ANGELES UNIVERSITY FOUNDATION

Angeles City

College of Nursing

RELATED LEARNING EXPERIENCE (RLE) 0107

Care of Mother, Child and Adolescent (Well Client)

First Semester, Academic Year 2020 – 2021

ACTIVITY 3: DRUG STUDY

Submitted by:

Bucud, Mari Belle O.

BSN II - E

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 Aspirin

Generic Name

 Aspirin

Brand Name

 Arthritis Pain
 Aspi-Cor
 Aspir 81
 Aspir-Low
 Bayer Plus
 Bufferin, Durlaza
 Ecotrin
 Ecpirin
 Fasprin
 Halfprin
 Miniprin.

Drug Classification

 Functional Classification
 Nonnarcotic analgesic
 Nonsteroidal anti-inflammatory
 Antipyretic
 Antiplatelet
 Chemical Classification
 Salicylate

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Mechanism of Action

 Blocks pain impulses in CNS

 Inhibition of prostaglandin synthesis
 Antipyretic action results from vasodilation of peripheral vessels
 Decreases platelet aggregation

Stock Dosage

 Pediatric patients
 Analgesic and antipyretic: 10-15 mg/kg/dose every 4 hours, up to 60-80
mg/kg/day
 Kawasaki Disease: 80– 100 mg/kg/day in 4 divided doses until fever
resolves; may be followed by maintenance dose of 3– 5 mg/kg/day as a
single dose for up to 8 week
 Adults
 Ischemic stroke and TIA: 51-325 mg/day
 Angina or recurrent myocardial infarction (MI): 75-325 mg/day
 Suspected MI: 160-325 g as soon as possible; continue for 30 days
 All forms of arthritis: 3g/ day in divided doses
 Acute rheumatic fever: 5-8g/day
 Pregnant women
 100 mg/day or less: use with caution; use only if clearly indicated (first and
second trimester)

Indication (relative to client’s case)

Prevent or delay the onset of preeclampsia. Other suggested indications for low-

dose aspirin have included prevention of stillbirth, fetal growth restriction, preterm birth,
and early pregnancy loss.

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Contraindications

 Hypersensitivity to salicylates
 Tatrazine
 GI bleeding
 Bleeding disorders
 Children <12 years old
 Children with flulike symptoms
 Pregnancy (3rd Trimester)
 Lactation
 Vitamin K deficiency
 Peptic ulcer

Side effects/adverse reactions

 HEMA
Common:
 Increased pro-time, bleeding time

Life-threatening:

 Thrombocytopenia, agranulocytosis, leukopenia, neutropenia, hemolytic

anemia,
 CNS

Common:

 Stimulation, drowsiness, dizziness, confusion, headache, flushing,

hallucinations

Life-threatening:

 Convulsion, coma
 GI

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 Common:

 Nausea, vomiting, diarrhea, heartburn, anorexia

Life-threatening:

 GI bleeding, hepatitis
 INTEG

Common:

 Rash, urticarial, bruising

 EENT

Common:

 Tinnitus, hearing loss

 CV

Common:

 Rapid pulse, pulmonary edema

 RESP

Common:

 Wheezing, hyperpenia
 ENDO

Common:

 Hypoglycemia, hyponatremia, hypokalemia

 SYST

Life-threatening:

 Reye’s Syndrome (children)

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Nursing interventions

 Assess
 Patients who have asthma, allergies, and nasal polyps or who are allergic
to tartrazine are at an increased risk for developing hypersensitivity
reactions.
 Pain: Assess pain and limitation of movement; note type, location, and
intensity before and at the peak after administration.
 Fever: Assess fever and note associated signs (diaphoresis, tachycardia,
malaise, chills).
 Administer
 Crushed or whole (PO)
 With food or milk to decrease gastric symptoms
 Give 30 minutes before or 2 hours after meals
 Evaluate
 Therapeutic response
 Decreased pain, inflammation, fever
 Teach patient/family
 To report any symptoms of hepatotoxicity, renal toxicity, visual changes,
ototoxicity, allergic reactions
 To avoid alcohol ingestion; GI bleeding may occur
 Take medication with 8 oz of water and sit upright for ½ hour after dose
 Medication is not to be given to children/teens with chickenpox or flulike
symptoms; Reye’s syndrome may develop

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 Fish oil

Generic Name

 Omega-3S-Dha-Epa-Fish Oil
 Omega-3 Fatty Acids

Brand Name

 Animi-3
 Cardio Omega Benefits
 Divista
 Icar Prenatal Essential Omega-3
 Lovaza
 Marine Lipid Concentrate

Drug Classification

 Functional Classification
 Antilipemic or lipid-regulating agents

Mechanism of Action

Inhibits the esterification of fatty acids, prevents hepatic enzymes from catalyzing
final step of triglyceride synthesis. May include inhibition of acylCoA:1,2-diacylglycerol
acyltransferase, increased mitochondrial and peroxisomal β-oxidation in the liver,
decreased lipogenesis in the liver, and increased plasma lipoprotein lipase activity; may
reduce synthesis of triglycerides in the liver because EPA and DHA are poor substrates
for the enzymes responsible for triglyceride synthesis, and EPA and DHA inhibit
esterification of other fatty acids.

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Stock Dosage

 Pediatric patients
 0–12 months: 0.5 grams
 1–3 years: 0.7 grams
 4–8 years: 0.9 grams
 Girls 9–13 years: 1.0 grams
 Boys 9–13 years: 1.2 grams
 14–18 years: 1.1 grams
 Boys 14–18 years: 1.6 grams
 Adults
 4 g/day, given as a single dose (4 capsules) or 2 capsules twice daily
 1 g/day in coronary heart disease,
 a minimum of 2 g/day up to a maximum of 4 g/day when triglycerides are
elevated.
 Pregnant women
 200 – 300 mg of omega

Indication (relative to client’s case)

Adequate consumption of omega-3 fatty acids is vitally important

during pregnancy as they are critical building blocks of fetal brain and retina. Omega-3
fatty acids may also play a role in determining the length of gestation and in preventing
perinatal depression.

Contraindications

 Fish oil is contraindicated for people who have any allergies or

hypersensitivity to Vitamin E Analogues, Omega-3(N-3)Polyunsaturated Fatty
Acids, Docosahexanoic Acid (DHA), Fish Containing Products, Linoleic Acid,
Linolenic Acid

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Side effects/adverse reactions

 GI

Common:

 Nausea, vomiting, altered taste, eructation

 DERM

Common:

 Rash

Nursing interventions

 Assess
 Signs and symptoms of hypersensitivity in those with known allergy to fish
 Lab tests: Baseline and periodic lipid profile
 Administer
 May be taken as a single 4-g dose or as 2 g twice daily
 May be administered with meals
 Swallow capsules whole; do not break or chew
 Evaluate
 Lowering of serum triglyceride levels. Patients who do not have an
adequate response after 2 mo of treatment should be withdrawn from
therapy
 Teach patient/family
 Instruct patient to take medication as directed, not to skip doses or double
up on missed doses. Take missed doses as soon as remembered, but if a
day is missed, do not double doses the next day. Medication helps control
but does not cure elevated serum triglyceride levels
 Advise patient that this medication should be used in conjunction with diet
restrictions (fat, cholesterol, carbohydrates, alcohol), exercise, weight loss

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 in overweight patients, and control of medical problems (such as diabetes
mellitus and hypothyroidism) that may contribute to hypertriglyceridemia
 Emphasize the importance of follow-up exams to determine effectiveness

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 Probiotic Vitamins

Generic Name

 Indian yogurt
 Lactobacillus combination no.6

Brand Name

 Florajen3
 Intestinex
 Acidophilus
 Florastor
 Dofus

Drug Classification

 Functional Classification
 Antidiarrheals

Mechanism of Action

Through the production of lactic acid, creates an environment unfavorable to the

overgrowth of potentially pathogenic fungi and bacteria (including putrefactive bacteria)
and favors establishment of an aciduric flora. Some commercially available preparations
containing Lactobacillus acidophilus also contain standardized viable culture
of Lactobacillus bulgaricus, which provides transient beneficial flora and enhances the
growth of desirable bacteria by forming lactic acid on fermentation of carbohydrates.

Stock Dosage

 Pediatric Patients

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  Children ≥3 years of age: Lactobacillus acidophilus preparations containing
sodium carboxymethylcellulose: 2 capsules 2–4 times daily.

 Lactobacillus acidophilus preparations containing L. bulgaricus: 2 capsules, 4

tablets, or 1 packet of granules 3 or 4 times daily.

 Enteric-coated capsules containing Lactobacillus acidophilus and L. casei: 1

capsule daily for the first 2 weeks of therapy; dosage may then be increased
up to a maximum of 3 capsules daily if necessary.

 Adults

 Lactobacillus acidophilus preparations (containing sodium

carboxymethylcellulose): 2 capsules 2–4 times daily.

 Lactobacillus acidophilus preparations containing L. bulgaricus: 2 capsules, 4

tablets, or 1 packet of granules 3 or 4 times daily.

 Enteric-coated capsules containing Lactobacillus acidophilus and L. casei: 1

capsule daily for the first 2 weeks of therapy; dosage may then be increased
up to a maximum of 3 capsules daily if necessary

Indication (relative to client’s case)

The use of probiotics seems to modulate the composition of vaginal microflora;

vaginal microbiota alterations and infections during pregnancy lead to a greater
possibility of preterm delivery; this is related to the development of neonatal infections,
sepsis, and necrotising entercocolitis. Also, with constipation and diarrhea being two
frequently experienced common discomforts during pregnancy, the use of probiotics
helps the intestines move food along, and reducing the bad bacteria help reduce the
likelihood of experiencing health complications.

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Contraindications

 Hypersensitivity to milk or lactose products

 Weakened immune system
 Intestinal damage, infection or flatus; may produce an increase in intestinal flatus
at the beginning of therapy; usually subsides with continued therapy
 Use with precaution in pregnant women and should only be use under medical
supervision
 Some manufacturers recommend that Lactobacillus preparations not be used in
infants and children <3 years of age unless under the direction and supervision of
a physician

Side effects/adverse reactions

 Cough
 difficulty with swallowing
 dizziness
 fast heartbeat
 hives, itching, or rash
 puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
 tightness in the chest
 increase in stomach gas or bloating
 unusual tiredness or weakness

Nursing interventions

 During pregnancy, probiotic should be used only when clearly needed. Discuss
the risks and benefits with a doctor.

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 Some probiotic products may contain live bacteria such as bifidobacteria, and
antibiotics may prevent these products from working well. Take any product
containing live bacteria at least 2 to 3 hours before or after taking antibiotics
 Although it is unknown whether this passes into breast milk; consult your doctor
before breast-feeding.
 Different types of probiotics may have different storage needs. Some may require
refrigeration while others should not be refrigerated. 

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 Folic Acid

Generic Name

 Folic Acid

Brand Name UNDER IT ARE

 Folvite
 Folacin-800
 FA-8
 FaLessa

Drug Classification

 Functional Classification
 Vitamin B complex group
 Antianemics

Mechanism of Action

 Needed for erythropoiesis

 Increases RBC, WBC, platelet formation in megaloblastic anemias

Stock Dosage

 Therapeutic Dose (Folic acid deficiency)

 PO, IM, IV, Subcut (Adults and Children 11 yr): 1 mg/day initial dose then 0.5
mg/day maintenance dose.

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  PO, IM, IV, Subcut (Children 1 yr): 1 mg/day initial dose then 0.1– 0.4 mg/day
maintenance dose.
 PO, IM, IV, Subcut (Infants): 15 mcg/kg/dose daily or 50 mcg/day.
 Recommended Daily Allowance
 PO (Adults and Children 15 yr): 0.2 mg/day.
 PO (Adults):Females of childbearing potential– 0.4– 0.8 mg/day.
 PO (Children 11– 14 yr): 0.15 mg/day.
 PO (Children 7– 10 yr): 0.1 mg/day.
 PO (Children 4– 6 yr): 0.075 mg/day.
 PO (Infants 6 mo– 3 yr): 0.05 mg/day.

Indication (relative to client’s case)

Treatment of megaloblastic or macrocytic anemias of pregnancy. Folic acid

requirements are markedly increased during pregnancy, and deficiency will result in
fetal damage such as neural tube defects and spina bifida.

Contraindications

 Hypersensitivity
 Anemias other than megaloblastic/macrocytic anemia
 Uncorrected pernicious anemia

Side effects/adverse reactions

 INTEG

Common:

 Flushing
 RESP
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 Life-threatening:

 Bronchospasm

Nursing interventions

 Assess
 For fatigue, dyspnea, weakness, dyspnea that are signs of megaloblastic
anemia
 Nutritional status
 Drugs currently taken: estrogen, carbamazepine, glucocorticoids,
hydantoins; these drugs may cause increase folic acid use by body and
contribute to a deficiency
 Administer
 IV: Direct undiluted 5 mg or less/1 min or more; or maybe added to most
IV sol or TPN
 Evaluate
 Therapeutic response: increased weight, oriented, well-being
 Absence of fatigue
 Increase in reticulocyte count within 5 days of beginning treatment
 Teach patient/family
 To take drug exactly as prescribed; periodic lab work is required
 Alter nutrition to include high-folic foods: organ meats, vegetables, fruit
 Urine will turn bright yellow
 Folic acid in early pregnancy is necessary to prevent neural tube defects
 Notify prescriber o any allergic reactions

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 Calcium

Generic Name

 Calcium citrate

Brand Name

 Cal-Cee
 Cal-C-Cap
 Tums
 Tums Chewy Delights
 Tums Extra
 Tums Freshers

Drug Classification

 Functional Classification
 Antacid
 Antihypocalcemic
 Antihyperkalemic
 Antihypermagnesemic
 Antihyperphosphatemic
 Dietary supplement
 Electrolyte replenisher

Mechanism of Action

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 Calcium plays an important role and essential for function, integrity of nervous,
muscular, skeletal systems, cardiac/renal function, respiration, blood coagulation, cell
membrane and capillary permeability. It is also for calcification of fetal bones(as early as
8 weeks). Increases serum calcium level through direct effects on bone, kidney, and GI
tract. Assists in regulating release/storage of hormones/neurotransmitters.
Neutralizes/reduces gastric acid (increases pH). Decreases osteoclastic osteolysis by
reducing mineral release and collagen breakdown in bone.

Stock Dosage

 Pediatric patients
 Children under 6 months old: 200 mg/day
 Children 6-12 months old: 260 mg/day
 Children 1-3 years old: 700 mg/day
 Children 4-8 years old: 1000 mg/day
 Children 9-18 years old: 1300 mg/day
 Adults
 Age less than 50 years: 1 g/day
 Over 50 years females: 1.2 g/day
 Over 50 years males: 1 g/day
 Over 70 years males: 1.2 g/day
 Pregnant women
 1200 mg

Indication (relative to client’s case)

Indicated for relief of heartburn and acid indigestion. May also be used as a
nutritional supplement, to treat hypocalcemia, cardiac arrest, magnesium intoxication,
and exchange transfusions. Needed for fetal skeletal mineralization during the third
trimester and contract muscle during labor.
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Contraindications

 Hypersensitivity to calcium formulation

 Ventricular fibrillation
 Hypercalcemia and hypophosphatemia
 Cancer
 Renal calculi
 Pregnancy or breastfeeding

Side effects/adverse reactions

 Chalky taste
 Pain, rash, redness, burning at injection site; flushing, nausea, vomiting,
diaphoresis, hypotension
 Mild constipation, fecal impaction, peripheral edema, metabolic alkalosis (muscle
pain, restlessness, slow respirations, altered taste

Nursing interventions

 Baseline assessment Assess B/P, EKG and cardiac rhythm, renal function,
serum magnesium, phosphate, calcium, ionized calcium. Intervention/evaluation
 Monitor serum BMP, calcium, ionized calcium, magnesium, phosphate; B/P,
cardiac rhythm, renal function, and signs of hypercalcemia frequently, especially
in elder patients.
 Instruct patient to consume plenty of milk and dairy products during therapy
 Do not take within 1–2 hrs of other oral medications, fiber-containing foods.
 Avoid excessive use of alcohol, tobacco, caffeine.

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 Magnesium

Generic Name

 Magnesium chloride
 Magnesium gluconate
 Magnesium hydroxide

Brand Name

 Citramag
 Citro-Mag
 Citroma
 Mag G
 Magonate
 Dulcolax Milk of Magnesia

Drug Classification

 Functional Classification
 Antiacid
 Anticonvulsant
 Electrolyte
 Laxative

Mechanism of Action

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 Magnesium is the second most plentiful cation of the intracellular fluids and is
essential for the activity of many enzyme systems. It plays an important role with regard
to neurochemical transmission and muscular excitability. Magnesium sulfate reduces
striated muscle contractions and blocks peripheral neuromuscular transmission by
reducing acetylcholine release at the myoneural junction. Additionally, Magnesium
inhibits Ca2+ influx through dihydropyridine-sensitive, voltage-dependent channels. This
accounts for much of its relaxant action on vascular smooth muscle.

Stock Dosage

 Adults
 2 tabs once daily for dietary supplement
 8-20 mEq/day for hypomagnesemia
 Pediatric patients
 25-50 mg/kg/dose over 10-20 mins. Maximum single dose of 2 g for severe
deficiency
 Pregnant women
 400 mg/day (18 years and below)
 320-350 mg/day (19 years to 30 years)
 360 mg/day (31 years and older)
 Breastfeeding women
 360 mg/day (18 years and below)
 310 mg/day (19 years to 30 years)
 320 mg/day (31 years and older)

Indication (relative to client’s case)

Treatment or prevention of hypomagnesemia and hypertension. Prevention of

seizures associated with severe eclampsia, pre-eclampsia, or acute nephritis. It can

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also help prolong a pregnancy for up to two days. It supports muscle relaxation and
prevents premature uterine contraction.

Contraindications

 Hypersensitivity
 Hypermagnesemia
 Hypocalcemia
 Anuria
 Heart block
 OB: Avoid using for more than 5– 7 days for preterm labor (may increase risk of
hypocalcemia and bone changes in newborn); avoid continuous use during
active labor or within 2 hr of delivery due to potential for magnesium toxicity in
newborn.

Side effects/adverse reactions

 CNS

Common:

 Muscle weakness, flushing, sweating, confusion, sedation, depressed

reflexes, hypothermia

Life-threatening:

 Flaccidity, paralysis
 GI

Common:

 Nausea, vomiting, anorexia, cramps

 CV

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 Common:

 Hypotension, heart block

Life-threatening:

 Circulatory collapse
 META

Common:

 Electrolyte, fluid imbalances

Nursing interventions

 Assess
 Monitor intake and output ratios; check for decrease urinary output
 Monitor pulse, BP, respirations, and ECG frequently throughout
administration of parenteral magnesium sulfate. Respirations should be at
least 16/min before each dose.
 Monitor newborn for hypotension, hyporeflexia, and respiratory depression
if mother has received magnesium sulfate.
 Cramping, rectal bleeding, nausea, vomiting; drug should be discontinued
 Magnesium toxicity: thirst, confusion, decrease in reflexes
 Administer
 IM: Administer deep IM into gluteal sites. Administer subsequent injections
in alternate sides. Dilute to a concentration of 200 mg/mL prior to injection.
 Direct IV: Diluent: 50% solution must be diluted in 0.9% NaCl or D5W to a
concentration of 20% prior to administration. Concentration: 20%. Rate:
Administer at a rate not to exceed 150 mg/min.
 Diluent: Dilute in D5W, 0.9% NaCl, or LR. Concentration: 0.5 mEq/mL (60
mg/mL) (may use maximum concentration of 1.6 mEq/ mL (200 mg/mL) in
fluid-restricted patients). Rate: Infuse over 2-4 hr. Do not exceed a rate of

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 1 mEq/kg/hr (125 mg/kg/hr). When rapid infusions are needed (severe
asthma or torsade de pointes) may infuse over 10– 20 min.
 Evaluate
 Normal serum magnesium concentrations.
 Control of seizures associated with toxemias of pregnancy.

 Teach patient/family
 Purpose and side effects of medication to patient and family
 Advice the pregnant mother to make sure prescriber knows that she is
pregnant before taking drug.

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 Vitamin C supplements

Generic Name

 Ascorbic Acid

Brand Name

 Cecon
 Cenolate

Drug Classification

 Functional Classification
 Water soluble vitamin

Mechanism of Action

Needed for wound healing, collagen synthesis, Involved in oxidation reduction

reactions; tyrosine, folic acid, iron, and carbohydrate metabolism; lipid and protein
synthesis; cellular respiration; and resistance to infection.

Stock Dosage

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  PO (Adults): Scurvy—500 mg/day for at least 14 days. Prevention of deficiency—
50– 100 mg/day.
 PO (Children): Scurvy—100– 300 mg/day for at least 14 days. Prevention of
deficiency—30– 45 mg/day.

Indication (relative to client’s case)

Treatment and prevention of vitamin C deficiency (scurvy) due to a state of

increased requirements from pregnancy, lactation, infancy, and stress with the use of
dietary supplementation.

Contraindications

 Tartrazine hypersensitivity
 Use cautiously in recurrent kidney stones
 Avoid chronic use of large doses in pregnant women

Side effects/adverse reactions

 CNS

Common:

 Drowsiness, fatigue, headache, insomnia, dizziness, flushing

 GI
Common:
 Anorexia, cramps, diarrhea, heartburn, nausea, vomiting

 GU

Common:

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  Polyuria, urine acidification, oxalate or urate renal stones, dysuria

 HEMA

Life-threatening:

 Hemolytic anemia in patients with G6PD

Nursing interventions

 Assess
 Ascorbic acid levels throughout treatment if continued deficiency is
suspected
 Nutritional status: citrus fruits, vegetables

 Administer
 PO: Extended-release tablets and capsules should be swallowed whole
without crushing, breaking, or chewing; contents of capsules may be
mixed with jelly or jam. Chewable tablets should be chewed well or
crushed before swallowing.

 Evaluate
 Absence of anorexia, irritability, pallor, joint pain, hyperkeratosis,
petechiae, poor wound healing

 Teach patient/family
 Advise patient to take medication as directed and not to exceed dose
prescribed. Excess doses may lead to diarrhea and urinary stone
formation. If a dose is missed, skip dose and return to dose schedule.
 Vitamin C Deficiency: Encourage patient to comply with diet
recommendations of health care professional. Explain that the best source
of vitamins is a well-balanced diet.

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  Foods high in ascorbic acid include citrus fruits, tomatoes, strawberries,
cantaloupe, and raw peppers. Gradual loss of ascorbic acid occurs when
fresh food is stored, but not when it is frozen. Rapid loss is caused by
drying, salting, and cooking.
 Patients self-medicating with vitamin supplements should be cautioned not
to exceed RDA. The effectiveness of megadoses of vitamins for treatment
of various medical conditions is unproven and may cause side effects.
Abrupt withdrawal of megadoses of ascorbic acid may cause rebound
deficiency

Ferrous Sulfate

Generic Name

 Ferrous Sulfate

Brand Name

 Feosol
 Fer Iron
 Fer-Gen-Sol
 Fer-in-Sol
 Fer-Iron
 Feratab,
 FeoSol

Drug Classification

 Functional Classification
 Iron supplements
 Antianemics

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Mechanism of Action

Iron combines with porphyrin and globin chains to form hemoglobin, which is
critical for oxygen delivery from the lungs to other tissues. Iron deficiency causes a
microcytic anemia due to the formation of small erythrocytes with insufficient
hemoglobin.

Stock Dosage

 PO (Adults): Deficiency– 2– 3 mg/kg/day in 2– 4 divided doses or 60– 100 mg

elemental iron twice daily. Prophylaxis—60– 100 mg elemental iron daily.
 PO (Infants and Children): Severe deficiency—4– 6 mg/kg/day in 3 divided
doses. Mild to moderate deficiency—3 mg/kg/day in 1– 2 divided doses.
Prophylaxis—1– 2 mg/kg/day in 1– 2 divided dose (maximum: 15 mg/day).
 PO (Neonates , premature): 2– 4 mg/kg/day in 1– 2 divided doses, maximum of
15 mg/day

Indication (relative to client’s case)

Treatment and prevention of iron deficiency anemia during pregnancy. Iron is

largely needed for hemoglobin formation, transferred to the place and fetus to provide
iron store in the liver and to replace natural loses in skin, sweat and hair.

Contraindications

 Anemia not due to iron deficiency

 Hemochromatosis
 Hemosiderosis
 Hypersensitivity to iron products

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  Use cautiously in peptic ulcer disease; ulcerative colitis or regional enteritis
(condition may be aggravated); alcoholism; severe hepatic impairment; severe
renal impairment

Side effects/adverse reactions

 GI

Common:

 Nausea, constipation, epigastric pain, black and red tarry stools, vomiting,
diarrhea
 INTEG

Common:

 Temporarily discolored tooth enamel and eyes

Nursing interventions

 Assess
 Blood studies: Hct, Hgb, reticulocytes, bilirubin before treatment, at least
monthly
 Toxicity: nausea, vomiting, diarrhea, hematemesis, pallor, cyanosis,
shock, coma
 Elimination; if constipation occurs, increase water, bulk, activity
 Nutrition: amount of iron in diet
 Cause of iron loss or anemia, including salicylates, sulfonamides,
antimalarials, quinidine

 Administer
 Between meals for best absorption; may be given with juice; do not give
with antacids or milk, delay at least 1 hour; If GI symptoms occur, give pc

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 even if absorption is decreased; eggs, milk products, chocolate, caffeine
interfere with absorption
 Liquid through plastic straw to avoid discoloration of tooth enamel; dilute
thoroughly
 At least 1 hour before bed time, since corrosion may occur in the stomach
 For <6 mo for anemia

 Evaluate
 Improvement in Hct, Hgb, reticulocytes; decreased fatigue, weakness

 Teach patient/family
 Stools may become dark green or black.
 Iron poisoning may occur if increased beyond recommended level
 Not to substitute iron salt for another; elemental iron content differs

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References:

Msn Np, S. L. R. (2019). Mosby’s 2020 Nursing Drug Reference (Skidmore Nursing
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Bs, R. K. J., & Hodgson, K. (2019). Saunders Nursing Drug Handbook 2020 (1st ed.).
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Schull, P. (2013). McGraw-Hill Nurses Drug Handbook, Seventh Edition (McGraw-Hill’s

Nurses Drug Handbook) (7th ed.). McGraw-Hill Education / Medical.

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