Académique Documents
Professionnel Documents
Culture Documents
Peoria, Illinois
Date 2/14/2013
Allergies:
MEDICATION/
CLASSIFICATION
USUAL DOSE/SAFE DOSE
Acetaminophen (TYLENOL)
Dose: 650 mg
Freq: Q4H PRN
Route: Oral
OR
Acetaminophen (TYLENOL)
Dose: 650 mg
Freq: Q4H PRN
Route: Rectal
Class: Analgesic, antipyretic
Safe: no more than 4000 mg
Clients Initials GC
DESIRED EFFECT
NURSING IMPLICATIONS
Pain, fever
Adverse Effects
- constipation, N, V,
headache, liver failure,
Stevens-Johnson syndrome
Bisacodyl Suppository
Dose: 10 mg
Freq: Daily PRN
Route: Rectal
Class: laxative, stimulant
Safe: 10 mg as single dose
Constipation
Enoxaparin (LOVENOX)
Dose: 40 mg
Freq: Q24H-0700
Prevent DVT
Prevention of deep vein
thrombosis by preventing
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Form No. 691-0019 (7/97)
Stimulates peristalsis by
directly irritating the smooth
muscle of the intestine,
possibly the colonic
intramural plexus; alters
water and electrolyte
secretion producing net
intestinal fluid accumulation
and laxation
Monitor
-Neuro/mental status
- pain relief
- hepatic tests, liver enzymes
- body temp, reduction of
fever Pain
- Blood studies
- I & O ratio
- Allergic reactions
- Do not exceed
recommended dosage
- Toxicity includes s/s of N/V,
abdominal pain
Teaching
- no more than 4000mg in
24hrs
- report s/s of GI hemorrhage,
hepatotoxicity, nephrotoxcitiy
- take with full glass of water
- do not drink alcohol
Adverse Effects
-vertigo, electrolyte fluid
imbalance, mild abdominal
cramps, N/V, rectal burning
Monitor
-pain
-electrolyes
-I&O
-neuro status
Adverse Reactions
- D, N, anemia, bleeding,
thrombocytopenia, liver
EVALUATION OF DESIRED
EFFECT
conversion of fibrinogen to
fibrin and prothrombin to
thrombin by enhancing
inhibitory effects of
antithrombin III
Famotidine (PEPCID)
Dose: 20 mg
Freq: Q12H
Route: Intravenous
Class: Gastric Acid Secretion
Inhibitor, Histamine H2
antagonist
Safe: 20-80mg/day PO
Used for
GERD
Gastric Hypersecretion
Indigestion
Adverse Reactions
- thrombocytopenia,
headache, dizziness,
constipation, dysrhythmias, D
Other uses
Gastritis
GI hemorrhage
Urticaria
Stress ulcer; prophylaxis
Monitor
- epigastric and abdominal
pain and discomfort, GI
sounds, I&Os
- CBC panel, blood counts
- s/s of thrombocytopenia
Fentanyl (SUBLIMAZE)
Dose: 25 mcg
Freq: Q2H PRN
Route: Intravenous
OR
Fentanyl (SUBLIMAZE)
Dose: 25 mcg
Freq: Q2H PRN
Route: Subcutaneous
Class: Analgesic, Opioid
Safe: 50 mcg/ml subQ:
OR 25 mcg q15minutes (on
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Form No. 691-0019 (7/97)
Decrease pain
Decreased pain by binding to
opiate receptor sites within
the CNS.
Teaching
- drug must be continued for
prescribed time in prescribed
method
- report bleeding, bruising
- no smoking
- increase bulk and fluid
Adverse Effects
- site reaction, pruritius,
abdominal pain, constipation,
D, N, V, confusion,
nervousness, dizziness,
headache,anxiety,
depression, hallucinations,
urinary retention, dyspnea,
Upper Resp Infection, fatigue,
apnea, resp depression,
cough, chest pain
Monitor
Glucose (GLUTOSE)
Dose: 15 g
Freq: PRN
Route: Oral
Class: Antidote, hypoglycemia
Safe: 10-20 g single dose,
repeat in 10 minutes if
necessary
Hydralazine (APRESOLINE)
Dose: 10 mg
Freq: Q4H PRN
Route: Intravenous
Class: Peripheral Vasodilator
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Form No. 691-0019 (7/97)
Dextrose, a monosaccharide,
is a source of calories and
fluid for patients unable to
obtain an adequate oral
intake; may decrease body
protein and nitrogen losses;
promotes glycogen
deposition in the liver. When
used in the treatment of
hyperkalemia (combined with
insulin), dextrose stimulates
the uptake of potassium by
cells, especially in muscle
tissue, lowering serum
potassium.
Teaching
- report use of MAO inhibitor
within last 14 days prior to
therapy
- avoid activities until effects
known
- report absence of pain relief
or constipation
- report s/s of resp
depression, hypoventilation
- do not stop drug suddenly
- do not use OTC drugs
- avoid alcohol or other CNS
depressants
Adverse Effects
-edema, dehydration, venous
thrombosis, mental
confusion, unconsciousness,
polyuria, diarrhea, nausea,
vein irritation, pain
Monitor
-neuro/mental status
-pain
-I&O
-skin turgor
Adverse Effects
- chest pain, palpitations,
tachycardia, D, N, V,
headache, agranulocytosis,
heaptoxicitiy, leucopenia
Monitor
- reduction in S and D BP,
monitor BP frequently
- CBC with diff at baseline and
during therapy
- body wt, I&Os,
- Temp, RR, bowel sounds,
voiding pattern
- kidney function tests,
urinalysis
- LOC, reflexes, lymph node
palpation
Teaching
- report chest pain,
palpitations, dyspnea, s/s of
tachyarrhythmia, neuropathy,
hypoTN, agranulocytosis,
heapatoxicity
- take exactly as prescribed
- take with food
Hydrocodone-acetaminophen
(NORCO)
Dose: 1 Tab
Freq: Q6H PRN
Route: Oral
Class: Analgesic combination,
Opioid
SafeL 5-10 mg qid
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Form No. 691-0019 (7/97)
Decrease pain
Hydrocodone, as with other
narcotic (opiate) analgesics,
blocks pain perception in the
cerebral cortex by binding to
specific receptor molecules
(opiate receptors) within the
neuronal membranes of
synapses. This binding
results in a decreased
synaptic chemical
transmission throughout the
CNS thus inhibiting the flow
of pain sensations into the
higher centers. Mu and kappa
are the two subtypes of the
opiate receptor which
hydrocodone binds to cause
analgesia.
Acetaminophen inhibits the
synthesis of prostaglandins in
the CNS and peripherally
blocks pain impulse
generation; produces
antipyresis from inhibition of
hypothalamic heat-regulating
center.
Adverse Effects:
-hypotension, bradycardia,
cardiac arrest, dizziness,
drowsiness, mood changes,
rash, urinary retention,
abdominal pain, constipation,
heartburn, nausea
Monitor
-BP, pulse
-neuro/mental status
-I&O
-pain
-bowel sounds
Labetalol (NORMODYNE,
TRANDATE)
Dose: 20 mg
Freq: Q4H PRN
Route: Intravenous
Class: alpha- and betaadrenergic blocker,
antihypertensive
Metoclopramide (REGLAN)
Dose: 10 mg
Freq: Q6H
Route: Intravenous
Class: antiemetic, dopamine
antagonist
Safe: PO: 10-15mg up to
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Form No. 691-0019 (7/97)
Competitively blocks alpha 1and beta 1- and beta 2adrenergic receptors, and has
some sympathomimetic
activity at beta 2-receptors.
Alpha- and beta-blocking
actions contribute to the BPlowering effect; beta
blockade prevents the reflex
tachycardia seen with most
alpha-blocking drugs and
decreases plasma renin
activity
Adverse Effects
-tacycardia, palpation,
fatigue, headache, mental
confusion, hypoglycemia,
nausea, blurred vision
Monitor
-neuro/mental status, glucose
level, pulse, BP
Adverse Effects
- hypoTN, N, dizziness, nasal
congestion, fatigue, heart
failure, hyperkalemia,
hepatotoxicity, bronchospasm
Monitor
- BP
- hepatic function tests
- exacerbation of angina
pectoris
Teaching
- take drug with meals
- do not stop drug unless
instructed to
- report difficulty breathing,
night cough, confusion,
swelling of extremities, slow
HR, sore throat
- diabetic patients: drug may
mask usual symptoms of
hypoglycemiamonitor
glucose carefully
- avoid activity until effects
known
Adverse Reaction
- fluid retention, N, V,
headache, fatigue,
neuroleptic malignant
syndrome, tardive dyskinesia
Monitor
-CNS/Mental status
Ondansetron (ZOFRAN)
Dose: 4 mg
Freq: Q12H PRN
Route: Intravenous
Class: Antiemetic, Serotonin
Receptor Antagonist, 5-HT3
Safe: N/V: 4mg IV
Reduce nausea
Prevents nausea, vomiting by
blocking serotonin
peripherally, centrally, and in
the small intestine
- hydration level, BP
- signs of extrapyramidal side
effects, parkinsonian-like
syndromes
Teaching
- avoid driving
- avoid alcohol
- report s/s of tardive
dyskinesa, extrapyramidal
effects. Or parkisonaian
symptoms
- take oral formulations 30
mins before meals and at
bedtime, or single dose prior
to provoking situation
- avoid concomitant MAO
inhibitors, tricyclic
antidepressants, or
sympathomimetic amine
therapy
Adverse Reactions
- D, constipation, headache,
dizziness, drowsiness,
fatigue, EPS, fever, hypoxia,
urinary retention,
anayphylaxis
Monitor
-CNS/Mental status
- absence of N or V
- hypersensitivity reaction
- EPS
- ECG
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Form No. 691-0019 (7/97)
Teaching
- report D, constipation, rash
or changes in RR
- avoid concomitant use of
apomorphine due to risk of
sig hypoTN and loss of
consciousness
Adverse Effects:
- Fluid overload, hypercapnia,
hyperglycemia,
hyper-/hypokalemia,
hyper-/hypophosphatemia,
metabolic bone disease,
Reference
Lexi-Comp Online. (n.d.). Lexi-drugs. Retrieved from http://online.lexi.com.libproxy.osfhealthcare.org/lco/action/home
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Form No. 691-0019 (7/97)