Any nurses?? Who know about care planning!

[Smurfgirl]

I have a question about a care plan I am doing for an assignment. Am using Orem but its more general advice.

Well, the medication can cause liver failure, and makes the urine orange....
I would err on the side of caution as medication compliance is THE main problem with TB control. I would make it that the patient is eventually self caring with medication before discharge, he may only have two weeks in hospital, and he has 12 tablets and the side effects to learn.
Ethambutol- can make him go blind (reversable if he reports visual disturbances)
Rifampicin - liver damage and urine goes bright orange
Isoniazid- can cause neuropathy in fingers and toes
Pirazinamide- liver problem and swollen joints
are the main side effects, significant and not that uncommon.
If patient doesn't take meds every day they would get infectious again after 2 weeks.

I would worry about a systolic of 180, and worth keeping an eye on.

He would need liver function checked as a base line before starting drugs and during treatment, he needs to know he must contact hospital if liver problems occur...ie itchy skin, yellowing of skin, vomitting, nausea.....I have seen a lot of this and patient needs to be self caring in recognising side effects...V important imo

Thanks so much for the help my care plan makes so much more sense. Education about meds v/good for Orem!

You sound like a v.good nurse

One day I will be ;)

Oh and I know 180 is hypertensive but feel like I should be linking it to the tb and don't think I can so would't worry about it in that context - I would prob consider it as a separate prob.

he has a raised bmi? ex smoker? stress/ anxiety? diet?

i don't know anything about tb... or nursing men!!!!

180 would definitely need observing

I assume you've addressed the bowels and urinating??

You will be a good nurse (sounds like you are already!)
Anything else???

Bp is separate problem, they've done that to catch you out

LOL no I am done now, have an all day workshop on it tomorrow as well.

Will do some more careplans like this this semester though and have an essay on the ethics of DNRs in the elderly

Ooooooooooooooooo ethics- don't get me started.....love ethics!!!
Great I'm glad you're sorted...have fun at the workshop!!!

Have fun and good luck in the rest of your essays!!!
Best of luck and let me know when you get the reults of this essay!!!