#18 Deborah Nelson

Name of drug: Ampicillin injection D5W

Classification: Antibiotic
Action of the drug at the cellular level: anti bactericidal
Side effects: rash, hives, fever
Adverse effects: angioedema, peritus, Stevens-Johnson syndrome
Nursing implications: check for allergic reactions, assess vitals, examine for drug interaction
Patient and family education: avoiding drinking alcohol when taking ampicillin.
Is it safe to give? Yes
Name of drug: Lactated Ringer’s
Route: IV
Action of the drug at the cellular level: Isotonic solution, fluid and electrolyte replenishment,
restores fluid and electrolyte balances.
Side effects: difficulties with breathing
Adverse effects: edema and fluid overload
Nursing implications: check for edema and fluid overload, examine site of IV for irritation,
check vital signs
Patient and family education: This solution replaces any fluid and blood loss. Patient stays
hydrated as well.
Is it safe to give? Yes
Name of drug: Butorphanol
Classification: Opioid agonists-antagonists
Action of the drug at the cellular level: Binds to opiate receptors in the CNS. Alters the percep-
tion of and response to painful stimuli while producing
generalized CNS depression.
Side effects: CNS: confusion, dysphoria, hallucinations, sedation,
euphoria, floating feeling, headache, unusual dreams.
Adverse effects: n/v, constipation, headache, blurred vision, dizziness and drop in urine output
Nursing implications: assess respiration before, during and after using of this medication, check
for adverse effects
Patient and family education: avoiding driving and operating heavy machine.
Is it safe to give? Yes
Baby Nelson
Name of drug: Erythromycin
Classification: Antibiotic
Action of the drug at the cellular level: Suppresses protein synthesis at the level of the 50S
bacterial ribosome.
Side effects: CNS: seizures (rare). EENT: ototoxicity. CV: TOR- SADE DE POINTES,
VENTRICULAR ARRHYTHMIAS, QT inter- val prolongation. GI: PSEUDOMEMBRANOUS
COLITIS, nausea, vomiting, abdominal pain, cramping, diar- rhea, hepatitis, infantile
hypertrophic pyloric stenosis, pancreatitis (rare). GU: interstitial nephritis. Derm: rash. Local:
phlebitis at IV site. Misc: allergic reac- tions, superinfection. Adverse effects: it might cause
conjunctivitis
Nursing implications: it is given within the first hr after birth. Wear gloves, sterile cotton ball
should be used to wipe each eye lid before we give the ointment, after application check eyes for
irritation
Patient and family education: could be inflammable in the topical form so don’t use near heat
Is it safe to give? Yes
Name of drug: Phytonadione (Vit K)
Classification: Vitamin
Action of the drug at the cellular level: Required for hepatic synthesis of blood coagulation
factors II (prothrombin), VII, IX, and X. Side effects: edema and erythema
Adverse effects: hemolytic anemia, hyperbilirubinemia
Nursing implications: monitor for bleeding. Monitor for side effects and adverse reactions.
Children may be especially sensitive to the effects
and side effects of vitamin K. Neonates, especially
premature neonates, may be more sensitive than
older children.
Patient and family education: Do not involve in activities could lead to injury. Report any
symptoms of unusual bleeding or bruising.
Is it safe to give? Yes
#7 Carole Shotz
Name of drug: Lactated Ringer’s
Classification: Isotonic solution
Action of the drug at the cellular level: The same pressure stays inside and outside of the cell
Side effects: edema and fluid overload
Adverse effects: irritation may appear on the injection side, difficulties with breathing
Nursing implication: monitor fluid and electrolyte balance, check site for signs of irritation
Is it safe to give? Yes
Name of drug: Sodium Citrate and Citric Acid (prevent kidney stones, or metabolize
acidosis)
Classification: Alkalinizing agent, electrolytes
Action of the drug at the cellular level: Converted to bicarbonate in the body, resulting in in-
creased blood pH.
Nurse implications: Assess patient for signs of alkalosis (confusion, irri-
tability, paresthesia, tetany, altered breathing pat-
tern). Monitor fluid overload
Adverse effects: fluid overload, hypernatremia (severe renal impairment), hypocalcemia,
metabolic alkalosis (large doses only). MS: tetany.
Patient and family education: Instruct patients receiving chronic sodium citrate on
correct method of monitoring urine pH, mainte-
nance of alkaline urine,
Is it safe to give? Yes
#9 Kaira Abbot
Name of drug: Ampicillin in D5W
Classification: Antibiotic- aminopenicillin
Action of the drug at the cellular level: it penetrates gram negative bacteria
Side effects: n/v, diarrhea, increased WBC
Adverse effects: allergies, rash, pruritis, angioedema
Nursing implications: check vitals and interactions with other drugs, monitor BUN and
creatinine
Patient and family education: Safe for pregnant woman , category B
Is it safe to give? Yes.
Name of drug: Lactated Ringer’s
Classification: Isotonic solution
Action of the drug at the cellular level: outside and inside same pressure of the cell
Side effects: edema and fluid overload
Adverse effects: site of injection may be irritated, allergic reactions may occur, difficulties with
breathing
Nursing implications: check electrolytes and fluids , check injection site for irritation and check
for edema
Is it safe to give? Yes
Name of drug: Oxytocin in Lactated Ringer’s
Classification: Hormones, uterine stimulant
Action of the drug at the cellular level: Stimulates uterine smooth muscle, producing uterine
contractions similar to those in spontaneous labor.
Side effects: hypertensive uterine reaction to oxytocin, cervical laceration, postpartum
hemorrhage, uterine rupture
Adverse effects: hypotension and fetal arrhythmias
Nursing implications: check IV, monitor fetal heart rate, check vitals
Patient and family education: Advise patient to expect contractions similar to men-
strual cramps after administration has started
Is it safe to give? Yes
Name of drug: Nalbuphine
Classification: Opioid agonist-antagonist
Action of the drug at the cellular level: Binds to opiate receptors in the CNS. Alters the percep-
tion of and response to painful stimuli while producing
generalized CNS depression.
Side effects: Sedation, drowsiness, n/v, dizziness, respiratory depression
Adverse effects: hypotension, diaphoresis, opioid withdrawal, xerostomia
Nursing implications: check vital signs, pain level, check fetal heart rate
Patient and family education: Advise patient
to call for assistance when ambulating and to avoid
driving or other activities requiring alertness until
response to the medication is known.
Is it safe to give? Yes