I.

Introduction
Endophthalmitis is an infection that occurs as a result of seeding of

organisms into the interior of the eye following surgery (postoperative),

trauma (post-traumatic) or an infection elsewhere in the body (endogenous).
While the general rate of endophthalmitis has remained somewhat constant
over the past several years, the increased use of intravitreal injections for
the treatment of various degenerative and inflammatory ocular diseases, as
well as the growing number of invasive ocular surgeries, may create a
clinical environment in which organisms have a greater opportunity to infect
the eye. Endophthalmitis cases can be treated successfully if properly
managed, and useful vision can be retained. However, in severe cases of
bacterial endophthalmitis, significant vision loss can occur rapidly, despite
prompt and proper treatment.

Endophthalmitis is an inflammatory condition of the intraocular cavities

(ie, the aqueous and/or vitreous humor) usually caused by infection.
Noninfectious (sterile) endophthalmitis may result from various causes such
as retained native lens material after an operation or from toxic agents.
Panophthalmitis is inflammation of all coats of the eye including intraocular
structures.

The 2 types of endophthalmitis are endogenous (ie, metastatic) and

exogenous. Endogenous endophthalmitis results from the hematogenous
spread of organisms from a distant source of infection (eg, endocarditis).
Exogenous endophthalmitis results from direct inoculation of an organism
from the outside as a complication of ocular surgery, foreign bodies, and/or
blunt or penetrating ocular trauma.

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Endogenous endophthalmitis is rare, occurring in only 2-15% of all

cases of endophthalmitis. Average annual incidence is about 5 per 10,000
hospitalized patients. In unilateral cases, the right eye is twice as likely to
become infected as the left eye, probably because of its more proximal
location to direct arterial blood flow from the right innominate artery to the
right carotid artery. Since 1980, candidal infections reported in IV drug users
have increased. The number of people at risk may be increasing because of
the spread of AIDS, more frequent use of immunosuppressive agents, and
more invasive procedures (eg, bone marrow transplantation).

Most cases of exogenous endophthalmitis (about 60%) occur after

intraocular surgery. When surgery is implicated in the cause, endophthalmitis
usually begins within 1 week after surgery. In the United States,
postcataractendophthalmitis is the most common form, with approximately
0.1-0.3% of operations having this complication, which has increased over
the last 3 yearsAlthough this is a small percentage, large numbers of
cataract operations are performed each year making the chances that
physicians may encounter this infection higher. Endophthalmitis may also
occur after intravitreal injections, although this risk in an analysis of over
10,000 injections is estimated at 0.029% per injection.

Posttraumatic endophthalmitis occurs in 4-13% of all penetrating

ocular injuries. Incidence of endophthalmitis with perforating injuries in rural
settings is higher when compared with nonrural settings. Delay in the repair
of a penetrating globe injury is correlated with increased risk of developing
endophthalmitis. Incidence of endophthalmitis with retained intraocular
foreign bodies is 7-31%.

2 | Page

An association appears to exist between the developments of

endophthalmitis in cataract surgery and age greater than or equal to 85
years.

Pseudo means false or pretending to be somethig it is not. Phakia

means the condition of having a lens in the eye. So, pseudo--phakia means
having a lens in the eye BUT it isn't your own normal lens. It is a man made
lens that has been implanted during cataract surgery to replace the lens the
surgeon has removed.
Diabetic retinopathy is retinopathy damage to the retina) caused by
complications of diabetes, which can eventually lead to blindness. [It is an
ocular manifestation of diabetes, a systemic disease, which affects up to 80
percent of all patients who have had diabetes for 10 years or more. Despite
these intimidating statistics, research indicates that at least 90% of these
new cases could be reduced if there was proper and vigilant treatment and
monitoring of the eyes. The longer a person has diabetes, the higher his or
her chances of developing diabetic retinopathy.

Our group chose this case of Endophthalmitis OP, Pseudophakia OU,

DM retinophaty as a subject of our case presentation because the group is
concerned about the occurrence of the disease which continues to cause
significant number or rate of disease which is very common in both man and
women. And to also enhance our knowledge concerning of its clinical
manifestations, possible causes, cure and prevention, and among others.
This pertinent knowledge will eventually become an indispensable tool that
can be shared to others and will never go out of style. As a future nurses, it is
imperative to learn new techniques in modern science in order to develop
skills that would benefit the medical world. This learning prospective must be

3 | Page

conveyed to future generations and develop innovative techniques, state -of

the- art technology that caters the modern man.

II.

Objectives

General Objective:
The case study aims to acquire information about Endopthalmitis , OD
Pseudophabia OU DM Retinopathy to apply such knowledge and learning for
optimum level of nursing care practice.
Specific Objectives:
To assess the condition of the patient by establishing rapport, gather
all vital information and determine clients past and present health
history. Perform physical assessment on clients condition to attain
baseline data.
To know the different signs and symptoms, manifestations and other
things connected to the condition to help the health care providers to
diagnose the real condition properly.

4 | Page

 To plan on how to care patients and plan managements for their

condition regarding to this kind of case.
To be able to apply different nursing intervention on how to help them
lessen their sufferings about their condition.

III.

Nursing History
BIOGRAPHICAL DATA
Name
: Patient X
Age
: 53
Gender
: Male
Civil Status
: Widow
Address
: Brgy. Palanan, Makati
Nationality
: Filipino
Religion
: Roman Catholic
Birthdate
: November 13, 1960
Hospital

: Ospital ng Makati

Date of Admission
: January 17, 2014
Date of Interview : February 3, 2014
Reliability
: 90%
Source of information
: Patient
Criteria for reliability
:
A. Extent of data gathered demographics, history habits - 45%
=40%
B. Level of consciousness of interviewee condition, willingness to
5 | Page

disclose info 25%

= 25%

C. Completeness of correlating facts of transpiring events - 30% =

25%
Chief Complaint: Redness OD
PRESENT HISTORY:
Patient known case of Endopthalmitis, OD Pseudophakia, OU T/C DM
retinopathy OU. 4 days prior to admission patient noted redness, OD
associated with greenish discharges. No consultation was done. There was
also rate of severity, OD which was increasing in size, and the symptoms
persist. 1 day prior to admission the patient decided to consult medical
advice.
PAST HISTORY:
In the year 1978 the patient met a jeepney accident and survived. He
was only 17 years old that time. As the patient approach into his manhood
stage he loves alcoholic drinks such as gin, the current alcoholic drinks that
is well known in his time. According to the patient he drinks everyday and
always present in their drinking session with friends. He starts smoking at
the early age of 17 and smokes approximately 1 to 2 packs per day. In the
late 1990s the patient was diagnosed with hypertension and start taking
medication such as Lozartan. There are times that the patient was very
worried for he has no enough money to buy his medication if his blood
pressure rises. What he does is he crashed garlic eaten and chewed raw. In
the year 1994 the patient was rushed in Trese Martires Hospital for loss of
consciousness and prior to that incident he was complaining of blurring of
vision and dizziness. He was diagnosed with Diabetes Mellitus. Which he
believes he inherit it with his mother who died also with the same case. From
that time hes taking OHA (Oral Hypoglycemic Agent) such as metformin and
clevencamide to lower his sugar level. Patient verbalizes he only takes insulin
when hes admitted in the hospital. As his condition persist he was in and out
in the Philippine General Hospital from time to time if its not because of
diabetes then it is hypertension. In the year 2000 he was diagnosed with
PTB and treated only for 3 months. He was admitted in a private hospital but
he took the medication regimen only for 3 months and did not come back for
6 | Page

follow up check up. In the recent year in 2011 the patient suffered from a
mild stroke and he recovers. He recalls all his vices when he was in his young
age and verbalizes that Hanggat hindi ka sinisinggil ng katawan mo hindi
ka tititgil sa bisyo mo. On the same year the patient had undergone
cataract surgery for both eyes. In the year 2012 he decided to stop smoking
and drinking alcohol beverages. Last year November 2013 the patient
doesnt mind the blurring of vision because he understands that it is one of
sign and symptoms of his condition which is the Diabetes Mellitus until his
lost his right eye vision. And then his left eye starts to blurred and lost the
ability to see.

FAMILY GENOGRAM

Diabetes Mellitus
Hyper

Rheumatic
Fever and
Hypertensi
on

Diabetes
Mellitus and
Hypertension

Diabetes
Mellitus

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Father

Mother

Brother
Patient

Decease
d

8 | Page

IV.

GORDONS FUNCTIONAL HEALTH PATTERN

FUNCTION
HEALTH PATTERN

II

9 | Page

BEFORE HOSPITALIZATION

According to the patient, his

condition was not good because
of the redness in his right eye.
Health
Perceptio But still, he is performing a
normal daily activity. He exercises
n and
everyday. He is a smoker and
Health
Managem smokes 1 to 2 packs per day. He
starts smoking at the early age of
ent
17.Hes a drinker and drinks gin
Pattern
everyday. He starts drinking
alcoholic beverages at the age of
17.
Nutrition The patient states that he
and
consumes 1 cup of rice every
Metabolic meal. Before he got hospitalized,
Pattern
he had a good appetite and had
no problem swallowing food. He
drinks water at least 5-8 glasses
a day and whenever she wants to
drink. He stated too that he and
his family usually eat fish,
vegetables and chicken. He also
added that he is taking vitamins
such as B Complex. He is taking

DURING
HOSPITALIZATION
According to the patient,
he is not in a good state
and he is uncomfortable
of the environment. He
wants to go back to his
normal daily life because
he cant stand the fact
that he is staying in the
hospital.
During his hospitalization,
he only consumed what
kind of diet the physician
orders. Now that he is
admitted in the hospital,
he cannot eat the food he
prefers to eat but the
desired food for his
nutrition because of his
condition. Still he drinks 58 glasses of water.
Diet : DM Diet
Weight: 59 kilograms

INTERPRETATION

Ineffective health
maintenance
Nurses Pocket Guide
Edition 12

Imbalanced nutrition: less

than body requirements
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Edition 12

his maintenance medication for

Hypertension which is Lozartan
and Metformin and
Clavenocamide for Diabetes
Mellitus.
Weight: 59 kilograms
Height: 57

III

Eliminati
on
pattern

Before being hospitalized, he

regularly defecates. Once or twice According to the patient,
he doesnt feel difficulty in
a day.
defecating. He doesnt
have any difficulty in
Feces
- Color: Not stated
urinating and he urinates
- Texture: Not stated
frequently.

Readiness for enhanced

urinary elimination

H doesnt have any difficulty in

defecating and urinating.

Urine
- Color: Yellow
- Consistency: Cloudy
- Odor: Foul Odor
- Amount: Scanty urine
20cc/hour

Nurses Pocket Guide

Edition 12

During hospitalization,
according to him, he can
only perform minimal
movements because of
unfamiliar environment. In
their house he can
perform his activities and

Impaired physical mobility

Urine
- Color: Light Yellow
- Consistency: Clear
- Odor: Foul Odor
IV

Activity
and
exercise
pattern

10 | P a g e

Height: 57

According to the patient, he

regularly finishes his daily routine
despite the condition of his eyes.
He is doing the regular exercise
but he walks and strolls in his
neighbourhood. Before

Nurses Pocket Guide

Edition 12

hospitalization, he can perform

his daily activities; getting up
from bed, sitting, taking a bath,
change of clothes, and any other
movement on his own. He
routinely read newspaper and
listens to the radio every
morning. He recalls when he was
still a kid hes fun of karate.

Cognitive
perceptu
al
pattern

11 | P a g e

The patient can hear clearly. He

uses reading glasses whenever
he reads newspaper. He has a
difficulty in seeing things because
he lost his vision in his right eye
and his left eye slowly by slowly
starts to blur. Sometimes the
patient has a difficulty in memory
and remembering things, people
and past events.

daily living because he

memorizes the setting and
placement of things
respectively.

During hospitalization, still

he has difficulty in his
sense of sight. He is
assertive all throughout
the interview. He is
focused on what we are
talking. In addition to
that, he answers us
clearly.

Disturbed Sensory
Perception
Nurses Pocket Guide
Edition 12

VI

VII

Sleeprest
pattern

According to the patient, before

hospitalization, he sleeps at least
4 hours and waking from time to
time. Because of his age his
sleeping hours at night was
reduced. He doesnt take a nap at
noontime because according to
the patient either hell have a
difficulty to sleep at night or no
sleep at all.

During hospitalization, he
cant sleep well because
time to time the nurse is
giving him his eye drop
medication.

The patient stated that his

character of talkative is
According to the patient, he is a
talkative person. Most of the time, still the same. He stated
Selfthat he is feeling
he wants to talk and he loves to
perceptio
greet people. He stated that he is depressed and loses hope
n, Selfwell known in their barangay. Hes but he knows he can
concept
only silent and hot tempered when surpass this trial and can
pattern.
go home. He worries
his children are not listening to
about the hospital billing
him.
and he feels he is a
burden to his children.

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Disturbed sleep pattern

Nurses Pocket Guide
Edition 12

Readiness for enhanced

self concept.
Nurses Pocket Guide
Edition 12

VIII

Role
relations
hip
pattern

According to the patient,

now that he is admitted in
According to the patient, he is
the hospital his children
living with his two children and
are the ones taking good
granddaughter. He stated that
care of him. His children
mostly all families are undergoing
admit that they are having
financial problem like their family.
a hard time whos the one
He is a welder before and
to look out for him in the
because his income is insufficient
hospital. Sometimes
to his family needs he drives
because of stress and
pedicab to come up to their daily
financial insufficiency his
budget. The minimum he earns in
children are irritable and
pedicab driving is 300.
speak not so good words
towards him.

Sexuality
reproduc
tive
pattern.

According to the patient, he and

his late wife are using family
planning. He is widowed for
almost 7 years.

Ineffective role
performance
Nurses Pocket Guide
Edition 12

IX

13 | P a g e

According to him, there

would be no changes
because of his condition.

Ineffective sexual pattern

Nurses Pocket Guide
Edition 12

XI

Coping
stress
tolerance
pattern

According to the client, when he

is stressed, he usually releases it
by praying to God. When hes
worried he always think that he
can surpass it through God. In the
past 2 years of he feels sad
because he is in and out in the
hospital and he worries so much
about the financial matter.

According to the patient,

he cant manage stress
properly because he is
thinking of different
things.

Valuebelief
pattern

According to the patient, he is

Roman Catholic. He is attending
mass every week, he go to
church every Sunday. He trusts
his life to God. And when hes
worried he seeks Gods presence
for he finds peace and feels
stress relieved.

The patient states that

she believes in God and
he knows he can surpass
it. And he can attend the
Sunday mass when he
recovers.

14 | P a g e

Ineffective coping
Nurses Pocket Guide
Edition 12

Readiness for spiritual well

being
Nurses Pocket Guide
Edition 12

V.

Review of Systems

EENT

Masakit ang mata ko

Hindi na makakita ang kanan kong
mata

Integumentary System

No significant finding.

Respiratory System

No significant finding.

Gastrointestinal System

No significant finding.

Muscoskeletal System

No significant finding.

Genitourinary System

ihi ako ng ihi

Nervous System

Nahihilo ako dahil sa kundisyon ng

mata ko
Nahihirapan akong makatulog

15 | P a g e

VI.

Physical Assessment:

Date: February 3, 2014

Time: 10:30 AM
General survey:
The patient is awake, conscious and coherent; patient is also
cooperative . Upon interview, patient appears slightly pale and weak. The
initial vital signs were taken as follows:
Height:
Weight:
BMI:
Temperature:
Heart Rate:
Respiratory Rate:
Blood Pressure:
Organ/
System
Skin

173 cm
59 kg
17.35 Under weight
37.2 C
76 bpm
20 cpm
140/100 mmHg

Technique
Inspection

Palpation

Normal
Findings
Color: Pinkish

Actual
Findings
Color: Pale

Moisture:
Moist

(+) moist

Interpretati
on
Abnormal:
May indicate
decrease in
blood flow
due to lack of
sleep.
Normal

(+) smooth
Texture:
Smooth
Turgor: skin
quickly
returns to its
original
shape.
16 | P a g e

Normal
Skin quickly
returns to
original
shape

Normal

Hair

Inspection

Nails

Inspection

Temperature:
warm
Even
distribution
Color: Black
Color: Pinkish
Contour:
slightly
curved or flat
Capillary
Refill: 1-3
secs

Head

Eyes

(+)warm

Normal

Evenly
distributed
Color: Black

Normal

Color: Pinkish

Normal

Contour: flat

Normal

Capillary
Refill:
2 secs

Normal

Inspection

Inspection

Normal
Symmetrical
facial feature

Symmetrical
facial feature

Eye lids:
(-) lesion
(-)redness

Eye lids:
(-) lesion
(+)redness

(-) periorbital
edema

(-) periorbital
edema

Normal visual
acuity

Right:
(unable to
visualize)
Left: (able to
visualize but
blurred)

Conjunctiva:
Pinkish in
color
Sclerae:
white or buffy

Conjunctiva:
Red in color
(right)
Sclerae: Red
(Right)
Yellowish
(Left)

17 | P a g e

Normal
Due to eye
infection
Normal
Due to the
inflammation.
Due to the
inflammation.
Due to eye
irritation
Due to eye
irritation
Due to
infection

Palpation
Eyelids:
(-) Masses
Ears

Nose

Mouth

Inspection

Inspection

Inspection

Palpation

Eyelids:
(-) Masses

Normal

(-) discharges

(-) discharges

Normal

(-) lesions

(-) lesions

Normal

(-) nodules

(-) nodules

Normal

(-) redness

(-) redness

Normal

Symmetricall
y aligned

Symmetricall
y aligned

Normal

(-) discharge

(-) discharge

Normal

(-) flaring of
nares
Lips
Color: Pinkish

(-) flaring of
nares
Lips
Color: Pinkish

Normal

(-) lesions

(-) lesions

Normal

(-) scars/
incisions

(-) scars/
incisions

Normal.

(-) lumps

(-) lumps

Normal

(-) mass

(-) mass

Normal

Tongue:
Color: Pink
red

Tongue:
Color: Pink
red

Normal

(-) lesions

(-) lesions

(-) thrush

(-) thrush

Gums:

Gums:

Color: Pink

Color: Pink

Symmetry

Normal

Normal
Normal

Normal
18 | P a g e

Neck

Inspection

Red

Red

Oral Mucosa:
Color: Pinkish
(+) Moisture

Oral Mucosa:
Color: Pinkish
(+) Moisture

(-) lesions

(-) lesions

(-) odor

(-) odor

Symmetricall
y aligned

Symmetricall
y aligned

Normal

(-) scars

(-) scars

Normal

(-) mass

(-) mass

Normal

(-) swelling

(-) swelling

Normal

(+)
symmetrical
expansion
with
respiration

(+)
symmetrical
expansion
with
respiration

Normal

(-) retraction

(-) retraction

Normal

(+) smooth

(+) smooth

Normal

(+) warm

(+) warm

Normal

(+) dry

(+) dry

Normal
Normal
Normal
Normal

Palpation

Respiratory
System
Chest
/Thorax/
Lungs

Inspection

Palpation

Auscultatio
n

Heart
19 | P a g e

Inspection

Normal

Normal
(+) normal
breath
sounds

(+) normal
breath
sounds

(-)
adventitious
sound
(-) visible PMI

(-)
adventitious
sound
(-) visible PMI

Normal

Normal

Extremities

Auscultatio
n
Inspection

(+) regular
rhythm

(+) regular
rhythm

Normal

(-) thrills

(-) thrills

Normal

(-) murmurs

(-)murmurs

Normal

Upper
Extremities
(-) pallor

Upper
Extremities
(-) pallor

Normal

(-) rashes

(-) rashes

Normal

(-) bruise

(-) bruise

Normal

(-) swelling

(-) swelling

Normal

(-) edema

(-) edema

Normal

(-)
contraption

(-)
Contraption

Normal

(+) Radial
and Brachial
Pulses

(+) Radial
and Brachial
Pulses

Lower
Extremities

Lower
Extremities

Normal

(-) pallor

(-) pallor

Normal

(-) rashes

(-) rashes

Normal

(-) bruise

(-) bruise

Normal

(-) swelling

(-) swelling

Normal

(-) edema

(-) edema

Normal

(+) popliteal,
posterior
tibial, and
dorsalis pedis
pulses

(+) popliteal,
posterior
tibial, and
dorsalis pedis
pulses

Palpation

Inspection

Palpation

20 | P a g e

Normal

Abdomen

Genitalia

21 | P a g e

Inspection

Inspection

Symmetrical

Symmetrical

Normal

(+) globular
shape

(+) globular
shape

Normal

(-) masses

(-) masses

Normal

(-) lesions

(-) lesions

Normal

(-) discharges

(-) discharges

Normal

VII.

Course in the Ward

VIII. DATE & SHIFT

XII.
XIII.

February
3,2014
6AM-2PM

IX.

XIV.
XV.

DOCTORS
ORDER

Continuous
present
management

XVI.
XVII.
XVIII.
XIX.
XX.
XXI.
XXII.
XXIII.
XXIV. CBG monitoring
XXV.
XXVI.
XXVII.
XXVIII. Continue
giving
medications
XXIX.
XXX.
XXXI.
XXXII.
22 | P a g e

X.

NURSING
RESPONSIBILI
TIES
XXXVI.
XXXVII. -Monitor vital
signs and
perform
bedside care.
XXXVIII.
XXXIX. -Instruct
patient to
perform hand,
oral and body
hygiene.
XL.
XLI. -Instruct patient
not to
manipulate
affected and to
avoid infection.
XLII.
XLIII. -Instruct patient
to have CBG
monitoring first
before taking
meals.

XI.

PT REACTION/
EVALUATION

XLVIII.
XLIX. -Client was
monitored and
checked
thoroughly.
L.
LI.
LII.
-Client
understands the
importance of
the order.
LIII.
LIV.
LV.
LVI.
LVII. -Client
understands the
importance of
taking of CBG
before meals.
LVIII.
LIX. -Client received
medication

XXXIII. Refer
accordingly
XXXIV.
XXXV.

LX.
LXI.

February 4,
2014
6AM-2PM

23 | P a g e

LXII.
LXIII. Continuous
present
management
LXIV.
LXV.
LXVI.
LXVII.
LXVIII.
LXIX.
LXX.
LXXI.
LXXII. Continue giving
medications
LXXIII.

XLIV.
XLV. -Administer
medications
with the right
dosage, route
and frequency,
and without
adding injury to
the patient.
XLVI.
XLVII. -Refer to the
physician if
there is any
alterations.
LXXIX.
LXXX.-Monitor vital
signs and
perform
bedside care.
LXXXI.
LXXXII. -Instruct
patient to
perform hand,
oral and body
hygiene.
LXXXIII.
LXXXIV. -Instruct
patient not to
manipulate

accordingly.

LXXXIX.
XC. -Client was
monitored and
checked
thoroughly.
XCI.
XCII.
XCIII. -Client
understands the
importance of
the order.
XCIV.
XCV.
XCVI.
XCVII.

LXXIV.
LXXV.
LXXVI.
LXXVII. Refer
accordingly
LXXVIII.

XCIX.
C.
CI.
CII.
CIII.
CIV.
CV.

24 | P a g e

affected and to
avoid infection.
LXXXV.
LXXXVI. -Administer
medications
with the right
dosage, route
and frequency,
and without
adding injury to
the patient.
LXXXVII.
LXXXVIII.
-Refer
to the physician
if there is any
alterations.

XCVIII. -Client
received
medication
accordingly.

CVI. Diagnostics
CVII.
CVIII.

HEMATOLOGY:

January 18 2014

CIX. COMPO
NENTS

CX.

RESULT

CXI. NORMA
L
VALUE
CXV. 14-18
g/L

CXIII. Hemogl
obin

CXIV. 12.5

CXVII.Hemato
crit

CXVIII. 0.39

CXIX. 0.400.54

CXXII.11.0

CXXIII. 4-11
x10^9/l

CXXVI. 4.2

CXXVII. 5.06.4

CXXXI.

CXXXII.

CXXXV. 0.03

CXXXVI. 0.020.04

CXXI.

White
Blood
Cells
Count
CXXV. Red
Blood
Cells
Count

CXXX. DIFFE
RENTIAL
COUNT
CXXXIV.
E
osinophi
ls
Neutrop
25 | P a g e

CXII. INTERP
RETATI
ON
CXVI.
Decreas
e,
indicate
s iron
deficien
cy
CXX. decreas
e, may
indicate
anaemi
a or
fatigue
CXXIV. norm
al

CXXVIII. decre
ase,
may
indicate
risk for
anaemi
a
CXXIX.
CXXXIII.

CXXXVII.
ormal

hil
CXXXVIII.
S
egment
ers
CXLII. Lympho
cyctes
CXLVI. Mono
cytes

CL.

Platelet
s Count
CLIV. ESR

CXXXIX. 0.63

CXLIII.

0.28

CXLVII. 0.06

CLI.

360

CLV. 81

CXL. 0.500.70
CXLIV.

0.200.40
CXLVIII. 0.020.05

CLII. 150-450
x10^9/L
CLVI. 0-15
mm/hr

CXLI. normal

CXLV. normal
CXLIX. incre
ase,
may
indicate
inflamm
ation
CLIII. normal
CLVII. increas
e in
inflamm
ation

CLVIII.
CLIX. JANUARY 22 2014
CLX. COMPO
NENTS
CLXIV.

Hemo
globin

CLXI. RESULT

CLXV. 10.5

CLXII. NOR
MAL
VALUE
CLXVI. 14-18
g/L

CLXVIII. Hema
tocrit

CLXIX. 0.33

CLXX.0.400.54

CLXXII. White
Blood

CLXXIII. 8.8

CLXXIV. 4-11
x10^9/l

26 | P a g e

CLXIII. INTE
RPRET
ATION
CLXVII. decre
ase,
may
indicate
iron
deficien
cy
CLXXI. decre
ase,
may
indicate
anemia
or
fatigue
CLXXV. Decre
ased

Cells
Count

CLXXVI.

CLXXVII.

ed
Blood
Cells
Count
CLXXX. DIFFE
RENTIAL
COUNT
CLXXXIV.
E
osinophi
ls
Neutrop
hil
CLXXXVIII.
S
egment
ers
CXCII.Lympho
cyctes
CXCVI. Mono
cytes

CC.

Platelet
s Count
CCIV. ESR

27 | P a g e

3
.5

CLXXXI.

CLXXXV.0.03

CLXXXIX.
.60
CXCIII. 0.31
CXCVII. 0.06

CCI.

315

CCV. 65

CLXXXII.

leucope
nia,
result of
chemot
herapy,
radiatio
n
therapy,
or
immune
system
disorder
s.
CLXXIX.
d
ecrease,
may
indicate
risk for
anemia
CLXXXIII.

CLXXXVI.
0
.02-0.04

CLXXXVII.
ormal

CLXXVIII.
5
.0-6.4

CXC. 0.500.70
CXCIV.

0.200.40
CXCVIII. 0.020.05

CCII. 150-450
x10^9/L
CCVI. 0-15

CXCI. normal

CXCV. normal
CXCIX. decre
ase,
may
indicate
risk for
anemia
CCIII. normal
CCVII.increas

mm/hr

e in
inflamm
ation

CCVIII.
CCIX.February 23, 2014
CCX. COMPO
NENTS

CCXI.RESULT

CCXIV. Hemo
globin

CCXV.12.0

CCXIX. Hema
tocrit
CCXXIII.
W
hite
Blood
Cells
Count
CCXXVII.
R
ed
Blood
Cells
Count

CCXXXII.
D
IFFEREN
TIAL
COUNT
CCXXXVI.
E
osinophi
ls
Neutrop
hil
CCXL.Segmen
28 | P a g e

CCXX.

CCXII. NOR
MAL
VALUE
CCXVI. 14-18
g/L

0.37

CCXXI. 0.400.54
CCXXV. 4-11
x10^9/l

CCXXIV. 11

CCXXVIII.
.1

CCXXXIII.

CCXXXVII.
.03

CCXLI. 0.62

CCXXIX. 5.06.4

CCXIII. INTE
RPRET
ATION
CCXVII. decre
ase,
may
indicate
risk for
anemia
CCXVIII.
CCXXII. norm
al
CCXXVI. norm
al

CCXXXIV.

CCXXX. decre
ase,
may
indicate
risk for
anemia
CCXXXI.
CCXXXV.

CCXXXVIII.
0
.02-0.04

CCXXXIX.
ormal

CCXLII. 0.50-

CCXLIII. norm

ters
CCXLIV. Lymp
hocycte
s
CCXLVIII.
M
onocyte
s

CCLII. Platelet
s Count
CCLVI.

ESR

CCXLV. 0.25

CCXLIX. 0.10

CCLIII.

355

0.70
CCXLVI. 0.200.40

al
CCXLVII.norm
al

CCL. 0.020.05

CCLI. Increase
respons
e to
chronic
infectio
ns, in
autoim
mune
disorder
s, in
blood
disorder
s.
CCLV. normal

CCLIV.

150450
x10^9/L
CCLVIII. 0-15
mm/hr

CCLVII. 0.7

CCLIX. norm
al

CCLX.
CCLXI. February 26, 2014
CCLXII. COM
PONEN
TS
CCLXVI. Hemo
globin

CCLXX. Hema
tocrit

29 | P a g e

CCLXIII.
R
ESULT
CCLXVII.

1
1.6

CCLXXI. 0.36

CCLXIV.
N
ORMAL
VALUE
CCLXVIII.
1
4-18 g/L

CCLXXII.
0
.40-0.54

CCLXV. INTE
RPRET
ATION
CCLXIX.
d
ecrease,
may
indicate
risk for
anemia
CCLXXIII.
d
ecrease,
may
indicate
anemia
or

CCLXXV.
W
hite
Blood
Cells
Count
CCLXXIX.
R
ed
Blood
Cells
Count

CCLXXVI.

CCLXXXIII. D
IFFEREN
TIAL
COUNT
CCLXXXVII. E
osinophi
ls
Neutrop
hil

CCLXXXIV.

CCLXXVII.
4
-11
x10^9/l

CCLXXXI.
5
.0-6.4

.8

CCLXXX.
.0

CCLXXXVIII.
.06

CCLXXXV.

CCLXXXIX.
0
.02-0.04

CCXCI. Segm
enters
CCXCV. Lymp
hocycte
s
CCXCIX. Mono
cytes

CCXCII. 0.61

CCC. 0.07

CCCI. 0.020.05

CCCIII. Platel
ets
Count
CCCVII.

CCCIV. 345

CCCV.150-450
x10^9/L

CCCVIII.
30 | P a g e

CCXCVI. 0.26

February 03, 2014

CCXCIII. 0.500.70
CCXCVII.
0
.20-0.40

fatigue
CCLXXIV.
CCLXXVIII.
n
ormal

CCLXXXII.
d
ecrease,
may
indicate
risk for
anemia
CCLXXXVI.

CCXC. Incre
ase,
infectio
n or
inflamm
ation
CCXCIV. norm
al
CCXCVIII.
n
ormal
CCCII.

Incre
ase,
body is
fighting
off
somethi
ng viral.
CCCVI. norm
al

CCCIX. COM
PONEN
TS
CCCXIII. Hemo
globin

CCCX. RESU
LT

CCCXVII.
H
ematocr
it

CCCXVIII.
.34

CCCXIX. 0.400.54

CCCXXII.
W
hite
Blood
Cells
Count
CCCXXVI.
R
ed
Blood
Cells
Count

CCCXXIII.

CCCXXIV.
4
-11
x10^9/l

CCCXXVIII.
5
.0-6.4

CCCXXXI.
D
IFFEREN
TIAL
COUNT
CCCXXXV.
E
osinophi
ls
Neutrop
hil

CCCXXXII.

CCCXXXIX. L
ymphoc
31 | P a g e

CCCXI. NOR
MAL
VALUE
CCCXV. 14-18
g/L

CCCXIV. 11.1

CCCXXVII.
.7

CCCXXXVI.
.05

CCCXL. 0.18

CCCXXXIII.

CCCXXXVII. 0
.02-0.04

CCCXLI. 0.200.40

CCCXII.INTE
RPRET
ATION
CCCXVI.
d
ecrease,
may
indicate
risk for
anemia
CCCXX. decre
ase,
may
indicate
anemia
or
fatigue
CCCXXI.
CCCXXV.
n
ormal

CCCXXIX.
d
ecrease,
may
indicate
risk for
anemia
CCCXXX.
CCCXXXIV.

CCCXXXVIII. I
ncrease
infectio
n or
inflamm
ation
CCCXLII.
d
ecrease,

ytes

CCCXLIV.
M
onocyte
s

CCCXLVIII. P
latelet
Count
CCCLII. ESR

CCCLVI. Segm
ent
CCCLX.

CCCXLV.0.07

CCCXLIX.
58

CCCXLVI.
0
.02-0.05

CCCL.150-450
x10^9/L

CCCLIII. 86

CCCLIV. 0-15
mm/hr

CCCLVII.0.70

CCCLVIII.
0
.50-0.70

CCCLXI.

January 18

CCCLXII.

CHEMISTRY SECTION

may
indicate
infectio
n
CCCXLIII.
CCCXLVII.
I
ncrease
, body is
fighting
off
somethi
ng viral.
CCCLI. norm
al
CCCLV. Incre
ase, in
inflamm
ation
CCCLIX. norm
al

CCCLXIII. CCCLXIV.
CCCLXV.CCCLXVI.
CCCLXVII. CCCLXVIII.
CCCLXIX.
CCCLXX.
CCCLXXI.
TES
R
NO
U
INTE
R
N
U
INTERP
RE
TA
TI
ON
CCCLXXII. CCCLXXIII.
CCCLXXIV.
CCCLXXV.
CCCLXXVI. CCCLXXVII.
CCCLXXVIII.
CCCLXXIX.
CCCLXXX.
Gluc
7.
2.5
M
norm
1
45.
m
normal
CCCLXXXI. Panel11
CCCLXXXII.CCCLXXXIII.
CCCLXXXIV.
CCCLXXXV.
CCCLXXXVI.CCCLXXXVII.
CCCLXXXVIII.
CCCLXXXIX.
CCCXC. n
SGO
2
0.4
U/
Incre
20
0U
or
ma
l
CCCXCI. CCCXCII.
CCCXCIII.CCCXCIV.CCCXCV. CCCXCVI.
CCCXCVII.
CCCXCVIII.
CCCXCIX.
32 | P a g e

SGP

CD. Panel 7
CDI.
CDII.
SODI
1

0.4

U/

Incre

20

0-

CDIII.
13

CDIV.
M

CDV.
norm

CDVI.
13

CDVII.
13

CDX.
POT

CDXI. CDXII.
4.
3.5

CDXIII. CDXIV.
M
norm

CDXIX.
URE

CDXX. CDXXI.
8.
2.1

CDXXII. CDXXIII.
M
Incre

CDXXVIII. CDXXIX.CDXXX. CDXXXI.CDXXXII.

CRE
1
45.
U
Incre

CDXXXVII.
33 | P a g e

normal

CDVIII. CDIX. nor

m
ma
l
CDXV. CDXVI. CDXVII.CDXVIII. n
4.
3.
m
or
ma
l
CDXXIV. CDXXV. CDXXVI.
CDXXVII.
22
6.
m
Increase,
kid
ne
ys
ma
y
not
wo
rki
ng
pro
per
ly.
CDXXXIII.
CDXXXIV.
CDXXXV.
CDXXXVI.
1.
0.
m
Decrease
,
kid
ne
ys
ma
y
not
wo
rki
ng
pro
per
ly.

CDXXXVIII.
CDXXXIX.
CDXL.
Test

January 22, 2014

CDXLI. CDXLII. CDXLIII.CDXLIV. CDXLV.CDXLVI.

R
NO
U
IN
R
NOR

CDXLIX.
BUN/CREA
CDL.
CDLI. CDLII. CDLIII. CDLIV. CDLV. CDLVI.
URE
5
2.
M
no
1
6.0CDLIX.
CRE

CDLX. CDLXI. CDLXII. CDLXIII. CDLXIV.

CDLXV.
1
45
U
Inc
1
0.51

CDXLVII.
CDXLVIII.
U
INTERPR
ETA
TIO
N
CDLVII.CDLVIII. n
M
orm
al
CDLXVI.
CDLXVII.
M
Increase,
kidn
eys
ma
y
are
not
wor
king
pro
perl
y

CDLXVIII.
CDLXIX.

January 23, 201

CDLXX.CHEMISTRY SECTION
CDLXXI. CDLXXII.
CDLXXIII.
CDLXXIV.
CDLXXV.
CDLXXVI.
CDLXXVII.
CDLXXVIII.
CDLXXIX.
TES
R
NO
UN
IN
RE
NO
U
INTERP
R
ET
AT
IO
N
CDLXXX. CDLXXXI.
CDLXXXII.CDLXXXIII.
CDLXXXIV.
CDLXXXV.CDLXXXVI.
CDLXXXVII.
CDLXXXVIII.
Fasti
6.
4.1
M
In
10
74.
M
Increase
,
34 | P a g e

in
di
ca
te
s
hy
pe
rgl
yc
e
mi
a
CDLXXXIX.
CDXC.
CDXCI.
CDXCII.
CDXCIII.
CDXCIV.
CDXCV.
CDXCVI.
CDXCVII.
CDXCVIII.
CDXCIX.

January 18, 2014

D.

DI.

Microbiology

Examination:

DII.

GRAM STAIN

DIII.

Specimen: Ocular Discharge

DIV.

Microscopic Examination:

DV.

SMEAR SHOWS FEW EPITHELIAL CELLS AND LEUKOCYTES. NO

MICROORGANISM SEEN.

35 | P a g e

KOH

DVI.

KOH-NEGATIVE

DVII.
DVIII.

X-RAY

DIX. January 18, 2014

DX.

Examination: Chest

DXI. Film number: 14-00733

DXII. Follow-up examination to 1/10/14 shows no significant change in
the fibriotic densities in both upper lobes which may be from
previous kochs infection.
DXIII. The heart is not enlarge.
DXIV. Mediot tinum and visualized osseous structures are unremarkable.
DXV. Other findings remain unchanged.
DXVI.
DXVII.
DXVIII.
DXIX.
DXX.
DXXI.

DXXII.
36 | P a g e

Anatomy and Physiology

DXXIII. The eye is the organ of sight.

DXXIV. It is a small paired organ, each eye being a leathery sphere of
about 2.5cm diameter.
DXXV. The function of the eye is to target an object of interest, gather
and focus light from the object and transmit a clear image to the
light-sensitive tissues which line the back of the eye where the
image is received and initially processed.
DXXVI. The image is then transmitted by electrical impulses along the
optic nerve, a nerve which connects the back of the eye to the
brain. The optic nerves join together in the brain in such a way that
images from both eyes are merged to give binocular vision.
DXXVII. The part of the brain which receives these visual messages is
called the visual cortex and lies at the very back of the brain.
DXXVIII. From the visual cortex, connections reach out to many other
parts of the brain. The experience of sight is the result of very highlevel processing of the basic electrical impulses which are the raw
input from the eyes themselves.
DXXIX.
DXXX.
DXXXI.
DXXXII.
DXXXIII.
DXXXIV. Important tissues of the eye

37 | P a g e

DXXXV.

E
ye anterior chamber cross-section with lens, angle, ciliary body, iris
and cornea.
DXXXVI.
DXXXVII.
Cornea: This is the clear front window' of the eye, where
its dense leathery wall is specialised to make it perfectly clear and
allow clear images to enter the inside of the eye. It also acts as a
powerful lens to refract or focus the light from an object.
DXXXVIII.
Iris: Acts as a diaphragm or circular shutter to control the
amount of light entering the eye. The iris gives the eye its beautiful
colour.
DXXXIX.Lens: This is a clear specialised protein structure which helps
focus the images and adjusts the eye's focusing power according to
whether the object being viewed is close or far away.
DXL. Vitreous Gel: This is a clear, firm jelly which forms the main bulk
of the eye and helps to support its internal structure.
DXLI. Ciliary Body: This is a muscle which changes the shape of the lens
to allow clear fine focusing. It is also a gland which produces a
watery fluid, the aqueous fluid. The balance between the
production and the drainage of the aqueous is what determines the
pressure to which the eye is pumped up'.
DXLII.Retina: This is the nerve tissue which lines the inside of the eye. It
consists of very finely layered and delicate nerve tissue. The
central part of the retina is the part we use when we look at
38 | P a g e

something. This part of the retina is called the macula. It contains

the greatest concentration of light-sensitive cells, called
photoreceptors.
DXLIII. Optic Nerve: This structure is formed from all the fine nerve
fibres which come from all over the retina. Where they all meet,
they are gathered into a bundle which exits the eye through a fine
grid of tiny holes in the wall of the eye and then extends back, like
a fine cable, taking the
DXLIV.

impulses to the brain.

DXLV. All of these tissues are finely structured and most of them are quite
delicate except for the outer wall of the eye which is quite tough.
The other tissues need protection, so the eye sits in a wellprotected cavity in the face (called the orbit) where it is surrounded
by bone which is rigid in parts and able to crumple in other parts.
There are good reflex mechanisms to protect the eye and a good
system of washing (with tears) and wiping the clear front surface
(the eyelids' blinking action).
DXLVI. Common problems

DXLVII.
39 | P a g e

DXLVIII. Macula with normal eyeball anatomy.

DXLIX. Cornea: Can be affected by trauma, by infections such as
trachoma, and by nutritional problems such as Vitamin A deficiency
(called Nutritional Blindness) which leads to gross abnormalities
and dryness of the surface cells. Trachoma and nutritional
blindness are major sight-affecting problems in developing parts of
the world where many people live in poverty. Trauma is an
important cause of vision loss in impoverished agricultural
communities.
DL.

Lens: When the lens loses its clarity light transmission is affected
severely because all light entering the eye is focused there. This
loss of clarity is called cataract. It is the major cause of blindness in
the world today. Cataract is not preventable but it is treatable.

DLI.

Retina: Can be affected by many diseases. The main ones are an

ageing change in the central part, the macula, called macular
degeneration, and the effects of diabetes on the retina,
called diabetic retinopathy.

DLII. Macular degeneration is the main cause of untreatable visual loss

in developed countries and is very difficult to treat. Diabetic
retinopathy can be treated with laser but it must be identified early
before it becomes too advanced to treat. It is becoming a rapidly
increasing problem worldwide, as diabetes becomes more common.
DLIII. Optic Nerve: If the pressure within an eye is too high, it can
damage the optic nerve at the point where it leaves the eye. This
condition is called glaucoma. There are various common ways for
the pressure to become abnormally high. People's susceptibility to
this damage is highly variable. Glaucoma is a major cause of
blindness and visual disability throughout the world.
DLIV. All of these conditions can and do cause blindness.
DLV. https://youtube.googleapis.com/v/sQRwViF0EBw%26hl=en
DLVI.
DLVII.
DLVIII.
40 | P a g e

DLIX.
DLX.
DLXI.
DLXII.
DLXIII.
DLXIV.
DLXV.
DLXVI.
DLXVII.
DLXVIII.
DLXIX. Differential Diagnosis
DLXX.
DLXXI. Sign
s and
Sympt
oms

DLXXII.
DLXXIII.
Endopt
halmiti
s

DLXXIV.
DLXXV.
Cornea
l
Lacera
tion

DLXXIX. Loss
of vision
DLXXXIII.
P
ain
DLXXXVII.
R
ed eyes
DXCI. Swollen
Eyelids
DXCV.Sensitivi
ty to
light
DXCIX.
Headac
he
DCIII.

DLXXX.

DLXXXI.

DLXXXIV.

DLXXXV.

DLXXVI.
DLXXVII.
Ulcerat
ive
Keratiti
s
DLXXVIII.
DLXXXII.
x
DLXXXVI.

DLXXXVIII.

DLXXXIX.

DXC.

DXCII.

DXCIV.

DXCVI.

DXCIII.
x
DXCVII.

DC.

DCI.

DCII.

41 | P a g e

DXCVIII.

DCIV.
DCV.
DCVI.
DCVII.
DCVIII.
DCIX.
DCX.
DCXI.
DCXII.
DCXIII.
DCXIV.
DCXV.
DCXVI.
DCXVII.
DCXVIII.

42 | P a g e

DCXIX. Drug Study

DCXX. D
ru
g
N
a
m
e

43 | P a g e

DCXXI. C
las
sifi
cat
ion

DCXXII.
Action

DCXXIII.
Indication

DCXXIV.
Dosage/
Rout
e/
DCXXV.Fr
equ
ency

DCXXVI.
Nu
rsing
Considera
tions

DCXXVII
Evaluati
n

DCXXVIII.
DCXXIX.
Generic
na
m
e:
DCXXX.
DCXXXI.
Timolol
m
al
ea
te
DCXXXII.
DCXXXIII.
Brand
N
a
m
e:
DCXXXIV.
betimol
DCXXXV.

DCXXXVI.
DCXXXVII.
Pharmac
olo
gic
:
DCXXXVIII.
BetaAdr
ene
rgic
Blo
cke
r
DCXXXIX.
Therape
uti
c:
DCXL. A
ntihyp
ert
ens
ive
DCXLI.

44 | P a g e

DCXLIV.
DCXLV. Bl
ocks
stim
ulati
on of
beta
1adre
nergi
c
and
beta
2adre
nergi
c
rece
ptor
sites
DCXLVI.
DCXLVII.
DCXLVIII.
Reduce
aque
ous
prod
uctio
n
DCXLIX.
DCL.
DCLI. Decr

DCLII.
DCLIII. Ocula
r
hyperte
nsion
and
open
angle
glauco
ma

DCLIV.
DCLV. 1gtts
To
OS
BID

DCLVI.
DCLVII. -give
ophthalmic
drugs
atleast 10
minutes
before
giving gel
form of
drug
DCLVIII.
DCLIX. -monitor
diabetic
patients
systemic
beta
blocking
effects can
mask some
signs and
symptoms
of
hypoglyce
mia
DCLX.
DCLXI. -some
patients
may need a
few weeks
of
treatment
to stabilize
pressure

DCLXIV.
DCLXV. T
e
intr
ocu
ar
pre
sur
was
red
ced

DCXLII.
DCXLIII.

ease
intra
ocul
ar
pres
sure

lowerimg
response
DCLXII.
DCLXIII. -drug can
be used
safely in
patients
with
glaucoma

DCLXVI.
DCLXVII.
DCLXVIII.
Drug
Na
me
45 | P a g e

DCLXIX.
Classific
ati
on

DCLXX.Act
ion

DCLXXI.
Indication

DCLXXII.
Dosage/
Rou
te/

DCLXXIV.
Nu
rsing
Considera
tions

DCLXXV.
Evaluatio
n

DCLXXVI.
DCLXXVII.
Generic
na
me
:
DCLXXVIII.
Insulin
HN
DCLXXIX.
DCLXXX.
Brand
Na
me
:
DCLXXXI.
Humulin
50/
50

46 | P a g e

DCLXXXII.
DCLXXXIII.
Pharma
col
ogi
c:
DCLXXXIV.
Pancreati
c
Hor
mo
ne
DCLXXXV.
Therape
uti
c:
DCLXXXVI.
Hypoglyc
em
ic

DCLXXXVII.
DCLXXXVIII.
Increase
glucos
e
transp
ort
DCLXXXIX.
DCXC.
DCXCI. Sti
mulat
es
carbo
hydrat
e
metab
olism
DCXCII.
DCXCIII.
DCXCIV. Pro
motes
phosp
horyla
tion of
glucos
e in
lver
DCXCV.

DCCVII.
DCCVIII. sever
e
diabe
tic
ketoa
cidos
is
DCCIX. mild
diabe
tic
ketoa
cidos
is
DCCX. contr
ol of
hype
rglyc
emia
DCCXI. hype
rkale
mia
DCCXII.
DCCXIII.

DCLXXIII.
Frequenc
y
DCCXIV.
DCCXV. 26
units
prebrea
kfast
DCCXVI.16
units
predinn
er

DCCXVII.
DCCXVIII.
regula
insulin is
for patients
with
circulatory
collapse
and
diabetic
ketoacidosi
s
DCCXIX.
DCCXX. -dont
use insulin
that
changes
color or
becomes
clumped in
appearanc
e
DCCXXI.
DCCXXII.
ch
eck
expiration
date on vial
before
using
contents

DCCXXVII.

DCCXXVIII.
The
gluc
ose
will
decr
ease
and
main
taine
d

DCXCVI.
DCXCVII.
Affects fat
and
protei
n
metab
olism
DCXCVIII.
DCXCIX.
DCC. Stimul
ates
protei
n
synth
esis
DCCI.
DCCII.
DCCIII. Inhi
bits
releas
e of
fatty
acids
DCCIV.
DCCV.
DCCVI. Dec
reases
phosp
hate
and
potas
47 | P a g e

DCCXXIII.
DCCXXIV.
monitor
patients for
hyperglyce
mia
DCCXXV.
DCCXXVI.
some
patients
may
develop
insulin
resistance
and need
large
insulin
doses to
control
symptoms
of diabetes

sium

DCCXXIX.

DCCXXXI.

DCCXXXIII.

DCCXXXV.

DCCXXXVII.

DCCXXXIX.

DCCXXX.
Drug Name

DCCXXXII.
Classificati
on

DCCXXXIV.
Action/Indi
catio
n

DCCXXXVI.
Dosage/Ro
ute/Fr
eque
ncy

DCCXXXVIII.
Nursing
Consi
derati
ons

DCCXL. Eva
luatio
n

48 | P a g e

DCCXLI.
DCCXLII.
Generic
Nam
e:
DCCXLIII.
moxifloxaci
n
DCCXLIV.
DCCXLV.
Brand
Nam
e:
DCCXLVI.
Avelox
DCCXLVII.

DCCXLVIII.
DCCXLIX.
Pharmaco
logic
:
DCCL. Av
elox
DCCLI.
DCCLII. Th
erap
euti
c:
DCCLIII. An
tiinfec
tive
DCCLIV.
DCCLV.

49 | P a g e

DCCLVI. Indic
ation:
DCCLVII.
-To treat
bacteri
al
conjun
ctivitis
DCCLVIII.
DCCLIX. Actio
n:
DCCLX. Inhib
its
synthe
sis of
bacteri
al
enzym
e DNA
gyrase
by
counte
racting
excessi
ve
superc
oiling
of DNA
during
replicat
ion or
transcr

DCCLXVI.
DCCLXVII.
E/D 1gtt
to
O
D
TI
D

DCCLXVIII.
DCCLXIX.
Administer the
drug at the
same time
everyday
DCCLXX.
DCCLXXI.
-Use
the drug until
you finish the
prescription
and the full
course of the
drug therapy
DCCLXXII.
DCCLXXIII.
-When
using the
eyedrops be
careful not to
let the tip of the
bottle touch
your eyes
because
bacteria may
get into the eye
drops
DCCLXXIV.
DCCLXXV.
-Your
vision may be
temporarily
blurred or
unstable after
applying this

DCCLXXVIII.
DCCLXXIX.
Patients
ba
ct
eri
al
co
nj
un
cti
vit
is
wa
s
tre
at
ed

iption
DCCLXI.
DCCLXII.
DCCLXIII.
DCCLXIV.
Inhibiting
DNA
gyrase
causes
rapid
and
slowgrowin
g
bacteri
al cells
to die
DCCLXV.

drug.
DCCLXXVI.
DCCLXXVII.
-Do not
drive, use
machinery, or
do any activity
that requires
clear vision
until you are
sure you can
perform such
activities
safely.Use of
this medication
for prolonged or
repeated
periods may
result in a
secondary
infection.

DCCLXXX.
DCCLXXXI.
DCCLXXXII.
Drug
Nam
e

50 | P a g e

DCCLXXXIII.

DCCLXXXV.

DCCLXXXIV.
Classificati
on

DCCLXXXVI.
Action/Indi
catio
n

DCCLXXXVII. DCCLXXXIX.
DCCLXXXVIII. DCCXC.Nursing
Dosage/
Considera
Ro
tions
ut
e/
Fr
eq

DCCXCI.
DCCXCII.
Evaluation

DCCXCIII.
DCCXCIV.
Generic
Nam
e:
DCCXCV.
Dorzolamid
e
optha
lmic
DCCXCVI.
DCCXCVII.
Brand
Nam
e:
DCCXCVIII.
Trusopt
DCCXCIX.

51 | P a g e

DCCC.
DCCCI. Ph
arma
colog
ic:
DCCCII. Bet
aadren
ergic
block
er
DCCCIII.
DCCCIV.
Therapeuti
c:
DCCCV. Anti
glauc
oma
agent

DCCCVI.
DCCCVII.
Indication:
DCCCVIII.
-To reduce
intrao
cular
press
ure
DCCCIX.
DCCCX. Acti
on:
DCCCXI.It
cataly
zes
the
revers
ible
reacti
on
involvi
ng the
hydra
tion of
carbo
n
dioxid
e and
the
dehyd

ue
nc
y
DCCCXVI.
DCCCXVII.
Dosage:
DCCCXVIII.
1 drops
DCCCXIX.
DCCCXX.
Route:
DCCCXXI.
OD
DCCCXXII.
DCCCXXIII.
Frequenc
y:
DCCCXXIV.
TID

DCCCXXV.

DCCCXXX.

DCCCXXVI.
Patients
should be
advised
that if they
develop
any ocular
reactions,
particularly
conjunctivit
is and lid
reactions,
they should
discontinue
use and
seek their
physicians
advice.

DCCCXXXI.
Patients
intrao
cular
press
ure
was
decre
ased

DCCCXXVII. Patients
should be
instructed
to avoid
allowing

ration
of
carbo
nic
acid.
DCCCXII.

DCCCXIII.
Inhibition of
carbo
nic
anhyd
rase
in the
ciliary
proce
sses
of the
eye
decre
ases
aqueo
us
humor
secret
ion,
presu
mably
by
slowin
g the
forma
tion of
52 | P a g e

the tip of
the
dispensing
container
to contact
the eye or
surrounding
structures.
DCCCXXVIII. Patients
should also
be
instructed
that ocular
solutions, if
handled
improperly
or if the tip
of the
dispensing
container
contacts
the eye or
surrounding
structures,
can
become
contaminat

bicarb
onate
ions
with
subse
quent
reduct
ion in
sodiu
m and
fluid
transp
ort.
DCCCXIV.

DCCCXV.
The result is
a
reduct
ion in
intrao
cular
press
ure
(IOP)

53 | P a g e

ed by
common
bacteria
known to
cause
ocular
infections.
Serious
damage to
the eye and
subsequent
loss of
vision may
result from
using
contaminat
ed
solutions.
DCCCXXIX.
-If
more than
one topical
ophthalmic
drug is
being used,
the drugs
should be
administere
d at least
ten minutes

apart.

DCCCXXXII.
DCCCXXXIII.
54 | P a g e

DCCCXXXIV. DCCCXXXV.
Drug
Classifica
Na
tion
me

DCCCXXXVI. DCCCXXXVII.
Action
Indication

DCCCXLII.
DCCCXLIII.
Generic
na
me
:
DCCCXLIV.

DCCCLVIII.
DCCCLIX.
sti
mu
lat
es
col
lag
en
for
ma
tio
n
an
d
tis
su
e
rep
air

Asc
orb
ic
aci
d
DCCCXLV.
DCCCXLVI.
DCCCXLVII.
Brand
Na
me
:
DCCCXLVIII.
cecon
DCCCXLIX.

DCCCL.
DCCCLI. Vi
tami
ns
and
min
eral
s
DCCCLII.
DCCCLIII.
DCCCLIV.
DCCCLV.
DCCCLVI.
DCCCLVII.

55 | P a g e

DCCCLX.
DCCCLXI.
-subclinical
scurvy
DCCCLXII.
DCCCLXIII.
-extensives
burns,
delayed
fracture
or
wound
healing,
severe
febrile
or
chronic
disease
states
DCCCLXIV.
DCCCLXV.
-to prevent
vitamin

DCCCXXXVIII. DCCCXL.
Nu
Dosage/
rsing
Rout
Considera
e/
tions
DCCCXXXIX.
Frequenc
y
DCCCLXIX.
DCCCLXXI.
DCCCLXXII. DCCCLXX.
when giving
500mg/tab
for urine
OD
acidification
, check
urine ph to
ensure
efficacy
DCCCLXXIII.
DCCCLXXIV. take large
of vitamin c
in divided
amounts
because
the body
uses only
what is
needed at
a particular
time
excretes
the rest in
urine
DCCCLXXV.

DCCCXLI
Evaluati
n

DCCCLXX

DCCCLXX
-vitamin C
defi
ien
was
pre
ent
d.
DCCCLXX

c
deficien
cy
DCCCLXVI.
DCCCLXVII.
to acidify
urine
DCCCLXVIII.

DCCCLXXVI. megadoses
can
interfere
with
absorption
of vitamin
B12
DCCCLXXVII.

DCCCLXXXI.
DCCCLXXXII.
DCCCLXXXIII.
DCCCLXXXIV. DCCCLXXXV.DCCCLXXXVI.
56 | P a g e

DCCCLXXXVII. DCCCLXXXVIII.DCCCXC.

Nu

DCCCXCI.

Drug
Nam
e

DCCCXCII.
DCCCXCIII.
Generic
nam
e:
DCCCXCIV.
Cyanocoba
lami
n
DCCCXCV.
DCCCXCVI.
Brand
Nam
e:
DCCCXCVII.
nascobal
DCCCXCVIII.

57 | P a g e

Classifi
c
a
ti
o
n
DCCCXCIX.
CM. Vi
ta
m
in
s
a
n
d
m
in
er
al
s

Action

Indication

CMI.
CMII. Activa
tion of
folic
acid
coenz
ymes
CMIII.
CMIV.
CMV.
CMVI. Red
blood
cell
forma
tion

CMVII.
CMVIII. vita
min
B12
defici
ency
from
inade
quat
e
diet
CMIX.
CMX. perni
cious
anem
ia or
vita
min
B12
mala
bsorp
tion
CMXI.
CMXII.

Dosage/
rsing
Rou
Considera
te/
tions
DCCCLXXXIX.
Frequenc
y
CMXIII.
CMXV.
CMXIV. 10
CMXVI. mcg
determine
OD
reticulocyte
count,
hematocrit,
vitamin
B12, iron,
and folate
levels.
CMXVII.
CMXVIII.- obtain
a
sensitivity
test history
before
administrat
ion
CMXIX.
CMXX. -dont
mix
parenteral
preparation
s in same
syringe
with other
drugs

Evaluatio
n

CMXXII.
CMXXIII.-it
impr
oves
dieta
ry
defic
ienc
y
and
incre
ased
activ
ation
of
neur
ons

CMXXI.

CMXXIV.
CMXXV.
CMXXVI.
CMXXVII.
Drug
58 | P a g e

CMXXVIII.
Classific

CMXXIX.
Action

CMXXX.
Indicatio

CMXXXI.
Dosage/

CMXXXIII.
Nu
rsing

CMXXXIV.
Evaluatio

N
a
m
e
CMXXXV.
CMXXXVI.
Generic
na
m
e:
CMXXXVII.
Atropin
e
su
lfa
te
CMXXXVIII.
CMXXXIX.
Brand
N
a
m
e:
CMXL. S
altr
op
in
e
CMXLI.

59 | P a g e

ati
on

CMXLII.
CMXLIII.
Pharma
col
ogi
c:
CMXLIV. A
nti
ch
oli
ner
gic
CMXLV.
CMXLVI.
CMXLVII.
Therape
uti
c:
CMXLVIII.
Antiarrhy
th
mi
cs
CMXLIX.
CML.

CMLI.
CMLII.

Inhibi
ts
acetylc
holine
CMLIII.
CMLIV.
CMLV.
CMLVI. Block
s
choliner
gic
stimula
tion to
iris and
ciliary
bodies.
CMLVII.
CMLVIII.
CMLIX.
CMLX. Causi
ng
pupillar
y
dilation
and
accom
modati

CMLXI.
CMLXII. sym
pto
mati
c
brad
ycar
dia
CMLXIII.
CMLXIV. preo
pera
tivel
y to
dimi
nish
ed
secr
etio
ns
and
bloc
k
card
iac
vaga
l

Rou
te/
CMXXXII.
Frequenc
y
CMLXIX.
CMLXX. 1g
tt
TIV
OD

Considera
tions

CMLXXI.
CMLXXII.
may
adverse
reaction
such as dry
mouth, and
constipatio
n vary with
the dose
CMLXXIII.
CMLXXIV.
monitor
fluid intake
and urine
output
drug
causes
urine
retention
and urinary
hesitancy
CMLXXV.
CMLXXVI.
watch for
tachycardia
in cardiac
patients

CMLXXVII.

CMLXXVIII.
It
enha
ncin
g
cond
uctio
n
thro
ugh
the
AV
node
s
and
it
may
decr
ease
abso
rptio
n of
antic
holin
ergic
s

on of
paralysi
s.

refle
xes
CMLXV.
CMLXVI.adju
nct
treat
men
t of
pept
ic
ulce
r
dise
ase
CMLXVII.
CMLXVIII.
-pupillary
dilat
ion
in
acut
e
infla
mm
ator
y
cond
ition
s of
iris
and

60 | P a g e

because it
may lead
to
ventricular
fibrillation.

uvea
l
tract

CMLXXIX.
CMLXXX.
CMLXXXI.
CMLXXXII.
Drug
61 | P a g e

CMLXXXIII.
Classific

CMLXXXIV.
Action

CMLXXXV.
Indication

CMLXXXVI.
Dosage/

CMLXXXVIII. Nu
rsing

CMLXXXIX
Evaluatio

N
a
m
e
CMXC.
CMXCI. G
en
er
ic
na
m
e:
CMXCII.
Amlodi
pi
ne
CMXCIII.
CMXCIV.
Brand
N
a
m
e:
CMXCV.
norvasc
CMXCVI.

62 | P a g e

ati
on

CMXCVII.
CMXCVIII.
Pharmac
olo
gic:
CMXCIX.C
alci
um
Cha
nnel
Bloc
ker
M.
The
rap
eut
ic:
MI.
Anti
hyp
erte
nsiv
e

MII.
MIII. Inhibit
s
calciu
m ion
influx
across
cardia
c and
smoot
h
muscl
e cells
MIV.
MV.
MVI.
MVII. Decre
asing
myoc
ardial
contra
ctility
and
oxyge
n
dema
nd

MVIII.
MIX. chron
ic
stabl
e
angin
a
MX.
MXI. varia
nt
angin
a
MXII.
MXIII. hype
rtens
ion
MXIV.
MXV.

Rou
te/
CMLXXXVII.
Frequenc
y
MXVI.
MXVII. 10
mg/t
ab
OD

Considera
tions

MXVIII.
MXIX. -monitor
blood
pressure
frequently
during
intiation of
therapy
MXX.
MXXI. -notify
prescriber
if signs of
heart
failure
occur such
as swelling
of hands
feet or
shortness
of breath.
MXXII.
MXXIII. -advise
patient to
minimize
GI upset by
eating
small,
frequent

MXXIV.
MXXV. may
incre
ase
drug
level
and
indu
ced
vaso
dilati
on

servings of
food and
drink
plenty of
fluids.

MXXVI.
MXXVII.
Drug
Na
m
e

63 | P a g e

MXXVIII.
Classific
atio
n

MXXIX. Act
ion

MXXX. In
dicat
ion

MXXXI. D
osa
ge/
Rou
te/
MXXXII.

MXXXIII.
Nu
rsing
Considera
tions

MXXXIV.
Evaluatio
n

MXXXV.
MXXXVI.
Generic
na
m
e:
MXXXVII.
Ceftazi
di
m
e
MXXXVIII.
MXXXIX.
Brand
Na
m
e:
MXL. ta
zi
di
m
e
MXLI.

64 | P a g e

MXLII.
MXLIII. P
har
ma
col
ogi
c:
MXLIV. T
hrid
Gen
erat
ion
Cep
halo
spor
ins
MXLV.
MXLVI. T
her
ape
utic
:
MXLVII. A
ntiinfe
ctiv
e
MXLVIII.

MXLIX.
ML. Third
gener
ation
cepha
lospor
in
MLI.
MLII.
MLIII.
MLIV. Inhibit
s cell
wall
synth
esis
MLV.
MLVI.
MLVII.
MLVIII. Pro
motin
g
osmot
ic
instab
ility,
usuall
y
bacter
icidal

MLIX.
MLX. -Skin
infect
ions;
bone
and
joint
infect
ions;
urina
ry
tract
and
gyne
colog
ical
infect
ions,
respir
atory
tract
infect
ions;
intra
bdom
inal
infect
ions

Frequenc
y
MLXI.
MLXII. e/
d
1gtt
to
OD
Q3

MLXIII.
MLXIV. -before
administrat
ion ask
patient if
he is
allergic to
penicillins
or
cephalospo
rins
MLXV.
MLXVI. -obtain
specimen
for culture
and
sensitivity
test before
giving first
dose
MLXVII.
MLXVIII. -if large
doses are
given
therapy is
prolonged
or patient
is at high
risk,
monitor
patient for

MLXX.
MLXXI. Decr
ease
infec
tion.

signs and
symptoms
of infection
MLXIX. .

MLXXII.
MLXXIII.
MLXXIV.

65 | P a g e

MLXXV.
Drug
N
a
m
e
MLXXXIII.
MLXXXIV.
Generic
na
m
e:
MLXXXV.

MLXXVI.
Classifica
tion

MXCI.
MXCII. P
har
mac
olog
ic:
Angi
oten
lo
sin II
sa
rece
rt
ptor
an
MXCIII. An
po
tago
ta
nist
ss
MXCIV.
iu
MXCV. T
m
her
MLXXXVI.
ape
MLXXXVII.
utic:
MLXXXVIII.
Anti
Brand
hype
N
rten
a
m
sive
e:
MLXXXIX.
66 | P a g e

MLXXVII.
Action

MLXXVIII.
Indication

MCII.
MCIII. Block
s
bindi
ng of
angio
tensi
n II to
recep
tor
MCIV. sites
in
many
tissu
es,
inclu
ding
vasc
ular
MCV. smoo
th
musc
le
and
adren
al

MCXXI.
MCXXII. mana
ge
hypert
ension
MCXXIII.
MCXXIV.

MLXXIX.
Dosage/
Rout
e/
MLXXX.
Frequenc
y
MCXXV.
MCXXVI.
50mg PO
BID
MCXXVII.

MLXXXI.
Nu
rsing
Considera
tions

MLXXXII
Evaluati
n

MCXXVIII.

MCXLI.
MCXLII. H
per
nsio
is
ma
age

MCXXIX.

Periodically
monitor
patients
serum
potassium
level, as
appropriate
, to detect
hyperkalem
ia.
MCXXX. Monitor
blood
pressure
and renal
function.
MCXXXI.
MCXXXII.

Instruct
patient to

MCXLIII.

Cozaar

MXCVI.

MXC.

MXCVII.
MXCVIII.
MXCIX.
MC.
MCI.

67 | P a g e

gland
s
MCVI.
MCVII.
MCVIII. va
soco
nstric
t
MCIX.
MCX.
MCXI. stimu
lates
the
adren
al
corte
x
MCXII.
MCXIII.
MCXIV. sec
rete
aldos
teron
e
MCXV.
MCXVI.
MCXVII. inh
ibit
effect
s of
MCXVIII.an
giote
nsin

avoid
potassium
containing
MCXXXIII.
salt
substitutes
because
that may
increase
risk of
hyperkalem
ia.
MCXXXIV.
MCXXXV.

Advise
patient to
avoid
exercising
in hot
MCXXXVI.
we
ather and
drinking
excessive
amounts
MCXXXVII.
of
alcohol;
instruct him
to notify
prescriber
MCXXXVIII.
if
he has
prolonged
diarrhea,
nausea, or

II

MCXXXIX.
vo
miting.

MCXIX.

MCXL.

MCXX. red
uce
blood
press
ure

MCXLIV.
Drug
Nam
e

68 | P a g e

MCXLV. Cla
ssific
ation

MCXLVI.
Action

MCXLVII.
Indication

MCXLVIII.
Dosage/
Rout
e/
MCXLIX.
Frequency

MCL. Nurs
ing
Cons
idera
tions

MCLI. Ev
aluat
ion

MCLII.
MCLIII. G
en
eri
c
na
me
:
MCLIV. c
ipr
of
ox
aci
n
MCLV.
MCLVI.
MCLVII.B
ra
nd
Na
me
:
MCLVIII.
Cipro
MCLIX.

69 | P a g e

MCLX.
MCLXI. P
har
mac
olog
ic:
Fluor
oqui
nolo
ne
MCLXII.
MCLXIII.
MCLXIV. T
her
ape
utic:
Anti
bioti
c
MCLXV.
MCLXVI.

MCLXVII.

MCLXXV.

MCLXXX.

MCLXVIII.
Inhibits
the
enzy
me
DNA
gyra
se,
(res
pons
ible
for
the
unwi
ndin
g
and
supe
rcoili
ng
MCLXIX.of
bact
erial
DNA
befo
re it
repli
cate
s.)
MCLXX.
MCLXXI.

MCLXXVI.

MCLXXXI.
500 mg
caps
ule
TID

MCLXXVII.
-To treat
bone
and
joint
infect
ions
caus
ed
MCLXXVIII.
by
susc
eptibl
e
orga
nism
s
MCLXXIX.

MCLXXXII.

MCLXXXIII.
MCLXXXIV.

Dont give
oral
suspension
by feeding
MCLXXXV.
tub
e.
MCLXXXVI.

Patient
should be
well
hydrated
during
MCLXXXVII. the
rapy to
help
prevent
alkaline
urine,
MCLXXXVIII. wh
ich may
lead to
crystalluria
and
MCLXXXIX.
ne
phrotoxicity
.
MCXC.
MCXCI. Assess
patients
hepatic,

MCCI.
MCCII. Treat
infec
tion.

MCLXXII.
causes
bact
erial
cells
to
die
MCLXXIII.
MCLXXIV.

70 | P a g e

renal, and
hematologi
c
MCXCII. functions
periodically
, as
ordered,
MCXCIII. if hes
receiving
prolonged
therapy.
MCXCIV.
MCXCV. Monitor
patient
closely for
diarrhea,
MCXCVI.which
may reflect
pseudome
mbranous
MCXCVII.
coli
tis. If it
occurs,
notify
prescriber
and
MCXCVIII.
ex
pect to
withhold
drug and
treat
diarrhea.
MCXCIX.

MCC.

MCCIII. Dr
ug
Nam
e

71 | P a g e

MCCIV. Cla
ssific
ation

MCCV. Ac
tion

MCCVI. In
dicat
ion

MCCVII.
Dosage/
Rout
e/
MCCVIII.
Frequency

MCCIX. Nu
rsing
Cons
idera
tions

MCCX. Ev
aluat
ion

MCCXI.
MCCXII.
Generic
na
m
e:
MCCXIII.
omepra
zo
le
MCCXIV.
MCCXV.
MCCXVI.
Brand
N
a
m
e
MCCXVII.
Losec
MCCXVIII.
MCCXIX.

MCCXX.
MCCXXI.
Pharmac
olo
gic:
Sub
stit
ute
d
ben
zimi
daz
ole
MCCXXII.
MCCXXIII.
Therape
utic
:
Anti
ulce
r
MCCXXIV.

MCCXXV.

MCCXXXVII.

MCCXLIII.

MCCXXVI.
Interferes
with
gastric
acid
MCCXXVII.
secretion
MCCXXVIII.

MCCXXXVIII.
- To
prov
ide
shor
tterm
treat
men
t of
MCCXXXIX.
active
beni
gn
gast
ric
ulce
r
MCCXL.
MCCXLI.
MCCXLII.

MCCXLIV.
40 mg tab
OD
A.C.
MCCXLV.

MCCXXIX.
MCCXXX.
Increase
gastric
mucus
and
bicarb
onate
produc
tion
MCCXXXI.
MCCXXXII.
Creating
protect
ive

72 | P a g e

MCCXLVI.
MCCXLVII.

Give
omeprazole
before
meals,
preferably
MCCXLVIII.
in
the
morning for
once-daily
dosing. If
MCCXLIX.
ne
eded, also
give an
antacid, as
prescribed.
MCCL.
MCCLI.
Because
drug can
interfere
with
absorption
MCCLII. of
vitamin
B12,
monitor
patient for
MCCLIII. macrocyt
ic anemia.
MCCLIV.
MCCLV.

MCCLXVI.

MCCLXVII.
-Gastric
dise
ases
was
prev
ente
d.

coatin
g on
gastric
mucos
a
MCCXXXIII.
MCCXXXIV.
Easing
discom
fort
from
excess
gastric
acid
MCCXXXV.
MCCXXXVI.

73 | P a g e

Encourage
patient to
avoid
alcohol,
aspirin
MCCLVI. products,
ibuprofen,
and foods
that may
MCCLVII.
inc
rease
gastric
secretions
during
therapy.
MCCLVIII.
Tell
him to
notify all
prescribers
about
MCCLIX.prescripti
on drug
use.
MCCLX.
MCCLXI. Advise
patient to
notify
prescriber
immediatel
y
MCCLXII.
ab
out
abdominal

pain or
diarrhea.
MCCLXIII.
MCCLXIV.
MCCLXV.

MCCLXVIII.
Drug
Nam
e

74 | P a g e

MCCLXIX.
Classificat
ion

MCCLXX.
Action

MCCLXXI.
Indication

MCCLXXII.
Dosage/
Rout
e/
MCCLXXIII.
Frequency

MCCLXXIV.
Nursing
Cons
idera
tions

MCCLXXV.
Evaluation

MCCLXXVI.
MCCLXXXIV.
MCCLXXVII. MCCLXXXV.
Generic
Pharma
na
col
m
ogi
e:
c:
MCCLXXVIII.
Am
tobram
ino
yc
gly
in
cos
su
ide
lfa
MCCLXXXVI.
te
MCCLXXXVII.
MCCLXXIX. MCCLXXXVIII.
MCCLXXX. Therape
Brand
uti
N
c:
a
Ant
m
ibi
e:
oti
MCCLXXXI.
c
Tobi
MCCLXXXIX.
MCCLXXXII.
MCCLXXXIII.

75 | P a g e

MCCXC.
MCCXCI.Inhibit
s
bacterial
protein
synthesi
s
MCCXCII.
MCCXCIII.
MCCXCIV.
B
inds
irreversi
bly to
one of
two
aminogl
ycosideMCCXCV.
b
inding
sites on
the 30S
ribosom
al
MCCXCVI.
s
ubunit
MCCXCVII.
MCCXCVIII.
MCCXCIX.
R
esults in
bacterio
static
effects
MCCC.

MCCCX.
MCCCXI.
To treat
bac
tere
mia
MCCCXII.
MCCCXIII.

MCCCXIV.
MCCCXV.
e/d OD
1gtt
to
OD

MCCCXVI.
MCCCXVII.
W
atch for
signs of
nephrotoxi
city, such
as
MCCCXVIII.
ele
vated BUN
and serum
creatinine
levels.
MCCCXIX.
MCCCXX.

Expect
dehydratio
n to
increase
the risk of
MCCCXXI.
ne
phrotoxicity
.
MCCCXXII.
MCCCXXIII.
M
onitor
patient
closely for
diarrhea,
MCCCXXIV.
wh
ich may
indicate
pseudome
mbranous

MCCCXXXI

MCCCXXXI
-Bacteria
was
kille
d.

MCCCI.
MCCCII. Bacte
ricidal
effects
may
stem
from
MCCCIII.tobra
mycins
ability to
accumul
ate
within
MCCCIV.cells
MCCCV.
MCCCVI.
MCCCVII.
i
ntracellu
lar drug
level
MCCCVIII.
e
xceeds
the
extracell
ular
level.
MCCCIX.

76 | P a g e

MCCCXXV.
coli
tis caused
by C.
difficile.
MCCCXXVI.
MCCCXXVII.
Urge
patient to
immediatel
y report
highfreque
ncy
MCCCXXVIII. he
aring loss
and vertigo
MCCCXXIX.
MCCCXXX.

Urge
patient to
tell
prescriber
about
diarrhea
MCCCXXXI.
tha
ts severe
or lasts
longer than
3 days.
Remind
patient that
watery or
bloody
stools may

occur 2 or
more
months
after
antibiotic
therapy.

MCCCXXXIV.
Drug
Nam
e

77 | P a g e

MCCCXXXV.
Classificat
ion

MCCCXXXVI.
Action

MCCCXXXVII.
Indication

MCCCXXXVIII. MCCCXL.
Dosage/
Nursing
Rout
Cons
e/
idera
MCCCXXXIX.
tions
Frequency

MCCCXLI.
Evaluation

MCCCXLII.
MCCCXLIII.
Generic
na
m
e:
MCCCXLIV.
vancom
yc
in
MCCCXLV.
hydroc
hl
or
id
e
MCCCXLVI.
MCCCXLVII.
Brand
N
a
m
e:
MCCCXLVIII.
Vancoci
n
MCCCXLIX.
MCCCL.
MCCCLI.

MCCCLII.
MCCCLIII.
Pharmac
olo
gic:
Tric
ycli
c
glyc
ope
ptid
e
MCCCLIV.
MCCCLV.
Therape
utic
:
Anti
biot
ic
MCCCLVI.

MCCCLVII.

MCCCLXVIII.

MCCCLXXIII.

MCCCLVIII.
Inhibits
bacter
ial
RNA
and
cell
wall
synth
esis
MCCCLIX.

MCCCLXIX.
-To treat
bacte
rial
endo
cardi
tis
caus
ed by
MCCCLXX.
methicillinresist
ant
Stap
hyloc
occu
s
MCCCLXXI.
aureus
MCCCLXXII.

MCCCLXXIV.
E/D 1gtt to
OD
Q3

MCCCLX.
MCCCLXI.
MCCCLXII.
Alters
perme
ability
of
bacter
ial
memb
ranes
MCCCLXIII.
MCCCLXIV.
MCCCLXV.

78 | P a g e

MCCCLXXV.
MCCCLXXVI. M
onitor
serum
vancomyci
n
concentrati
on in
patients
with renal
impairment
or colitis
because
significant
increases
in blood
MCCCLXXVII. dru
g level
have
occurred in
such
patients
taking
multiple
oral doses
of
vancomyci
n.
MCCCLXXVIII.
MCCCLXXIX.
Check CBC
results and
serum

MCCCLXXX

MCCCLXXX
-Bacteria
was
kille
d.
MCCCLXXX

MCCCLXVI.
Causing cell
wall
lysis
and
cell
death
MCCCLXVII.

79 | P a g e

creatinine
and BUN
levels
during
therapy,
especially
if patient
has renal
impairment
or takes an
aminoglyco
side.
MCCCLXXX.
MCCCLXXXI. O
bserve I.V.
infusion
site for
evidence of
MCCCLXXXII. ext
ravasation,
including
necrosis,
pain,
MCCCLXXXIII. ten
derness,
and
thrombophl
ebitis. If
MCCCLXXXIV. ext
ravasation
occurs,
discontinue
infusion

MCCCLXXXV. im
mediately
and notify
prescriber.
MCCCLXXXVI.

MCCCXC.
MCCCXCI.
MCCCXCII.
CUES

80 | P a g e

Nursing Care Plan

MCCCXCIII.
DIAGNOS
IS

MCCCXCIV.
INFEREN
CE

MCCCXCV.
PLANNIN
G

MCCCXCVI.
NURSING
INT
ERV

MCCCXCVII.
RATIONA
LE

MCCCXCVIII.
EVALUATI
ON

MCCCXCIX.
MCD.S>
MCDI.
mas
akit
ang
mat
a ko

MCDII.
MCDIII. O
>
MCDIV. >
PRigh
t
eye
MCDV. >
QShar
p
MCDVI. >
S8/10
MCDVII. >
R81 | P a g e

MCDX.
MCDXI. A
cute
pain
relat
ed
to
infla
mm
ator
y
resp
onse
s
from
infla
mm
atio
n

MCDXII.
MCDXIII.
Endopthal
miti
s
MCDXIV.
MCDXV.
MCDXVI.
Inflammat
ion
of
insid
e
the
eye
MCDXVII.
MCDXVIII.
MCDXIX.
Inflammat
ory
resp
ons
e
MCDXX.
MCDXXI.

MCDXXIII.
Short
Ter
m:
MCDXXIV.
After 30
min
s- 1
hr.
of
nurs
ing
inter
vent
ion
the
clien
t will
repo
rt
that
pain
has
less
en
from
the

ENT
ION
MCDXXVIII.
Independ
ent:
MCDXXIX.
-Monitor
skin
colo
r,
tem
p.
and
v/s.
MCDXXX.
MCDXXXI.
-Provide
com
fort
mea
sure
s
and
quie
t
envi
ron
men

MCDXXXVII.
MCDXXXVIII.
-To
esta
blish
base
line
para
met
er.
MCDXXXIX.
MCDXL. To
pro
mot
e
nonphar
mac
olog
ical
pain
man
age
men

MCDLII.
Short
ter
m:
MCDLIII. Af
ter
30
min
s- 1
hr.
of
nurs
ing
inter
vent
ion
the
clien
t
repo
rted
that
pain
has
bee
n
less

Nonradi
atin
g
pain
MCDVIII.
>TCont
inou
s
MCDIX. >I
rrita
ble

82 | P a g e

MCDXXII.
Acute Pain

pain
scal
e of
8/10
4/10
.
MCDXXV.
MCDXXVI.
Long
Ter
m:
MCDXXVII.
After 8
hour
s of
nurs
ing
inter
vent
ion
the
clien
t will
gath
er
som
e

t.
MCDXXXII.

t.
MCDXLI.

MCDXXXIII.
-Instruct
and
enc
oura
ge
use
of
rela
xati
on
tech
niqu
es
such
as
focu
sed
brea
thin
g,
watc
hing
T.V.,
read
ing

MCDXLII.
-To
pro
mot
e
nonphar
mac
olog
ical
pain
man
age
men
t.
MCDXLIII.
MCDXLIV.
MCDXLV.
MCDXLVI.
MCDXLVII.
MCDXLVIII.

en
from
the
pain
scal
e of
8/10
4/10
.
MCDLIV.
MCDLV. L
ong
Ter
m:
MCDLVI. Af
ter 8
hour
s of
nurs
ing
inter
vent
ion
the
clien
t
gath
ered

infor
mati
on
on
how
to
dive
rt
pain
.

boo
ks
and
liste
ning
to
mus
ic.
MCDXXXIV.
MCDXXXV.
Depende
nt:
MCDXXXVI.
Adm
inist
er
eye
drop
s
med
icati
ons
as
orde
red
by
the

83 | P a g e

MCDXLIX.
MCDL.
MCDLI. To
less
en
pain
.

som
e
infor
mati
on
on
how
to
dive
rt
pain
.

phys
ician
.

MCDLVII.
CUES

84 | P a g e

MCDLVIII.
DIAGNO
SI
S

MCDLIX.
IN
FERENCE

MCDLX.
PLANNI
NG

MCDLXI.
NURSIN
G
INT

MCDLXII.
RATION
AL
E

MCDLXIII.
EVALUAT
IO
N

MCDLXIV.
MCDLXV.
S>
MCDLXVI.
hindi
na
ma
ka
kit
a
an
g
ka
na
n
ko
ng
ma
ta

MCDLXVII.
MCDLXVIII.
O>
MCDLXIX.
>Lack of
85 | P a g e

MCDLXXVI.
MCDLXXVII.
Disturbe
d
sen
sor
y
per
ce
pti
on
rel
ate
d
to
un
der
lyi
ng
co
ndi
tio
n
Dia
bet

MCDLXXVIII.
MCDLXXIX.
Di
abetes
Mellitus
MCDLXXX.
MCDLXXXI.
MCDLXXXII. Hy
perglycemi
a-induced
intramural
pericyte d
eath and
thickening
of
the basem
ent
membrane
MCDLXXXIII.
MCDLXXXIV.
MCDLXXXV. le
ad to
incompete
nce of the
vascular
walls

MCDXCVI.
Short
Ter
m:
MCDXCVII.
After 2-4
hrs.
of
nur
sin
g
int
erv
ent
ion
clie
nt
will
ide
ntif
y
ext
ern
al
fac

ER
VE
NTI
ON
MDII.Ind
epe
nde
nt:
MDIII. Ide
ntif
y
clie
nt
with
con
diti
on
that
affe
cts
sen
sing
.
MDIV.
MDV. Eval
uat
e

MDVIII.
MDIX.-To
be
aw
are
of
the
un
der
lyi
ng
ca
use
.
MDX.
MDXI.
MDXII. To
ass
ess
the
de
gre
e
of

MDXVI.S
hor
t
ter
m:
MDXVII. A
fter
2-4
hrs.
of
nur
sin
g
inte
rve
ntio
n
clie
nt
ide
nti
fied
ext
ern
al

ey
e
co
nt
act
MCDLXX.
MCDLXXI.
>Irritabil
ity
MCDLXXII.
MCDLXXIII.
>Deviati
on
of
ey
e
MCDLXXIV.
MCDLXXV.
>Unable
to
vis
ual
ize
(ri
gh
t
ey
e)
86 | P a g e

es
me
llit
us
as
evi
de
nc
ed
by
reti
no
pat
hy.

MCDLXXXVI.
MCDLXXXVII.
MCDLXXXVIII. ch
ange the
formation
of
the bloodretinal
barrier
MCDLXXXIX.
MCDXC.
MCDXCI.
MCDXCII.
Re
tinopathy
MCDXCIII.
MCDXCIV.
MCDXCV.
Di
sturbed
sensory
perception
(visual)

tor
s
tha
t
con
trib
ute
to
alt
era
tio
ns
in
sen
sor
y
abil
itie
s.
MCDXCVIII.
MCDXCIX.
Long
Ter
m:
MD. Aft
er
8
hrs.
of

sen
sor
y
awa
ren
ess.
(vis
ual
acui
ty)
MDVI.
MDVII. Assi
st
clie
nts/
SO
to
lear
n
effe
ctiv
e
way
s of
copi
ng
with
and

im
pai
rm
ent
.
MDXIII.
MDXIV.
MDXV. To
be
aw
are
of
co
pin
g
skil
ls
on
bot
h
par
tie
s
( cl
ien
t
an
d

fact
ors
tha
t
con
trib
ute
to
alte
rati
ons
in
sen
sor
y
abil
itie
s.
MDXVIII.
MDXIX.L
on
g
Ter
m:
MDXX. A
fter
8
hrs.
of

nur
sin
g
int
erv
ent
ion
s
clie
nt
will
rec
ogn
ize
s
and
co
mp
ens
ate
for
sen
sor
y
imp
air
me
nt.
MDI.
87 | P a g e

ma
nag
ing
sen
sor
y
dist
urb
anc
es
and
anti
cipa
ting
sen
sor
y
defi
cits.

SO
)

nur
sin
g
inte
rve
ntio
ns
clie
nt
rec
ogn
ize
d
and
co
mp
ens
ate
d
for
sen
sor
y
imp
air
me
nt.
MDXXI.

MDXXII.
MDXXIII.
CUES

88 | P a g e

MDXXIV.
DIAGNOS
IS

MDXXV.
INFEREN
CE

MDXXVI.
PLANNIN
G

MDXXVII.
NURSING
INT
ERV
ENT
ION

MDXXVIII.
RATIONA
LE

MDXXIX.
EVALUATI
ON

MDXXX.
MDXXXI.
S>
MDXXXII.

nahi
hira
pan
ako
ng
mat
ulog
dahi
l
may
atmay
a
pina
pata
kan
ako
sa
mat
a
MDXXXIII.
MDXXXIV.
89 | P a g e

MDXLII.
MDXLIII. Di
stur
bed
slee
p
patt
ern
relat
ed
to
hos
pital
izati
on

MDXLIV.
MDXLV. Di
abet
es
Melli
tus
MDXLVI.
MDXLVII.
MDXLVIII.
Hospitaliz
atio
n
MDXLIX.
MDL.
MDLI. Inter
rupti
ons
MDLII. (e
.g.
med
icati
ons
Q1)
MDLIII.
MDLIV.
MDLV.Lack
of
Slee

MDLXIII.
Short
Ter
m:
MDLXIV. Af
ter
2-4
hrs.
of
nurs
ing
inter
vent
ion
clien
t will
achi
eve
opti
mal
amo
unt
of
slee
p.
MDLXV.
MDLXVI.
Long
Ter

MDLXVIII.
Independ
ent:
MDLXIX.Asse
ss
slee
p
patt
ern
dist
urba
nces
that
are
asso
ciat
ed
with
the
envi
ron
men
t
MDLXX.
MDLXXI.Iden
tify
pres

MDLXXIX.
MDLXXX.
-High
perc
enta
ge
of
slee
p
dist
urba
nce
can
affe
ct
the
reco
very
of
the
clien
t.
MDLXXXI.
MDLXXXII.
-Sleep
prob
lems

MDLXXXVIII.
Short
Ter
m:
MDLXXXIX.
After 2-4
hrs.
of
nurs
ing
inter
vent
ion
clien
t
achi
eve
d
opti
mal
amo
unt
of
slee
p.
MDXC.
MDXCI. L
ong
Ter

O>
MDXXXV.
>Presence
of
dark
circl
e
und
er
the
eyes
(eye
bag
s)
MDXXXVI.
MDXXXVII.
>Irritabilit
y
MDXXXVIII.
MDXXXIX.
>restlessn
ess
MDXL.
MDXLI.

90 | P a g e

p
MDLVI.
MDLVII.
MDLVIII.
MDLIX. Di
stur
bed
Slee
p
Patt
ern
MDLX.
MDLXI.
MDLXII.

m:
MDLXVII.
After 8
hrs.
of
nurs
ing
inter
vent
ions
clien
t will
iden
tify
indi
vidu
ally
appr
opri
ate
inter
vent
ions
to
pro
mot
e
slee
p.

enc
e of
fact
ors
kno
wn
to
inter
fere
with
slee
p.
MDLXXII.

can
aris
e
from
inter
nal
and
exte
rnal
fact
ors.
MDLXXXIII.
MDLXXXIV.

MDLXXIII.
-Listen to
repo
rts
of
slee
p
qual
ity.
MDLXXIV.
MDLXXV.
MDLXXVI.

MDLXXXV.
-Helps
clari
fy
clien
ts
perc
epti
on
of
slee
p
qua
ntity

m:
MDXCII.
After 8
hrs.
of
nurs
ing
inter
vent
ions
clien
t
iden
tifie
d
indi
vidu
ally
appr
opri
ate
inter
vent
ions
to
pro
mot
e
slee

MDLXXVII.
MDLXXVIII.
-Provide
bedt
ime
care
such
as
strai
ghte
ning
bed
she
ets,
cha
ngin
g
dam
p
line
ns
or
gow
n.
MDXCIII.

91 | P a g e

and
qual
ity.
MDLXXXVI.
MDLXXXVII.
-To
pro
mot
e
phys
ical
com
fort.

p.

MDXCIV.
CUES

92 | P a g e

MDXCV.
DIAGN
O
S
I
S

MDXCVI.
INFERENC
E

MDXCVII.
PLANNIN
G

MDXCVIII.
NURSING
INTER
VENTI
ON

MDXCIX.
RATIONA
LE

MDC.EVA
LUA
TIO
N

MDCI.
MDCII. S
>
MDCIII.
hin
di
ko
na
ma
ga
wa
an
g
mg
a
ba
ga
y
na
gus
to
kon
g
ga
win
da
hil
na
hihi
93 | P a g e

MDCXIII.
MDCXIV.
Activity
in
to
le
r
a
n
c
e
re
la
te
d
to
p
re
s
e
n
t
c
o
n
di
ti
o
n

MDCXV.
MDCXVI.
Diabetes
Mellit
us
MDCXVII.
MDCXVIII.
MDCXIX.
Retinopath
y
MDCXX.
MDCXXI.
MDCXXII.
Unable to
visua
lize
MDCXXIII.
MDCXXIV.
MDCXXV.
Activity
Intole
rance
MDCXXVI.

MDCXXXII.
Short
Ter
m:
MDCXXXIII.
After 3
hrs.
of
nur
sing
inte
rve
ntio
n
clie
nt
will
rep
ort
dec
reas
e in
acti
vity
into
lera
nce
with
enh

MDCXXXVII.
Independen
t:
MDCXXXVIII.
-Provide
health
teachin
g on
the
client
regardi
ng the
organiz
ation
and
time
manag
ement
techniq
ue to
prevent
while
on
activity.
MDCXXXIX.
MDCXL. Provide
enough

MDCXLVII.
MDCXLVIII.
-To
prov
ide
ade
quat
e
kno
wled
ge
on
the
clien
t.
MDCXLIX.
MDCL.
MDCLI.
MDCLII.
MDCLIII. To
enh
anc
e
clien
ts
abili

MDCLX.
Short
Ter
m:
MDCLXI.
After 3
hrs.
of
nurs
ing
inter
vent
ion
clien
t
repo
rted
decr
ease
in
acti
vity
intol
eran
ce
with
enh
anc
ed

rap
an
na
ako
ng
ma
kak
ita
MDCIV.
MDCV. O
>
MDCVI. >
Tir
ed
faci
al
exp
res
sio
n
MDCVII.
MDCVIII.
>Uncomf
ort
abl
e
MDCIX.
MDCX. >
Wo
94 | P a g e

MDCXXVII.
MDCXXVIII.
MDCXXIX.
MDCXXX.
MDCXXXI.

anc
ed
ene
rgy
and
the
pati
ent
will
part
icip
ate
willi
ngly
in
nec
ess
ary
or
desi
red
acti
viti
es.
MDCXXXIV.
MDCXXXV.
Long
Ter
m:

air
coming
from
the
electric
fan or
from
the
window.
MDCXLI.
MDCXLII.
-Develop and
adjust
simple
activity
like
brushin
g his
teeth.
MDCXLIII.
MDCXLIV.
-Assist client
with
activity.
MDCXLV.
MDCXLVI.

ty to
parti
cipa
te in
acti
vity.
MDCLIV.
MDCLV. To
mon
itor
clien
ts
resp
ond
to
acti
vitie
s.
MDCLVI.
MDCLVII.
-To
prev
ent
over
exer
tion.
MDCLVIII.

ener
gy
and
the
pati
ent
parti
cipa
ted
willi
ngly
in
nec
essa
ry or
desi
red
acti
vitie
s.
MDCLXII.
MDCLXIII.
Long
Ter
m:
MDCLXIV.
After 8
hrs.

rrie
d
MDCXI.
MDCXII.

95 | P a g e

MDCXXXVI.
After 8
hrs.
of
nur
sing
inte
rve
ntio
ns
clie
nt
will
use
ide
ntifi
ed
tec
hni
que
s to
enh
anc
e
acti
vity
tole
ran
ce.

-Promote
comfort
measur
es on
the
activity.

MDCLIX.
-To protect
clien
t
from
injur
y.

of
nurs
ing
inter
vent
ions
clien
t
used
iden
tifie
d
tech
niqu
es
to
enh
anc
e
acti
vity
toler
anc
e.

MDCLXV.
MDCLXVI.
CUES

96 | P a g e

MDCLXVII.
DIAGNO
SI
S

MDCLXVIII. IN
FERENCE

MDCLXIX.
PLANNI
NG

MDCLXX.
NURSIN
G
INT
ER
VE
NTI
ON

MDCLXXI.
RATION
AL
E

MDCLXXII.
EVALUAT
ION

MDCLXXIII. MDCLXXXVI. MDCLXXXVIII. Di

MDCLXXIV. MDCLXXXVII.
abetes
S>
Risk for
Mellitus
MDCLXXV.
inj
MDCLXXXIX.
hindi
ury
MDCXC.
na
rel
MDCXCI.
Hy
m
ate
perglycemi
ak
d
a-induced
ak
to
intramural
ita
pre
pericyte d
an
se
eath and
g
nt
thickening
is
co
of
a
ndi
the basem
ko
tio
ent
ng
n
membrane
m
MDCXCII.
at
MDCXCIII.
a
MDCXCIV.
Le

ad to
MDCLXXVI.
incompete
MDCLXXVII.
nce of the
O>
vascular
MDCLXXVIII.
walls
>unable
MDCXCV.
to
MDCXCVI.
vi
MDCXCVII.
Ch
su
ange the
ali
formation
97 | P a g e

MDCCXII.
Short
Ter
m:
MDCCXIII.
After 2-3
hrs.
of
nur
sin
g
inte
rve
ntio
n
clie
nt
will
be
free
fro
m
inju
ry.
MDCCXIV.
MDCCXV.
Long
Ter
m:

MDCCXVII.
Indepen
den
t:
MDCCXVIII.
-Assess
gen
eral
stat
us
of
the
clie
nt.
MDCCXIX.
MDCCXX.
MDCCXXI.
-Assess
mo
od
copi
ng
abili
ties
,
per
son
alit
y

MDCCXXX.
MDCCXXXI.
-To
det
er
mi
ne
clie
nts
con
diti
on
tha
t
ma
y
cau
se
inju
ry.
MDCCXXXII.
MDCCXXXIII.
-To
det
er
mi
ne
the
lev

MDCCXLV.
Short
Ter
m:
MDCCXLVI.
After 2-3
hrs.
of
nur
sing
inte
rve
ntio
n
clie
nt
was
free
fro
m
inju
ry.
MDCCXLVII.
MDCCXLVIII.
Long
Ter
m:
MDCCXLIX.
After 8

ze
(ri
gh
t
ey
e)
MDCLXXIX.
MDCLXXX.
>rednes
s
(ri
gh
t
ey
e)
MDCLXXXI.
MDCLXXXII.
>Irritabl
e
MDCLXXXIII.
MDCLXXXIV.
MDCLXXXV.

98 | P a g e

of
the bloodretinal
barrier
MDCXCVIII.
MDCXCIX.
MDCC. Retinop
athy
MDCCI.
MDCCII.
MDCCIII.
Da
mage to
Retina
MDCCIV.
MDCCV.
MDCCVI.
Un
able to
visualize
MDCCVII.
MDCCVIII.
MDCCIX.
Ri
sk for
Injury
MDCCX.
MDCCXI.

MDCCXVI.
After 8
hrs.
of
nur
sin
g
inte
rve
ntio
ns
clie
nt
will
ver
bali
ze
und
erst
and
ing
of
indi
vid
ual
fact
ors
tha
t

styl
es
that
ma
y
res
ult
in
car
eles
sne
ss.
MDCCXXII.
MDCCXXIII.
-Assess
envi
ron
me
ntal
fact
ors
that
ma
y
lea
d to
inju
ry.
MDCCXXIV.

el
of
coo
per
ati
on.
MDCCXXXIV.
MDCCXXXV.
MDCCXXXVI.
MDCCXXXVII.
-To
det
er
mi
ne
cau
se
of
inju
ry.
MDCCXXXVIII.
MDCCXXXIX.
MDCCXL.
MDCCXLI.
MDCCXLII.
MDCCXLIII.
MDCCXLIV.
-To lessen
the

hrs.
of
nur
sing
inte
rve
ntio
ns
clie
nt
ver
bali
zed
his
und
erst
and
ings
reg
ardi
ng
of
indi
vidu
al
fact
ors
that
con

con
trib
ute
to
pos
sibil
ity
of
inju
ry.

99 | P a g e

MDCCXXV.
Promoting
clie
nts
safe
ty
by:
MDCCXXVI.
MDCCXXVII.
-Monitor
V/S
MDCCXXVIII.
MDCCXXIX.
-Providing
mat
eria
ls to
pre
ven
t
fro
m
inju
ry.

risk
for
inju
ry,
saf
e
en
vir
on
me
nt
an
d
pro
mo
te
clie
nts
co
mf
ort.

trib
ute
to
pos
sibil
ity
of
inju
ry.

MDCCL.
DISCHARGE PLAN
MDCCLI.
MDCCLII. Medication
MDCCLIII.
Advice the patient, as well as the significant others that medication

should be taken as prescribed by the physician.

Stress the importance of compliance to prescribed medication and
never stop the medication abruptly.

MDCCLIV.
MDCCLV. Exercise
MDCCLVI.
Encourage the client to resume tolerable daily activities which
achieving and maintaining an optimum level of wellness and health.

Exercise can help keep your blood sugar level steady, decrease your
risk of heart disease, and help you lose weight.
Exercise for at least 30 minutes, 5 days a week.

Remember that physical activity lowers blood sugar.

MDCCLVII.
MDCCLVIII.
Treatment
Monitor blood glucose
Encourage the patient to seek nearest hospital as soon as possible if
symptoms are observed and cannot be relieved by medication.
Advice patient to comply prescribe medication.
MDCCLIX.
MDCCLX. Health Teaching

Emphasize the importance of hygiene and hand washing to prevent

infection.

Instruct the patient to eat well-balanced diet.

Blood sugar monitoring
Healthy eating
Regular exercise
Diabetes medication or insulin therapy

MDCCLXI.

These steps will help keep your blood sugar level closer to

normal, which can delay or prevent complications.

100 | P a g e

MDCCLXII.
MDCCLXIII.
OPD
MDCCLXIV.
Advice client to have a follow up check-up with his attending physician.
Emphasize the importance and benefits of following the scheduled
dates of checkup to prevent further complications.
MDCCLXV.
MDCCLXVI.
Diet
MDCCLXVII.

Diet as Tolerated
Eat a well balanced diet.
Keep track of carbohydrates: Your blood sugar level can get too

high if you eat too many carbohydrates in 1 meal or snack.

Eat low-fat foods: Choose foods that are low in fat. Some

examples are skinless chicken and low-fat milk.

Eat less salt: Limit foods that are high in sodium (salt), such as soy

sauce, potato chips, and soup. Do not add salt to food you cook.
Eat high-fiber foods: Foods that are a good source of fiber include
vegetables, whole grain breads, and beans.

MDCCLXVIII.
MDCCLXIX.
MDCCLXX.
MDCCLXXI.
MDCCLXXII. Diet Meal Plan Endodthalmitis
MDCCLXXIII.
A case of 53 year old male with a diagnosis of Endopthalmitis
OD, Pseudophakia OU, T/C DM Retinopathy OU. Actual weight of 59 kg.
and height of 57. Compute for DBW (Desirable Body Weight). Compute
for TER (Total Energy Requirement). Compute for the CHO, CHON and FAT
requirement per day. Make a food exchange table. Make a food
distribution table. Plan a menu.
MDCCLXXIV.

DBW = 5 x 12 = 60 + 7

MDCCLXXV.

= 67 x 2.54

MDCCLXXVI.

= 170.18 100

101 | P a g e

MDCCLXXVII.

= 70.18 10%

MDCCLXXVIII.

= 70.18 7.018

MDCCLXXIX.

= 63.162 kg.

MDCCLXXX.
MDCCLXXXI.
MDCCLXXXII.

BMI

= 59 kg.

(1.70)2

MDCCLXXXIII.

= 59 kg.

MDCCLXXXIV.

3.4

MDCCLXXXV.

= 17.35 kg. (Underweight)

MDCCLXXXVI. Normal BMI = <18.5

MDCCLXXXVII. TER

= (Actual weight x Activity)

MDCCLXXXVIII.

= (59 x 30)

MDCCLXXXIX.

= 1770 kcal

MDCCXC.
MDCCXCI.

CHO = 1770 x 60% = 1062 4 = 265.5 or 256 gr.

MDCCXCII.

CHON = 1770 x 15 % = 265.5 4 = 66.375 or 65 gr.

MDCCXCIII.

FAT = 1770 x 25% = 442.5 9 = 49.16 or 50 gr.

MDCCXCIV.
MDCCXCV.
MDCCXCVI.
MDCCXCVII.

FOOOD EXCHANGE TABLE

MDCCXCVIII. MDCCXCIX. MDCCC.

MEASU
CHO
R
2
E
6
5
g
r.

102 | P a g e

MDCCCI.
CHON
6
5
g
r.

MDCCCII.
FAT
5
0
g
r.

MDCCCIII.
ENERG
Y
1
7
7
0
k

MDCCCIV.
MDCCCV.
Vegeta
6
b
l
e
A
MDCCCX.
MDCCCXI.
Vegeta
6
b
l
e
B
MDCCCXVI. MDCCCXVII.
Fruits
4
MDCCCXXII. MDCCCXXIII.
Milk
2
MDCCCXXVIII.
MDCCCXXIX.
Rice
7
MDCCCXXXIV.
MDCCCXXXV.
Meat
3
MDCCCXL. MDCCCXLI.
Fat
4
MDCCCXLVI. MDCCCXLVII.
Sugar
2
MDCCCLII. MDCCCLIII.
Total
MDCCCLVIII.
MDCCCLIX.
MDCCCLX.

MDCCCVI.
18

MDCCCVII.
6

MDCCCVIII.
-

c
a
l.
MDCCCIX.
96

MDCCCXII.
18

MDCCCXIII.
6

MDCCCXIV.
-

MDCCCXV.
96

MDCCCXVIII. MDCCCXIX. MDCCCXX.

MDCCCXXI.
40
160
MDCCCXXIV. MDCCCXXV. MDCCCXXVI. MDCCCXXVII.
24
16
10
250
MDCCCXXX. MDCCCXXXI. MDCCCXXXII. MDCCCXXXIII.
161
14
700
MDCCCXXXVI. MDCCCXXXVII.MDCCCXXXVIII.
MDCCCXXXIX.
24
18
258
MDCCCXLII. MDCCCXLIII. MDCCCXLIV. MDCCCXLV.
20
180
MDCCCXLVIII. MDCCCXLIX. MDCCCL.
MDCCCLI.
10
40
MDCCCLIV.
MDCCCLV.
MDCCCLVI.
MDCCCLVII.
271
66
1780

FOOD DISTRIBUTION TABLE

MDCCCLXI. MDCCCLXII. MDCCCLXIII. MDCCCLXIV. MDCCCLXV.

BREAK
LUNCH
DINNE
SNACK
SNACK
F
R
A
P
A
M
M
S
T
MDCCCLXVI. MDCCCLXVII. MDCCCLXVIII. MDCCCLXIX. MDCCCLXX. MDCCCLXXI.
Vegeta
4
2
b
l
e
A
103 | P a g e

MDCCCLXXII.MDCCCLXXIII. MDCCCLXXIV. MDCCCLXXV. MDCCCLXXVI. MDCCCLXXVII.

Vegeta
2
2
2
b
l
e
B
MDCCCLXXVIII.
MDCCCLXXIX. MDCCCLXXX. MDCCCLXXXI. MDCCCLXXXII.MDCCCLXXXIII.
Fruit
1
1
1
1
MDCCCLXXXIV.
MDCCCLXXXV. MDCCCLXXXVI.MDCCCLXXXVII.
MDCCCLXXXVIII.
MDCCCLXXXIX.
Milk
1
1
MDCCCXC. MDCCCXCI.
MDCCCXCII. MDCCCXCIII. MDCCCXCIV. MDCCCXCV.
Rice
2
2
2
1
MDCCCXCVI. MDCCCXCVII. MDCCCXCVIII. MDCCCXCIX. MCM. 1
MCMI. Meat
1
1
1
MCMII.
MCMIII.
MCMIV.
MCMV.
MCMVI.
MCMVII.
Fat
1
1
1
MCMVIII.
MCMIX.
MCMX.
MCMXI.
MCMXII.
MCMXIII.
Sugar
1
1
MCMXIV.
PLAN A MENU
MCMXV.
MCMXVI.

BREAKFAST

MCMXVII.

Sinabawang Gulay

1
1
1
1
1
1

C Squash fruit
C Malunggay Leaves
Okra
Meduim Eggplant
C Sitaw
C Kangkong Leaves

MCMXVIII.

1 C Cooked Rice

MCMXIX. 1 MBS Milk Fish

MCMXX. 1 Medium size orange
MCMXXI. 1 Cup Milk (4 Teaspoon of Milk)
MCMXXII. 1 Teaspoon Brown Sugar
MCMXXIII.
MCMXXIV.

LUNCH

MCMXXV.

1 C Toge

104 | P a g e

MCMXXVI.

1 C Carrot

MCMXXVII.

1 MBS Chicken

MCMXXVIII.

1 C Cooked Rice

MCMXXIX.

1 Medium size Banana

MCMXXX.
MCMXXXI.
MCMXXXII.
MCMXXXIII.
MCMXXXIV.
MCMXXXV.

DINNER

MCMXXXVI.

1 C Green beans

MCMXXXVII.

1 C Carrots

MCMXXXVIII.

1 C Cabbage

MCMXXXIX.

1 C Chayote

MCMXL. 1 MBS Pork

MCMXLI. 1 C Cooked Rice
MCMXLII.

Mango

MCMXLIII.

1 Cup Milk (4 Teaspoon of Milk)

MCMXLIV.

1 Teaspoon Brown Sugar

MCMXLV.
MCMXLVI.

SNACK AM

MCMXLVII.

C Lugaw

MCMXLVIII.

1 Medium size egg

MCMXLIX.
MCML. SNACK PM
MCMLI. 1 Medium size apple

105 | P a g e

MCMLII.
MCMLIII.
MCMLIV.

LEGEND:

MCMLV. C = Cup
MCMLVI. MBS = Match Box Size

MCMLVII.
MCMLVIII.
MCMLIX.

Evaluation

MCMLX. Through that assessment and data gathering, certain problems

and needs at the client were identified. Nursing care plan was established to
improve clients status and recovery. Information and health teaching not
only to the client who are suffering from this condition but also to the people
who are interested to be aware in different conditions were imparted which
lead to increase clients/ people awareness and knowledge with regards to
her condition. The student nurse gained additional information about
Endophthalmitis OP, Pseudophobia OU, DM retinophasty including diagnostic
examination, medical management needed and as well as the factors
affecting the condition which may help the group and different people in
handling properly this kind of condition that the student nurse may possible
encounter again.

106 | P a g e