VII.

Medical Management: Drug Study

Drug Name Mechanism Indication Contraindic Side Nursing Responsibility

of Action ation Effects
Generic It works by Used to •Hypersensi • nausea, • Assess patients who
name: stopping relieve tivity to vomiting, develop severe diarrhea
Mefenamic the body’s mild to drug abdominal and vomiting for
acid production moderate cramps dehydration and
of a pain electrolyte imbalance
Brand name: substance •Give with meals, food,
Ponstan that causes or milk to minimize GI
pain, adverse effects
Dose: fever, and
500mg inflammatio  Drowsiness • Raise side rails
n. • Do not drive or engage
Route: in potentially hazardous
P.O. activities until response
to drug is known. It may
Frequency: cause dizziness and
TID drowsiness.

• Sore
throat discontinue if adverse
• Headache effect was shown
• Rash
 Drug Name Mechanism Indication Contraindica Side Nursing Responsibility
of Action tion Effects
Generic It works Used to • • rash • Before administering the
name: by treat sensitivity • itching drug, perform skin test
Cloxacillin stopping bacterial to • chil • Intruct the patient to
the growth infection penicillin report rash, itching, and
Brand name: of chills or other signs or
Cloxapen bacteria symptoms of
It exerts hypersensitivity reaction
Dose: bactericid as with other penicillins.
1g al
activity • Monitor signs of
Route: via allergic reactions and
IV inhibition •Wheezing anaphylaxis, including
of pulmonary symptoms
Frequency: bacterial (tightness in the throat
q6 cell wall and chest, wheezing, cough
synthesis dyspnea) or skin reaction
by binding
one or • Lab tests: Periodic
more of assessments of renal,
the hepatic, and hematopoietic
penicillin •Hematolog function are advised in
binding ic: patients on long-term
proteins Eosinophil therapy
(PBPs). ia,
leukopenia
,
agranulocy
tosis
 Drug Name Mechanism of Indication Contraindic Side Nursing Responsibility
Action ation Effects
Generic - works the treatment •hypoglycem •Hypoglycem • Monitor for S&S of
name: same way as for adults ic patient ia hypoglycemia
Insulin natural and •Hypersensi • Monitor Blood Glucose
Glargine human children tivity to Level
insulin, but with type drug • Ingest some form of
Brand name: it's action 1 diabetes sugar (e.g., orange
Lantus lasts juice, dissolved table
longer. It sugar, honey) if symptoms
Dose: helps of hypoglycemia develop;
6units diabetic and seek medical
patients assistance.
Route: regulate • Rash, •Instruct the patient to
Subq glucose or itching report any signs of
sugar in the hypersensitivity to drug
Frequency: body. • Fever • Notify the physician of
AC Insulin •Diarrhea any of the following:
glargine • Nausea or fever, infection, trauma,
works by vomiting diarrhea, nausea, or
promoting vomiting. Dosage
movement of adjustment may be needed.
sugar from • Skin
blood into thickening • Avoid injection of cold
body tissues or pits at insulin; it can lead to
and also the lipodystrophy, reduced
stops sugar injection rate of absorption, and
production site local reactions
in liver.
 Drug Name Mechanism of Indication Contraindic Side Nursing Responsibility
Action ation Effects
Generic It lowers Humulin R •hypersensi • Low Blood • Monitor for
name: blood U-100 is tivity to Sugar hypoglycemia at time of
Insulin glucose indicated drug peak action of insulin.
regular levels by as an • Check blood sugar
human increasing adjunct to • During before injecting humulin
peripheral diet and episodes of R
Brand name: glucose exercise hypoglycemi • Carry some form of
Humulin R uptake, to improve a fast-acting carbohydrate
especially glycemic at all times to treat
Availabilit by skeletal control in hypoglycemia
y: 100U/mL muscle and adults and • Skin
fat tissue, children thickening • Avoid injection of cold
Dose: 5–10 and by with type or pits at insulin; it can lead to
Units inhibiting 1 and type the lipodystrophy, reduced
the liver 2 diabetes injection rate of absorption, and
Route: SQ from mellitus. site local reactions.
changing • Learn correct injection
Classificat glycogen to technique
ions: glucose. • Allergic
HORMONE AND reactions ( • Instruct the patient to
SYNTHETIC Itching and notify physician of local
SUBSTITUTE; rash) reactions at injection
ANTIDIABETI site.
C AGENT;
INSULIN
 Drug Name Mechanism of Indication Contraindic Side Nursing Responsibility
Action ation Effects
Generic Vitamin C is Used to • •Nausea • Assess patients who
name: an prevent or Thalassemia •vomiting develop severe diarrhea
Ascorbic antioxidant treat low • G6PD and vomiting for
Acid which is levels of deficiency dehydration and
thought to vitamin C • sickle electrolyte imbalance
Brand name: have a in people cell • Give with meals and
Cecon protective who do not disease, food to minimize GI
role in get enough and adverse effect
Classificat diabetes by of the •hemochroma
ion: reducing the vitamin tosis •Headache • Raise side rails
Vitamin damage from their
caused by diets. •Fatigue • Monitor for S&S of
free Most acute hemolytic anemia,
Dose: radicals people who sickle cell crisis.
500mg eat a
normal
Route: diet do
P.O not need
extra
Frequency: ascorbic
0D acid
 Drug Name Mechanism of Indication Contraindi Side Nursing Responsibility
Action cation Effects
Generic As the Vitamin B Hypersensi •Headache • Assess patient for signs
name: building complex tivity to due to of vitamin deficiency
Vitamin B blocks of a may have a drug excess before and periodically
complex healthy strong intake of during therapy. •Assess
body, B role to Vitamin B nutritional status through
Brand name: vitamins play when complex 24-hr diet recall.
Nephro-vite have a treating • Raise side rails
direct diabetic
Classificat impact on neuropathy
ion: your energy . The •Itching or • Take a careful history
Vitamin levels, presence rash of sensitivities to drug.
brain of vitamin
Dose: 25mcg function, complex is
and cell necessary •nausea • Assess patients who
Route: P.O metabolism. for the •vomiting develops vomiting for
Vitamin B correct dehydration and
Frequency: complex functionin electrolyte imbalance
OD helps g of nerve
prevent cells, and •Give with meals, food, or
infections therefore milk to minimize GI
and helps taking it adverse effects
support or as a
promote: supplement •Encourage patient to
cell health. may help comply with diet
to reduce recommendations of health
nerve care professional. Explain
damage. that the best source of
vitamins is a well-
balanced diet with foods
from the four basic food
groups.
VIII Surgical Management

Surgical Description Indication Complication

Treatment
Wound Debridement is a  presence ● Pain
Debridement procedure for of ● Bleeding
treating a wound in necrotic, ● Infection
the skin. It senescent ● Delayed healing
involves thoroughly tissue or ● Loss of healthy tissue
cleaning the wound biofilm
and removing all  when
hyperkeratotic there is
(thickened skin or excessive
callus), infected, fibrotic
and nonviable tissue
(necrotic or dead)
tissue, foreign
debris, and
residual material
from dressings.
Debridement can be
accomplished either
surgically or
through alternate
methods such as use
of special
dressings and gels.
Pre-Operative Nursing Care

-The nurse should immobilize the wounded part of the foot

-Perform a physical examination before the operation

-Measure the size of the wound in the affected part

-Perform and maintain wound care •

-The patient should be in supine position.

Post-Operative Nursing Care

-Use an aseptic, non-touch technique for changing or removing dressings

-Aim to leave the wound untouched for up to 48 h after surgery, using sterile saline for
wound cleansing during this period only if necessary

-Advise patients that they may shower safely 48 h after surgery

-Use tap water for wound cleansing after 48 h if the wound has separated or has been
surgically opened to drain pus

-Use an interactive dressing for surgical wounds that are healing by secondary healing

-Refer to a tissue viability nurse (or another healthcare professional with tissue
viability expertise) for advice on appropriate dressings for surgical wounds that are
healing by secondary intention.
 IX. Nursing Care Plan
ASSESSMENT BACKGROUND DIAGNOSIS PLANNING NURSING RATIONALE EVALUATION
KNOWLEDGE INTERVENTION
Subjective As part of Elevated After 4 Independent: After 4
: immune body hours of  Monitor  Vital signs hours of
“Dalawang response of temperatu nursing vital signs provide more nursing
araw na the body, re intervent accurate intervention
akong elevated related ion the indication the
nilalagnat temperature to left patient’s of core patient’s
” as is usually foot temperatu temperature temperature
verbalize caused by infection re will  Provide  To lessen was
by the infection of as decrease tepid the body decreased
patient injury in evidenced from sponge bath temp in from 38.9°C
the left by warm 38.9°C to process of to 37.2°C
Objective: foot. As skin and 37.2°C conduction
inoculation temperatu and
 Facial occurs, re of evaporation
grimace proliferatio 38.9°C
 Remove  These
 Irritabl n of
excess decrease
e bacteria
clothing warmth and
follows and
 Flushed covers increase
multiplicati
skin evaporative
on occurs.
 Warm to cooling
Once that
touch bacteria  Promote a  To promote
 Wound on starts to well clear flow
left grow in ventilated of air in
foot number, it area to the
will soon patient patient’s
Vital reach it area. One
signs pathogenic way of
taken as level that promoting
follows: will result heat loss
 into pyrexia  Advise  Additional
T – 38.9°C or fever as patient to fluids help
P – 100 defense increase prevent
bpm mechanism of fluid elevated
R – 28 bpm the body. intake temperature
BP -130/80 associated
mmHg with
dehydration
 Maintain  To reduce
bed rest metabolic
demands/
oxygen
consumption
 Place a  Gives
cool cloth cooling
on the sensation
forehead

Collaborative:

 Administer
medication
as  to reduce
prescribed the progress
by the of infection
physician and fever
ASSESSMENT BACKGROUND DIAGNOSIS PLANNING NURSING RATIONALE EVALUATION
KNOWLEDGE INTERVENTIONS
Subjective Neuropathy Impaired After 8  Assess the  Assessment After 8
Data: is both a physical hours of overall of the hours of
major cause mobility nursing condition condition of nursing
“Hindi ko
of injury related intervent of the the skin intervention
maigalaw
in to wound ion, the skin. provides , the
ang
individuals infection patient baseline patient was
kaliwang
with as will be data for able to
paa ko,
diabetes, manifeste able to possible maintained
namamanhid,
and also a d by maintain intervention or increased
at ilang
reason for slowed or s for the strength and
araw na rin
complicatio movement increase nursing function of
na sariwa
ns in strength diagnosis affected and
ang sugat
diabetes and Risk for compensatory
ko.” As
wound function Impaired body part.
verbalized
healing. of Skin
by the
When high affected Integrity.
patient.
blood sugar and  Evaluate  The greatest Goal met.
destroys compensat the risk factor
nerves, ory body patient’s in skin
Objective they do not part.
Data: strength to breakdown is
regenerate; move (e.g., immobility.
-Wound thus many shift
drainage patients weight
(Pus) with while
diabetes sitting,
-Redness are turn over
around increasingl in bed,
wound y less move from
-Foul sensitive bed to
smelling to pain in chair).
wound their  Assisted/ha
limbs. With ve client
-Darkening
this loss reposition  To decrease
skin at the
of self on a numbness and
edges
sensation, regular pain in the
-Fever patients schedule affected
don't feel from side area.
- developing to side.
tenderness blisters,
at the  Used side
infections, rails of
affected or existing
extremity bed.  To prevent
wound
the patient
- localized changes.
from
heat That means
possible
that wound
- feeling fall or
healing is
of numbness accident
complicated
on the  Encouraged that might
not only by
affected patient to happen.
the fact
part that move the  To help ease
affected the pain and
patients
don't feel part from numbness of
time to said part.
wounds as
they occur, time.
but they  Assess the
also have surface
no pain to that the  Patients who
alert them patient spend the
that a consumes majority of
wound is most of his time on one
time on surface
getting (e.g., require a
worse or mattress pressure
infected. for reduction or
For many bedridden pressure
with patient, relief
diabetes, cushion for device to
injuries people in distribute
are only wheelchairs pressure
noticed ). more evenly
with  Encourage and reduce
careful the patient the risk for
daily skin to change breakdown.
checking. position  The aims of
However, every 15 repositionin
limited minutes and g are to
mobility change reduce or
can make it chair-bound relieve the
difficult positions pressure on
for some every hour. the area at
individuals risk,
to check maintain
the most muscle mass
vulnerable and general
areas, such tissue
as the integrity
bottom of and ensure
their feet.  Encourage adequate
ambulation blood supply
if the to the at
patient is risk area.
able.
  Ambulation
reduces
pressure on
the skin
from
immobility
thus
 Reinforce lessening
the the factors
importance that may
of turning, result in
mobility, impaired
and skin
ambulation integrity.
 These will
enhance
their sense
 Educate of efficacy
patients and can
and improve
caregivers compliance
about with the
proper prescribed
wound & intervention
skin care. s.
 Educating
patients and
caregivers
methods to
maintain
 Reassess skin
the skin integrity
regularly enhances
and their sense
whenever of self-
the efficacy and
patient’s prevents
condition skin
or breakdown.
treatment  The
plan incidence
results in and onset of
an skin
increased breakdown is
number of directly
risk related to
factors. the number
of risk
factors
present.