BPPV Case
BPPV Case
BPPV Case
Antipolo City
S COLLEGE OF NURSING
In Partial Fulfillment of the Requirements
For the Actual Clinical Hospital: Related Learning Experience
Affiliating Institution: Unciano Medical Center
SUBMITTED BY:
Camille Marasigan Daracan
(Student)
SUBMITTED TO:
MILAGROS JAVIER - NUEZ, RN, MAN
(Clinical Instructor)
INTRODUCTION
Benign Paroxysmal Positional Vertigo is listed as a "rare disease" by the Office of Rare
Diseases (ORD) of the National Institutes of Health (NIH). This means that Benign
Paroxysmal Positional Vertigo, or a subtype of Benign Paroxysmal Positional Vertigo,
affects less than 200,000 people in the US population. Prognosis of Benign Paroxysmal
Positional Vertigo: may last for weeks or months and then spontaneously disappear.
Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of
vertigo the sudden sensation that you're spinning or that the inside of your head is
spinning.
Benign paroxysmal positional vertigo causes brief episodes of mild to intense dizziness.
Benign paroxysmal positional vertigo is usually triggered by specific changes in the
position of your head. This might occur when you tip your head up or down, when you
lie down, or when you turn over or sit up in bed.
Although benign paroxysmal positional vertigo can be a bothersome problem, it's rarely
serious except when it increases the chance of falls.
GENERAL OBJECTIVES
To be able to come up with an understanding of the disease process and
formulate a comprehensive nursing care plan using the specific objectives nursing
process.
SPECIFIC OBJECTIVES
1. To review the anatomy and physiology of the disease.
2. To practice nursing assessment during data gathering.
3. To prioritize identified health problems of the patient.
4. To understand the pathophysiology of it.
5. To know the medical treatment such as the medications and laboratory works
involved.
6. To know the importance of laboratory and diagnostic procedure.
7. To know the nursing management of the disease.
I.
PATIENTS PROFILE
Name
Address
: Tanay,Rizal
Age
: 57 years old
Birthday
Gender
: Female
Civil Status
: Single
Religion
: Roman Catholic
Nationality
: Filipino
Chief Complaint
: Dizziness
Impression
Admission Date
Admission Time
: 2:18 pm
II.
NURSING HISTORY
III.
IV.
V.
Social/Environmental/Personal History
The patient is not a smoker even the other family member in their house do not
smoke also she did not drinking liquor. They live in a village with no open drainage
surrounded with trees and houses. Patient owns a sari-sari store.
VI.
immune system.
Before
Hospitalization
Patient Health
During
Analysis
Hospitalization
She is aware of her
situation she
weakness prior to
Problem
wanted to heal as
admission her
soon as possible.
feeling of being
took a medicine
healthy unsatisfied.
Nutritional-
afraid.
The patient usually
There is a change
Metabolic Pattern
in eating pattern of
the patient.
meal.
meat.
Patient usually
Elimination Problem
Her elimination
Activity and
breakfast 4 to 5
4 to 5 times a day
times.
Patient habit of
Patient is always
affected.
She is only
Exercises Pattern
exercise is walking
every day.
He has a regular
exercises at all.
The patient is
sleeping pattern.he
sleeping.
Due to adherence
up at 10:00pm,
12:00nm,and
3:00am then she
Cognitive and
sleep again.
The patient is aware The patient is aware The patient is aware
Perceptual Pattern
of the
of the time,
on his health
time,place,whre she
place,where she is
condition and
follows doctors
name.
name.
advice and
condition. He
realizes the
importance of
maintaining health
Self- Perception/
lifestyle.
Persons self
Self- Concept
to express his
concept affected by
feelings. He is
contented seeing
as illness, stressors,
Role- Relationship
care.
She was able to do
Pattern
her responsibilities
being a mother to
he is not aware of
as a mother.
met.
The patients always
of responding to a
television.
problem.
changing
environment.
He is not sexually
sexually active.
active.
Coping Stress
Sexual
etc.
avtivity.
Reproductive
Pattern
Values- Belief
The patients
Spiritual and
Pattern
religious affiliation is
a Roman
condition. The
a significant role in
her.
unchanged.
PHYSICAL EXAMINATION
Date assessed: September 14, 2016
Initial vital signs: T= 36.0 C, PR= 76 bpm, RR= 15 cpm, BP= 140/90 mmHg.
Physical
Actual finding
Analysis
assessment
I.
Head
Palpation
Head is
Symmetric in
Normal
symmetric,
in the midline. No
in midline. no
Visible lesions.
lesions are
A. Hair
Inspection,
visible.
Black evenly
palpation
distributed and
evenly distributed
whole scalp.
B. Face
C. Eyes
Inspection
Inspection
split ends.
Oval, square or
Round in shape.
Pale
heart shape.
Absence of
appearance
Symmetry and
involuntary
Facial
no involuntary
muscle. Face is
expression
muscle.
and irritable
anxiety and
due to his
Parallel and
irritable
Eyes are black in
condition.
Normal
evenly placed,
color, Parallel
symmetrical.
inposition and
none protruding
with scant
shape.
amount of
secretions, both
eyes black and
D. Ears
Inspection
clear.
Position of the
Normal
ears is line up
The color is
shape is
proportional to the
facial color.
face
Shape is
proportion to the
face; no
drainage,
nodules or
E. Nose
F. Mouth
Inspection/
lesions.
Midline and
Palpation
Inspection
Nose is in the
normal
nasal opening.
Presence of
there is no nasal
nasal folds.
discharges.
Dry lips
smooth and
caused by
dry.
dehydration.
any discharges.
3 molar, 2
Complete teeth
Patient is
premolar, 1
using fake
moist and
pinkish without
G. Teeth
Inspection
canine and 1
H. Inspectio Inspection/
n
II.
palpation
Align well.
central incisor.
broken year
foul odor
passed by.
Proportion to the
Proportion to the
symmetrical in
No tenderness
shape, palpable
present.
Scapula are
Thor
Inspection,
masses.
Scapula are
ax
palpation,
symmetric and
symmetric and no
and
percussion,
no protruding.
protrusion. No
lungs
auscultation
accessory muscle
accessory
use during
muscle in
breathing. no
breathing. No
tenderness, pain.
:
A. Posterior
thorax
tenderness, pain.
has a normal
breath sound
B. Anterior
thorax
teeth due to
Inspection,
and pattern.
Sternum is
Sternum located at
palpation,
positioned at the
Normal
Normal
percussion,
midline and
straight. Relaxed,
auscultation
straight.
respiration is
during respiration.
relaxed,
No use of
effortless and
accessory muscle.
quite. Use of
accessory
muscle is not
seen with normal
respiratory effort.
No tenderness or
pain palpated.
C. Breathin
g
Inspection,
Respiratory rate
Respiratory rate of
Patient
Auscultation
of 12 to 20
19 per minute
breathing
counts per
pattern is
minute. Lung
normal.
D. Heart
Rate
Palpation
bilaterally.
Heart rate of 60
Heart rate of 78
Patient known
hypertensive
minute. Blood
And blood
bp of 140/90
pressure is
pressure of 140/90
is normal to
within 90-120/
E. Breast
F. Abdome
n
her.
Inspection,
60-90 mmhg
Texture is
palpation
smooth with no
edema. Areolas
in texture. Areolas
dark brown.
color. there is no
nipples are
tenderness upon
equally bilateral
palpation.
Inspection,
in size
Abdomen is free
Abdomen has
palpation,
from lesions,
auscultation,
tenderness or
percussion
pain and
palpable
heard on
masses.
auscultation.
Normal.
Normal
Umbilicus is free
from swelling
bulge and
G. Lower
extremiti
es:
A. Legs
Inspection,
masses.
Skin color varies
He has brown
palpation
complexion,no
range, skin is
lesions, absence
smooth no
of varicose veins
lesions, absence
and there is
Normal
of varicose
presence of good
muscle tone.
is presence of
good muscle
H. Mental
Status
Listening,
tone.
The patient
Patient is awake
Observation
should be
and cooperative
conscious and
upon assessment.
aware in her
surroundings.
Normal
The inner ear (internal ear, auris interna) is the innermost part of the vertebrate ear. In
vertebrates, the inner ear is mainly responsible for sound detection and balance. [1] In
mammals, it consists of the bony labyrinth, a hollow cavity in the temporal bone of the
skull with a system of passages comprising two main functional parts:[2]
The cochlea, dedicated to hearing; converting sound pressure patterns from the outer
ear into electrochemical impulses which are passed on to the brain via the auditory
nerve.
The vestibular system, dedicated to balance
The inner ear is found in all vertebrates, with substantial variations in form and function.
The inner ear is innervated by the eighth cranial nerve in all vertebrates.
PATHOPHYSIOLOGY OF OTOCONIA
Precipitating factor:
Predisposing
factor:
8
Age (57)
Female
Behavior
Environment
Life style
Otoconia
Signs and
symptoms:
-
Spinning
dizziness
Can be
induced by a
change
position.
Nausea
Feeling faint
or fainting.
DRUG STUDY
Sensation of vertigo.
PhARMACOKINETICS
PHARMACODYNAMICS
PHARMACOTHERAPEUTICC
Generic Name:
Indication
Nursing responsibilities
Serc
Classification:
deafness
intensity, duration,
Tablet:
Contraindication
8mg,16mg,24mg
Previoushypersensitive
Mechanism of action:
Adverse Effect
Itis readilyabsorbedfrom
-Urticarial
thegastrointestinal tract. It
-Pruritus
isconverted
-Mildgastriccomplaints
totwometabolitesand
-False heartbeat
peakconcentrations in blood
-Insomnia
of the twometabolitesare
achievedwithin 3 to 5hours.
Mostof a dose isexcreted
inthe urine, inthe form of
themetabolites,in about
3days.Themechanismof
action of betahistine isnot
known.Pharmacological
discontinued.
teach patient to recognized
signs of chronic overdose:
bleeding, bruising, malaise,
PHARMACOKINETICS
Generic Name:
Stugeron
PHARMACODYNAMICS
Indication
Control of vestibular
PHARMACOTHERAPEUTIC
Nursing responsibilities:
-
Administer medication
Brand Name:
symptoms of both
Cinnarizine
meal.
Provide quite room.
Classification:
Dosage:
vomiting.
simultaneous intake of
25mg
Prophylaxis of motion
Frequency:
sickness.
TID
Mechanism Of Action:
symptoms of peripheral
Cinnarizine inhibits
arterial disease.
contractions of vascular
smooth muscle cells by
blocking calcium
Contraindication
In patients with known
channels. Cinnarizine
hypersensitivity to
increases erythrocyte
cinnarizine.
deformability and
in vitro. Cinnarizine
been established.
vestibular system.
Parkinson's disease.
Adverse Effect
drowsiness, sweating,
dry mouth, headache, skin
problems, lethargy,
gastrointestinal irritation,
hypersensitivity reactions,
as well as movement
problems/muscle rigidity,
and tremor.
Diagnosis
Disturbed
Planning
After several
Nahihilo ako.
sensory
hours of
relaxation
hours of
As verbalized
perception
nursing
techniques,
nursing
by the patient.
related to
intervention
music
intervention the
otoconia As
therapy, and
patient will be
manifested
be able to
meditation to
able to report
by dizziness.
report
prepare for
improvement
improvement
rest/sleep.
Provide calm,
and decreases
Objective:
- Pallor
- Fatigue
Intervention
Instruct in
Evaluation
After several
- Body
and
quiet
level of
weakness
decreases
environment
dizziness.
level of
and manage
dizziness.
controllable
sleepdisrupting
factors.
Administer
medication as
ordered by
her physician.
Listen to
clients /SOs
subjective
reports of any
abnormality
feeling.