Medications
Content
MEDICA
Generic Trade Admin Time Dose
acetaminophen
Tylenol
Albuterol Sulfate
Airomir
amLODIPine
Norvasc
aspirin
Bayer Aspirin
Azithromycin
Zithromax
Biscacodyl
Dulcolax
busPIRone
BuSpar
Carvedilol
Coreg
Ceftriaxone Sodium
Rocephin
Dextrose/Water
Insta-glucose
Digoxin
Lanoxin
Diphenhydramine
Benadryl
Docusate Sodium
Colace
Enalapril
Vaslotec
Famotidine
Pepcid
Ferrous Sulfate
Fer-Iron
Fondaparinux
Arixtra
Furosemide
Lasix
Glyburide
DiaBeta
Hydromorphone
Dilaudid
Insulin Human Regular
Humulog
iron polysaccaride
PolyIron
Ketorolac
Toradol
Levothyroxine
Synthroid
Lisinopril
Zestril
Losartan Potassium
Cozaar
Magnesium Hydroxide
Milk of Magnesia
Metformin
Metaglip
Mupirocin
Bactroban
Nalbuphine Hydrochloride
Nubain
Naloxone
Naloxone
Nitroglycerin
Nitropaste
Ondanestron Hydrochlorine
Zofran
Oxycodone
Supeudol
Pantoprazole Sodium
Protonix
Promethazine HCL
Promethacon
ramipril
Altace
Simethicone
Maalox
simvastatin
Zocor
Sodium Chloride 0.9%
Slo-Salt
Tamsulosin
Flomax
Vancomycin HCL
Vancocin
Warfarin Sodium
Coumadin
Zolpidem
Ambien
MEDICATIONS
Route Routine or PRN
(Including IV medications)
Class & Action
antipyretic, nonopioid analgesic: Inhibits the synthesis of prostaglandins that may serve as mediators of pain and fever, primarily in the CNS.
Major/Common Side Effects
HEPATOXICITY, constipation, renal failure, neutropenia, pancytopenia, rash, urticaria
"Brochodilators, "Nervousness, restlessness, tremor, Adrenergics. Used as a headache, insomnia, paradoxical quick-relief acute bronchospasm, chest pain, bronchospasm and for palpitations, angina, arrhythmias, prevention of exercisehyertension, nausea, vomitting, induced bronchospasm" hyperglycemia, hypokalemai, (Deglin & Vallerand, tremor" (Deglin & Vallerand, 2013, 2013,p.112). p. 113). antihypertensive: inhibits transport of calcium into headache, dizziness, fatigue, myocardial & vascular peropheral edema, angina, smooth muscle cellsbradycardia, hypostension, inhibition of excitationpalpatations, gingival hyperplasia, contraction coupling & nausea, flushing subsequent contraction antipyretic, nonopioid GI BLEEDING, EXFOLIATIVE analgesic: Decreased DERMATITIS, STEVEN JOHNS incidence of transient SYNDROME, dyspepsia, epigastric ischemic attacks and MI. distress, nausea
dizziness, seizures, drowsiness, fatigue, headache, chest pain, hypotension, palpitations, HEPATOTOXICITY, Th: antiinfective Ph: PSEUDOMEMBRANOUS macrolides Inhibits COLITIS, abdominal pain, diarrhea, protein synthesis at the nausea, thrush, anemia, leukopenia, level of the 50S bacterial thrombocytopenia, STEVENSribosome. JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, photosensitivity, rash, ototoxicity, hyperkalemia, ANGIOEDEMA. "Laxatives, stimulant laxatives. Stimulates peristalsis. Alters fluid and electrolyte transport, producing fluid accumulation in the colon" (Deglin & Vallerand, 2013,p.218).
"Abdominal cramps, nausea, diarrhea, rectal burning, hypokalemia, muscle weakness, tetany" (Deglin & Vallerand, 2013,p.98).
dizziness, drowsiness, fatigue, antianxiety agent: Binds to headache, insomnia, weakness, seratonin & dopamine blurred vision, congestion, sore receptors in the brain. throat, tinnitus, chest pain, Increases norepinephrine palpatations, nausea, rashes, metabolism in the brain. myalgia, incoordination, numbness, sweating.
Dizziness, fatigue, weakness, anxiety, depression, drowsiness, insomnia, memory loss, mental status changes, nervousness, nightmares, blurred vision, dry eyes, Th: antihypertensive Ph: bronchospasm, wheezing, beta blocker Blocks BRADYCARDIA, HF, stimulation of beta1 PULMONARY EDEMA. diarrhea, (myocardial) and beta2 constipation, nausea, erectile (pulmonary, vascular, and dysfunction, STEVENS-JOHNSON uterine)-adrenergic receptor SYNDROME, TOXIC sites. EPIDERMAL NECROLYSIS, itching, rashes, urticaria, hyperglycemia, hypoglycemia, arthralgia, back pain, muscle cramps, paresthesia, ANAPHYLAXIS, ANGIOEDEMA SEIZURES (HIGH DOSES), PSEUDOMEMBRANOUS COLITIS, diarrhea, cholelithiasis, gallbladder sludging, rashes, urticaria, bleeding, eosinophilia, hemolytic anemia, leukopenia, thrombocytosis pain at IM site, phlebitis at IV site, ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS, superinfection.
Th: antiinfective Ph: third generation cephalosporins Binds to the bacterial cell wall membrane, causing cell death.
Fluid overload, hypokalemia, Th: caloric source Ph: hypomagnesemia, carbohydrate Provision of hypophosphatemia, local calories. Prevention and pain/irritation at IV site (hypertonic treatment of hypoglycemia. solution), glycosuria, hyperglycemia.
Fatigue, headache, weakness, Th: antiarrhythmic Ph: blurred vision, yellow or green digitalis glycosides vision, ARRHYTHMIAS, Increases the force of bradycardia, ECG changes, AV myocardial contraction. block, SA block, anorexia, nausea, Prolongs refractory period vomiting, diarrhea, of the AV node. Decreases thrombocytopenia, electrolyte conduction through the SA imbalances with acute digoxin and AV nodes. toxicity.
"Allergy, cold, and cough remedies, antihistamines, antitiussives. Relief of symptoms caused by histamine release including: Anaphylaxis, seasonal and perennial allergic rhinitis, allergic dermatoses, pruritus" (Deglin & Vallerand, 2013,p.443). "Laxatives, stool softeners. Prevention of constipation, promotes incorporation of water into stool, resulting in softer fecal mass. May also promote electrolyte and water secretion into the colon" (Deglin & Vallerand, 2013 ,p. 457)
"Drowsiness, dizziness, headache, paradoxical exicitation, blurred vision, tinnitus, hypotension, palpitations, anorexia, dry mouth, constipation, nausea, frequency, urinary retention, chest tightness, wheezing, photosensitivity" (Deglin & Vallerand, 2013,p.444).
"Throat irritation, mild cramps, diarrhea, rashes" (Deglin & Vallerand, 2013,p. 458).
"Antihypertensives, ACE inhibitors, lower of b/p in hypertensive patients" ((Deglin & Vallerand, 2013,p.160).
Th: antiulcer agent Ph: histamine H2 antagonist Inhibits the action of histamine at the H2receptor site located primarily in gastric parietal iron supplement: essential mineral, enters SEIZURES, dizziness, headache, bloodstream, transported to syncope, hypotension, constipation, liver, spleen, bone marrow nausea, diarrhea, epigastric pain, where it is separated out & staining of the teeth. becomes part of iron stores.
"Dizziness, drowsiness, fatigue, headache, insomina, vertigo, weakness, cough, dyspnea, hypotension, taste distrubances, abdominal painn, anorexia, constipation, diarrhea, nausea, vomitting, renal failure, flushing, pruritis" (Deglin & Vallerand, 2013,p.160). confusion, dizziness, drowsiness, headache, ARRHYTHMIAS, constipation, diarrhea, nausea, AGRANULOCYTOSIS, APLASTIC ANEMIA, anemia
Confusion, dizziness, headache, insomnia, edema, hypotension, Th: anticoagulant constipation, diarrhea, dyspepsia, ↑ Prevention and treatment of liver enzymes, nausea, vomiting, deep vein thrombosis and urinary retention, bullous eruption, pulmonary embolism. hematoma, purpura, rash, bleeding, thrombocytopenea, hypokalemia, fever, ↑ wound drainage.
Th: Diuretic Ph: Loop diuretic Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium. Effectiveness persists in impaired renal function.
Blurred vision, dizziness, headache, vertigo, hearing loss, tinnitus. hypotension. anorexia, constipation, diarrhea, dry mouth, dyspepsia, ↑ liver enzymes, nausea, pancreatitis, vomiting,↑ BUN, excessive urination, nephrocalcinosis, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, photosensitivity, pruritis, rash, hypercholesterolemia, hyperglycemia, hypertriglyceridemia, hyperuricemia, dehydration, hypocalcemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis, APLASTIC ANEMIA, AGRANULOCYTOSIS, hemolytic anemia, leukopenia, thrombocytopenia, muscle cramps, paresthesia, fever.
Th: antidiabetic Ph: sulfonylureas Lowers blood sugar by stimulating the release of insulin from the pancreas and increasing the sensitivity to insulin at receptor sites. May also decrease hepatic glucose production.
Dizziness, drowsiness, headache, weakness, constipation, cramps, diarrhea, drug-induced hepatitis, dyspepsia, ↑ appetite, nausea, vomiting, photosensitivity, rashes, hypoglycemia, hyponatremia, APLASTIC ANEMIA, agranulocytosis, hemolytic anemia, leukopenia, pancytopenia, thrombocytopenia.
" Antitussives, opioid analgesics, opoid agnoist. Decrease in moderate to severe pain. Supression of cough" (Deglin & Vallerand, 2013, p. 666).
"Confusion, sedation, dizziness, constipatin, dysphoria, hallucinations, respiratory depression, hypotensions, bradycardia, urinary retention, sweating, vomitting" (Deglin & Vallerand, 2013, p. 666).
Th: antidiuetic, hormone Lowers blood glucose by stimulating glucose uptake HYPOGLYCEMIA, lipodystrophy, in skeletal muscle and fat, pruritus, erythema, swelling, inhibiting hepatic glucose ALLERGIC REACTIONS production, inhibition of INCLUDING ANAPHYLAXIS . lipolysis and proteolysis, enhanced protein synthesis.
iron supplement: essential mineral, enters SEIZURES, dizziness, headache, bloodstream, transported to syncope, hypotension, constipation, liver, spleen, bone marrow nausea, diarrhea, epigastric pain, where it is separated out & staining of the teeth. becomes part of iron stores. "NSAID, pyroziline carboxylic acid. Decreased pain for a short time period" (Deglin & Vallerand, 2013,p.750). "Stroke, drowsiness, abnormal thinking, euphora, headache, MI, Stevens-Johnsons Syndrome, Necrosis, edema, vasodilation" (Deglin & Vallerand, 2013,p751).
"Hormones and thyroid "Headache, insomina, irritability, preparations. Replacement angina pectoris, arrhythmias, in hypothyroidism to tachycardia, abdominal cramps, restore normal hormonal diarrhea, vomitting, sweating, balance. Suppression of weight loss, heat intolerance" thyroid cancer" (Deglin & (Deglin & Vallerand, 2013, p. 780). Vallerand, 2013, p. 779).
Th: antihypertensive Ph: Ace Inhibitor ACE inhibitors block the conversion of angiotensin I Dizziness, fatigue, headache, to the vasoconstrictor weakness, cough, hypotension, angiotensin II. Also prevent chest pain, abdominal pain, the degradation of diarrhea, nausea, vomiting, erectile bradykinin and other dysfunction, impaired renal vasodilatory function, rashes, hyperkalemia, prostaglandins. Also ↑ ANGIOEDEMA. plasma renin levels and ↓ aldosterone levels. Net result is systemic vasodilation. "Antihypertensives. Angiotensin II receptor antagonists. Lowering of the B/P"(Deglin & Vallerand, 2013,p.167). "Antiulcer agents, antacids. Neutralization of gastric acid with healing of ulcers and decrease in associated pain" (Deglin & Vallerand, 2013,p.805). "Dizziness, hypotension, anxiety, depression, fatigue, headache, weakness,, chest pain, edema, tachycardia, diarrhea, nausea,vomitting" (Deglin & Vallerand, 2013,p.167).
"Constipation, diarrhea, hypermagnesemia" (Deglin & Vallerand, 2013,p.805).
The: antidiabetic Ph: biguanides Decreases hepatic glucose production. Decreases intestinal glucose absorption. Increases sensitivity to insulin.
Abdominal bloating, diarrhea, nausea, vomiting, unpleasant metallic taste, hypoglycemia, LACTIC ACIDOSIS, decreased vitamin B12 levels.
"Headache, cough, itching, "Anti-infectives. Eradicates pharyngitis, rhinitis, upper nasal colonization with respiratory tract congestion, nausea, methicillin-resistant S. altered taste, burning, itching, pain Aureus" stinging" (Deglin & Vallerand, 2013, p. 886). "Opioid analgesics. "Dizziness, headache, sedation, dry Prevention or treament of mouth, nausea, vomiting, clammy opiod induced pruritius, feeling, sweating" (Deglin & decreased pain" (Deglin & Vallerand, 2013,p.896). Vallerand, 2013,p.895). "Antidotes, opiod "hypertension, hypotension, nausea, antagonists, opiod induced vomitting" (Deglin & Vallerand, pruritius" (Deglin & 2013,p.898). Vallerand, 2013,p.897).
Th: antianginals Ph: nitrates Increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions. dizziness, headache, restlessness, Produces vasodilation weakness, blurred vision, (venous greater than hypotension, tachycardia, syncope, arterial). Decreases left abdominal pain, nausea, vomiting, ventricular end-diastolic flushing pressure and left ventricular end-diastolic volume (preload). Reduces myocardial oxygen consumption. "Antiemetics, 5-HT3 antagonists, prevention and "Headache, constipation, diarrhea, treatment of postoperative dizziness, drowsiness, fatigue, nausea and vomitting" weakness" (Deglin & Vallerand, (Deglin & Vallerand, 2013,p.948). 2013,p.948). "Opiod analgesics, for moderate to severe pain" (Deglin & Vallerand, 2013,p.963). "Confusion, sedation, dizziness, constipation, dysphoria, euphoria, hallucinations, diplopia, blurred vision, nausea, vomitting" (Deglin & Vallerand, 2013,p.963).
Th: antiulcer agent Ph: proton-pump inhibitor Binds to an enzyme in the headache, abdominal pain, diarrhea, presence of acidic gastric flatulence, hyperglycemia, pH, preventing the final hypomagnesaemia, bone fracture transport of hydrogen ions into the gastric lumen. "Antiemetics, antihistamines, sedative/hypnotics. Relief "Confusion, disorientation, sedation, of symptoms of histamine dizziness, extrapyramidal ractions, excess usually seen in fatigue, insomnia, nervousness, allergic conditions. bradycardia, tinnitus, hypotension" Diminished nausea or (Deglin & Vallerand, 2013,p.1058) vomitting. Sedation" (Deglin & Vallerand, 2013,p.1050).
dizziness, drowsiness, fatigue, headache, insomnia, weakness, ACE inhibitor: blocks the cough, hypotension, taste conversion of angiotensin I disturbances, abdominal pain, to the vasoconstrctor flushing, back pain, muscle cramps. angiotensin II. ANGIOEDEMA, AGRANULOCYTOSIS "Antiflatulent. Helps relieve symptoms of excessive gas that may None significant occur post operatively" (Deglin & Vallerand, 2013,p.1149). lipid-lowering agent: dizziness, headache, insomnia, Inhibit HMG-CoA weakness, chest pain, blurred reductase, which is vision, abdominal cramps, responsible for catalizing constipation, diarrhea, flatus, an early step in the heartburn, rashes, synthesis of cholesterol. RHABDOMYOLYSIS. Th. Mineral & electrolyte replacement/ supplement Sodium is a major cation in extracellular fluid and helps maintain water distribution, fluid and electrolyte balance, acidHEART FAILURE, PULMONARY base equilibrium, and EDEMA, edema, hypernatremia, osmotic pressure. Chloride hypervolemia, hypokalemia, is the major anion in extravation, irritation at IV site extracellular fluid and is involved in maintaining acid-base balance. Solutions of NaCl resemble extracellular fluid. Reduces corneal edema by an osmotic effect.
Ph: peripherally acting antiadrenergics Decreases contractions in smooth muscle of the prostatic capsule by preferentially binding to alpha1-adrenergic receptors.
Dizziness, headache, rhinitis, orthostatic hypotension, priapism, retrograde/diminished ejaculation.
"Anti-infectives, treatment "Ototoxicity, hypotension, nausea, of life threatening vomiting, nephrotoxicity, rashes, infections when less toxic eosinophilla, leukopenia, phlebitis, anti-infectives are back and neck pain, anaphalxis, contraindicated" (Deglin & chills, fever, superinfection" (Deglin Vallerand, 2013,p.1261). & Vallerand, 2013,p.1262).
Th: anti coagulant Ph: coumarins Interferes with hepatic synthesis of vitamin Kdependent clotting factors
Cramps, nausea, dermal necrosis, BLEEDING, fever.
"Daytime drowsiness, dizziness, "Sedative/hypnotics, abnormal thinkin, behavior changes, promotes sedation" (Deglin diarrhea, anaphalyactic reactions, & Vallerand, 2013,p.1317). vomitting, nausea"(Deglin & Vallerand, 2013,p.1317).
Nursing Implications
Why on these meds?
Assess overall health status and alcohol use. Assess type, location, and intensity of pain prior to administration. If OD occurs acetylcysteine is the antidote. "Assess lung sounds, pulses, and BP before administration, and during peak of medication. Note amount olor, and character of sputum produced. Monitor pulmonary function tests before initiating therapy and periodically during therapy. Observe for paradoxical bronchospasm" (Deglin & Vallerand, 2013, p 114). Monitor BP and pulse before theapy and dose adjustments. Monitor I&O ratios & daily weights. Assess signs of HF. Assess location, duration and intensity of anginal pain.
Assess pain type, location, and intensity. Assess for fever. Monitor hepatic function during asprin therapy. Prolongs bleeding time for 4-7 days after administration. Monitor for tinnitus, headache and confussion, signs of OD
Assess patient for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy. Obtain specimens for culture and sensitivity before initiating therapy. Observe for signs and symptoms of anaphylaxis. Assess patient for skin rash frequently during therapy. Discontinue azithromycin at first sign of rash. May cause ↑ serum bilirubin, AST, ALT, LDH, and alkaline phosphatase concentrations.
"Assess patient for abdominal distention, presence of bowel sounds, and usual pattern of bowel function. Assess color, consistency, and amount of stool produced" (Deglin & Vallerand, 2013,p.219).
Assess degree and manifestations of anxiety before and during therapy. Patients with a HX of drug abuse should be monitored for tolerance or dependance.
Monitor BP and pulse frequently during dose adjustment period and periodically during therapy. Assess for orthostatic hypotension when assisting patient up from supine position. Monitor intake and output ratios and daily weight. Assess patient routinely for evidence of fluid overload.
Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy. Assess for allergy to penicillins. Obtain specimens for culture and sensitivity before initiating therapy. Observe patient for signs and symptoms of anaphylaxis. Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stoolssigns of pseudomembranous colitis.
Assess the hydration status of patients receiving IV dextrose. Monitor intake and output and electrolyte concentrations. Assess patient for dehydration or edema. Assess nutritional status, function of gastrointestinal tract, and caloric needs of patient. Diabetic patients and patients receiving hypertonic dextrose solution (>5%) should have serum glucose, potassium, and phosphate monitored regularly. Monitor IV site frequently for phlebitis and infection. May cause an ↑ serum glucose level.
Monitor apical pulse for 1 full min before administering. Withhold dose and notify health care professional if pulse rate is <60 bpm. Monitor BP periodically in patients receiving IV digoxin. Monitor ECG throughout IV administration and 6 hr after each dose. Notify health care professional if bradycardia or new arrhythmias occur. Observe IV site for redness or infiltration. Monitor intake and output ratios and daily weights. Risk for falls in elderly. Evaluate serum electrolyte levels (especially potassium, magnesium, and calcium) and renal and hepatic functions periodically during therapy. Therapeutic serum digoxin levels range from 0.5–2 ng/mL. Serum levels may be drawn 6–8 hr after a dose is administered. OD use digoxin immune Fab (Digibind)
"Assess for urticaria and for patency of airway, assess nausea, vomiting, bowel sounds, and abdominal pain, assess degree of itching, skin rash, and inflammation" (Deglin & Vallerand, 2013,p.444).
" Assess for abdominal distention, presence of bowel sounds, and usual pattern of bowel function. Assess color, consistency, and amount of stool produced" (Deglin & Vallerand, 2013, 458).
"Monitor BP and pulse frequently, monitor frequency of prescription refills to determine adherence. Monitor weight and assess patient routinely for resolution of fluid overload" (Deglin & Vallerand, 2013,p.163).
Assess for abdominal pain and blood in stool, Monitor CBC periodically, Assess for confusion, Assess for any sudden bleeding
Assess nutritional status and determine cause for iron deficiency. nAssess bowel function for constipation or diarrhea. Assess for S&S of anaphylaxis. Assess for signs of bleeding and hemorrhage (bleeding gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in hematocrit; sudden drop in BP; guaiac positive stools); bleeding from surgical site. Assess for evidence of additional or increased thrombosis. Monitor neurological status frequently for signs of impairment, especially in patients with indwelling epidural catheters for administration of analgesia or with concomitant use of drugs affecting hemostasis (NSAIDs, platelet inhibitors, other anticoagulants). Monitor platelet count closely; may cause thrombocytopenia. If platelet count is <100,000/mm3, discontinue fondaparinux. Monitor CBC, serum creatinine levels, and stool occult blood tests routinely during therapy. May cause asymptomatic ↑ in AST and ALT.
Assess fluid status. Monitor daily weight, intake and output ratios, amount and location of edema, lung sounds, skin turgor, and mucous membranes. Monitor BP and pulse before and during administration. Diuretic use is associated with increased risk for falls in older adults. Assess patients receiving digoxin for anorexia, nausea, vomiting, muscle cramps, paresthesia, and confusion. Patients taking digoxin are at increased risk of digoxin toxicity because of the potassium-depleting effect of the diuretic. Assess patient for tinnitus and hearing loss. Assess for allergy to sulfonamides. Assess patient for skin rash frequently during therapy. Discontinue furosemide at first sign of rash; may be lifethreatening, Stevens-Johnson syndrome. Monitor electrolytes, renal and hepatic function, serum glucose, and uric acid levels before and periodically throughout therapy.
Observe for signs and symptoms of hypoglycemic reactions (sweating, hunger, weakness, dizziness, tremor, tachycardia, anxiety). Monitor serum glucose and glycosylated hemoglobin periodically during therapy to evaluate effectiveness. Monitor CBC periodically during therapy. Report ↓ in blood counts promptly. May cause an ↑ in AST, LDH, BUN, and serum creatinine. Overdose is manifested by symptoms of hypoglycemia. Mild hypoglycemia may be treated with administration of oral glucose. Severe hypoglycemia should be treated with IV D50W followed by continuous IV infusion of more dilute dextrose solution at a rate sufficient to keep serum glucose at approximately 100 mg/dL.
Assess BP, Pulse, and respirations before and periodically during administration. Assess bowel function routinely, and patients on a continuous infusion should have additional bolus doses provided every 15-30 minutes, as needed, for breakthrough pain (Deglin & Vallerand, 2013). Assess for signs of hypoglycemia and hyperglycemia - monitor body weight periodically, Monitor blood glucose q6h during therapy, administer 15-30 mins prior to meal – OD/toxicity –treat with IV glucose, glucagon, or epinephrine – roll vial – store with needles pointing up – only insulin needles – do not use if cloudy – Direct IV (50 units/1min)or SubQ – maybe added to TPN solutions – Teach importance of compliance with meds and diet/exercise – do not miss follow ups - teach administration and S/S of hypo/hyperglycemia. Assess nutritional status and determine cause for iron deficiency. nAssess bowel function for constipation or diarrhea. Assess for S&S of anaphylaxis.
"Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reasctions.
"Assess apical pulse and BP prior to and periodically throughout therapy. Assess for tachyarrhythmias and chest pain" (Deglin & Vallerand, 2013, p. 780).
Monitor BP and pulse frequently during initial dosage adjustment and periodically during therapy. Monitor frequency of prescription refills to determine compliance. Assess patient for signs of angioedema (dyspnea, facial swelling). Monitor weight and assess patient routinely for resolution of fluid overload (peripheral edema, rales/crackles, dyspnea, weight gain, jugular venous distention). Monitor renal function. May cause increase in BUN and serum creatinine. May cause hyperkalemia. Monitor CBC periodically during therapy. May cause elevated AST, ALT, alkaline phosphatase, and serum bilirubin. "Assess B/P, and pulse periodically during therapy. Notify health care professional of significant changes. Monitor frequency of prescription refills to determine adherence. Assess patient for signs of angioedema"(Deglin & Vallerand, 2013,p.168). "Assess for heartburn and indigestion as well as location, duration, character, and precipating factors of gastric pain" (Deglin & Vallerand, 2013,p.805).
Monitor blood glucose daily.When combined with oral sulfonylureas, observe for signs and symptoms of hypoglycemic reactions (abdominal pain, sweating, hunger, weakness, dizziness, headache, tremor, tachycardia, anxiety). Patients who have been well controlled on metformin who develop illness or laboratory abnormalities should be assessed for ketoacidosis or lactic acidosis. Assess serum electrolytes, ketones, glucose, and, if indicated, blood pH, lactate, pyruvate, and metformin levels. If either form of acidosis is present, discontinue metformin immediately and treat acidosis. Monitor serum glucose and glycosylated hemoglobin periodically during therapy to evaluate effectiveness of therapy. Assess renal function before initiating and at least annually during therapy. Discontinue metformin if renal impairment occurs. Monitor serum folic acid and vitamin B12 every 1–2 yr in long-term therapy
"Assess lesions before and daily during therapy" (Deglin & Vallerand, 2013,p. 886).
"Assess type, location, and intensity of pain before and 30 minutes after IV administration" (Deglin & Vallerand, 2013,p.896). "Monitor respiratory rate, rhythm, and depth pulse, ECG, BP, and level of consciousness between 3-4 hour after the expected peak of blood concentrations" (Deglin & Vallerand, 2013,p.898).
Assess location, duration,and intensity of anginal pain. Monitor BP and pulse before and during therapy.
"Assess patient for nausea, vomiting, abdominal distention, and bowel sounds prior to and following administration. Monitor ECG in patients with hypokalemia or hypomagnesemia, hf, or bradyarrhythmias" (Deglin & Vallerand, 2013,p. 949). "Assess BP, Pulse, and respirations before and periodically during administration. Assess type, location, and intensity of pain prior to and 1 hour after administration" (Deglin & Vallerand, 2013,p.965).
Assess patient for epigastria or abdominal pain and occult blood in stool, May cause abnormal liver function tests, May cause hypomagnesaemia- monitor serum mag periodically during therapy
"Monitor BP, pulse, and respiratory rate. Assess level of sedation afte administration" (Deglin & Vallerand, 2013,p.1058).
Monitor BP and pulse before theapy and dose adjustments. Assess for S&S of angioedema. Monitor weight. Monitor BUN, creatinine, and electrolyte levels periodically. Monitor CBC periodically. "Assess patient for abdominal pain, distention, and bowel sounds prior to and periodically throughout course of therapy. Frequency of belching and passage of flatus should also be assessed" (Deglin & Vallerand, 2013,p.1150). Obtain dietary history in regard to fat intake. Evaluate serum cholesterol & triglycerides before therapy & 4-6 wks after. Monitor liver function tests. If pt develops muscle tenderness monitor CK if >10 DC.
Assess fluid balance(daily weight I&Os, edema, lung sounds), Assess for headache, tachycardia, dry mucous membranes, nausea, muscle cramps, Monitor electrolytes during therapy.
Assess patient for symptoms of prostatic hyperplasia (urinary hesitancy, feeling of incomplete bladder emptying, interruption of urinary stream, impairment of size and force of urinary stream, terminal urinary dribbling, straining to start flow, dysuria, urgency) before and periodically during therapy. Assess patient for first-dose orthostatic hypotension and syncope. Monitor intake and output ratios and daily weight, and assess for edema daily, especially at beginning of therapy. Report weight gain or edema. Rectal exams prior to and periodically throughout therapy to assess prostate size are recommended. May cause dizziness & orthostatic hypotension. "Assess patient for infection (vital signs, appearance of wound, sputum, urine, stool, and WBC) at beginning of and throughout therapy. Obtain specimens for culture ans sensitivitiy prior to initiating therapy. Monitor IV site closely. Monitor BP throughout infusion. Monitor intake and output values and daily weight. Cloudy or pink urine may sign of nephrotoxicty" (Deglin & Vallerand, 2013,p.1263). Assess for signs of bleeding. Monitor PT, INR and other clotting factors frequently during therapy. Instruct patient to take medication as directed. Caution patient to avoid IM injections and activities leading to injury. Instruct patient to use a soft toothbrush, not to floss, and to shave with an electric razor during warfarin therapy. Advise patient that venipunctures and injection sites require application of pressure to prevent bleeding or hematoma formation. Limit Vit K foods. Advise patient to report any symptoms of unusual bleeding or bruising. Instruct patient not to drink alcohol or use NSAIDs. Maintain appointments for follow up labs.
"Assess mental status, sleep patterns, and potential for abuse prior to administration. Assess alertness at time of peak effect. Assess patient for pain, medicate if needed" (Deglin & Vallerand, 2013,p.1317).
Generic Trade Admin Time Dose
acetaminophen
Tylenol
Albuterol Sulfate
Airomir
amLODIPine
Norvasc
aspirin
Bayer Aspirin
Azithromycin
Zithromax
Biscacodyl
Dulcolax
busPIRone
BuSpar
Carvedilol
Coreg
Ceftriaxone Sodium
Rocephin
Dextrose/Water
Insta-glucose
Digoxin
Lanoxin
Diphenhydramine
Benadryl
Docusate Sodium
Colace
Enalapril
Vaslotec
Famotidine
Pepcid
Ferrous Sulfate
Fer-Iron
Fondaparinux
Arixtra
Furosemide
Lasix
Glyburide
DiaBeta
Hydromorphone
Dilaudid
Insulin Human Regular
Humulog
iron polysaccaride
PolyIron
Ketorolac
Toradol
Levothyroxine
Synthroid
Lisinopril
Zestril
Losartan Potassium
Cozaar
Magnesium Hydroxide
Milk of Magnesia
Metformin
Metaglip
Mupirocin
Bactroban
Nalbuphine Hydrochloride
Nubain
Naloxone
Naloxone
Nitroglycerin
Nitropaste
Ondanestron Hydrochlorine
Zofran
Oxycodone
Supeudol
Pantoprazole Sodium
Protonix
Promethazine HCL
Promethacon
ramipril
Altace
Simethicone
Maalox
simvastatin
Zocor
Sodium Chloride 0.9%
Slo-Salt
Tamsulosin
Flomax
Vancomycin HCL
Vancocin
Warfarin Sodium
Coumadin
Zolpidem
Ambien
MEDICATIONS
Route Routine or PRN
(Including IV medications)
Class & Action
antipyretic, nonopioid analgesic: Inhibits the synthesis of prostaglandins that may serve as mediators of pain and fever, primarily in the CNS.
Major/Common Side Effects
HEPATOXICITY, constipation, renal failure, neutropenia, pancytopenia, rash, urticaria
"Brochodilators, "Nervousness, restlessness, tremor, Adrenergics. Used as a headache, insomnia, paradoxical quick-relief acute bronchospasm, chest pain, bronchospasm and for palpitations, angina, arrhythmias, prevention of exercisehyertension, nausea, vomitting, induced bronchospasm" hyperglycemia, hypokalemai, (Deglin & Vallerand, tremor" (Deglin & Vallerand, 2013, 2013,p.112). p. 113). antihypertensive: inhibits transport of calcium into headache, dizziness, fatigue, myocardial & vascular peropheral edema, angina, smooth muscle cellsbradycardia, hypostension, inhibition of excitationpalpatations, gingival hyperplasia, contraction coupling & nausea, flushing subsequent contraction antipyretic, nonopioid GI BLEEDING, EXFOLIATIVE analgesic: Decreased DERMATITIS, STEVEN JOHNS incidence of transient SYNDROME, dyspepsia, epigastric ischemic attacks and MI. distress, nausea
dizziness, seizures, drowsiness, fatigue, headache, chest pain, hypotension, palpitations, HEPATOTOXICITY, Th: antiinfective Ph: PSEUDOMEMBRANOUS macrolides Inhibits COLITIS, abdominal pain, diarrhea, protein synthesis at the nausea, thrush, anemia, leukopenia, level of the 50S bacterial thrombocytopenia, STEVENSribosome. JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, photosensitivity, rash, ototoxicity, hyperkalemia, ANGIOEDEMA. "Laxatives, stimulant laxatives. Stimulates peristalsis. Alters fluid and electrolyte transport, producing fluid accumulation in the colon" (Deglin & Vallerand, 2013,p.218).
"Abdominal cramps, nausea, diarrhea, rectal burning, hypokalemia, muscle weakness, tetany" (Deglin & Vallerand, 2013,p.98).
dizziness, drowsiness, fatigue, antianxiety agent: Binds to headache, insomnia, weakness, seratonin & dopamine blurred vision, congestion, sore receptors in the brain. throat, tinnitus, chest pain, Increases norepinephrine palpatations, nausea, rashes, metabolism in the brain. myalgia, incoordination, numbness, sweating.
Dizziness, fatigue, weakness, anxiety, depression, drowsiness, insomnia, memory loss, mental status changes, nervousness, nightmares, blurred vision, dry eyes, Th: antihypertensive Ph: bronchospasm, wheezing, beta blocker Blocks BRADYCARDIA, HF, stimulation of beta1 PULMONARY EDEMA. diarrhea, (myocardial) and beta2 constipation, nausea, erectile (pulmonary, vascular, and dysfunction, STEVENS-JOHNSON uterine)-adrenergic receptor SYNDROME, TOXIC sites. EPIDERMAL NECROLYSIS, itching, rashes, urticaria, hyperglycemia, hypoglycemia, arthralgia, back pain, muscle cramps, paresthesia, ANAPHYLAXIS, ANGIOEDEMA SEIZURES (HIGH DOSES), PSEUDOMEMBRANOUS COLITIS, diarrhea, cholelithiasis, gallbladder sludging, rashes, urticaria, bleeding, eosinophilia, hemolytic anemia, leukopenia, thrombocytosis pain at IM site, phlebitis at IV site, ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS, superinfection.
Th: antiinfective Ph: third generation cephalosporins Binds to the bacterial cell wall membrane, causing cell death.
Fluid overload, hypokalemia, Th: caloric source Ph: hypomagnesemia, carbohydrate Provision of hypophosphatemia, local calories. Prevention and pain/irritation at IV site (hypertonic treatment of hypoglycemia. solution), glycosuria, hyperglycemia.
Fatigue, headache, weakness, Th: antiarrhythmic Ph: blurred vision, yellow or green digitalis glycosides vision, ARRHYTHMIAS, Increases the force of bradycardia, ECG changes, AV myocardial contraction. block, SA block, anorexia, nausea, Prolongs refractory period vomiting, diarrhea, of the AV node. Decreases thrombocytopenia, electrolyte conduction through the SA imbalances with acute digoxin and AV nodes. toxicity.
"Allergy, cold, and cough remedies, antihistamines, antitiussives. Relief of symptoms caused by histamine release including: Anaphylaxis, seasonal and perennial allergic rhinitis, allergic dermatoses, pruritus" (Deglin & Vallerand, 2013,p.443). "Laxatives, stool softeners. Prevention of constipation, promotes incorporation of water into stool, resulting in softer fecal mass. May also promote electrolyte and water secretion into the colon" (Deglin & Vallerand, 2013 ,p. 457)
"Drowsiness, dizziness, headache, paradoxical exicitation, blurred vision, tinnitus, hypotension, palpitations, anorexia, dry mouth, constipation, nausea, frequency, urinary retention, chest tightness, wheezing, photosensitivity" (Deglin & Vallerand, 2013,p.444).
"Throat irritation, mild cramps, diarrhea, rashes" (Deglin & Vallerand, 2013,p. 458).
"Antihypertensives, ACE inhibitors, lower of b/p in hypertensive patients" ((Deglin & Vallerand, 2013,p.160).
Th: antiulcer agent Ph: histamine H2 antagonist Inhibits the action of histamine at the H2receptor site located primarily in gastric parietal iron supplement: essential mineral, enters SEIZURES, dizziness, headache, bloodstream, transported to syncope, hypotension, constipation, liver, spleen, bone marrow nausea, diarrhea, epigastric pain, where it is separated out & staining of the teeth. becomes part of iron stores.
"Dizziness, drowsiness, fatigue, headache, insomina, vertigo, weakness, cough, dyspnea, hypotension, taste distrubances, abdominal painn, anorexia, constipation, diarrhea, nausea, vomitting, renal failure, flushing, pruritis" (Deglin & Vallerand, 2013,p.160). confusion, dizziness, drowsiness, headache, ARRHYTHMIAS, constipation, diarrhea, nausea, AGRANULOCYTOSIS, APLASTIC ANEMIA, anemia
Confusion, dizziness, headache, insomnia, edema, hypotension, Th: anticoagulant constipation, diarrhea, dyspepsia, ↑ Prevention and treatment of liver enzymes, nausea, vomiting, deep vein thrombosis and urinary retention, bullous eruption, pulmonary embolism. hematoma, purpura, rash, bleeding, thrombocytopenea, hypokalemia, fever, ↑ wound drainage.
Th: Diuretic Ph: Loop diuretic Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium. Effectiveness persists in impaired renal function.
Blurred vision, dizziness, headache, vertigo, hearing loss, tinnitus. hypotension. anorexia, constipation, diarrhea, dry mouth, dyspepsia, ↑ liver enzymes, nausea, pancreatitis, vomiting,↑ BUN, excessive urination, nephrocalcinosis, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, photosensitivity, pruritis, rash, hypercholesterolemia, hyperglycemia, hypertriglyceridemia, hyperuricemia, dehydration, hypocalcemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis, APLASTIC ANEMIA, AGRANULOCYTOSIS, hemolytic anemia, leukopenia, thrombocytopenia, muscle cramps, paresthesia, fever.
Th: antidiabetic Ph: sulfonylureas Lowers blood sugar by stimulating the release of insulin from the pancreas and increasing the sensitivity to insulin at receptor sites. May also decrease hepatic glucose production.
Dizziness, drowsiness, headache, weakness, constipation, cramps, diarrhea, drug-induced hepatitis, dyspepsia, ↑ appetite, nausea, vomiting, photosensitivity, rashes, hypoglycemia, hyponatremia, APLASTIC ANEMIA, agranulocytosis, hemolytic anemia, leukopenia, pancytopenia, thrombocytopenia.
" Antitussives, opioid analgesics, opoid agnoist. Decrease in moderate to severe pain. Supression of cough" (Deglin & Vallerand, 2013, p. 666).
"Confusion, sedation, dizziness, constipatin, dysphoria, hallucinations, respiratory depression, hypotensions, bradycardia, urinary retention, sweating, vomitting" (Deglin & Vallerand, 2013, p. 666).
Th: antidiuetic, hormone Lowers blood glucose by stimulating glucose uptake HYPOGLYCEMIA, lipodystrophy, in skeletal muscle and fat, pruritus, erythema, swelling, inhibiting hepatic glucose ALLERGIC REACTIONS production, inhibition of INCLUDING ANAPHYLAXIS . lipolysis and proteolysis, enhanced protein synthesis.
iron supplement: essential mineral, enters SEIZURES, dizziness, headache, bloodstream, transported to syncope, hypotension, constipation, liver, spleen, bone marrow nausea, diarrhea, epigastric pain, where it is separated out & staining of the teeth. becomes part of iron stores. "NSAID, pyroziline carboxylic acid. Decreased pain for a short time period" (Deglin & Vallerand, 2013,p.750). "Stroke, drowsiness, abnormal thinking, euphora, headache, MI, Stevens-Johnsons Syndrome, Necrosis, edema, vasodilation" (Deglin & Vallerand, 2013,p751).
"Hormones and thyroid "Headache, insomina, irritability, preparations. Replacement angina pectoris, arrhythmias, in hypothyroidism to tachycardia, abdominal cramps, restore normal hormonal diarrhea, vomitting, sweating, balance. Suppression of weight loss, heat intolerance" thyroid cancer" (Deglin & (Deglin & Vallerand, 2013, p. 780). Vallerand, 2013, p. 779).
Th: antihypertensive Ph: Ace Inhibitor ACE inhibitors block the conversion of angiotensin I Dizziness, fatigue, headache, to the vasoconstrictor weakness, cough, hypotension, angiotensin II. Also prevent chest pain, abdominal pain, the degradation of diarrhea, nausea, vomiting, erectile bradykinin and other dysfunction, impaired renal vasodilatory function, rashes, hyperkalemia, prostaglandins. Also ↑ ANGIOEDEMA. plasma renin levels and ↓ aldosterone levels. Net result is systemic vasodilation. "Antihypertensives. Angiotensin II receptor antagonists. Lowering of the B/P"(Deglin & Vallerand, 2013,p.167). "Antiulcer agents, antacids. Neutralization of gastric acid with healing of ulcers and decrease in associated pain" (Deglin & Vallerand, 2013,p.805). "Dizziness, hypotension, anxiety, depression, fatigue, headache, weakness,, chest pain, edema, tachycardia, diarrhea, nausea,vomitting" (Deglin & Vallerand, 2013,p.167).
"Constipation, diarrhea, hypermagnesemia" (Deglin & Vallerand, 2013,p.805).
The: antidiabetic Ph: biguanides Decreases hepatic glucose production. Decreases intestinal glucose absorption. Increases sensitivity to insulin.
Abdominal bloating, diarrhea, nausea, vomiting, unpleasant metallic taste, hypoglycemia, LACTIC ACIDOSIS, decreased vitamin B12 levels.
"Headache, cough, itching, "Anti-infectives. Eradicates pharyngitis, rhinitis, upper nasal colonization with respiratory tract congestion, nausea, methicillin-resistant S. altered taste, burning, itching, pain Aureus" stinging" (Deglin & Vallerand, 2013, p. 886). "Opioid analgesics. "Dizziness, headache, sedation, dry Prevention or treament of mouth, nausea, vomiting, clammy opiod induced pruritius, feeling, sweating" (Deglin & decreased pain" (Deglin & Vallerand, 2013,p.896). Vallerand, 2013,p.895). "Antidotes, opiod "hypertension, hypotension, nausea, antagonists, opiod induced vomitting" (Deglin & Vallerand, pruritius" (Deglin & 2013,p.898). Vallerand, 2013,p.897).
Th: antianginals Ph: nitrates Increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions. dizziness, headache, restlessness, Produces vasodilation weakness, blurred vision, (venous greater than hypotension, tachycardia, syncope, arterial). Decreases left abdominal pain, nausea, vomiting, ventricular end-diastolic flushing pressure and left ventricular end-diastolic volume (preload). Reduces myocardial oxygen consumption. "Antiemetics, 5-HT3 antagonists, prevention and "Headache, constipation, diarrhea, treatment of postoperative dizziness, drowsiness, fatigue, nausea and vomitting" weakness" (Deglin & Vallerand, (Deglin & Vallerand, 2013,p.948). 2013,p.948). "Opiod analgesics, for moderate to severe pain" (Deglin & Vallerand, 2013,p.963). "Confusion, sedation, dizziness, constipation, dysphoria, euphoria, hallucinations, diplopia, blurred vision, nausea, vomitting" (Deglin & Vallerand, 2013,p.963).
Th: antiulcer agent Ph: proton-pump inhibitor Binds to an enzyme in the headache, abdominal pain, diarrhea, presence of acidic gastric flatulence, hyperglycemia, pH, preventing the final hypomagnesaemia, bone fracture transport of hydrogen ions into the gastric lumen. "Antiemetics, antihistamines, sedative/hypnotics. Relief "Confusion, disorientation, sedation, of symptoms of histamine dizziness, extrapyramidal ractions, excess usually seen in fatigue, insomnia, nervousness, allergic conditions. bradycardia, tinnitus, hypotension" Diminished nausea or (Deglin & Vallerand, 2013,p.1058) vomitting. Sedation" (Deglin & Vallerand, 2013,p.1050).
dizziness, drowsiness, fatigue, headache, insomnia, weakness, ACE inhibitor: blocks the cough, hypotension, taste conversion of angiotensin I disturbances, abdominal pain, to the vasoconstrctor flushing, back pain, muscle cramps. angiotensin II. ANGIOEDEMA, AGRANULOCYTOSIS "Antiflatulent. Helps relieve symptoms of excessive gas that may None significant occur post operatively" (Deglin & Vallerand, 2013,p.1149). lipid-lowering agent: dizziness, headache, insomnia, Inhibit HMG-CoA weakness, chest pain, blurred reductase, which is vision, abdominal cramps, responsible for catalizing constipation, diarrhea, flatus, an early step in the heartburn, rashes, synthesis of cholesterol. RHABDOMYOLYSIS. Th. Mineral & electrolyte replacement/ supplement Sodium is a major cation in extracellular fluid and helps maintain water distribution, fluid and electrolyte balance, acidHEART FAILURE, PULMONARY base equilibrium, and EDEMA, edema, hypernatremia, osmotic pressure. Chloride hypervolemia, hypokalemia, is the major anion in extravation, irritation at IV site extracellular fluid and is involved in maintaining acid-base balance. Solutions of NaCl resemble extracellular fluid. Reduces corneal edema by an osmotic effect.
Ph: peripherally acting antiadrenergics Decreases contractions in smooth muscle of the prostatic capsule by preferentially binding to alpha1-adrenergic receptors.
Dizziness, headache, rhinitis, orthostatic hypotension, priapism, retrograde/diminished ejaculation.
"Anti-infectives, treatment "Ototoxicity, hypotension, nausea, of life threatening vomiting, nephrotoxicity, rashes, infections when less toxic eosinophilla, leukopenia, phlebitis, anti-infectives are back and neck pain, anaphalxis, contraindicated" (Deglin & chills, fever, superinfection" (Deglin Vallerand, 2013,p.1261). & Vallerand, 2013,p.1262).
Th: anti coagulant Ph: coumarins Interferes with hepatic synthesis of vitamin Kdependent clotting factors
Cramps, nausea, dermal necrosis, BLEEDING, fever.
"Daytime drowsiness, dizziness, "Sedative/hypnotics, abnormal thinkin, behavior changes, promotes sedation" (Deglin diarrhea, anaphalyactic reactions, & Vallerand, 2013,p.1317). vomitting, nausea"(Deglin & Vallerand, 2013,p.1317).
Nursing Implications
Why on these meds?
Assess overall health status and alcohol use. Assess type, location, and intensity of pain prior to administration. If OD occurs acetylcysteine is the antidote. "Assess lung sounds, pulses, and BP before administration, and during peak of medication. Note amount olor, and character of sputum produced. Monitor pulmonary function tests before initiating therapy and periodically during therapy. Observe for paradoxical bronchospasm" (Deglin & Vallerand, 2013, p 114). Monitor BP and pulse before theapy and dose adjustments. Monitor I&O ratios & daily weights. Assess signs of HF. Assess location, duration and intensity of anginal pain.
Assess pain type, location, and intensity. Assess for fever. Monitor hepatic function during asprin therapy. Prolongs bleeding time for 4-7 days after administration. Monitor for tinnitus, headache and confussion, signs of OD
Assess patient for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy. Obtain specimens for culture and sensitivity before initiating therapy. Observe for signs and symptoms of anaphylaxis. Assess patient for skin rash frequently during therapy. Discontinue azithromycin at first sign of rash. May cause ↑ serum bilirubin, AST, ALT, LDH, and alkaline phosphatase concentrations.
"Assess patient for abdominal distention, presence of bowel sounds, and usual pattern of bowel function. Assess color, consistency, and amount of stool produced" (Deglin & Vallerand, 2013,p.219).
Assess degree and manifestations of anxiety before and during therapy. Patients with a HX of drug abuse should be monitored for tolerance or dependance.
Monitor BP and pulse frequently during dose adjustment period and periodically during therapy. Assess for orthostatic hypotension when assisting patient up from supine position. Monitor intake and output ratios and daily weight. Assess patient routinely for evidence of fluid overload.
Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy. Assess for allergy to penicillins. Obtain specimens for culture and sensitivity before initiating therapy. Observe patient for signs and symptoms of anaphylaxis. Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stoolssigns of pseudomembranous colitis.
Assess the hydration status of patients receiving IV dextrose. Monitor intake and output and electrolyte concentrations. Assess patient for dehydration or edema. Assess nutritional status, function of gastrointestinal tract, and caloric needs of patient. Diabetic patients and patients receiving hypertonic dextrose solution (>5%) should have serum glucose, potassium, and phosphate monitored regularly. Monitor IV site frequently for phlebitis and infection. May cause an ↑ serum glucose level.
Monitor apical pulse for 1 full min before administering. Withhold dose and notify health care professional if pulse rate is <60 bpm. Monitor BP periodically in patients receiving IV digoxin. Monitor ECG throughout IV administration and 6 hr after each dose. Notify health care professional if bradycardia or new arrhythmias occur. Observe IV site for redness or infiltration. Monitor intake and output ratios and daily weights. Risk for falls in elderly. Evaluate serum electrolyte levels (especially potassium, magnesium, and calcium) and renal and hepatic functions periodically during therapy. Therapeutic serum digoxin levels range from 0.5–2 ng/mL. Serum levels may be drawn 6–8 hr after a dose is administered. OD use digoxin immune Fab (Digibind)
"Assess for urticaria and for patency of airway, assess nausea, vomiting, bowel sounds, and abdominal pain, assess degree of itching, skin rash, and inflammation" (Deglin & Vallerand, 2013,p.444).
" Assess for abdominal distention, presence of bowel sounds, and usual pattern of bowel function. Assess color, consistency, and amount of stool produced" (Deglin & Vallerand, 2013, 458).
"Monitor BP and pulse frequently, monitor frequency of prescription refills to determine adherence. Monitor weight and assess patient routinely for resolution of fluid overload" (Deglin & Vallerand, 2013,p.163).
Assess for abdominal pain and blood in stool, Monitor CBC periodically, Assess for confusion, Assess for any sudden bleeding
Assess nutritional status and determine cause for iron deficiency. nAssess bowel function for constipation or diarrhea. Assess for S&S of anaphylaxis. Assess for signs of bleeding and hemorrhage (bleeding gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in hematocrit; sudden drop in BP; guaiac positive stools); bleeding from surgical site. Assess for evidence of additional or increased thrombosis. Monitor neurological status frequently for signs of impairment, especially in patients with indwelling epidural catheters for administration of analgesia or with concomitant use of drugs affecting hemostasis (NSAIDs, platelet inhibitors, other anticoagulants). Monitor platelet count closely; may cause thrombocytopenia. If platelet count is <100,000/mm3, discontinue fondaparinux. Monitor CBC, serum creatinine levels, and stool occult blood tests routinely during therapy. May cause asymptomatic ↑ in AST and ALT.
Assess fluid status. Monitor daily weight, intake and output ratios, amount and location of edema, lung sounds, skin turgor, and mucous membranes. Monitor BP and pulse before and during administration. Diuretic use is associated with increased risk for falls in older adults. Assess patients receiving digoxin for anorexia, nausea, vomiting, muscle cramps, paresthesia, and confusion. Patients taking digoxin are at increased risk of digoxin toxicity because of the potassium-depleting effect of the diuretic. Assess patient for tinnitus and hearing loss. Assess for allergy to sulfonamides. Assess patient for skin rash frequently during therapy. Discontinue furosemide at first sign of rash; may be lifethreatening, Stevens-Johnson syndrome. Monitor electrolytes, renal and hepatic function, serum glucose, and uric acid levels before and periodically throughout therapy.
Observe for signs and symptoms of hypoglycemic reactions (sweating, hunger, weakness, dizziness, tremor, tachycardia, anxiety). Monitor serum glucose and glycosylated hemoglobin periodically during therapy to evaluate effectiveness. Monitor CBC periodically during therapy. Report ↓ in blood counts promptly. May cause an ↑ in AST, LDH, BUN, and serum creatinine. Overdose is manifested by symptoms of hypoglycemia. Mild hypoglycemia may be treated with administration of oral glucose. Severe hypoglycemia should be treated with IV D50W followed by continuous IV infusion of more dilute dextrose solution at a rate sufficient to keep serum glucose at approximately 100 mg/dL.
Assess BP, Pulse, and respirations before and periodically during administration. Assess bowel function routinely, and patients on a continuous infusion should have additional bolus doses provided every 15-30 minutes, as needed, for breakthrough pain (Deglin & Vallerand, 2013). Assess for signs of hypoglycemia and hyperglycemia - monitor body weight periodically, Monitor blood glucose q6h during therapy, administer 15-30 mins prior to meal – OD/toxicity –treat with IV glucose, glucagon, or epinephrine – roll vial – store with needles pointing up – only insulin needles – do not use if cloudy – Direct IV (50 units/1min)or SubQ – maybe added to TPN solutions – Teach importance of compliance with meds and diet/exercise – do not miss follow ups - teach administration and S/S of hypo/hyperglycemia. Assess nutritional status and determine cause for iron deficiency. nAssess bowel function for constipation or diarrhea. Assess for S&S of anaphylaxis.
"Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reasctions.
"Assess apical pulse and BP prior to and periodically throughout therapy. Assess for tachyarrhythmias and chest pain" (Deglin & Vallerand, 2013, p. 780).
Monitor BP and pulse frequently during initial dosage adjustment and periodically during therapy. Monitor frequency of prescription refills to determine compliance. Assess patient for signs of angioedema (dyspnea, facial swelling). Monitor weight and assess patient routinely for resolution of fluid overload (peripheral edema, rales/crackles, dyspnea, weight gain, jugular venous distention). Monitor renal function. May cause increase in BUN and serum creatinine. May cause hyperkalemia. Monitor CBC periodically during therapy. May cause elevated AST, ALT, alkaline phosphatase, and serum bilirubin. "Assess B/P, and pulse periodically during therapy. Notify health care professional of significant changes. Monitor frequency of prescription refills to determine adherence. Assess patient for signs of angioedema"(Deglin & Vallerand, 2013,p.168). "Assess for heartburn and indigestion as well as location, duration, character, and precipating factors of gastric pain" (Deglin & Vallerand, 2013,p.805).
Monitor blood glucose daily.When combined with oral sulfonylureas, observe for signs and symptoms of hypoglycemic reactions (abdominal pain, sweating, hunger, weakness, dizziness, headache, tremor, tachycardia, anxiety). Patients who have been well controlled on metformin who develop illness or laboratory abnormalities should be assessed for ketoacidosis or lactic acidosis. Assess serum electrolytes, ketones, glucose, and, if indicated, blood pH, lactate, pyruvate, and metformin levels. If either form of acidosis is present, discontinue metformin immediately and treat acidosis. Monitor serum glucose and glycosylated hemoglobin periodically during therapy to evaluate effectiveness of therapy. Assess renal function before initiating and at least annually during therapy. Discontinue metformin if renal impairment occurs. Monitor serum folic acid and vitamin B12 every 1–2 yr in long-term therapy
"Assess lesions before and daily during therapy" (Deglin & Vallerand, 2013,p. 886).
"Assess type, location, and intensity of pain before and 30 minutes after IV administration" (Deglin & Vallerand, 2013,p.896). "Monitor respiratory rate, rhythm, and depth pulse, ECG, BP, and level of consciousness between 3-4 hour after the expected peak of blood concentrations" (Deglin & Vallerand, 2013,p.898).
Assess location, duration,and intensity of anginal pain. Monitor BP and pulse before and during therapy.
"Assess patient for nausea, vomiting, abdominal distention, and bowel sounds prior to and following administration. Monitor ECG in patients with hypokalemia or hypomagnesemia, hf, or bradyarrhythmias" (Deglin & Vallerand, 2013,p. 949). "Assess BP, Pulse, and respirations before and periodically during administration. Assess type, location, and intensity of pain prior to and 1 hour after administration" (Deglin & Vallerand, 2013,p.965).
Assess patient for epigastria or abdominal pain and occult blood in stool, May cause abnormal liver function tests, May cause hypomagnesaemia- monitor serum mag periodically during therapy
"Monitor BP, pulse, and respiratory rate. Assess level of sedation afte administration" (Deglin & Vallerand, 2013,p.1058).
Monitor BP and pulse before theapy and dose adjustments. Assess for S&S of angioedema. Monitor weight. Monitor BUN, creatinine, and electrolyte levels periodically. Monitor CBC periodically. "Assess patient for abdominal pain, distention, and bowel sounds prior to and periodically throughout course of therapy. Frequency of belching and passage of flatus should also be assessed" (Deglin & Vallerand, 2013,p.1150). Obtain dietary history in regard to fat intake. Evaluate serum cholesterol & triglycerides before therapy & 4-6 wks after. Monitor liver function tests. If pt develops muscle tenderness monitor CK if >10 DC.
Assess fluid balance(daily weight I&Os, edema, lung sounds), Assess for headache, tachycardia, dry mucous membranes, nausea, muscle cramps, Monitor electrolytes during therapy.
Assess patient for symptoms of prostatic hyperplasia (urinary hesitancy, feeling of incomplete bladder emptying, interruption of urinary stream, impairment of size and force of urinary stream, terminal urinary dribbling, straining to start flow, dysuria, urgency) before and periodically during therapy. Assess patient for first-dose orthostatic hypotension and syncope. Monitor intake and output ratios and daily weight, and assess for edema daily, especially at beginning of therapy. Report weight gain or edema. Rectal exams prior to and periodically throughout therapy to assess prostate size are recommended. May cause dizziness & orthostatic hypotension. "Assess patient for infection (vital signs, appearance of wound, sputum, urine, stool, and WBC) at beginning of and throughout therapy. Obtain specimens for culture ans sensitivitiy prior to initiating therapy. Monitor IV site closely. Monitor BP throughout infusion. Monitor intake and output values and daily weight. Cloudy or pink urine may sign of nephrotoxicty" (Deglin & Vallerand, 2013,p.1263). Assess for signs of bleeding. Monitor PT, INR and other clotting factors frequently during therapy. Instruct patient to take medication as directed. Caution patient to avoid IM injections and activities leading to injury. Instruct patient to use a soft toothbrush, not to floss, and to shave with an electric razor during warfarin therapy. Advise patient that venipunctures and injection sites require application of pressure to prevent bleeding or hematoma formation. Limit Vit K foods. Advise patient to report any symptoms of unusual bleeding or bruising. Instruct patient not to drink alcohol or use NSAIDs. Maintain appointments for follow up labs.
"Assess mental status, sleep patterns, and potential for abuse prior to administration. Assess alertness at time of peak effect. Assess patient for pain, medicate if needed" (Deglin & Vallerand, 2013,p.1317).
