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Nursing Care Plan
Diarrhea
Assessment Nursing
Diagnos
is
Background
Knowledge
Planning Interventions Rationale Evaluation
Subjective
Apat na beses
na akong
dumudumi as
"verbalized by
the patient"
Objective
-Loose bowelmovementwith yellowishwatery stoolminimum ofthrice a day.
-Increasebowel sounds/
peristalsis.
-ausea and
!omiting
-Abdominal
cramping
iarrhea
related
to
infectiou
s
processe
s
#esult from
Infectious$vir
al% bacteria
or parasitic&
'
Increaseabsorption of
(uid by the
intestinal
mucosa
'
)yper
motility of
the intestine
'
IA##)*A
+ithin ,
hours of
nursing
interventions%
the patient
will report
reduction in
freuency ofstools and
return to
more normal
stool
consistency
- bserve and
record stool
freuency%
characteristics%
amount% and
precipitating
factors.
- romote bed rest
and
provide bedside
commode.
- #emove stoolpromptly.
rovide room
deodorizers.
- Identify foods
and (uids that
precipitate
-)elps
di0erentiate
individual disease
and assesses
severity of
episode.
- #est decreases
intestinal motility
and reduces
the metabolic
rate when
infection or
hemorrhage is a
complication.
- #educes no1ious
odors to avoid
undue client
embarrassment.
After , hours of
nursing
interventions%
the client was
be able to
report
reduction in
freuency ofstools and
returned to
more normal
stool
consistency
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diarrhea% such as
raw vegetables
and fruits% whole-
grain cereals%
condiments%
carbonated drinks%
and milk products.
- #estart oral (uid
intake gradually.
0er clear liuids
hourly and avoid
cold (uids.
- rovide
opportunity to
vent frustrations
related to disease
process.
-bserve for fever%
tachycardia%
lethargy%
leukocytosis%
- Avoiding
intestinal irritants
promotes
intestinal rest.
- rovides colon
rest by omitting
or decreasing thestimulus of foods
and (uids.
- resence of
disease with
unknown cause
that is di2cult to
cure and that
may reuiresurgical
intervention can
lead to stress
reactions that
may aggravate
condition.
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decreased serum
protein% an1iety%
and prostration.
- Administer
medications% as
indicated3
Antidiarrheals%
such as
dipheno1ylate
$Lomotil&%
loperamide
$Imodium&% and
anodyne
suppositories.
- 4ay signify that
to1ic megacolon
or perforation and
peritonitis are
imminent or have
occurred%
necessitating
immediate
medical
intervention.
- ecreases 5I
motility or
propulsion
$peristalsis& and
diminishes
digestive
secretions to
relieve cramping
and diarrhea.
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Defcient uid volume
Assessment Nursing
Diagnosis
Background
Knowledge
Planning Intervention
s
Rationale Evaluation
Subjective
6)alos
sampung
beses akongdumumi at
apat na beses
na nagsuka%7
as verbalized
by the patient.
Objective
e8cient (uid
volume
related to
e1cessivelosses through
normal routes
as evidenced
by freuent
passage of
loose watery
stool and
#apid
propulsion of
intestinal
contents
through thesmall bowels
may lead to a
serious (uid
volume de8cit.
9he body
would want to
e1pel the
foreign
Short term
+ithin :
hours of
nursinginterventions%
the patient will
report
understanding
of causative
factors for
(uid volume
de8cit
;. lace
patient in
comfortable
position
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• abdominal
cramping
• dehydratio
n
• nausea
• fatigue
• weakness
• dry mucous
membrane
• confusion
vomiting
ob>ective as
much as
possible thus
it doesn?t
undergo its6normal7
speed% with
that% the
digestive
system organs
are not able to
absorb the
e1cess (uids
that are
usually
absorbed by
the body.
Long Term
+ithin = days
of nursinginterventions%
the patient will
maintain (uid
volume at
functional
level as
evidenced by
being well
hydrated%
intake is eual
as output% and
normal skin
turgor
=. 4onitor
input andoutput
balance
:. 4aintain
adeuate
hydration%
increase (uid
intake
@. rovide oral
as well as eye
care
. *ncourage
bed rest
B. Change
accurate
picture of (uid
status
:. 9o correct
losses and
maintain
hydration
status
@. 9o prevent
in>ury from
dryness
. 9o prevent
fatigue
B. 9o reduce
pressure on
fragile skin
Long Term
After = days of
nursing
interventions%the patient
maintained
(uid volume at
functional
level as
evidenced by
being well
hydrated%
intake was
eual as
output% and
normal skin
turgor
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position every
< hours
,. Administer
4etoclopramid
e and
meprazole
:D g asprescribed
E. Feep side-
rails up
;D. iscuss
factors related
to occurrence
and ways to
prevent
dehydration
and tissues
,. 9o limit
gastric and
intestinal
losses
E. 9o avoid
falls since the
patient is
e1periencing
weakness%
fatigue and
confusion
;D. 9o avoid
recurrence of
condition
;;. 9o promote
wellness
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;;. Identify
and instruct in
ways to meet
speci8c (uid
needs
Acute Pain
Assessment Nursing
Diagnosis
Background
Knowledge
Planning Intervention
s
Rationale Evaluation
Subjective
64ahapdi ang
sikmura ko%7 asverbalized by
the patient.
Objective
• !erbalization of pain
Acute pain
related to
gastric
irritation asevidenced by
pain scale of
/;D
5astric
irritation
'
#elease of cytokine and
prostaglandin
'
Increase in
vascular
permeability
'
+ithin ; hour
of nursing
interventions%
the patient willreport a
decrease of
pain
; lace
patient in
supine
position
< *ncourage
patient to
do deep
breathing
e1ercise
; 9o make
the patient
comfortabl
e
< 9o reduce
sensation
of pain
After ; hour of
nursing
interventions%
the patientreported a
decrease of
pain from a
pain scale of
/;D to =/;D
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with a painscale of/;D
• Appearsweak
• Limitedrange ofmotion
• #estlessness
• Impairedthoughtprocess
• #educedinteraction
withpeople
ain in the
abdomen
= Limit
environme
ntal stimuli
such as
noise
: Instruct the
relative to
massage
the area
where pain
is elicited if
not
contraindic
ated
@ *ncourage
doing
diversional
activities%
such asvisualizatio
n%
verbalizatio
n of
feelings or
listening to
music
= *1cessive
environme
ntal stimuli
can
contributeto feeling
of
increasing
pain
: 9o lessen or
alleviate
pain
@ 9o distract
patient?s
attention
from pain
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rovide
adeuate
rest
B Change
position
every <
hours
, rovide
cool
environme
nt
E Feep side-
rails up
;D #eview
ways tolessen
pain%
including
techniues
such as
therapeutic
touch%
biofeedbac
9o reduce
pain and
promote
relief or
comfort
B 9o avoid
bed sores
, 9o make
the patient
feel more
rela1
E 9o promote
patient?s
safety
;D art of
pain
manageme
nt
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k% self-
hypnosis
and
rela1ation
skills
;; Identify
speci8c
signs and
symptoms
and
changes in
pain
characteris
tics
reuiring
medical
follow-up
;; 9o promote
timely
interventio
n
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edications
DR!" C#A$$I%IC
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NAE*
(me+ra,o
le
BRAND
NAE*
Losec-Prilo
sec
gastrointesti
nal
agentG +rot
on +um+
inhi.itor
/0g I) (D
An
antisecretory
compound that
is a gastric acid
pump inhibitor.
Huppresses
gastric acid
secretion by
inhibiting the
)% F-A9ase
enzyme system
Jthe acid
$proton )&
pumpK in the
parietal cells.
uodenal and
gastric ulcer.
5astroesopha
geal re(u1
disease
including
severe
erosive
esophagitis
$: to , wk
treatment&.
Long-term
treatment of
pathologic
hypersecreto
ry conditionssuch as
ollinger-
*llison
syndrome%
multiple
endocrine
adenomas%
and systemic
Long-term
use for
gastroesopha
geal re(u1
disease%
duodenal
ulcersG
lactation.
CN$*)eadach
e% dizziness%
fatigue.
"I*iarrhea%
abdominal
pain% nausea%
mild transient
increases in
liver function
tests.
!rogenital*)
ematuria%
proteinuria.
$kin*#ash.
Lab
tests3
4onitor
urinalysis
for
hematuria
and
proteinuri
a. eriodic
liver
function
tests with
prolonged
use.
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mastocytosis.
In
combination
with
clarithromyci
n to treat
duodenal
ulcers
associated
with
)elicobacter
pylori.
DR!" C#A$$I%IC
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IN'ER)EN'I(
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NAE*
obutamin
e
BRAND
NAE*
obutamin
e
)ydrochlori
de
Inotropic
agent
obutamine
drops < ampule
obutamine is
an inotropic
agent whose
primary
activity is the
stimulation of
beta receptors
of the heart
while
producing
comparatively
mild
chronotropic%
hypertensive%
arrhythmogeni
-Hevere
cardiac
failure
secondary to
A4I or
cardiomyopat
hy.
-Cardiogenic
shock.
-Heptic
shock.
-Congestive
Idiopathic
hypertrophic
subaortic
stenosisG
hypersensitivi
ty to any
component of
the productG
dobutamine
with de1trose
should not be
administered
simultaneousl
y with blood
through the
1eart-Increasedheart rateand bloodpressure%chest pain%palpitation.
#ocal-In(ammationof vein.
iscellaneous- ausea%vomiting%headache%
Ideally monitor
M
continuously.
A catheter
often desirable.
-atient must
be on cardiac
monitor.
- *C5% M% and
hourly urine
measures must
be
continuously
monitored
while A+
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c and
vasodialative
e0ects.
Causes an
increase in
cardiac output
$C.& usually
not associated
with a marked
increase in
heart rate%
while the
stroke volume
is usually
increased.
Hystemic
vascular
resistance is
usually
decreased due
to stimulation
of beta <
receptors
which
contributes to
the increased
C..
cardiac
failure.
-Acute
pulmonary
oedema
same infusion
set because
of the
possibility of
pseudoagglut
ination of red
cells.
an1iety%fatigue andshortness ofbreath
Potentiall2%atal-)eartdiseases.
and C. should
be monitored
wherever
possible.
- obutamine
is chemically
stable for
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"ENERIC
NAE*
aracetam
ol
BRAND
NAE*
Miogesic%
anadol%
9ylenol
on-
narcotic
analgesic% A
nti+2retic
er rem3
@DDmg :h for
temp. above
=B.,
-ecreases
fever by a
hypothalamic
e0ect leading
to sweating
and
vasodilation
-Inhibits
pyrogen e0ect
on the
hypothalamic-
heat-regulating
centers
-Inhibits CHprostaglandin
synthesis with
minimal e0ects
on peripheral
prostaglandin
synthesis
-oes not
cause
ulceration ofthe 5I tract
and causes no
anticoagulant
action.
-Control of
pain due to
headache%
earache%
dysmenorrhe
a% arthralgia%
myalgia%
musculoskele
tal pain%
arthritis%
immunization
s% teething%
tonsillectomy
-9 reduce
fever in viraland bacterial
infections
-As a subs-
titute for
aspirin in
upper 5I
disease%
bleeding
disordersclients in
anticoagulant
therapy and
gouty
arthritis
-#enal
Insu2ciency
-Anemia
-4inimal 5I
upset.
-4ethemo
5lobinemia
-)emolytic
Anemia
-eutropenia
-
9hrombocyto
pe
ia
-ancytopenia
-Leukopenia
-Nrticaria
-Liver
amage
-o not e1ceed
:gm/
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DR!" C#A$$I%I&
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IN'ER)EN'I(N"ENERIC
NAE*
4etoclopra
mide
BRAND
NAE
Clopra%
*me1 %
4a1eran %
a3olon-
#eglan*
gastrointesti
nal agentG
prokinetic
agent $gi
stimulant&G
autonomic
nervous
system
agentG
direct-acting
cholinergic
$parasympat
homimetic&G
antiemetic
, # otent central
dopamine
receptor
antagonist.
Htructurally
related to
procainamide
but has little
antiarrhythmic
or anesthetic
activity. *1act
mechanism of
action not clear
but appears to
sensitize 5I
smooth muscle
to e0ects of
acetylcholine by
direct action.
4anagement of
diabetic gastric
stasis
$gastroparesis&G
to prevent
nausea and
vomiting
associated with
emetogenic
cancer
chemotherapy
$e.g.% cisplatin%
dacarbazine&G
to facilitate
intubation of
small bowelG
symptomatic
treatment of
gastroesophag
eal re(u1.
Hensitivity or
intolerance to
metoclopramide
G allergy to
sul8ting agentsG
history of
seizure
disordersG
concurrent use
of drugs that
can cause
e1trapyramidal
symptomsG
pheochromocyt
omaG
mechanical 5I
obstruction or
perforationG
history of breast
cancer. Hafety
duringpregnancy
$category M& or
lactation is not
established.
CN$*
#estlessne
ss
%
drowsiness
%
fatigue%
insomnia
dizziness%
an1iety
C)*
tansient
hypertensi
on
"I*
nausea
and
diarrhea
#eport
immediately the
onset of
restlessness%
involuntary
movements%
facial grimacing%
rigidity% or
tremors.
*1trapyramidal
symptoms are
most likely to
occur in children%
young adults%
and the older
adult and with
high-dose
treatment of
vomiting
associated with
cancerchemotherapy.
Hymptoms can
take months to
regress.
Me aware that
during early
treatment period%
serum
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aldosterone may
be elevatedG
after prolonged
administration
periods% it
returns to
pretreatment
level.
DR!" C#A$$I%ICA'I(N
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"ENERIC
NAE*
piperacillin
and
tazobacta
m
BRAND
NAE*osyn
Antibiotic :.@L4H
9hen
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)gb% CMC with
di0erential and
platelet count&.
4onitor patient
carefully during
the 8rst =D min
after initiation of
the infusion for
signs of
hypersensitivity
$see Appendi1 R&.