XII.

MEDICAL MANAGEMENT

A. DIET

1. Soft Low Salt Low Fat Diet

Date ordered: November 20, 2019

Purpose: to reduce amount of cholesterol in the blood and to prevent fluid retention.

 NURSING RESPONSIBILITIES:
 Confirm Doctor’s Order.
RATIONALE: to determine what the advised diet is and to avoid any mistake.
 Explain the purpose of the diet to the patient and to watchers.
RATIONALE: to gain cooperation of the client and relatives as to not bring
any food that is to be avoided in the diet like fried foods and seasoned foods.
 Instruct client and watchers that he can only eat low sodium and low fat foods
like boiled or steamed fish with no seasoning, “lugaw”, and fruits and
vegetables that are boiled.
RATIONALE: to prevent fluid retention and to reduce cholesterol in the
blood.

2. Diabetic Diet

Date ordered: November 20, 2019

Purpose: to reduce blood glucose level and to maintain levels that are within normal
limits.

 NURSING RESPONSIBILITIES:
 Confirm Doctor’s Order.
RATIONALE: to determine what the advised diet is and to avoid any mistake.
  Explain the purpose of the diet to the patient and to watchers.
RATIONALE: to gain cooperation of the client and relatives as to not bring
any food that is to be avoided in the diet like pasta, too much rice and bread.
 Instruct client and watchers that he can only eat foods that are sugar free or
low in sugar such as oatmeals, eggs and vegetables and fruits that are fresh
and no artificial sweeteners.

B. INTRAVENOUS THERAPY

- it is administering liquid substances directly into a vein which is very common to

supply supplements that cannot be taken orally. It can be intermittent or continuous. It is also the
fastest way to deliver fluids and medications throughout the body.

1. D5NM 1L (Dextrose 5% in Normosol M Solution) KVO

Date administered: November 20, 2019 @ 6:30 am

Classification: Hypertonic Solution

Purpose: it is indicated for parenteral maintenance of routine daily fluid and electrolyte
requirements with minimal carbohydrate calories from dextrose.

NURSING RESPONSIBILITIES:

 Check the doctor’s order

Rationale: to avoid error in infusing IVF
 Explain the procedure and purpose to the client and family
Rationale: to gain trust and cooperation
 Observe aseptic technique
Rationale: to prevent infection and introduction of microorganism to the punctured site
 Assess the IV site for redness, swelling, edema
Rationale: it may indicate IV infiltration
 Regulate IVF to ordered flow rate.
Rationale: to prevent cardiac overload and to avoid under load of fluid intake

2. PNSS 1L (0.9 Sodium Chloride Solution) KVO

Date administered: November 24, 2019 @ 10:15 am

Classification: Isotonic Solution

Purpose: it is used because it has little to no effect on the tissue and make the person feel
hydrated preventing hypovolemic shock or hypertension

NURSING RESPONSIBILITIES:

 Check the doctor’s order

Rationale: to avoid error in infusing IVF
 Explain the procedure and purpose to the client and family
Rationale: to gain trust and cooperation
 Observe aseptic technique
Rationale: to prevent infection and introduction of microorganism to the punctured site
 Assess the IV site for redness, swelling, edema
Rationale: it may indicate IV infiltration
 Regulate IVF to ordered flow rate.
Rationale: to prevent cardiac overload and to avoid under load of fluid intake

C. OXYGEN ADMINISTRATION

- 3 L/min via Nasal Cannula

Date administered: February 27, 2019

Date discontinued: March 1, 2019

Purpose: to supplement oxygen to the patient and to relieve DOB caused by complications of
Heart Failure.

NURSING RESPONSIBILITIES:

 Ensure the patency of the oxygen tube

  Maintain the water level in the humidifier
 Monitor O2 saturation.

D. INDWELLING FOLEY CATHETER

Date ordered: November 20, 2019

Purpose: For Bladder Drainage and to measure amount of urine output

NURSING RESPONSIBILITIES:

 Check the patency of the tubings to make sure that it is intact and without any leakage.
 Before inserting the catheter perform aseptic technique.
 Apply water based lubricant to the tube before applying for easy insertion.
 Maintain hygiene on the site of insertion.
 Advise patient not to pull the tubings to prevent injury.

E. POSITIONING

1. Moderate High Back Rest

- is a standard patient position in which the patient is seated in a semi upright sitting
position (45-60 degrees) and may have knees either bent or straight. It is an intervention used to
promote oxygenation via maximum chest expansion and is implemented during events of
respiratory distress. This position facilitates the relaxing of tension of the abdominal muscles,
allowing improved breathing. In immobile patients and infants, this position alleviates the
compression of the chest that occurs due to gravity.