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NURSING RESPONSIBILITIES Do not administer if patient has already pass out stool especially if stool is liquid

Lactulos 10cc OD @ HS hold for BM 2xday

Laxative

Metabolism of lactulose by bacteria results in reduced colonic pH which stimulates peristalsis and decreases stool transit time. In turn, decreased water reabsorption from the feces further facilitates the passage of soft well-formed stools. And increased osmotic pressure of fecal material secondary to an increase in colonic organic acids results in accumulation of fluid from surrounding tissues, helping to soften stool mass.

Constipation

Low galactose diet & intestinal obstruction

Abdominal discomfort

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NURSING RESPONSIBILITIES >position patient on high back rest position >do back tapping after you nebulizer the patient >do not give a food immediately, it can cause vomiting

Duavent neb 1 tab + 2ml nss every 8 hours for T>37.8

Bronchodilator

Ipratropium bromide is aquaternary ammonium compound with anticholinergic (parasympatholytic) properties Ipratropium bromide relaxes smooth muscles of bronchi and bronchioles by blocking acetylcholine-induced stimulation of guanylcyclase, thus reducing formation of cyclic guanosine monophosphate (cGMP), a mediator of bronchoconstriction. Ipratropium generally exhibits greater antimuscarinic activity of bronchial smooth muscle than on secretory (eg, salivary, gastric) glands.

>management of reversible bronchospasm associated obstructive airway disease. >patient with COPD on a regular inhaled bronchospasm and who required a bronchodilator

>hypertrophic obstructive cardiomyopathy or tachyarrythmia >hypersensitivity to atropine and its derivatives

Headache, pain, influenza, chest pain, nausea. Bronchitis, dyspnea, coughing, pneumonia, bronchospasm pharyngitis, sinusitis, rhinitis, edema, fatigue, hypertension, dizziness, nervousness, paresthesia, tremor, dyspepsia, vomiting, arrhythmia, palpitation, tachycardia, arthralgia, angina, increased sputum, taste perversion and UTI/dysuria, allergictype reactions.

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NURSING RESPONSIBILITIES PRE: >Check for the doctors order before giving medications. >Follow the 10rs of the patient. >Assess nutritional status through 24 h diet recall. >Determine frequency of consumption of vitamin rich foods INTRA: >Assess patient for signs of vitamin deficiency before and periodically throughout therapy. POST: >Advice the relative of thepatient toreport when patient experiences adversereaction

Moriamin Forte 1 cap OD

Multivitamins Essential Aminoacids Folic acid

Vitamins and minerals contents are absorbed by the intestine and into the blood stream which is distributed and consumed by the body or stored in the body

Malnutrition, protein and Contraindicated for vitamin deficiencies, patients with malanemia, convalescence, absorption syndrome Restoration and maintenance of body resistance.

Severe allergic reactions, which includes, swelling of the face, throat, lips, or tongue, skin irritation, redness, itching, hives, difficulty in breathing, chest pain and extreme stomach pain

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NURSING RESPONSIBILITIES Use liquid form for children and patients who have difficulty swallowing. In children, dont exceed five doses in 24 hours. Advise patient that drug is only forshort term use and to consult thephysician if giving to children for longer than 5 days or adults for longer than 10 days. Advise patient or caregiver that many over the counter products contain acetaminophen; be awareof this when calculating total dailydose. Warn patient that high doses o runsupervised long term use cancause liver damage

Paracetamol 500mg 1tab every 4 hours

Anti pyretic

Reduces fever by acting directly on the hypothalamic heatregulating center to cause vasodilation and sweating, which helps dissipate heat.

Symptomatic relief of pain and fever.

>Contraindicated in patients hypersensitive to drug. >Use cautiously in patients with long term alcohol use because therapeutic doses cause hepatotoxicity in these patients. >Hematologic: hemolytic anemia, neutropenia, leucopenia, pancytopenia. >Hepatic: Jaundice >Metabolic: Hypoglycemia >Skin: rash, urticaria.

CNS: Headache CV: Chest pain, dyspnea, myocardialdamage whendoses of 58 g/day are ingested daily forseveral weeks or when doses of 4g/day are ingested for 1 yr GI: Hepatictoxicity andfailure, jaundice GU: Acute kidney failure, renal tubular necrosis Hematologic: Methemoglobinemia cyanosis; hemolytic anemiahematuria, anuria; neutropenia, leucopenia, pancytopenia, thrombocytopenia, hypoglycemia Hypersensitivity: Rash, fever

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NURSING RESPONSIBILITIES *Caution should be exercised in patients with abnormal heart rhythm, high blood pressure, stroke, who are taking other medications, liver impairment, runny nose, any allergy, during pregnancy and breastfeeding. * Patient may develop with increased risk of fluctuating eye pressure; if it is so stop the medication immediately. * Monitor regularly for atrial flutter occurrence while taking this medication. * It may cause blurred vision, do not drive a car or operate machinery while taking this medication.

Ivabradine 75mg 1 tab OD

Anti-anginal

Ivabradine is a pure heart rate-lowering agent, acting by selective and specific inhibition of the cardiac pacemaker current that controls the spontaneous diastolic depolarisation in the sinus node and regulates heart rate. The cardiac effects are specific to the sinus node with no effecton intra-atrial, atrioventricular or intraventricular conduction times, nor on myocardial contractility or ventricular repolarisation

Symptomatic treatment of chronic stable angina pectoris in coronary artery disease patients w/ normal sinus rhythm

Contraindicated in patients with severe heart disease, and hypersensitivity. It should not be administered along with calcium channel blockers.

Cardiovascular: bradycardia, palpitations, supra ventricular extrasystoles GI: nausea, constipation

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NURSING RESPONSIBILITIES

Hexetidine Oral Antiseptic gargle BID

Oral antiseptic

Protection against oral bacterial and fungal infection to give fast relief from sore throat and mouth ulcers. First, bactidol quicly reduces bacteria in the affected areas to hel relieve and prevent soreness, then hexetidine contains adheres to affected areas for extended period of time, giving long lasting protection

Minor sore throat; halitosis, general oral hygiene, Improves appearance of mouth tissue, protects toothe surfaces afaints formation of decay acids.

Lesions and ulcerations of oral/buccal mucosa

Allergic contact dermatitis, taste alterations, transient anesth, mouth or tongue irritation

>Instruct patient not to swallow the medication. >Caution the patient that the solution may be too harsh to taste. >Assess for any lesions in the mouth of the patient.