Make a Nursing Care plan and Drug study based on the given scenario Case Scenario: Mrs. Beltran
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Make a Nursing Care plan and Drug study based on the given scenario
Case Scenario:
Mrs. Beltran, a 30-year-old woman, gravida 1, para 1 who gave birth at term, birth weight 3.5 kg. Mrs. Beltran and her son, 5 days of age, were seen in the lactation clinic for sore nipples. She experienced breast fullness during the third post-partum day, and by the fifth day they are painfully engorged. Following engorgement, her nipples began to crack. Nipples now “seem to hurt all the time”. She reports that severe nipple pain occurs with latch-on. Mrs. Beltran appeared to be tired and down hearted. She reports that her baby was crying a lot, did not sleep well and was not gaining weight well. Her baby starts well, but soon stop, apparently because he was not getting enough. He would then cry and be reluctant to take the breast again. Her vital signs were: BP: 130/90 mmHg, PR: 95 bpm, RR: 20 cpm and Temp: 37.8 C. Maternal breast examination revealed moderately engorged breasts. Nipples are everted, approximately 1 cm in size with a linear fissure diagonally from 2 to 8 o’clock on the left side and 10 to 4 o’clock on the right. She was given ibuprofen to reduce the discomfort and pain.
NURSING CARE PLAN FORMAT
ASSESSMENT NURSING DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION
Subjective
Problem, Etiology, Signs(P.E.S) Format Short Term Goal: S.M.A.R.T + Evidence
Independent
* Assessment
* Therapeutic
* Educative
Dependent
* Assessment
* Therapeutic
* Educative
Interdependent/Collaborative
* Assessment
* Therapeutic
* Educative
Short Term Goal Evaluation
Objective
INFERENCE Scientific Explanation (Diagram Form) Long Term Goal: S.M.A.R.T + Evidence Long Term Goal Evaluation
DRUG STUDY FORMAT
DRUG CLASSIFICATION INDICATION SIDE EFFECTS ADVERSE EFFECTS NURSING RESPONSIBILITIES
Generic Name:
Brand Name:
Dosage:
Route:
Frequency:
MECHANISM OF ACTION
CONTRAINDICATIONS
SCIENCE
HEALTH SCIENCE
NURSING
NURSING 101
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