skin redness,

5. Advise patient to report signs and symptoms
 itching, of infection
CORTICOSTEROID
 skin discoloration, 6. Caution patient not to stop taking drug
 thinning skin, abruptly
INDICATION:
 stretch marks, 7. Tell patient to report visual disturbances
Acceleration of fetal lungs  muscle weakness, (long-term drug use may cause cataracts)
to reduce the incidence Instruct patient to eat low-sodium, high
and severity of respiratory  nausea, potassium diet
distress syndrome
DOSAGE & FREQUENCY  bloating, and
 stomach pain
0.5 to 9 mg I.M or I.V of
betamethasone sodium
phosphate and
betamethasone acetate
suspension
 DRUG STUDY 2
         
NAME OF DRUG MECHANISM OF CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS NURSING RESPONSIBILITIES
  ACTION

RIC NAME A single course of PREDNISONE Some notable side effects are: Serious side effects of prednisone may 1. Tell patient to take with food or milk
corticosteroids has been is contraindicated to: Weight gain include: to reduce GI upset
dnisone shown to help with a   Dizziness Allergic reactions
ND NAME baby’s development and Hypersensitivity to drug, other Muscle weakness Cardiovascular problems 2. Teach patient to recognize and
corticosteroids, alcohol, Increased hair growth Decrease in bone density immediately report signs and
erapred therefore will increase the
bilsulfite, or tartrazine (with Acne Eye damage symptoms of early adrenal
chance of your baby
SIFICATION surviving, once born. It
some products) Mood changes Fetal toxicity insufficiency and cushingoid effects
Systemic fungal infections Difficulty sleeping High blood sugar
ticosteroid also lessens the chance of Live virus vaccines (with Increased risk of GI perforation 3. Inform patient that drug increases hid
diate acting), your baby having serious immunosuppressant doses) Increased risk of infection risk of infection. Instruct him to
complications after birth
coid, Hormone such as breathing
Active untreated infections Severe depression contact prescriber at first sign of
(except in selection meningitis Shifting body fat infection
ICATION problems owing to the patients) Skin problems
lungs not being fully 4. Caution patient not to stop drug
oid therapy in developed, bleeding into suddenly. Advise him to discuss any
s appropriate to the brain, serious infection changes in therapy with prescriber
cally active or bowel inflammation.
ness; to treat an 5. Tell patient to immediately report
bleeding or joint, muscle, tendon, or
ant suffering abdominal pain
tal lupus-
carditis; in stress 6. Advise patient or significant other to
orticosteroid- immediately report depression or
ents) for labor psychosis
y: and, pre-
induce fetal
ation.

& FREQUENCY
DRUG STUDY 3
NAME OF DRUG
GENERIC NAME
Magnesium Sulfate
BRAND NAME
Epsom Salt
CLASSIFICATION
Anticonvulsant
INDICATION
To prevent/ control seizure in
pre-eclampsiaTo manage
preterm labor
DOSAGE & FREQUENCY
Dosage:Pre-eclampsia
woman: 4g IV in 250mL D5W
with normal saline and 4-5 g.
deep IM into buttock
alternate in every 4hrs., P.R.N
4g I.V. Lodding dose then 1-2
q hr. as I.V infusion. Dose
should not exceed 30-40 g.
daily
MECHANISM OF ACTION
Magnesium is the second most
plentiful cation of the intracellular
fluids. It is essential for the activity of
many enzyme systems and plays an
important role with regard to
neurochemical transmission and
muscular excitability. Magnesium
sulfate reduces striated muscle
contractions and blocks peripheral
neuromuscular transmission by
reducing acetylcholine release at the
myoneural junction. Additionally,
Magnesium inhibits Ca2+ influx
through dihydropyridine-sensitive,
voltage-dependent channels. This
accounts for much of its relaxant
action on vascular smooth muscle.
CONTRAINDICATIONS
Parenteral administration
contraindicated inpatient with heart
block myocardial damage.
Use cautiously inpatients with impaired
renal function.
Use cautiously in pregnant woman
during labor.
SIDE EFFECTS/ADVERSE EFFECT
CNS: drowsiness, depress reflexes,
placid paralysis, hypothermia
 
CV: hypotension, arrhythmias,
circulatory collapse,
GI: nausea, vomiting, cramps,
flatulence, anorexia
 
Skin: diaphoresis
NURSING RESPONSIBILITIES
1. When giving prolonged or
repeated I.V infusions, assess
patellar reflex and monitor for
respiratory rate of 15
breaths/minute or more
2. With I.V use, monitor blood
magnesium level. Check for signs
and symptoms of magnesium
toxicity (hypotension, nausea,
vomiting, mental or respiratory
depression)
3. Monitor electrolyte levels and
liver function tests
4. Teach patient about adverse
reactions. Instruct him to report
symptoms that occur during I.V
administration
5. Tell pregnant female to make sure
prescriber knows she’s pregnant
before taking drug
DRUG STUDY 4
         
NAME OF DRUG MECHANISM OF ACTION CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS NURSING RESPONSIBILITIES
 
GENERIC NAME The mechanism of action of Use of DICLEGIS is Drowsiness  Somnolence 1. Inform women to avoid engaging
Doxylamine succinate DICLEGIS is unknown. contraindicated in women who Stomach upset Falls or other accidents in activities requiring complete
are taking monoamine oxidase Diarrhea resulting from the effect of the mental alertness, such as driving or
BRAND NAME inhibitors (MAOIs), which Constipation combined use of DICLEGIS operating heavy machinery, while
Diclegis prolong and intensify the  Headache with CNS depressants using DICLEGIS until cleared to
anticholinergic (drying) effects Insomnia including alcohol do so.
CLASSIFICATION of antihistamines. Concurrent use Blurred Visions
Diclegis is Classified as a of alcohol and other CNS Shortness of Breath 2. Inform women of the importance of
depressants (such as hypnotic Vertigo not taking DICLEGIS with alcohol
Miscellaneous sedatives and tranquilizers) with Bloating or sedating medications, including
Antiemetics DICLEGIS is not recommended. other antihistamines (present in
some cough and cold medications),
INDICATION opiates and sleep aids because
DICLEGIS is a fixed dose somnolence could worsen leading
combination drug to falls or other accidents.
product of doxylamine 3. Inform women to Do not drink
succinate, an alcohol, or take other central
antihistamine, and nervous system depressants such as
pyridoxine cough and cold medicines, certain
pain medicines, and medicines that
hydrochloride, a Vitamin help you sleep while you take
B6 analog, indicated for DICLEGIS. Severe drowsiness can
the treatment of nausea happen or become worse causing
and vomiting of falls or accidents.
pregnancy in women  
 
who do not respond to
conservative
management.

DOSAGE & FREQUENCY

Route: ORALDosage and
DRUG STUDY 5
         
NAME OF DRUG MECHANISM OF ACTION CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS NURSING
  RESPONSIBILITIES
GENERIC NAME   Terbutaline sulfate is For the mother Cardiovascular: 1. Assess vital signs: Baseline
Terbutaline Terbutaline is a bronchodilator, a contraindicated in patients Since terbutaline is related to increased heart rate, cardiac pulse and BP and before
medication that dilates (expands) known to be hypersensitive to hormones released in the fight- arrhythmias, pulmonary edema, each dose. If significantly
BRAND NAME air passages in the lungs. It sympathomimetic amines or any or-flight response, a woman and myocardial ischemia. altered from baseline level,
Bricanyl attaches to beta adrenergic component of this drug product. may experience the same   consult physician.
Immediate hypersensitivity effects when taking terbutaline Fluid and Electrolyte:
CLASSIFICATION receptors on muscles
reactions and exacerbations of as she does when under stress. hyperglycemia, hypokalemia 2. Tell patient he may take
surrounding the air passages,
Terbutaline is a beta-2 causing the muscles to relax and
acute bronchospasm have been Many women experience: with or without food.
adrenergic agonist used reported after terbutaline a racing heartbeat
dilate the air passages. Wider air administration. myocardial ischemia 3. Advise patient or parents to
as a bronchodilator and passages allow more air to flow skin flushing establish effective bedtime
to prevent premature in and out of the lungs. transient hyperglycemia routine to minimize
labor. hypokalemia insomnia.
Tremors
Restlessness 4. Instruct patient or parents
INDICATION   to space doses evenly
For the baby during walking hours, to
Terbutaline can cause a avoid taking drug at
Terbutaline is approved temporary increase in the bedtime.
to prevent and treat baby’s heart rate and blood
bronchospasm sugar levels. These side effects 5. Review all other significant
usually aren’t serious and are adverse reactions. 
DOSAGE & FREQUENCY easy to treat after delivery if  
they occur.

Initiate at 2.5-5
mcg/min IV. Increase
gradually as tolerated at
20-30-minute
intervalsTypical effective
dose ranges between
17.5-30 mcg/min IV;
some require doses up
to 70-80 mcg/min
DRUG STUDY 6
         
NAME OF DRUG MECHANISM OF CONTRAINDICATIONS SIDE EFFECTS ADVERSE EFFECTS NURSING RESPONSIBILITIES
  ACTION
GENERIC NAME   Hypersensitivity (including Rare side effects of Neurological:  
Carboprost is a synthetic anaphylaxis and andioedema) Carboprost: Headache, dystonia and 1. Monitor frequency, duration, and force of
Carboprost prostaglandin. It binds the Acute pelvic inflammatory Skin Rash dizziness. contractions and uterine resting tone. Notify
prostaglandin E2 receptor, disease. Paralysis of the intestines Gastrointestinal: the physician or other health care
causing mymometrial Patients with active cardiac, Slow and fast heartbeat. Vomiting, Nausea Dry
BRAND NAME contractions, causing the pulmonary, renal or hepatic Reaction at the site of throat and mouth, diarrhea
professional if contractions are absent or last
more than 1 minute.
induction of labour of the disease. injection.
Hemabate expulsion of the placenta. Psychiatric:
2. Monitor temperature, pulse and BP
Prostaglandins occur Anxiety and sleep
naturally in the body and act disorders. periodically throughout course of therapy.
CLASSIFICATION Large dose may cause hypertension.
several sites in the body
including the womb (uterus). Temperature elevation beginning 1 to 16 hr.
Therapeutic: They act on the muscles of after initiation of therapy and lasting for
Abortifications the womb, causing them to several hours is not usual.
Pharmacologic:Oxytocic contract.
3. Auscultate breath sounds. Wheezing and
s Pregnancy Category: C sensation of chest tightness may indicate
hypersensitivity reaction.
INDICATION
4. Assess for nausea, vomiting and diarrhea.
Hemabate is indicated Vomiting and diarrhea occur in
for the treatment of approximately two-thirds of patients.
postpartum Premedication with antiemetic and
antidiarrheal is recommended.
hemorrhage due to
uterine atony which has 5. Monitor amount and type of vaginal
not responded to discharge. Notify physician or other health
conventional methods care professional immediately if symptoms
of management. Prior of hemorrhage (increased bleeding,
treatments should hypotension, pallor tachycardia) occur.
include the use of  
intravenously
administered oxytocin,
manipulative techniques
such as uterine
REFERENCES
 Debra Rose Wilson et al. , Healthline, (2017,September 20), Terbutaline

https://www.healthline.com/health/pregnancy/preterm-labor-terbutaline

 Dr. Debra Rose Wilson, Healthline (2020 October 13), Corticosteroids

https://www.healthline.com/health/pregnancy/preterm-labor-adjunctive-therapy?fbclid=IwAR1slttuT5HyVDnm1hxlw3Qm5vaXGKH1xj0k89LfMn58YFt7LTn7glE
N--4#17-ohpc

 Drugbank, (2005, June 13), Carboprost

https://go.drugbank.com/drugs/DB00429prednisone (Rx)

 Highlights of Prescribing Information. (n.d.). (2013, September), Diclegis

https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021876s002lbl.pdf?fbclid=IwAR1CvCrk8imLwiEHLskjD6-iO01Y2rfHCqVn3_3UDAEwMyFwrgxui6
0j8Sg

 MIMS, (2020, January 21), Carboprost https://www.mims.com/philippines/drug/info/carboprost?mtype=generic

 Prednisone (Rx).Medscape (2019), Prednisone

https://reference.medscape.com/drug/prednisone-intensol-342747#90>

 Rugbank, (2005, June 13), Magnesium Sulfate

https://go.drugbank.com/drugs/DB00653

 Rxlist (2020 September 29), Celestone Soluspan

https://www.rxlist.com/celestone-soluspan-drug.htm?fbclid=IwAR02fqMbC9utnonG73-LH-Wu2DvfG8mb3hO8AZ5ySpn9eecVurUlwKY7GLg

 
REFERENCES
Scribd, Mark Keem Escuadrohttps, Magnesium Sulfate
https://www.scribd.com/document/130509176/Magnesium-Sulfate

 Scribd, (2017, January 23), Prednisone

https://www.scribd.com/document/337301438/Prednisone-Drug-Study

 Scrib, (2021, November 11), Carboprost

https://images.app.goo.gl/51beCPbi1sH9opFU6

 StudeerSnel B.V., StuDuco, (2022), Magnesium Sulfate

https://www.studocu.com/ph/document/university-of-perpetual-help-system-jonelta/nursing/drug-study/13905713

 Web MD, Prednisone

https://www.webmd.com/drugs/2/drug-6007-9383/prednisone-oral/prednisone-oral/details