Kristian Karl B.

Kiw-is

PRESCRIBED THERAPEUTIC (MEDICAL/SURGICAL) MANAGEMENT, AND HEALTH PROMOTION PROGRAMS:  

Activity 5:  After reading your textbook or notes on pharmacology and/or med-surgical books, answer what
are asked on the following table.   

Drug/ Dose/Route/  Mechanism of action  Common Side Effects  Nursing responsibilities 

Classification 
Frequency 

Dopamine    Shock  Actions  CV: Hypotension, ecto

Adult/Child: IV  pic
Naturally occurring  Monitor blood pressure,
2–5 beats, tachycardia, ang
neurotransmitter and pulse, peripheral pulses,
mcg/kg/min inal pain, palpitation,
immediate precursor of and urinary output at
increased vasoconstriction
norepinephrine. Major intervals prescribed by
gradually up to (indicated by
cardiovascular effects physician. Precise
20–50 disproportionate rise
produced by direct measurements are
mcg/kg/min if in diastolic pressure),
action on alpha- and essential for accurate
necessary cold extremities; less
beta-adrenergic titration of dosage.
frequent: aberrant
receptors and on
Renal Failure conduction,  Report the following
specific dopaminergic
Adult: IV 2–5 bradycardia, widening indicators promptly to
receptors in mesenteric
mcg/kg/min of QRS complex, physician for use in
and renal vascular beds.
elevated blood decreasing or
Therapeutic Effects pressure. GI: Nausea, temporarily suspending
vomiting. CNS: Headac dose: Reduced urine
Positive inotropic effect he. Skin: Necrosis, flow rate in absence of
on myocardium tissue sloughing with hypotension; ascending
increases cardiac output extravasation, gangren tachycardia;
with increase in systolic e, dysrhythmias;
and pulse pressure and piloerection. Other: Az disproportionate rise in
little or no effect on otemia, dyspnea, diastolic pressure
diastolic pressure. dilated pupils (high (marked decrease in
Improves circulation to doses). pulse pressure); signs of
renal vascular bed by
peripheral ischemia
decreasing renal
(pallor, cyanosis,
vascular resistance with
mottling, coldness,
resulting increase in
complaints of
glomerular filtration rate
tenderness, pain,
and urinary output.
numbness, or burning
sensation).

 Monitor therapeutic
effectiveness. In
addition to
improvement in vital
signs and urine flow,
other indices of
adequate dosage and
perfusion of vital organs
include loss of pallor,
increase in toe
temperature, adequacy
of nail bed capillary
filling, and reversal of
confusion or comatose
state.

2.  Depression,  Actions  CNS: Headache,  Assessment & Drug Effects

Fluox Obsessive- Oral antidepressant nervousness, anxiety,  Use with caution in the
etine  Compulsive chemically unrelated to insomnia, drowsiness, older adult patient or
Disorder tricyclic, fatigue, tremor, patient with impaired
Adult: PO 20 tetracyclic, MAOI, or dizziness. CV: Palpitati renal or hepatic function
mg/d in a.m., other available ons, hot flushes, chest (may need lower dose).
may increase antidepressants. pain. GI: Nausea,
 Use with caution in
by 20 mg/d at Antidepressant effect is diarrhea, anorexia,
anorexic patient, since
weekly presumed to be linked dyspepsia, increased
weight loss is a possible
intervals (max: to its inhibition of CNS appetite, dry
side effect.
80 mg/d); 20 neuronal uptake of mouth. Skin: Rash,
mg/d in a.m.; serotonin, a pruritus, sweating,  Monitor for S&S of
when stable neurotransmitter. hypersensitivity anaphylactoid reaction
may switch to Known as a selective reactions. Special (see Appendix F).
90 mg serotonin reuptake Senses: Blurred
 Lab tests: Periodic
sustained- inhibitor (SSRI). vision. Body as a
release capsule Whole: Myalgias, serum electrolytes;
Therapeutic Effects monitor closely plasma
qwk (max: 90 arthralgias, flu-like
mg/wk) glucose in diabetes.
Effectiveness may take syndrome,
Child: PO > 7 from several days to 5 hyponatremia. Urogeni  Monitor serum sodium
y 10–20 mg/d wk to develop fully. Drug tal: Sexual dysfunction, level for development of
in a.m. (max: has antidepressant, menstrual hyponatremia, especially
60 mg/d for antiobsessive- irregularities. in patients who are
OCD) compulsive, and taking diuretics or are
Geriatric: PO St antibulimic actions. otherwise hypovolemic.
art with 10
mg/d  Monitor diabetics for
loss of glycemic control;
Premenstrual hypoglycemia has
Dysphoric occurred during
Disorder initiation of therapy, and
Adult: PO 10– hyperglycemia during
20 mg q.d. drug withdrawal.
(max: 60 mg/d)  Monitor for S&S of
improved affect.
Bulimia Requires approximately
Nervosa 2–3 wk for therapeutic
Adult: PO 60 effects to be felt.
mg q.d.
 Weigh weekly to
monitor weight loss,
particularly in the older
adult or nutritionally
compromised patient.
Report significant weight
loss to physician.

 Observe for and

promptly report rash or
urticaria and S&S of
fever, leukocytosis,
arthralgias, carpal tunnel
syndrome, edema,
respiratory distress, and
proteinuria. Drug may
have to be discontinued
or adjunctive therapy
instituted with steroids
or antihistamines.

 Observe for dizziness

 and drowsiness and
employ safety measures
(up with assistance, side
rails, etc.) as indicated.

 Monitor for and report

increased anxiety,
nervousness, or
insomnia; may need
modification of drug
dose.

 Monitor for seizures in

patients with a history of
seizures. Use
appropriate safety
precautions.

 Supervise patients
closely who are high
suicide risks; especially
during initial therapy.

 Monitor patients with

hepatic or renal
impairment carefully for
S&S of toxicity (e.g.,
agitation, restlessness,
nausea, vomiting,
seizures).

Patient & Family Education

 Notify physician of
intent to become
pregnant.

 Notify physician of any

rash; possible sign of a
serious group of adverse
effects.

 Do not drive or engage

in potentially hazardous
activities until response
to drug is known;
especially if dizziness
noted.

 Monitor blood glucose

for loss of glycemic
control if diabetic.

 Note: Drug may increase

seizure activity in those
with history of seizure.

 Do not breast feed while

taking this drug without
consulting physician.

3.  Depression  Actions  Body as a  Assessment & Drug Effects

Well Adult: PO 75– Whole: Weight loss,
butri 100 mg t.i.d., The neurochemical weight  Monitor for therapeutic
n    start with 75 mechanism of gain. CNS: Seizures. effectiveness. The full
mg t.i.d., or bupropion is unknown. The risk of seizure antidepressant effect of
100 mg SR It does not inhibit appears to be strongly drug may not be realized
b.i.d., or 150 monoamine oxidase. associated with dose for 4 or more weeks.
mg XL q.d., and Compared to tricyclic (especially >450 mg/d)
 Close observation for
increase dose antidepressants (TCA), it and may be increased
worsening of depression
q3d to 300 is a weak blocker of by predisposing factors
or suicidal tendencies.
mg/d; doses neural uptake of (e.g., head trauma,
>450 mg/d are serotonin and CNS tumor) or a  Use extreme caution
associated norepinephrine. history of prior when administering
with an seizure; agitation, drug to patient with
Therapeutic Effects
increased risk insomnia, dry mouth, history of seizures,
of adverse Its antidepressive effect blurred vision, cranial trauma, or other
reactions is related to CNS headache, dizziness, factors predisposing to
including stimulant effects. tremor. GI: Nausea, seizures; during sudden
seizures vomiting, and large increments in
Geriatric: PO 5 constipation. CV: Tachy dose, seizure potential is
0–100 mg/d, cardia. Skin: Rash. increased.
may increase
 Report significant
by 50–100 mg
q3–4d (max: restlessness, agitation,
150 mg/dose) anxiety, and insomnia.
Symptoms may require
Smoking treatment or
Cessation discontinuation of drug.
Adult: PO Start  Monitor for and report
with 150 mg delusions,
once daily x 3 hallucinations, psychotic
d, then episodes, confusion, and
increase to 150 paranoia.
mg b.i.d. (max:
300 mg/d) for  Lab tests: Monitor
7–12 wk hepatic and renal
function tests while
patient is taking this
drug.

Patient & Family Education

 Take drug at the same

times each day.

 Monitor your weight at

least weekly. Report
significant changes in
weight (+/–5 lb) to
physician.

 Minimize or avoid
alcohol because it
increases the risk of
seizures.

 Do not drive or engage

in potentially hazardous
activities until response
to drug is known
because judgment or
motor and cognitive
skills may be impaired.
  Do not abruptly
discontinue drug.
Gradual dosage
reduction may be
necessary to prevent
adverse effects.

 Do not take any OTC

drugs without consulting
physician.

 Do not breast feed while

taking this drug.

IVF  Amount  Infusion rate  Purpose  Nursing responsibilities 

1.  1000 ml  1000 ml @25gtts/min  Make the person feel  Monitor patient frequently or:
  hydrated preventing a. Signs of infiltration/sluggish
hypovolemic shock or flow
hypotension-Normal
b. signs of phlebitis/infection
Saline is a sterile
c. well time of catheter and need
To be replaced

d. Condition of catheter
dressing.

Check the level of the IVF.

a. Correct solution, medication

and volume.

b. Check and regulate the drop

rate.

c. Change the IVF solution if

needed.

d. Do not connect flexible

plastic

Diagnostic Description  Purpose  Nursing Responsibilities 

Procedure 

   A  CT scans can detect  CT scans can detect bone and joint problems, like
computerized bone and joint complex bone fractures and tumors. If you have a
1. CT-
tomography problems, like complex condition like cancer, heart disease, emphysema, or liver
scan
(CT) scan bone fractures and masses, CT scans can spot it or help doctors see any
combines a tumors. If you have a changes. They show internal injuries and bleeding, such
series of X-ray condition like cancer, as those caused by a car accident.
images taken heart disease,
from different emphysema, or liver
angles around masses, CT scans can
your body and spot it or help doctors
uses computer see any changes. They
processing to show internal injuries
create cross- and bleeding, such as
sectional those caused by a car
images (slices) accident.
of the bones,
blood vessels
 and soft tissues
inside your
body.
  

2. Liver Liver function tests can

Liver function
functi be used to: Screen for
tests, also Generally, the patient should be N.P.O. for 4 hours
on liver infections, such as
referred to as a before you draw blood for bilirubin and ALP levels and
test   hepatitis. Monitor the
hepatic panel, be N.P.O. for 8 hours and abstain from alcohol for 24
progression of a disease,
are groups of hours before a GGT level. Otherwise, no special
such as viral or alcoholic
blood tests preparation is needed.
hepatitis, and determine
that provide
how well a treatment is
information
working. Measure the
about the state
severity of a disease,
of a patient's
particularly scarring of
liver. These
the liver (cirrhosis)
tests include
prothrombin
time, activated
Partial
Thromboplasti
n Time,
albumin,
bilirubin, and
others.

A vitamin B-12 level test

A vitamin B-12 checks the amount of It is a nursing responsibility to ensure that the patient
3. Vit B- test measures
has had the appropriate preparation. A special diet or
12   the amount of vitamin B-12 in the
blood or urine to gauge fasting. It is a nursing responsibility to be aware of the
B-12 in your the body's overall normal and abnormal ranges of blood tests, in order to
blood. Find out vitamin B-12 stores. understand the significance of the test results.
what your B-12 Vitamin B-12 is
results mean necessary for several
and how to bodily processes,
optimize your including nerve function
B-12 intake. and the production of
DNA and red blood cells.

Reference/s:  Textbooks /Online resources are allowed but should not come from blogs or Wikipedia