DRUG STUDY

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE NURSING CONSIDERATION

EFFECTS
GENERIC NAME: Increases osmotic pressure of Prevention, treatment of oliguric SIDE EFFECTS: Before:
Mannitol plasma in glomerular filtrate, phase of acute renal failure  Pulmonary congestion  Check B/P, pulse before
inhibiting tubular reabsorption of (before evidence of permanent  Fluid and electrolyte giving medication.
BRAND NAME: water and electrolytes. These renal failure). Reduces increased imbalance  Assess skin turgor,
Renimax actions enhance water flow from ICP due to cerebral edema,  Acidosis mucous membranes,
various tissues and ultimately spinal cord edema, IOP due to  Electrolyte loss mental status, muscle
CLASSIFICATION: decrease intracranial and acute glaucoma. Promotes  Dry mouth strength.
Osmotic diuretic intraocular pressures; serum urinary excretion of toxic  Thirst  Obtain baseline weight,
sodium level rises while substances (aspirin, bromides, chemistry studies.
 Marked diuresis
DOSAGE: potassium and blood urea levels imipramine, barbiturates).  Assess I&O.
 Urinary retention
200cc IV bolus fall. Also protects kidneys by
preventing toxins from forming  Edema
ROUTE: and blocking tubules.  Headache
During:
IV  Blurred vision
 Monitor urinary output to
Contraindication ascertain therapeutic
FREQUENCY: Contraindications: Dehydration, Adverse Effects response. Monitor serum
q4H intracranial bleeding, severe CNS: dizziness, headache,
electrolytes
pulmonary edema, congestion; seizures  Assess vital signs, skin
TIMING: severe renal disease (anuria), CV: chest pain, hypotension, turgor, mucous
8 AM – 12 NN – 4 PM increasing oliguria, azotemia, hypertension, tachycardia
membranes. Weigh daily.
– 8 PM – 12 MN – 4 AM progressive heart failure. thrombophlebitis
Signs of hyponatremia
Cautions: Concurrent nephrotoxic EENT: rhinitis and hypokalemia
agents, conditions increasing GI: nausea, vomiting, diarrhea
sensitivity to bronchoconstriction. GU: polyuria, osmotic nephrosis
Metabolic: water intoxication,
hypernatremia, hypokalemia Skin: After:
rash, urticaria Other: chills, fever,  Expect increased urinary
extravasation with edema and frequency/ volume. May
tissue necrosis. cause dry mouth.
DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE NURSING CONSIDERATION
EFFECTS
GENERIC NAME: Citicoline consumption Cerebrovascular diseases – SIDE EFFECTS: Before:
Citicholine promotes brain e.g. from ischaemia due to  Instruct patient to take the
metabolism by restoring stroke, where Citicoline medication as prescribed.
BRAND NAME: phospholipid content in the accelerates the recovery of  Body temperature elevation  Citicoline may be taken with or
Cholinerv brain and regulation of consciousness and  Restlessness without food. Take it with or
neuronal membrane overcoming motor deficit. Head  Headache between meals.
CLASSIFICATION: excitability. It also Trauma of varying severity: In  Nausea and vomiting  The supplement should not be
Nootropics & Neurotronic influences the a clinical trial, Citicoline  Diarrhea taken in the late afternoon or at
Neurotrophic mitochondria or energy accelerated the recovery from  Low or high blood pressure night because it can cause
Peripheral Vasodilators factories of the brain cells post-traumatic coma and the difficulty sleeping.
 Tachycardia
Cerebral Activators and found to improve recuperation of walking ability,
 Sleeping troubles or insomnia During:
memory function. After achieved abetter final  Monitor for adverse effects;
DOSAGE: several clinical trials, functional result and reduced  Blurred vision
instruct patient to report
1 gm Citicoline has been shown hospital stay. immediately if he/she develops
to raise the amount of chest tightness, tingling in mouth
ROUTES: acetylcholine in the brain. Adverse Effects
 Cardiac disorders: and throat, headache, diarrhea
IVTT and blurring of vision
Bradycardia, tachycardia.
After:
FREQUENCY:  Gastrointestinal disorders:
Diarrhea, epigastric  Contact the physician immediately
q8H Contraindication: if allergic reaction such as hives,
Hypersensitivity patients with discomfort, stomach pain.
rash, or itching, swelling in your
TIMING: hypertonic of the General disorders and admin site face or hands, mouth or throat,
8 AM – 4 PM – 12 MN parasympathetic conditions: Fatigue. Skin and
subcutaneous tissue disorders: chest tightness or trouble
Rashes. Vascular disorders: breathing are experienced.
Hypotension.  Citicoline therapy should be
started within 24 hours of a stroke.
 DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE NURSING CONSIDERATION
EFFECTS
GENERIC NAME: Inhibits calcium transport Chronic stable angina, given Side Effects Before:
Nicardipine into myocardial and alone or with beta-adrenergic  Assess vital signs and cardiovascular
vascular smooth muscle blockers; hypertension, given  Headache status.
BRAND NAME: cells, causing cardiac alone or with other anti-  Upset stomach  Sustained-release capsule taken whole;
Cardepine output and myocardial hypertensive; short- term  Dizziness do not break, chew, crush, or divide.
contractions to decrease. treatment for hypertension  Excessive tiredness  May take without regard to food.
CLASSIFICATION: when oral therapy is not  Flushing
Antianginal, Antihypertensive feasible or desirable.  Numbness During:
 Fast heartbeat  Monitor B/P during and following IV
DOSAGE: infusion.
 Muscle cramps
10mg  Assess for peripheral edema behind
medial malleolus. Assess skin for facial
ROUTE: flushing, dermatitis, rash. Question for
IVTT Contraindication: asthenia (loss of strength, energy), headache.
Adverse Effects:
Contraindications: Advanced  Monitor serum hepatic enzyme results.
FREQUENCY: aortic stenosis.
CNS: asthenia, drowsiness,  Assess EKG, pulse for tachycardia.
OD Cautions: Cardiac, renal,
paresthesia After:
hepatic dysfunction;
CV: hypotension, peripheral  Avoid alcohol, grapefruit juice, limit
TIMING: 4 PM heart failure; hypertrophic
edema, chest pain, increased caffeine.
cardiomyopathy; aortic
stenosis; coronary artery
angina, palpitations  Inform physician if angina pains not
GI: nausea, dypepsia, dry relieved or hypotension occur.
disease.
mouth  Avoid tasks requiring motor skills,
Musculoskeletal: myalgia alertness until response to drug is
established.
DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE NURSING CONSIDERATION
EFFECTS
Generic name: Inhibits HMG-CoA Primary prevention of cardiovascular Side Effects: Before:
Atorvastatin reductase, the enzyme that disease in high-risk pts. Reduces risk  Assess baseline lab results: cholesterol,
catalyzes the early step in of stroke and heart attack in pts with Common: Atorvastatin is triglycerides, hepatic function tests.
Brand name: cholesterol synthesis. type 2 diabetes with or without generally well tolerated. Side  Obtain dietary history.
Lipitor Classification: Therapeutic Effect: evidence of heart disease. Reduces effects are usually mild and
Antihyperlipidemic Decreases LDL and VLDL, risk of stroke in pts with or without transient.
plasma triglyceride levels; evidence of heart disease with Frequent (16%): Headache. During:
Dosage: increases HDL multiple risk factors other than Occasional (5%–2%): Myalgia,  Monitor for headache.
80mg/tab concentration. diabetes. Adjunct to diet therapy in rash, pruritus,  Assess for rash, pruritus, malaise.
management of hyperlipidemias allergy.  Monitor cholesterol, triglyceride lab
Route: (reduces elevations in total Rare (less than 2%–1%): values for therapeutic response.
PO cholesterol, LDL-C, apolipoprotein B Flatulence, dyspepsia,  Monitor hepatic function tests, CPK.
triglycerides in pts with primary depression.
Frequency: hypercholesterolemia).
OD (per night) After:
Adverse Effects:
 Follow special diet (important part of
Timing: 8 am Contraindication:
treatment).
Active hepatic disease, lactation, Potential for cataracts,
 Periodic lab tests are essential part of
pregnancy, unexplained elevated photosensitivity, myalgia,
therapy.
hepatic function test results. rhabdomyolysis.
Cautions: Anticoagulant therapy;  Do not take other medications without
history of hepatic disease; substantial consulting physician.
alcohol consumption; major surgery;  Report dark urine, muscle fatigue, bone
severe acute infection; trauma; pain.
hypotension; severe metabolic,  Avoid excessive alcohol intake, large
endocrine, electrolyte disorders; quantities of grapefruit juice.
uncontrolled seizures.
 DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE NURSING CONSIDERATION
EFFECTS
Generic name: Irreversibly binds to, Erosive esophagitis Side Effects Before:
Pantoprazole inhibits hydrogen caused by gastroesophageal reflux  Rare (less than 2%):  Obtain baseline lab values, including
potassium adenosine disease (GERD); pathologic  Diarrhea, serum creatinine, cholesterol.
Brand name: triphosphate, an enzyme hypersecretory conditions.  headache,
Pantoloc on surface of gastric  dizziness,
parietal cells. Inhibits  pruritus,
Classification: hydrogen ion transport  rash. During:
PHARMACOTHERAPEUTIC into gastric lumen.  Evaluate for therapeutic response
: Therapeutic Effect: (relief of GI symptoms).
Benzimidazole. CLINICAL: Increases gastric pH,  Question if GI discomfort, nausea
Proton pump inhibitor reduces gastric acid occur.
production.
Dosage: Adverse Effects
40mg Contraindication Hyperglycemia occurs rarely. After:
Hypersensitivity to proton pump  PATIENT/FAMILY TEACHING
Route: inhibitors (e.g., omeprazole).  Report headache, onset of black, tarry
IVTT stools, diarrhea.
 Avoid alcohol.
Frequency:
 Swallow tablets whole
OD
 Do not chew, crush.
Timing:  Best if given before breakfast.
8 am  May give without regard to food.
.
NURSING CARE PLAN
 DEFINING NURSING DIAGNOSIS SCIENTIFIC GOAL OF CARE NURSING RATIONALE EVALUATIO
CHARACTERISTICS ANALYSIS INTERVENTIONS
SUBJECTIVE Impaired verbal Dysarthria is a motor After 8 hours of INDEPENDENT: After 8 hours o
“Mag lisod ko ug litok communication related speech disorder in nursing intervention nursing
sa mga words.” as to impaired motor which the muscles that the patient will be ● Use one-on-one The nurse enters the intervention th
verbalized by the patient. function of muscles of are used to produce able to: interactions to engage the client’s world in a patient was ab
speech secondary to speech are damaged,  the patient will client in nonverbal play. nonthreatening to:
OBJECTIVE cerebrovascular paralyzed, or report interaction to form a
- Impaired ability to accident or brain attack. weakened. The person improved trusting relationship. ● Communicate
speak with dysarthria cannot satisfaction words/gestures
- Incongruence between control their tongue or with ability to ● Recognize subtle Cues are often difficult are understood
verbal and nonverbal voice box and may slur communicate. cues indicating the client to recognize (glancing others.
messages words. There are  The patient will is paying attention or out of the corner of the
- Stuttering strategies to improve demonstrate attempting to eye).
- Slurring of speech communication. increased communicate.
- Word-finding problems ability to
understand. ● Describe for the Naming objects and
 The patient will client what is happening, describing actions,
VITAL SIGNS demonstrate and put into words what thoughts, and feelings
T – 36.8 °axilla improved ability the client might be helps the client to use
P – 90 bpm to express self. experiencing. symbolic language.
R – 18 cpm  The patient will
BP – 100/80 mmHg be able to use ● Assess response Education may provide
O2 – 97% alternative to activity. motivation to increase
methods of activity level even
communication though patient may feel
, as indicated. too weak initially.

● Identify desired
behaviors and reward Behaviors that are
them rewarded will increase
 in frequency. Desire for
food is a powerful
incentive in modifying
behavior.
● Instruct patient to
perform deep breathing Helps promote
exercises. relaxation.

COLLABORATIVE:

● Increase verbal Play is the normal

interaction with parents medium for learning in a
and siblings by teaching pt. development.
them how to facilitate
language development.

● Administer oxygen as
ordered by the To provide proper
physician.C ventilation.

DEFINING NURSING SCIENTIFIC GOAL OF CARE NURSING RATIONALE EVALUATION

CHARACTERISTICS DIAGNOSIS ANALYSIS INTERVENTIONS
Impaired Physical Cerebrovascular SHORT TERM: Independent
SUBJECTIVE: Mobility related to accident (CVA), also After 8 hours of nursing After 8 hours of nursing
Neuromuscular known as stroke, intervention, the patient will: • Assess Identifies strengths and
“kapoyan kayo ko
intervention, the patient
involvement: cerebral infarction,  Patient will extent of deficiencies that may
ug lihok,mura weakness, brain attack, is any maintain/increase impairment initially provide information was able to:
gamayng lihok naku paresthesia; functional or structural strength and function and on a regular regarding recovery.  Patient will
kay dali kayo ko flaccid/hypotonic abnormality of the of affected or basis. Classify Assists in choice of maintain/increase
kapoyon unya mura paralysis brain caused by compensatory body according to 0–4 interventions, because strength and func
sakit sakit sad sya (initially); spastic pathological condition part. scale. different techniques are of affected or
gamay” as paralysis. of the cerebral  Patient will maintain used for flaccid and
compensatory bo
verbalized by the vessels of the entire optimal position of spastic paralysis.
patient. cerebrovascular function as . part.
system. It is the evidenced by  Patient will
sudden impairment of absence of • Observe Edematous tissue is demonstrate
cerebral circulation in contractures, foot affected side for more easily traumatized techniques/behav
OBJECTIVE : one or more of the drop. color, edema, or and heals more slowly. that enable
blood vessels  Patient will other signs of
supplying the brain. compromised
resumption of
demonstrate
 lack of energy techniques/behavior circulation. activities.
 restlessness s that enable
 Sleepy resumption of
 withdrawn activities.
behavior  Patient will maintain • Change
skin integrity. positions at least Reduces risk of tissue
every 2 hr (supine, injury. Affected side has
side lying) and poorer circulation and
possibly more often reduced sensation and
if placed on affected is more
side.

During flaccid paralysis,

• Use arm use of sling may reduce
sling when patient is risk of shoulder
in upright position, subluxation and
as indicated. shoulder-hand
syndrome.
Collaborative

• Set goals Promotes sense of

with patient and SO expectation of
for participation in improvement, and
activities and provides some sense of
position changes. control and
independence.

• Assist patient ROM exercise helps in

with exercise and reducing muscle
perform ROM stiffness and spasticity.
exercises for both It can also helps prevent
the affected and contractures.
unaffected sides.
Teach and
encourage patient
to use his
unaffected side to
exercise his
affected side.