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REPUBLIC of the PHILIPPINES

City of Makati
UNIVERSITY OF MAKATI
COLLEGE OF ALLIED HEALTH STUDIES
J. P. Rizal Extension, West Rembo, Makati City 1215
Telephone No. : (+632) – 881 – 1571
_____________________________________________________________________________________
CENTER OF NURSING
NAME OF STUDENT: RAMOS, Louwella Faith M. YEAR/GROUP: II-AN/ GROUP 2 AREA: Delivery room DATE: 9 DECEMBER 2020

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ CONTRADICTION NURSING


ADVERSE CONSIDERATION
REACTION
Anti-inflammatory; analgesic, and General: CNS: headache, Contraindicated  Before:
antipyretic activities related to > relief of moderate pain when dizziness, insomnia with > Check doctor’s
Generic name:  inhibition of prostaglandin therapy will not exceed 1 week hypersensitivity to order
synthesis; exact mechanisms of > treatment of primary Dermatologic: mefenamic acid, > Assess pain score
action are not known. dysmenorrhea rash, pruritus, aspirin allergy, and > Assess for history
Mefenamic acid sweating as treatment of of allergies to
Onset: varies perioperative pain NSAIDs
Patient’s actual indications: GI: nausea, GI with coronary > Educate patient
Brand name:  Peak: 2-4 hr Mefenamic acid is given to patient pain, diarrhea, artery bypass regarding desired
for relief of acute to moderately constipation grafting and adverse effects
Ponstel, Ponstan Duration: 6 hr severe pain > Educate patient
GU: dysuria, renal that prolonged use
Dosage: Capsules –
Metabolism: hepatic, 2-4 hr impairment Precaution: of drug may
250mg
Use cautiously with damage liver
Route: Oral /PO Distribution: crosses placenta, Hematologic: asthma, renal or
enters breast milk bleeding, platelet hepatic impairment, During:
Frequency: every 6hrs as inhibition with peptic ulcer disease, > Give drug with
needed Excretion: feces, urine higher doses, GI bleeding, food, milk or
neutropenia hypertension, heart antacids
Source: 2011 Lippincott’s NDG failure, pregnancy, > Do not increase
Classification: Analgesic, Respiratory: lactation or double the dose,
dyspnea, follow exactly as
hemoptysis, prescribed and
antipyretic pharyngitis Interactions: indicated
> drug-drug: > Administer drug
Other: peripheral increased risk of Gi with full glass of
edema, bleeds with ASA, water
anaphylactoid anticoagulants, > Do not break,
reactions to other NSAIDs chew or crush
anaphylactic shock. > drug-lab test: capsule and tablet
false-positive > Do not
reaction for urinary administer with
bile using the Diazo anticoagulants and
tablet test. other drug that
causes GI upset

After:
> Document
accordingly
> Monitor for
adverse effects
> Instruct
discontinuation of
medication if
adverse effect
occurs
> Symptomatic
management for
Non serious side
effects
> Assess for
occurrence of GI
ulcers after taking.

NAME OF PATIENT: DIAGNOSIS: NORMAL DELIVERY WARD/ROOM: _________________


DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ CONTRADICTION NURSING
ADVERSE CONSIDERATION
REACTION
Oxytocin is a protein produced by Pitocin (oxytocin injection) is a Nausea and Antepartum use of  Before:
the pituitary gland of mammals natural hormone that causes the vomiting Pitocin is 1. Check MAR
Generic name:  including man. Pitocin is a uterus to contract used to induce Increase of blood contraindicated in and medication
manmade version of oxytocin used labor, strengthen labor contractions pressure any of the following before
Oxytocin for stimulating contraction of the during childbirth, control bleeding Hyperstimulation circumstances:
administering
Brand name:  uterus. Oxytocin works by after childbirth, or to induce an of the uterus 1. Where there is
increasing the concentration of abortion. Sinus bradycardia significant
2. Review
Pitocin  calcium inside muscle cells that Premature cephalopelvic baseline
control contraction of the uterus. Reference: ventricular disproportion; data and review
Dosage: 10 units/mL Increased calcium increases Pitocin (Oxytocin Injection): complexes 2. In unfavorable history of any
Route: Intramuscular  contraction of the uterus. Uses, Dosage, Side Effects, Neonatal fetal positions or contraindications
Frequency: Once  Interactions, Warning. (2020, hyperbilirubinemia presentations, such 3. Cleanse the site
October 27). Retrieved Jaundice as transverse lies, before injecting
November 18, 2020, from which are the drug.
Classification:  https://www.rxlist.com/pitocin undeliverable During:
drug.htm without conversion 1. Administer
Exogenous Hormone  prior to delivery;
intramuscularly 1
3. In obstetrical
emergencies where
minute after birth
the benefit-to-risk of baby.
ratio for either the After:
fetus or the mother 1. Monitor for
favors surgical signs of adverse
intervention; effects and refer
4. In fetal distress immediately.
where delivery is not
imminent;
5. Where adequate
uterine activity fails
to
NAME OF PATIENT: DIAGNOSIS: NORMAL DELIVERY WARD/ROOM: ________________
DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ CONTRADICTION NURSING
ADVERSE CONSIDERATION
REACTION
Chemical: a second-generation General Indications: CNS: headaches, Contraindicated  
cephalosporin that binds to > pharyngitis, tonsillitis dizziness, lethargy, with allergy to Before:
Generic name:  bacterial cell membranes and > bacterial meningitis paresthesia’s cephalosporins or > check the doctor’s
inhibits cell wall synthesis > usual neonatal dosage penicillin’s order
> gynecologic GI: nausea, > assess for history:
Cefuroxime vomiting, diarrhea, hepatic and renal
Therapeutic: anorexia, Precaution: impairment, lactation,
Bactericidal: inhibits synthesis of abdominal pain, Use cautiously pregnancy
bacterial cell wall, causing cell Patient’s actual indication: flatulence, with renal failure, > assess for physical
Brand name:  death Cefuroxime is given to postpartum pseudomembranous lactation, cues: skin status,
mothers to prevent them from post- colitis, pregnancy LFTs, renal function
Ceftin, Zinacef operational infections especially c/s hepatotoxicity tests, culture of
Onset: mothers. affected area
Dosage: Rapid GU: nephrotoxicity Interactions: > Have Vit. K
Route: > drug-drug: available in case
Peak: Hematologic: bone increased hypoprothrombinemia
Frequency: Immediate marrow depression nephrotoxicity occurs
(decreased WBC, with > culture injection
Duration: platelets, Hct) aminoglycosides, site, and arrange for
Classification:  18-24 hr. increased sensitivity tests before
Antibiotic Hypersensitivity: bleeding effects and during therapy if
Half-life: ranging from rash with expected response is
1.3 hr to fever to anticoagulants not seen
anaphylaxis; serum > take the pt’s BP
Source: Nursing 2011 Drug Guide sickness reaction > drug-lab test:
Lippincott, pg. 260 possibility of During:
Local: pain, abscess false results of > administer the right
at injection site, urine glycose, drug
phlebitis, using Benedict’s > explain to the
inflammation at IV solution, patient about the
site Fehling’s importance and
solution, Clingiest purpose of the drug
Other: tablets. > administer at the
superinfections, right time and right
disulfiram-like dosage
reaction with > avoid alcohol while
alcohol taking this drug and
for 3 days after
because severe
reactions often occur
> discontinue if
hypersensitivity
reaction occurs

After:
> document and
record.
> take note of side
effects: stomach upset
or diarrhea
> report severe
diarrhea, difficulty
breathing and unusual
tiredness or fatigue,
pain at injection site
> take patient’s V/S
> perform bedside
care

NAME OF PATIENT: DIAGNOSIS: NORMAL DELIVERY WARD/ROOM: ________________


DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ CONTRADICTION NURSING
ADVERSE CONSIDERATION
REACTION
Provides elemental iron, an GI: nausea,pain, Contraindicated
essential component in the This medication is an iron vomiting, inpatients with - GI upset maybe
Generic name:  supplement used to treat or prevent constipation, primary related to dose.
formation of hemoglobin.
low blood levels of iron (such as diarrhea, hemochromatosis or -Between meal
Ferrous Sulfate
those caused by anemia or blackstools, hemosiderosis, doses are
Brand name:  pregnancy). Iron is an important anorexia hemolytic anemia, preferable, but drug
mineral that the body needs to peptic ulcer disease, can be given with
Apo-Ferrous sulfate, produce red blood cells and keep you regional enteritis, or some foods,
ED-IN-SOL in good health. ulcerative colitis although absorption
Dosage: Oral solution may be decreased.
220mg (44mg -Check for
Fe)/5mL, 300mg constipation; record
(60mg Fe)/5mL (adult color and number
only)15 mg elemental of stools.
Fe/mL -Alert: Oral iron
may turn stools
Oral liquid drops black. Although
-75mg (15mg Fe)/mL this unabsorbed
iron is harmless, it
Route: PO could mask
presence of melena.
Frequency: Twice or
-Monitor
three times each day.
hemoglobin level,
hematocrit, and
Classification:  reticulocyte count
during therapy.
Iron Supplement,
Nutritional
Supplementn /
Hematinic
NAME OF PATIENT: DIAGNOSIS: NORMAL DELIVERY WARD/ROOM: _________________
DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ CONTRADICTION NURSING
ADVERSE CONSIDERATION
REACTION
Calcium is an essential element Negative calcium balance (as in GI: PO Ventricular  >Assess for
for regulating the excitation neonatal tetany, preparation: fibrillation, metastatic cutaneous
Generic name:  threshold of nerves and muscles, hypoparathyroidism, vitamin D Constipation, bone disease, burning
for blood clotting mechanisms, deficiency, alkalosis). Also, to increased gastric injection into sensations and
Calcium Gluconate
cardiac function (rhythm, tonicity, overcome cardiac toxicity of acid secretion. myocardium;
peripheral
Brand name:  contractility), maintenance of hyperkalemia, for cardiopulmonary administration by SC
renal function, for body skeleton resuscitation, to prevent CV: (With rapid or IM routes; renal
vasodilation, with
Kalcinate and teeth. Also plays a role in hypocalcemia during transfusion of infusion) calculi, moderate fall in
regulating storage and release of citrated blood. Also, as antidote for hypotension, hypercalcemia, BP, during direct
Dosage: IV injection.
neurotransmitters and hormones; magnesium sulfate, for acute bradycardia, predisposition to
Adults: 500 mg - 2 regulating amino acid uptake and symptoms of lead colic, to decrease cardiac hypercalcemia >Monitor ECG
grams (5-20 mL) absorption of vitamin B12, gastrin capillary permeability in sensitivity arrhythmias, (hyperparathyroidism during IV
Children: 200-500 mg secretion, and in maintaining reactions, and to relieve muscle cardiac arrest, , certain administration to
(2-5 mL) Infants: not structural and functional integrity cramps from insect bites or stings. malignancies); detect evidence of
more than 200 mg of cell membranes and capillaries. Oral calcium may be used to Skin: Pain and pregnancy (category hypercalcemia:
(not more than 2 mL) Calcium gluconate acts like maintain normal calcium balance burning at IV site, B). decreased QT
digitalis on the heart, increasing during pregnancy, lactation, and severe venous
interval
Route: Intravenous cardiac muscle tone and force of childhood growth and to prevent thrombosis,
systolic contractions (positive primary osteoporosis. Also, in necrosis and
associated with
Frequency: Dependent inotropic effect). osteoporosis, osteocalcin, chronic sloughing (with inverted T wave.
to the individual hypoparathyroidism, rickets, and as extravasation). >Observe IV site
requirements of the adjunct in treatment of myasthenia closely.
client. gravis and Eaton-Lambert Extravasation
syndrome. may result in
Classification:  tissue irritation
and necrosis.
Fluid and Electrolytic >Monitor for
and water balance hypocalcemia and
agent; Replacement hypercalcemia
solution. (see Signs &
Symptoms,
Appendix F).
>Lab tests:
Determine levels
of calcium and
phosphorus (tend
to vary inversely)
and magnesium
frequently, during
sustained therapy.
Deficiencies in
other ions,
particularly
magnesium,
frequently coexist
with calcium ion
depletion.

>Report S&S of
hypercalcemia
(see Appendix F)
promptly to your
care provider.
>Milk and milk
products are the
best sources of
calcium (and
phosphorus).
Other good
sources include
dark green
vegetables, soy
beans, tofu, and
canned fish with
bones.
>Calcium
absorption can be
inhibited by zinc-
rich foods: nuts,
seeds, sprouts,
legumes, soy
products (tofu).
>Check with
physician before
self-medicating
with a calcium
supplement.
>Do not breast
feed while taking
this drug without
consulting
physician.

NAME OF PATIENT: DIAGNOSIS: NORMAL DELIVERY WARD/ROOM: _________________

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ CONTRADICTION NURSING


ADVERSE CONSIDERATION
REACTION
Methylergonovine Following delivery of placenta, for Serious illness or Pregnancy, hepatic >Monitor fundal
maleate(methergine) is an ergot routine management of uterine atony, high fever, or renal disease, height and
Generic name:  alkaloid that stimulates smooth hemorrhage and subinvolution of the malnutrition, cardiac disease, consistency and the
muscle tissue. Because the smooth uterus. For control of uterine progressive hypertension or amount and
muscle of the uterus is especially hemorrhage in the second stage of dermatitis, serious preeclampsia character of the
Methylergonovine sensitive to this drug, it is used labor following delivery of the heart, kidney or contraindicate this lochia.
maleate postnatally to stimulate the uterus anterior shoulder. liver drugs use.
to contract in order to decrease disease, serious Methylergonovine >Assess the blood
Brand name:  blood loss by clamping off uterine cell-mediated maleate must be used pressure before and
Methergine blood vessels and to promote the immunodeficiency. with caution during routinely
involution process. In addition, the Child w/clinical lactation. throughout drug
Dosage: 0.2 mg/ml drug has vasoconstrictive effect on AIDS administration.
ampule all blood vessels, especially the
larger arteries. >Observe for
0.2 mg tablet adverse effects or
symptoms of ergot
Route: Intravenous,
toxicity(ergotism)
Intramuscular, PO
such as nausea and
  Frequency: 2-4h vomiting,
Maximum 5 doses headache, muscle
pain,
cold or numb
Classification:  fingers and toes,
chest pain and
Ergot alkaloids/ general weakness.
Methylergonovine >Instruct patient to
take medication as
directed; do not
skip or double up
on missed doses. If
a dose is missed,
omit it and return to
regular dose
schedule.
>Advise patient
that medication
may cause
menstrual-like
cramps
>Caution patient to
avoid smoking,
because nicotine
constricts blood
vessels.
>Instruct patient to
notify health care
professional if
infection develops,
as this may cause
increased
sensitivity to the
medication.
NAME OF PATIENT: DIAGNOSIS: NORMAL DELIVERY WARD/ROOM: _________________

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ CONTRADICTION NURSING


ADVERSE REACTION CONSIDERATION
Cofactor of many enzyme  Contraindicate Assess possibility
systems  IV or IM: SLE: syndrome d with allergy for interactions w/
Generic name:  involved in neurochemical Preeclampsia joint-swelling, to magnesium other drugs or
transmission and muscular or eclampsia fever) reaction, products; heart herbal products the
Magnesium Sulfate
excitability; prevents or controls anemia, block, patient may be
Brand name:  seizures by blocking agranulocytosis, myocardial taking especially
neuromuscular transmission;  To correct or hepatitis, damage; fecal anything that may
Magnesium Sulfate attracts and retains water in the Prevent glomerulonephritis impaction, impact blood
intestinal lumen and distends hypomagnesemia in , acute renal failure intestinal and pressure before
Dosage: Adults: 1 g bowel to promote mass biliary tract start treatment.
I.V. or I.M. Or, 1 to 2 patients or parenteral
movement and relieve nutrition obstruction,
g (as 10% solution) constipation.  Monitor
I.V. over 15 minutes; patients
then 1 g I.M. q 4 to 6 closely
 Do not give
hours, Children: 0.2 during and
during2 hours
ml/kg of 50% following
preceding
solution I.M. q 4 to 6 infusions.
delivery
hours, p.r.n., or 100 to Observe
because of risk
200 mg/kg as a 1% to orthostatic
of magnesium
3% solution I.V. precaution.
toxicity to the
Route: Intramuscular, neonate.
Intravenous
Frequency: Mild: 1 g
intramuscularly (IM)
every 6 hours for 4
doses. Severe: 5 g
intravenously (IV)
over 3 hours.

Classification: 
Anticonvulsant
NAME OF PATIENT: DIAGNOSIS: NORMAL DELIVERY WARD/ROOM: _________________

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ CONTRADICTION NURSING


ADVERSE CONSIDERATION
REACTION
Vitamin B complex essential for Folate deficiency, macrocytic Reportedly Folic acid alone for Assessment & Drug
nucleoprotein synthesis and anemia, and megaloblastic anemias nontoxic. Slight pernicious anemia or Effects
Generic name:  maintenance of normal associated with flushing and feeling another vitamin B •Obtain a careful
erythropoiesis. Acts against folic Malabsorption of warmth 12 deficiency states; history of dietary
Folic Acid
acid deficiency that impairs syndromes, alcoholism, primary liver following I normocytic, intake and drug
Brand name:  thymidylate synthesis and results in disease, inadequate dietary intake, administration refractory, aplastic, and alcohol usage
production of defective DNA that pregnancy, infancy, and childhood or undiagnosed prior to start of
Folvite leads to megaloblast formation and anemia.
therapy. Drugs
arrest of bone marrow maturation
Dosage: reported to cause
folate deficiency
1mg include oral
Route: contraceptives,
alcohol,
PO, Subcutaneous, barbiturates,
intramuscular methotrexate,
Frequency: daily during phenytoin,
pregnancy primidone, and
trimethoprim.
Folate deficiency
Classification:  may also result
from renal dialysis.
Vitamin B
•Keep physician
informed of
patient’s response
to therapy.
•Monitor patients
on phenytoin for
subtherapeutic
plasma levels.
NAME OF PATIENT: DIAGNOSIS: NORMAL DELIVERY WARD/ROOM: _________________

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ CONTRADICTION NURSING


ADVERSE CONSIDERATION
REACTION
Inhibits the transport of calcium Management of hypertension, angina CNS: Hypersensitivity; ● Monitor blood
into myocardial and vascular pectoris, and/or vasospastic (Prinz abnormal dreams, Sick pressure and pulse
Generic name:  smooth muscle cells, resulting in metal’s) anxiety, sinus syndrome; before
inhibition of excitation-contraction angina. Management of confusion, 2nd- or therapy, during
Verapamil
coupling and subsequent supraventricular arrhythmias and dizziness/light 3rd-degree AV block dosage titration,
hydrochloride
contraction. rapid ventricular rates inatrial flutter headedness, (unless an artificial and periodically
Brand name:  Decreases SA and AV conduction or fibrillation drowsiness, pacemaker throughout therapy.
and prolongs AV node refractory headache, is in place); Monitor ECG
period in conduction tissue. BP<90mmHg; CHF, periodically during
Apo-Verapamil, Resp: severe ventricular prolonged therapy.
Calan Therapeutic Effects: cough, dyspnea, dysfunction, Verapamil may
Systemic vasodilation resulting in shortness of breath. or cardiogenic shock, cause prolonged PR
Dosage: 80-120 mg
decreased blood pressure. Coronary unless associated interval.
Route: PO vasodilation resulting in decreased GI: with ● Monitor intake
frequency and severity of attacks of abnormal liver supraventricular and output ratios
Frequency: Twice daily angina. Suppression of ventricular function studies tachyarrhythmias; and daily
tachyarrhythmia anorexia, Concurrent beta weight. Assess for
constipation, blocker therapy. signs of CHF
Classification:  diarrhea, dry (peripheral edema,
rales/crackles,
GU: dyspnea, weight
Anti-Anginal gain, jugular
dysuria, nocturia,
Antiepileptic polyuria, venous distention)
sexual dysfunction, ● Monitor renal
urinary frequency. and hepatic
functions
periodically during
Derm: long-term therapy.
dermatitis, May cause increase
erythema hepatic enzymes
multiforme, after several days
flushing, increased of therapy, which
sweating. return to normal on
discontinuation of
therapy.
NAME OF PATIENT: DIAGNOSIS: NORMAL DELIVERY WARD/ROOM: _________________
DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ CONTRADICTION NURSING
ADVERSE CONSIDERATION
REACTION
Acts directly on vascular smooth General Indications Concentrations Before
muscle to cause vasodilation, - Hypertension- CNS: - Hypersensitivity- -Check blood
Generic name: primarily arteriolar, decreasing Eclampsia Headache, peripheral neuritis, CAD- mitral valvular pressure.
peripheral resistance; maintains or dizziness, tremors, psychotic rheumatic heart disease - Arrange for CBC,
increases renal and cerebral flow. reactions, characterized by Precaution LE cell
Hydralazine depression, disorientation, - with CAV’s- preparations, and
hydrochloride anxiety increased intracranial ANA titers before
CV: pressure- severe therapy.
Brand name: 
Palpitations, tachycardia, hypertension with - Assess for
Apresoline angina pectoris, hypotension, uremia- advanced renal contraindicated
paradoxical pressor response, damage- slow conditions.
Dosage: Adult: 10mg / orthostatic hypotension acetylators- lactation- - Observe the 15
25mg/50mg/300mg GI: pregnancy- pulmonary rights of drug
Children: Anorexia, nausea, vomiting, hypertension administration.
0.75mg/200mg diarrhea, constipation, Drug interaction - Assess bowel
paralytic ileus Drug to drug- Increased sounds.
Route: Frequency: GU: pharmacologic effects - Assess voiding
4 times daily Difficult micturition, of beta-adrenergic pattern.
impotence blockers and During
Hematologic: hydralazine when given - Give oral drug
Classification:  Blood dyscrasias concomitantly Drug to with food.
Hypersensitivity: food- Increased - Use parenteral
Antihypertensive Rash, urticaria, pruritus, bioavailability of oral drug immediately
fever, chills, arthralgia, hydralazine given with after opening
eosinophilia; rarely, hepatitis, food. ampule.
obstructive jaundice - Discard
Other: discolored
Nasal congestion, flushing, solutions.
edema, muscle cramps, - Arrange for CBC,
lymphadenopathy, LE cell
splenomegaly, dyspnea, preparations, and
lupus-like syndrome, possible ANA titers during
carcinogenesis, lacrimation prolonged therapy.
and conjunctivitis. - Instruct to take
drug exactly as
prescribed.
After
- Withdraw drug
gradually.
- Discontinue if
blood dyscrasias
occur.
- Arrange for
pyridoxine therapy
if patient develops
symptoms of
peripheral neuritis.
- Monitor for
orthostatic
hypotension.
- Report persistent
or severe
constipation,
unexplained fever
or malaise, muscle
or joint aching,
chest pain, rash,
numbness,
tingling.- Do proper
documentation.
NAME OF PATIENT: DIAGNOSIS: NORMAL DELIVERY WARD/ROOM: _________________

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