ASSESSMENT

Subjective: Bigla na lang sumakit ng matindi ang tiyan ko , kahit 22 linggo palang ang ipinagbubuntis ko verbalized by the patient. Objective: Abdominal guarding. Muscle tension. Irritability. V/S taken as follows: T: 37.3 P: 95 R: 22 Bp: 100/70

DIAGNOSIS
Acute pain related to collection of blood between uterine wall and placenta.

ANALYSIS Abruptio placenta is premature separation of the normally implanted placenta in the third trimester. Women at risk for developing abruption placentae include those with history of hypertension or previous abruption placenta, abdominal trauma during pregnancy, anomaly of the umbilical cord, uterine fibroids, advanced maternal age, cigarette smoking, and cocaine abuse.

PLANNING
After 8 hours of nursing interventions, the patient will demonstrate use of relaxation skills, other methods to promote comfort.

INTERVENTION
Independent: Monitor amount of bleeding by weighing all pads. Investigate pain reports, noting location, duration, intensity (0-10 scale), and characteristics (dull, sharp, constant). Monitor maternal vital signs and fetal heart rate through continuous monitoring. Measure and record fundal height. Position mother in the left lateral position, with the head of the bed elevated. Provide comfort measure like back rubs, deep breathing. Instruct in

RATIONALE
To measure the amount of blood loss. Changes in location or intensity are not uncommon but may reflect developing complications. Early recognition of possible adverse effects allows for prompt intervention. Fundal height may increase with concealed bleeding. To enhance placental perfusion. Promotes relaxation and may enhance patients

EVALUATION
After 8 hours of nursing interventions, the patient was able to demonstrate use of relaxation skills, other methods to promote comfort.

relaxation or visualization exercises. Provide diversional activities.

coping abilities by refocusing attention.

Collaborative: Administer oxygen as indicated.

To supply adequate oxygen to the fetus and mother and prevents further complication.

Murriel S. Llobrera

Drug study
Drug name GENERIC NAME: Metformin Indication -adjunct to diet, to lower blood glucose with type 2 DM -As a part of combination therapy with a sulfonylurea or insulin when either drug alone cannot control glucose levels in patients with type 2 DM BRAND NAME: Glucophage Increased risk of hypoglycaemia if taken with juniper berries, ginseng and garlic. Action Exact mechanism is unknown/ not understood; possibly increase peripheral utilization of glucose, decreases hepatic glucose production ,& intestinal absorption of glucose Drug interaction DRUG- DRUG: -increased risk of hypoglycaemia with sulfonylureas, cimetidine. -increased risk of lactic acidosis with ethanol Contraindication Contraindicated with allergy to metformin; heart failure & severe infections Adverse effect ENDOCRINE: Hypoglycaemia Lactic acidosis Nursing consideration -do not discontinue this medication without consulting your health care provider -avoid using alcohol while taking this medication

Use cautiously with elderly.

GI: Anorexia Nausea Vomiting Epigastric discomfort.

DRUG-ALTERNATIVE THERAPY:

-monitor blood for glucose and ketones as prescribed.

DRUG CLASS: Anti Diabetic