TANAWE, ORLYN JOY J.

NOVEMBER 20-23, 2023

BSN IV-C CI: Ma’am KAREN DORADO

DRUG STUDY 1
DRUG NAME MECHANISM OF INDICATION / SIDE NURSING RESPONSIBILITIES
ACTION CONTRAINDICATION EFFECTS/ADVERSE
EFFECT
GENERIC: Tramadol and its INDICATIONs: Respiratory: BEFORE:
TRAMADOL active metabolite (M1) Relief of moderate to Bronchitis, cough, nasal Dx:
binds to μ-opiate moderately severe pain. congestion, a. Observe 10 rights in drug administration
BRAND: receptors in the CNS nasopharyngitis, to avoid medication errors.
ULTRAM, CONZIP causing inhibition of CONTRAINDICATION: pharyngitis, rhinitis, b. Check for allergies.
ascending pain Suicidal patients, acute rhinorrhea, sinus c. Monitor vital signs.
CLASS: pathways, altering the alcoholism; head congestion, sinusitis,
THERAPEUTIC perception of and injuries; raised sneezing, upper Tx:
ANALGESIC response to pain; also intracranial pressure; respiratory tract infection a. Perform a thorough physical assessment
inhibits the reuptake severe renal to establish baseline data before drug
PHARMACOLOGIC of norepinephrine and impairment; lactation. GI: therapy begins, to determine the
OPIOID serotonin, which are GI pain, diarrhea, effectiveness of therapy
AGONISTS neurotransmitters vomiting, nausea, b. Do a pain scale check.
involved in the DRUG TO DRUG constipation
descending inhibitory INTERATION: EDx:
DOSAGE: pain pathway Ambien: CNS: a. Educate patient on drug therapy to
50mg. q responsible for pain Using narcotic pain or Anxiety, apathy, ataxia, promote understanding and compliance.
8hrs. relief. cough medications chills, confusion, b. Educate patient and family
together with other depersonalization, regarding drug therapy.
ROUTE: medications that also depression, falling, feeling
IV cause central nervous hot, hypoesthesia, DURING:
system depression can lethargy, nervousness, Dx:
lead to serious side pain, paresthesia, a. Asses mental status for worsening of
effects including restlessness, rigors, depression, suicidal ideation, anxiety,
respiratory distress, agitation, euphoria, social functioning, and/or panic attack
coma, and even death. hypertonia, malaise, sleep (especially during initiation of therapy
Celecoxib: disorder, withdrawal and when dosage is changed
Celecoxib may increase syndrome, insomnia, b. Monitor mood changes.
the blood levels and seizures dizziness, c. Monitor for adverse effects
effects of tramadol. headache, somnolence d. Watch for new seizures or increased
Benadryl: seizure activity, especially at the onset of
Using Hematologic: drug treatment.
diphenhydramine neutropenia, leukopenia, Tx:
together with tramadol decreased Hgb or Hct, a. Administered prescribed medication.
may increase side bone marrow depression
effects such as EDx:
dizziness, drowsiness, Dermatologic: a. Instruct patient to report any adverse or
confusion, and Diaphoresis, dermatitis, side effects.
difficulty concentrating. skin rash, pruritus b. Instruct patient to verbalize feelings and
Lipitor: concerns.
No interactions were Cardiovascular: c. Guard against falls and trauma (hip
found between Lipitor Flushing, chest pain, fractures, head injury).
and tramadol. hypertension, vasodilation,
peripheral edema, AFTER:
orthostatic hypotension Dx:
DRUG TO FOOD a. Monitor for effectiveness as exhibited by
INTERACTION: Gastrointestinal: decrease in symptoms.
Alcohol: Constipation, nausea, b. Evaluate patient understanding on drug
Alcohol can increase vomiting, xerostomia, therapy by asking patient to name the
the nervous system dyspepsia drug, its indication, and adverse effects
side effects of tramadol to watch for.
such as dizziness,
drowsiness, and Tx:
difficulty concentrating. a. Use pain scale to assess if the drug was
Some people may also effective.
experience impairment b. Do another thorough physical
in thinking and assessment and compare to baseline.
judgment. c. Provide safety measures (e.g., adequate
lighting, raised side rails, etc.) to prevent
injuries.

EDx:
a. Encouraged a healthy diet that is packed
with essential nutrients.
b. Instruct to complete full course
of therapy
DRUG STUDY 2
DRUG NAME MECHANISM OF INDICATION / SIDE NURSING RESPONSIBILITIES
ACTION CONTRAINDICATION EFFECTS/ADVERSE
EFFECT
GENERIC: Antagonizes the INDICATIONs: CNS: BEFORE:
METOCLOPRA- inhibitory effect of Prevention of Drowsiness, Dx:
MIDE dopamine on GI chemotherapy-induced extrapyramidal reactions, a. Use metoclopramide cautiously in
smooth muscle. This emesis. Treatment of restlessness, neuroleptic patients with hypertension because it
BRAND: causes gastric postsurgical and malignant syndrome, may increase catecholamine levels.
METOZOLV, contraction, which diabetic gastric stasis. anxiety, depression, b. Assess for drug allergies
REGLAN promotes gastric Facilitation of small irritability, tardive c. Assess drug history that may cause
emptying and bowel intubation in dyskinesia. interactions with metoclopramide
CLASS: peristalsis, thus radiographic CV: d. Assess bp and compare to normal values
THERAPEUTIC reducing procedures. arrhythmias
ANTIENEMIC, gastroesophageal Management of (supraventricular Tx
upper GI reflux. esophageal reflux. tachycardia, bradycardia), a. Perform a thorough physical assessment
stimulant Metoclopramide also Treatment and hypertension, hypotension. to establish baseline data before drug
blocks dopaminergic prevention of GI: therapy begins, to determine the
PHARMACOLOGIC receptors in the postoperative nausea constipation, diarrhea, dry effectiveness of therapy, and to evaluate
DOPAMINE chemoreceptor trigger and vomiting when mouth, nausea. for the occurrence of any adverse effects
RECEPTOR zone, preventing nasogastric suctioning ENDO: associated with drug therapy.
ANTAGONISTS nausea and vomiting. is undesirable. Gynecomastia b. Monitor for possible hypernatremia and
Migraine. HEMAT: hypokalemia especially if patient has
DOSAGE: SOURCE: methemoglobinemia, CHF or cirrhosis.
10mg. Jones & Bartlett, CONTRAINDICATIONS neutropenia, leukopenia, EDx:
(2018). Nurse’s drug : agranulocytosis. a. Educate patient and family regarding
handbook, seventh GI hemorrhage, drug therapy.
ROUTE: edition, p. 705. ISBN: mechanical obstruction b. Ensure the patient takes the medication
IV 978-1-284-12134-6 and perforation; as prescribed.
phaeochromocytoma; c. Educate patient about the risks and side
history of seizures. effects.
d. Caution patient that dizziness may
DRUG TO DRUG occur.
INTERACTIONS:
antipsychotic drugs DURING:
(such as aripiprazole, Dx:
haloperidol), a. Monitor patient, especially one with
atovaquone, dopamine heart failure or cirrhosis, for possible
agonists (such as fluid retention or volume overload due to
cabergoline, pergolide, transient increase in plasma aldosterone
ropinirole), Fosfomycin, level.
MAO inhibitors
(isocarboxazid, Tx:
linezolid, methylene a. Administer prescribed medication.
blue, moclobemide, b. Rinse mouth frequently to combat
phenelzine, dryness.
procarbazine, c. Monitor BP carefully during IV
rasagiline, safinamide, administration.
selegiline,
tranylcypromine), EDx:
pramlintide, a. Educate client on drug therapy to
phenothiazines (such promote understanding and compliance.
as promethazine, b. Instruct patient to verbalize feelings and
prochlorperazine), concerns.
rivastigmine.
AFTER:
DRUG TO FOOD Dx:
INTERACTIONS: a. Monitor patient compliance to drug
AVOID therapy.
ALCOHOL b. Monitor for effectiveness as exhibited by
a decrease in symptoms and possible
side effects.
Tx:
a. Provide safety measures (e.g., adequate
lighting, raised side rails, etc.) to prevent
injuries.
b. Provide comfort measures (e.g., voiding
before dosing, taking food with drug,
etc.) to help patient tolerate drug effects.

EDx:
a. Instruct to complete full course
 of therapy.
b. The drug can be safely stopped as soon
as a patient no longer needs it.

DRUG NAME MECHANISM OF INDICATION / SIDE NURSING RESPONSIBILITIES

ACTION CONTRAINDICATION EFFECTS/ADVERSE
EFFECT
GENERIC: INDICATIONs: CNS: Confusion, headache BEFORE:
MANNITOL Increases the osmotic EENT: blurred vision, Check vital signs and urine output.
pressure of the Adjunct in the rhinitis Assess signs of dehydration and muscle
BRAND: glomerular filtrate, treatment of cute CV: Transient volume weakness
OSMITROL, thereby inhibiting oliguria renal failure, expansion, Chest pain, Monitor neurologic status and intracranial
RESECTISOL reabsorption of water edema, increased CHF, pulmonary edema, pressure
and electrolytes. intracranial or tachycardia
CLASS: Causes excretion of: intraocular pressure, GI: Nausea, thirst,
THERAPEUTIC water, sodium, toxic overdose vomiting DURING:
DIURETICS potassium, chloride, GU: Renal failure, urinary Administer over 30min
calcium, phosphorus, retention Monitor urine output and refer in accordance
PHARMACOLOGIC magnesium, urea, CONTRAINDICATIONs with parameters set by physician
OSMOTIC uric acid Hypersensitivity, F&E:Dehydration, Ensure safety and report signs of electrolyte
DIURETIC anuria, dehydration, hyperkalemia, imbalance
Therapeutic effects: active intracranial hypernatremia,
Mobilization of excess bleeding, use hypokalemia,
DOSAGE: fluid in oliguric renal cautiously in pregnant hyponatremia AFTER
150cc failure or edema. & lactation Check effectiveness of therapy
Every 4hours Reduction of Local: Phlebitis@ IV site Continuously monitor neurologic status and
intraocular or urine output
ROUTE: intracranial pressure. Reassess signs/symptoms of dehydration
IV bolus Increased urinary Watch out for abnormal responses
excretion of toxic
materials.
Decreased hemolysis
when used as an
irrigant after
transurethral
prostatic resection
 ASSESSMENT EXPLANATION OF PLANNING INTERVENTION RATIONALE EVALUATION
THE PROBLEM
SUBJECTIVE DATA: Stimulation of the STO:  Assess underlying  To determine what STO: Goal was
“kinanayon sumakit vasomotor center (loc After 8 hours of condition triggers the elevated met
dytoy batok ko” in the medulla) sends nursing BP
impulses to CNS intervention, the  Monitor blood After 8 hours of
patient blood pressure for every  Changes in BP may effective nursing
Acetylcholine released pressure will 30 mins indicate changes in intervention the
OBJECTIVE DATA: by prosta decrease to patients’ status client has no
 With BP of preganglionic neurons acceptable limits requiring prompt elevation in his NCP
180/100mmgH medical attention blood pressure
; HR: 120 bpm Preganglionic fiber  Observe skin color,
 Restless releases temperature,  Peripheral
 Perspiration capillary refill, and vasoconstriction may
bits Norepinephrine diaphoresis result in pale, cool,
 Dizziness noted (constriction of blood clammy skin, with
 Irritable at vessels thereby prolonged capillary
times increasing blood refill time
 Body weakness pressure  Do frequent  It may decrease LTO: Goal was
LTO: positioning for the peripheral venous met.
adrenal medulla After 72 hours of patient pooling that may be After 72 hours of
secrets epinephrine nursing potentiated by effective nursing
interventions, the vasodilators and interventions, the
Dx: Elevated Blood increased blood client will be able to prolonged sitting or client will able to
Pressure related to pressure causing it to maintain normal  Administered standing maintain normal
hypertension as increase blood supply and stable blood prescribed drugs and stable blood
manifested by in the brain causing pressure (anti-hypertensive)  Inhibits influx of Ca pressure
occipital headache occipital headache ion across the cell
membrane to produce
relaxation of coronary
 Encouraged smooth muscle
patient to decrease
intakes of caffeine,  These is are cardiac
cola, and chocolate stimulants and may
adversely affect
 Emphasized the cardiac function
concept of
controlling  Hypertension is life
hypertension time illness,
rather than curing controlling it is the
it. best way to stop it
from reoccurring
 Encouraged