drug study

DRUG STUDY

GENERIC NAME

BRAND NAME

DOCTOR’S ORDER CLASSIFICATION INDICATION SIDE EFFECT

NURSING CONSIDERATION

Dopamine Hydrochloride

November 25, 2007 (3:00

PM)

Start Dopamine

200 mg/250 cc Premix @ 86 gtts/min

Sympathomimetic, Direst & Indirect

Acting

To increased renal blood

flow & sodium excretion

Tachycardia Anginal pain Palpitstions Hypotension Bradycardia Dyspnea N/V headache

Must be diluted before use.

Prevent fluid overload, may use more concentrated solutions with higher doses.

When discontinuing, gradually decrease dose; sudden cessation may cause mark hypotension.

GENERIC NAME

BRANDNAME

DOCTOR’S ORDER CLASSIFICATION INDICATION

SIDEEFFECTS


Metoclopramide Maxolon November 25, 2007 (12:55 PM)

Metoclopramide 1 amp IV PRN for

N/V

Gastrointestinal Stimulant

To treat acute & recurrent diabetic

gastroparesis, gastroesophageal

reflux

Restlessness, drowsiness, fatigue, anxiety, insomnia, confusion, headache, dizziness

Nausea, bowel disturbances

Hypertension, hypotension

Inject slowly IV over 1-2 mins. To prevent transient feelings of anxiety & restlessness.

Metoclopramide is physically & chemically incompatible with a number of drugs.

GENERIC NAME

BRAND NAME


ADVERSE EFFECTS


Ranitidine Zantac November 25, 2007 (12:55

PM)

Ranitidine 50 mg IV q 8º

Histamine H2 receptor blocking

drug

Maintenance treatment of

duodenal ulcer

Constipation Bradycardia/tachycardia Dizziness Malaise Insomnia Vertigo

Avoid alcohol, aspirin-containing products, & beverages that contain caffeine (tea, cola, coffee); these increase stomach acid. Avoid things that may aggravate symptoms, i.e., alcohol, aspirin, NSAIDS, caffeine, & black pepper.

Do not smoke; interferes with healing & drug’s effectiveness.

Report any evidence of yellow discoloration of skin or eyes, or diarrhea. Maintain adequate hydration. Report any confusion or disorientation.

GENERIC NAME

BRAND NAME


ADVERSE EFFECT


Paracetamol Aeknil November 25, 2007 (8:00 PM)

Paracetamol 300 mg IV now

Antipyretic Mild pain & fever

jaundice Excessive alcohol use may increase the risk of liver damage.

Contraindicated in pt. with hypersensitive to drug.

GENERIC NAME

BRAND NAME


ADVERSE EFFECTS


Furosemide Lasix November 26, 2007 PM

Furosemide 1 amp IV push now with BP

precaution

Loop Diuretic To treat edema & fluid

retention

Headache, dizziness, weakness, restlessness, fever

Abdominal discomfort & pain, diarrhea, anorexia, N/V

Take the BP before giving the drug.

Measure & record weight daily to monitor fluid changes.

Monitor I&O

GENERIC NAME

BRAND NAME


ADVERSE EFFECTS


Vitamin K Mephyton November 25, 2007 (2:15 PM)

Vit. K 1 amp IV Now

Hormones & synthetic substitute

Antidote for over dosage of

oral anti-coagulants.

Prophylaxis of & therapy for hemorrhagic

disease.

Facial flushing, chills, fever, diaphoresis, dizziness

Headache dyspnea

Aspirate carefully to avoid intravascular injection.

Maintain consistency in diet & avoid significant increase in daily intake of Vit. K rich foods.

GENERIC NAME


ADVERSE EFFECT


Pen G November 25, 2007 (2:15 PM)

Pen G 3,000,000 ‘U’ q 4º IV ANST ( )

start this PM

Antibiotic Prophylactic therapy for

rheumatic heart disease & acute

glomerulonephritis.

Local pain, tenderness, chills, fever.

Report immediately to physician the onset of allergic reaction.

There is great risk of severe prolonged reactions because drug is absorbed slowly.

GENERIC NAME

BRAND NAME


ADVERSE EFFECT NURSING CONSIDERATION

Tramadol Hydrochloride

Godex November 26, 2007

Godex 1 cap BID

November 30, 2007

Godex 1 cap BID x 7 days (6

am & 6 pm)

Narcotic Analgesic Management of moderate to moderately severe pain.

Drowsiness, dizziness, vertigo,fatigue, headache, restlessness,seizure, sleep disturbances

Palpitation, vasodilation

N/V, constipation, dyspepsia abdominal pain, anorexia

Dosage reduction is recommended for pts with renal insufficiency & hepatic impairment.

Assess for level pain of relief.

Assess bowel & bladder function; report urinary frequency or retention.

Exercise caution with potentially hazardous activities until response to drug is known.

GENERIC NAME

BRAND NAME


ADVERSE EFFECTS


Pantoprazole Sodium

Ulcepraz November 30, 2007

Ulcepraz 20 mg OD x 7 days (6

am)

Gastrointestinals; Proton pump

inhibitors

To treat mild to severe hepatic

impairment & severe renal impairment

Headache, back pain, chest pain, neck pain, flu syndrome, infection, pain

Migraine Diarrhea,

flatulence, abdominal pain, constipation, dyspepsia, gastroenteritis, gastrointestinal disorder, nausea, rectal disorder, vomiting.

Hyperglycemia, hyperlipemia

Insomnia, anxiety, dizziness

Urinary frequency and urinary tract infection.

Administration with food may delay its absorption up to 2 hours or longer

It may be taken without regard to timing of meals.

Patients should be cautioned that delayed-release tablets should not be split, crushed or chewed.

The tablets should be swallowed whole, with or without food in the stomach.

Concomitant administration of antacids does not affect the absorption of Ulcepraz.

GENERIC NAME

BRAND NAME


ADVERSE EFFECT


Ampicillin Sumapen November 30, 2007

Sumapen 500 mg QID p.c x 3 days ( 6 am, 12 noon, 6

pm, 10 pm)

Antibiotic Used to treat moderately severe

to severe infections.

Hemolytic anemia

Seizures Diarrhea,

nausea & vomiting

Severe pain rash

Give wit a full glass of water on an empty stomach (at least 1º before or 2º after meals) for maximum absorption.

Food hampers rate & extent of oral absorption.

Report diarrhea to physician; do not self-medicate.

NURSING CARE PLAN

Date: November 27, 2007

ASSESSMENT NURSING DIAGNOSIS

PLANNING INTERVENTION RATIONALE EVALUATION

S: “Nasakit ti bakrang ko” as verbalized by the pt.

Pain at the RUQ with a pain scale of 6/10

O: Abdominal pain Abdominal

tenderness Weak & pale in

appearance Guarding behavior grimace

Alteration in comfort, moderate abdominal

pain r/t liver inflammation 2º disease

condition

After 30 minutes of nursing intervention, the

pt. will be able to relieve from pain, to be comfortable & be able

to know ways on how to control pain.

Monitor V/S

Assess pain in RUQ.

Encouraged used of relaxation technique such as deep breathing exercise.

Provide rest period to facilitate comfort. Sleep or relaxation such as proper ventilation, wrinkle free bed & quiet environment.

Encouraged verbalization of pain.

Encouraged high fowler’s position.

Administered pain medication as ordered.

Baseline data & comparison.

Baseline data to relate on worsening of underlying condition.

To divert attention from pain.

To prevent aggravation of pain by frequent disturbances.

To determine appropriate nursing intervention.

To relieve pain & enhance circulation.

Inhibits the action of prostaglandin that initiates pain.

After 30 minutes of nursing interventions, the pt. was comfortable & relieved from pain & gain knowledge on how to control pain.




S: “Agkakapsutak pay laeng” as verbalized by the pt.

O: Weak & pale in

appearance Myalgia Body weakness Limited

movement Guarded

movement

Activity intolerance r/t body weakness 2º disease process

After 5º of nursing intervention, the pt’s level of tolerance to activities will increase.

Monitor V/S

Monitor physiologic activities.

Assess physiological & emotional factors affecting the pt’s situation.

Provided passive exercise.

Encouraged the pt to eat carbohydrate rich foods & protein rich foods.

Encouraged frequent rest periods.

Provided positive


To denote degrees of fatigue & intolerance to activities.

To determine factors that contributing to activity intolerance.

To maintain wellness of the extremities.

To increase physical wellness & strength; for the consistency of liver function.

To prevent & reduce fatigue.

To minimize frustrations &

After 5º of nursing intervention, the pt’s level of tolerance to activities gradually increased & was able to do light activities such as sitting, stretching.

atmosphere while acknowledging difficulty of the situation for the pt.

Encouraged deep breathing exercise.

Administered medications as ordered.

rechannel energy.

To enhance wellness.

For treatment regimen.




S: “Marigatanak nga maturok” as verbalized by the pt.

O: Pale & weak in

appearance Frequent

yawning Presence of eye

bag Irritable Abdominal pain

on RUQ Sleep hours: 2-3

with interval

Sleep pattern disturbance r/t abdominal pain on RUQ

After 4º of nursing intervention, the pt will be able to sleep comfortably & free from pain.

Monitor V/S

Established a quiet, peaceful environment during sleep periods.

Observe/obtain feedback from pt regarding usual bedtime routine.

Instructed the pt to avoid caffeine containing foods such as cola beverages 4º before bed sleep.

Advised the pt to drink hot milk at bedtime.

Instructed the pt to decrease & limit fluid intake


A quiet & peaceful environment promotes restful sleep.

To determine usual sleep pattern & provide comparative baseline.

Caffeine containing foods & beverages attribute sleep pattern disturbances because they are stimulants.

To promote sleep.

To prevent the need to awaken

After 4º of nursing intervention, the pt was able to sleep comfortably & soundly & free from pain.

before bedtime.

Encouraged to do deep breathing exercise when with pain.

for frequent voiding.

To divert the pain.




S: “Nasakit ti tiyan ko” as verbalized by the pt.

Pain Scale: 6/10

O: Abdominal

tenderness Weak & pale in

appearance Guarding

behavior grimace

Pain r/t hepatomegaly

After 30 minutes of nursing intervention, the pt. will be able to relieve from pain & be able to know ways on how to control pain.

Monitor V/S

Assess pain in RUQ.

Encouraged used of relaxation technique such as deep breathing exercise.

Encouraged verbalization of pain.

Encouraged high fowler’s position.

Administered pain medication as ordered.


Baseline data to relate on worsening of underlying condition.

To divert attention from pain.

To determine appropriate nursing intervention.

To relieve pain & enhance circulation.

Inhibits the action of prostaglandin that initiates pain.

After 30 minutes of nursing intervention, the pt. was relieved from pain & be able to know ways on how to control pain.




O: Bloody sputum Episodes of

epistaxis jaundice

Risk for hemorrhage r/t internal (gastrointestinal) bleeding

After 8º of nursing intervention, the pt will develop no episodes of bleeding & hemorrhage.

Monitor V/S

Assess pt for evidence of bleeding or hemorrhage.

Encouraged pt to avoid activities that increases intra-abdominal pressure (straining, turning).

Avoid sneezing/coughing & assist pt to turn.

Encouraged to use measures to prevent constipation such as adequate fluid intake: stool softeners


Allows early detection of signs & symptoms of bleeding & hemorrhage.

Minimizes increase in intra-abdominal pressure that could lead to rupture & bleeding of esophageal or gastric varices.


Minimizes increase in intra-abdominal pressure that could lead to rupture & bleeding of

After 8º of nursing intervention, the pt was free from episodes of bleeding & hemorrhage.

Encouraged to eat small frequent feeding.

Monitor pt for recurrence of bleeding & hemorrhage.

Administered medications as ordered.

esophageal or gastric varices.


Risk of rebleeding is high with all treatment modalities used to halt gastrointestinal bleeding.

For treatment regimen.

drug study

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