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NURS 1566 Clinical Form 3: Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Classification Dose Route Time/frequency

polyethylene Name Therapeutic: laxatives 17g in 8 oz liquid PO Once/ Now
glycol MiraLax Pharmacologic: osmotics
Peak Onset Duration Normal dosage range
2-4 days Unknown Unknown 17g. (One heaping teaspoon) in 8 oz. of water may be used
for up to two weeks
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
Constipation N/A

Mechanism of action and indications Nursing Implications (what to focus on)

(Why med ordered) Contraindications/warnings/interactions
Acts as an osmotic agent, drawing water into the lumen of the GI obstruction, Gastric retention, Toxic colitis, Megacolon/ Use
GI tract. Indicated for evacuation of the GI tract without water cautiously in Abdominal pain of uncertain cause, particularly if
or electrolyte imbalance. accompanied by fever/ No significant interactions
Common side effects
abdominal bloating, cramping, flatulence, nausea,

Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) None found
Be sure to teach the patient the following about this
Inform patient that 2-4 days may be required to produce a bowel
movement. PEG should not be used for more than 2 wk. Prolonged,
frequent, or excessive use may result in electrolyte imbalance and
laxative dependence. Advise patient to notify health care professional if
unusual cramps, bloating, or diarrhea occurs
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this med? Check after giving
Assess patient for abdominal distention, presence Diarrhea, obstruction A soft, formed bowel
of bowel sounds, and usual pattern of bowel movement