Clinical Medication Worksheet Karen Nielsen

Generic Name Trade Name Classification Dose Route Time/frequency

Folic acid Folate Water soluble 1mg PO QD

vitamin
Peak Onset Duration For IV meds, compatibility with IV drips and /or
solutions:
1 hr 30-60 min unknown N/A
Nursing Implications (what to focus on)
Why Med ordered: Contraindications/warnings/interactions:

Nutritional Supplement. Uncorrected pernicious, aplastic, or normocytic anemias

Prevention of megaloblastic and macrocytic anemias.
Mechanism of action and indications:
Required for protein synthesis and red blood cell function.
Stimulates the production of red blood cells, white blood
cells, and platelets.
Restoration and maintenance of normal hematopoiesis.
Interactions with other patient drugs, OTC or
herbal medicines (ask patient specifically):
Pyrimethamine, methotrexate, trimethoprim, and
triamterene prevent the activation of folic acid (leucovorin
should be used instead to treat overdoses of these drugs).
Absorption of folic acid is ↓ by sulfonamides (including
sulfasalazine), anatacids, and cholestyramine.
Folic acid requirements are ↑ by estrogens, phenytoin,
phenobarbital, primidone, carbamazepine, or
corticosteroids.
May ↓ phenytoin serum concentration.
(neurologic damage will progress despite correction of
hematologic abnormalities)
Use Cautiously in:
Undiagnosed anemias.
Common side effects:
Derm: rashes.
CNS: irritability, difficulty sleeping, malaise, confusion.
Misc: fever.
Lab value alterations caused by medicine:
Monitor plasma folic acid levels, hemoglobin, hematocrit, and
reticulocyte count before and periodically during therapy.
May cause ↓ serum concentrations of other B complex vitamins
when given in high continuous doses.
Be sure to teach the patient the following about this
medication:
Explain that the best source of vitamins is a well-balanced diet with
foods from the four basic food groups. Foods high in folic acid include
vegetables, fruits, and organ meats; heat destroys folic acid in foods.
Patients should be cautioned not to exceed RDA.
Explain that folic acid may make urine more intensely yellow. .
Instruct patient to notify health care professional if rash occurs,
which may indicate hypersensitivity.
Emphasize the importance of follow-up exams to evaluate progress.

Nursing Process- Assessment Assessment Evaluation

(Pre-administration) Why would you hold or not give this Check after giving
Assess for signs of megaloblastic anemia med?
(fatigue, weakness, dyspnea) before therapy. Hypersensitivity-rash, labs showing No signs of megaloblastic
uncorrected pernicious, aplastic, or anemia.
normocytic anemias.