SHERYL ANN B.

PEDINES BSN-IV

Generic Name: Retaplase Nursing Responsibilities

Action Rationale
Brand Name: Retavase 1. Verify Doctor’s order. To ensure that this is the drug of choice for the patient

Dose/ Route/Frequency: IV 10 units slow IV push over 2
minutes and 30 minutes later.
Mechanism of Action: Binds to fibrin (in clot) and activates
plasminogen to convert into plasmin, which in turn degrades the
fibrin matrix of the thrombus, thereby exerting its thrombolytic
action. Therefore, dissolve blood clots and improve heart
functions.
Physiologic classification: Anticoagulant
Pharmacologic Classification: Thrombolytic Enzyme
2. Consider the 10 rights of drug administration.
3. Explain the purpose of the drug.
5. Screen patient carefully for possible
contraindications prior to fibrinolytic therapy.
6. Flush IV line with 30 ml of normal saline prior to
and after administering each IV push.
8. Be certain to give IV bolus slowly over 2 minutes.
To prevent medical error.
To gain cooperation and promote compliances.
To prevent risk of life-threatening.
To ensures that any medication remaining within the IV line is
delivered at the correct rate and to avoid giving the patient an
accidental bolus of the medication.
To minimize adverse effects.

Desired Effect: relief of chest pain. 9. Monitor all possible sites of bleeding during To prevent risk of complications.
therapy
10. Assess injection site during and after IV To prevent risk of complications.
Indication/s: acute ST-elevation myocardial infarction (STEMI) administration.
9.Watch for neurological alterations like change in To prevent risk of life-threatening. Because neurological
mental status, level of consciousness, seizures, alterations may indicate cerebral hemorrhage
hemiparesis/hemiplegia, changes in pupils.

Contraindication/s: contraindicated to active internal bleeding, Document and record. For references.
history of CVA, recent neurologic surgery or trauma, intercranial
neoplasm, or aneurysm, bleeding disorders, severe uncontrolled
hypertension.

Side Effects: nausea, vomiting, fever, injection site bleeding, blood in the urine, bloody or tarry stools, stomach pain, or
vomiting blood or vomit that looks like coffee grounds
Adverse Effects: rash, pruritis, erythema, glossal (tongue) edema, hypotension, and respiratory distress, cholesterol embolization,
bleeding, livedo reticularis, “purple toe” syndrome, acute renal failure, gangrenous digits, hypertension, pancreatitis,
myocardial infarction,
SHERYL ANN B. PEDINES BSN-IV

Generic Name: Nitroglycerine Nursing Responsibilities

Action Rationale
Brand Name: Nitrostat 1. Verify Doctor’s order. To ensure that this is the drug of choice for the patient

Dose/ Route/Frequency: 5mcg/min IV and titrate q3-5min. 2. Consider the 10 rights of drug administration. To prevent medical error.

Mechanism of Action: Dilating coronary vessels to increases
blood flow to the heart to get more blood flow to ischemic area.
Physiologic classification: Vasodilators, antianginals
Pharmacologic Classification: Nitrates
Desired Effect: reduces chest pain.
Indication/s: HF after MI, angina pectoris in acute situations.
3. Explain the purpose of the drug.
5. Check blood pressure and pulse before
administration.
6. Closely monitor Vital signs during infusion,
particularly blood pressure.
8. Do not discontinue NTG intravenous infusion
abruptly.
9. Instruct patient to rise slowly when standing up
carefully and to lied down at the first sign of
dizziness.
10. Give acetaminophen if headache occurs after
the therapy.
12. Document and record.
To gain cooperation and promote compliances.
To determine the hemodynamic effect.
For early recognition of adverse events.
To prevent precipitous rebound hypertension, angina, or
coronary artery vasospasms
To minimize dizziness.
To relieve headache secondary to NTG therapy.
For references.

Contraindication/s: contraindicated in patients’ hypersensitivity 13.

to I.V form and in those with cardiac tamponade, restrictive
cardiomyopathy, or constrictive pericarditis.

Side Effects: headache, dizziness, lightheadedness, nausea, flushing, abdominal pain, dyspnea.

Adverse Effects: orthostatic hypotension, bradycardia, palpitations, peripheral edema, pharyngitis, rhinitis, hypersensitivity reactions.
SHERYL ANN B. PEDINES BSN-IV

Generic Name: Morphine Nursing Responsibilities

Action Rationale
Brand Name: Duramorph 1. Verify Doctor’s order. To ensure that this is the drug of choice for the patient

Dose/ Route/Frequency: 4 mg IV q5mins prn 2. Consider the 10 rights of drug administration. To prevent medical error.

3. Explain the purpose of the drug.
Mechanism of Action: Binds with opioid receptors in the CNS by
altering perception of pain. 5. Assess Respiratory rate and heart rate before
administering
Physiologic classification: Opioid analgesics 6. Dilute administer slowly.
To gain cooperation and promote compliances.
To determine hemodynamic effects.
To minimize adverse effects.

Pharmacologic Classification: Opioids

8. Monitor respiratory rate carefully. To prevent respiratory depression.

Desired Effect: to relieve chest pain 9. Instruct patient to report severe nausea, vomiting or For early interventions.
shortness of breath occur.
10. Reassess pain after administering breakthrough To determine effectiveness.
Indication/s: moderate to severe pain doses
12. Document and record. For references.

Contraindication/s: Contraindicated in patient hypersensitive to 13.

give drug and in those with conditions that would preclude I.V
administration of opioids such as acute bronchial asthma or upper
airway obstruction.

Side Effects: nausea, dizziness, sedation, apnea, light-headedness, nightmares, nervousness, anxiety, constipation, vomiting, anorexia,
dry mouth, flatulence, abdominal pain, pain at injection site, apnea, biliary tract spasm, ileus, hallucinations,
somnolence, euphoria
Adverse Effects: flushing, tachycardia, bradycardia, arrythmia, hypertension, seizures, cardiac arrest, shock, decreased libido, respiratory
depression, blurred vision., edema, peripheral edema, thrombocytopenia, anemia, peripheral circulatory collapse,
urineretention
SHERYL ANN B. PEDINES BSN-IV

Generic Name: Heparin Nursing Responsibilities

Action Rationale
Brand Name: Heparin 1. Verify Doctor’s order. To ensure that this is the drug of choice for the patient

Dose/ Route/Frequency: IV 2. Consider the 10 rights of drug administration. To prevent medical error.

Mechanism of Action: Inhibits the action of clotting factors that
cement the clumps of platelets together thus prevents the
formation and growth of blood clots.
Physiologic classification: Anticoagulants
Pharmacologic Classification: Anticoagulants
Desired Effect: prevent formation of clot.
3. Explain the purpose of the drug. To gain cooperation and promote compliances.
5. Establish baseline coagulation parameters before To determine
therapy.
6. Check continuous infusions regularly, even when To ensure correct dosing.
pumps are in good working order.
8. During intermittent infusion, always draw blood 30 To avoid falsely prolonged PTT.
minutes before next scheduled dose.
9. Watch out for platelets levels. To prevent risk of

10. Monitor for signs of bleeding. To prevent risk of complications.

Indication/s: Acute myocardial infarction.
12. Document and record. For references.

Contraindication/s: Hypersensitive to drug or pork products. 13.

Conditionally contraindicated in patients with active bleeding,
blood dyscrasia, or bleeding tendencies such as hemophilia,
thrombocytopenia, history of heparin-induced thrombocytopenia
(HIT), or hepatic disease

Side Effects: easy bleeding and bruising, pain, redness, warmth, irritation, or skin changes where the medicine was injected, itching of
your feet; or bluish-colored skin.
Adverse Effects: Osteoporosis, chills, anaphylactoid reactions, hematoma, transient alopecia, urticaria, pruritis, hypersensitivity reactions,
hemorrhage, thrombocytopenia, hypoaldosteronism, mild pain, subcutaneous necrosis, rhinitis, overly prolonged clotting
SHERYL ANN B. PEDINES BSN-IV
time,

Generic Name: Metropolol Nursing Responsibilities

Action Rationale
Brand Name: Lopressor 1. Verify Doctor’s order. To ensure that this is the drug of choice for the patient

Dose/ Route/Frequency: 5 mg IV q5mins 3 doses 2. Consider the 10 rights of drug administration. To prevent medical error.

Mechanism of Action: Blocking the action of certain
natural chemicals in the body such as epinephrine on the
heart and blood vessels. This effect lowers the heart rate,
blood pressure, and strain on the heart.
Physiologic classification: Antihypertensive
Pharmacologic Classification: Selective beta-adrenergic
blockers.
3. Explain the purpose of the drug. To gain cooperation and promote compliances.
5. Check patient’s apical pulse rate before To determine hemodynamic effects.
administering.
6. Monitor BP and pulse frequently during dose To determine hemodynamic effects.
adjustment and periodically during therapy.
8. Advise patient to change positions slowly To minimize orthostatic hypotension.

Desired Effect: decreased BP, heart rate, and myocardial 7.Check blood pressure an hour or two after To evaluate therapeutic effectiveness.
contractility. administering the drug.

9. Document and record. For references.

Indication/s: HTN, Early interventions in acute MI.
11.

Contraindication/s: Hypersensitive to drug or other beta 12.

blockers and Contraindicated in patients with less than 45
beats/min, greater than first-degree heart block, PR interval
of 0.24 second or longer with first-degree heart block,
systolic BP less than 100 mmHg, or moderate to severe
cardiac failure.
Side Effects: dizziness or lightheadedness, tiredness, depression, nausea, dry mouth, stomach pain, vomiting, gas or
bloating, heartburn, constipation, rash or itching, cold hands and feet, runny nose
SHERYL ANN B. PEDINES BSN-IV
Adverse Effects: shortness of breath, wheezing, swelling of the hands, feet, ankles, or lower legs, weight gain, fainting, rapid,
pounding, or irregular heartbeat

Generic Name: Aspirin Nursing Responsibilities

Action Rationale
Brand Name: Bayer 1. Verify Doctor’s order. To ensure that this is the drug of choice for the patient.

Dose/ Route/Frequency: 325 mg P.O OD (chewable)
Mechanism of Action: Interfere with clotting by keeping
platelet-aggregating substance from forming.
Physiologic classification: NSAIDs
Pharmacologic Classification: Salicylates
2. Consider the 10 rights of drug To prevent medical error.
administration.
3. Explain the purpose of the drug. To gain cooperation and promote compliances.
4. Advise patient to take the drug with food, To reduce GI reactions.
milk, or large glass of water
5. Monitor patient for hypersensitivity To prevent risk of life-threatening.
reactions such as anaphylaxis and asthma.
7. Monitor for signs of gastrointestinal To prevent risk of complication.
bleeding or hepatic toxicity.

Desired Effect: decreased clot forming. 8. Monitor the therapeutic effectiveness of To evaluate the therapeutic efficacy.
the drug.
9. Document and record. For references.
Indication/s: Suspected acute MI

Contraindication/s: Hypersensitive to drug and in those

with NSAID-induced sensitivity reactions, G6PD deficiency,
or bleeding disorders, such as hemophilia, von Willebard
disease, telangiectasia, bleeding ulcers, and hemorrhagic
states.
Side Effects: rash, gastrointestinal ulcerations, abdominal pain, upset stomach, heartburn, drowsiness, headache, cramping,
nausea, gastritis, and bleeding.
SHERYL ANN B. PEDINES BSN-IV
Adverse Effects: agitation, cerebral edema, coma, confusion, dizziness, lethargy, hypotension, arrythmias, GI bleeding,
dehydration, tachycardia, hearing loss, renal failure, rash, bruising, urticaria, hives, respiratory alkalosis,
hyperkalemia, seizures, tinnitus, dyspepsia.