PALETTE 1

knock*
I am Glyza Adalla, your student nurse for today. Wrist band, state name
Check IV line is patent (not swelling or red)
Check VS (para sa baseline data nato, para malaman if naa bay abnormal vital signs nimo,
T- 38.5 ˚
B/P-120/80 mmHg
RR- 20 cpm
PR-122 bpm (hiv patients are at risk of irregular heartbeat / possible din sa high temperature).
Kumusta?

Palette 2
Question-answer
Cause of HIV- Unprotected sex of any kind that allows fluids from you and your partner to enter
each other's body. Paiba iba ng sexual partners.
Possibly transmitted? Yes through vaginal fluid. The doctor ordered that possible CS if you
deliver
Hyperacidity- due to hormonal changes and growing baby pressing against your stomach.
Cough- hiv patients are at risk for bacterial pneumonia.
Keso sa panty and pangangati- called yeast infection is a common cause HIV
Init pakiramdam- due to bacteria
Cure to HIV- there is no cure for HiV, but it can be controlled and maprevent ang further
complications by antiretroviral therapy.

LABS:

CBC
Low hemoglobin- anemia
Low mch, mcv, mchc- low iron deficiency
High eosinophils- too much disease-fighting wbc
High basophil- chronic inflammation in body sign of infection
Low hematocrit- insufficiency supply of healthy rbc (anemia)

UA
Color- Yellow orange sign of dehydration
High rbc- due to bladder, kidney or urinary tract problems.
Bacteria 3- sign of uti (bacteria in urine)

PATIENT EDUC:
Drink lots of water.
Do not forget to continue taking prescribed medication from your physician.
Wash and change underwear 2-3 times a day. Maintain good hygiene. Magsuot sab ka og
protective barriers para dili ka makatakod sa imo HIV.
Exercise such as walking.
After birth, it is better to give your baby bottle feeding with formula since HIV can be transmitted
through droplets (saliva, blood, vaginal fluids or breast milk).

Palette 3

MEDICATIONS

TDF/FTC (TRUVADA) INDICATIONS:

ARV -To treat human immunodeficiency virus
(HIV).
Dose: 300 mg -Treatment of HIV positive adults and
Route: PO pediatric patients.
Frequency: OD -RECOMMENDED FOR USE IN
MOA: HIV, ART Combos PREGNANCY.
-Lowers the chance of the baby to get
infected.

CONTRAINDICATIONS:
For unknown or positive HIV-1 status.

ADVERSE EFFECTS:
headaches, rash, nausea, vomiting, and
weight loss

RESPONSIBILITIES:
- Educate the importance of taking
TRUVADA on a regular dosing
schedule.
- Advice to report any signs of acute
HIV-1 infection (flu-like symptoms) to
your physician immediately.

Raltegravir (Isentress®) INDICATIONS:

ARV -To treat human immunodeficiency virus
(HIV).
Dose: 400 mg -Treatment of HIV positive adults.
Frequency: BID - RECOMMENDED FOR USE IN
Route: PO PREGNANCY.

MOA: An HIV-1 antiviral drug. Inhibits the ADVERSE EFFECTS:

catalytic activity of HIV-1 integrase. Integrase
prevents covalent insertion, or integration of
unintegrated linear HIV-1 DNA into the host of
the cell genome preventing the formation of
the HIV-1 provirus.
- nausea, headaches, dizziness,
sleeping problems like insomnia.
RESPONSIBILITIES:
- This should always be taken in combination
with other antiretroviral drugs like truvada.

AMPICILLIN INDICATIONS:
Unasyn Principen -To treat infections caused by bacteria. Sa lab
result is may 3 bacteria found sa urine /
Dose: 1gm cough due to bacteria
Route: IVTT (into vein)
- SAFE FOR PREGNANCY
Frequency: q6hr

MOA: Works by binding penicillin-binding CONTRAINDICATIONS:

proteins to inhibit bacterial cell wall and leads - Allergies to penicillins and other allergens.
to bacteria death. Use cautiously with renal disease, pregnancy,
lactation (may cause diarrhea or candidiasis
to the infant).

ADVERSE EFFECTS:
- redness and peeling of the skin
(exfoliative dermatitis)
- rash/hives
- fever
- diarrhea.

RESPONSIBILITIES:
- Ensure bathroom facilities are readily
available if diarrhea occurs.
- Check IV site carefully for signs of
thrombosis (blood clots block blood
vessels) or local drug reaction.

PARACETAMOL INDICATIONS:
Tylenol, Alvedon, Panadol - For fever
 -Since taas imong temperature, need ni para
Dose: 300 mg magbaba ang temp
Frequency: q4hr
Route: IVTT
CONTRAINDICATIONS:
MOA: Severe hepatic impairment or active liver
disease.

ADVERSE EFFECTS:
- Nausea, vomiting, tachycardia (fast
heartbeat), fatigue, rash/flashing.

RESPONSIBILITIES:
- Make sure that the patient is aware that they
must not exceed the recommended dose.

MICONAZOLE (Monistat) ovule INDICATIONS:

Dose: 200 mg
Frequency: HS x 3 days
Route: insert the tablet or applicator into
the vagina as far as it will comfortably go.
- To treat vaginal yeast infections and the
relief of associated vulvar itching and
irritation.
CONTRAINDICATIONS:
Allergy to miconazole, other azole
antifungals.

ADVERSE EFFECTS:
- Allergic rash, itching, fever, chills,
anemia, nausea, vomiting, diarrhea.

RESPONSIBILITIES:
- Do not mix with other medications.
- Discard darkened solutions.

Palette 4
My shift is done. Thank you for cooperating. If you need something, pls call me or other nurses
so that we can help you. Thank you.
ENDORSEMENT:
Good afternoon. Endorsing room 201b. Margerie Ramos, 32 yrs old, Female, under the service
of Dr. Manuel. Patient is in her 34th week of pregnancy. Came in due to regular contractions for
almost 2 days. Upon admission, the patient verbalized that she is cold and feels hot inside.
Ma’am Margerie has a high body temp of 38.5 C. She also reported to be having diarrhea for 3
days now and observed to be coughing a few times during the interview.

Patient admitted that she was into drugs during her High School days and has been engaging in
promiscuous sexual activity. She was diagnosed positive for HIV testing in 2015, and got tested
again in her 20th week of pregnancy. She started Truvada in combination with Raltegravir but
usually forgets to take her evening Raltegravir dose.

Secure consent to care. VS q4 I and O q shift. NPO except meds, on DAT diet. Start venoclysis
with D5LR 1L at 120cc/hr. For possible C Section once decelerations are noted in progression
Her labs. CBC, hemoglobin 102 (l), low mch, mcv, and mchc. High eosinophil of 9, basophil 1,
hematocrit 0.33(low). Normal platelet count 214. Blood type A+, hepatitis b non-reactive. VDRL
non-reactive. Chest x-ray done.
Urinalysis, high rbc of 24 and found 3 bacteria in urine.
Positive for amniotic fluid, ferning present. To secure 1 unit rbc of pts blood type with
crossmatching, for standby.
Meds, Ampicillin 1 gram IVTT q6, Paracetamol for fever 300 mg IVTT q4.
Fetal heart tone monitoring. Refer for profuse vaginal bleeding or passage of meaty tissue.
Co-manage with Dr. Tubeo of Infectious Disease Possible curettage of uterine cavity once fetus
has passed out. Miconazole 200 mg (Monistat) ovule, 1 supp, PV @ HS x 3 days for fungal
infection. Continue ARV meds. TFD/FTC (Truvada) 300 mg tab OD PO and Raltegravir
(Isentress) 400 mg 1 tab BID PO. Universal Precaution Please. To secure consent. Inform OR
for anesthesia. CP Clearance done by Dr. Saceda, will classify patient as low CP risk.

End of endorsement.