DRUG MECHANISM INDICATIONS CONTRAINDICATIONS SIDE EFFECTS/ NURSING

OF ACTION ADVERSE RESPONSIBILITIES

REACTIONS
Generic Name Inhibits cell- Moderate to  Hypersensitivity to  Hypersensitivity  Monitor patient for
Piperacillin + wall synthesis severe infection penicillins, reactions diarrhea and initiate
Tazobactam during bacterial cephalosporins, or B-  Diarrhea therapeutic measures
multiplication. lactamase inhibitors or  Nausea as needed.
Brand Name any component in this  Constipation  Additional doses
Piptaz product.  Hematologic, may be needed after
hepatic & renal each dialysis period.
Classifications effects  Monitor patient’s
Penicillins  CNS effects such sodium intake and
as headache, electrolyte levels.
Dose insomnia,  Monitor
4.5 g agitation, hematologic and
dizziness & coagulation
Route anxiety parameters.
Intravenous  Local reactions  Tell patient to report
adverse reactions
promptly.
 Tell patient to report
discomfort at the
I.V. site.
 DRUG MECHANISM INDICATIONS CONTRAINDICATIONS SIDE EFFECTS/ NURSING
OF ACTION ADVERSE RESPONSIBILITIES
REACTIONS
Generic Name Unknown. Moderate to  Hypersensitivity.  Seizure  Reassess patient’s
Tramadol Thought to bind moderately  Hypersensitivity level of pain at least
to opioid severe chronic reactions 30 minutes after
Classifications receptors and pain  Occasionally, administration.
Opiates & inhibit reuptake respiratory  Monitor CV and
Antagonists of depression respiratory status.
norepinephrine  Palpitation Withhold dose and
Dose and serotonin.  Vasodilation notify prescriber if
50 mg  Decreased BP respirations are
 Arrhythmia shallow or rate is
Route  Face pallor below 12
Intravenous  CNS reactions breaths/minute.
 GI disturbances  Monitor bowel and
bladder function.
Anticipate need for
stimulant laxative.
 For better analgesic
effect, give drug
before onset of
intense pain.
 Monitor patients at
risk for seizures.
Drug may reduce
seizure threshold.
 Monitor patient for
drug dependence.
 Reduce dosage
gradually.
 DRUG MECHANISM INDICATIONS CONTRAINDICATIONS SIDE EFFECTS/ NURSING
OF ACTION ADVERSE RESPONSIBILITIES
REACTIONS
Generic Name Hinders Serious or  Hypersensitivity.  Red man  Obtain hearing
Vancomycin bacterial cell- severe infection syndrome evaluation before
wall synthesis,  Swelling of face, and during
Classifications damaging the lips, mouth, prolonged therapy.
Glycopeptide bacterial throat, or  Monitor patient’s
antibiotic plasma elsewhere in the fluid balance and
membrane and body which may watch for oliguria
Dose making the cell cause difficulty in and cloudy urine.
4.5 g more swallowing or  Monitor patient
vulnerable to breathing carefully for red-
Route osmotic  Urticaria man syndrome,
Intravenous pressure. Also  Loss of which can occur if
interferes with consciousness drug is infused too
RNA synthesis.  Blisters or peeling rapidly.
of the skin or  Don’t give drug I.M.
mucous  Assess renal
membranes function (BUN,
Creatinine level, and
CrCl, urinalysis, and
urine output) before
and during therapy.
 Patients with renal
dysfunction need
dosage adjustment.
Monitor blood levels
to adjust I.V. dosage
requirements.
 Monitor patient for
signs and symptoms
of superinfection.
 DRUG MECHANISM INDICATIONS CONTRAINDICATIONS SIDE EFFECTS/ NURSING
OF ACTION ADVERSE RESPONSIBILITIES
REACTIONS
Generic Name Inhibiting CNS It breaks down a  Hypersensitivity.  Jaundice  Observe the 10
Paracetamol prostaglandin high  Hypoglycemia rights of medication
synthesis. The temperature.  Rash  Assess patient’s
Brand Name mechanism of  Urticaria fever or pain: type
Biogesic morphine is  Hemolytic anemia of pain, location,
believed to  Leukopenia intensity, duration,
Classifications involve  Neutropenia temperature and
Analgesic decreased of  Pancytopenia diaphoresis.
permeability of  Thrombocytopenia  Assess allergic
Dose cell membrane  Liver damage reactions: rash,
500 mg to sodium in urticarial; if these
which results in occur drug may
Route diminished have to be
Oral transmission of discontinued
pain impulses  Teach patients to
therefore recognize signs of
analgesia chronic overdose;
bleeding, bruising,
malaise, fever, and
sore throat
 Tell patient to notify
prescriber for
pain/fever lasting
for more than 3
days
Student Nurse: Se, Hanna Kathleen V.
Patient Name: Paula Pescador
Diagnosis: Diabetic foot; Chronic Kidney Disease secondary to Type 2 Diabetes Mellitus; DM Retinopathy

ASSESSMENT NURSING PLANNING IMPLEMENTATION RATIONALE EVALUATION

DIAGNOSIS
Subjective Acute pain related After 4 hours of Independent Independent After 4 hours of
- Pain Scale 10/10 to diabetic foot as nursing 1. Evaluated pain 1. to serve as nursing
manifested by pain interventions, characteristics and baseline data interventions,
Objective scale of 10/10, patient will report intensity patient is relieved
- Guarding guarding behavior, pain is relieved or 2. Observed nonverbal 2. indicator from pain as
behavior; protective controlled. cues and pain because client is evidenced by being
protective behavior, behaviors having difficulty able to rest; no
behavior; positioning to ease talking guarding behavior,
positioning to ease pain, facial 3. Monitored skin color 3. usually altered protective
pain grimace, and temperature and in acute pain behavior,
- Facial grimace restlessness and vital signs positioning to ease
- Restlessness crying 4. Encouraged deep 4. relaxation pain, facial
- Crying breathing exercise technique grimace,
5. Provided change of 5. another comfort restlessness and
positioning measure crying.
6. Provided music 6. diversional
activity
Dependent Dependent
1. Administer 1. to maintain
medications as “acceptable” level
prescribed by the of pain
doctor