NURS 1566 Clinical Form 3: Clinical Medications Worksheets
(You will need to make additional copies of these forms)
Generic Name Trade Name Classification Dose
Prednisolone Norpred Antiasthmatics, 50 mg
corticosteroids
Peak Onset Duration
1 hr Rapid Unknown
Why is your patient getting this medication
Used systemically and locally in a wide variet of chronic
diseases including: Inflammatory, allergic, hematologic,
neoplastic, autoimmune disorders, asthma.
Mechanism of action and indications
(Why med ordered)
In pharmacologic doses, all agents suppress
inflammation and the normal immune response. All
agents have numerous intense metabolic effects.
Suppress adrenal function at chronic doses of rednisolone
5 mg/day. Prednisolone have minimal mineralocorticoid
activity. Suppression of inflammation and modification
of the normal immune response. Replacement therapy in
adrenal insufficiency.
Interactions with other patient drugs, OTC or herbal
medicines (ask patient specifically)
At chronic doses that suppress adrenal function, may
decrease antibody response to and increase risk of
adverse reactions from live virus vaccines. May decrease
salicylate levels and effectiveness.
Route Time/frequency
IV Q Day
Normal dosage range
4-60 mg/day
For IV meds, compatibility with IV drips and/or solutions
Do not use the acetate form of this drug for IV
administration. May be added to D5W or 0.9% NaCl
RATE: No more than 10 mg/min
Nursing Implications (what to focus on)
Contraindicated in active untreated infections. Known
alcohol, bisulfite, or tartrazine hypersensitivity or
intolerance. Use cautiously in chronic treatment; Stress;
supplemental doses may be needed.
Common side effects
Much more common with high-dose long term therapy—
CNS: Depression, euphoria, headache, personality changes,
psychoses, restlessness. EENT: Cataracts, increased
intraocular pressure. CV: hypertension. GI: Peptic ulceration,
anorexia, nausea, vomiting. DERM: acne, decreased wound
healing, ecchymosis, fragility, hirsutism, petechiae. ENDO:
adrenal suppression, hyperglycemia. F and E: fluid retention,
hypokalemia, hypokalemic alkalosis. HEMAT:
Thromboembolism, thrombophlebitis. METAB: Weight gain.
MS: muscle wasting, osteoporosis, aseptic necrosis of joints,
muscle pain. MISC: cushingoid appearance (moon face,
buffalo hump), increased susceptibility to infection.
Lab value alterations caused by medicine
Monitor serum electrolytes and glucose, may cause
hyperglycemia. Routine hematologic values, serum
electrolytes, and serum and urine glucose with long term
treatment. May decrease WBCs. May decrease serum
potassium and calcium and increase serum sodium
concentrations. May increase serum cholesterol and lipid
values. May decrease the uptake of thyroid. Periodic adenal
function tests should be ordered
Be sure to teach the patient the following about this
medication
Take as directed. Take missed doses as soon as remembered
unless almost time for the next dose. Do not abruptly stop
medication. Watch for signs of adrenal insufficiency.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
Assess involved systems before and med? Decrease in presenting
periodically during therapy. Assess for signs Signs or symptoms of adrenal symptoms with minimal
of adrenal insufficiency (hypotension, weigh insufficiency systemic side effects.
loss, weakness, nausea, vomiting, anorexia, Supression of the inflammatory
lethargy, confusion, restlessness) before and immune responses.
administering. Monitor I & O and daily
weights. Observe for peripheral edema, steady
weight gain, rales/crackles, or dyspnea