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Mindanao State University Iligan Institute of Technology College of Nursing Resource Unit
Mindanao State University Iligan Institute of Technology College of Nursing Resource Unit
COLLEGE OF NURSING
Resource Unit
TOPIC:
DEFINITION:
RESOURCE UNIT
Orthopedic Ward
Nursing History
Psychosocial History:
Patient describes her body as fine and well and maintains good
health status for her family.
3. Elimination Pattern:
4. Activity Exercise
Patient usually sleeps for about 6 hours and no use of sleeping aids.
Patient sleeps together with her family.
6. Cognitive-Perceptual
Patient is able to see, hear, taste, and smell without problem. Patient
is able to distinguished touch/pain receptors and able to convey to
the people.
7. Self-Perception/Self-Concept
8. Role-Relationships
9. Sexuality-Reproductive
10. Coping-Stress
11. Values-Belief
Review of Systems
3. Integumentary System
5. Cardiovascular System
- Patient has limited ROM due to affected right and left lower
limbs with external fixators and spiral bandages is applied to
the affected limbs with ice packs on right distal tibia and pain
felt in a twisting, non-radiating and with 6/10 in scale per
episode on right distal tibia when no pain medication given.
9. Nervous System
INDICATION:
Management of seasonal and perennial allergic rhinitis
Treatment of chronic, idiopathic urticarial
Treatment of year-round allergic rhinitis
MECHANISM OF ACTION:
CNS:
Somnolence
sedation
CV:
Palpitation
edema
GI:
Nausea
Diarrhea
abdominal
Pain
constipation
Respiratory:
Bronchospasm
pharyngitis
Other:
Fever
Photosensitivity
Rash
Myalgia
Arthralgia
angioedema
NURSING RESPONSIBILITY:
Assessment
Indication:
Contraindication:
• Undiagnosed anemia
Adverse Reaction:
• Slight flushing
Nursing Responsibilities:
Adverse Reaction:
Dizziness
Constipation
Black/Dark Stools
Taste Disorders
Flushing
Cough
Dyspnea
Fever
Sweating
Nursing Responsibilities:
Mechanism of Action:
May selectively inhibitCOX-2, decreasing prostaglandin synthesis.
Therapeutic Effects:
Relieves pain and inflammation in joints and smooth muscle tissue.
Pharmacokinetics
Absorption:
Level peaks in about 3hrs.. If patient receives multiple doses,
expect steady-state level within 5 days. Elder lypts. Have higher
level than younger adults.
Distribution:
Extensive. High lyprotein-bound, mainly to albumin.
Metabolism:
By CYP 2C9. No active metabolites have been identified.
Excretion:
Mainly through hepatic metabolism, with less than 3% as
unchanged drug in urine and feces
Side Effects and Adverse Reactions:
CNS: headache, dizziness, stroke
CV: hypertension, MI, peripheral edema
EENT: pharyngitis, rhinitis, sinusitis
GI: abdominal pain ,diarrhea, dyspepsia, flatulence
Metabolic: hyperchloremia, hypophosphatemia
Musculoskeletal: back pain
Respi: URTI
Skin: erythema multiforme, exfoliativ edermatitis, rash
Other: accidentalinjur
Contraindications:
Contraindicated with allergies to sulphonamides, celecoxib,
NSAIDs, or aspirin; significant renal impairment; pregnancy (3
rd
trimester);lactation
Precautions
Use cautiously with impairedhearing, hepatic and CV conditions
Drug interactions
>drug to drug-Increased risk of bleeding if taken concurrently with
warfarin. Monitor patient closely and reduce warfarin dose as
appropriate.-Increased lithium levels and toxicity-Increased risk of
GI bleeding with long-term alcohol use, smoking
Nursing Interventions:
before
-
Assess patient for allergy to sulfonamides, aspirin, or NSAIDS.
Patients with these allergies should notreceive celecoxib.-Assess
patient’s range of motion, degree of swelling, and pain in affected
joints before and periodically throughout therapy.-Assess patient’s
and family’s knowledge of drug therapy-Obtain baseline
assessment beforestarting therapy-Rehydrate patient before therapy
During
-May be administered without regard to meals.-Administer right
dose-Administer to right patient-Administer to right route
After
-Instruct patient to take celecoxib exactly as directed. Do not take
more than prescribed dose. Increasing doses does not appear to
increase effectiveness.- Advise patient to notify health care
professional promptly if signs or symptoms of GI toxicity
(abdominal lpain, black stools), skin rash, unexplained weight gain,
edema occurs.-Instruct patient that she should discontinue
celecoxib and notify healthcare professional if signs and symptoms
of hepatotoxicity (nausea, fatigue, lethargy, pruritus, jaundice,
upper right quadrant tenderness, flu-like symptoms) occur
INDICATION:
Nursing Responsibilities:
-Inform patient thata drug may cause metallic taste and may
discolor urine deep brown-red.
GENERIC NAME: Clindamycin
Brand Name: Cleocin, Dalacin-C
Drug Classification: Antibiotic, Lincosamide
MECHANISM OF ACTION:
-Suppresses protein synthesis by microorganisms by binding to
ribosomes.
-Prevents peptide formation
-Does not diffuse adequately to the CSF.
CONTRAINDICATIONS:
-Hypersensitivity
-Use in threatening minor bacterial infections
-Use in clients with a history of regional enteritis, ulcerative
colitis, meningitis, antibiotic associated colitis
-Use for treating viral infections
-Lactation
NURSING RESPONSIBILITIES:
Injection:10, 40 mg/mL
Ophthalmic Solution: 3 mg/mL
Ophthalmic ointment: 3 mg/g Topical ointment: 0.1%
Topical cream:0.1% Ointment:1 mg
Cream: 1 mg
INDICATION:
MECHANISM OF ACTION:
-Dizziness or vertigo
-Acute renal failure
-Interstitial nephritis
-Acute tubular necrosis
-Electrolyte imbalances
-Transient elevation of serum bilirubin and aminotransferases
-Purpura
-Nausea/vomiting
-Convulsions
-Mental depression and hallucinations
-Atrophy or rat necrosis at injection sites.
CONTRAINDICATIONS:
NURSING RESPONSIBILITIES:
1. Cleanse area before application of dermatologic
preparations.
PNSS 1L,
30 gtts/min
chest pain
chest discomfort,
decreased heart rate
Tachycardia
blood pressure decreased
respiratory distress,
Bronchospasm
rash,
throat irritation
headache
Metabolic:
Hyperkalemia
CONTRAINDICATION:
severe metabolic acidosis or alkalosis
severe liver disease
anoxic states
NURSING RESPONSIBILITY:
Do not administer unless solution is clear and container is
undamaged.
Caution must be exercised in the administration of parenteral
fluids, especially those containing sodium ions to patients
receiving corticosteroids or corticotrophin.
Solution containing acetate should be used with caution as
excess administration may result in metabolic alkalosis.
Solution containing dextrose should be used with caution in
patients with known subclinical or overt diabetes mellitus.
Discard unused portion.
In very low birth weight infants, excessive or rapid
administration of dextrose injection may result in increased
serum osmolality and possible intracerebral hemorrhage.
Properly label the IV Fluid
Observe aseptic technique when changing IV fluid
Generic Name: Ciprofloxacin
Dosage, Route, Frequency: 200 mg
IV
INDICATION: Ciprofloxacin is used to treat infections of the skin,
lungs, airways, bones, and joints caused by susceptible bacteria.
Mechanism of Action: Inhibits bacterial DNA synthesis by
inhibiting DNA gyrase.
Therapeutic Effects:
Death of susceptible bacteria.
SURGICAL MANAGEMENT
Nursing Management:
- Assess pin site and provide pin site care.
- Maintain alignment
- Ensure that weights hang free/correct weight
- Assess Vital signs
VAC Therapy is a therapeutic technique using a vacuum
dressing to promote healing in acute or chronic wounds and
enhance healing of second- and third-degree burns. The
therapy involves the controlled application of sub-atmospheric
pressure to the local wound environment, using a sealed wound
dressing connected to a vacuum pump. The use of this
technique in wound management increased dramatically over
the 1990s and 2000s and a large number of studies have been
published examining, appears to be useful for diabetic ulcers
and management of the open abdomen but further research is
required for other wound types. Promotes wound healing by
applying a vacuum through a special sealed dressing. The
continued vacuum draws out fluid from the wound and
increases blood flow to the area.[3] The vacuum may be applied
continuously or intermittently, depending on the type of wound
being treated and the clinical objectives
XRAY 02/17/18
Procedure: CHEST PA
Impression:
- Consider pulmonary nodule right upper lung
- Atherosclerosis @ thoracic aorta
Mechanism of
Mechanism of
Action
Mechanism of
Action