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 - nausea - vomiting - rashes bleeding pain at IM site super infection
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.
Take missed dose as soon as possible unless almost time for the next dose.Anemia NURSING IMPLICATION: -neutropenia -pain at IM site -hypersensivity reactions.Drowsiness . to report s/s of super infection and allergy.Nausea . 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.Instruct patient to take medication around the clock at evenly spaced times and to finish the medication completely. and sour stomach. .Patient teaching: .vasculitis
. 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. ACTION: Inhibits the action of histamine at h2 receptors site located primarily in gastric parietal cells.Diarrhea . Treatment of heart burn.Advise pt. SIDE EFFECTS: . and if feeling better. do not double doses.Gynecomastia .Hallucination . Advise patient that sharing of this medication may be dangerous.Confusion . acid indigestion.Dizziness . Maintenance therapy for duodenal and gastric ulcers after healing of active ulcers. Decrease symptoms of gastroesophageal reflux. resulting in inhibition of gastric acid secretion. THERAPEUTIC EFFECTS: healing and prevention of ulcers.
relief anxiety. .advise patients taking OTC preparations not to take the maximum dose continuously for more than two weeks with out consulting health care professional.Therapeutic effects: sedation. sedatives.drowsiness . SIDE EFFECTS: .antipruritic .agitation .-
assess for abdominal and epigastric pain LAB TEST CONSIDERATION: monitor CBC w/ differential periodically during therapy. HYDROXYZINE CLASIFICATION Therapeutic: anti anxiety agents. .
PATIENT/FAMILY TEACHING . Have anticholinergic. even if feeling better. . May cause false negative results in skin test using allergenic extracts.instruct patient to take medication as directed for the full course of therapy. decreased nausea and vomiting.headache
.May combine with opiod analgesics. Blocks histamine 1 receptors.dizziness . -use cautiously in: severe hepatic dysfunction.preoperative sedation . CONTRAINDICATIONS: -contraindicated in: hypersensitivity.treatment of anxiety . anti histamine. . -geriatric patients are more susceptible to adverse reactions due to anticholinergic effects.anti emetic .may cause drowsiness or dizziness.inform patient that increased fluid and fiber intake and exercise may minimize constipation. antihistaminic and antiemetic properties.acts as CNS depressants at subcortical level of CNS. hypnotics Pregnancy category: C Doctors order: 50 mg deep IM INDICATION: . ACTION: .
Teach other methods to decrease anxiety.Contraindicated as prophylactic analgesic before major surgery or intraoperatively when hemostasis is critical. support groups. increase exercise. . to produce anti-inflammatory. 2010 Ketorolac tromethamine CLASSIFICATION NSAID DOCTOR’S ORDER Ketorolac 30mg IV q 8° INDICATION Short term management of moderately severe. . . Caution patient to avoid driving and other activities requiring alertness.
July 25. bed in low position. PATIENT/FAMILY TEACHING . such as. . and antipyretic effect CONTRAINDICATION . and in patients currently receiving aspirin.may cause dizziness or drowsiness. call bell with in reach) .May cause false negative results in skin test using allergenic extracts. acute pain.Contraindicated in clients hypersensitive to drug and in those with active PUD.instruct patient to take medication as directed for the full course of therapy . -
. and relaxation techniques. analgesic.-
weakness dry mouth bitter taste constipation nausea
NURSING IPMPLICATION: .Anxiety (assess mental status) orientation. mood and behavior. ACTION May inhibit prostaglandin synthesis. or any bleeding problem or at risk of bleeding.assess patient for profound sedation and provide safety precautions as indicated( side rails up.Assess degree of nausea and frequency and amount of emesis. Advise patient to avoid concurrent use of alcohol or other CNS depressants with this medication.
Increase fluid intake .Give ice chips . drowsiness .May cause dizziness or drowsiness.Correct hypovolemia before giving . A centrally acting synthetic analgesic compound not chemically related to opioids.Encourage high fiber diet . including peptic ulcer and bleeding Perform skin testing prior to drug administration PATIENT TEACHING .Do not take more than prescribed or for longer than five days . Use cautiously in patients at risk for seizures or respiratory depression. flatulence NURSING IMPLICATION . Caution patient to avoid driving and other activities requiring alertness. dizziness.Encourage ambulation .Provide safety of the patient .GI: GI pain. nausea.
Tramadol hydrochloride CLASSIFICATION Opioid analgesic DOCTOR’S ORDER 50mg IV every 8 hours x 3 doses INDICATION Moderate to moderately severe pain ACTION Unknown.Do not double doses. Thought to bind to opioid receptors and inhibit reuptake of norepinephrine and serotonin CONTRAINDICATION Contraindicated in clients hypersensitive to drug or other opioid. Advise patient to avoid concurrent use of alcohol or other CNS depressants with this medication.Serious GI toxicity.SIDE EFFECTS .CNS: headache.Instruct patient on how and when to ask for pain medication . in patient with increased ICP or head injury.Instruct patient to take medication exactly as directed . constipation.
GI: constipation.Monitor CV and respiratory status .Encourage patient to turn and breath deeply and cough every 2 hours to prevent atelectasis. . Taper dosage.For better effect.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.May cause dizziness or drowsiness.Decrease gastric acid secretion . PATIENT TEACHING .Encourage high fiber diet . FAMOTIDINE CLASSIFICATION Antiulcer agient DOCTOR’S ORDER 20mg every 12 hours x 2 doses INDICATION . .CNS: dizziness. vomiting.Some products contain alcohol and should be avoided in patients with no tolerance.Advise patient to change position slowly to minimize orthostatic hypotension. Caution patient to avoid driving and other activities requiring alertness.Increase fluid intake .Encourage ambulation .Hypersensitivity . Advise patient to avoid concurrent use of alcohol or other CNS depressants with this medication.Reassess patients level of pain at least 30 minutes after administration .Give ice chips . CONTRAINDICATION .
. nausea.Provide safety of the patient .SIDE EFFECTS . give drug before onset of intense pain Withdrawal symptoms may occur if drug is topped abruptly. resulting in inhibition of gastric acid secretion.Frequent light feeding . flatulence Skin: diaphoresis NURSING IMPLICATION . headache . abdominal pain.
advise patients taking OTC preparations not to take the maximum dose continuously for more than two weeks with out consulting health care professional.May cause false negative results in skin test using allergenic extracts. drug induced hepatitis NURSING IMPLICATION .may cause drowsiness or dizziness. even if feeling better.inform patient that increased fluid and fiber intake and exercise may minimize constipation. PATIENT TEACHING . . .LAB TEST CONSIDERATION: monitor CBC w/ differential periodically during therapy.-
Use cautiously in patient with renal impairment
SIDE EFFECTS GI: constipation.
.instruct patient to take medication as directed for the full course of therapy.assess for abdominal and epigastric pain .. . diarrhea. .