NCP & DRUG STUDY

PATIENT NAME: S.L.S

Name of Drug Mechanism of Action Indication Side Effects/ Adverse Effects Nursing Considerations
Generic name: It exerts its bactericidal activity by For the treatment of the following  diaper rash Assessment
CEFUROXIME interfering with the bacterial cell wall infections caused by susceptible History: Hepatic and renal impairment,
synthesis. It binds to specific penicillin- microorganisms: Upper respiratory  diarrhea lactation, pregnancy
Brand name: binding proteins responsible for the tract infections including: Acute
ZEGEN synthesis of peptidoglycan, a sinusitis, Acute otitis media, Acute  dislike of taste Physical: Skin status, LFTs, renal function
heteropolymeric structure that gives the tonsillopharyngitis. tests, culture of affected area, sensitivity
Route: cell wall its mechanical stability.  dizziness tests
TIV Lower respiratory tract infections
including: Acute bacterial  gas formation Interventions
Dosage and frequency: exacerbations of chronic bronchitis, Culture infection and arrange for sensitivity
750mg x8 Secondary bacterial infections of  headache tests before and during therapy if expected
acute bronchitis. response is not seen.
Drug Classification:
 increase in the level of liver
CEPHALOSOPRINS Uncomplicated skin and skin Give oral drug with food to decrease GI
enzymes.
structure infections including upset and enhance absorption.
furunculosis, pyoderma and
 increased number of eosinophils
impetigo. Give oral drug to children who can swallow
 inflammation of the vagina. tablets, crushing the drug results in a bitter,
Uncomplicated urinary tract unpleasant taste.
infections including pyelonephritis.  microbial overgrowth (candida
Uncomplicated gonorrhea. overgrowth) Have vitamin K available in case
hypoprothrombinemia occurs.
Early Lyme disease (erythema  mouth ulcers
migrans). Discontinue if hypersensitivity reaction
 nausea occurs.
Step down treatment for infections
due to susceptible organisms, initially  reaction caused by harmful
given antimicrobial therapy, products released into the body
particularly parenteral cefuroxime. after killing of microbes.

 thirst

 vomiting

 whitish fluid secretion from vagina

 Name of Drug Mechanism of Action Indication Side Effects/ Adverse Effects Nursing Considerations

Generic name: he inhibition of the H+/K+-ATPase helps treat several gastrointestinal  Headache Assess the patient's medical history,
OMEPRAZOLE enzyme, also known as the gastric proton disorders, including acid reflux,  Abdominal pain allergies, and any current medications to
pump, which is responsible for the final ulcers, and stomach pain. It can  Nausea avoid any potential drug interactions or
Brand name: step in the production of stomach acid. By also help prevent ulcers caused by  Diarrhea contraindications.
PRILOSEC irreversibly binding to the proton pump and certain medications or in critically ill  Constipation
inhibiting its function, omeprazole reduces patients. However, it is important to  Gas Verify the correct dosage and route of
Route: the amount of acid secreted by the parietal use omeprazole only under the administration as prescribed by the
 Dry mouth
PER OREM, IV cells in the stomach. guidance of a healthcare provider healthcare provider.
 Dizziness
and not to treat occasional
Dosage & frequency: heartburn or acid reflux.  Rash or itching Monitor the patient for any adverse reactions
40mg OD, BID, TID or side effects of the medication, especially if
before meals ADVERSE EFFECTS: the patient is taking it for an extended period
of time.
Drug Classification:  Severe stomach pain
PROTON-PUMP  Severe diarrhea or vomiting Advise the patient to take the medication at
INHIBITORS  Chest pain or heart palpitations the same time each day and to avoid missing
 Difficulty breathing or swallowing doses.
 Swelling of the face, lips, tongue,
or throat Instruct the patient not to crush, chew or
 Severe skin reactions break the delayed-release capsules, and to
swallow them whole.

Advise the patient to avoid alcohol, caffeine,

and smoking, which may worsen the
symptoms of the condition being treated.

Monitor the patient's electrolyte levels and

kidney function, especially if the patient is
taking omeprazole for a long period of time.

Advise the patient to seek medical attention

immediately if they experience any serious
side effects or allergic reactions.
 Name of Drug Mechanism of Action Indication Side Effects/ Adverse Effects Nursing Considerations

Generic name: It is complex and not fully understood, but is a commonly used medication  Skin rashes, itching or hives Dosage and administration: The
PARACETAMOL it is believed to involve inhibition of that is indicated for the treatment of recommended dose of paracetamol depends
prostaglandin production and modulation mild to moderate pain and fever. It  Swelling of the throat, tongue or on the patient's age, weight, and medical
Brand name: of the hypothalamic heat-regulating center. is widely available over the counter face condition. It is important to follow the dosing
PANADOL and is used to relieve pain instructions on the label or as prescribed by a
associated with conditions such as  Shortness of breath or wheezing healthcare provider, and to avoid exceeding
Route: headache, toothache, menstrual the recommended maximum daily dose.
IV cramps, muscle aches, and  Skin rash or peeling, or mouth
arthritis. ulcers Patient allergies: Before administering
Dosage & frequency: paracetamol, it is important to check if the
1gm every 4hrs  Breathing problems. This is more patient has any known allergies to the
likely if you have experienced them medication or to any other medications in the
Drug Classification: before when taking other painkillers same class.
ANALGESICS AND such as ibuprofen and aspirin
ANTIPYRETIC DRUGS Drug interactions: Paracetamol may interact
 Unexplained bruising or bleeding or with other medications, such as blood
becoming unusually tired. Getting thinners, which can increase the risk of
more infections than usual. bleeding. It is important to check for potential
drug interactions before administering
paracetamol.
 Liver problems. Nausea, sudden
weight loss, loss of appetite and
Patient education: It is important to educate
yellowing of the eyes and skin can
patients on the proper use of paracetamol,
occur
including the recommended dose, how to
take the medication, and potential side
effects. Patients should also be advised to
avoid taking other medications that contain
paracetamol to prevent accidental overdose.

Monitoring: After administering paracetamol,

it is important to monitor the patient for any
adverse reactions or side effects, such as
liver damage or gastrointestinal upset. The
patient's vital signs, including blood pressure
and heart rate, should also be monitored as
needed.
 Name of Drug Mechanism of Action Indication Side Effects/ Adverse Effects Nursing Considerations
Generic name: inhibits key pathways in prostaglandin Postoperative pain: Ketorolac is  Gastrointestinal effects: Ketorolac Assess the patient's medical history,
KETOROLAC synthesis which is crucial to it's often used to manage pain can cause stomach pain, nausea, allergies, and any current medications to
mechanism of action.4 Although ketorolac following surgical procedures, such vomiting, and diarrhea. It can also avoid any potential drug interactions or
Brand name: is non-selective and inhibits both COX-1 as dental extractions, orthopedic increase the risk of gastrointestinal contraindications.
PRILOSEC and COX-2 enzymes, it's clinical efficacy is surgeries, or gynecological bleeding or ulcers, particularly in
derived from it's COX-2 inhibition. The procedures. people with a history of these Verify the correct dosage and route of
Route: COX-2 enzyme is inducible and is conditions. administration as prescribed by the
PER OREM, IV responsible for converting arachidonic acid Acute pain: Ketorolac may also be healthcare provider.
to prostaglandins that mediate used to treat acute pain, such as  Central nervous system effects:
Dosage & frequency: inflammation and pain. By blocking this that caused by a kidney stone, a Ketorolac can cause dizziness, Monitor the patient for any adverse reactions
20 – 40mg OD, BID, TID pathway, ketorolac achieves analgesia migraine headache, or a drowsiness, headache, and fatigue. or side effects of the medication, especially if
before meals and reduces inflammation. musculoskeletal injury. the patient is taking it for an extended period
 Kidney effects: Ketorolac can of time.
Drug Classification: Cancer pain: Ketorolac may be reduce blood flow to the kidneys,
PROTON-PUMP used in combination with other pain which can cause kidney damage, Advise the patient to take the medication at
INHIBITORS medications to manage cancer- particularly in people with pre- the same time each day and to avoid missing
related pain. existing kidney disease. doses.

 Cardiovascular effects: Ketorolac Instruct the patient not to crush, chew or

can increase the risk of heart break the delayed-release capsules, and to
attack, stroke, and other swallow them whole.
cardiovascular events, particularly
in people with pre-existing Advise the patient to avoid alcohol, caffeine,
cardiovascular disease. and smoking, which may worsen the
symptoms of the condition being treated.
 Allergic reactions: Ketorolac can
cause allergic reactions in some Monitor the patient's electrolyte levels and
people, including rash, itching, kidney function, especially if the patient is
hives, and swelling of the face, lips, taking omeprazole for a long period of time.
tongue, or throat.
Advise the patient to seek medical attention
immediately if they experience any serious
side effects or allergic reactions.
 Assessment
Diagnosis Nursing Goals Interventions Rationale Evaluation
Acute Pain Patient will report pain relief Assess the patient's pain To Identify the pain intervention Patient reports reduction in pain or no
related to or reduction. using a pain scale and note of the patient. pain
OBJECTIVE: epigastric Patient will demonstrate the location, intensity, and Patient demonstrates relaxation
relaxation techniques to duration of the pain. techniques to manage pain.
VS: Temp: 37.8, tachycardia and hypotension inflammation as
manage pain Administer pain medication Patient is able to modify diet to
evidenced by as ordered by the physician to For managing pain and reduce symptoms.
Abdominal assessment: Tenderness and guarding on patient reports of reduce the pain. promoting the patient's overall
palpation in the right lower quadrant, rebound tenderness, sharp, burning Assess the patient's diet and well-being and recovery.
and positive Rovsing's sign. pain in the make modifications as
epigastric area. necessary to reduce For managing a wide range of
symptoms. health conditions and promoting
Monitor the patient's vital overall health and well-being.
SUBJECTIVE: signs and report any changes
to the physician.
 Patient reports severe, localized pain in the right
Encourage the patient to use
lower quadrant of the abdomen, which may have To ensure positive patient
relaxation techniques such as
started as vague epigastric discomfort and has now outcomes.
migrated to the right lower quadrant. deep breathing, meditation,
or visualization to help
 Patient may report a history of fever, chills, and manage the pain.
malaise in the days leading up to the onset of To help improve their quality of
abdominal pain. life and reduce the need for
more invasive or aggressive
 Patient may report nausea, vomiting, anorexia, and treatments.
constipation or diarrhea.
 Assessment
Diagnosis Nursing Goals Interventions Rationale Evaluation

OBJECTIVE:
 Tenderness and guarding in the right lower
quadrant of the abdomen.
 Rebound tenderness.
 Low-grade fever
 Elevated white blood cell count.
 Nausea and vomiting
 Decreased or absent bowel sounds.
SUBJECTIVE:
 Abdominal pain, typically starting near the
navel and then moving to the right lower
quadrant.
 Pain that worsens with movement or coughing
 Loss of appetite
 Feeling bloated or gassy
 Diarrhea or constipation
Acute Pain related to The patient will
inflammation of the experience relief from
appendix as evidenced pain and discomfort.
by patient reports of
RLQ abdominal pain
and tenderness.
Administer prescribed For pain management that The patient reports relief from pain
analgesics as ordered by the can improve patient and discomfort.
healthcare provider. Vital signs are within normal limits.
outcomes, provide pain relief, The patient is able to rest and sleep
and ensure compliance with comfortably.
Encourage the patient to rest
legal and ethical standards. The patient is able to follow dietary
in a comfortable position
that promotes relaxation and and activity restrictions as ordered by
reduces tension in the To promote relaxation and the healthcare provider.
abdomen. reduces tension in the The patient is prepared for surgery if
indicated.
abdomen can help alleviate
Apply heat or cold therapy as discomfort, reduce muscle
appropriate to alleviate pain
tension, and promote
and discomfort.
healing.
Monitor vital signs,
To prevent patients,
particularly temperature and
condition from worsening
heart rate, to detect any
signs of worsening of the
condition.
Assist the patient with any
activities of daily living as
needed to reduce pain and
promote rest.

Instruct the patient to avoid

eating or drinking until
cleared by the healthcare
provider.

Prepare the patient for

surgery as needed.
Nursing Diagnosis 1: Acute Pain related to epigastric Lab: Nursing Diagnosis 2: Acute Pain related to inflammation of
inflammation as evidenced by patient reports of sharp, the appendix as evidenced by patient reports of RLQ
CBC, PC - WBC, NEUTROPHIL: HIGH; LYMPOCYTE,
burning pain in the epigastric area. abdominal pain and tenderness.
EOSINOPHIL: LOW
 Age: 41 y/o URINALYSIS - PUS CELLS 6-8/HPF  Age: 41 y/o
 BP: 120/80  BP: 200 / 130
 Pain Score: 8/10 WHOLE ABDOMEN CT scan - Bulbous Appendix (1.5cm),  Temp: 36.1
 Temp: 37.1 enlarge size of uterus with myoma hypertrophic degenerative  PR: 71
 PR: 82 disease.  RR: 20
 RR: 19  On going PNSS 1L x 80 cc/hour
 On going D5LR 1L x 100 cc/hour
Medications:
Medications:
 OMEPRAZOLE (TIV, 40mg; OD)
 OMEPRAZOLE (TIV, 40mg; OD)  PARACETAMOL (TIV, 1gm; x4hrs)
 PARACETAMOL (TIV, 1gm; x4hrs) ROOM # 604  KETOROLAC (TIV, 30mg; x6hrs)
 KETOROLAC (TIV, 30mg; x6hrs) NAME: S.L. S  CEFUROXIME (TIV, 750mg; x8hrs)
 CEFUROXIME (TIV, 750mg; x8hrs) AGE: 41 Y/O
CC: Acute Appendicitis Subjective:
Subjective:
 Patient reports severe, localized pain in the right
 Patient reports severe, localized pain in the right ASSESSMENT: lower quadrant of the abdomen, which may have
lower quadrant of the abdomen, which may have Physical Assessment started as vague epigastric discomfort and has now
started as vague epigastric discomfort and has now Vital Signs migrated to the right lower quadrant.
migrated to the right lower quadrant. Treatment and Medication
Pain Assessment  Patient may report a history of fever, chills, and
 Patient may report a history of fever, chills, and malaise in the days leading up to the onset of
malaise in the days leading up to the onset of GI Assessment abdominal pain.
abdominal pain.
Fluid & Electrolyte Assessment  Patient may report nausea, vomiting, anorexia, and
 Patient may report nausea, vomiting, anorexia, and constipation or diarrhea.
Laboratory Assessment
constipation or diarrhea.
Objective:
Objective:
VS: Temp: 37.1, PR: 82, RR: 19, CR: 84
VS: Temp: 37.1, PR: 82, RR: 19, CR: 84

 Tenderness and guarding in the right lower

 Tenderness and guarding in the right lower
quadrant of the abdomen.
quadrant of the abdomen.
 Rebound tenderness.
 Rebound tenderness.
 Low-grade fever
 Low-grade fever
 Elevated white blood cell count.
 Elevated white blood cell count.
 Nausea and vomiting
 Nausea and vomiting
 Positive Rovsing’s sign
 Decreased or absent bowel sounds.
 Pain Score: 8/10
 Pain Score: 7/10