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PART 1: to be completed prior to clinical experience. Generic Name: erythromycin Dosage Range: 2% ointment (Topical Apply 0.5–1 cm ribbon in lower conjunctival sacs shortly after birth)
Trade Name(s): Apo-Erythro Base (Canadian) A/T/S E-Mycin Eryc EryDerm EryTab, Erythrocin Erythromid (Canadian) Erythromycin Base Novorythro (Canadian) PCE Ro-Mycin (Canadian) Classification: MACROLIDE ANTIBIOTIC Action of Medication (in 1-2 sentences using your own words): More active against gram-positive organisms than against gram-negative organisms due to its superior penetration into gram-positive organisms. Therapeutic Uses (in 1-2 sentences using your own words): Pyodermas, acne vulgaris, and external ocular infections, including neonatal chlamydial conjunctivitis and gonococcal ophthalmia. Common Side Effects or Adverse Effects
GI: Nausea, vomiting, abdominal cramping, diarrhea, heartburn, anorexia. Body as a Whole: Fever, eosinophilia, urticaria, skin eruptions, fixed drug eruption, anaphylaxis. Superinfections by nonsusceptible bacteria, yeasts, or fungi. Special Senses: Ototoxicity: reversible bilateral hearing loss, tinnitus, vertigo. Digestive: (Estolate) Cholestatic hepatitis syndrome. Skin: (topical use) Erythema, desquamation, burning, tenderness, dryness or oiliness, pruritus.
Food: Grapefruit juice may increase side effects.
Report onset of GI symptoms after PO administration to physician. These are dose related; if symptoms persist after dosage reduction, physician may prescribe drug to be given with meals in spite of impaired absorption. Observe for S&S of superinfection by overgrowth of nonsusceptible bacteria or fungi. Emergence of resistant staphylococcal strains is highly predictable during prolonged therapy. Monitor for S&S of hepatotoxicity. Premonitory S&S include: Abdominal pain, nausea, vomiting, fever, leukocytosis, and eosinophilia; jaundice may or may not be present. Symptoms may appear a few days after initiation of drug but usually occur after 1–2 wk of continuous therapy. Symptoms are reversible with prompt discontinuation of erythromycin. Monitor for ototoxicity that appears to develop most frequently in patients receiving 4 g/d or more, older adults, female patients, and patients with kidney or liver dysfunction. It is reversible with prompt discontinuation of drug. Report any ototoxic effects including dizziness, vertigo, nausea, tinnitus, roaring noises, hearing impairment
PART 1: to be completed prior to clinical experience. Generic Name: hydromorphone hydrochloride Dosage Range: PO 2–4 mg q4–6h prn in naïve patients SC/IM/IV 0.75–2 mg q4–6h depending on patient response Trade Name(s): Dilaudid Classification: NARCOTIC (OPIATE) AGONIST; ANALGESIC Action of Medication (in 1-2 sentences using your own words): An effective narcotic analgesic that controls mild to moderate pain. Also has antitussive properties. Therapeutic Uses (in 1-2 sentences using your own words): Relief of moderate to severe pain and control of persistent nonproductive cough. Common Side Effects or Adverse Effects CNS: Euphoria, dizziness, sedation, drowsiness CVS: Hypotension, bradycardia or tachycardia GI: Nausea, vomiting, constipation Respiratory: Respiratory depression Hypersensitivity: Blurred vision Nursing Responsibilities
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Note baseline respiratory rate, rhythm, and depth and size of pupils before administration. Respirations of 12/min or less and mitosis are signs of toxicity. Withhold drug and promptly notify physician. Monitor vital signs at regular intervals. Drug-induced respiratory depression may occur even with small doses and increases progressively with higher doses. Assess effectiveness of pain relief 30 min after medication administration. Monitor drug effects carefully in older adult or debilitated patients and those with impaired renal and hepatic function. Assess effectiveness of cough. Drug depresses cough and sigh reflexes and may induce atelectasis, especially in postoperative patients and those with pulmonary disease. Nausea and orthostatic hypotension most often occur in ambulatory patients or when a supine patient assumes the head-up position. Monitor I&O ratio and pattern. Assess lower abdomen for bladder distension. Report oliguria or urinary retention. Monitor bowel pattern; drug-induced constipation may require treatment Use caution with activities requiring alertness; drug may cause drowsiness, dizziness, and blurred vision.
FLEET ENEMA Sodium Phosphate Classification: Laxative Action and Therapeutic Use: An enema is a way of cleaning out the large intestine, which is called the colon or bowel. Various solutions are inserted into the rectum to soften the stool. This causes the colon and rectum to stretch and expand and helps the bowel to empty. Enemas may be given: • • • • to relieve constipation. Enemas may be given at home by the person, a family member, or a visiting nurse. to prepare for an exam of the rectum or colon, such as a sigmoidoscopy or colonoscopy prior to surgery on the bowel prior to certain X-ray procedures, such as a barium enema. A barium enema is a series of X-ray films that shows the colon after a contrast agent is inserted in the rectum
How is the procedure performed? The person will be asked to lie on his or her left side. The right leg should be bent up toward the chest. This position helps the enema solution flow easily into the colon. The solution most commonly used is a mixture of mild soap and warm water, and is known as a soapsuds enema. This solution is placed into a small plastic container with a flexible tube. Lubricating jelly is applied to the tip of the tube. The tube is then gently inserted into the rectum about 4 to 6 inches. Next, the solution is slowly released through the tube into the bowel. A fleet enema is a small, prefilled enema with a prelubricated tip. An oil retention enema is useful for hard stool, because the stool absorbs the oil and is softened. Preparation & Expectations What happens right after the procedure? After an enema, the person is asked to hold the solution in the rectum for at least 3 minutes. After this time, he or she can expel the enema while sitting on a toilet or bedpan. The results should be evaluated to be sure that the enema was successful. Responsibilities: If the enema was given for constipation, the person should check his or her bowel movements for further constipation.
If the enema was given to prepare for surgery or for an exam, it may need to be repeated. The goal of this type of enema is to cleanse the bowel. It needs to be repeated until there is no fecal matter expelled after the enema. After a barium enema, the person will have white stool for a short time as the body expels the barium. What are the potential complications after the procedure? Sometimes a person may feel faint while having an enema. A more serious risk is a perforated colon, but this is very rare. A perforated colon occurs when the tip of the enema pokes through the colon and causes damage to the tissue. Side Effects: are the same as Bisacodyl.