HOLY NAME UNIVERSITY

COLLEGE OF HEALTH SCIENCES

NURSING DEPARTMENT
City of Tagbilaran

DRUG STUDY
Name of Patient: LEE CHON Address: Impression: DIABETES MELLITUS, TYPE 2 Date of Visit / Admission: APRIL 26, 2022

Ward: Room: MEDICAL Status: MARRIED Age: 48Y Sex: M

CLASSIFICATION: NURSING
Date Brand Generic DOSA Route & CONTRA
MECHANISM OF INDICATIONS RESPONSIBILITIE EVALUATION
Ordered Name Name GE Frequency INDICATIONS
ACTION S
4/26/2022 Humulin R insulin 10 SQ, NOW Acts via specific Treatment of type Hypersensitivity BASELINE GOAL MET
receptor to regulate 1 diabetes (insulin to insulin, use ASSESSMENT Client did not
metabolism of de- pendent) and during episodes Obtain serum glucose have signs of
carbohydrates, protein, type 2 diabetes of level, Hgb A1c. Dis- hyperglycemia:
and fats. Acts on liver, (non–insulin hypoglycemia. cuss lifestyle to cool, wet skin,
skeletal muscle, and dependent) to determine extent of tremors,
adipose tissue. improve glycemic learning, emotional dizziness,
control. needs. If given IV, headache,
obtain serum anxiety,
chemistries (esp. tachycardia,
serum potassium). numbness in
INTERVENTION/ mouth, hunger,
EVALUATION diplopia. Client
Assess for understood that
hypoglycemia (refer to diet and
pharmacokinetics exercise are
table for peak times essential part
and duration): cool, of the
wet skin, tremors, treatment.
Prepared by: dcasquejo@hnu.edu.ph
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dizziness, headache,
anxiety, tachycardia,
numbness in mouth,
hunger, diplopia.
Assess sleeping pt for
restlessness,
diaphoresis. Check for
hyperglycemia:
polyuria, polyphagia
nausea/vomiting, dim
vision, fatigue, deep
and rapid breathing.
Be alert to conditions
altering glucose
requirements: fever,
trauma, increased
activity/stress, surgical
procedure.
PATIENT/FAMILY
TEACHING
• Instruct on proper
technique for drug
administration, testing
of glucose, signs/
symptoms of
hypoglycemia and
hyperglycemia. • Diet
and exercise are
essential parts of
treatment; do not
skip/delay meals.
• Carry candy, sugar
packets, other sugar
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supplements for
immediate response to
hypoglycemia.
• Wear or carry
medical alert
identification.
• Check with
physician when insulin
demands are altered.
• Do not take other
medication without
consulting physician.
• Weight control,
exercise, hygiene
(including foot care),
not smoking are
integral parts of
therapy.
• Protect skin, limit
sun exposure.
•Inform dentist,
physician, surgeon of
medication before any
treatment is given.
4/26/22 Glucophage metformin 500mg NGT, TID Decreases hepatic Management of hypersensitivity BASELINE GOAL MET
production of glucose. type 2 diabetes to metFORMIN. ASSESSMENT Client’s fasting
Decreases intestinal mellitus as Renal disease/ Verify pt has not serum glucose,
absorption of glucose, monotherapy or dysfunction; received IV contrast Hgb A1c, renal
improves insulin concomitantly abnormal CrCl dye within last 48 hrs. function, CBC
sensitivity. with oral from any cause Obtain CBC, renal are within
sulfonylurea or including MI, function test, fasting normal
insulin. septicemia, or serum glucose, Hgb
parameters.
shock; acute or A1c.
Client did not
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chronic INTERVENTION/ complain nor
metabolic EVALUATION show signs of
acidosis (with or Monitor fasting serum hyperglycemia:
with- out coma). glucose, Hgb A1c, cool/wet skin,
renal function, CBC. tremors,
Monitor folic acid, dizziness,
renal function tests for
anxiety,
evidence of early
headache,
lactic acidosis. If pt is
on concurrent oral tachycardia,
sulfonylureas, assess numbness in
for hypoglycemia mouth, hunger,
(cool/wet skin, and diplopia.
tremors, dizziness,
anxiety, headache,
tachycardia, numbness
in mouth, hunger,
diplopia). Be alert to
conditions that alter
glucose requirements:
fever, increased
activity, stress,
surgical procedure.
PATIENT/FAMILY
TEACHING
• Discontinue
metformin, report im-
mediately if evidence
of lactic acidosis
appears (unexplained
hyperventilation,
muscle aches, extreme
fatigue, unusual
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drowsiness).
• Prescribed diet is
principal part of
treatment; do not skip,
delay meals.
• Diabetes requires
lifelong control.
• Avoid alcohol.
• Report persistent
headache, nausea,
vomiting, diarrhea or
if skin rash, unusual
bruising/ bleeding,
change in color of
urine or stool occurs.
• Do not take dose for
at least 48 hrs after
receiving IV contrast
dye with radiologic
testing.
4/26/22 Losec omeprazole 40mg IVTT, OD Inhibits hydrogen- Short-term Hypersensitivity INTERVENTION/ GOAL MET
potassium adenosine treatment (4–8 to omeprazole, EVALUATION Client did not
triphosphatase (H+/K+ wks) of erosive other proton Evaluate for show nor
ATP pump), an enzyme esophagitis pump inhibitors. therapeutic response complain about
on the surface of (diagnosed by Concomitant use (relief of GI signs of
gastric parietal cells. endos- copy), with products symptoms). Question gastrointestinal
symptomatic containing if GI discomfort, discomfort,
gastroesophageal rilpivirine. nausea, diarrhea
nausea and
reflux disease occurs.
diarrhea. Client
(GERD) poorly PATIENT/FAMILY
responsive to TEACHING did not report
other treatment. • Report headache, occurrence of
H. pylori– onset of black, tarry headache and
abdominal
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associated stools, diarrhea, pain.
duodenal ulcer abdominal pain.
(with amoxicillin • Avoid alcohol.
and • Swallow capsules
clarithromycin). whole; do not chew,
Long-term crush, dissolve, or
treatment of divide.
pathologic • Take before eating.
hypersecretory
conditions,
treatment of
active duodenal
ulcer or active
benign gastric
ulcer.
Maintenance
healing of erosive
esophagitis.
4/26/22 Novasen aspirin 80mg NGT Inhibits cyclo- Treatment of mild Hypersensitivity BASELINE GOAL MET
oxygenase enzyme via to moderate pain, to salicylates, ASSESSMENT Client
acetylation. Inhibits fever. Reduces NSAIDs. Do not use if vinegar- verbalized
formation of inflammation like odor is noted therapeutic
related to (indicates chemical response on
rheumatoid breakdown). Assess relief of pain,
arthritis (RA), history of GI bleed, stiffness,
juvenile arthritis, peptic ulcer disease,
swelling;
osteoarthritis, OTC use of products
increased joint
rheumatic fever. that may contain
aspirin. Assess type, mobility;
location, duration of reduced joint
pain, inflammation. tenderness;
Inspect appearance of improved grip
affected joints for strength.
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immobility,
deformities, skin
condition.
Therapeutic serum
level for antiarthritic
effect: 20–30 mg/ dL
(toxicity occurs if
level is greater than 30
mg/dL).
INTERVENTION/
EVALUATION
Monitor urinary pH
(sudden acidification,
pH from 6.5 to 5.5,
may result in toxicity).
Assess skin for
evidence of
ecchymosis. If given
as antipyretic, assess
temperature directly
before and 1 hr after
giving medication.
Evaluate for
therapeutic response:
relief of pain,
stiffness, swelling;
increased joint
mobility; reduced joint
tenderness; improved
grip strength.
PATIENT/FAMILY
TEACHING
• Do not, chew, crush,
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dissolve, or di- vide
enteric-coated tablets.
• Avoid alcohol, OTC
pain/cold products that
may contain aspirin.
• Report ringing of the
ears or persistent
abdominal GI pain,
bleeding.
• Therapeutic anti-
inflammatory effect
noted in 1–3 wks.
• Behavioral changes,
persistent vomiting
may be early signs of
Reye’s syndrome;
contact physician.
4/26/22 Plavix clopidogrel 75mg PO, OD Inhibits binding of To decrease rate Hypersensitivity BASELINE GOAL MET
enzyme adenosine of MI and stroke to clopidogrel. ASSESSMENT Client’s
phosphate (ADP) to its in pts with non– Active bleeding Obtain baseline platelet count
platelet receptor and ST-segment (e.g., peptic chemistries, platelet is within
subsequent ADP- elevation acute ulcer, count, PFA. Perform normal
mediated activation of coronary intracranial platelet counts before parameter
a glycoprotein syndrome (ACS), hemorrhage). drug therapy, q2days therefore there
complex. acute ST- during first week of
is no evidence
elevation MI treatment, and weekly
of
(STEMI); pts thereafter until
with history of therapeutic thrombocytope
recent MI or maintenance dose is nia. Hgb, Hct,
stroke, reached. Abrupt were also in
established discontinuation of normal
peripheral arterial drug therapy produces parameter
disease (PAD). elevated platelet count therefore there
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within 5 days. is no evidence
INTERVENTION/ of bleeding.
EVALUATION
Monitor platelet count
for evidence of
thrombocytopenia.
Assess Hgb, Hct, for
evidence of bleeding;
serum ALT, AST,
bilirubin, BUN,
creatinine;
signs/symptoms of
hepatic insufficiency
during therapy.
PATIENT/FAMILY
TEACHING
• It may take longer to
stop bleeding during
drug therapy.
• Report any unusual
bleeding.
• Inform physicians,
dentists if clopidogrel
is being taken, esp.
before surgery is
scheduled or before
taking any new drug.