MEDICAL MANGAEMENT

I. IV THERAPY

Date Ordered: (7-2-17)

 D5 LR (5% Dextrose in Lactated Ringer’s Solution)

Regulation: KVO

Date ordered: (7-3-17)

 D5 NSS (5% Dextrose in 0.9% Sodium Chloride Solution)

Incorporation: 10 units of Oxytocin
Regulation: to run for 10 hours or 33gtts/min.

 D5 LR (5% Dextrose in Lactated Ringer’s Solution)

Regulation: to run for 10 hours or 33gtts/min.

Date ordered: (7-3-17)

 D5 LR (5% Dextrose in Lactated Ringer’s Solution)

Incorporation: 20 units of Oxytocin
Regulation: to run for 30gtts/min.

 D5 LR (5% Dextrose in Lactated Ringer’s Solution)

Incorporation: 10 units of Oxytocin
Regulation: to run for 20gtts/min.

 D5 LR (5% Dextrose in Lactated Ringer’s Solution)

Regulation: to run for 10 hours or 33gtts/min.

 VOLUVEN (Hydroxyethyl Starch in Sodium Chloride) 500 ml as side drip

Regulation: to run for 30gtts/min

Date ordered: (7-4-17)

 D5 LR (5% Dextrose in Lactated Ringer’s Solution)

Incorporation: 20 units of Oxytocin
Regulation: to run for 30gtts/min.

 D5 LR (5% Dextrose in Lactated Ringer’s Solution)

Incorporation: 10 units of Oxytocin
Regulation: to run for 20gtts/min.

Purpose:
Used to maintain the patient’s hydration.
Serves as a route for medication.
Oxytocin- for postpartum control of bleeding after expulsion of the placenta
Voluven- indicated for the treatment and prophylaxis of hypovolemia.

Nursing Management:
 Verify the Doctor’s order.
 Inform the client and explain the purpose of IV therapy.
 Instruct the patient that the procedure may cause a little bit pain upon insertion.
 Practice aseptic technique.
 Regulate IVF at prescribed rate.
 Check IV patency.
 Observe for potential complications.

II. Oxygen therapy

Date ordered: (7-3-17)

 Via nasal cannula

 Regulation: 2 LPM

Purpose:
 This supplies sufficient amount of oxygen to the body.

Nursing Management:
 Determine the need for Oxygen therapy
 Verify the Doctor’s order on which type of delivery system and how many liter
of oxygen are actually needed.
 Regulate the oxygen at the prescribed rate and ensure proper functioning.
 Provide support while the patient adjusts to the device.
 Apply water-soluble lubricant as required to soothe the mucous membrane and to prevent
irritation of the nares.
 Change tubing.
 Instruct S.O to avoid smoking inside the room or anything that can cause fire because
oxygen is highly combustible.

III. BLOOD TRANSFUSION

Date Ordered: (07-03&04-17)

 PACKED RBC
Doctor’s Order:
- 1 unit to run for 4 hours (07-03-17)
- 1 unit to run for 4 hours (07-04-17)

CROSMATCHING (TUBE METHOD)

07-03-17 07-04-17
Donor number : 17-01129-DT 17-09449-NV
Extraction date: 06-12-2071 06-16-2017
Expiration date: 07-17-2017 07-21-2017
Component : PACKED RBC PACKED RBC
ABO Blood type: O O
RH type: POSITIVE POSITIVE
Tubing number 698P3859 599P282

Purpose:
 To raise the hemoglobin level of the patient due to uterine atony secondary to vaginal
bleeding.

Nursing Management:
 Cross matching should be done prior to the procedure.
 Verify the patient’s identity.
 Verify the Doctor’s order.
 Packed RBC must be prepared 30 minutes prior to transfusion. It should be maintained
on a room temperature.
  Check the requisition form, the blood bag, and the serial number.
 Two nurses must be present in checking prior to transfusion.
 Check for the patient’s initial vital signs.
 Ensure the Doctor’s counter check on the order and sign thereafter.
 Monitor patient for signs and symptoms of adverse reactions such as hemolytic reactions
(chills, fever, headache, cyanosis, chest pain, tachycardia, hypotension), febrile reaction,
mild or severe allergic reaction, circurlatory overload, or sepsis.

IV. IFC (Indwelling Foley Catheter)

 Date ordered: August 14, 2013

Purpose:
 To drain urine from the bladder
 To facilitate accurate measurement of urinary output

Nursing Management:
 Explain to the patient the purpose of the procedure.
 Check if the patient has allergy to latex.
 Instruct the patient to take a deep breath upon insertion.
 Make sure that urine is flowing out of the catheter into the urine collection bag.
 Make sure that the catheter tube is not twisted or linked.
 Keep the urine collection bag below waist level to prevent urine from flowing back to the
bladder.

V. POSITIONING

a. Complete Bed Rest

Date Ordered: (07-03-17)

Purpose:
 To save the patient’s energy thus, preventing oxygen consumption

b. Moderate High Back Rest

Date ordered: (07-04-17)

Purpose:
 To promote maximum lung expansion
 To facilitate easy breathing

Nursing Management:
 Explain to the patient the purpose of the position.
 Assist the patient in assuring a certain position.
 Instruct the patient not to alter the position and inform the possible complications.

VI. DIET

A. NPO (non per orem) Post Midnight

Date Ordered: (07-02-17 / 07:02 pm)

Purpose:
 Preparation for the surgical procedure (caesarian section).
 B. NPO (non per orem) Temporarily (Post-operative order)
Date Ordered: (07-03-17)

Purpose:
 To prevent aspiration and GI distress.

C. SOFT DIET (1st Post-op day)

Date ordered (07-04-17))

Purpose:
 To prevent aspiration and requires less energy for digestion.

D. DIET AS TOLERATED (2nd Post-op day)

Date ordered (07-05 & 06-17)

Purpose:
 To maintain a state of good nutrition

NURSING MANAGEMENT
 Check Doctors order
 Explain the purpose of the diet.
 Provide health teachings on the foods the patient need to avoid such as preserved foods,
canned goods, fried foods, and etc.

VII. DEEP BREATHING & COUGHING EXERCISES

Date Ordered: (07-03-17)

PURPOSE:

 To facilitate a wide exchange of gases.

 To maximize the amount of oxygen available to the cells.
 To prevent orthostatic pneumonia.
 To help cope with pain
 To facilitate an effective coughing of secretions.

Nursing Management:
 Check Doctor’s order
 Explain the purpose of the exercise