Name of Drug Drug Nursing

Common Side
Dose, Route & Classification Consideration
Effects
Timing
PHARMACOTHERAPEUTIC: Frequent (10%– Baseline assessment:
Trade name: Loop diuretic. 4%): Headache, Obtain serum electrolyte
Demadex dizziness, rhinitis. levels, esp. potassium.
(Torsemide) CLINICAL: Obtain baseline weight;
Antihypertensive, diuretic. Occasional check for edema. Assess
Dose: 20mg (3%–1%): lungs for crackles, signs of
Route: PO, IV Asthenia, HF. Obtain B/P.
(diuresis) insomnia,
Onset: 30–60 nervousness, Intervention/Evaluation:
min diarrhea, Monitor B/P, serum
Peak: 1–2 hrs constipation, electrolytes (esp.
Duration: 6–8 nausea, potassium), I&O, weight.
hrs dyspepsia, Notify physician of any
Timing: within 4 edema, EKG hearing abnormality. Note
hours of bedtime changes, extent of diuresis. Assess
pharyngitis, lungs for rales. Check for
cough, arthralgia, signs of edema, particularly
myalgia. of dependent areas.

Rare (Less Than Patient/Family teaching:

1%): Syncope, Take medication in morning
hypotension, to prevent nocturia. Report
arrhythmias. palpitations, muscle
weakness, cramps, nausea,
dizziness. Do not take other
medications (including OTC
drugs) without consulting
physician. Eat foods high in
potassium such as whole
grains (cereals), legumes,
meat, bananas, apricots,
orange juice, potatoes
(white, sweet), raisins.
What initial manifestation/s that the doctor observed that concluded that the
patient is having an imbalance of calcium or hypercalcemia?

Aling Marites has history of 640 ng/ml of c-terminal parathyroid hormone 4 years
ago, the normal range of c-terminal parathyroid hormone is 50-330 pg/mL and too
much PTH produces excessive calcium levels in the blood. Several studies found out
that primary hyperthyroidism (HPT) is responsible for more than 90% cases of
hypercalcemia and it is more prevalent in women over the age of 50. Most of the
time, this is caused by an overactive parathyroid gland. During the admission, the
son stated that Aling Marites developed anorexia, nausea and vomiting, and
lost seven pounds. The nurse reported low-grade fever and orthostatic
hypotension. Upon initial assessment of Aling Marites, her blood pressure quickly
drops when she stands up from a lying position. She is having cachexia, pale
looking and lethargic due to neuromuscular eefect of hypercalcemia where
symptoms include weakness, has fast breathing since respiratory muscular
capacity may be decreased. And there was 2.5 cm mass just lateral to the lower
pole of the right thyroid lobe which increases her risk for malignancy. Aling
Marites stated, "dugay naman ko wala kalibang", upon assessment it was observed
that her abdomen is bloated. The gastrointestinal (GI) manifestations of
hypercalcemia include peptic ulcer disease and pancreatitis. Constipation is seen
frequently and can worsen due to dehydration associated with hypercalcemia, and
Aling Marites report anorexia and nausea because anorexia, nausea, and vomiting
are made worse by increased gastric residual volume. At 9:00, Dr. Moi made his
assessment and laboratory results are Hgb: 116g/L, Hct: 0.35, Platelet: 105,
Calcium: 17.2mg/dL, and Phosphate: 2.3 mg/dL. Low hemoglobin count is less than
135 g/L or less than 12 g/dL. Normal hematocrit range for female is 36%-48%.
Low platelet count (<150) can cause fatigue, bleeding, etc. Calcium level of
17.2mg/dL is hypercalcemia. The above mentioned are the initial manifestations
of Aling Marites, which led Dr. Moi to conclude that the patient is having an
imbalance of calcium.

Aling Marites stated “Ngano man malipong man ko?” and “og ngano abunohan ko’g
dugo?” what should be the best respond to this??? (As a knowledgeable nursing
student.)

As an effective student nurse, I must keep in mind first how and the goals of my
response. I must first learn what are the concern, ensuring that I understand it and
I must let the patient knows that I understand to address legitimate concerns and
to improve my performance and most important, to strengthen patient relationship.
The best response to Aling Marites’ question “ngano man malipong ko”, is first,
hypercalcemia is characterized by elevated calcium levels in the blood and it may
affect the Central Nervous System which causes headaches, drowsiness,
lethargy, etc. Aling Marites complete blood count are decreased, so her lack of
enough healthy red blood cells to carry adequate oxygen to her body's tissues
causes feelings of fatigue, weakness, and dizziness or lightheadedness. Aling
Marites will undergo blood transfusion because her complete blood count was below
normal. I have to deliver my answer with empathy and be as transparent with Aling
Marites as to why she needs to undergo blood transfusion, since this provides blood
or blood components that is lost blood due to a certain medical condition.