COLEGIO DE DAGUPAN

SCHOOL OF HEALTH SCIENCES

Arellano St., Dagupan City, Pangasinan
DRUG STUDY

Name: __________________________________________ Date: _________________ Inclusive Dates of Rotation: _____________

Year & Block: ____________ Area/ Shift/Days: ________ Clinical Instructor: ____________________________________________

Patient’s Name (Optional)/ Case Number:

Medical Diagnosis: URINARY TRACT INFECTION
DRUG NAME: CEPHALEXIN
DRUG CLASSIFICATION: First-generation cephalosporins
MECHANISM OF INDICATIONS & CONTRAINDICATIONS ADVERSE EFFECTS INTERACTIONS NURSING
ACTION DOSAGES & CAUTIONS IMPLICATIONS WITH
PATIENT TEACHINGS
Inhibits bacterial cell  Upper, lower  CONTRAINDICATIONS: ADVERSE EFFECTS NTERACTIONS NURSING
wall synthesis,  respiratory tract,  Hypersensitivity to CNS: Headache, Individual drugs CONSIDERATIONS
rendering cell wall  urinary tract, skin,  cephalosporins, infants dizziness, weakness, Probenecid: increased Assessment
osmotically unstable,  bone infections;  ,1 mo paresthesia, fever, chills, toxicity • Assess patient for
leading to cell death by otitis me Precautions: Pregnancy  seizures (high doses) Drug classifications previous sensitivity
binding to cell wall B, breastfeeding, GI: Nausea, vomiting, Aminoglycosides, reaction
membrane, lysis mediated Moderate infections hypersensitivity to diarrhea, anorexia, diuretics (loop): increased to penicillins or other
by cell wall autolytic Adult: PO 250-500 mg penicillins, renal disease pain, glossitis, bleeding; toxicity cephalosporins;
enzymes q6hr, max 4 g/day increased AST, ALT, Anticoagulants: increased crosssensitivity between
Child: PO 25-100 bilirubin, LDH, alkaline protime; use cautiously penicillins and
mg/kg/day in 4 equal phosphatase; abdominal Oral contraceptives: cephalosporins is
doses, pain, pseudomembranous decreased effectiveness common
max 4 g/day colitis possible; use another • Assess patient for signs
Moderate skin infections GU: Proteinuria, form of contraception and symptoms of
Adult: PO 500 mg q12hr vaginitis, pruritus, Drug/lab test infection including
Endocarditis prophylaxis candidiasis, increased Increased: AST, ALT, characteristics of wounds,
2 g 1 hr before procedure BUN, nephrotoxicity, alkaline phosphatase, sputum, urine, stool,
Severe infections renal LDH, WBC .10,000/mm3
Adult: PO 500 mg-1 g failure BUN, creatinine, ,
q6hr, max 4 g HEMA: Leukopenia, bilirubin earache, fever; obtain
Child: PO 50-100 thrombocytopenia, False positive: urinary baseline information and
mg/kg/day in 4 equal agranulocytosis, anemia, protein, direct Coombs’ during treatment
doses, neutropenia, test, urine glucose • Obtain C&S before
max 4 g/day lymphocytosis, Interference: cross- beginning product
Renal dose eosinophilia, matching therapy
Adult: PO CCr 10-40 pancytopenia, to identify if correct
ml/min 250-500 mg, then hemolytic anemia treatment has been
250-500 mg q8-12hr; CCr INTEG: Rash, urticaria, initiated
,10 mg/min 250- dermatitis • Assess for anaphylaxis:
500 mg, then 250-500 mg MS: Arthralgia, arthritis rash, urticaria,
q12-24hr RESP: Dyspnea pruritus, chills, fever,
Available forms: Caps SYST: Anaphylaxis, joint pain; angioedema
250, 500 mg; tabs serum sickness, may occur a few days
250, 500 mg, 1 g; oral superinfection, Stevens- after therapy begins;
susp 125, 250 mg/5 ml Johnson syndrome epinephrine and
resuscitation equipment
should
be available for
anaphylactic reaction
• Identify urine output; if
decreasing, notify
prescriber (may indicate
nephrotoxicity); also
check for increased BUN,
creatinine
• Monitor blood studies:
AST, ALT, CBC, Hct,
bilirubin, LDH, alkaline
phosphatase, Coombs’
test monthly if patient is
on long-term therapy
• Monitor electrolytes:
potassium, sodium,
chloride monthly if
patient is on long-term
therapy
• Assess bowel pattern
 daily; if severe diarrhea
occurs, product should be
discontinued; may
indicate
pseudomembranous
colitis
• Monitor for bleeding:
ecchymosis, bleeding
gums, hematuria, stool
guaiac daily if on
longterm therapy
• Assess for
superinfection: perineal
itching,
fever, malaise, redness,
pain, swelling, drainage,
rash, diarrhea, change in
cough, sputum

Patient/family education •
Teach patient to report sore
throat, bruising, bleeding,
joint pain; may indicate blood
dyscrasias (rare) • Advise
patient to contact prescriber
if vaginal itching, loose foul-
smelling stools, furry tongue
occur; may indicate
superinfection • Instruct
patient to take all medication
prescribed for the length of
time ordered • Advise patient
to notify prescriber of
diarrhea with blood, pus,
mucus, which may indicate
pseudomembranous colitis

______________________________________________ __________________________________________________
Patient/ Significant Other’s Signature Student Nurse’s Signature