GENERIC NAME: Dextrose 5% MECHANISM OF ACTION: SIDE EFFECTS/ ADVERSE NURSING RESPONSIBIITY

in Lactated Ringers Solution REACTION:

DRUG ILLUSTRATION:
CLASSIFICATION: Hypertonic,
Nonpyrogenic, Parenteral Fluid,
Electrolyte, Nutrient Replenisher
DOSAGE/FREQUENCY/ROUTE:
 D5LRs is supplied in single- dose
500 and 1000 mL flexible plastic
containers.
 1000 mL @ 30 gtts/min or as
prescribed by the physician
Hypertonic solution are those that have
an effective osmolarity greater than the
body fluids. This pulls the fluid into the
vascular by osmosis resulting in an
increase vascular volume. It raises
intravascular osmotic pressure and
provides fluid, electrolytes and calories
for energy.
INDICATION:
These solutions are indicated for
parenteral replacement of extracellular
losses of fluid and electrolytes, with or
without minimal carbohydrate calories,
as required by the clinical condition of
the patient.
CONTRAINDICATION:
Solutions containing lactate are NOT
FOR USE IN THE TREATMENT OF
LACTIC ACIDOSIS.
 Watch out for signs
Reactions which may occur because of the of hypervolemia
solution or the technique of administration
include febrile response, infection at the
site of injection, venous thrombosis or  Do not administer unless solution is
phlebitis extending from the site of clear and container is undamaged.
injection, extravasation and hypervolemia.
If an adverse reaction does occur,  Never stop hypertonic solutions
discontinue the infusion, evaluate the abruptly.
patient, institute appropriate therapeutic
countermeasures and save the remainder
of the fluid for examination if deemed  Don’t give concentrated solutions
necessary. IM or subcutaneously.
 Check vital signs frequently.
Report advers ereactions.
 Monitor fluid intake and output
and weight carefully. Watch
carefully for signs and symptoms
of fluid overload.
REFERENCES:
https://www.drugs.com/pro/dextrose-in-  Monitor patients for signs of
lactated-ringer-s.html mental confusion
 GENERIC NAME: Cefuroxime
BRAND NAME: Zinacef
DRUG ILLUSTRATION:
CLASSIFICATION: cephalosporins,
2nd Generation.
DOSAGE/FREQUENCY/ROUTE:
 IV Fluid
750 mg to 1.5 grams every 8 hours
MECHANISM OF ACTION: SIDE EFFECTS/ ADVERSE NURSING RESPONSIBIITY
REACTION:
Cefuroxime is a bactericidal agent that The most common side effects of  Watch for seizures; notify
acts by inhibition of bacterial cell wall Zinacef include:
physician immediately if patient
synthesis. Cefuroxime has activity in the 1. swelling, redness, pain, or soreness at develops or increases seizure
presence of some beta-lactamases, both the injection site,
penicillinases and cephalosporinases, activity.
2. loss of appetite,
of Gram-negative and Gram-positive bac 3.. nausea,
teria.  Monitor signs of
4. vomiting,
pseudomembranous colitis,
INDICATION: 5. diarrhea,
including diarrhea, abdominal
6. irritability, and.
pain, fever, pus or mucus in stools,
ZINACEF is indicated for the treatment of 7. headache.
patients with infections caused by and other severe or prolonged GI
susceptible strains of the designated problems (nausea, vomiting,
organisms in the following diseases:
heartburn). Notify physician or
1. Lower Respiratory Tract nursing staff immediately of these
Infections signs.
2. Urinary Tract Infections 
3. Skin and Skin-Structure  Monitor signs of allergic reactions
4. Septicemia 
5. Meningitis  and anaphylaxis, including
6. Gonorrhea pulmonary symptoms (tightness in
7. Bone and Joint Infections  the throat and chest, wheezing,
cough dyspnea) or skin reactions
 CONTRAINDICATION:
ZINACEF is contraindicated in patients
with known allergy to the cephalosporin
group of antibiotics
 Monitor signs of blood dyscrasias,
 Monitor injection site for pain,
(rash, pruritus, urticaria). Notify
physician or nursing staff
immediately if these reactions
occur.
including eosinophilia (fatigue,
weakness, myalgia), hemolytic
anemia (malaise, dizziness,
jaundice, abdominal pain),
leukopenia (fever, sore throat,
mucosal lesions, signs of
infection), and
thrombocytopenia (bruising,
nose bleeds, bleeding gums,
other bleeding problems). Report
these signs to the physician.
swelling, and irritation. Report
prolonged or excessive injection
site reactions to the physician.
 GENERIC NAME: packed Red MECHANISM OF ACTION: SIDE EFFECTS/ ADVERSE NURSING RESPONSIBIITY
Blood Cells REACTION:

DRUG ILLUSTRATION:
CLASSIFICATION: Blood
Components
DOSAGE/FREQUENCY/ROUTE:
Given through IV
1 unit increase hemoglobin 1 g/dL
in average sized adults without active
bleeding or hemolysis; usually given
over 1-2 hours but not longer than 4
hours
Packed red blood cells, also known
as packed cells, are red blood cells that
have been separated for blood
transfusion.[1] The packed cells are
typically used in anemia that is either
causing symptoms or when
the hemoglobin is less than usually 70–
80 g/L (7–8 g/dL).[1][2][3] In adults, one
unit brings up hemoglobin levels by
about 10 g/L (1 g/dL).[4][5] Repeated
transfusions may be required in people
receiving cancer chemotherapy or who
have hemoglobin disorders.[1] Cross
matching is typically required before the
blood is given.[1] It is given by injection
into a vein.[6]
INDICATION:
Indications: o To increase oxygen
carrying capacity in the following
settings:  Treatment of chronic,
symptomatic anemia in patients
unresponsive to conservative therapy or
Side effects include  client and explain the purpose of
allergic reactions such as anaphylaxis, red
blood cell breakdown, infection, volume
overload, and lung injury.
Chronic ingestion: Hemolytic
Transfusion Reactions
Febrile Non-Hemolytic Reactions
Allergic Reactions ranging from urticaria
to anaphylaxis
Septic Reactions
Transfusion Related Acute Lung Injury
(TRALI)
Circulatory Overload
Transfusion Associated Graft Versus Host
Disease
Postransfusion Purpura
1. Verify doctor’s order. Inform the
the procedure.
2. Check for cross matching and
typing. To ensure compatibility
3. Obtain and record baseline vital
signs
4. Practice strict asepsis
5. At least 2 licensed nurse check
the label of the blood transfusion.
Check the following:
 Serial number
 Blood component
 Blood type
 Rh factor
 Expiration date
 Screening test (VDRL,
HBsAg, malarial smear) –
this is to ensure that the
blood is free from blood-
carried diseases and
therefore, safe from
transfusion.
6. Warm blood at room temperature
before transfusion to prevent
chills.
7. Identify client properly. Two
Nurses check the client’s
when medical necessity does not allow
time for conservative therapy
(hemolysis, marrow failure) 
Treatment of an actively bleeding patient
(i.e. from trauma, surgery, spontaneous
hemorrhage) o In most patients, a
hemoglobin level of 7-8 g/dL is
sufficient to maintain an adequate
oxygen carrying capacity. o Rarely need
to transfuse patient with Hgb>10g/dL o
If Hgb is between 7 and 10g/dL: need to
assess patient. Transfusion threshold
should be patient-specific. Factors such
as age, degree of anemia, intravascular
volume, and underlying cardiac,
pulmonary, or vascular disease should
be used to assess the need for
transfusion.
CONTRAINDICATION:
Transfusion of RBCs is not indicated
when restoration of blood volume and
symptomatic relief can be accomplished
using crystalloids or colloids alone
(generally when blood loss is less than
20% of blood volume).
identification.
8. Use needle gauge 18 to 19 to allow
easy flow of blood.
9. Use BT set with special micron
mesh filter to prevent
administration of blood clots and
particles.
10. Start infusion slowly at 10
gtts/min. Remain at bedside for 15
to 30 minutes. Adverse reaction
usually occurs during the first 15
to 20 minutes.
11. Monitor vital signs. Altered vital
signs indicate adverse reaction
(increase in temp, increase in
respiratory rate)
12. Do not mix medications with
blood transfusion to prevent
adverse effects. Do not incorporate
medication into the blood
transfusion. Do not use blood
transfusion lines for IV push of
medication.
13. Administer 0.9% NaCl before;
during or after BT. Never
administer IV fluids with dextrose.
Dextrose based IV fluids cause
hemolysis.
14. Administer BT for 4 hours (whole
blood, packed RBC). For plasma,
platelets, cryoprecipitate, transfuse
quickly (20 minutes) clotting
factor can easily be destroyed.
15. Observe for potential
complications. Notify physician.