J.H.

CERILLES STATE COLLEGE

In consortium with
Western Mindanao State University
Balangasan, Pagadian City
Zamboanga del Sur 7016
_________________________________________________________________________

A Drug Study on [Ibuprofen]

In Partial Fulfillment of the Requirements for the

NCM 106: Pharmacology Subject

[Adavan, Yzel]
[Bahjin, Dayang Fhernea]
[Busmion, Kristel Jade]
[Caylan, Dimple Grace]
[Esguerra, Karen Joy]
[Lee, Stephanie]
[Paul, Rica]
[Somoso, Mechiel]

ALFRED ZOMAR B BONGOLAN MN

Instructor

[1st Semester; School Year 2021-2022]

Table of Contents

Flyleaf…………………………………………………………………………………I

Cover Page……………………………………………………………………………II

Introduction.......................................................................................................................1

a. Implementation.......................................................................................................1.1

b. Pharmacokinetics...................................................................................................1.2

c. Pharmacodynamics................................................................................................1.3

d. Interactions.............................................................................................................1.4

Drug Study.........................................................................................................................3

Nursing Care Plan (1) – Headache..................................................................................8

Nursing Care Plan (2) – Primary Dysmenorrhea..........................................................9

Nursing Care Plan (3) – Back Pain...............................................................................11

References........................................................................................................................14

Illustrations (Figures/Tables).........................................................................................15
Introduction

a. Implementation

These drugs are used for the management of mild to severe pain, dysmenorrhea, and

fever. This medication can be administered orally, parentally, or intravenously, and

topically or depends on the one who takes it. Ibuprofen tablets and capsules should be

taken with food or a glass of milk to minimize the risk of an upset stomach. Ibuprofen is

often used in doses of 200- 400 mg every 4-6 hours as needed. It can take around 20 to

30 minutes to take effect orally and parentally and roughly 1- 2 days when applied on the

skin.

b. Pharmacokinetics

Oral ibuprofen absorption is rapid and complete. Adults quickly absorb ibuprofen from

the upper G.I. tract.

Ibuprofen's area under the plasma concentration-time curve (AUC) is dose-dependent.

Ibuprofen binds to plasma albumin in a concentration-dependent manner. At doses above

600mg, the unbound fraction increases, resulting in increased ibuprofen clearance and

decreased AUC. It is found in high concentrations in synovial fluid, a potential site of

action for nonsteroidal anti-inflammatory drugs. Orally, it is well absorbed and reaches

peak serum concentration in 1–2 hours. When ibuprofen is taken immediately after a

meal, the absorption rate is reduced but not to the extent.

Ibuprofen has a volume of distribution of 0.1 L/kg. The binding of ibuprofen to plasma

proteins and purified albumin appears to be saturable and non-linear at doses over 20

mcg/ml. It is rapidly metabolized and biotransformed in the liver to form major

metabolites, which are the hydroxylated and carboxylated derivatives. 

1
Ibuprofen is almost completely metabolized, with little to no unchanged drug found in

the urine. This accounts for more than 90% of the administered dose. It is eliminated 24

hours after the last dose, and almost all the administered dose goes through metabolism,

representing about 99% of the eliminated dose. The two main metabolites, carboxy-

ibuprofen, and 2-hydroxy-ibuprofen (and their acyl glucuronides) are excreted in the

urine in ~37 and 25% of a given dosage, respectively. Other hydroxylated metabolites

(3-hydroxy- and 1-hydroxy-ibuprofen) were found in urine. Hepatitis and cystic fibrosis

may affect ibuprofen disposition kinetics. Ibuprofen is not excreted in large amounts in

breast milk. Ibuprofen elimination is not hindered by age or renal impairment.

The serum half-life of ibuprofen is 1.2-2 hours. This can be prolonged to 3.1-3.4 hours in

individuals with compromised liver function. However, several studies have shown that

young children (0.5–5 years) had greater rates of ibuprofen clearance. Its half-life in

premature newborns is 30–45 hours after intravenous injection, perhaps due to

developmental effects on CYP enzyme activity and lower glomerular filtration rates than

in adults.

c. Pharmacodynamics

Ibuprofen has several actions in various inflammatory pathways that are involved in both

acute and chronic inflammation. The major effects of ibuprofen have been linked to the

control of pain, fever, and acute inflammation via the inhibition of prostanoids

production by COX-1 and COX-2.

The antipyretic action is related to prostanoid production, as prostanoids are the primary

signaling mediators of pyresis in the hypothalamic-preoptic region (central regulation of

body temperature).

Ibuprofen is mostly utilized in over-the-counter (OTC) products, such as an agent for

managing dysmenorrhea, where it has been shown to decrease menstrual prostanoids and

2
uterine hypercontractility. Additionally, it has been shown to lessen the fever and pain

associated with migraines considerably.

a. Interactions
Increase: bleeding risk—valproic acid, thrombolytics, antiplatelets, anticoagulants,

salicylates, SSRIs

Increase: blood dyscrasia risk—antineoplastics, radiation

Increase: toxicity—lithium, oral anticoagulants, cyclosporine, methotrexate

Increase: G.I. reactions—aspirin, corticosteroids, NSAIDs, alcohol, tobacco

Increase: hypoglycemia—oral antidiabetics

Decrease: effect of antihypertensives, thiazides, furosemide

Decrease: ibuprofen action—aspirin

HERBAL: Glucosamine, herbs with anticoagulant/antiplatelet properties (e.g., garlic,

ginger, ginseng, ginkgo Biloba) may increase concentration/effect.

LAB VALUES: May prolong bleeding time. May alter serum glucose level. May

increase serum BUN, creatinine, potassium, ALT, AST. May decrease serum calcium,

glucose; Hgb, Hct, platelets.

Drug Study

a. [ibuprofen, Advil, nonsteroidal anti-inflammatory drugs (NSAIDs),

pregnancy category B, pregnancy category D ( 3rd Trimester)]

b. 200–400 mg (dosage), q4–6h prn (frequency), P.O. (route)

c. Ibuprofen's exact method of action is uncertain. However, because ibuprofen is

classified as an NSAID, it is a non-selective inhibitor of cyclooxygenase, an

enzyme involved in the manufacture of prostaglandins (pain and fever

mediators) and thromboxane (blood clotting stimulators) via the arachidonic

acid pathway.

3
 Ibuprofen is a non-selective COX inhibitor, which means that it suppresses

both COX-1 and COX-2 activity. Inhibiting COX-2 activity reduces the

synthesis of prostaglandins involved in inflammation, pain, fever, and

swelling, whereas inhibiting COX-1 activity is responsible for some of the

ibuprofen's adverse effects, including G.I. ulcers.

d. Patent Ductus Arteriosus is a neonatal condition wherein the ductus arteriosus

(the blood vessel that connects the main pulmonary artery to the proximal

descending aorta) fails to close after birth, causing severe risk of heart failure.

The prostaglandin inhibition of ibuprofen has been studied to treat this

condition, as it is known that prostaglandin E2 is responsible for keeping the

ductus arteriosus open.

Rheumatoid- and osteoarthritis - ibuprofen is very commonly used in the

symptomatic treatment of inflammatory, musculoskeletal and rheumatic

disorders.

Cystic fibrosis - the use of high dosages of ibuprofen has been proven to

decrease inflammation and decreasing polymorphonuclear cell influx in the

lungs.

Orthostatic hypotension - ibuprofen can induce sodium retention and

antagonize the effect of diuretics which has been reported to be beneficial for

patients with severe orthostatic hypotension.

Dental pain - ibuprofen is used to manage acute and chronic orofacial pain.

Minor pain - ibuprofen is widely used to reduce minor aches and pains and

reduce fever and manage dysmenorrhea. It is very commonly used for the

relief of acute indications such as fever and tension headaches.

4
 Investigational uses - efforts have been put into developing ibuprofen to

prevent Alzheimer's disease, Parkinson's disease, and breast cancer.

b. History of hypersensitivity to ibuprofen, aspirin, other NSAIDs. Pregnancy 3rd

trimester; treatment of perioperative pain in coronary artery bypass graft

(CABG) surgery. Aspirin triad (bronchial asthma, aspirin intolerance, rhinitis).

NeoProfen: Preterm neonates with proven or suspected untreated infection,

elevated total bilirubin, congenital heart disease in whom patency of the patent

ductus arteriosus is necessary for satisfactory pulmonary or systemic blood

flow (e.g., pulmonary atresia), bleeding, thrombocytopenia, coagulation

defects, proven or suspected necrotizing enterocolitis, significant renal

impairment. Precautions: Pregnancy 1st and 2nd trimesters, breastfeeding,

children, geriatric patients, bleeding disorders, G.I. disorders, cardiac disorders,

HF, CCr <25 mL/min Cautions: Pts with fluid retention, H.F., dehydration,

coagulation disorders, concurrent use with aspirin, anticoagulants, steroids;

history of G.I. disease (e.g., bleeding, ulcers), smoking, use of alcohol, elderly,

debilitated pts, hepatic/ renal impairment, asthma.

c. Central Nervous: Aseptic meningitis, CVA, dizziness, headache, nervousness,

seizures Cardiovascular: Fluid retention, heart failure, hypertension, MI,

peripheral edema, tachycardia EENT: Amblyopia, epistaxis, stomatitis, tinnitus

Gastrointestinal: Abdominal cramps, distention, or pain; anorexia;

constipation; diarrhea; diverticulitis; dyspepsia; dysphagia; elevated liver

enzymes; epigastric discomfort; esophagitis; flatulence; gastritis;

gastroenteritis; gastroesophageal reflux disease; G.I. bleeding, hemorrhage,

perforation, or ulceration; heartburn; hemorrhoids; hepatic failure; hepatitis;

hiatal hernia; indigestion; melena; nausea; stomatitis; vomiting Genitourinary

(G.U.): Cystitis, hematuria, renal failure (acute) HEME: Agranulocytosis,

5
 anemia, aplastic anemia, eosinophilia, hemolytic anemia, leukopenia,

neutropenia, pancytopenia, prolonged bleeding time, thrombocytopenia

Respiratory: Bronchospasm, dyspnea, wheezing Skin: Blisters, erythema

multiforme, photosensitivity, pruritus, rash, Stevens-Johnson syndrome, toxic

epidermal necrolysis, urticaria Other: Anaphylaxis, angioedema, flu-like

symptoms, hypokalemia, weight gain

d. Nursing Responsibilities

 Advise patient to take the medication with food or immediately after meals to

alleviate gastrointestinal upset. Additionally, he should take tablets with a full

glass of water and refrain from lying down for 15 to 30 minutes to avoid

esophageal irritation.

 Advise patient not to take the medication in higher dosages or for a longer

duration than advised, as gastrointestinal bleeding may develop, increasing the

risk of MI or stroke.

 Instruct patient to consult prescriber if he needs to take the drug for more than

3 days for fever or 10 days for pain; if stomach problems recur; history of

bleeding problems, heart or renal disease, hypertension, or ulcers; if he takes a

diuretic; or if he's over age 65.

 Notify phenylketonuric patients that Motrin chewable pills contain aspartame.

 Inform the patient that the full therapeutic effect of arthritis may take up to two

weeks or longer to manifest.

 Urge patient to avoid taking two different NSAIDs simultaneously, unless

directed, and alert prescriber if the patient has ever had an adverse reaction to

any other analgesic or fever-reducing medicine or has a history of asthma.

6
  Instruct the patient to abstain from alcohol, aspirin, and corticosteroids while

on ibuprofen unless otherwise prescribed.

 If the patient takes aspirin to prevent MI or stroke, inform them that ibuprofen

may negate this effect.

 Advise patient to report flu-like symptoms, rash, signs of G.I. bleeding,

swelling, vision changes, and weight gain.

 Urge parents to tell the prescriber promptly if the child receiving the drug

develops a headache, high fever, nausea, persistent diarrhea, severe persistent

sore throat, or vomiting or hasn't been drinking fluids.

 Advise parents to consult a doctor before administering OTC ibuprofen to a

child with asthma, bleeding issues, heart or kidney disease, high blood

pressure, ulcers, or a need for diuretic medication.

 Caution pregnant patients not to take NSAIDs such as ibuprofen during the

last Trimester because they may cause premature closure of the ductus

arteriosus.

 Explain that ibuprofen may cause severe cardiovascular problems; advise

patient to seek medical assistance if chest pain, edema, shortness of breath,

slurred speech, limb swelling, weight gain, or weakness occur.

 Emphasize the necessity of obtaining immediate medical assistance if patients

experience stomach or epigastric pain, black or tarry stools, indigestion, or

vomiting blood, or coffee grounds.

 Alert patient to rare but severe skin reactions. Urge him to seek immediate

medical attention for blisters, fever, itching, rash, or other indications of

hypersensitivity.

Nursing Care Plan (1) – Headache

7
a. Assessment

Subjective:

“Sakit kayo akoang ulo Ma’am”as verbalized by the patient.

Objective:

Pain scale 7/10, With a facial grimace, Restlessness, Sweating, VS 120/80, 85,

19 PS 6/10

b. Diagnosis

Impaired comfort related to headache.

c. Planning

After 4 hours of nursing interventions, the patient's perception of altered

comfort/pain will be decreased; the patient will be able to verbalize relief of

pain; there will be diminished or absent non-verbal indicators.

d. Nursing Interventions

Independent:

 Note for the location, scale, intensity, and onset of pain.

 Maintain a calm and quiet environment.

 Use relaxation techniques such as deep breathing exercises.

Dependent:

 Administer pain medications as ordered.

e. Rationale

8
  To determine the nursing care to be given to the patient.

 To minimize stimuli that could aggravate the condition of the patient.

 To promote comfort and relaxation.

 To help relieve the pain.

 To add comfort to the patient.

They serve as non-pharmacological methods of reducing

pain/promoting comfort.

e. Evaluation

After four (4) hours of nursing interventions, the goal was met.

The patient verbalized relief from pain, and there are no non-verbal indicators of

pain/discomfort present.

Nursing Care Plan (2) – Primary Dysmenorrhea

a. Assessment.

Subjective:

“Sakit kaayo akong pus-on.” Verbalized by patient

Objective:

 Facial grimace

 Guarding behavior

 Lack of effort when standing or engaging in activities.

 Limited mobility

 Vital Signs:

B.P.- 126/75

9
 H.R.- 84 bpm

R.R.- 20 cpm

 Pain scale of 8 out of 10.

b. Diagnosis

Activity Intolerance Related to Pain of Dysmenorrhea.

c. Planning

After 4 hours of nursing intervention:

 The patient will display an increase in activity tolerance, as evidenced by

the client's verbalized decreased level of pain and discomfort during

activities.

d. Nursing interventions:

 Apply heat compress to the patient’s abdomen.

 Massage the abdominal area that feels pain.

 The patient will take Ibuprofen 200mg every 4-6 hours as needed as per

the doctor's order for pain.

 Observations over the level of pain, and motor response, an hour after

drug administration.

 Have the patient perform the activity more slowly, in a long time with

more rest or pauses, or with assistance if necessary.

 Encourage adequate rest.

e. Rationale

 Heat increases vasodilation and muscle relaxation while decreasing the

ischemic uterus, thus relieves abdominal cramps.

 May reduce pain due to the stimulus of therapeutic touch.

 For pain relief.

10
  The assessment will provide optimal nursing objective data to prevent

possible complications and appropriate interventions.

 It helps in increasing the tolerance for the activity.

 Rest between activities provides time for energy.

f. Evaluation

The goal was fully met after 4 hours of nursing interventions. The patient

verbalized a decrease in pain on a pain scale of 2/10 and can perform ADLs

and self-care activities.

Nursing Care Plan (3) – Back Pain

Nursing Care Plan - Back Pain

a. Assessment

Subjective:

“Sakit akong likod dayon mag ngolngol” as stated by a 50yr old woman.

Objective:

 Facial Grimace

 Poor Posture

Vital Signs:

 B.P.: 125/80

 H.R.: 86

 R.R.: 19

 Pain scale of 7 out of 10

11
b. Diagnosis

Impaired physical mobility related to back pain.

c. Planning

Short term goal:

After 4 hours of nursing interventions, the patient will be able to participate in

activities of daily living and desired activities; the patient's back pain will reduce.

d. Implementation

 Monitor the daily routine of the patient.

 Maintain light activity, such as walking.

 Encourage the patient to limit bed rest.

 Teach significant others about non-pharmacological ways to lessen the pain,

such as massage and applying heat compress.

 Administer 400mg ibuprofen orally every 4-6 hours as needed for pain,

prescribed by the doctor.

e. Rationale

 To have an idea on how to lessen back pain.

 To increase blood flow and ease the pain.

 Staying in bed for an extended amount of time can cause stiffness and

soreness.

 Increase chances of being able to manage the pain.

 To relieve the pain.

f. Evaluation

12
Within 4 hours of nursing interventions, the goals were met as evidenced by:

 The patient was able to participate in ADLs and desired activities.

 The patient's pain scale was decreased from 7 to 3 out of 10

13
References

 Ogbru (2020). Implementations to make when using Ibuprofen. Retrieved from

https://www.medicinenet.com/ibuprofen/article.htm#what_is_ibuprofen_advil_m

otrin_nuprin_and_how_does_it_work

 NHS. UK (2018). Implementations to make when using Ibuprofen. Retrieved

from. (https://www.nhs.uk/medicines/ibuprofen-for-adults/

 Ackley, B., & Ladwig, G. (2014). Nursing diagnosis handbook (10th ed).

Retrieved from https://rnlessons.com/impaired-comfort/?fbclid=IwAR1-
vLYSV4ktkfb5KfBT4__y-YYAWa3QX6uEv6U9_B-Hml7OYHGh6O6yps8

 Wayne (2021) Nursing Care Plan. Retrieved from https://nurseslabs.com/acute-

pain/?fbclid=IwAR0oIbhIE0JxNuK9nSwC4ervQb-
A8fsJkFvmgh3yAoQsMy4egupVaI1cFMo

 Hodgson & Kizior (2021) Saunder’s Nursing Handbook Elsevier 3251 Riverport
Lane St. Louis, Missouri 63043

14
Illustrations (Figures/Tables)

Drug Study

ibuprofen, Advil, nonsteroidal anti-inflammatory drugs (NSAIDs), pregnancy category

B, pregnancy category D (3rd Trimester)

Prescribed dosage, 200–400 mg (dosage), q4–6h prn (frequency), P.O. (route)
frequency, and
route of
administration
Mechanism of Ibuprofen's exact method of action is uncertain. However,

Action because ibuprofen is classified as an NSAID, it is a non-

selective inhibitor of cyclooxygenase, an enzyme involved in

the manufacture of prostaglandins (pain and fever mediators)

and thromboxane (blood clotting stimulators) via the

arachidonic acid pathway.

Ibuprofen is a non-selective COX inhibitor, which means that

it suppresses both COX-1 and COX-2 activity. Inhibiting

COX-2 activity reduces the synthesis of prostaglandins

involved in inflammation, pain, fever, and swelling, whereas

inhibiting COX-1 activity is responsible for some of the

ibuprofen's adverse effects, including G.I. ulcers.

Indication  Patent Ductus Arteriosus is a neonatal condition

wherein the ductus arteriosus (the blood vessel that

connects the main pulmonary artery to the proximal

descending aorta) fails to close after birth, causing severe

risk of heart failure. The prostaglandin inhibition of

ibuprofen has been studied to treat this condition, as it is

known that prostaglandin E2 is responsible for keeping

the ductus arteriosus open.

15
  Rheumatoid- and osteoarthritis - ibuprofen is very

commonly used in the symptomatic treatment of

inflammatory, musculoskeletal and rheumatic disorders.

 Cystic fibrosis - the use of high dosages of ibuprofen has

been proven to decrease inflammation and decreasing

polymorphonuclear cell influx in the lungs.

 Orthostatic hypotension - ibuprofen can induce sodium

retention and antagonize the effect of diuretics which has

been reported to be beneficial for patients with severe

orthostatic hypotension.1

 Dental pain - ibuprofen is used to manage acute and

chronic orofacial pain.

 Minor pain - ibuprofen is widely used to reduce minor

aches and pains and reduce fever and manage

dysmenorrhea. It is very commonly used for the relief of

acute indications such as fever and tension headaches.

 Investigational uses - efforts have been put into

developing ibuprofen to prevent Alzheimer's disease,

Parkinson's disease, and breast cancer.

Contraindications History of hypersensitivity to ibuprofen, aspirin, other NSAIDs.

Pregnancy 3rd trimester; treatment of perioperative pain in

coronary artery bypass graft (CABG) surgery. Aspirin triad

(bronchial asthma, aspirin intolerance, rhinitis). NeoProfen:

Preterm neonates with proven or suspected untreated infection,

elevated total bilirubin, congenital heart disease in whom

patency of the patent ductus arteriosus is necessary for

16
 satisfactory pulmonary or systemic blood flow (e.g., pulmonary

atresia), bleeding, thrombocytopenia, coagulation defects,

proven or suspected necrotizing enterocolitis, significant renal

impairment. Precautions: Pregnancy 1st and 2nd trimesters,

breastfeeding, children, geriatric patients, bleeding disorders,

G.I. disorders, cardiac disorders, HF, CCr <25 mL/min

Cautions: Pts with fluid retention, H.F., dehydration,

coagulation disorders, concurrent use with aspirin,

anticoagulants, steroids; history of G.I. disease (e.g., bleeding,

ulcers), smoking, use of alcohol, elderly, debilitated pts, hepatic/

renal impairment, asthma.

Adverse Effects Central Nervous: Aseptic meningitis, CVA, dizziness,

headache, nervousness, seizures Cardiovascular: Fluid

retention, heart failure, hypertension, MI, peripheral edema,

tachycardia EENT: Amblyopia, epistaxis, stomatitis, tinnitus

Gastro-Intestinal: Abdominal cramps, distention, or pain;

anorexia; constipation; diarrhea; diverticulitis; dyspepsia;

dysphagia; elevated liver enzymes; epigastric discomfort;

esophagitis; flatulence; gastritis; gastroenteritis;

gastroesophageal reflux disease; G.I. bleeding, hemorrhage,

perforation, or ulceration; heartburn; hemorrhoids; hepatic

failure; hepatitis; hiatal hernia; indigestion; melena; nausea;

stomatitis; vomiting Genitourinary (G.U.): Cystitis, hematuria,

renal failure (acute) HEME: Agranulocytosis, anemia, aplastic

anemia, eosinophilia, hemolytic anemia, leukopenia,

neutropenia, pancytopenia, prolonged bleeding time,

thrombocytopenia Respiratory: Bronchospasm, dyspnea,

17
 wheezing Skin: Blisters, erythema multiforme, photosensitivity,

pruritus, rash, Stevens-Johnson syndrome, toxic epidermal

necrolysis, urticaria Other: Anaphylaxis, angioedema, flu-like

symptoms, hypokalemia, weight gain

Nursing • Advise patient to take the medication with food or

Responsibilities immediately after meals to alleviate gastrointestinal upset.

Additionally, he should take tablets with a full glass of water

and refrain from lying down for 15 to 30 minutes to avoid

esophageal irritation.

• Advise patient not to take the medication in higher

dosages or for a longer duration than advised, as

gastrointestinal bleeding may develop, increasing the risk of

MI or stroke.

• Instruct patient to consult prescriber if he needs to take

the drug for more than 3 days for fever or 10 days for pain; if

stomach problems recur; history of bleeding problems, heart

or renal disease, hypertension, or ulcers; if he takes a

diuretic; or if he's over age 65.

• Notify phenylketonuric patients that Motrin chewable

pills contain aspartame.

• Inform the patient that the full therapeutic effect of

arthritis may take up to two weeks or longer to manifest.

• Urge patient to avoid taking two different NSAIDs

simultaneously, unless directed, and to alert prescriber if the

18
patient has ever had an adverse reaction to any other

analgesic or fever-reducing medicine or has a history of

asthma.

• Instruct the patient to abstain from alcohol, aspirin, and

corticosteroids while on ibuprofen, unless otherwise

prescribed.

• If the patient takes aspirin to prevent MI or stroke, inform

them that ibuprofen may negate this effect.

• Advise patient to report flu-like symptoms, rash, signs of

G.I. bleeding, swelling, vision changes, and weight gain.

• Urge parents to tell prescriber promptly if the child

receiving drug develops a headache, high fever, nausea,

persistent diarrhea, severe persistent sore throat, or vomiting

or hasn't been drinking fluids.

• Advise parents to consult a doctor before administering

OTC ibuprofen to a child with asthma, bleeding issues, heart

or kidney disease, high blood pressure, ulcers, or a need for

diuretic medication.

• Caution pregnant patients not to take NSAIDs such as

ibuprofen during the last Trimester because they may cause

premature closure of the ductus arteriosus.

• Explain that ibuprofen may cause severe cardiovascular

problems; advise patient to seek medical assistance if chest

19
 pain, edema, shortness of breath, slurred speech, limb

swelling, weight gain, or weakness occur.

• Emphasize the necessity of obtaining immediate medical

assistance if patients experience stomach or epigastric pain,

black or tarry stools, indigestion, vomiting blood, or coffee

grounds.

• Alert patient to rare but severe skin reactions. Urge him

to seek immediate medical attention for blisters, fever,

itching, rash, or other indications of hypersensitivity.

Nursing Care Plan #1

Assessment Nursing Plan Intervention Ratio Evaluatio

Diagnosis Ning s Nale n
Subjective: Impaired After 4 Independent After four
“Sakit kayo comfort hours of :  To (4) hours f
akoang ulo related to nursing  Note for determi nursing
Ma’am”as headache. intervention the ne the interventio
verbalized by s, the location, nursing ns, the goal
the patient. patient's scale, care to was met.
perception intensity, be given The patient
Objective: of altered and onset to the verbalized
 With comfort/pai of pain. patient. relief from
facial n will be  Maintain  To pain, and
grimace decreased; a calm minimiz there are
 Restlessn the patient and quiet e stimuli no non-
ess will be able environm that verbal
 Sweating to verbalize ent. could indicators
relief of  Use aggravat of
Vital Signs pain; there relaxatio e the pain/disco
will be mfort

20
  BP: diminished n conditio present.
120/80 or absent techniqu n of the
 H non-verbal es such patient.
indicators. as deep  To
.R.: 85 breathing promote
 R.R.: 19 exercises comfort
 Pain . and
scale of 6 relaxatio
out of 10 Dependent: n.
 Adminis  To help
ter pain relieve
medicati the pain.
ons as  To add
ordered. comfort
to the
patient.
 They
serve as
non-
pharmac
ological
methods
of
reducing
pain/pro
moting
comfort.

Nursing Care Plan #2

ASSESSMENT NURSIN PLANNIN NURSING RATIONAL EVALUATI
G G IMPLEME E ON
DIAGNO NTATION
SIS

Subjective: Activity Short  Apply  Heat The goal was

“Sakit kaayo Intoleranc Term Goal: heat increases fully met
akong pus-on.” e Related After 4 compre vasodilati after 4 hours
as verbalized by to Pain of hours of ss to the on and of nursing
the patient. Dysmenor nursing patient’ muscle interventions.
rhea. intervention s relaxation The patient
, the patient abdome while verbalized a
Objective: will display n. decreasin decrease in
increased g the pain on a
 Facial activity ischemic pain scale of
grimace tolerance, as uterus, 2/10 and can
evidenced thus perform
by the relieves ADLs and
 Guarding

21
 behavior client's abdomina self-care
verbalized l cramps. activities.
 Lack of decreased  Massag
effort when level of pain e the  May
standing or and abdomi reduce
engaging in discomfort nal area pain due
activities. during that to the
activities. feels stimulus
 Limited pain. of
mobility therapeuti
c touch.
 Vital Signs:
o B.P.-
126/75  The  For pain
o H.R.- patient relief.
84 will
bpm take
o R.R.- Ibuprof
20 en
cpm 200mg
every 4-
 Pain scale 6 hours
of 8 out of as
10. needed
as per
doctor’s
order
for
pain.

 The
 Observa assessme
tions nt will
over the provide
level of optimal
pain, nursing
and objective
motor data to
respons prevent
e, an possible
hour complicat
after ions and
drug appropriat
adminis e
tration. interventi
ons.

 It helps in
increasing
the

22
 tolerance
for the
 Have activity.
the
patient
perform
the
activity
more
slowly,
in a
 Rest
long
between
time
activities
with
provides
more
time for
rest or
energy.
pauses,
or with
assistan
ce if
necessa
ry.

 Encoura
ge
adequat
e rest.

23
 Nursing Care Plan #3
Assessment Nursing Planning Nursing Rationale Evaluati
Implementati on
Diagnosis on

SUBJECTI SHORT
VE: TERM
Impaired GOAL:  Monitor To have an idea Within 4
physical the daily on how to lessen hours of
mobility routine of back pain. nursing
“Sakit akong related to the intervent
likod dayon back pain. After 4 hours patient. ions, the
mag of nursing goals
ngolngol” as interventions, To increase
 Maintain blood flow and were met
stated by a the patient as
light ease the pain.
50yr old will be able activity, evidence
woman. to participate such as d by:
in activities walking.
of daily Staying in bed
living and for an extended
desired  Encourag amount of time • Patient
OBJECTIV actions; the e the can cause was able
E: patient’s back patient to stiffness and to
limit bed soreness. participat
pain will
 Facial rest. e in
reduce.
Grim
Increase chances ADLs
ace
 Poor of being able to and
Postu manage the pain. desired
re activities
Vital Signs  Teach .
significant
 BP: others
125/8 about
non- •
0
 H pharmacol Patient’s
.R.: 86 ogical pain
ways to scale was
 R.R.: lessen the
decrease
19 pain, such
as d from 7
 Pain To relieve the
massage to 3 out
scale pain.
and of 10
of 7
out of applying
10 heat
compress.

 Administe
r 400mg
ibuprofen

24
orally
every 4-6
hours as
needed for
pain,
prescribed
by the
doctor.

25