University of Cebu-Banilad

College of Nursing

NCM 110: Nursing Informatics

(Laboratory)

Name: Mongaya, Michael John D.

Year & Section: 2-I
Date Submitted: 05/04/2024

ACTIVITY 2:

CLINICAL GUIDELINES, PROCEDURES AND PROTOCOLS

INSTRUCTIONS:

✔ ANSWER THIS RESEARCH-TYPE ACTIVITY

✔ USING ANY WEB BROWSER, SEARCH FOR ANY UPDATED CLINICAL GUIDELINES, PROTOCOLS AND
PROCEDURES FOR THE FOLLOWING GIVEN CHRONIC ILLNESSES.
✔ PDF

✔ ONE EXAMPLE IS PROVIDED BELOW

✔ FONT: ARIAL, SIZE: 12 , LINE SPACING: 1.5

✔ SUBMIT AND TURNED-IN YOUR ACTIVITY IN GOOGLE CLASSROOM ONLY

HYPERTENSI
ON
 GUIDELINES

NOTE: (FOR SAMPLE USE ONLY. PRINT SCREEN/SCREEN SHOT NOT ALLOWED.)

PROCEDURES
(INCLUDE NEW
MEDICINES/
TREATMENT AND
NEW
PROCEDURES)
PROTOCOLS

REFERENCES
 DIABETES

GUIDELINES
 Medications for type 1 diabetes
PROCEDURES
(INCLUDE NEW
MEDICINES/ Insulin - Insulin is the most common type of medication used in type 1 diabetes treatment. There are
TREATMENT AND more than five classes of insulin:
NEW
PROCEDURES) ● Short-acting insulin - Regular or “short-acting” insulin may reach the bloodstream 30 minutes
after injection and peak 2–3 hours afterward. These injections also work up to 3–6 hours.

● Rapid-acting insulin - As the name suggests, rapid-acting insulin works within 15 minutes. The
peak time is 1–2 hours after use, and the medication lasts between 2 and 4 hours.

● Intermediate-acting insulin - Intermediate-acting insulin works about 2–4 hours after use, with
an average peak time of 12 hours. You can expect this type of insulin to last between 12 and 18
hours.

● Long-acting insulin - Long lasting insulin helps lower your blood glucose levels for up to 24
hours or longer. It stabilizes your bloodstream longer without a peak.

● Combination (premixed) insulins - insulin aspart protamine/insulin aspart 70/30 (NovoLog Mix
70/30, NovoLog Mix 70/30 FlexPen)

Amylinomimetic injectables - It’s an injectable medication that’s used before meals. It works by
delaying the time your stomach takes to empty itself. It also reduces the secretion of the hormone
glucagon after meals. These actions lower your blood sugar.

Medications for type 2 diabetes

Insulin - Some people with type 2 diabetes may also need to take insulin. The same types of insulin
used to treat type 1 diabetes can also treat type 2 diabetes.

Alpha-glucosidase inhibitors - These medications help your body break down starchy foods and table
sugar. This effect lowers your blood sugar levels.Biguanides - Biguanides decrease how much
glucose your liver makes. They also decrease how much glucose your intestines absorb, help your
muscles absorb glucose, and make your body more sensitive to insulin.

Dipeptidyl peptidase-4 (DPP-4) inhibitors - DPP-4 inhibitors are used to help reduce blood sugar
without causing hypoglycemia.

Glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) - LP-1 receptor agonists increase
how much insulin your body uses and the growth of pancreatic beta cells. They decrease your
appetite and how much glucagon your body uses.

Meglitinides - These medications help your body release insulin. However, they’re not for everyone. In
some cases, they may lower your blood sugar too much, especially if you have advanced kidney
disease.

Sodium-glucose transport protein 2 (SGLT2) inhibitors - SGLT2 inhibitors work by preventing the
kidneys from holding on to glucose. Instead, your body gets rid of the glucose through your urine.

Sulfonylureas - These are among the oldest diabetes drugs still used today. They work by stimulating
the pancreas with the help of beta cells. This causes your body to make more insulin.
Thiazolidinediones - Thiazolidinediones work by decreasing glucose in your liver. They also help your
fat cells use insulin better by targeting insulin resistance.

Other drugs

People with type 1 or type 2 diabetes often need to take other medications to treat conditions that are
common with diabetes.

These drugs can include

● aspirin for heart health

● medications for high cholesterol
● high blood pressure medications

Treatment and Procedures

Lifestyle Management Lifestyle management (LM) is essential in diabetes care and includes diabetes
self-management education and support (DSMES), medical nutrition therapy (MNT), physical activity,
smoking cessation counseling, and psychosocial care. DSMES should be assessed at diagnosis,
annually, when complicating factors arise, and when transitions in care occur.

Nutritional Therapy - MNT has an integral role in the overall management of diabetes and requires
individualized eating plans (Appendix II). Each patient should be actively engaged in education,
self-management, and treatment planning with his or her care team.
Weight Management - is important for overweight and obese people with prediabetes, type 1 and type
2 diabetes. Care teams should work closely with patients to set and achieve weight reduction goals
and improve clinical indicators. Modest, persistent weight loss can delay the progression from
prediabetes to type 2 diabetes.

Physical Activity and Exercise - have been shown to improve blood glucose control, reduce
cardiovascular risk factors, contribute to weight loss, and improve overall well-being. Adults with type 1
and type 2 diabetes should engage in 150 minutes or more of moderate-to-vigorous intensity aerobic
activity per week with no more than two consecutive days without activity. Shorter durations (minimum
75 minutes per week) of vigorous-intensity or interval training may be sufficient for younger and more
physically fit individuals. Amount of time spent in daily sedentary behavior should be decreased,
particularly in adults with type 2 diabetes. Flexibility training and balance training are recommended
2–3 times per week for older adults (60 years or older) with diabetes.

Tobacco and Smoking Cessation - Individuals with diabetes who smoke, are exposed to secondhand
smoke, or use tobacco have a heightened risk of CVD, premature death, and microvascular
complications. Smoking may have a role in the development of Type 2 diabetes. All patients are
advised not to use cigarettes and other tobacco products or e-cigarettes.

Assessing Glycemic Control - Patient self-monitoring of blood glucose (SMBG) and A1C, and
continuous glucose monitoring (CGM),
are two methods that are often used to assess the effectiveness and safety of a diabetes management
plan.
 Clinic Visit – Allows topics to be addressed individually to allow patient-centered therapy.

PROTOCOLS
Physical Assessment – Assessment of condition to measure the severity of the problem.
Medication Management – To control the state of the disease and prevent worsening.
Patient Education – Ensure that the client understands the necessity and other undesirable effects of
the medications and the factors causing the disease in order to avoid it.
Action Plan – To determine the necessary actions in order to ease symptoms, if possible, cure the
disease.
Documentation – Documentation provides the assessments, changes, and other client information in
the case of modification of care.
Follow-up – For another assessment to ensure that the care given is effective, if not, modifications will
be done
REFERENCES https://www.lark.com/resources/blood-sugar-chart
https://championprovider.ucsf.edu/sites/champion.ucsf.edu/files/images/DIABETES%20PROTOCOL.pdf
https://www.healthline.com/health/diabetes/medications-list#type-1-diabetes
HEART TRANSPLANT
GUIDELINES
 Medications

PROCEDURES Immunosuppressants - You will need to take immune suppressant medicines to reduce the risk of
(INCLUDE NEW heart rejection. The doses of these medicines usually reduce over time, but some immunosuppressant
MEDICINES/ medicines will be needed for the lifetime of the heart transplant.
TREATMENT AND
NEW
antibiotic and antiviral medicines - You will need antibiotic and antiviral medicines to reduce the risk of
PROCEDURES)
infection. These usually stop between 3 and 12 months after a transplant, but your transplant team will
advise you about this.

Painkillers - You will need painkillers for the first few months.

Statin - All heart transplant patients are prescribed a statin. This has several important beneficial
effects including lowering cholesterol.

Blood pressure medicines - You may need medicines to lower your blood pressure. This is often
required at some point in the first year

Anticoagulants - These are known as anticoagulants and work to thin your blood and prevent clots.
Some transplant patients will be prescribed anticoagulants to reduce the risk of blood clots.

Treatment and Procedures

When a donor heart becomes available, your transplant coordinator will call you.
It's crucial that you get to the hospital right away. We ask people on the heart transplant waiting list to
be within four hours of UPMC.
Before coming to the hospital for your heart transplant:
● Do not eat or drink anything.
● Pack your phone and charger.
● Bring your medicines.
 ● If you have a ventricular assist device (VAD), bring your equipment.

When you arrive at UPMC, we will prep you for your heart transplant surgery.
The donor team will inspect the heart to make sure it's good for transplant and a match for you.
In the meantime — to make sure you're in good health with no active illnesses — you'll:
● Complete a medical history and physical examination
● Have blood work
● Get x-rays
Before moving you to the OR, the anesthesiologist will speak with you about what to expect. You'll
receive general anesthesia and sleep through the heart transplant procedure.
You will also speak to one of the surgical team members to get consent for the transplant to take
place.
PROTOCOLS

REFERENCES https://www.researchgate.net/figure/Comparison-of-German-and-US-listing-criteria-for-heart-transplant
_tbl1_326901938
https://www.sciencedirect.com/science/article/abs/pii/S0828282X22001465
https://www.nhsbt.nhs.uk/organ-transplantation/heart/living-with-a-heart-transplant/heart-transplant-me
dicines/
https://www.upmc.com/services/transplant/heart/process/surgery

CARDIOPULMARY RESUSCITATION (CPR)

GUIDELINES

Medication

PROCEDURES
 ( INCLUDE NEW
MEDICINES/
TREATMENT AND
NEW
PROCEDURES)
 ● Untrained. If you're not trained in CPR or worried about giving rescue breaths, then provide

PROTOCOLS
hands-only CPR. That means uninterrupted chest compressions of 100 to 120 a minute until
paramedics arrive. Details are described below. You don't need to try rescue breathing.
● Trained and ready to go. If you're well-trained and confident in your ability, check to see if
there is a pulse and breathing. If there is no pulse or breathing within 10 seconds, begin
chest compressions. Start CPR with 30 chest compressions before giving two rescue
breaths.
● Trained but rusty. If you've previously received CPR training but you're not confident in
your abilities, then just do chest compressions at a rate of 100 to 120 a minute. Details are
described below.

Remember to spell C-A-B

The American Heart Association uses the letters C-A-B to help people remember the order to perform
the steps of CPR.

● C: compressions
● A: airway
● B: breathing
Compressions: Restore blood flow

Compressions means you use your hands to push down hard and fast in a specific way on the
person's chest. Compressions are the most important step in CPR. Follow these steps for performing
CPR compressions:

1. Put the person on their back on a firm surface.

2. Kneel next to the person's neck and shoulders.
3. Place the lower palm of your hand over the center of the person's chest, between the
nipples.
4. Place your other hand on top of the first hand. Keep your elbows straight. Place your
shoulders directly above your hands
5. Push straight down on the chest at least 2 inches (5 centimeters) but no more than 2.4
inches (6 centimeters). Use your entire body weight, not just your arms, when doing
compressions.
6. Push hard at a rate of 100 to 120 compressions a minute. The American Heart
Association suggests performing compressions to the beat of the song "Stayin' Alive."
Allow the chest to spring back after each push.
7. If you haven't been trained in CPR, continue chest compressions until there are signs of
movement or until emergency medical personnel take over. If you have been trained in
CPR, go on to opening the airway and rescue breathing.

Airway: Open the airway

 ● If you're trained in CPR and you've performed 30 chest compressions, open the person's
airway using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and
gently tilt the head back. Then with the other hand, gently lift the chin forward to open the
airway.

Breathing: Breathe for the person

Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is

seriously injured or can't be opened. Current recommendations suggest performing rescue breathing
using a bag-mask device with a high-efficiency particulate air (HEPA) filter.

1. After opening the airway (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for
mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.
2. Prepare to give two rescue breaths. Give the first rescue breath — lasting one second —
and watch to see if the chest rises.
3. If the chest rises, give a second breath.
4. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give a second
breath. Thirty chest compressions followed by two rescue breaths is considered one cycle.
Be careful not to provide too many breaths or to breathe with too much force.
5. Continue chest compressions to restore blood flow.
6. As soon as an automated external defibrillator (AED) is available, apply it and follow the
prompts. Give one shock, then continue chest compressions for two more minutes before
giving a second shock. If you're not trained to use an AED, a 911 operator or another
 emergency medical operator may be able to give you instructions. If an AED isn't
available, go to step 5 below.
7. Continue CPR until there are signs of movement or emergency medical personnel take
over.

REFERENCES
https://www.medicalnewstoday.com/articles/324712

https://www.msdvetmanual.com/multimedia/table/drugs-and-defibrillation-used-in-cardiopulmonary-res
uscitation

https://www.mayoclinic.org/first-aid/first-aid-cpr/basics/art-20056600