Far Eastern University Institute of Nursing

Submitted by: Pascua, Angelique R. BSN 301 Group 4

Name and Age of Patient:Mary Rose Morales, 37 y/o Chief Complaint: Difficulty of Breathing Initial/Final Diagnosis: PTB5, Bronchiectasis Drug Study

Name of Drug Ipatropium Bromide + Salbutamol

Dosage/ Classifica Indication Frequency tion 1 neb q 6o BetaTo relieve adrenergi bronchoc agonist spasm (sympatho mimetic); bronchodilator

Contraindication Contraindicated with patients who have hypersensitivity to albuterol, tachyarrythmias, tachycardia, unstable vasomotor system disorder, coronary insufficiency, CAD, history of stroke, COPD patient with degenerative heart disease.

Side effects

Nursing Responsibilities Patient may Assess for experience the hypersensitivity and following side other effects: contraindications. Dizziness, Teach patient and drowsiness, SO not to exceed headache, recommended fatigue, dosage, adverse nausea,vomiting, effects or loss of change in taste, effectiveness may rapid heart rate, result. sweating, Teach patient and anxiety, flusing, SO to report insomnia. dizziness, insomnia, chest pain, weakness, tremors, irregular heartbeat, difficulty breathing, productive cough, failure to respond to usual dosage.

Hydrocorti sone

100mg IV q6o

Corticosteroid, short acting Glucocorti costeroid Adrenal Corticoste roid Hormone

Allergic statessevere or incapacitati ng allergic conditions, short-term inflammato ry and allergic disorders, such as rheumatoid arthritis, collagen

Contraindicated with allergy to any component of the drug, fungal infections, amebiasis, hepatitis B, vaccinia, or varicella, and antibiotic resistant infections, immunosupression

Increase in appetite, weight gain (some of gain may be fluid retention, monitor intake), heartburn, indigestion (eat frequent small meals, use of antacids may help), increased susceptibility to infections(avoid crowds during

Monitor therapeutic effectiveness which is indicated by significant subjective improvement in pulmonary function within 6090 min after drug administration. Teach patient and SO not to use OTC drugs without physician approval. Many medications (e.g., cold remedies) contain drugs that may intensify albuterol action. Give daily before 9 am to mimic normal peak diurnal corticosteroid levels and minimize HPA suppression Space multiple doses evenly throughout the day. Take this drug exactly as prescribed. Do not stop taking this drug without notifying your healthcare

disease, dermatolog ic diseases, status asmaticus, and autoimmun e disorders

peak coold or flu provider, slowly seasons, and taper dosage to avoid anyone avoid problems with a known Dosage reduction infection), poor may create adrenal wound healing(if insufficiency. Report injured or any fatigue, muscle wounded, and joint pains, consult anorexia, nausea, healthcare vomiting, diarrhea, provider), muscle weight loss, weakness, weakness, fatigue(frequent dizziness, low blood rest periods may sugar ( if you help) monitor blood glucose) Take with meals, or snacks if GI upset occurs frequent follow-up visits to your healthcare providerare needed to monitor drug response and adjust dosage. report any unusual weight gain, swelling of lower extremeties, muscle weakness, black or tarry stools, vomiting of blood, epigastric burning,

Doxofylline

400mg tab BID

Antiasthmatic Bronchodi lator Antittussiv e

Treatment of bronchial asthma, and pulmonary disease with spastic bronchial component

Hypersensitivity to doxofylline, hypotension and myocardial infarction

Nausea, vomiting, epigastric pain

puffing of face, menstrual irregularities, fever, prolonged sore throat, cold or other infection, worsening of symptoms >may be takenwith or withoutfood.>store at roomtemperature notexceeding 30C Assess lung sounds, pulse and blood pressure before administration and during peak of medication. Not amount, color, and character of sputum produced. function tests before initiating therapy and periodically during therapy to determine effectiveness of medication. paradoxical bronchospasm (wheezing). If conditions occur,

Digoxin (Lanoxin)

0.25 mg tab OD

Cardiac glycoside

CHF Atrial Fibrillation

Hypersensitivity to other digitalis glycosides. Intermittent complete heart block or 2nddegree AV block esp if there is a history of Stokes-Adams attacks; arrhythmia caused by cardiac glycoside intoxication, supraventricular arrhythmia caused by Wolff-Parkinson-White syndrome; ventricular tachycardia or fibrillation; hypertrophic obstructive cardiomyopathy; renal insufficiency, electrolyte imbalance (decreased K, decreased Mg, increase Ca).

Nausea, vomiting, diarrhea, loss of appetite; feeling weak or dizzy; headache, anxiety, depression; enlarged breasts in men; or mild skin rash.

withhold medication and notify physician of other health care professional immediately Assess allergy to digitalis preparation, ventricular fibrillation, ventricular tachycardia, heart block, sick sinus syndrome and other contraindications. Monitor apical pulse for 1 miute before administering. Hold dose if <60. if adult pulse remains <60 hold drug and notify physician. Monitor for therapeutic drug levels. Encourage patient not to stop taking the drugs without notifying health care provider. Weigh patient every other day, with the same clothing and at the same time

Isosorbidemononitrat e (Imdur)

30 mg tab OD

Antianginal, Nitrate, Vasodilator

Prevention of angina pectoris

Contraindicated with allergy to nitrates, severe anemia, head trauma, cerebral hemorrhage, hypertrophic cardiomyopathy, narrow-angle glaucoma, postural hypotension

Report unusual slow pulse, irregular pulse,rapid weight gain, loss of appetite, nausea, vomiting, diarrhea, blurred or yellow vision, unsual tiredness or weakness, swelling of the ankles, legs or fingers, and difficulty of breathing Dizziness, Assess patient for lightheadedness, allergy to nitrates, GI headache, hypermobility, flushing of the anemia, head neck or face. trauma, cerebral hemorrhage, hypertrophic cardiomyopathy. Give sublingual preparations under the tongue or in the buccal pouch; discourage the patient from swallowing,. Create a nitrate free period to minimize tolerance. Keep life support equipment readily

Cefuroxime 750mg TIV q8o

Antibiotic Secondgeneration

Lower respiratory infections caused by

Hypersensitivity to cephalosporins and related antibiotics;

Stomach upset or diarrhea

available if overdose occurs or cardiac condition worsens. Gradually reduce dose if angina treatment is terminated; rapid discontinuation can lead to problems of withdrawal. Teach patient to place sublingual tablets under the tongue or cheek; do not chew, crush, or swallow the tablet. Take the isosorbide before chest pain begins, when activities or situation may precipitate an attack. Instruct patient to report blurred vision, persistent or severe headache, and rash, more frequent or more severe angina attacks, fainting. Determine history of hypersensitivity reactions to cephalosporins,

cephalosporin

S. pneumonia . S. aureus, E.coli, Klebsiella. H. influenza. S. pyogenes

Celecoxib (Celebrex)

200 mg/cap 1 cap BID per orem

Nonsteroi dal AntiInflammat ory Drugs (NSAIDs) Analgesic

Management of acute pain

Patients with the following conditions are not advise to take celebrex: *Allergies to sulfonamides,celecoxi

Patient may experience dizziness, or drowsiness.

penicillins, and history of allergies, particularly to drugs, before therapy is initiated. Inspect IV injection sites frequently for signs of phlebitis. Have vit. K available incase hypothrombinemia occurs Intruct patient to avoid alcohol while taking this drug and for 3 days after because severe reactions often occur. Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes. Assess patient for allergy to sulfonamides, aspirin, or NSAIDS. Patients with these allergies should not

(Non opioid)

b, NSAIDs, or aspirirn *significant renal impairment *lactation/pregnancy *Asthma, urticaria *Treatment of peri-op pain in the setting of CABG surgery.

receive celecoxib. Administer drug with food or after meals if GI upset occurs. Establish safety measures if CNS or visual disturbances occur. Provide further comfort measures to reduce pain (e.g. positioning, environmental control) and to reduce inflammation (e.g. warmth, positioning, and rest). Instruct patient to take celecoxib exactly as directed. Do not take more than prescribed dose. Increasing doses does not appear to increase effectiveness. Advise patient to notify health care professional promptly if signs or symptoms of GI toxicity (abdominal

Acetylcyst eine (Fluimucil)

600 mg 1 tab x 3 doses OD

Mucolytic

Acute & chronic respiratory tract infections w/ abundant mucus secretions due to bronchiect asis

Contraindicated with Productive hypersensitivity to cough, nausea. acetylcysteine. GI upset. As Acetylcysteine (Fluimucil) granules and tablets contain aspartame, it is contraindicated in patients suffering from phenylketonuria

pain, black stools), skin rash, unexplained weight gain, edema occurs. Patient should discontinue celecoxib and notify health care professional if signs and symptoms of hepatotoxicity (nausea, fatigue, lethargy, pruritus, jaundice, upper right quadrant tenderness, flu-like symptoms) occur. Assess for history of hypersensitivity to acetylcysteine and asthma. Dissolve the tablets in a glass containing a small quantity of water, mixing it, if necessary, with a spoon. Do not to mix other drugs with the Acetylcysteine (Fluimucil) solution. Patients suffering from bronchial

Multivitam ins (Centrum)

1 Tab OD

Vitamis and/or Minerals

Prevention & treatment of vit & mineral deficiencie s.

Hypersensitivity

When taken as directed, multivitamins and minerals are not expected to cause serious side effects. Less serious side effects of

asthma must be strictly monitored during the therapy. Should bronchospasm occur, the treatment must be suspended immediately. It should be used with caution in asthmatic patients and patients with a history of peptic ulceration. The possible presence of a sulfurlike odor does not indicate an alteration of the product but is a characteristic of the active ingredient contained in the preparation. Report difficulty of breathing or nausea. Administer with or without food. May be taken w/ meals for better absorption or if GI discomfort occurs Instruct patient never take more than the

multivitamin with minerals may include: stomach upset, headache, or unusual or unpleasant taste in your mouth.

recommended dose of multivitamins and minerals. Instruct patient not take this medication with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain ingredients of the multivitamin.