DRUG ORDER Furosemide (Lasix) 20 mg/tab; 1 tab OD PO Pharmacologi c class: Loop diuretic

PHARMACOLO GIC ACTION Inhibits the reabsorption of sodium chloride from the ascending limb of the loop of Henle, leading to a sodium-rich diuresis. TE: Promotes water and sodium excretion.

INDICATIONS Management of hypertension ; Edema associated with CHF as a complication of diabetes mellitus.

CONTRAINDICATI ONS Contraindicated with allergy to furosemide, sulfonamides. Use cautiously with diabetes mellitus./ with metabolic disorders.

ADVERSE EFFECTS CNS: dizziness, fever, vertigo, tinnitus CV: arrhythmias, orthostatic hypotension GI: nausea, vomiting, constipation, vomiting GU: frequent urination, nocturia

DESIRED ACTION For diuresis.

Irbesartan (Aprovel) 150 mg/tab; 1 tab OD PO Pharmacologi c class: Angiotensin II receptor antagonist

Selectively blocks the binding of angiotensin II to specific tissue receptors found in the vascular smooth muscle and adrenal gland; this action blocks the vasoconstricti on effect of the reninangiotensin system as well as the release of

Treatment of hypertension .

Contraindicated with hypersensitivity to irbesartan.

CNS: headache, muscle weakness, anxiety CV: flushing, orthostatic hypotension, chest pain GI: nausea, constipation, diarrhea, vomiting Resp: cough

To decrease blood pressure.

NURSING RESPONSIBILITIES Arrange to monitor sodium and potassium serum electrolytes. Give early in the day so that increased urination will not disturb sleep. Blood glucose levels may become temporarily elevated in patients with diabetes after starting this drug. Give medications as ordered that will help loosen stools in case of constipation. Monitor patient’s blood pressure regularly because dizziness and orthostatic hypotension may occur. Give medications as ordered that will help loosen stools in case of constipation. Instruct the patient to notify prescriber if headache and other side effects occur. Maintain a quiet, comfortable environment to

Ipratropium + salbutamol (Combivent) neb 200 mcg/ml prn for DOB

The ipratropium ingredient is an anticholinergi c drug which relaxes smooth Pharmacolog muscle in the ic class: lung. The Anticholinerg salbutamol ic ingredient is a beta-2 agonist which stimulates beta-2 sites in the lungs to relax the bronchi. TE: Relieves bronchospas ms. Clindamycin hydrochlori de (Cleocin) 300 mg/cap; 1 cap TID PO Pharmacolo Inhibits protein synthesis in susceptible bacteria, causing cell death.

Bronchodila tor for maintenanc e therapy of bronchospa sm.

Contraindicated with hypersensitivity to atropine or its derivatives.

CNS: dizziness, blurred vision GI: nausea, dry mouth Respi: dyspnea, bronchospasms, horseness CV: palpitations, chest pain

To relieve bronchospa sms and open airways.

Monitor the patient’s vital signs, noting hypotension and an irregular or abnormal pulse. Maintain a quiet, comfortable environment to minimize anxiety and perhaps decrease palpitations. Teach the patient pursed-lip breathing, diaphragmatic breathing, and chest splinting.

Treatment of infections caused by susceptible strains of bacteria.

Contraindicated with allergy to clindamycin, history of asthma or other allergies.

CV: hypotension, cardiac arrest GI: nausea, vomiting, diarrhea Dermat: urticaria

To treat infection.

Culture infection before therapy. Administer oral drugs with a full glass of water or with food to prevent

gic class: Lincomycin derivative

TE: Hinders or kills susceptible bacteria.

Bumetanide (Bumex) 1 mg TIV q 12 w/ BP prec Pharmacologic class: Loop diuretic

Inhibits the reabsorption of sodium and chloride from the proximal and distal renal tubules and the loop of Henle, leading to a natriuretic diuresis. TE: Promotes sodium and water excretion.

Treatment of edema associated with CHF as a complication of DM.

Contraindicated with allergy to bumetanide and anuria. Use cautiously with diabetes mellitus.

CNS: paresthesia, fatigue, tinnitus CV: orthostatic hypotension, thrombophlebitis GI: nausea, vomiting, dry mouth GU: polyuria

For diuresis.

esophageal irritation. Check the patient's vital signs frequently to determine if low blood pressure is constant or intermittent. Keep the patient's room clean-smelling by removing bedpans and emesis basins promptly after use. Provide information about avoiding excessive noise. Give single dose early in the day fo increased urination will not disturb sleep. Encourage or provide regular oral hygiene. Record intake and output, and weigh the patient daily. Monitor the patient’s blood

pressure throughout therapy. Mentronidazol e (Flagyl) 500 mg TIV q 6 ANST (-) Pharmacologic class: Nitroimidazole Bactericidal: Inhibits DNA synthesis in specific anaerobes, causing cell death. Acute infection with susceptible anaerobic bacteria. Contraindicated with hypersensitivity to metronidazole. CNS: dizziness, seizure, peripheral neuropathy CV: edema, flushing GI: nausea, vomiting, cramps GU: darkening of urine, dysuria To treat infection. Instruct the patient that the urine may be darker in color. Institute seizure precautions. Monitor intake and output. Keep the patient's room clean-smelling by removing bedpans and emesis basins promptly after use. Instruct patient in the proper use of the Handihaler inhalation device. Encourage or provide regular oral hygiene. Provide chest physiotherapy. Teach the client to perform deepbreahing exercises. Give medications as ordered that will help loosen stools in

Tiotropium bromide (Spiriva) 18 mcg cap; 1 cap via handihaler Pharmacologic class: Long-acting anticholinergic

TE: Hinders growth of selected organisms, including most anaerobic bacteria. Competitively Treatment of antagonistic at bronchospasm muscarinic s. receptor sites; causes smooth muscle relaxation, leading to bronchodilation. TE: Improves breathing.

Contraindicated with allergy to atropine or its derivatives, ipratropium or any component of the product.

CNS: blurred vision CV: edema GI: dry mouth, constipation, vomiting Respi: epistaxis, sinusitis, cough

To relieve bronchospas ms and open airways.

Paracetamol biogesic 300 mg TIV STAT Pharmacologic class: Paraaminophenol derivative

Antipyretic: Treatment of Reduces fever fever. by acting directly on the hypothalamic heat-regulating center to cause vasodilation and sweating, which helps dissipate heat. TE: Reduces fever.

Contraindicated with allergy to acetaminophen.

CNS: headache To decrease CV: chest pain temperature. Respi: dyspnea hypersensitivity: rash, urticaria

case of constipation. Monitor the client’s temperature throughout therapy. Teach the patient deep-breathing exercises. Instruct client to report rashes.

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