2A - Pasay - Module 8 - Elaborate

UNIVERSITY OF CEBU - BANILAD
Gov. M. Cuenco Ave, Cebu City, 6000 Philippines

College of Nursing
Telephone No: (032) 231- 8631
Delivery Room
DRUG STUDY
Patient : T.L.R.____________ _________ _______ Age : 33______________ _ __ Hospital : 071________________

No
Impression : In labor __________ Attending Physician : Dr. Kim________ _____ Room No : 012________________
Allergic to : N/A_______________________________
Generic / Brand Dose, Strenght Indication/Mechanism Adverse Effects & Nursing Responsibilities Client Teaching
Name & And Formulation Of Action Contraindications
Classification
Generic: Ordered: Indication: Adverse Effects: Baseline assessment: • Instruct patient to stay on her side
Dinoprostone 0.5 mg endocervical Initiation and/or CNS: fatigue, dizziness, • Assess Bishop score for 15–30 minutes after injection of
gel intravaginally continuation of cervical depression, headache, • Assess degree of gel.
Brand: ripening in patients at or insomnia, mental confusion, effacement (determines • Tell patient she may experience
Cervidil Timing: near term with medical nightmares, short-term size of shielded side effects such as nausea,
q6h prn indication for induction memory loss, hallucinations, endocervical catheter) vomiting, diarrhea, uterine or
Classification: of labor vertigo • Offer emotional support vaginal pain, fever, headache,
Oxytocics Duration: CV: hypotension, weakness, dizziness.
24 hours Mechanism of Action: bradycardia, HF, edema, Intervention/evaluation: • Caution patient to report severe
Relaxes smooth muscle at palpitations, stroke • Monitor uterine activity pain, difficulty breathing,
Other Forms: the cervix EENT: blurred vision, (onset of uterine palpitations, eye pain, rash.
Endocervical gel tinnitus, rhinitis contractions), fetal status
Vaginal insert GI: nausea, diarrhea, (heart rate), character of
Vaginal constipation, heartburn, dry cervix (dilation,
suppositories mouth, flatulence, gastric effacement)
pain, vomiting • Have patient remain
recumbent 12 hours after
Pharmacology Drug Study 1st Semester S.Y. 2021- 2022 UCBC Page 1
College of Nursing
Telephone No: (032) 231- 8631
GU: decreased libido, application with

erectile dysfunction continuous electronic
Musculoskeletal: pain monitoring of fetal heart
Respiratory: dyspnea, rate, uterine activity
wheezing, bronchospasm • Record maternal vital
Skin: rash, pruritus signs at least hourly in
presence of uterine
Contraindications: activity
• Contraindicated in patients • Reassess Bishop score
hypersensitive to drug
• Contraindicated in patients
with active cardiac, hepatic,
pulmonary, renal disease
with prolonged uterine
contractions that are
inappropriate (eg, caesarean
delivery, uterine surgery,
fetal distress, obstetric
emergency)
• Use cautiously in patients
with history of scarred
uterus, cervicitis, infected
endocervical lesions, and
acute vaginitis
College of Nursing
Telephone No: (032) 231- 8631
DRUG STUDY
Patient : R.A.C._________________ ___________ Age : 36__________________ Hospital : 071________________

No
Impression : In labor ___ ____________ Attending Physician : Dr. Kim________ _____ Room No : 012________________
Allergic to : N/A_______________________________
Name & Classification And Formulation Of Action Contraindications
Generic: Ordered: Indication: Adverse Effects: Baseline assessment: • Explain use and administration
Oxytocin 1 milliunit/minute Induction of labor in Maternal • Assess baselines for of drug to patient and family.
IV infusion patients with medical CNS: subarachnoid vital signs, B/P, fetal heart • Instruct patient to promptly
Brand: indication (e.g., at or near hemorrhage, seizures, coma rate report adverse reactions.
Pitocin Timing: term), to stimulate CV: arrhythmias, HTN, • Determine frequency, • Keep patient and family
at 30- to 60-minute reinforcement of labor, as PVCs, hypotension, duration, strength of informed of labor progress.
Classification: intervals until adjunct in managing Tachycardia contractions
Uterine stimulant normal contraction incomplete or GI: nausea, vomiting
pattern is inevitable abortion GU: abruptio placentae, Intervention/Evaluation:
established tetanic uterine contractions, • Monitor B/P, pulse,
Mechanism of Action: postpartum hemorrhage, respirations, fetal heart
Duration: Causes potent and uterine rupture, impaired rate, intrauterine pressure,
12 hours selective stimulation of uterine blood flow, increased contractions q15min
uterine and mammary uterine motility • Notify physician of
Other Forms: gland smooth muscle Hematologic: pelvic contractions that last
Injection hematoma, afibrinogenemia longer than 1 min
Other: anaphylaxis, death • Maintain careful I&O
from oxytocin-induced water • Be alert to potential
water intoxication
College of Nursing
Telephone No: (032) 231- 8631
intoxication, hypersensitivity • Check for blood loss

reactions
Fetal
CNS: infant brain damage,
seizures
CV: bradycardia,
arrhythmias, PVCs
EENT: neonatal retinal
hemorrhage
Hepatic: neonatal jaundice
Other: low Apgar scores at 5
minutes, death
Contraindications:
• Contraindicated when
vaginal delivery isn't advised
• Contraindicated when
cephalopelvic disproportion
is present, or when
delivery requires conversion,
as in transverse lie
• Contraindicated in fetal
distress when delivery isn't
imminent, in prematurity, in
other obstetric emergencies,
and in patients with severe
toxemia or hypertonic uterine
patterns
College of Nursing
Telephone No: (032) 231- 8631
DRUG STUDY
Patient : A.L.F. ______________ ______________ Age : 25_______ ___________ Hospital : 071________________

No
Impression : In labor __________ ________ Attending Physician : Dr. Kim________ _____ Room No : 012________________
Allergic to : N/A_______________________________
Generic: Ordered: Indication: Adverse Effects: Baseline assessment: • Tell patient she may experience
Misoprostol 50 mcg PO Cervical ripening, labor CNS: headache, anxiety, • Monitor vital signs, these side effects: abdominal pain,
induction, depression, drowsiness, compare with patient’s nausea, diarrhea, flatulence,
Brand: Timing: treatment/prevention of dizziness, impotence, normal or previous menstrual cramping, abnormal
Cytotec every 4 hours postpartum hemorrhage, neuropathy, confusion readings. menstrual periods, spotting and
treatment of incomplete or CV: hypertension, • Note patient’s individual headache.
Classification: Duration: missed abortion hypotension, chest pain, physiological response to • Caution patient to report severe
Prostaglandin 24 hours diaphoresis, arrythmia, bleeding such as changes diarrhea, spotting or abdominal
Mechanism of Action: syncope, myocardial in weakness, restlessness, pain, and severe bleeding.
Other Forms: Softens the cervix and infarction and pallor
Capsules stimulates uterine GI: diarrhea, nausea,
Tablets contractions vomiting, constipation, Intervention/Evaluation:
abdominal pain, flatulence, • Monitor intake and
dyspepsia, GI bleeding output (I&O), and
GU: polyuria, dysuria, correlate with weight
hematuria, urinary tract changes
infection • Maintain bed rest
• Increase oral fluid intake
to prevent occurrence UTI
College of Nursing
Telephone No: (032) 231- 8631
Hematologic: anemia, • Administer with food to

abnormal differential, prevent GI upset
thrombocytopenia • Advise against doing
Metabolic: glycosuria, gout, activities requiring mental
increased nitrogen, increased alertness
alkaline phosphatase
Musculoskeletal: arthralgia,
myalgia, muscle cramps,
stiffness, back pain
Respiratory: URTI,
bronchitis, bronchospasm,
pneumonia, dyspnea,
epistaxis
Skin: rash, dermatitis,
alopecia, pallor
Other: anaphylactic
reactions, hypersensitivity
reactions
Contraindications:
with confirmed or suspected
ectopic pregnancy
with uterine infections,
severe anemia, coagulopathy,
and hypertension
College of Nursing
Telephone No: (032) 231- 8631
OB Ward
DRUG STUDY
Patient : T.F.P.____________________ ________ Age : 32________ __________ Hospital : 071________________

No
Impression : Abortion _______ ____ Attending Physician : Dr. Kim________ _____ Room No : 012________________
Allergic to : N/A_______________________________
Generic: Ordered: Indication: Adverse Effects: Baseline assessment: •Tell patient menses begin within
Mifepristone 200 mg PO Termination of pregnancy CNS: headache, dizziness • Assess allergy to 5 days of treatment and will last 1-
through 49 days GI: vomiting, diarrhea, prostaglandin preparations 2 weeks.
Brand: Timing: gestational age nausea, abdominal pain and other •Instruct patient to report
Mifeprex once daily GU: heavy uterine bleeding, contraindications immediately sustained fever,
Mechanism of Action: endometritis, uterine or • Obtain initial B/P, heart severe abdominal pain, prolonged
Classification: Duration: Acts as an antagonist of vaginal pain rate, respirations heavy bleeding, dizziness on
Abortifacient 7 days progesterone sites in Other: potentially serious to • Perform pelvic arising, persistent malaise,
the endometrium, fatal infection, loss of examination and assess uncontrolled blood sugar.
Other Forms: allowing prostaglandins to pregnancy uterine tone
Tablets stimulate uterine
contractions, causing Contraindications: Intervention/evaluation:
implanted trophoblast to • Contraindicated with • Prepare for dilation and
separate from the allergy to prostaglandin curettage if heavy
placental wall preparations bleeding does not resolve
with acute PID; active
College of Nursing
Telephone No: (032) 231- 8631
cardiac, hepatic, pulmonary, • Provide analgesic and

renal disease; undiagnosed antiemetic as needed to
adrenal mass; hemorrhagic increase comfort
disorder, anticoagulation, and • Ensure patient follow-
ectopic pregnancy up; serious to fatal
• Contraindicated in patients infections have been
with an IUD in place reported
• Use cautiously with history • Monitor serum glucose
of asthma; anemia, jaundice, and potassium levels
diabetes, epilepsy, scarred carefully
uterus, cervicitis, infected • Alert patient that menses
endocervical lesions, acute usually begins within 5
vaginitis days of treatment and
lasts for 1–2 weeks
• Provide appropriate
referrals and counseling
for abortion
College of Nursing
Telephone No: (032) 231- 8631
DRUG STUDY
Patient : J.J.R.____________________ ______ __ Age : 39_______ ___________ Hospital : 071________________

No
Impression : Postpartum hemorrhage ______________ Attending Physician : Dr. Kim________ _____ Room No : 012________________
Allergic to : N/A______________________________
Generic: Ordered: Indication: Adverse Effects: Baseline assessment: • Caution patient to avoid
Methylergonovine 0.2 mg PO Management of uterine CNS: dizziness, headache, • Determine baseline smoking: causes increased
atony, hemorrhage and tinnitus, diaphoresis serum calcium level, B/P, vasoconstriction.
Brand: Timing: subinvolution of uterus CV: hypertension, pulse • Tell patient to report increased
Methergine three times a day following delivery of palpitations, chest pain, • Assess for any evidence cramping, bleeding, foul-smelling
placenta dyspnea of bleeding before lochia.
Classification: Duration: GI: nausea, vomiting administration • Tell patient to report pale, cold
Oxytocic 48 hours Mechanism of Action: hands/feet (possibility of
Increases tone, rate, Contraindications: Intervention/evaluation: diminished circulation).
Other Forms: amplitude of contraction • Contraindicated in patients • Monitor uterine tone,
Injection of uterine smooth muscle hypersensitive to drug bleeding, B/P, pulse
Tablets • Contraindicated in patients q15min until stable
with hypertension and • Assess extremities for
toxemia color, warmth, movement,
• Use cautiously with sepsis, pain
obliterative vascular disease, • Report chest pain
hepatic or renal impairment promptly
College of Nursing
Telephone No: (032) 231- 8631
• Provide support with

ambulation if dizziness
occurs
College of Nursing
Telephone No: (032) 231- 8631
DRUG STUDY
Patient : S.E.R.____________________________ Age : 27__________________ Hospital : 071________________

No
Impression : Postpartum hemorrhage _______ Attending Physician : Dr. Kim________ _____ Room No : 012________________
Allergic to : N/A______________________________
Generic: Ordered: Indication: Adverse Effects: Baseline assessment: • Tell patient she may experience
Carboprost 250 mcg by deep Prevention and treatment CNS: headache, paresthesia, •Assess baseline these side effects: nausea,
IM injection of postpartum hemorrhage flushing, anxiety, weakness, renal/hepatic function vomiting, diarrhea, uterine or
Brand: due to uterine atony syncope, dizziness tests, B/P, apical pulse vaginal pain, fever, headache,
Hemabate Timing: unresponsive to CV: hypotension, weakness, dizziness
repeat doses every conventional methods arrhythmia, chest pain Intervention/evaluation: • Instruct patient to report severe
Classification: 15-90 minutes as GI: vomiting, diarrhea, • Arrange for pretreatment pain, difficulty breathing,
Prostaglandin needed Mechanism of Action: nausea or concurrent treatment palpitations, eye pain, rash
Stimulates the GU: endometritis, perforated with antiemetics and
Duration: myometrium of the gravid uterus, uterine rupture, antidiarrheals to decrease
48 hours uterus to contract in a uterine or vaginal pain, the incidence of GI side
manner that is similar to incomplete abortion effects
Other Forms: the contractions of the Respiratory: coughing, • Monitor T, using care to
Injection uterus during labor, thus dyspnea differentiate
evacuating the contents of Other: chills, diaphoresis, prostaglandin-induced
the gravid uterus backache, breast tenderness, pyrexia from postabortion
eye pain, skin rash, pyrexia endometritis pyrexia
• Monitor uterine tone and
vaginal discharge during
College of Nursing
Telephone No: (032) 231- 8631
Contraindications: procedure and several

• Contraindicated in patients days after to assess drug
hypersensitive to drug effects and recovery
• Contraindicated in patients • Ensure adequate
with acute PID, active hydration throughout
cardiac, hepatic, pulmonary, procedure
and renal disease
with history of asthma,
hypotension, hypertension,
adrenal, renal, or hepatic
disease
with scarred uterus,
cervicitis, infected
endocervical lesions or acute
vaginitis
College of Nursing
Telephone No: (032) 231- 8631
Fertility Clinics
DRUG STUDY
Patient : S.E.R.___________________ _________ Age : 29__________________ Hospital : 071________________

No
Impression : Infertility __ ______________ Attending Physician : Dr. Kim________ _____ Room No : 012________________
Allergic to : N/A______________________________
Generic: Ordered: Indication: Adverse Effects: Baseline assessment: • Prepare a calendar showing the
Clomiphene 50 mg PO Treatment of ovulatory CNS: visual symptoms • Assess baseline treatment schedule, plotting
failure in patients with (blurring, spots, flashes), renal/hepatic function ovulation.
Brand: Timing: normal liver function and nervousness, insomnia, tests, B/P, apical pulse • There is an increased incidence
Clomid once daily normal endogenous dizziness, light-headedness, of multiple births in women using
estrogen levels, whose photophobia, diplopia Intervention/evaluation: this drug.
Classification: Duration: partners are fertile and CV: vasomotor flushing • Assess B/P (if systolic • You may experience these side
Fertility drug 5 days potent GI: abdominal discomfort, B/P is less than 90 mm effects: Abdominal distention;
distention, bloating, nausea, Hg, withhold medication, flushing; breast tenderness;
Other Forms: Mechanism of Action: vomiting contact physician) dizziness, drowsiness, light-
Tablets Binds to estrogen GU: uterine bleeding, • Assess for peripheral headedness, visual disturbances
receptors, decreasing the ovarian enlargement, ovarian edema behind medial (use caution driving or performing
number of available overstimulation, birth malleolus (sacral area in tasks that require alertness).
estrogen receptors, which defects in resulting bedridden patients) • Report bloating, stomach pain,
gives the hypothalamus pregnancies • Assess skin for flushing blurred vision, yellow skin or
and pituitary the false Other: breast tenderness • Question for headache, eyes, unusual bleeding or bruising,
signal to increase FSH and asthenia fever, chills, visual changes.
College of Nursing
Telephone No: (032) 231- 8631
LH secretion, resulting in Contraindications: • Monitor BP, PR before

ovarian stimulation • Contraindicated in patients during and after
with known sensitivity to administration.
clomiphene • Watch out for
• Contraindicated in patients bradycardia
with liver disease, uterine • Administer these
fibroids, ovarian cyst, medications with meals
uncontrolled thyroid or • Monitor renal status:
adrenal dysfunction, and urine output
organic intracranial lesions
• Use cautiously in lactating
patients.
College of Nursing
Telephone No: (032) 231- 8631
Health Center
DRUG STUDY
Patient : S.E.R.____________________________ Age : 31__________________ Hospital : 071________________

No
Impression : Ovulation regulation _ ____ _ Attending Physician : Dr. Kim________ _____ Room No : 012________________
Allergic to : N/A______________________________
Generic: Ordered: Indication: Adverse Effects: Baseline assessment: • Instruct patient to take drug in
Norethindrone acetate 5 mg PO Prevention of pregnancy CNS: sudden, partial, or • Assess allergy to accordance with a marked
complete loss of vision, prostaglandin preparations calendar.
Brand: Timing: proptosis, diplopia, migraine, and other • Caution patient to avoid
Ortho Micronor once daily Mechanism of Action: precipitation of acute contraindications pregnancy, serious fetal
Inhibits the secretion of intermittent porphyria, • Arrange for pretreatment abnormalities or fetal death could
Classification: Duration: pituitary gonadotropins, mental depression, pyrexia, and periodic (at least occur.
Contraceptive 2 weeks which prevents follicular insomnia, somnolence annual) history and • Tell patient to report pain or
maturation and ovulation; CV: thrombophlebitis, physical, including BP, swelling and warmth in the calves,
Other Forms: and inhibits spontaneous cerebrovascular disorders, breasts, abdomen, pelvic acute chest pain or shortness of
Tablets uterine contraction retinal thrombosis, organs, and a Pap test breath, sudden severe headache or
pulmonary embolism, vomiting, dizziness or fainting,
thromboembolic and numbness or tingling in the arm or
thrombotic disease, increased Intervention/evaluation: leg.
BP • Warn patient prior to
GI: cholestatic jaundice, therapy to prevent
nausea pregnancy and to obtain
College of Nursing
Telephone No: (032) 231- 8631
GU: Breakthrough bleeding, frequent medical follow-

spotting, change in menstrual up care
flow, amenorrhea, changes in • Use caution when
cervical erosion and cervical administering drug to
secretions, breast tenderness ensure preparation
and secretion ordered is the one being
Other: decreased glucose used
tolerance, fluid retention, • Monitor B/P, weight,
edema, increase in weight serum calcium, glucose,
LFT
Contraindications: • Monitor for loss of
• Contraindicated in patients vision, sudden onset of
with allergy to progestins proptosis, diplopia,
• Contraindicated in patients migraine, and
with thrombophlebitis, thromboembolic disorders
thromboembolic disorders, • Discontinue medication
cerebral hemorrhage or and consult physician if
history of these conditions sudden, partial, or
• Contraindicated in patients complete loss of vision
with hepatic disease, occurs; if papilledema or
carcinoma of the breast or retinal vascular lesions are
genital organs; undiagnosed present, discontinue drug
vaginal bleeding; missed
abortion; pregnancy;
lactation
•Use cautiously in patients
with epilepsy, migraine,
asthma, cardiac dysfunction,
or renal impairment
College of Nursing
Telephone No: (032) 231- 8631
NCM 106 – Pharmacology
Course Outputs /Assessment of Learning for CILO # 1

Written Outputs (Mental Models, Group Activity and Reflection Journal)
Name of Student : Trisha Faye Y. Pasay________ Yr.& Sec. : BSN 2 - A______

Module/Topic : Module 8 - Elaborate________ Date : 12/05/2021____ _
1. Create a Drug Study on Reproductive Drugs that are commonly used in clinical settings.
Utilize the drug study template.
a. Delivery Room (3 Medications)
b. OB Ward (3 Medications)
c. Fertility Clinics (1 Medication)
d. Health Center (1 Medication)
2. Briefly organize and bring together main ideas. Explain in your own words. (50 – 150 words
for each question)
I. TA (gravida 3, para 1) is ready to leave the hospital after delivery of a healthy baby. TA
had developed gestational hypertension during her pregnancy, but she had no prior history
of hypertension. TA plans to breastfeed for 3 months; she desires contraception and asks
about hormonal contraceptive methods.
A. As a nurse, it is important to refer the patient to her attending physician for such
concerns. However, giving an idea to the patient about family planning is also
helpful to her. Lactation-Amenorrhea Method is a form of natural contraception.
It is known that exclusively breastfeeding the infant for 6 months stops the release
of hormones that triggers ovulation. The suppression of ovulation occurs because
of the release of prolactin during suckling that in turn decreases gonadotropin-
releasing hormone (GnRH) from the hypothalamus decreasing luteinizing
hormone (LH) release so that follicular development is suppressed. There are also
available contraceptive methods that TA can use such as the progestin only pill
(Minipill) that she can take while breastfeeding.
Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 1

College of Nursing
Telephone No: (032) 231- 8631
B. Combined hormonal contraceptives contain both estrogen and progestin that work
mainly by preventing ovulation. The American Academy of Pediatrics has
approved the use of low-dose CHCs in breastfeeding women once milk production
is well established. CHCs do not affect the composition of milk substantially in
healthy, well-nourished mothers and do not adversely affect long-term infant
growth and development. Postpartum women who are breastfeeding should not
use combined hormonal contraceptives during the first 3 weeks after delivery
because of concerns about increased risk for venous thromboembolism.
Postpartum breastfeeding women with other risk factors generally should not use
combined hormonal contraceptives 4 to 6 weeks after delivery. TA should know
that using CHC also warrants further assessment because it can cause
cardiovascular diseases. It is also not recommended in patients with diabetes,
seizure disorders and active liver disease.
C. Progestin-only Pill (Minipill) stops ovulation and does not reduce the quantity of
breast milk. This can be recommended to women who cannot tolerate the side
effects of combined oral contraception. However, this requires dependable supply
and strict daily pill taking and is not recommended in women with a history of
vaginal bleeding. Injectable Contraception like DMPA and NET-EN thickens
cervical mucus, stops ovulation. This does not reduce the quantity of breast milk,
and this can also prevent anemia. This type of contraception requires
administration by a trained person and often causes irregular bleeding, weight gain
and headache.
D. Oral contraceptives mimic ovarian hormones. Once ingested, they inhibit the
release of gonadotropin-releasing hormone (GnRH) by the hypothalamus, thus
inhibiting the release of the pituitary hormones that stimulate ovulation.
Advantages of oral contraceptives include prevention of ectopic pregnancies, it can
be used as long as a woman wants and can be stopped at any time, fertility returns
soon after stopping and it can also prevent iron deficiency anemia. Disadvantages
include increased risk of external genital warts and chlamydia, it affects the quality
and quantity of milk in breastfeeding mothers, causes mood changes such as
depression and loss of libido, return of fertility may be delayed and it does not
protect against STDs. Taking the pills same time everyday ensures efficacy of
contraception.
II. MT, age 16 years, is a high school junior who is 59.3 inches tall and weighs 126 pounds.
He is having increased feelings of discomfort about not fitting in with the other students at
school because he has not yet begun sexual maturation. He is a good student and an
accomplished violinist in the school orchestra. His father states that he also was a “late
bloomer,” but both parents are concerned about MT’s increasing social withdrawal and
seem determined to seek medical intervention for him. The nurse at the clinic assesses the
needs and status of MT and his parents.

College of Nursing
Telephone No: (032) 231- 8631
A. MT is a 16-year-old male who is feeling discomfort about not fitting in with the
other students at school due to his condition which is his primary complaint,
delayed state of puberty and lack of sexual maturation. Delayed puberty is defined
as absence of the start of sexual maturation at the expected time. Adolescents who
have delayed puberty may be noticeably shorter than their peers, can be teased or
bullied, and often need help coping with and managing social concerns. Although
adolescents are typically uncomfortable about being different from their peers,
boys in particular are more likely to feel psychologic stress and embarrassment
resulting from delayed puberty.
B. MT is a good student and an accomplished violinist in the school orchestra. His

father states that he also was a “late bloomer,” but both parents are concerned about
MT’s increasing social withdrawal because of the status and situation of MT. MT’s
parents are determined to seek medical intervention for him. Children with delayed
puberty often need additional support from parents, family members, and friends
to ensure they have a healthy body image and self-esteem.
C. For delayed puberty, a history suggestive of underlying chronic disease, nutrition

and exercise patterns, poor psychosocial functioning, cryptorchidism, anosmia is
needed to assess. Growth patterns, such as constitutional delay, may be familial.
Thus, family history should include pubertal timing, especially the mother's age of
menarche and father's age of reaching adult height. History of any allergy to
testosterone or androgen for patient to avoid hypersensitivity, hepatic dysfunction,
cardiovascular disease, and prostate cancer. Also, patient’s weight, height, skin
color, lesions, texture, and hair distribution, affect, orientation, peripheral
sensation, testicular examination, abdominal examination, serum electrolytes,
serum cholesterol, liver function tests should be done in the physical examination.
D. Androgens control the development and maintenance of sexual processes,

accessory sexual organs, cellular metabolism, and bone and muscle growth.
Testosterone is the principal male sex hormone and is an anabolic steroid. The
most common clinical use is for androgen deficiency in males, specifically
hypogonadism, replacement therapy for testicular failure in adult males, and
delayed puberty in adolescents. The nurse should provide patient and family
education with all the information and guidelines regarding the medication
prescribed such as proper amount of medication to give, proper administration,
indications and contraindications, food and drugs not to take with medication, what
medication does to the patient, how drug affects the patient, side effects with
respective interventions, and what to do if severe adverse effects occur.

College of Nursing
Telephone No: (032) 231- 8631
E. An adolescent who is naturally late in developing needs no treatment, but if the

adolescent is severely stressed by delayed or absent development, some doctors
may give supplemental sex hormones to begin the process sooner. Treatment is not
initiated before 14 years of age and after a full evaluation. Since MT did not show
sign of puberty at his age, he will be given a 4-month course of androgen therapy
and testosterone injections once a month. Therapy for 4 to 6 months or less before
epiphyseal closure may result in linear growth without adverse permanent effects
on hypothalamic, pituitary, or gonadal maturation.
F. Androgen therapy may cause hypercalcemia by stimulating bone resorption in

patients with breast cancer or immobilized patients. The drug should be
discontinued, and appropriate measures instituted if signs of hypercalcemia occur
including nausea and vomiting, lethargy, decreased muscle tone, polyuria, and
increased urine and serum calcium. MT and his parents need to be informed that
MT may experience the aforementioned adverse effects and needs to keep in mind
that he may also experience profound virilization as well as impaired bone growth.
Rare complications of long-term therapy include hepatic necrosis, hepatic peliosis
(blood-filled cysts), hepatic tumors, and leukopenia.
G. At MT’s monthly visit, the following parameters should be assessed:

• Ability to adhere to treatment plan and discuss treatment and effects
knowledgeably suggests that teaching has been effective, and that patient
accepts treatment
• Ask patient about therapeutic and adverse drug effects on follow-up visits
• Monitoring of weight, blood pressure, and laboratory tests will continue
throughout therapy, with alterations in the plan of care as needed
• Periodically assess if he experiences virilizing effects or acne for ability to
cope with these changes and maintain a positive self-concept
• Assess sexual function when appropriate
H. As a nurse, it is important to coach patient about good skin hygiene to decrease

severity of acne. The rise in androgen levels can trigger a process of higher sebum
production, changes in skin cell activity, inflammation, and this can lead to acne.
An underarm solution (Axiron) is applied to one or both axillary areas at the same
time each day. The patient should not apply Axiron to the genitals. These skin
application products can be transferred to others through personal contact with skin
or clothing. The treatment eliminates the need for injections and provides circadian
fluctuations in dosage.

College of Nursing
Telephone No: (032) 231- 8631
I. To know whether the patient has any signs of puberty, the patient will have a
physical exam and might have blood tests to check hormone levels. The patient’s
growth will also be checked by measuring height and weight and doing an X-ray
of the hand to see if his or her bones are developing more slowly than usual. In
addition to a complete health history and physical exam, diagnosis of delayed
puberty may include x-ray. This test uses a small amount of radiation to make
images of tissues inside the body. An X-ray may be done of the left hand and wrist.
This can estimate the patient's bone age. When a prepubertal child is treated, obtain
hand and wrist x-rays before, every 6 months during, and after treatment to monitor
growth.
J. Anabolic steroids are a class of steroid hormones related to the hormone

testosterone. They increase protein synthesis within cells, which results in the
buildup of cellular tissue (anabolism), especially in muscles. The American
College of Sports Medicine notes that gain in muscular strength achieved through
high intensity exercise and proper diet can be additionally enhanced by the
anabolic steroid use in some individuals. However, health risks can result from
long-term use or excessive intake of anabolic steroids; these effects include
increased low-density lipoprotein (bad) cholesterol and decreased high-density
lipoprotein (good) cholesterol, acne, high blood pressure, liver damage, and
dangerous changes in the structure of the left ventricle of the heart. All major
athletic organizations prohibit the use of anabolic steroids.

College of Nursing
Telephone No: (032) 231- 8631
References:
• Calabria, A. (2021, November 17). Delayed Puberty. MSD Manual Consumer Version. Retrieved
December 5, 2021, from https://www.msdmanuals.com/home/children-s-health-issues/hormonal-
disorders-in-children/delayed-puberty
• Comerford, K. C., & Durkin, M. T. (2021). Nursing 2021 drug handbook. 41st edition.
Philadelphia: Wolters Kluwer.
• Department of Health. The Philippine Clinical Standards Manual on Family Planning (2014 Edition).
Manila, Philippines: DOH. 2014. pp. 29-177.
• Doenges, Marilynn E., Moorhouse, Mary Frances, Murr, Alice C. (2014). Nursing care plans:
guidelines for individualizing client care across the life span (9th). Philadelphia: F.A. Davis
Company.
• Karch, A. M. (2017). Focus on nursing pharmacology. Philadelphia: Lippincott Williams & Wilkins.
• Karch, A. M. (2014). 2014 Lippincott's nursing drug guide. Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins.
• Kee, J. LeFever, Hayes, E. R., & McCuistion, L. E. (2015). Pharmacology: A Patient-Centered Nursing
Process Approach. 8th edition. St. Louis, Missouri: Elsevier/Saunders.
• NHS website. (2021, November 18). Combined pill. Nhs.Uk. Retrieved December 5, 2021,
from https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/
• Vogt, S. E. K. D. A. E. S. (2017, November 1). Disorders of Puberty: An Approach to Diagnosis and
Management. American Family Physician. Retrieved December 5, 2021, from
https://www.aafp.org/afp/2017/1101/p590.html

College of Nursing
Telephone No: (032) 231- 8631
Prepared by:
Trisha Faye Y. Pasay

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Submitted to:
Lemuel C. Candelasa, EdD(c) ,MAN,RN

ProfeAmeliaor – Pharmacology

2A - Pasay - Module 8 - Elaborate

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UNIVERSITY OF CEBU - BANILAD

Gov. M. Cuenco Ave, Cebu City, 6000 Philippines

Patient : T.L.R.____________ _________ _______ Age : 33______________ _ __ Hospital : 071________________

GU: decreased libido, application with

Patient : R.A.C._________________ ___________ Age : 36__________________ Hospital : 071________________

intoxication, hypersensitivity • Check for blood loss

Patient : A.L.F. ______________ ______________ Age : 25_______ ___________ Hospital : 071________________

Hematologic: anemia, • Administer with food to

Patient : T.F.P.____________________ ________ Age : 32________ __________ Hospital : 071________________

cardiac, hepatic, pulmonary, • Provide analgesic and

Patient : J.J.R.____________________ ______ __ Age : 39_______ ___________ Hospital : 071________________

• Provide support with

Patient : S.E.R.____________________________ Age : 27__________________ Hospital : 071________________

Contraindications: procedure and several

Patient : S.E.R.___________________ _________ Age : 29__________________ Hospital : 071________________

LH secretion, resulting in Contraindications: • Monitor BP, PR before

Patient : S.E.R.____________________________ Age : 31__________________ Hospital : 071________________

GU: Breakthrough bleeding, frequent medical follow-

NCM 106 – Pharmacology

Course Outputs /Assessment of Learning for CILO # 1

Name of Student : Trisha Faye Y. Pasay________ Yr.& Sec. : BSN 2 - A______

a. Delivery Room (3 Medications)

c. Fertility Clinics (1 Medication)

d. Health Center (1 Medication)

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 1

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 2

B. MT is a good student and an accomplished violinist in the school orchestra. His

C. For delayed puberty, a history suggestive of underlying chronic disease, nutrition

D. Androgens control the development and maintenance of sexual processes,

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 3

E. An adolescent who is naturally late in developing needs no treatment, but if the

F. Androgen therapy may cause hypercalcemia by stimulating bone resorption in

G. At MT’s monthly visit, the following parameters should be assessed:

H. As a nurse, it is important to coach patient about good skin hygiene to decrease

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 4

J. Anabolic steroids are a class of steroid hormones related to the hormone

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 5

December 5, 2021, from https://www.msdmanuals.com/home/children-s-health-issues/hormonal-

Philadelphia: Wolters Kluwer.

Manila, Philippines: DOH. 2014. pp. 29-177.

Health/Lippincott Williams & Wilkins.

Process Approach. 8th edition. St. Louis, Missouri: Elsevier/Saunders.

• Vogt, S. E. K. D. A. E. S. (2017, November 1). Disorders of Puberty: An Approach to Diagnosis and

Management. American Family Physician. Retrieved December 5, 2021, from

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 6

Trisha Faye Y. Pasay

Lemuel C. Candelasa, EdD(c) ,MAN,RN

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 7

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Patient : T.L.R.________ _ _ Age : 33____________ _ Hospital : 071______________

Patient : R.A.C.___________ _ Age : 36 Hospital : 071__

Patient : A.L.F. ____ Age : 25_ _ Hospital : 071________

Patient : T.F.P.__ Age : 32 Hospital : 071

Patient : J.J.R.______________ Age : 39_ _ Hospital : 071__________

Patient : S.E.R.__________ Age : 27 Hospital : 071

Patient : S.E.R._______________ _ Age : 29 Hospital : 071__

Patient : S.E.R.__________ Age : 31 Hospital : 071

Name of Student : Trisha Faye Y. Pasay__ Yr.& Sec. : BSN 2 - A