VI. THE PATIENT AND HIS CARE MEDICAL MANAGEMENT A.
DRUGS Generic Name Brand Name Date ordered , taken/given Date changed, D/C Route of administration Dosage Frequency General action Classification Mechanism of action Indication/ Purpose Nursing responsibilities Clients response
CEFUROXIME
Date ordered: Route: TIV January 16, 2014 Dosage: 750 mg
Classification: Antibiotic Cephalosporin (second generation)
Perioperative prophylaxis.
Date given: Frequency: every 8 January 16, hours Mechanisms of 2014 7:35 pm Action: January 17, Bactericidal: Inhibits 2014 synthesis of bacterial 4 am, 12 pm, 8 cell wall causing cell pm death.
Prior: The medication Check for doctors serves as order for the route prophylaxis of administration, from frequency and surgical dosage. infection for Check if the the patient. patient has an allergy on the No adverse effects medication. noted. Inform patient if possible or family members about the purpose of administration of these drug and the possible side effects. During: For
direct
IV
administration, slowly inject drug over 3 to 5 min. or give in tubing or other IV solutions. After: Continue to monitor vital signs and observe patient closely. Dispose used material properly Document the drug that has been given.
Generic Name Brand Name
Date ordered , taken/given Date changed, D/C
Route of administration Dosage Frequency
General action Classification Mechanism of action
Indication/ Purpose
Nursing responsibilities Clients response
KETOROLAC
Date ordered: Route: TIV January 16, 2014 Dosage: 30 mg
Classification: Nonsteroidal antiinflammatory drug Nonopioid analgesic of
Short-term management of pain.
Date given: Frequency: every 6 January 16, hours Mechanisms 2014 10:30 pm Action:
Prior: Effective pain control. Check for doctors order for the route No adverse of administration, effects noted. frequency and dosage. Check if the
January 2014 6 pm
17,
Anti-inflammatory and analgesic activity, inhibits prostaglandins and leukotriene synthesis.
patient has an allergy on the medication. Inform patient if possible or family members about the purpose of administration of these drug and the possible side effects.
During: The IV injection must be given over no less than 15 sec. After: Continue to monitor vital signs and observe patient closely. Dispose used material properly Document the drug that has been given.
Generic Name Brand Name
Date ordered , taken/given Date changed, D/C
Route of administration Dosage Frequency
General action Classification Mechanism of action
Indication/ Purpose
Nursing responsibilities Clients response
MAGNESIUM SULFATE
Date ordered: Route: Deep IM on January 16, alternating buttocks 2014 Dosage: 5 g Date given: January 16, Frequency: every 4 2014 4 pm, 8pm hours for 24 hours January 17, 2014 4 am, 11 am, 3pm
Classification: Anticonvulsant Mechanisms of Action: Magnesium (Mg) is an essential element for muscle contraction, ertain enzyme systems, and nerve transmission. Extracellular fluid levels: 1.52.5mEq/L. Mg depresses the CNS and controls convulsion by blocking release of acetylcholine at the myoneural junction.
Prevention and treatment of seizures in severe pre-eclampsia or eclampsia withut producing deleterius CNS depression in mother or infant.
Prior: Possible seizures Check for doctors prevented. order for the route of administration, No adverse frequency and dosage. effects noted. Check for the following: Absent patellar reflexes Respirations below 16/min Urine output <100 mL in past 4 hours Early signs of hypermagnesemia: flushing, sweating, hypotension, or, hyperthermia Past histoy of heart block or myocardial damage. Inform patient if possible or family members about the purpose of
administration of these drug and the possible side effects. During: Give IM route by deep IM injection. After: Continue to monitor vital signs and observe patient closely. Monitor neurologic status therapy. Institute seizure precautions. Patellar reflex (knee jerk) should be tested before each dose of magnesium sulfate. Monitor intake and output ratios. Urine out put should be maintained at a level of at least 100 ml/4 hr. Dispose used material properly Document the drug that has been given.
Generic Name Brand Name
Date ordered , taken/given Date changed, D/C
Route of administration Dosage Frequency
General action Classification Mechanism of action
Indication/ Purpose
Nursing responsibilities Clients response
CLONIDINE
IV Date ordered: Route: January 16, incorporation with 2014 D5W 500 cc placed as side drip Date given: January 16, Regulation: 15 2014 10:20 am microdrops per minute Dosage: 4 ampules
Classification: antihypertensive, centrally acting Mechanisms of Action: Stimulates CNS alpha-adrenergic receptors, inhibits cardioaccelerator and vasoconstrictor centers, and decreases sympathetic outflow from the CNS.
Hypertension, used alone or as a part of combination therapy.
Prior: The patients Check for doctors Blood order for the route pressure of administration, decreased. frequency, dosage Latest BP and regulation. 120/ 70 Check vital signs mmHg before starting the No adverse therapy. effects Inform patient if noted. possible or family members about the purpose of administration of these drug and the possible side effects. During: Monitor BP Constantly watch flow rate. Do not change regimen or discontinue drug abruptly.
Withdrawal should be gradual to prevent hypertension. After: Continue to monitor vital signs and observe patient closely. Dispose used material properly Document the drug that has been given.
Generic Name Brand Name
Date ordered , taken/given Date changed, D/C
Route of administration Dosage Frequency
General action Classification Mechanism of action
Indication/ Purpose
Nursing responsibilities Clients response
HYDRALAZINE
IV Date ordered: Route: January 16, incorporation with 2014 D5W 500 cc placed as side drip Date given: January 16, Regulation: 15 2014 10:25 am microdrops per minute
Classification: antihypertensive, Vasodilator (peripheral) Mechanisms Action: Acts directly
Severe essential hypertension when cannot be given orally or when need to lower blood of pressure is urgent. on
Prior: The patients Check for doctors Blood order for the route pressure of administration, decreased. frequency, dosage Latest BP and regulation. 120/ 70 Check vital signs mmHg before starting the
Dosage: 4 ampules
vascular smooth muscle to cause vasodilation, primarily arteriolar, maintains or increases renal and cerebral blood flow.
No adverse effects noted.
therapy. Use parenteral drug immediately after opening ampule. Use as quickly as possible after withdrawing through a needle into a syringe. Hydralazine changes color after contact with metal, and discolored solutions should be discarded. Inform patient if possible or family members about the purpose of administration of these drug and the possible side effects.
During: Monitor BP Constantly watch flow rate. Withdraw drug gradually. Rapid withdrawal may cause possible increase in blood
pressure After: Continue to monitor vital signs and observe patient closely. Dispose used material properly Document the drug that has been given.
Generic Name Brand Name
Date ordered , taken/given Date changed, D/C
Route of administration Dosage Frequency
General action Classification Mechanism of action
Indication/ Purpose
Nursing responsibilities Clients response
TRAMADOL
IV Date ordered: Route: January 17, 2014 incorporation with D5W 500 cc placed Date given: as side drip January 17, 2014 11:00 am Regulation: 20 microdrops per minute Dosage:
Classification: Analgesic, Centrallyacting Mechanisms of Action: Binds to mu-opioid receptor and inhibits the reuptake of norepinephrine and serotonin; causes
Management of moderate to severe pain.
Prior: Pain controlled. Check for doctors order for No adverse the route of effects administration, noted. frequency, dosage and regulation. Check vital signs before starting the therapy. Inform patient if
many effects similar to opioids- dizziness, somnolence, nausea, constipationbut dose not have the respiratory depressant effects.
possible or family members about the purpose of administration of these drug and the possible side effects. During: Monitor the patient Constantly watch flow rate. After: Continue to monitor vital signs and observe patient closely. Dispose used material properly Document the drug that has been given.
Generic Name Brand Name
Date ordered , taken/given Date changed, D/C
Route of administration Dosage Frequency
General action Classification Mechanism of action
Indication/ Purpose
Nursing responsibilities Clients response
DICLOFENAC
IV Date ordered: Route: January 17, 2014 incorporation with D5LR 1L placed as Date given: side drip January 17, 2014 11:10 am Regulation: 30 drops per minute Dosage: 750 mg
Classification: Nonsteroidal antiinflammatory drug Mechanisms of Action: Inhibits prostaglandin synthetase to cause anti-pyretic and antiinflammatory effects; the exact mechanisms is unknown.
Acute or long term treatment of mild to moderate pain.
Prior: Pain controlled. Check for doctors order for No adverse the route of effects administration, noted. frequency, dosage and regulation. Check vital signs before starting the therapy. Inform patient if possible or family members about the purpose of administration of these drug and the possible side effects. During: Monitor the patient Constantly watch flow rate. After:
Continue to monitor vital signs and observe patient closely. Dispose used material properly Document the drug that has been given.
