CASE STUDY: OBSTRUCTIVE JAUNDICE

DRUG STUDY
 DRUG MECHANISM OF ACTION INDICATION CI ADVERSE EFFECT NURSING RESPONSIBILITY
Name: Ketorolac Inhibits Short term Hypersensitivity GI: GI bleeding, Monitor BP upon
prostaglandin management of abnormal taste, diarrhea, administration.
Class: Nonsteroidal Anti- synthesis, producing CASE STUDY:
pain (not OBSTRUCTIVE
to exceed JAUNDICE
Cross-sensitivity with dry mouth, dyspepsia,
Inflammatory Drugs (NSAIDS) peripherally 5 days total for all other NSAIDs may exist GI pain, nausea Assess pain (note type,
  mediated analgesia. routes combined) “Pre- or perioperative location, and intensity) prior
Route: IV use” to and 1-2 hr following
Also has antipyretic administration
Dosage: 30mg and anti- Use Cautiously:
inflammatory Caution patient to avoid
Frequency: every 6 hours properties History of GI bleeding concurrent use of alcohol,
aspirin, NSAIDs
Therapeutic effect: Renal Impairment
Decreased pain (dosage reduction may
be required)

Name: Metoclopramide Stimulates motility of
upper GI tract without
Class: Antiemetic stimulating gastric,
GI stimulant billiary, or pancreatic
secretions; appears to
Route: IV sensitize tissues to action
of acetylcholine; relaxes
Dosage: 1 amp pyloric sphincter, which,
when combined with
Frequency: every 8 hours for PRN effects on motility,
accelerates gastric
emptying and intestinal
transit; little effect on
gallbladder or colon
motility; increases lower
esophageal sphincter
pressure; has sedative
properties; induces
release of prolactin.
Name: Metronidazole Bactericidal:
inhibits DNA
Prevention of Allergy to CNS: Restlessness, Monitor BP carefully during IV
nausea and metoclopramide drowsiness, fatigue, administration.
vomiting lassitude, insomnia,
associated with GI hemorrhage extrapyramidal Monitor for extrapyramidal
emetogenic cancer reactions,dizziness, reactions, and consult
chemotherapy Mechanical obstruction anxiety physician if they occur.
or perforation
Prophylaxis of CV: Transient Give direct IV doses slowly
postoperative Pheochromocytoma hypertension over 1-2 minutes.
nausea and (may cause
vomiting when hypertensive GI: Nausea, diarrhea For IV infusion, give over at
nasogastric suction crisis); least 15 minutes.
is undesirable
Epilepsy
Stimulation of
gastric emptying
and intestinal
transit of barium
when delayed
emptying
interferes with
radiologic
examination of the
stomach or small
intestine
Acute infection Contraindicated CNS:Headache, dizziness, Instruct to take drug with
with susceptible with ataxia, food or milk to decrease GI
 CASE STUDY: OBSTRUCTIVE JAUNDICE

NURSING CARE PLAN

ASSESSMENT NURSING DIAGNOSIS PLANNING NURSING INTERVENTION RATIONALE EVALUATION

Subjective: Chronic Lower back After 8 hours of Independent: Pain assessment can provide clues Goal not met
“Nasakit datoy pain related to swelling nursing Assess pain, character, about diagnosis, and be used to
likod ko” of organ interventions, location, severity, and determine treatment required.
As verbalized by the patient will duration; used a pain rating
the patient be able to scale. Pain is subjective experience and
experience cannot be felt by others.
Objective: reduction/relief Accepted client’s description
Facial grimace of pain from a of pain. Acknowledged the Slight increase of RR could be
Restlessness pain scale of 10 pain experience and convey resulted from the possibility of
Irritated to at least 5. acceptance of client’s patient’s reaction towards pain.
response to pain.
V/S taken as
follows: Monitor v/s every 4 hrs.
BP: 120/70
mmHg
PR: 82 bpm
RR: 23 cpm
T: 36.2C
SPO2: 99%