Question

need the concept map please

PN 200 Fundamentals of Nursing II Concept Map: Diverticulitis Tim Haute, a 57-year-old stockbroker, has come to the gastroenterologist for treatment of recurrent mild to severe cramping in his abdomen and blood streaked stool. You are the nurse doing his initial assessment. You findings include a mildly obese man (male pattern obesity) who demonstrates mild guarding of his abdomen with both direct and rebound tenderness, especially in the LLQ. Vital signs are 168/98, P 110, R 24, T. 98.4 and he is slightly diaphoretic. Mr. Haute states that he has periodic constipation. He has had previous episodes of abdominal cramping, but this time the pain is getting worse. PMH: Mr. Haute has a sedentary job with many emotional moments"; he has smoked a pack of cigarettes a day for the past 30 years and has had “2-3 mixed drinks in the evening" until 2 months ago. He states, “I have not had anything to drink in 60 days." He denies regular exercise with the statement "Just no tie." His diet consists of white bread, meat, potatoes and ice cream with fruits and nuts over it. He denies a history of pulmonary or cardiac and no personal history of cancer, although his father and older brother died of colon cancer. He takes no "routine" medications and denies the use of any other drugs. The physician orders a KUB, CBC, and CMP. Based on the X-ray and lab findings, physical exam and history the physician diagnosis the patient with acute diverticulitis and discusses the outpatient treatment plan with him. The physician now orders bed rest and anticholenergics for Mr. Haute. The physician orders metronidazole for this patient. 1. Prepare a list of questions you would ask this patient prior to administering metronidazole and state your rationale. 2. Explain what a disulfiram reaction is. You continue to teach the patient about both disulfiram and metronidazole reactions and interactions. You decide that there are some other instructions you need to give to the patient regarding his metronidazole prescription. The physician has now ordered Ampicillin for the patient. 3. State additional information you would need to know before starting the patient on Ampicillin Revised 1/20

Answer 1

1.The list of questions which has to be asked prior to administration of metronidazole are

• Any medical condition like renal ,liver disease, epilepsy, etc., because this drug can affect the function of various organs
• Use of any medication because this drugs interacts with most of the drug
• History for any hypersensitivity or allergy
• Current or chief complaints
• Any problems associated with gastrointestinal system because this can cause nausea, vomiting, pain ,diarrhea

2.Disulphiram is a drug used in deaddiction of alcohol. Disulfiram reaction refers patient having symptoms which is similar too when there is consumption of alcohol.

Metronidazole should be taken as prescribed

Not to overdose or underdose

Take after meals at same time

Milk can reduce the acidity nature of the stomach

No alcohol atleast three days after stopping metronidazole

No driving is recommended

3.Before administration of Ampicillin the following things as to be asked

• Any medication or herbal supplements
• Hypersensitivity
• Allergy to penicillin group of drugs
• Assess for diarrhea

Diverticulitis

●Nursing diagnosis

Acute pain (in abdomen) related to diverticular formation as evidenced by abdominal cramps, pain ,constipation

Bloody stools

Intervention

• Collect a thorough history to plan for care
• Administer medication as per order to relieve pain
• Antibiotics to treat pain

Positive outcomes

Patient will have good tolerance to pain level and overcome it

Negative outcomes

Risk for electrolyte imbalance anemia

Evaluation

The patient has no pain and able to do all activities by self

●Nursing diagnosis

Impaired cardiac output related to increased vascular resistance as evidenced by elevated blood pressure, heart rate

Intervention

• Monitor vital signs, baseline data to plan for care
• Administer medication to lower the blood pressure as per order
• Treat pain ,because this can aggravate and elevated blood pressure

Positive outcomes

Will maintain normal blood pressure

Negative outcomes

The patient is at risk for developing complications

Evaluation

The patient exhibits a normotensive range