Homework Help https://www.homeworkping.com/ Research Paper help https://www.homeworkping.com/ Online Tutoring https://www.homeworkping.com/ click here for freelancing tutoring sites OURLADY OF FATIMA UNIVERSITY College of Nursing Valenzuela City A Case Study On Pleural Effusion In Partial Fulfillment Of the course NCM 103 Submitted to: THFS 6:00 pm – 2:00 pm
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Inhibits the reabsorption of sodium and chloride from the ascneding limb of the loop of Henle, leading to a sodium-rich diresis
Acute Pulmonary edema
Contraindicated with allergy to furosemide, sulfonamides; allergy to tartrazine (in oral solution0; anuria,severe renal failure; hepatic coma; pregnancy; lactation
Hematologic: Leukopenia, anemia, thrombocytopenia, fluid and electrolyte imbalances, hyperglycemia
Other: Muscle cramps and muscle spasms
Adminiser with food or milk to prevent GI upset
Reduce dosage if given with other antihypertensives; readjust dosae gradually as BP responds
Give early in the day so that increased urination will not disturb sleep
Avoid IV use of oral use is at all possible
Arrange for potassium-rich diet or supplemental potassium as needed.
DRUG ORDER(Generic name, brand name, classification,
dosage, route, frequency)
MECHANISM OF ACTION
INDICATIONSCONTRAINDICATIONS ADVERSE EFFECTS OF
THE DRUG
NURSING RESPONSIBILITIES/
PRECAUTIONS
Generic Name:Amikacin sulfate
Brand Name:Amikin
Classification:Anti-infective
Dosage:95 mg
Route:IVTT
Frequency:q 12 hr
Bactericidal: inhibits protein synthesis in susciptible strains of gram-negative bacteria, and the functional integrity of bacterial cell membrane appears to be disrupted, causing cell death.
Severe systemic infection caused by sensitive straints
Contraindicated with allergy to any aminoglycosides, renal or hepatic disease, preexisting hearing loss, myasthenia gravis
Use cautiously with elderly patients, any apatient with deminished hearing, decreased renal function, dehydration
CNS: Confusion, disorientation, depression,
CV: Palpitations,hypotension, hypertension
GI: Nausea, vomiting, anorexia
GU: nephrotoxicity
Hematologic: Granulocytosis, leukopenia,
Hepatic: Hepatic toxicity; hepatomegaly
Hypersensitivity: Purpura, rash, exfoliative dermatitisOther: Superinfections, pain and irritation at IM injection sites
Arrange forculture and sensitivity testing of infected area before treatment.
Give IM dosage by deep injection
Ensure that patient is well hydrated before and during therapy
Report pain at injection site, severe headache, dizziness, loss of hearing, changes in urine pattern, difficulty breathing, rash or skin lesions.
DRUG ORDER(Generic name, brand name, classification,
Local: Pain, phlebitis, thrombosis at injection site
Other: Superinfections, sodium overload leading to CHF
Culture infection before treatment; reculture if response is not as expected
Reconstitite for IM use to a dilution of 250 mg/1.5 mL using sterile water for injection or sodium chloride injection. Discard after 3 days at room temperature or after 7 days if refrigerated.
TP:
You may experiencethese side effects: Upset stomach, nausea, diarrhea, (eat frequent small meals), mouth ssores (perform mouth care), pain at the injection site
DRUG ORDER(Generic name, brand name, classification,
dosage, route, frequency)
MECHANISM OF ACTION
INDICATIONSCONTRAINDICATIONS ADVERSE EFFECTS OF
THE DRUG
NURSING RESPONSIBILITIES/
PRECAUTIONS
Generic Name:Cefuroxime
Brand Name:Cefuroxime sodium (Zinacef)
Classification:Antibiotic
Dosage:385 mg
Route:IVTT
Frequency:q.8 hr
Bactericidal: Inhibits synthesis of bacterial cell wall, causing cell death
Lower respiratory infections
contraindicated with allergy to cephalosporins or penicillins
Use cautiously with enal failure, lactation, pregnancy
Subjective:“Wala ko’y gana mo kaon sir” as verbalized by the mother.
Objective:
- Poor muscle tone- Pale- Weakness
Imbalanced nutrition, less than body requirement related to illness.
After 8 hours of care patient will be able to demonstrate progressive good appetite.
Independent:-Identify underlying condition involved.R. To assess causative factors.
-Identify clients at risk for malnutrition.R. to assess contributing factors.
- Discuss eating habits, including food preferences, intolerance.R. To appeal to clients like and dislike.
-Assess weight, age, body build, and strength of the client.R. To evaluate degree of deficit.
Dependent:-Administer pharmaceutical agents as indicated.R. To evaluate degree deficit.
After 8 hours of care goals met. Patient was able to demonstrate progressive good appetite.
VIII. DISCHARGE PLAN
M- Medication Medication includes Amikacin, Cefuroxime, Oxacilin, Furosemide. These medicines are taken depending on severity and kind of pleural effusion.
E- E xercise Teaching breathing retaining exercise to increase diaphragmatic excursion and reduce work of breathing. Teach relaxation techniques to reduce anxiety with dyspnea. Augment the patient’s ability to cough effectively by splinting the patient’s chest manually.
T- Treatment Follow strict compliance to treatment regimen given to improve condition especially medications, diet and lifestyle.
H- Health Teachings Keep a list of your medicines: Keep a written list of the medicines you take, the amounts and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Do not take any medicines, over the counter drugs, vitamins, herbs or food supplements without first talking to caregivers. To decrease your pain; when coughing, hold a pillow over your chest where the pain is. Quit smoking. Do not smoke and do not allow others to smoke around you. Smoking increases your risk of lung infections such as pneumonia. Smoking also makes it harder for you to get better after having a lung problem. Talk to your caregiver if you need help quitting smoking. Drink enough liquids and get plenty of rest. Be sure to drink enough liquids every day. Most people should drink at least 8(oz.) Cups of water a day. This help to keep your air passages moist and better able to get rid of germs and other irritants. You may feel like resting more. Slowly start to do more each day. Rest when you feel it is needed. Exercise your lungs. The discomfort of pleural effusion may cause you to avoid breathing as deeply as you should. Coughing and deep breathing can help prevent a new or worsening lung infection. Take a deep breath and hold the breath as long as you can then push the air out of your lungs with a deep, strong cough. Take 10 deep breaths in a row every hour that you are awake. Remember to follow each deep breathe with a cough.
O- Out patient Compliance to home medication regimen.
D- Diet Ensure adequate protein intake such as milk, eggs, oral nutritional supplements, chicken, and fish if other treatments not tolerated. Advice patient to eat small amounts of high-calorie and protein foods frequently rather than three daily large meals.
IX. LEARNING EXPERIENCE
Caring is our major responsibility. That’s why we have to treat everyone as such,
despite the consequences we might to commit, that wouldn’t matter. We learned to always
have a presence of mind while on duty.
For all those times, time management best thump us a lot. We learned to adjust and
manage time exactly as possible because when you say you are going to do something,
you have do it right away! You don’t have to wait for the time to come when it’s too late for
you to do such actions. It would be your lose and at the end you’ll realized that you acquire
worse. Another thing is to establish a therapeutic and a trusting relationship to each patient
because that’s one of the ways a person can feel free to open lines communication. And
the best experience we had is to be in one piece, helping each other and persevering.
Regarding this case we chose, we found it out to be enjoyable. We thought we don’t
have enough time focusing on this one especially that we still have other subjects to be
tackled. Surfing the net and printing is money consuming but we still feel happy because
doing these things helps us improved our learning about the disease and makes us think of
possible task that can also be helpful to the patients
At the end, we’re still thankful because God never put us down. All these things
wouldn’t be possible if nobody helps us find ways to finish this requirement. There goes the
time we learned to value our selves, we learned how to be “flexible”, and we learn how to
adjust things somehow. It’s never easy but we have to be with our selves to make things
possible.
X. REFERENCES
BOOKS:
Doenges, M.E., Moorhouse, M.F., & Geissler, A.C, (2002). Nursing Care Plans Guidelines for Individualizing Patient Care, (6th ed.). Thailand
ACKNOWLEDGEMENTIn behalf of our group, we would like to thank each member
for their unending support and cooperation and for being patient in
making this case study possible.
For the sleepless nights that we have been together, that despite of each our
own differences we were able to stand united through thick and thin..
To our PCI who guides us as we go along in our duties,
Thank you Mrs Helen Yorong.
To our diligent and responsible CI,
who provides us with ample knowledge and skills to make us efficient student
nurses,
and for helping us develop the right attitude while in this rotation.
Thank You so much, Mrs. Maria Rica Adane, RN.
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