TABIGUE, JESHA G.

BSN 4- BLOCK 4 UNIVERSITY OF SAN JOSE-RECOLETOS College of Nursing INDIVIDUAL CASE CONFERENCE

Signs and Symptoms

1. Fever

Etiology or Cause
Fever is the defense mechanism of our body to fight against infection, due to infection and viruses fever arises.

Management
Administer antipyretic as prescribed. Increased fluid intake. Monitor V/S. Provide adequate rest. Elevate head over bed. Provide comfort. Provide adequate rest.

2. Headache

Headache often results from traction to or irritation of the meninges and blood vessels. The nociceptors may also be stimulated by other factors than head trauma or tumors and cause headaches. Some of these include stress, dilated blood vessels and muscular tension. Once stimulated, a nociceptor sends a message up the length of the nerve fiber to the nerve cells in the brain, signaling that a part of the body hurts. Due to excessive lose of body fluid.

3. Dehydration

Increased fluid intake. Monitor I&O. IVF therapy. Small frequent feeding. Bland diet.

Caused by infection, irritation of the lining of the stomach. 4. Vomiting

Due to the decrease amount of electrolytes in the body. 5. Restlessness

Provide adequate rest. Avoid environmental stimuli. Provide comfort.

DRUG STUDY NAME OF DRUG CLASSIFICATION AND MECHANISM OF ACTION INDICATION AND DOSAGE CONTRAINDICATION Contraindicated in patients hypersensitive to drug or its components and in those w/ idiopathic hypertrophic subaortic stenosis. SIDE EFFECTS/ ADVERSE REACTION CNS: headache CV: hypertension, increased heart rate NURSING RESPONSIBILITIES Before starting therapy, give a plasma volume to correct hypovolemia and a cardiac glycoside. Continuously monitor ECG, blood pressure, pulmonary artery wedge pressure, cardiac output and urine output. Tell patient to report adverse reactions promptly, especially labored breathing and drug-induced headache.

Dobutamine Hydrochloride

Classification: Indication: Vasopressors Increase cardiac output in short Inotropic tern treatment of Mechanism of action: cardiac Stimulates heats beta decompensation 1 receptors to increase cause by depressed myocardial contractility contractility, and stroke volume. At such as during therapeutic dosages, refractory heart drug increases cardiac failure; adjunctive output by decreasing therapy in cardiac peripheral surgery. vascular resistance, Dosage: reducing Adult (usual): ventricular filling 2.5-20 pressure, and mcg/kg/minute. facilitating AV node Maximum: 40 conduction. mcg/kg/min. Titrate to desired response. Administer into large vein. Usual doses to increase cardiac output are 2.5 to 15 mcg/kg/minute IV.

STUDENT: TABIGUE, JESHA BSN 4- BLOCK 4

NURSING CARE PLAN NURSING DIAGNOSIS

Hyperthermia related to dehydration. Subjective: Init ang ako pamati as verbalized by the patient. Objective: Flushed skin, warm to touch. Restlessness. V/S taken as follows: T: 38.1 P: 70 R: 19 BP: 110/90

SCIENTIFIC ANALYSIS
Infectious agents(Pyrogens) stimulate Monocytes release Pyrogenic cytokines stimulate Anterior hypothalamus results in Elevated thermoregulatory set point leads to Increased Heat conservation (Vasoconstriction/behaviour changes) Increased Heat production (involuntary muscular contractions) result in FEVER

NURSING OBJECTIVES
After 4 hrs. Of nursing interventions, the patient will maintain core temperature within normal range.

NURSING INTERVENTIONS
Independent: Monitor hear trate and rhythm.

RATIONALE
Dysrhythmias and ECG changes are common due to electrolyte imbalance and dehydration and direct effect of hyperthermia on blood and cardiac tissues. To monitor or potentiates fluid and electrolyte loses. To decrease temperature by means through evaporation and conduction. To minimize shivering. To offset increased oxygen demands and consumption. To support circulating volume and tissue perfusion. To reduce metabolic demands and oxygen

EVALUTAION After 4 hrs. Of nursing interventions, the patient was able maintain core temperature within normal range.

Record all sources of fluid loss such as urine, vomiting and diarrhea. Promote surface cooling by means of tepid sponge bath.

Wrap extremities with cotton blankets.

Provide supplemental oxygen.

Administer replacement fluids and electrolytes.

Maintain bed rest.

Provide high calorie diet, tube feedings, or parenteral nutrition. Administer antipyretics orally or rectally as prescribed by the physician.

consumption To increased metabolic demands. To facilitate fast recovery.

STUDENT: TABIGUE, JESHA G. BSN 4- BLOCK 4