Republic of the Philippines

NORTHERN NEGROS STATE COLLEGE OF SCIENCE AND TECHNOLOGY

Barangay Old Sagay, Sagay City, Negros Occidental

College of Nursing and Allied Health Sciences

MEDICAL SURGICAL
MIDTERM EXAMINATION

Submitted by:
LINE, SHELLA MAE S. BSNIII- LEVINE

Situation: A 25 years old male was brought in the clinic by his mother with a cc of rash, redness and pruritus. Upon history taking, the patient
was known to be allergic in seafood and thar he acquired the allergy at present an hour after he ingested a shrimp. Vital signs are BP:
120/80mmHg, PR: 98bpm, RR: 24cpm, Temp: 37.4 degree centigrade. Wheezing is noted upon auscultation. Antihistamine is given
intramuscularly. Oxygen is given at 2 to 4 LPM via nasal cannula. Patient is conscious and oriented can converse well. Patient claimed "I feel
sleepy, I wanna sleep"

Base on the situation, select 3 nursing problems and formulate a nurses notes using the FDAR format. Make a drug study about
diphenhydramine

DRUG STUDY

Patient Name: Juan Delacruz Chief Complaint: Rash, redness and pruritus
Age: 25 years old Admitting Diagnosis: Allergy
Room ward: RM 4 Attending physician: Dr. Boo
DRUG NAME: CLASSIFICATIO INDICATION MECHANISM OF ADVERSE ACTION NURSING CONSIDERATION PATIENT TEACHING
N ACTION
 GENERIC: Antihistamine, -Allergy Interferes with CNS: drowsiness, -Monitor vital signs. -Instruct the patient the
Diphenhydramin Anticholinergic. symptoms histamine effects dizziness, -Monitor cardiovascular drug may make dizzy or
e Hydrochloride antiemetic caused by at histamine1- headache, status, especially in patients drowsy or blur
histamine receptor sites; paradoxical with cardiovascular disease. your vision
BRAND NAME: release prevents but stimulation -Before -Tells the patient that to
Benadryl (including doesn’t reverse (especially in giving diphenhydramine, ask minimize dizziness and li
anaphylaxis, histamine- children) the patient if they are allergic ght-headedness, get up
Dosage: 50mg seasonal and mediated CV: hypotension, to it; or to dimenhydrinate; or slowly when rising from a
perennial response. Also palpitations, if they have any seated or lying position.
Route: IM allergic possesses CNS tachycardia EENT: other allergies.
rhinitis, and depressant and blurred vision, - Assess the patient for any -Tell the patient the
Frequency: q6 allergic anticholinergic tinnitus allergy reaction of Diphenhydramine
dermatoses); properties. GI: diarrhea, antihistamines injection may cause side
Timing: 6-12-6-12 nausea; vertigo constipation, dry -Assess the skin color, effects. Tell physician if
mouth texture, orientation and any of symptoms are
GU: dysuria, reflexes severe or do not go away
urinary frequency -Observe for vision changes - - Advise the patient to
or retention Skin: -Supervise patient during report difficulty of
photosensitivity ambulation. Use side rails as breathing, hallucination,
Other: decreased necessary. tremors and irregular
appetite, pain at - Supervise patient during breathing
I.M. injection site ambulation. Use side rails as
necessary.
-For I.V. use, check -Advise patient to avoid
compatibility before mixing alcohol and other
with other drugs. depressants such as
References: 2010 Nursing Spectrum Drug Handbook by Patricia Dwyer Schull sedatives while taking
- Inject I.M. dose deep into
drug.
large muscle mass; rotate
sites.
-Caution patient to avoid
driving and other
hazardous activities until
he knows how drug affects
concentration and
alertness.