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KALIUM DURULE DRUGS INDICATION ACTION SIDE EFFECT/ ADVERSE REACTION Side Effect: Nausea and vomiting, diarrhea,

flatulence, abdominal discomfort. Adverse Reaction: Arrhythmias, heartblock, cardiac arrest, hyperkalemia, respiratory paralysis. ( 2008 Nurses Drug Handbook,Georg e Spratto and Adrienne Woods copyright by Thomson Delmar Learning Inc. page.1283) NURSING CONSIDERATIO N/ PATIENT TEACHING Nursing Consideration: Monitor renal function. After surgery, dont give drug until urine flow is established. Many adverse reactions may reflect potassium excess. Make sure powders are completely dissolved before giving. Patient Teaching: Take drug after meals or with food and a full glass of water to decrease gastrointestinal upset. Do not chew or crush tablets, swallow tablets whole. Mix or dissolve oral liquids, soluble powders, and effervescent tablets completely in 38 ounces of cold water, juice, or other

Date Ordered: September 12,2013 Generic Name: Kalium Durule

( 2008 Nurses Drug Handbook,Georg Brand Name: ( 2008 Nurses Potassium Drug e Spratto and Chloride Handbook,Georg Adrienne Woods e Spratto and copyright by Classification Adrienne Woods Thomson Delmar copyright by Learning Inc. : Electrolytic Thomson Delmar page.1282) and Learning Inc. water balance page.1282) agent Dosage: 750mg /tablet

To prevent and treat potassium deficit with or without metabolic acidosis and following surgical condition.

Potassium is readily and rapidly absorbed from the gastrointestinal tract.

suitable beverage, and drink it slowly. Take the drug as prescribed; do not take more than prescribed. Do not use salt substitutes. You may find wax matrix capsules in the stool. The wax matrix is not absorbed in the gastrointestinal tract. Report tingling of the hands or feet, unusual tiredness or weakness, feeling of heaviness in the legs, severe nausea, vomiting, abdominal pain, black or tarry stools.

PARACETAMOL DRUG INDICATION ACTION SIDE EFFECT/ ADVERSE REACTION Side Effect: NURSING CONSIDERATION/ PATIENT TEACHING Nursing Consideration:

Date Ordered: September 12,2013 and September 13, 2013 Generic Name: Paracetamol Brand Name: Classification: Analgesic Dosage: 600mg Intravenous

Short-term treatment of moderate pain, especially following surgery.

(www.actavis.ie/en/ PARACETAMOL)

Feeling unwell, dizziness, lightPatient Teaching: headedness bleeding or bruising more easily than normal, vomiting, nausea, constipation. Adverse Reaction:

KETOROLAC (ANALAC) DRUG INDICATION ACTION SIDE EFFECT/ ADVERSE REACTION Side Effect: Headache, dizziness, drowsiness, diarrhea, nausea, dyspepsia, epigastric pain, edema. Adverse Reaction: Somnolence, NURSING CONSIDERATIO N/ PATIENT TEACHING Nursing Consideration: Nonsteroidal antiinflammatory drugs may mask signs and symptoms of infection because of their antipyretic and anti- inflammatory actions.

Date Ordered: September 12,2013 and September 13,2013 Generic Name: Ketorolac Brand Name: Analac

Short- term treatment (5-7 days) of acute pain after surgery.

May inhibit prostaglandin synthesis, to produce antiinflammatory (www.idruginfo.com , analgesic ) and antipyretic effects. ( Nursing 2008 Drug Handbook copyright

Serious

Classification : Nonsteroidal antiinflammatory drug Dosage: 30mg Intradermal

Lippincott Williams and Wilkins page.385)

headache, dizziness, paresthesias, dry mouth, nausea, vomiting, abdominal pain, and dyspepsia. ( 2008 Nurses Drug Handbook,Georg e Spratto and Adrienne Woods copyright by Thomson Delmar Learning Inc. page.859)

gastrointestinal toxicity, including peptic ulcers and bleeding, can occur in patient taking nonsteroidal antiinflammatory drugs, despite lack of symptoms. Patient Teaching: Teach patient signs and symptoms of gastrointestinal bleeding, including blood in vomit, urine, or stool, coffee- ground vomit, and black, tarry stool. Tell him to notify prescriber immediately if any of these occurs. Tell patient not to take drug for more than 5 days in a row.

LACTULOSE DRUG INDICATION ACTION SIDE EFFECT/ ADVERSE REACTION NURSING CONSIDERATION/ PATIENT TEACHING

Date Ordered: September 12,2013 Generic Name: Lactulose Brand Name:

Treatment of constipation. ( Nursing 2008 Drug Handbook copyright Lippincott Williams and Wilkins page. 696)

Classification: Laxatives Dosage: 30ml

Produces an osmotic effect in colon, resulting distention promotes peristalsis. Also decreases ammonia, probably as a result of bacterial degradation, which lowers the Ph of colon contents. ( Nursing 2008 Drug Handbook copyright Lippincott Williams and Wilkins page.696)

Side Effect: Gastrointestinal: Flatulence, diarrhea, gaseous distention, nausea,vomiting, belching and abdominal discomfort. Adverse Reaction:

Nursing Consideration: Patient Teaching: Inform patient about adverse reactions and tell him to notify prescriber if reactions become bothersome or if diarrhea occurs. Instruct patient not to take other laxatives during lactulose therapy. Make sure you have ready access to bathroom; bowel movements will be increased to two or three per day. Report diarrhea, severe belching, abdominal fullness.

NALBUPHINE HYDROCHLORIDE ( NUBAIN)

DRUG

INDICATION

ACTION

SIDE EFFECT/ ADVERSE REACTION Side Effect: Adverse Reaction:

Date Ordered: Generic Name: Nalbuphine Hydrochloride Brand Name: Nubain Classification: Opioid analgesic Dosage: 15mg Intramuscular

Treating and preventing moderate to severe pain. It can also be used for pain relief before and after surgery. ( Nursing 2008 Drug Handbook copyright Lippincott Williams and Wilkins page.409)

Unknown. Binds with opiate receptors in the CNS, altering perception of and emotional response to pain. ( Nursing 2008 Drug Handbook copyright Lippincott Williams and Wilkins page.410)

NURSING CONSIDERATION/ PATIENT TEACHING Nursing Consideration:

Monitor circulatory and respiratory status Central Nervous and bladder and System:Dizziness, bowel function. If headache, respirations are sedation, vertigo. shallow or rate is below 12 breaths per Cardiovascular: minute, withhold Bradycardia, dose and notify hypertension, prescriber. hypotension, tachycardia. Constipation is often severe with Gastrointestinal: maintenance therapy. Constipation, Make sure stool cramps, softener or other dyspepsia, nausea, laxative is ordered. vomiting Patient Teaching: Respiratory: Respiratory Caution ambulatory depression. patient about getting out of bed or ( Nursing 2008 walking. Drug Handbook copyright Teach patient how to Lippincott manage troublesome Williams and adverse effects such Wilkins page.410) as constipation.

INSULIN GLULISINE (APIDRA) DRUG INDICATION ACTION SIDE EFFECT/ ADVERSE REACTION NURSING CONSIDERATION/ PATIENT TEACHING

Date Ordered: September 12,2013 Generic Name: Insulin Glulisine Brand Name: Apidra Classification: Insulin Dosage: 2 units Subcutaneous

Diabetes mellitus in adults. Usually used in regimens that include a longer-acting insulin or basal insulin analog. ( 2008 Nurses Drug Handbook,George Spratto and Adrienne Woods copyright by Thomson Delmar Learning Inc. page.796)

Lowers glucose level by increasing peripheral glucose uptake and decreasing hepatic glucose production.

Side Effect: Hypoglycemia, hypokalemia, injection site reaction, lipodystrophy, pruritus, rash.

Nursing Consideration: Drug has a more rapid onset and shorter duration of action than regular human insulin. Give within 15 minutes before or immediately after a meal. When used in an external subcutaneous infusion pump, dont mix drug with any other insulin or diluent.

( Nursing 2008 Drug Handbook copyright Lippincott Williams and Wilkins page.815)

Adverse Reaction: Metabolic: hypoglycemia Skin: injectionsite reactions, lipodystrophy, pruritus, rash Other: allergic reactions, anaphylaxis

Patient Teaching: ( Nursing 2008 Drug Handbook copyright Lippincott Williams and Wilkins page.816)

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