F > Hyperthermia D > Received patient sitting on bed with bottle # 1D5NSS 1 liter @ 30gtts/min.

at the level of 350cc, hooked at the right basalic vein, infusing well. warm to touch flushed skin diaphoresis on forehead T- 38.5C; PR- 110bpm; RR- 38cpm; BP160/60mmHg A > Bedside care done. Vital signs taken and recorded. IVF checked and maintained on prescribed rate. TSB done. Instructed significant other to continue tepid sponge bath. Temperature rechecked 37.6C. Instructed patient to increase fluid intake. Instructed significant other not to leave patient alone. Kept back dry. > Ambroxol 30mg 1 tab given p.o Demonstrated how to perform deep breathing exercises. Comfort measures performed such as back rubbing. Encouraged to assume different positions on bed.

Encouraged to loosen clothing and straighten linens for comfort. Instructed to increase calorie intake. 9:15pm > Above IVF consumed and followed-up with bottle #2 D5NSS 1 liter regulated at 30gtts/min. 9:30pm > Cefuroxime 750mg given IVTT. 10:00pm > Vital signs rechecked and recorded. R > Patient was able to maintain temperature within normal range, T- 36.9 C. with the same IVF at the level of 930cc. Endorsed to staff asleep, with the latest V/S of: T- 36.9 C; PR- 100bpm; RR- 38cpm; BP170/70mmHg F > Ineffective airway clearance D > Received patient sitting on a chair with bottle # 3 PNSS 1 liter regulated at 30gtts/min. at the level of 90cc, hooked at the left metacarpal vein, infusing well. with O2 inhalation via nasal cannula regulated at 1L/min. RR28cpm diaphoresis on forehead pale looking sweating A > Bedside care done. Vital signs taken and recorded.

6:00pm

 IVF checked and maintained on prescribed rate. Instructed significant other to keep patients back dry. Demonstrated how to perform deep breathing exercises and pursed lip breathing. 6:00pm > Nebulization with Salbutamol 1 nebule done. 6:15pm > Above IVF consumed and followed up with bottle #4 D50.3NaCl 1 liter at KVO rate. Encouraged to be in complete bed rest with bedside commode. Instructed significant other not to leave patient alone. Advised t keep patient well ventilated to facilitate breathing. Positioned comfortably in bed. 9:30pm > Cefuroxime 750mg given IVTT. Instructed patient and significant other to prepare soft diet eg. Lugao. 10:00pm > Vital signs rechecked and recorded. R > Patient was able to maintain effective airway clearance and had no complaints of difficulty of breathing. with the same IVF at the level of 920cc. Endorsed to staff asleep, with the latest V/S of: T- 36.7 C; PR- 87bpm; RR- 25cpm; BP120/80mmHg

F > Sleep disturbance D > Received patient sitting on bed awake, with bottle # 2 PNSS 1 liter regulated at 10gtts/min. at the level of 350cc, hooked at the left metacarpal vein, infusing well. weak restless irritable T- 37.1C; PR- 86bpm; RR- 24cpm; BP130/90mmHg A > Bedside care done. > Vital signs taken and recorded. IVF checked and maintained on prescribed rate. Determined presence of physical and environmental stressors affecting sleep. Encouraged to have adequate rest periods. Advised to increase fluid intake. Advised to regularly change clothing when wet. > Distinguished beneficial bedtime habit such and drinking milk rather than drinking late evening coffee. Encouraged to restrict caffeine and avoid eating large evening meals. Instructed to perform adequate physical exercise during the day. Suggested to abstain frequent daytime naps. Instructed to keep back dry.

5:00pm

6:00pm

 Advised to do relaxation technique such as deep breathing exercise. 8:00pm > Kept comfortable. Reminded on S/E. 10:00pm > Vital signs rechecked and recorded. R > After 4hrs. of nursing interventions the patient was able to sleep comfortably in bed. with the same IVF at the level of 190cc. Endorsed to staff asleep, with the latest V/S of: T- 36.6 C; PR- 85bpm; RR- 23cpm; BP110/80mmHg F > Body malaise D > Received patient lying on bed awake, with PNSS 1 liter regulated at 15gtts/min. at the level of 220cc, hooked at the right cephalic vein, infusing well. weak as seen restless at times irritable slowed movement needs assistance in doing ADLs T- 36.2C; PR- 90bpm; RR- 30cpm; BP160/80mmHg A > Bedside care done such as fixing linens and pillows. 5:00pm > Vital signs taken and recorded.

IVF checked and maintained on prescribed rate. 6:00pm > Isosorbide mononitrate 30mg given p.o Encouraged to have adequate bedrest. Advised to regularly change clothing when wet. Emphasized the importance of maintaining proper hygiene. Encouraged significant other to assist patient in performing ADLs. Instructed to keep back dry. 7:20pm > Repeat hemoglobin result attached to chart. Advised to do relaxation technique such as deep breathing exercise. Instructed to move slowly and steadily. Encouraged to perform active range of motion. Provided divertional activities by encouraging conversation to significant others. Instructed on complete bed rest. Keptcomfortable. Instructed on diabetic diet. 10:00pm > Vital signs rechecked and recorded. R > After 4hrs. of nursing interventions the patient was able to demonstrate ways to conserve energy. with the same IVF at the level of 130cc. Endorsed to staff awake, with the latest V/S of: T- 36.4C; PR- 88bpm; RR- 28cpm; BP150/70mmHg

F > Ineffective airway clearance D > Received patient sitting on bed awake, with PNSS 1 liter regulated at KVO rate at the level of 900cc, hooked at the right metacarpal vein, infusing well. with O2 inhalation regulated at 1L/min. at the level of 500psi pale looking restless with non-productive cough T- 36.2C; PR- 112bpm; RR-20cpm; BP120/80mmHg A > Bedside care done. Vital signs taken and recorded. IVF checked and maintained on prescribed rate. Auscultated lung fields for alteration in breath sounds. 5:30m > Referred to Dr. Talan with order carried out. Demonstrated to perform effective coughing. 6:00pm > Salbutamol 2ml given thru nebulization. Cefuroxime 750mg given IVTT. Medication started: glimeperide 2mg and Multivitamins with Fe 1cap given p.o Humulin N 10units administered subcutaneously at deltoid area. Encouraged to do deep breathing exercises. Encouraged position of comfort. Advised to have adequate bed rest.

Instructed to keep back dry as always. Instructed to increase fluid intake at least 8-10 glasses of water a day. 8:30pm > O2 off temporarily. Encouraged to eat nutritious food to maximize energy production; reminded on soft diet. Instructed patient and significant other to secure materials for OR use. Monitored for signs of respiratory distress. 10:00pm > Vital signs rechecked and recorded. R > After 4hrs. of nursing interventions the patient was able to maintain effective airway clearance and had no complaints of respiratory distress. with the same IVF at the level of 650cc. Endorsed to staff awake, with the latest V/S of: T- 36.4C; PR- 108bpm; RR- 19cpm; BP130/80mmHg F > Dizziness D > Received patient lying on bed asleep, with PNSS 1 liter regulated at 15gtts/min at the level of 930cc, hooked at the left metacarpal vein, infusing well. Sige rako malipong. weak pale looking needs assistance in getting out of bed T- 36.7C; PR- 67bpm; RR-20cpm; BP170/100mmHg

A > Bedside care done. Vital signs taken and recorded. IVF checked and maintained on prescribed rate. BP monitored every hour. 8:30pm > Referred to Dr. Talan for IV to follow with order carried out. 6:00pm > Cefuroxime 750mg given IVTT. Encouraged to have adequate rest periods to prevent fatigue. Advised significant other to keep patients back dry. Encouraged to eat nutritious foods to maximize energy production; with low salt, low fat diet. Encouraged position of comfort. Advised to wear loose and thin clothing. BP rechecked 180/110mmHg. 8:00pm > Clonidine 150mg 1tab given sublingual. Instructed to secure Lozartan + HCTZ 50mg HPN med maintenance. Encouraged significant other to assist patient in doing ADLs. Advised significant other not to leave patient alone. 10:00pm > Vital signs rechecked and recorded. R > After 4hrs. of nursing interventions the patient was able to comfortably position self on bed with less complaint of dizziness. with the same IVF at the level of 590cc. Endorsed to staff awake, with the latest V/S of:

T- 36.9C; PR- 71bpm; RR- 21cpm; BP150/90mmHg F > Noncompliance to therapeutic regimen D > Received patient sitting on bed awake and responsive upon interaction, without IVF. unable to secure medication refuse for IVF insertion T- 37.2C; PR- 82bpm; RR-21cpm; BP130/90mmHg A > Bedside care done. Vital signs taken and recorded. IVF checked and maintained on prescribed rate. 6:00pm > U/A result referred to Dr. Barrosa with order carried out. 6:15pm > Referred to Dr. Kho not around. Allopurinol 100mg 1tab given p.o. Determined who manages the medication regimen and ascertained whether they know the indication of the medication. Ascertained how client remembers to take medication and how many doses hve been missed and the possible effects if not taken regularly. Identified factors that interfere with taking medication or lead to lack of compliance to treatment eg. financial constraints. Noted length of illness.

 Encouraged client to maintain self-care activities and providing for assistance when necessary. Provided health teaching: - Instructed to keep back dry always. - Advised to change to clean clothing. - Instructed to wear loose clothing. - Reminded to increase fluid intake. Advised to secure medication. Reminded patient and significant other on soft diet. 10:00pm > Vital signs rechecked and recorded. R > She was able to verbalize the importance of securing medications. Endorsed to staff awake, with the latest V/S of: T- 37.4C; PR- 80bpm; RR- 20cpm; BP100/80mmHg

hooked at the right metacarpal vein regulated at 30gtts/min., infusing well. pale looking with limited range of motion Cant tolerate to move out of bed without assistance Needs assistance in doing ADLs T- 35.2C; PR- 76bpm; RR-20cpm; BP100/70mmHg A > Vital signs taken and recorded. Bedside care done. IVF checked and maintained on prescribed rate. 6:00pm > Omeprazole 20mg 1tab given p.o.. Assumed position of comfort for patient. Encouraged to have adequate rest periods. Instructed to move out of bed slowly and steadily. Advised to eat nutritious foods which are high in iron such as kalamunggay and meat. Instructed significant other to assist patient in doing ADLs eg. eating and urinating. Advised to drink adequate fluid intake. Safety measures rendered such as putting linens on sides. Advised to secure medication. 10:00pm > Vital signs rechecked and recorded. Reminded on U/A and S/E.

Name of patient: Migduyan, Myrna F > Dizziness D > Received patient sitting on bed, coherent, responsive, oriented to time, place, and date, with IVF of bottle #2 D5LR 1liter at the level of 700cc,

R > After 4hrs. of nursing interventions the patient she was able to demonstrate ways to conserve energy. with the same IVF at the level of 90cc Endorsed to staff awake, with the latest V/S of: T- 36.8C; PR- 80bpm; RR- 20cpm; BP100/80mmHg

Generic name

: Isosorbide mononitrate

Dosage and route: 30mg, p.o Classification : anti-anginals

Caution pt. to avoid alcohol because it may worsen low blood pressure effects. Instruct pt. to store drug in a cool place, in a tightly closed container and away from the light. : Omeprazole : Flazomel

Indication : acute angina attack (sublingual and chewable tablets of Isosorbide dinitrate only); for prevention in situations likely to cause angina attack Action : not completely known; thought to reduce cardiac oxygen demand by decreasing preload and afterload; drug also may increase blood flow through the collateral coronary vessels. Contraindications: Contraindicated with hypersensitivity or idiosyncrasy to nitrates and in those with severe hypotension. Use cautiously in patients with blood volume depletion (such as diuretic therapy) or mild hypotension. Nursing Considerations: Monitor blood pressure and intensity of drug response. Caution pt. to take drug regularly as prescribed and to keep it accessible at all times. Tell pt. to take tablets sublingually.

Generic name Brand name

Dosage and route: 20mg, 1tab BID, p.o Classification : anti-ulcer

Action : suppresses gastric acid secretion by inhibiting the parietal cells; blocks the final step of acid production Adverse effects : Headache, dizziness, vertigo, insomnia Rash, urticaria, dry skin Nursing Considerations: Take as directed (before meal) Do not crush or chew capsules One may experience anorexia; small frequent meals may help to maintain adequate nutrition. Report changes in urination or pain on urination.

Generic name Brand name

: Allopurinol : Zyloprim

Report any unusualties such as rash, painful urination, blood in urine or stool, and muscle weakness. : Cefuroxime : Betcef

Dosage and route: 100mg, 1tab, p.o Classification : anti-gout agent

Generic name Brand name

Indication : prevention of attacks of gouty arthritis and nephropathy Action : inhibits xanthine oxidase, the enzyme responsible for the conversion of hypoxanthine to xanthine to uric acid. Allopurinol is metabolized to oxypurinol whch is also an inhibitor of xanthine oxidase, acts on purine catabolism, reducing the production of uric acid without disrupting the biosynthesis of vital purines. Adverse effects : Headache, dizziness, nausea, vomiting, and abdominal pain Nursing Considerations: Take as directed (preferably before meal) Maintain hydration, at least 2liters of water a day. Avoid alcohol, OTC medication and additional Vitamin C without consulting prescriber.

Dosage and route: 750mg, q8h, IVTT Classification Indication : anti-bacterial :

Action : inhibits third and final stage of bacterial cell wall synthesis, thus killing the bacteria Contraindication : - hypersensitivity to cephalosporins and related antibiotic Adverse effects : Pruritus, chills Abdominal discomfort Nursing Considerations: Determine history of hypersensitivity. Report onset of loose stools. Monitor manifestations of hypersensitivity. Inspect IV injection site for phlebitis. Do skin testing prior to administration.

Generic name Brand name

: Salmeterol xinafoate : Salbutamol

Alert pt. to prevent exercise induced bronchospasm.

Dosage and route: 2ml, q6h, thru nebulization Classification : bronchodilator

Generic name Brand name

: Ephedrine sulfate : Ambroxol

Indication : to prevent bronchospasm in pt. with nocturnal asthma or reversible obstructive airway disease who had regular short-acting beta-agonist. Action :

Dosage and route: 30mg, 1tab TID, p.o Classification Indication : bronchodilator :

Contraindication : - patient with known hypersensitivity to drug and its components Adverse effects : headache palpitation nasopharyngitis

Action : stimulates alpha and beta receptors; direct and indirect acting sympathometic Contraindication : - patient with known hypersensitivity to drug and its components Adverse effects : Insomnia Palpitation Dryness of nose and throat Nausea and vomiting

Nursing Considerations: Assess patients respiratory condition before starting the therapy. Be alert for adverse reaction and drug interaction. Dont give drug for acute bronchospasm. If headache occurs, give mild analgesic as ordered.

Nursing Considerations: Obtain history of pts underlying condition before starting therapy, and reassess regularly.

Be alert for adverse reactions and drug interactions. Warn pt. not to take OTC drugs. Instruct pt. to notify prescriber if adverse reaction occurs. Caution pt. not to perform hazardous activities if adverse CNS reactions occur.

Dry mouth Rash, urticaria, pruritus, swelling Drug interactions: drug-drug; ACE inhibitors, Clonidine Nursing Considerations: Advise pt. not to change orders in which insulins are mixed or brand of insulin, syringe or needle. Advise pt. not to smoke within 30mins. After insulin injection because smoking decreases amount of insulin absorbed subcutaneously. Advise pt. to avoid vigorous exercise immediately after insulin injection, especially in the area where injection was given because it decreases absorption and risk of high glucose episodes. Make sure that pt. knows that drug relieves symptoms but doesnt cure the disease. Generic name Brand name : Glimepiride : Amaryl

Generic name Brand name

: Insulin, Isophane (NPH) : Humulin N

Dosage and route: 10units, BID, s.c Classification : antidiabetic agent; hormone substitute

Indication : control of hyperglycemia in patient with Type 1 and 2 DM Action : increases glucose transport across muscle and fat cell membrane to reduce glucose level Contraindication : - in patients with history of systemic allergic reaction to pork when porcine-derived products are used or hypersensitivity to any component of preparation - During episodes of hypoglycemia Adverse effects : Blurred vision

Dosage and route: 2mg, OD, p.o Classification : antidiabetic agent

Indication : to lower glucose level in patients with Type 2 DM whose hyperglycemia cant be managed by diet and exercise alone Action : lowers glucose level, possibly by stimulating the release of insulin from functioning pancreatic beta cells and may lead to increase sensitivity of peripheral tissues to insulin Contraindication : - in patients hypersensitive to drug and in those with diabetic ketoacidosis, which should be trated with insulin Adverse effects : Dizziness, asthenia, headache Drug interactions: drug-drug; beta-blockers, may mask symptoms of hypoglycemia Nursing Considerations: Tell pt. to take drug with first meal of the day. Teach pt. to carry candy or other simple sugars to treat mild episodes of low glucose level. Advise pt. to avoid alcohol which lowers glucose level. Advise pt. to consult prescriber before taking any OTC products.

Make sure that pt. knows that drug relieves symptoms but doesnt cure the disease. : Clonidine : Catapres

Generic name Brand name

Dosage and route: 150mg, 1tab, SL Classification : anti-hypertensive

Indication : hypertension, used alone or as part of combination therapy Action : stimulates alpha-2 receptors and inhibit the central vasomotor centers, decreasing sympathetic outflow to the heart, kidneys, and peripheral vasculature and lowering peripheral vascular resistance, blood pressure and heart rate. Contraindication : - hypersensitivity to Clonidine or any adhesive layer components of the transdermal system Adverse effects : Drowsiness, sedation, dizziness Headache, fatigue agitation, depression

Nursing Considerations: Instruct pt. to take drug as ordered.

Advise pt. that stopping drug abruptly may cause severe rebound high blood pressure. Tell pt. to take the last dose immediately before bedtime. Inform pt. that dizziness upon standing can be minimize by rising slowly from a sitting or lying position and avoiding sudden position changes. : Salbutamol sulfate : Acro--vent

Interactions and beverage

: drug-drug - beta adrenergic blockers Drug-food caffeine containing food

Generic name Brand name

Dosage and route: 1neb 2.5ml, thru nebulization Classification Indication : bronchodilator : to prevent and relieve bronchospasm

Nursing Considerations: Instruct pt. in proper way of using the nebulizer. Advise pt. to clean the mouthpiece in a warm soapy water every week. Advise pt. to limit intake of caffeine containing foods and beverages and to avoid herbs unless prescriber approves. Caution pt. to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness. Generic name Brand name : Cefuroxime : Harox

Action : relaxes smooth muscle by stimulating beta2-receptor, thereby causing bronchodilation and vasodilation Contraindication : - hypersensitivity to drug Adverse effects : Dizziness, insomnia, hypertension, chest pain, dry and irritated throat Nausea and vomiting, anorexia, dry mouth, heart burn, tooth discoloration

Dosage and route: 750mg, IVTT Classification Indication : anti-infectives : lower respiratory tract infection

Action : second generation cepholosporins that inhibit cell wall synthesis, promoting osmotic instability, usually bactericidal

Contraindication : - hypersensitivity to penicillin Adverse effects : Headache, dizziness, lethargy, paresthesias Nursing Considerations: Assess pt.s infection before therapy and regularly thereafter Ask pt. about previous reaction to cephalosporin or penicillin Do not double dose the drug if there are lapses in taking the medication. Tell pt. to take full course of therapy. Advise pt. to take drug with food. Cues: O > RR of 30cpm
> weak > adventitious sound heard upon auscultation; crackles > with dry cough

Planning: Within 8hrs. of rendering nursing interventions, the patient will be able to identify ways to soothe dry cough by expectorating secretions. Nursing Interventions: Independent 1. Assess respiratory rate. Rationale - provides basis confirming the presence of shortness of breath - identifies consolidation that causes the obstruction and shortness of breath - take advantage of gravity decreasing pressure on diaphragm and enhancing drainage of secretions on different lung segments - can promote expectoration of secretions - assist pt. in relaxing respiratory muscles - expels enough carbon dioxide in the lungs and inhale sufficient oxygen, promoting good ventilation - aids in proper expectoration of secretions - warm liquids can aid in mucus liquefaction more than cold ones.

2. Recheck breath sounds and presence of secretions. 3. Position pt. in high/semifowlers position.

4. Provide back tapping. 5. Encourage for slow deep respirations. 6. Encourage to perform deep breathing and pursed lip breathing exercises. 7. Demonstrate technique of effective coughing. 8. Encourage to provide warm liquids than cold ones.

Nursing diagnosis: Ineffective airway clearance related to retained secretions in the bronchi Scientific basis : A part of the respiratory function is the exchange of gases, where the bronchi is the gateway of passage for gas travelling to the alveoli where gas exchange happens. As the passage way for proper respiration is obstructed by retained secretions, the travelling of gas in the tract is impaired.

9. Encourage pt. and significant other to allow pt. minimal but increase fluid intake. 10. Encourage adequate sleep periods. 11. Provide good ventilation of environment, limiting allergens. Dependent 1. Administer Salbutamol sulfate (Acro-vent) 1neb 2.5ml, thru nebulization.

- increase intake of fluid can help liquefy the mucus secretion - limits fatigue and improves condition - so as not to aggravate the pt.s condition

Scientific basis : Pain usually is viewed in the context of tissue integrity. In the presence of invading pathogens, the GIT compensates by increasing peristaltic movement in an attempt to get rid of the invaders. Noceciptive stimulation that activates with fibers can cause a response known as neurogenic inflammation that produces vasodilation and an increase release of chemical mediator to which the receptors respond Planning: Within 8hrs. of rendering nursing interventions, the patient will be able to verbalize pain is reduced from 6/10 to 2/10. Nursing Interventions: Independent 1. Monitor/ document characteristics of pain, noting verbal reports, non-verbal cues, and hemodynamic response. 2. Encourage pt. to report type and intensity of pain using pain scale. Rationale - variation of appearance and behavior of pt. present a challenge in assessment

- relaxes smooth muscle by stimulating beta2-receptor, thereby causing bronchodilation and vasodilation

Evaluation: After 8hrs. of rendering nsg. Interventions the patient was able to identify ways to soothe dry cough like deep breathing exercises and increasing fluid intake. Cues: S > Sakit pa gihapon ilihok akong lawas. Painscale of 6/10
O > grimace > pallor > guarding behavior on abdomen > diaphoresis > restless

Nursing diagnosis: Acute abdominal pain related to increase peristaltic movement due to bacterial invation

3. Observe for crying, irritability, restlessness,sleep disturbance

- pain is perceived and tolerated individually; it is also a subjective experience; provides baseline for comparison to aid in determining effectiveness of care - non-verbal cues may indicate indicate pain exerienced

4. Provide comfort measures, eg. back rubbing, assist selfcare activities 5. Encourage to perform deep breathing exercises and splinting 6. Instruct to put ice pack on the area. 7. Instruct to report increasing pain immediately. 8. Encourage to have divertional activities eg. frequent communication to SO. 9. Provide a quiet, calm,restful environment 10. Encourage adequate rest. Dependent 1. Administer analgesic as ordered.

- promotes relaxation and redirect attention - promotes relaxation

> difficulty of vocalizing > grimace Nursing diagnosis: Ineffective airway clearance related to productive cough Scientific basis : Presence of retained secretions in respiratory tract impedes airflow. And inability to clear secretions results to ineffectivity of airway clearance.

- provides nonpharmacological relief of pain; - prompt assessment and intervention may be given - redirects feeling of pain

Planning: Within 8hrs. of rendering nursing interventions, the patient will be able to identify ways to expectorate secretions. Nursing Interventions: Independent 1. Assess respiratory rate. 2. Recheck breath sounds and presence of secretions. 3. Position pt. in high/semifowlers position. Rationale - provides basis confirming the presence of shortness of breath - identifies consolidation that causes the obstruction and shortness of breath - take advantage of gravity decreasing pressure on diaphragm and enhancing drainage of secretions on different lung segments - can promote expectoration of secretions - assist pt. in relaxing respiratory muscles - expels enough carbon dioxide in the lungs and inhale

- external stimuli may aggravate pain and anxiety - provision of comfort - prevents the synthesis of prostaglandin from smooth muscles, inhibiting the stimulation of receptor to synthesize pain

4. Provide back tapping. Cues: S > Magsige paman ko og ubo. O > crackles upon auscultation
> RR- 38cpm > restless

5. Encourage for slow deep respirations. 6. Encourage to perform deep breathing and pursed

lip breathing exercises. 7. Demonstrate technique of effective coughing. 8. Encourage to provide warm liquids than cold ones. 9. Encourage pt. and significant other to allow pt. minimal but increase fluid intake. 10. Encourage adequate sleep periods. 11. Provide good ventilation of environment, limiting allergens. Dependent 1. Administer Ambroxol 30mg 1tab, TID p.o

sufficient oxygen, promoting good ventilation - aids in proper expectoration of secretions - warm liquids can aid in mucus liquefaction more than cold ones. - increase intake of fluid can help liquefy the mucus secretion - limits fatigue and improves condition - so as not to aggravate the pt.s condition

- inhibits phosphodiesterase, the enzyme that degrades cAMP, thereby relaxing smooth muscle of bronchial airway and pulmonary blood vessels