Case Study:

REPEAT
CESAREAN SECTION
I. ASSESSMENT
A.BIOGRAPHIC DATA
Client’s Name: Data Not Available
Address: Data Not Available
Age: 26 years old
Sex: Female
Civil status: Data Not Available
Occupation: Data Not Available
Religious preference: Data Not Available
Health care financing: Data Not Available
Usual Source of Medical care: Data Not Available
 B. CHIEF COMPLAINT:

The patient reported abdominal pain, edema in the

feet and legs.
 C. HISTORY OF THE PRESENT
ILLNESS/CONDITION
The patient reported abdominal pain, edema in the
feet and legs.
D. PAST MEDICAL HISTORY
The had a previous cesarean delivery.
E. FAMILY MEDICAL HISTORY
Data Not Available.

F. SOCIAL HISTORY

Data Not Available.

 G. OBSTETRIC HISTORY
The patient is a 26-year-old female, gravida 4,
para 3 with 41 weeks of high-risk pregnancy, and
late prenatal care. No contraception use prior to
conception. The patient had previous cesarean
section.
 H. PATTERNS OF FUNCTIONING
(Use Gordon’s
Pattern Functional Patterns when
During Hospitalization applicable)
Analysis (Cite references)
Health - While in the postanesthesia care - Much information can be obtained
Perception/Health unit, the patient received two liters by close monitoring of the vital signs,
Management of oxygen, and vital signs were including blood pressure, pulse, and
monitored. respiratory rate. More importantly,
  the trend and changes of these
- Dressings were removed and measurements more accurately
changed 48 hours after reflect the patient's ongoing
surgery. condition.
(
https://www.glowm.com/section-view
/heading/postoperative-care/item/36
#)
 
- Wound dressings should provide
the most optimum conditions for
wound healing, while protecting the
wound from infection with
microorganisms and further trauma.
(https://www.ncbi.nlm.nih.gov/books/
NBK470199/)
 -Liquid diet if with flatus; Proceed to regular In the initial hours following the surgery. Diet
diet after BM may only consist of ice chips or liquids. Once the
Nutritional/Metabolic   gas pass, a sign that intestines are functioning
- The patient is morbidly obese well, regular diet will likely progress to solid
  foods and eventually to a normal diet. (
- The patient may follow a routine diet https://www.happyfamilyorganics.com/learning-c
enter/mama/nutrition-management-after-a-c-secti
on
)
-Having a high BMI during pregnancy increases
the risk of various pregnancy complications,
including: The risk of miscarriage, stillbirth and
recurrent miscarriage. Gestational diabetes (
https://www.mayoclinic.org › in-depth › art-20044
409
)
- Postpartum complications
In morbidly obese patients the incidence of
endometritis is almost three times higher than in
non-obese patients and amounts to nearly 10%,
the OR being 1.5 (95% CI 1.1 to 2.1). In massively
obese patients weighing more than 136 kgs the
incidence of postoperative endometritis is even
higher at 32.6% versus 4.9% in normal-weight
women
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3
289484/)
Elimination The Foley catheter Urinary elimination is a basic human
was discontinued 24 hours following function that can be compromised by
surgery. illness, surgery, and other conditions.
Urinary catheterization may be used to
support urinary elimination in patients
who are unable to void naturally.
(
https://opentextbc.ca/clinicalskills/cha
pter/10-3-urinary-catheters/
)
    - A C-section is major surgery Just like
Activity/Exercise The patient was restricted to bed with any surgery, the body needs time
rest for the first 24 hours post- to heal afterward. Expect to stay in the
operatively. hospital for three to four days after the
operation, and give the body up to six
weeks to fully heal. While in bed, the
patient can lie down both right and left
side and also can sit.
(https://www.healthline.com/health/p
regnancy/c-section-tips-for-fast-
recovery)

Sleep/Rest The patient was restricted to bed It's important to get out of bed and
rest for the first 24 hours post- walk around within 24 hours after
operatively. surgery. This can help ease gas pains,
help you have a bowel movement
(https://www.webmd.com/baby/recov
ery-after-c-section#1)
Cognitive/Perceptual The patient has reported The Patient is going through
abdominal pain,edema in the labor. The abdominal pain is
feet and legs. caused by the contractions of
the uterine.
 
https://www.ncbi.nlm.nih.gov/b
ooks/NBK532927/
 
During pregnancy, the extra
fluid in the body and the
pressure from the growing
uterus can cause swelling or
edema in the ankles and feet.
The swelling tends to get worse
as a woman's due date nears,
particularly near the end of the
day and during hotter weather.
https://kidshealth.org/en/parent
Self Perception/ No Data Available s/ankles.html
No Data Available
Self Concept
Role/Relationship No Data Available No Data Available

Sexuality/ Four counts of cesarean Health risks increase with each

Reproductive section are performed subsequent cesarean, yet some
women are able to have six or
more without complication.
(https://www.parents.com/pregna
ncy/giving-birth/how-many-c-
sections-can-a-woman-have/)
Coping/Stress Prochlorperazine and Metoclopramide is an anti-
Tolerance metoclopramide was sickness medicine known as an
prescribed as needed for antiemetic . It's used to help stop
nausea. Meperidine was feeling or being sick (nausea or
prescribed as needed for pain. vomiting).
IV amoxicillin 500 mg TID was (
prescribed. https://www.google.com/medmd.
search
Value/Belief Pattern No Available Data ?metoclopramide)
No Available Data
I. VITAL SIGNS
A. Temperature: 98.9° F

B. Pulse Rate: 82 bpm

C. Respiratory Rate: 20/minute

D. Blood Pressure: 119/45 mmHg

E. O2 saturation: 100%
 J. PHYSICAL ASSESSMENT
Body Part Technique of Actual Findings Analysis (Cite
Assessment references)
Adnominal Inspection Large pannus The panniculus is made
solely of excess skin and
fatty tissue deposits. In
some cases,
the panniculus may be
the result of stretched
out skin and excess fat
deposits following a
pregnancy. Weight gain
and obesity can
also cause the formation
of a panniculus.
https://www.seton.net/re
constructive-plastic-surg
ery/cosmetic/body/abdo
minoplasty-tummy-tuck/p
anniculectomy/#:~:text=T
he%20panniculus%20is
%20made%20solely,the
%20formation%20of%20
a%20panniculus
.

 
Umbilicus Inspection Hung below the During late pregnan
patient’s pelvic cy, the hormone
bones relaxin helps soften
and relax these
ligaments,
making the
pelvis elastic, rather
than rigid. This
gives the pelvic
bones the ability to
stretch and open
more easily
for the birth
of the baby.
https://www.kidspot.
com.au/birth/pregna
ncy/pregnancy-healt
h/your-pelvis-during-
pregnancy/news-sto
ry/d44388db283085
85e83c0391baa465
a5
Feet and Legs Inspection Edema in the feet and Swelling is caused  body
legs holding more water than
usual when pregnant.
Throughout the day the
extra water tends to
gather in the lowest
parts of the body,
especially if the weather
is hot or have been
standing a lot. The
pressure of growing
womb can also affect
the blood flow in
the legs.
https://www.nhs.uk/preg
nancy/related-conditions
/common-symptoms/sw
ollen-ankles-feet-and-fin
gers/
 K. LABORATORY/DIAGNOSTIC
Laboratory/Diagnostic Normal Values  Actual Finding/Values Analysis(Cite references)
Examination
Urinalysis FINDINGS
For a urinalysis, your urine sample is
evaluated in three ways: visual
Urinalysis is within acceptable
ranges
-A urinalysis is a part of a routine
medical exam, pregnancy
exam, dipstick test and microscopic
exam.   checkup, pre-surgery preparation,
or on hospital admission to screen
Visual exam for a variety of disorders.
Urine is typically clear. Cloudiness or
an unusual odor may indicate a -Experiencing abdominal pain,
problem, such as an infection. back pain, frequent or painful
Dipstick test urination, blood in your urine, or
A dipstick — a thin, plastic stick with other urinary problems. 
strips of chemicals on it — is placed
in the urine to detect abnormalities. -A urinalysis may help diagnose
A dipstick test checks for: Acidity the cause of these symptoms.
(pH), Concentration, Protein, Sugar,
Ketones, Bilirubin, Evidence of https://www.mayoclinic.org/tests-
infection, and Blood. procedures/urinalysis/about/pac-
Microscopic exam
If any of the following are observed 20384907
in above-average levels, additional
testing may be necessary: White
blood cells (leukocytes), Red blood
cells (erythrocytes), Bacteria or
yeasts, Casts , and Crystals .
Prenatal Panel The prenatal panel are within -These tests are done during pregnancy
acceptable ranges to check a mother's health and the
baby. It can detect conditions that can
put a baby at risk for problems like
preterm birth if they're not treated.
-Tests also can help health care
providers to find things like a birth
defect or a chromosomal abnormality.
https://kidshealth.org/en/parents/test
s-first-trimester.

Drug study Drug  study are negative - Most mothers need pain medication
after birth. Controlling pain makes it
easier to feed and take care of the
baby.
-Several medicines can help with pain
after surgery.
https://www.drugs.com/condition/ces
arean-section.html

Serology Serology is also negative -It can help to know a little about the
immune system and to know how we
get sick, to understand serologic tests
and how it's useful. 
-The presence of certain types of
antibodies can also imply that you’re
immune to one or more antigens.
Ultrasound  -Normal amniotic Single living intrauterine -Essential to note that the heart
pregnancy, transverse lie, rate can, and does, change
anterior grade II placenta with depending on the gestational
-Fetal heart rates range a normal amniotic fluid index age of the baby.
between 110 to 160 bpm of 18.2 cm. Heart rate of 137
bpm. -From around 6 weeks the
normal range varies during
-Heart rate range from 60 to gestation, increasing to around
100 bpm 170 bpm at 10 weeks and
decreasing from then to around
130 bpm at term.
-A heart rate of 137 beats per
minute (or 22.8 beats every 10
seconds) is higher than the
range considered normal for
adults and children over ten.

https://assets.radiopaedia.org/
articles/fetal-heart-rate-1
 II. List of Nursing
Diagnoses (in order of
priority)
Rank Subjective Cues Objective Cues Nursing Diagnosis
       
 
- no subjective cues show in data/ -The patient has edema in feet Acute pain as manifested by the
1 case scenario. and legs. verbal report of pain felt in the
lower abdominal region of the
 
patient. Related to contraction of
  uterine.
 

     -no objective cues show in data/  

  case scenario
  fluid volume excess as evidenced
  - The patient is morbidly obese. by the edema of the patient in
- no subjective cues show in data/ feet and legs. Related to the
2 case scenario. -The patient’s weight is 325 lbs, it pressure from the growing uterus.
shows that she is obese.
 
 

    - The patient is morbidly obese.  

 
-the patient reported that she has - The patient’s weight is 325 lbs, it imbalanced nutrition related
3 abdominal pain. shows that she is obese. excessive weight of the patient.
  
III. Nursing Care
Plan
 Nursing Analysis Desired Interventions Rationale Resources Evaluation Plan
Diagnosis Outcomes
Contraction of After the delivery -Established rapport. -Building up trust Material After nursing
Acute uterine related to of the baby this helps resuource : interventions, 
pain as labor of pregnancy uterine -Observe nonverbal Nurse- patient such as goal met as
manifested contraction will cues/pain behaviors  interaction more brochure evidence by:
by the
slowly fades. the and other effective. and
verbal objectives defining 1.Express
report of
pain will last to 2 presentatio
to 3 days after characteristics, as -Observations n reduction of
pain felt in noted, especially may be congruent discomfort
the lower giving birth.  
in persons, who with verbal Human
abdominal 2.Appear
1. Express can’t communicate. reports. Resource:
region of relaxed, able to
the patient. reduction of Time and
discomfort - Assisted patient to -Position affects rest
find position of the patient's ability effort of appropriately.
2. Appear comfort. to sleep nurse and
relaxed, able to effectively. patient
rest appropriately -Encouraged early
ambulation. -It enhances
coping abilities.
-
Administer prescribe -Provides relief of
d pain medication. discomfort.
 Nursing Analysis Desired Outcomes Interventions Rationale Resources Evaluation Plan
Diagnosis

During pregnancy, After 8 hours - Establish rapport- -To Reduce the Material After 8 hours
Fluid the extra fluid in the of nursing Monitor and record discomfort of resource of nursing
volume body and the interventions, vital signs. pain. s : such interventions,
excess as pressure from the patient will as patient verbalized
evidenced
growing uterus can verbalize - Compare current -To give patient brochure understanding
by the weight gain with enough
edema of
cause swelling (or understanding and of measures to
"edema") in the of the measures to admission or previous knowledge presentat prevent and
the patient stated weight. about how to
in feet and ankles and feet. prevent and lessen ion lessen fluid
The swelling tends fluid volume handle pain.   volume excess.
legs. - Discuss the
Related to to get worse as a excess. following measures to -To reduce and Human
the woman's due date prevent and lessen minimize edema Resource
pressure nears, particularly fluid volume excess: : Time
from the near the end of the and effort
growing day and during a) Advise patient to of nurse
uterus. elevate feet when
hotter weather. and
  sitting down. patient
b) Instruct patient
regarding restricting
fluid intake.
 
 IV. MANAGEMENT
(Medical and Surgical)
 Caesarean section, also known as C-section, or caesarean
delivery, is the surgical procedure by which a baby is delivered through
an incision in the mother's abdomen, often performed because vaginal
delivery would put the baby or mother at risk. The procedure is used
most often as a prophylactic measure to alleviate problems of birth
such as cephalopelvic disproportion, breech or multiple fetus birth, or
failure to progress in labor
This increased rate has resulted from a combination of the
increasing safety of cesarean birth, the use of fetal monitors, an
increased incidence of obese women, and scheduled or elective
cesarean birth, chosen by women for convenience or to prevent
potential urinary or anal incontinence later in life.
 Scheduled ceserean birth are planned, which means there time for
thorough preparation for experience throughout the antepartal period.
Emergent cesarean birth are done for reason that arise suddenly labor, such
as placenta previa, premature separation of the placenta, fetal distress, or
failure to progress.
A Breech presentation means either the buttocks or the feet are the first
body parts that will contact the cervix.
V. ANATOMY AND
PHYSIOLOGY
 The reproductive system or genital system is a set of organs within
an organism that work together to produce offspring. Many non-living
substances, such as fluids, hormones, and pheromones, are important
accessories to the reproductive system. Unlike most organ systems,
the sexes of differentiated species often have significant differences.
These differences allow for a combination of genetic material between
two individuals and thus the possibility of greater genetic fitness of the
offspring.
The Reproductive Process
Human reproduction takes place as internal fertilization by sexual
intercourse. During this process, the erect penis of the male is inserted into the
female’s vagina until the male ejaculates semen, which contains sperm, into the
vagina. The sperm travels through the vagina and cervix into the uterus for
potential fertilization of an ovum. Upon successful fertilization and implantation,
gestation of the fetus occurs within the female’s uterus for approximately nine
months (pregnancy). Gestation ends with labor resulting in birth. In labor, the
uterine muscles contract, the cervix dilates, and the baby passes out through
the vagina. Human babies and children are nearly helpless and require high
levels of parental care for many years. One important type of parental care is
the use of the mammary glands in the female breasts to nurse the baby.
The Female Reproductive System
The human female reproductive system is a series of organs primarily
located inside the body and around the pelvic region. It contains three main
parts: the vagina, which leads from the vulva, the vaginal opening, to the
uterus; the uterus, which holds the developing fetus; and the ovaries, which
produce the female’s ova. The breasts are also a reproductive organ during
parenting but are usually not classified as part of the female reproductive
system. The vagina meets the outside at the vulva, which also includes the
labia, clitoris, and urethra. During intercourse, this area is lubricated by mucus
secreted by the Bartholin’s glands. The vagina is attached to the uterus through
the cervix, while the uterus is attached to the ovaries via the Fallopian tubes. At
certain intervals, approximately every 28 days, the ovaries release an ovum
that passes through the Fallopian tube into the uterus.
FETAL PRESENTATION
The most common relationship between fetus and mother is the
longitudinal lie, cephalic presentation. A breech fetus also is a longitudinal lie,
with the fetal buttocks as the presenting part. Breech fetuses also are referred
to as malpresentations because of the many problems associated with them.
Fetuses that are in a transverse lie may present the fetal back (or shoulders, as
in the acromial presentation), small parts (arms and legs), or the umbilical cord
(as in a funic presentation) to the pelvic inlet. In an oblique lie, the fetal long
axis is at an angle to the bony inlet, and no palpable fetal part generally is
presenting. This lie usually is transitory and occurs during fetal conversion
between other lies.
 The most dependent portion of the presenting part is known as the point of
direction. The occiput is the point of direction of a well-flexed fetus in cephalic
presentation. The fetal position refers to the location of the point of direction
with reference to the four quadrants of the maternal outlet as viewed by the
examiner. Thus, position may be right or left as well as anterior or posterior.
Fetal attitude refers to the posture of a fetus during labor. Mammalian
fetuses have a tendency to assume a fully flexed posture during development
and during parturition. Flexion of the fetal head on the chest allows for the
delivery of the head by its smallest bony diameter. A loss of this flexed posture
presents a progressively larger fetal head to the bony pelvis for labor and
delivery. The fetal arms and legs also tend to assume a fully flexed posture.
The longitudinal posture of the fetus likewise is flexed under normal
circumstances.
 Importance of cranial flexion is emphasized by noting the increased
diameters presented to the birth canal with progressive deflection. A. Flexed
head. B. Military position. C, D. Progressive deflection.
  
Transverse and oblique lies also are seen with greater frequency earlier in
gestation. A fetus in a transverse lie may present the shoulder or acromion as a
point of reference to the examiner. As term approaches, spontaneous
conversion to a longitudinal lie is the norm. As seen with breech presentation,
there is a rapid decrease in nonaxial lie during the third trimester. With the
comprehensive application of ultrasound in the antepartum period, discovery of
a transverse or oblique lie has increased. However, nonaxial fetal lies usually
are transitory.
VI. PATHOPHYSIOLOGY
Etiology of Footling breech
Footling breech is when the position of the baby is head-up with one
or both feet hanging down (meaning the baby come out feet-first if
delivered vaginally). This happens if the uterus has too much or too little
amniotic fluid, meaning the baby has extra room to move around in or not
enough fluid to move around in. if the woman has an abnormally shaped
uterus or has other complications, such as fibroids in the uterus. if a
woman has placenta previa. Prematurity, multiple gestations, congenital
anomalies, Mullerian anomalies, uterine leiomyoma, and placental polarity
as in placenta previa are most commonly associated with a breech
presentation.
Consequences of breech presentation
- A major complication of breech presentation is cord
prolapse (where the umbilical cord drops down below the presenting
part of the baby, and becomes compressed). The incidence of cord
prolapse is 1% in breech presentations, compared to 0.5% in cephalic
presentations. Other complications include fetal head entrapment.
VII. DRUG STUDY
 Classification/ Nursing Responsibilities
Drug Name Indications Contraindications Adverse Reactions
Mechanism of Action
Generic Name: Mechanism of action -Indicated for the -History of allergy to AUTONOMIC - Position nauseated patients
not fully understood: symptomatic prochlorperazine or the who have received this drug
Prochlorperazine phenothiazine drug -Dry mouth,
Antipsychotics block treatment of severe class carefully to prevent aspiration
Brand Name: postsynaptic nausea and vomiting. salivation, nasal of vomitus
-Concomitant
dopamine receptors use of CNS depressants congestion, nausea,
Compazine  -Indicated for the (opioids,  
in the brain, but this vomiting, anorexia,
management of benzodiazepines, and
  may not be necessary barbiturates) leading to fever, pallor, flushed -Do not administer
and sufficient for manifestations of
sedation facies, sweating, subcutaneously because of
Dosage: antipsychotic activity; psychotic disorders, -Concomitant
such as schizophrenia constipation, paralytic, local irritation.
Adult depresses the RAS, use of anticholinergic
including the parts of and generalized non- medications polyuria.  
Nausea, vomiting psychotic anxiety. (scopolamine, atropine,
the brain involved etc.) CNS
related to surgery: 5-10 -Give IM injections deeply into
with wakefulness and -Pre-existing -Drowsiness,
mg IM 1-2 hr before cardiac conduction the upper outer quadrant of
emesis; dizziness, insomnia,
anesthesia or during abnormalities the buttocks.
and after surgery (may anticholinergic,
-History of vertigo, headache,
repeat once in 30 min); antihistaminic, and seizure/epilepsy  
alpha-adrenergic (prochlorperazine weakness, cerebral
5-10 mg IV 15 min
before anesthesia or blocking activity may lowers seizure edema, seizures. - Avoid skin contact with Oral
during and after contribute to some threshold)
CV
solution
-Narrow-angle
surgery (may repeat of its therapeutic glaucoma -Prostatic
once); or IV infusion, 20 action. hypertrophy -Past or
mg/L of isotonic current history of -Hypotension,
solution added to   tardive dyskinesia hypertension,
  -Patients under
infusion 15-30 min tachycardia,
before anesthesia.   two years of age
bradycardia, cardiac
 
arrest.
ENDOCRINE
– lactation, breast
enlargement.
 Classification/ Nursing Responsibilities
Drug Name Indications Contraindications Adverse Reactions
Mechanism of Action
Generic Name: Stimulates motility postoperative Concentrations Fatigue, dizziness, -Assess if the patient has
of upper GI tract nausea and anxiety. allergy to metoclopramide
Metoclopramide without stimulating vomiting - Allergy to then assess for other
gastric, biliary or metoclopramide GI: Nausea, diarrhea contraindications.
Brand Name: pancreatic
secretions, appears -Lactation   - Monitor BP carefully during IV
Reglan, Maxolon,
Gimoti, Metozonlv ODT to sensitive tissues   administration then educate
to action of the patient about side effects.
acetylcholine,
relaxes pylorie -Instruct patient to take drug
Dosages: sphincter which exactly as prescribed and
when combined with
 10-15 mg PO up to 4 effects on motility, -Instruct patient not to use
times a day, 30 minutes accelerates gastric alcohol, sleep remedies or
before each meal and at emptying and sedatives; serious sedation
bedtime for 2-8 weeks intestinal transit: could occur.
 Route of increase lower
esophageal -Do proper documentation.
Administration: Oral, sphincter pressure
Intravenous (IV) has sedative
properties induces
release of prolactin.
 
 
 Classification/ Mechanism of Nursing Responsibilities
Drug Name Indications Contraindications Adverse Reactions
Action
Generic Name: Meperidine mimics -acute pain -Significant respiratory The major hazards of -Before using, check this product
the actions of depression. meperidine, as with visually for particles or
 Meperedine endogenous   discoloration. If either is present,
-Acute or severe other opioid
 Brand Name: neuropeptides via analgesics, are do not use the liquid. Learn how
opioid receptors, - severe enough to bronchial asthma in an to store and discard medical
 Demerol thereby producing the require an opioid unmonitored setting or in respiratory supplies safely.
analgesic and for the absence of depression and, to a
characteristic lesser degree,
 Dosage:
morphine-like effects which alternative resuscitative equipment.  
on the mu-opioid treatments are circulatory
 Adults  -Concomitant use of -When meperidine is injected
receptor, including inadequate. depression,
monoamine oxidase into a vein, it is given very slowly
 Initiate treatment with analgesia, euphoria, inhibitors (MAOIs) or
respiratory arrest, to prevent serious side effects. If
DEMEROL Tablets or Oral
Solution in a dosing range sedation, respiratory within 14 days of having shock, and cardiac this medication is given into a
of 50 mg to 150 mg orally, depression, miosis, taken an MAOI. arrest. The most muscle or under the skin, it is
every 3 or 4 hours as bradycardia and frequently observed important to change the
needed for pain. physical dependence.  - Known or suspected adverse reactions injection site each time to lessen
  gastrointestinal included injury under the skin. The
 Pediatric Patients obstruction, including lightheadedness, patient should be lying down
 Initiate treatment with
  paralytic ileus. dizziness, sedation, when the injection is given to
DEMEROL Tablets or Oral  - Hypersensitivity to nausea, vomiting, prevent side effects such as
Solution in a dosing range dizziness.
of 1.1 mg/kg to 1.8 mg/kg
meperidine or to any of and sweating.
orally, up to the adult other ingredients of the
dose, every 3 or 4 hours as product (e.g.,
necessary. anaphylaxis.
 Nursing Responsibilities
Classification/
Drug Name Indications Contraindications Adverse Reactions
Mechanism of Action
Generic Name: Amoxicillin is in the Treatment of -Hypersensitivity to -Agitation -take this drug around-the-
class of beta- lactam genitourinary amoxicillin -Anxiety clock.
Amoxicillin
antimicrobials. tract infections, -Confusion
  ears, nose, and  -Patient with  
Beta lactams throat infection allergies or atopic
  -Hypersensitivity -take the full course of therapy;
Act by binding to condition. do not stop because you feel
Lower respiratory -Diarrhea
Brand Names: penicillin-binding better.
tract infection,
Amoxil proteins -Insomnia
Helicobacter  
That inhibit a -hyperactivity.
process called Pylori infection -This antibiotic is specific for
Dosage: transpeptidation pharyngitis this problem and should not be
(cross-linking used to self-treat other
Tablets process in cell wall Tonsillitis, and infection.
500 mg, 875 mg. Each synthesis leading to skin structure
tablet contains 500 mg activation of infection.  
or 875 mg amoxicillin as autolytic enzymes in
the trihydrate. Each film- -Report unusual bleeding or
coated, capsule-shaped,
the bacterial cell bruising, sore throat, fever,
pink tablet is debossed wall. rash, hives, severe diarrhea,
with AMOXIL centered  
difficulty breathing.
over 500 or 875,
respectively. The 875-mg  
tablet is scored on the
reverse side.
 
 Classification/ Mechanism of Nursing Responsibilities
Drug Name Indications Contraindications Adverse Reactions
Action
Generic Name: Acetaminophen Acetaminophen is Contraindications to -nausea, Consult physician if needed for
Acetaminophen with
belongs to a class of used to relieve the use of -stomach pain, children < 3 yr; if needed for
codeine drugs called mild to moderate acetaminophen -loss oflonger than 10 days; if
analgesics (pain pain from include appetite, continued fever, severe or
Brand Name: relievers) and headaches, muscle hypersensitivity to -itching, recurrent pain occurs (possible
-APAP wCodeine antipyretics (fever aches, menstrual acetaminophen, -rash, serious illness). Avoid using
reducers). The exact periods, colds and severe hepatic multiple preparations
-Capital wCodeine mechanism of action -headache,
-Pyregesic-C of acetaminophen is sore throats, impairment, or severe -dark urine, containing acetaminophen.
-Tylenol wCodeine not known. It may toothaches, active hepatic -clay Carefully check all OTC
reduce the backaches, and disease. -colored stools, -or products. Give drug with food
-Tylenol wCodeine 3
production of reactions to jaundice (yellowing of if GI upset occurs.
-Tylenol wCodeine 4 vaccinations
prostaglandins in the skin or eyes).
-Tylenol with Codeine No 3 brain. Prostaglandins (shots), and to
-Vopac are chemicals that reduce fever.
Dosage: cause inflammation  
and swelling.
352-650 mg every 4-6 hours
or 1 g every 6 hours  
 
Route of administration  
- Oral: Acetaminophen is
available as a tablet,
capsule, syrup, oral
solution, or suspension.
Rectal:Acetaminophen is
available as a rectal
suppository for both adult
and pediatric patient
populations. Intravenous:
Acetaminophen also comes
as an IV infusion for
administration.
 
 Classification/ Mechanism Nursing Responsibilities
Drug Name Indications Contraindications Adverse Reactions
of Action
Generic Name: Codeine binds to mu- Codeine plays a Codeine sulfate is -Dizziness -If codeine-containing drugs
Codeine
opioid receptors, which role in the contraindicated in are prescribed, nurses
are involved in the treatmen of mild patients with acute -tiredness should administer them in
Brand Name: transmission of pain to moderate pain. or severe bronchial the lowest dose in the range
Codeine is not available throughout the body asthma or -confusion, difficulty and carefully monitor the
under different brand and central nervous hypercarbia. Codeine concentrating patient's response.
names. system.  
sulfate is
Dosage:   -euphoria - Nurses, the child's parents,
contraindicated in
15-60 mg PO q4- any patient who has and other caregivers should
6hr PRN; not to exceed 360   -restlessness report any unusual
mg/day in naive patients or is suspected of -blurred sleepiness, confusion, or
having paralytic ileus. vision
Dosing considerations: difficult or noisy breathing in
-Patients with prior opioid
-dry mouth the child.
exposure may require
higher initial doses -limbs feeling heavy or
-Titrate dose to pain muscles feeling stiff
relief; use lowest effective
dose for shortest period -sweating
of time -mild
allergic rash, itching and
hives
Route of Administration: -low
-A capsule, and a solution blood pressure
(liquid) to take by mouth -decreased
- Soluble tablets
codeine phosphate are heart rate, palpitations
administered
subcutaneously or -stomach-ache,
intramuscularly. nausea, vomiting,
constipation
-difficulty
urinating.
PRESENTED BY:
Cuntapay, Rachel V.
Herbito, Junaly B.
Jang, Nessy Rose
Jinang, Kian Bryne P.
Yahya, Omeyah
Bachelor of Science in Nursing
Level II
Section 2
Group 3