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7/23/10

CEFUROXIME
Cefuroxime - cephalosporins-2nd generation

Classification:
Therapeutic: anti-infectives
Pharmacologic: 2nd generation cephalosporin’s
Pregnancy category B

Doctor’s Order: 1.5 gm IV 1hr prior to OR (-) ANST

Indications:
Treatment of the following infections caused by susceptible organisms: respiratory tract
infections, skin and skin structure infections, bone and joint infections, urinary tract
infections. Otitis media, meningitis gynecologic infections, and lyme disease.

Action:
Bind the bacterial cell wall membrane, causing cell death.
Therapeutic effects: bactericidal action against susceptible bacteria.
Spectrum: similar to 1st generation cephalosporin but have increase activity
against several others gram- negative pathogens.
Cefuroxime: active against borelia burgdorferi.

Contraindication:
Contraindicated in hypersensitivity to cephalosporins; serious hypersensitivity to
penicillin’s. Use cautiously in: renal impairment (decrease dose/ increase dosing interval
recommended for: cefuroxime if CCr < 20ml/min)

Side-effects:
- diarrhea - bleeding
- nausea - pain at IM site
- vomiting - super infection
- rashes

Nursing implication:
- Assess for infection (vital signs, appearance of wound, sputum, urine, and stool;
WBC) at the beginning and during the therapy.
- Before initiating the therapy, obtain a history to determine the previous use of and
reaction to penicillin’s or cephalosporins. Persons with a negative history of
penicillin sensitivity may still have an allergic response.
- Obtain specimen for culture and sensitivity before initiating therapy. First dose
may be given before receiving results.
- Observe s/s of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). If those
occur stop the medication and notify physician or other health care provider
immediately.

vasculitis . Treatment of heart burn.Advise pt.Hallucination .Confusion -neutropenia .Diarrhea . and if feeling better. 7/24/2010 RANITIDINE Classification: Therapeutic: anti-ulcer agents Pharmacologic: Histamine H2 antagonists Pregnancy Category: B Doctor’s order: 50mg IV at 6 am Indication: Short term treatment of active duodenal ulcers and benign gastric ulcers. do not double doses.Nausea .Anemia NURSING IMPLICATION: . Take missed dose as soon as possible unless almost time for the next dose. acid indigestion.Gynecomastia . and sour stomach. THERAPEUTIC EFFECTS: healing and prevention of ulcers. resulting in inhibition of gastric acid secretion. Advise patient that sharing of this medication may be dangerous. to report s/s of super infection and allergy. Decrease symptoms of gastroesophageal reflux.Patient teaching: .Dizziness -pain at IM site .Drowsiness -hypersensivity reactions. Decrease secretions of gastric acid CONTRAINDICATIONS: Contraindicated in: some products contains alcohol and should be avoided in patients with known intolerance - -some products aspartame and should be avoided in patient with PKU. . ACTION: Inhibits the action of histamine at h2 receptors site located primarily in gastric parietal cells. SIDE EFFECTS: .Instruct patient to take medication around the clock at evenly spaced times and to finish the medication completely. Maintenance therapy for duodenal and gastric ulcers after healing of active ulcers.

assess for abdominal and epigastric pain .dizziness .antipruritic . May cause false negative results in skin test using allergenic extracts.agitation .inform patient that increased fluid and fiber intake and exercise may minimize constipation.preoperative sedation . decreased nausea and vomiting. -use cautiously in: severe hepatic dysfunction. SIDE EFFECTS: . . anti histamine. relief anxiety. HYDROXYZINE CLASIFICATION Therapeutic: anti anxiety agents. hypnotics Pregnancy category: C Doctors order: 50 mg deep IM INDICATION: .headache . . . CONTRAINDICATIONS: -contraindicated in: hypersensitivity.instruct patient to take medication as directed for the full course of therapy.acts as CNS depressants at subcortical level of CNS.Therapeutic effects: sedation. even if feeling better. .anti emetic . Have anticholinergic. PATIENT/FAMILY TEACHING . ACTION: . -geriatric patients are more susceptible to adverse reactions due to anticholinergic effects.may cause drowsiness or dizziness.treatment of anxiety . antihistaminic and antiemetic properties.drowsiness . . Blocks histamine 1 receptors. . sedatives.May combine with opiod analgesics.advise patients taking OTC preparations not to take the maximum dose continuously for more than two weeks with out consulting health care professional. LAB TEST CONSIDERATION: monitor CBC w/ differential periodically during therapy.

Assess degree of nausea and frequency and amount of emesis. to produce anti-inflammatory. or any bleeding problem or at risk of bleeding. Caution patient to avoid driving and other activities requiring alertness. support groups. . . 2010 Ketorolac tromethamine CLASSIFICATION NSAID DOCTOR’S ORDER Ketorolac 30mg IV q 8° INDICATION Short term management of moderately severe. call bell with in reach) . Advise patient to avoid concurrent use of alcohol or other CNS depressants with this medication. mood and behavior.Anxiety (assess mental status) orientation. constipation . and relaxation techniques. analgesic. ACTION May inhibit prostaglandin synthesis.Contraindicated in clients hypersensitive to drug and in those with active PUD.assess patient for profound sedation and provide safety precautions as indicated( side rails up.Contraindicated as prophylactic analgesic before major surgery or intraoperatively when hemostasis is critical. nausea NURSING IPMPLICATION: . bitter taste . weakness . dry mouth . - .May cause false negative results in skin test using allergenic extracts.Teach other methods to decrease anxiety. increase exercise. acute pain. PATIENT/FAMILY TEACHING . July 25.may cause dizziness or drowsiness. . . and in patients currently receiving aspirin. . such as.instruct patient to take medication as directed for the full course of therapy . and antipyretic effect CONTRAINDICATION . bed in low position.

SIDE EFFECTS . nausea.Serious GI toxicity.May cause dizziness or drowsiness.GI: GI pain. .Encourage high fiber diet . .Correct hypovolemia before giving .Give ice chips .Do not double doses.Instruct patient on how and when to ask for pain medication . Thought to bind to opioid receptors and inhibit reuptake of norepinephrine and serotonin CONTRAINDICATION Contraindicated in clients hypersensitive to drug or other opioid.Increase fluid intake . Advise patient to avoid concurrent use of alcohol or other CNS depressants with this medication. in patient with increased ICP or head injury.Provide safety of the patient . Use cautiously in patients at risk for seizures or respiratory depression.Do not take more than prescribed or for longer than five days .Encourage ambulation .Instruct patient to take medication exactly as directed . flatulence NURSING IMPLICATION . constipation. dizziness. Caution patient to avoid driving and other activities requiring alertness. Tramadol hydrochloride CLASSIFICATION Opioid analgesic DOCTOR’S ORDER 50mg IV every 8 hours x 3 doses INDICATION Moderate to moderately severe pain ACTION Unknown. including peptic ulcer and bleeding Perform skin testing prior to drug administration PATIENT TEACHING . A centrally acting synthetic analgesic compound not chemically related to opioids. drowsiness .CNS: headache.

Provide safety of the patient . FAMOTIDINE CLASSIFICATION Antiulcer agient DOCTOR’S ORDER 20mg every 12 hours x 2 doses INDICATION . PATIENT TEACHING .SIDE EFFECTS . vomiting.For better effect.Give ice chips . . flatulence Skin: diaphoresis NURSING IMPLICATION .CNS: dizziness. CONTRAINDICATION . . Caution patient to avoid driving and other activities requiring alertness. give drug before onset of intense pain Withdrawal symptoms may occur if drug is topped abruptly. nausea.Some products contain alcohol and should be avoided in patients with no tolerance.May cause dizziness or drowsiness. headache .Advise patient to change position slowly to minimize orthostatic hypotension. abdominal pain.Reassess patients level of pain at least 30 minutes after administration .Encourage high fiber diet .Monitor CV and respiratory status .Increase fluid intake .Encourage patient to turn and breath deeply and cough every 2 hours to prevent atelectasis.Decrease gastric acid secretion . Taper dosage. Advise patient to avoid concurrent use of alcohol or other CNS depressants with this medication. resulting in inhibition of gastric acid secretion.GI: constipation.Prevention of acid inactivation of supplemental pancreatic enzyme ACTION Inhibits the action of histamine at the H2-receptor site located primarily in gastric parietal cells.Frequent light feeding . .Encourage ambulation .Hypersensitivity .

. PATIENT TEACHING .instruct patient to take medication as directed for the full course of therapy. . . diarrhea.may cause drowsiness or dizziness. drug induced hepatitis NURSING IMPLICATION . Use cautiously in patient with renal impairment SIDE EFFECTS GI: constipation..assess for abdominal and epigastric pain . .LAB TEST CONSIDERATION: monitor CBC w/ differential periodically during therapy.advise patients taking OTC preparations not to take the maximum dose continuously for more than two weeks with out consulting health care professional.inform patient that increased fluid and fiber intake and exercise may minimize constipation. . .May cause false negative results in skin test using allergenic extracts. even if feeling better.