DRUG       INDICATION and    MECHANISM OF        DOSE, ROUTE       SIDE –         CONTRAINDICATION                  NURSING
CLASSIFICATION         ACTION              and        EFFECTS                                      RESPONSIBILITIES
                                                      FREQUENCY
Generic       Indication:        Mood- stabilizing   Dose:         Headache,         Liver and renal disease,    1. Observe sign and
Name:         To treat bipolar   effects has been                  lethargy,         pregnancy, lactation,          symptoms of
Lithonate     manic-depressive   postulated to                     drowsiness,       severe dehydration, brain      depression; mood
              psychosis, manic   reduction of                      dizziness,        tumor damage, sodium           changes, insomnia,
              episodes.          catecholamine                     tremors,          depletion, severe              apathy, or lack of
Brand Name:                      neurotransmitter                  slurred speech,   cardiovascular disease         interest in activities.
Lithium                          concentration       Route:        dry mouth,                                    2. Record patient’s the
Carbonate     Classification:                                      anorexia,                                        vital signs;
              Antimanic                                            vomiting,                                        orthostatic
                                                                   diarrhea,                                        hypotension is
                                                                   polyuria,                                        common.
                                                                   hypertension,                                 3. Monitor for signs of
                                                     Frequency     abdominal                                        lithium toxicity.
                                                                   pain, muscle                                  4. Monitor for suicidal
                                                                   weakness,                                        tendencies when
                                                                   urinary                                          marked depression
                                                                   incontinence,                                    is present
                                                                   restlessness,
                                                                   stupor, clonic
                                                                   movements
    DRUG        INDICATION and        MECHANISM OF        DOSE, ROUTE   SIDE – EFFECTS         CONTRAINDICATION                NURSING
                CLASSIFICATION             ACTION              and                                                       RESPONSIBILITIES
                                                           FREQUENCY
Generic Name:   Indication:           The precise         Dose:         Mild                  Liver and renal disease   1. Take with or after
Divalproex      To treat certain      anticonvulsant                    drowsiness            or dysfunction. Known         meals to minimize
sodium          types of seizures     action in                         or weakness,          urea cycle disorders.         GI upset and at
                and convulsions       unknown; may                      depression,           Lactation                     bedtime to
                                      increase brain                    anxiety, or                                         minimize sedative
                                      levels of the                     other                                               effects.
                                      neurotransmitter    Route:        emotional                                       2. Take only as
                Classification:       GABA.                             changes,                                            directed and do not
Brand Name:     Anticonvulsant                                          enlarged                                            stop suddenly; may
Depakote                                                                breasts,                                            induce seizures
                                                                        weight                                              with disorder.
                                                                        changes,                                        3. Avoid alcohol, any
                                                          Frequency     tremors                                             other CNS
                                                                        (shaking),                                          depressants, or
                                                                        vision changes,                                     OTC products
                                                                        hallucination,                                      without approval.
                                                                        fever, sore throat,                             4. Report for periodic
                                                                        headache, dry                                       CBC, serum
                                                                        skin, leg cramps.                                   glucose/acetone
                                                                                                                            ammonia and LFT’s
    DRUG        INDICATION and        MECHANISM OF        DOSE, ROUTE   SIDE – EFFECTS         CONTRAINDICATION                NURSING
                CLASSIFICATION             ACTION              and                                                       RESPONSIBLITIES
                                                           FREQUENCY
Generic Name:   Indication:           Clonazepam          Dose:         Anxiety,              It is allergic to         1. Observe and record
Clonazepam      Clonazepam is         exerts its action                 increased heart       clonazepam, any other     the intensity , duration
                used to treat         by binding to the                 rate, tremor,         benzodiazepine (e.g.,     and location of seizure
                seizure               benzodiazepine                    general unwell        lorazepam, diazepam,      activity
                disorders. It helps   site of the GABA                  feeling, behavior     oxazepam), or to any of   2. Assess patient for
                by slowing the        receptors, which                  problems,             the ingredients of the    drowsiness,
    DRUG       INDICATION and           MECHANISM OF       DOSE, ROUTE       SIDE –          CONTRAINDICATION                  NURSING
               CLASSIFICATION                ACTION             and        EFFECTS                                        RESPONSIBILITIES
                                                            FREQUENCY
Generic       Indication:               My act by          Dose:         Sedation,          Hypersensitivity,           1. Encourage the
Name:         It is indicated for the   antagonizing                     height gain,       hypertension, dysrthmias,      patient to void in
Risperidone   short-term treatment      dopamine and                     headaches, dry     blood dyscrasias, liver        extremes in
              of acute manic or         serotonin in the                 mouth,             damage                         temperatures, and
              mixed episodes            CNS. Decreased                   photosensitivity                                  increased exercise.
Brand Name:
              associated                symptoms of                      , urinary                                      2. Advice the patient to
Risperidal
              with Bipolar              psychoses.         Route:        retention,                                        rise slowly from
                                                                         sexual                                            sitting or lying to
              Classification:                                            dysfunction,                                      standing to prevent a
              Atypical                                                   orthostatic                                       sudden decrease of
              Antipsychotic                                              hypotension,                                      blood pressure.
                                                                         convulsion.                                    3. Instruct the patient to
                                                           Frequency                                                       avoid direct sunlight
                                                                                                                           to prevent
                                                                                                                           photosensitivity and
                                                                                                                           use sunscreen and
                                                                                                                           protective clothing to
                                                                                                                           prevent a skin rash.
    ASSESSMENT             NURSING          SCIENTIFIC       PLANNING                 NURSING                 RATIONALE             EVALUATION
                          DIAGNOSIS        EXPLANATION                             INTERVENTION
Subjective Data:                                         Discharge               Independent:                                   Short Term Goal:
“Nahihirapan ako         Insomnia                        Outcome:                1. Identify presence     •   That can          The goal was
makatulog kagabe”        related to                      Upon discharge, the        of related factors        contribute to     achieved. After 3
as stated                elevated                        patient will be able                                 insomnia          hours of Nursing
                         energy level as                 to report                                                              Intervention, the
                         evidenced by 3                  improvement in          2. Encourage             •   To aid in stress patient will be able to:
                         hours of sleep                  sleep/rest pattern.        participation in          control/release   1. Verbalize 3/5
                                                                                    regular exercise          of energy.            understanding of
                                                                                    program during                                  sleep impairment.
Objective:                                                                          day                                         2. Identify 2/3
•   Difficulty falling                                                                                                              individually
    asleep                                                                       3. Recommend             •   Reduce need           appropriate
•   Waking up too                                        Short Term Goal:           limiting intake of        for night time        intervention to
    early                                                After 3 hours of           chocolate and             elimination           promote sleep.
•   Dissatisfaction                                      Nursing Intervention,      caffeine/alcoholic                          The plan is
    with sleep                                           the patient will be        beverages,                                  terminated.
•   3 hours of sleep                                     able to:                   especially prior to
                                                         1. Verbalize 3/5           bedtime.
                                                             understanding of
                                                             sleep               4. Recommend             •   To reduce
                                                             impairment.            inclusion of              sleep
                                    2. Identify 2/3         bedtime snacks in       interference      Discharge
                                       individually         dietary program         from hunger.      Outcome:
                                       appropriate                                                    The goal was
                                       intervention to   Collaborative:         •   Indicates long    achieve. Upon
                                       promote sleep.    1. Use barbiturates        – term use of     discharge, the patient
                                                            and/or other            these             was able to report
                                                            sleeping                medication can    improvement in
                                                            medication as           actually induce   sleep/rest pattern.
                                                            ordered.                sleep             The plan is
                                                                                    disturbances.     terminated
                                                                                •   Follow- up
                                                         2. Refer to sleep          intervention
                                                            specialist as           may be
                                                            indicated               needed when
                                                                                    insomnia is
                                                                                    seriously
                                                                                    impacting
                                                                                    patient’s
                                                                                    quality of life
                                                                                    productivity
                                                                                    and safety.
ASSESSMENT   NURSING   SCIENTIFIC       PLANNING              NURSING               RATIONALE            EVALUATION
                        DIAGNOSIS         EXPLANATION                             INTERVENTION
Subjective Data:                                        Discharge               1. Communicate          •   Establishing       Short Term Goal:
“Walang dumadalaw      Ineffective                      Outcome:                   properly and             rapport to the     The goal was
sakin simula nuong     copping                          Upon discharge, the        provide comfort.         client.            achieved. After 2
pumasok ako dito”      related to                       patient will be able                                                   weeks of Nursing
                                                                                                        •   May help the
as stated              inadequate                       to demonstrate use      2. Explain the                                 Intervention, the
                                                                                                            client to
                       family support                   or more adaptive           disease                                     patient will be able to
                                                                                                            express
                       as                               coping skills as           process/procedur                            develop the trust in
                                                                                                            emotions,
                       verbalization of                 evidenced by               es/events in a                              community people
                                                                                                            grasp situation,
                       “walang                          appropriateness of         simple, concise                             The plan is
                                                                                                            and feel more
                       dumadalaw                        interactions and           manner.                                     terminated.
                                                                                                            in control
Objective Data:        sakin simula                     willingness to
•   Verbalization of   nuong                            participate in          3. Avoid physical       •   Suspicious         Discharge
    “walang            pumasok ako                      therapies.                 contact.                 client may         Outcome:
    dumadalaw          dito”                                                                                perceive touch     The goal was
    sakin simula                                        Short Term Goal:                                    as a               achieve. Upon
    nuong pumasok                                       After 2 weeks of                                    threatening        discharge, the patient
    ako dito”                                           Nursing Intervention,                               gesture.           will be able to
•   Inadequate level                                    the patient will be                                                    demonstrate use or
    of confidence in                                    able to develop the     4. Encourage client     •   Verbalization      more adaptive coping
    ability to cope                                     trust in community         to                       of feelings in a   skills as evidenced by
•   Poor                                                people                     verbalize feeling.       non-               appropriateness of
    concentration                                                                                           threatening.       interactions and
•   Behavioural                                                                                                                willingness to
    changes                                                                                                                    participate in
•   Inadequate       5. Establish a           •   An ongoing        therapies.
    support of the      working                   relationship      The plan is
    family              relationship with         establishes       terminated
•   Inadequate          patient through           trust, reduces
    social support      continuity of care.       the feeling of
                                                  isolation and
                                                  may facilitate
                                                  coping.
                     6. Encourage             •   During crises,
                        patient to identify       patients may
                        own strengths             not be able to
                        and abilities.            recognize their
                                                  strengths.
                                                  Fostering
                                                  awareness can
                                                  expedite use of
                                                  these
                                                  strengths.
                     7. Provide outlets       •   Opportunities
                        that foster               to role play or
   feelings o                rehearse
   personal                  appropriate
   achievement and           actions can
   self-esteem.              increase
                             confidence
                             behaviour in
                             actual
                             situation.
8. Point out signs of    •   Patients who
   positive progress         are coping
   or change.                assess
                             progress
                             ineffectively
                             may not be
                             able to.
Collaborative:
1. Administer anti-      •   These facilitate
psychotic drugs as           ability to cope.
ordered.
2. Collaborate with      •   Additional
the psychiatrist about       knowledge is
the additional      needed to
knowledge for the   conduct a
therapy.            therapy.