Generic name

Brand name: Niazid

General Action: Antituberculotic

This medication is used with other medications to treat active tuberculosis (TB) infections or alone to prevent those who have a positive TB test from developing symptoms of TB. Isoniazid belongs to a class of drugs known as antibiotics that are active against tuberculosis. Interferes with lipid and nucleic acid biosynthesis in actively growing tubercle bacilli.

Indications

• Tuberculosis of all forms
• Prophylaxis in specific patients who are tuberculin reactors (positive Mantoux test) or who are considered to be high risk for TB.

Contraindication

Isoniazid is contraindicated in patients who develop severe hypersensitivity reactions, including drug -induced hepatitis; previous isoniazid-associated hepatic injury; severe adverse reactions to isoniazid such as drug fever, chills, arthritis; and acute liver disease of any etiology.

Stock dose

Tablets: 100,300 mg; syrup 50mg/5ml; injection 100 mg/ml

Side effects

• Peripheral neuropathy
• Nausea and vomitting
• Thrombocytopenia
• Local irritation at IM site
• Epigastric distress
• Elevated AST

Nursing Responsibilities

• History: allergy to the drug.
• Can cause peripheral neuropathy which is manifested by tingling sensation on extremities. It can be prevented through use of supplemental vitamin B6 (pyridoxine).
• Physical: skin color, lesions, T; orientation, reflexes, peripheral sensirivity, bilaterally grip strength ophthalmologic examination; R, adventitious sounds; liver evaluation; CBC;LFTs renal fxn tests, blood glucose.
• Give in an empty stomach 1 hr before or 2 after meals; may be given with food if GI UPSET OCCURS.
• Give in a single daily dose. Reverse parenteral dose for pt unable to take oral meds.
• Dec. foods containing tyramine or histamine in pt diet.
• Consult doctor and arrange for daily pyridoxine in diabetic, alcoholic or malnourished pt also for pt that develops peripheral neuritis, and those with HIV.
• Family health teachings:
  • Take this drug in single daily dose.
  • Take drug on an empty stomach, 1 hour before or 2 hours after meals. If GI distress occurs, may be taken with food.
  • Take this drug regularly, avoid missing doses, do not discontinue without first consulting your health care provider.
  • Do not drink alcohol or drink as little as possible. There is an inc. risk of heap if these two drugs are combined.
  • Avoid foods containing tyramine, consult a dietitian to obtain a list of foods containing tyramine or histamine.
  • Have periodic medical check-ups, including an eye examination and blood test, to evaluate the drug effects.
  • Report for weakness, fatigue, loss of appetite, n/v, yellowing of skin or eyes, darkening of the urine, numbness or tingling in hands or feet,

Isoniazid (Niazid) Drug Study Original source at: Nurseslabs

Home Visits

The home visit is a family-nurse contact which allows the health worker to assess the home and family situations in order to provide the necessary nursing care and health related activities. In performing this activity, it is essential to prepare a plan of visit to meet the needs of the client and achieve the best results of desired outcomes.

Purpose of home visit

1. To give care to the sick, to a post partum mother and her newborn with the view teach a responsible family member to give the subsequent care.
2. To assess the living condition of the patient and his family and their health  practices in order to provide the appropriate health teaching.
3. To give health teachings regarding the prevention and control of diseases.
4. To establish close relationship between the health agencies and the public for the promotion of health.
5. To make use of the inter-referral system and to promote the utilization of community services

Principles involved in preparing for a homevisit

1. A home visit must have a purpose or objective.
2. Planning for a home visit should make use of all available information about the patient and his family through family records.
3. In planning for a home visit, we should consider and give priority to the essential needs if the individual and his family.
4. Planning and delivery of care should involve the individual and family.
5. The plan should be flexible.

Guidelines to consider regarding the frequency of home visits

1. The physical needs psychological needs and educational needs of the individual and family.
2. The acceptance of the family for the services to be rendered, their interest and the willingness to cooperate.
3. The policy of a specific agency and the emphasis given towards their health programs.
4. Take into account other health agencies and the number of health personnel already involved in the care of a specific family.
5. Careful evaluation of past services given to the family and how the family avails of the nursing services.
6. The ability of the patient and his family to recognize their own needs, their knowledge of available resources and their ability to make use of their resources for their benefits.

Steps in conducting home visits

1. Greet the patient and introduce yourself.
2. State the purpose of the visit
3. Observe the patient and determine the health needs.
4. Put the bag in a convenient place and then proceed to perform the bag technique.
5. Perform the nursing care needed and give health teachings.
6. Record all important date, observation and care rendered.
7. Make appointment for a return visit.

Bag Technique

The bag technique is a tool by which the nurse, during her visit will enable her to perform a nursing procedure with ease and deftness, to save time and effort with the end view of rendering effective nursing care to clients.

The public health bag is an essential and indispensable equipment of a public health nurse which she has to carry along during her home visits. It contains basic medication and articles which are necessary for giving care.

Principles of bag technique

1. Performing the bag technique will minimize, If not prevent the spread of any infection.
2. It saves time and effort in the performance of nursing procedures.
3. The bag technique can be performed in a variety of ways depending on the agency’s policy, the home situation, or as long as principles of avoiding transfer of infection is always observed.

Contents of the public health bag

• Paper lining
• Extra paper for making waste bag
• Plastic/linen lining
• Apron
• Hand towel
• Soap in a soap dish
• Thermometers (oral and rectal)
• 2 pairs of scissors (surgical and bandage)
• 2 pairs of forceps (curved and straight)
• Disposable syringes with needles (g. 23 & 25)
• Hypodermic needles (g. 19, 22, 23, 25)
• Sterile dressing
• Cotton balls
• Cord clamp
• Micropore plaster
• Tape measure
• 1 pair of sterile gloves
• Baby’s scale
• Alcohol lamp
• 2 test tubes
• Test tube holders
• Solutions of:
  • Betadine
  • 70% alcohol
  • Zephiran solution
  • Hydrogen peroxide
  • Spirit of ammnonia
  • Ophthalmic ointment
  • Acetic acid
  • Benedict’s solution

*Sphygmomanometer and stethoscope are carried separately.

Important points to consider in the use of the bag

1. The bag should contain all the necessary articles, supplies and equipments that will be used to answer the emergency needs
2. The bag and its contents should be cleaned very often, the supplies replaced and ready for use anytime.
3. The bag and its contents should be well protected from contact with any article in the patient’s home. Consider the bag and its contents clean and sterile, while articles that belong to the patients as dirty and contaminated.
4. The arrangement of the contents of the bag should be the one most convenient to the user, to facilitate efficiency and avoid confusion.

Steps in Performing the Bag Technique Action

1. Upon arrival at the patient’s home, place the bag on the table lined with a clean paper. The clean side must be out and the folder part, touching the table. Rationale: To protect the bag from getting contaminated.
2. Ask for a basing of water or a glass of drinking water if tap waster is not available. Rationale: To be used for hand washing.
3. Open the bag and take out the towel and soap. Rationale: To prepare for hand washing.
4. Wash hands using soap and water, wipe to dry. Rationale: To prevent infection from the care provider to the client.
5. Take out the apron from the bag and put it on with the right side out Rationale: To protect the nurse’s uniform.
6. Put out all the necessary articles needed for the specific care. Rationale: To have them readily accessible
7. Close the bag and put it in one corner of the working area. Rationale: To prevent contamination
8. Proceed in performing the necessary nursing care treatment. Rationale: To give comfort and security and hasten recovery
9. After giving the treatment, clean all things that were used and perform hand washing. Rationale: To protect the caregiver and prevent infection
10. Open the bag and return all things that were used in their proper places after cleaning them.
11. Remove apron, folding it away from the person, the soiled side in and the clean side out. Place it in the bag.
12. Fold the lining, place it inside the bag and close the bag
13. Take the record and have a talk with the mother. Write down all the necessary data that were gathered, observations, nursing care and treatment rendered. Give instructions for care of patients in the absence of the nurse. Rationale: For reference in the next visit.
14. Make appointment for the next visit (either home or clinic) taking note of the date and time. Rationale: For follow-up care

Source: Public Heath Nursing Book

Home Visits & Bag Technique: Everything You Need to Know About Original source at: Nurseslabs

Generic Name:

Brand Name: Rifadin, Rimactane

General Action: Antibiotic, Antituberculotic (first line)

Stock Dose: Capsules-150,300mg; powder-600mg

Specific Action:

Inhibits DNA-dependent RNA polymerase activity in susceptible bacterial cells.

Indications of Rifampicin

• Treatment of Pulmonary TB in conjunction with at least one other effective antituberculotic.
• Neisseria meningitidis carriers, for asymptomatic carriers to eliminate meningococci from nasopharynx; not for treatment of meningitis.
• Unlabeled uses: Infections caused by Staphylococcus aureus and Staphylococcus epidermis, usually in combination therapy; gram-negative bacteremia in infancy; Legionella pneumophilia, not responsive to erythromycin; leprosy (in combination with dapsone); prophylaxis of meningitis caused by Haemophilis influenzae.

Contraindications of Rifampicin

• Contraindicated with allergy to any rifamycin, acute hepatic disease, lactation.
• Use cautiously with pregnancy (teratogenic effects have been reported in preclinical studies; safest antituberculous regimen for use in pregnancy is condidered to be rifampin, isoniazid, and ethambutol).

Adverse Effects of Rifampicin

• CNS: headache, drowsiness, fatigue, dizziness, inability to concentrate, mental confusion, generalized numbness, muscle weakness, visual disturbances.
• Dermatologic: Rash, pruritus, urticaria, flushing, reddish discoloration of body fluids—tears, saliva, urine, sweat, sputum.
• GI: heartburn, distress, anorexia, vomiting gas, cramps, diaarhea, hepatitis, pancreatitis.
• GU: hemoglobinuria, hematuria, renal insufficiency, acute renal failure, menstrual disturbances.
• Hematologic: eosinophilia, thrombocytopenia, transient leucopenia, hemolytic anemia, decreased Hgb, hemolysis.
• Other: pain in extremities, osteomalacia, myopathy, fever, flulike symptoms.

Nursing Responsibilities of Rifampicin

• Administer on an empty stomach, 1 hr before or 2 hr after meals.
• Administer in a single daily dose.
• Consult pharmacist for rifamoin suspension for patients unable to swallow capsules.
• Prepare patient for the reddish-orange coloring of body fluids (urine, sweat, sputum, tears, feces, saliva); soft contact lenses may be permanently stained; advise patients not to wear them during therapy.
• Warning: arrange for follow-up visits for liver and renal function tests, CBC, and ophthalmic  examinations.

Health Teachings During Rifampicin Therapy

• Teach client to take drug in a single daily dose. Take on an empty stomach, 1 hr before or 2 hrs after meals.
• Inform client to take this drug regularly; avoid missing any doses; do not discontinue this drug without consulting the health care provider.
• Tell client to have periodic medical checkups, including eye examinations and blood test, to evaluate the drug effects.
• Inform client that he may experience the drug’s side effects (especially the red colored secretion)
• Instruct client to see his physician if he experience fever, chills, muscle and bone pain, excessive tiredness or weakness, loss of appetite, N/V, yellowing of eyes/skin, unusual bleeding or bruising, skin rash or itching.
• Instruct client to remove contact lenses as they may discolor

Rifampicin Drug Study Original source at: Nurseslabs

Generic Name: Vitamin A

Brand Name: Aquasol A

General Action

Vitamin A is effective for treatment of conditions such as acne or lung diseases, or for treatment of eye problems, wounds, or dry or wrinkled skin not caused by lack of vitamin A has not been proven. Although vitamin A is being used to prevent certain types of cancer, some experts feel there is not enough information to show that this is effective, particularly in well-nourished individuals.

Indication

Vitamin A injection is effective for the treatment of vitamin A deficiency.

Side Effects

Anaphylactic shock and death have been reported using the intravenous route. Allergic reactions have been reported rarely with administration of AQUASOL A Parenteral including one case of an anaphylactoid type reaction. Vitamin A toxicity can cause growth retardation, hair loss and enlarged spleen and liver in its more severe form. Vitamin A overdose can also cause birth defects and has been linked to increased risk of bone fractures in some people.

Contraindication:

In Pregnancy: Safety of amounts exceeding 6,000 Units of vitamin A daily during pregnancy has not been established at this time. The use of vitamin A in excess of the recommended dietary allowance may cause fetal harm when administered to a pregnant woman. Animal reproduction studies have shown fetal abnormalities associated with over-dosage in several species. Malformations of the central nervous system, the eye, the palate, and the urogenital tract are recorded. Vitamin A in excess of the recommended dietary allowance is contraindicated in women who are or may become pregnant. If vitamin A is used during pregnancy, or if the patient becomes pregnant while taking vitamin A, the patient should be apprised of the potential hazard to the fetus.

Stock Dose

50,000 USP Units (15 mg retinol/mL)

Nursing Responsibilities:

• Teach the family about the Vitamin A toxicity
• Caution pregnant patient about the taking of vitamin A
• Teach patient that over consumption of vitamin A can cause nausea, irritability and blurred vision.
• Teach patient that Vitamin A must be avoided from direct sunlight exposure
• Instruct patient/family that if there is a sign of over dosage of vitamin A, it must be reported immediately to the physician.

Vitamin A Original source at: Nurseslabs

Generic name

Brand name: Septra (GSK), Bactrim (Roche)

Drug class: Sulfonamide antibiotic

Actions

Trimethoprim inhibits the synthesis of nucleic acids and proteins in susceptible bacteria; the bacterial enzyme involved in this reaction is more readily inhibited than the mammalian enzyme.

Sulfamethoxazole acts as a false-substrate inhibitor of dihydropteroate synthetase. Sulfonamides such as sulfamethoxazole are analogues of p-aminobenzoic acid (PABA) and are competitive inhibitors of the enzyme; inhibiting the production of dihydropteroic acid.

Indications

• Uncomplicated UTIs caused by susceptible strains of Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter species, and coagulase-negative Staphylococcus species, including S. Saprophyticus.
• Treatment of acute otitis media due to susceptible strains of S. Pneumoniae and Haemophilus influenzae in children.
• Unlabeled uses: With dapsone for treatment of initial episodes of Pneumocystis jiroveci (carinii) pneumonia in patients who can tolerate co-trimoxazole; treatment and prevention of traveller’s diarrhea.

Contraindications

• Contraindicated with allergy to trimethoprim and sulfamethoxazole, pregnancy (teratogenic in pre-clinical studies), megaloblastic anemia due to folate deficiency.
• Use cautiously with hepatic or renal impairment, lactation.

Available forms

Tablets – 100, 200 mg

Side Effects

• Rash
• Pruritus
• Fever
• Epigastric distress
• Nausea
• Vomiting

Nursing considerations

• Perform culture and sensitivity tests before beginning drug therapy.
• Protect the 200mg tablets from exposure to light.
• Arrange for regular, periodic blood counts during therapy.
• Discontinue drug and consult with physician if any significant reduction in any formed blood element occurs.

Co-Trimoxazole Original source at: Nurseslabs

Brand name: Vermox

Classifications: Antihelmintic

Therapeutic Actions

Irreversibly blocks glucose uptake by susceptible helminthes, depleting glycogen stores needed for survival and reproduction of helminths, causing death.

Indications

Treatment of Trichus trichiura (whipworm), Enterobius vermicularis (pinworm), Ascaris lumbricoides (roundworm), Ancylostoma duodenale (common hookworm), Necator anericanus (American hookworm).

Contraindications

Contraindicated with allergy to mebendazole, pregnancy (embryotoxic and teratogenic; avoid use, especially during first trimester). Use cautiously with lactation.

Adverse Effects

• GI: transient abdominal pain, diarrhea
• Other: fever
• Chewable tablets- 100mg
• Assess for pregnancy, lactation and allergy to mebendazole.
• Assess for temperature, bowel sounds and output.
• Culture for ova and parasites.
• Ad mister drug with food; tablets may be chewed, swallowed whole, or crushed and missed with food.
• Arrange for second course of treatment if patient is not cured 3weeks after treatment.
• Treat all family members for pinworm infestation.
• Disinfect toilet facilities after patient use. (pinworm)
• Arrange for daily laundry of bed linens, towels, nightclothes, and undergarments. (pinworm)
• Brown colored urine

Stock Dose

• Chewable tablets- 100mg

Nursing Responsibilities

• Assess for pregnancy, lactation and allergy to mebendazole.
• Assess for temperature, bowel sounds and output.
• Culture for ova and parasites.
• Ad mister drug with food; tablets may be chewed, swallowed whole, or crushed and missed with food.
• Arrange for second course of treatment if patient is not cured 3weeks after treatment.
• Treat all family members for pinworm infestation.
• Disinfect toilet facilities after patient use. (pinworm)
• Arrange for daily laundry of bed linens, towels, nightclothes, and undergarments. (pinworm)
• Give via side drip

Mebendazole Drug Study Original source at: Nurseslabs

Generic Name: streptomycin sulfate

General Action: Antibiotic, anti-tubercular,anti-infective

Specific Action

Inhibits CHON synthesis strains of gram negative bacteria, mechanisms of lethal action and fully understood, but functional integrity of cell membrane appears to be disrupted.

Indication

Infections caused by susceptible strain of mycobacterium tuberculosis.

Serious infections caused by susceptible strains of Yersinia Pestis

Contraindication

Allergy to aminoglycosides, pregnancy, lactation, Herpes vacinia fungal infection.

Stock Dose

1 gram* / vial
*Each vial contains Streptomycin Sulfate USP equivalent to 1 gram Streptomycin.

Nursing Responsibilities

• Use in route only: give by deep IM injection.
• Ensure adequate hydration of patient before and during the therapy.
• Monitor for hearing changes.
• This drug can only be given by injection.
• Report hearing changes,dizziness, pain at injection site, rash.

Streptomycin Drug Study Original source at: Nurseslabs

Generic name:

Brand name: Myambutol, Servambutol

Classification: Antituberculotic

Action

Ethambutol is bacteriostatic against actively growing TB bacilli, it works by obstructing the formation of cell wall. Mycolic acids attach to the 5′-hydroxyl groups of D-arabinose residues of arabinogalactan and form mycolyl-arabinogalactan-peptidoglycan complex in the cell wall. It disrupts arabinogalactan synthesis by inhibiting the enzyme arabinosyl transferase. Disruption of the arabinogalactan synthesis inhibits the formation of this complex and leads to increased permeability of the cell wall.

Indication

Ethambutol eliminates certain bacteria that cause tuberculosis (TB). It is used with other medicines to treat tuberculosis and to prevent you from giving the infection to others.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Side-effects

• loss of appetite
• upset stomach
• vomiting
• numbness and tingling in the hands or fee
• optic neuritis–blurring of vision

Contraindication

Ethambutol hydrochloride is contraindicated in patients who are known to be hypersensitive to this drug. It is also contraindicated in patients with known optic neuritis unless clinical judgemnet determines that it may be used. Ethambutol hydrochloride is contraindicated in patients who are unable to appreciate and report visual side ettects or changes in vision (eg, young children, unconscious patients).

Stock Dose

100mgs

Nursing Responsibilities

• Assess patient for infection (appearance of wounds, sputum, VS, urine and stool and WBC.) at beginning and during therapy.
• Obtain specimens before initiating therapy. Take drug as indicated.
• Not to be given to children 6 years below due to optic neuritis
• Provide supplemental vitamin A. if not contraindicated

Ethambutol Original source at: Nurseslabs