Name of Patient: G. F. Attending Physician: Dr.

T
Age: 55 Impression Diagnosis: DKA, Hypovolemic Shock 2º to AGE
with severe dehydration, DM II, HCVD
Name of Drug Dosage, Mechanism Indication Adverse Reactions Special Nursing
Route, of Action Precautions Responsibilities
Frequency,
Timing
Generic: Dosage: 500 Metronidazol Indicated for patient Significant: Severe Patient with or Before drug
Metronidazole mg e interacts since the patient has neurological disturbances, history seizure administration:
with the AGE, severe encephalopathy, disorder, Verify the
Brand: Flagyl Route: IV microbial dehydration, convulsive seizures, blood physician’s order,
DNA to amoeba (presence of aseptic meningitis, dyscrasias ensure right
break its stronglyloids peripheral and optic (e.g. medication, dosage,
Frequency: strand and stercolaris in stool) neuropathy, paraesthesia; agranulocytosi route, patient, time,
q6h (-) NST helical superinfection (e.g. fungal s, leukopenia, assessment,
structure or bacterial neutropenia); approach,
Timing: leading to superinfection, C. difficile- Cockayne prescription,
6 AM- 12 inhibition of associated diarrhoea). syndrome. handling, discard,
PM- 6 PM- protein Blood and lymphatic Hepatic storage, explanation,
12 AM synthesis, system impairment order, chart,
degradation, disorders: Leucopenia, and severe universal
and cell neutropenia. renal precautions.
death. Cardiac disorders: Chest impairment or
pain, tachycardia. ESRD. During drug
Ear and labyrinth Pregnancy and administration:
disorders: Tinnitus. lactation. Introduce yourself
Eye disorders: Light . and verify the
sensitivity, nystagmus. client’s identity
Gastrointestinal
disorders: Nausea, dry Perform hand
mouth, vomiting, hygiene.
constipation, abdominal
pain, diarrhoea, sharp Assess IV /heplock
unpleasant metallic taste. site prior to
Investigations: Flattening administration.
of T wave on ECG.
Metabolism and nutrition Administer dose for
disorders: Anorexia. over 30 minutes.
Musculoskeletal and
connective tissue After drug
disorders: Myalgia. administration:
Nervous system Perform hand
disorders: Insomnia, hygiene
headache, ataxia, vertigo,
incoordination, dizziness. Monitor daily
Psychiatric pattern daily of
disorders: Confusion, bowel activity, stool
hallucination. consistency.
Reproductive system and
breast disorders: Genital Monitor I&O,
pruritus. assess for urinary
Respiratory, thoracic and problems.
mediastinal
disorders: Pharyngitis, Be alert for onset
sinusitis. superinfection
Skin and subcutaneous (ulceration/ change
tissue in oral mucosa,
disorders: Erythematous furry tongue, anal
rash, urticaria, dry skin. pruritus
Vascular
disorders: Syncope. Patient Teaching:
Potentially Urine may be red-
Fatal: Stevens-Johnson brown or dark.
syndrome, toxic epidermal
 necrolysis; severe May cause
hepatotoxicity/acute drowsiness or
hepatic failure in patients dizziness. Advice
with Cockayne syndrome. patient to avoid
driving or other
Classification Contraindication Side Effects
activities requiring
Therapeutic Hypersensitivity to Nausea, vomiting,
alertness until
Class: metronidazole and diarrhea, dizziness,
response to the
Antiprotozoal other lightheadedness, and
medication is
nitroimidazoles. fatigue
known.
Pharmacologic Concomitant use
class: with disulfiram
Nitroimidazole within the last 14
antimicrobials days.

Name of Patient: G. F. Attending Physician: Dr. T

Age: 55 Impression Diagnosis: DKA, Hypovolemic Shock 2º to AGE
with severe dehydration, DM II, HCVD
Name of Drug Dosage, Mechanism of Indication Adverse Special Precautions Nursing Responsibilities
Route, Action Reactions
Frequency,
Timing
Generic: Dosage: Albendazole is a Indicated for CNS: Use this medicine Before drug
Albendazole 750 mg broad spectrum patient since stool seizures, exactly as directed by administration:
anti-helminthic. result showed 4 fever your doctor. Do not Verify the physician’s
Brand: Route: IV The principal larva of GI: Transient use more of it, do not order, ensure right
Albenza mode of action strongyloides abdominal use it more often, and medication, dosage, route,
for albendazole stercoralis pain and do not use it for a patient, time, assessment,
Frequency: is by its diarrhea in longer time than your approach, prescription,
q8h inhibitory effect massive doctor ordered. handling, discard, storage,
on tubulin infestation explanation, order, chart,
Timing: 8 polymerization and during Albendazole can universal precautions.
AM- 4 PM- which results in expulsion of temporarily lower the
12 AM the loss of worms. number of white Perform hand hygiene.
cytoplasmic Skin: blood cells in your
microtubules in urticaria blood, increasing the During drug
the intestines of chance of getting an administration:
nematodes infection. It can also Introduce yourself and
worms, lower the number of verify the client’s identity
ultimately platelets, which are
causing energy necessary for proper Instruct the patient to
depletion and blood clotting: swallow tablets. It can also
death of the be chewed or crushed and
organism. Check any unusual mixed with food.
bleeding or bruising,
black, tarry stools, After drug
blood in the urine or administration:
stools, or pinpoint Perform hand hygiene
red spots on skin.
Assess for signs and
 Use gloves when symptoms of
handling patient to hypersensitivity to drug.
Classification Contraindications: Side Effects avoid contamination.
Therapeutic Albendazole is abdominal Monitor signs of allergic
class: contraindicated reactions and anaphylaxis,
pain
Anthelminthic in patients with a including pulmonary
headache with
history of symptoms (tightness in the
Pharmacologic hypersensitivity to severe throat and chest, wheezing,
class: albendazole, blistering, cough dyspnea) or skin
Benzimidazole benzimidazoles, or peeling, and reactions (rash, pruritus,
anthelmintic any component of red skin rash urticaria). Notify physician
the formulation. hair loss immediately if these
reactions occur.
headache
increased
Patient Teaching
intracranial Instruct the patient to finish
pressure taking drug for 7-14 days as
meningeal prescribed by the physician.
signs
nausea
reduction
of red blood
cells, white
blood cells,
and platelets
rash
spinning
sensation
(vertigo)
unusual
 weakness
hives
vomiting

Name of Patient: G. F. Attending Physician: Dr. T

Age: 55 Impression Diagnosis: DKA, Hypovolemic Shock 2º to AGE
with severe dehydration, DM II, HCVD
Name of Drug Dosage, Mechanism of Indication Adverse Special Nursing
Route, Action Reactions Precautions Responsibilities
Frequency,
Timing
Generic: Dosage: 4.5 By binding to Indicated for CNS: seizure, Consideration Before drug
Piperacillin- gm specific patient’s infection as confusion, should be administration:
Tazobactam penicillin-binding evidenced by dizziness, given to Verify the physician’s
Route: IV proteins (PBPs) -AGE headache, official order, ensure right
insomnia,
located inside the -WBC of 12.3 × guidance on medication, dosage,
lethargy. 
Brand: Pipracil bacterial cell 109/L the route, patient, time,
Frequency: wall, Piperacillin -Pus cells- 2-4 GI: pseudomemb appropriate assessment, approach,
q6h inhibits the third -RBC- greater than ranous use of prescription, handling,
ANST (-) and last stage of 100 colitis, diarrhea, antibacterial discard, storage,
bacterial cell wall constipation, agents. explanation, order,
Timing: synthesis. Cell drug-induced chart, universal
hepatitis, nausea,
4 AM-10 lysis is then precautions.
vomiting. 
AM- 4 PM- mediated by
10 PM bacterial cell wall GU: interstitial Perform hand hygiene.
autolytic enzymes nephritis. 
such as Dilute the Piperacillin-
autolysins; it is Derm: rashes Tazobactam 4.5 gm in
possible that urticaria.  20 cc of sterile for
Piperacillin dilution.
Hemat: bleeding,
interferes with an leukopenia, During drug
autolysin neutropenia, administration:
inhibitor. thrombocytopenia Introduce yourself and
.  verify the client’s
Piperacillin is a identity.
penicillin Local: pain, phle
bitis at IV site. 
antibiotic Perform hand hygiene.
combined with Misc:
tazobactam to superinfection Check the IV’s line
treat piperacillin- patency prior to
Classification resistant, Contraindications Side Effects administration.
Therapeutic piperacillin/tazob History of allergic rash
class: Antibiotics actam susceptible, reactions to any of itching Infuse 50 cc of PNSS to
β-lactamase the penicillins, difficulty the soluset and add the
Pharmacologic generating strains cephalosporins, or breathing or 4.5 gm in 20 mL of
class: beta- of several β swallowing Piperacillin-Tazobactam
lactamase bacteria. -lactamase inhibitors. wheezing to it.
severe diarrhea
inhibitor
(watery or bloody
. stools) that may Clean the IV site, infuse
occur with or the medication and let it
without fever and run for 30 minutes.
stomach cramps
(may occur up to After drug
2 months or more administration:
after treatment)
Perform hand hygiene

Watch for seizures;

notify physician
immediately if patient
develops or increases
seizure activity.

Monitor signs of
pseudomembranous
colitis, including
diarrhea, abdominal
pain, fever, pus or
mucus in stools, and
other severe or
prolonged GI problems
(nausea, vomiting,
heartburn). Notify
physician immediately
of these signs.

Monitor signs of
allergic reactions and
anaphylaxis, including
pulmonary symptoms
(tightness in the throat
and chest, wheezing,
cough dyspnea) or skin
reactions (rash, pruritus,
urticaria). Notify
physician immediately
if these reactions occur.

Assess muscle aches

and joint pain
(arthralgia) that may be
caused by serum
sickness. Notify
physician if these
symptoms seem to be
drug-related rather than
caused by
musculoskeletal injury,
or if muscle and joint
pain are accompanied
by allergyc-like
reactions (fever, rashes,
etc.)

Patient Teaching
Use this medicine for
 Name of Patient: G. F. Attending Physician: Dr. T
Age: 55 Impression Diagnosis: DKA, Hypovolemic Shock 2º to AGE
with severe dehydration, DM II, HCVD
Name of Drug Dosage, Mechanism of Action Indication Adverse Special Nursing
Route, Reactions Precautions Responsibilities
Frequency,
Timing
Generic: Dosage: Tranexamic acid is a Indicated for patient DOB, severe Caution for Before drug
Tranexamic 500 mg synthetic derivative of since the patient has headache, slurred patients with administration:
Acid the amino acid lysine AGE and black tarry speech, balance hypersensitivity Verify the
problem, chest reaction to the
Route: IV and binds the 5 lysine stool physician’s
pain, sudden drug. Take this
Brand: binding sites on cough, wheezing, medicine only order, ensure
Cyklokapron plasminogen. This hypersensitivity, as directed by right medication,
Frequency inhibits plasmin DVT, problems the doctor. Do dosage, route,
: q8h formation and displaces with vision, and not take more patient, time,
plasminogen from the sudden numbness of it, do not assessment,
Timing: fibrin surface. It may or weakness take it more approach,
often, and do
6 PM- 2 also directly inhibit prescription,
not take it for a
Classification AM- 10 plasmin and partially Contraindications Side Effects longer time handling,
Therapeutic AM inhibit fibrinogenolysis Women who are using red, peeling or than the doctor discard, storage,
class: at higher concentrations. combination hormonal blistering skin, ordered. To do explanation,
Antifibrinolytic contraception rash, hives, so may increase order, chart,
itching, swelling the chance of universal
containing an estrogen
Pharmacologic and a progestin. of the face, side effects. precautions.
class: amino Known allergy to throat, tongue,
acids TXA, intracranial lips, eyes, hands, During drug
feet, ankles, or
bleeding, known administration:
lower legs,
defective color vision, hoarseness, Introduce
history of venous or difficulty yourself and
arterial breathing or verify the
thromboembolism, or swallowing client’s identity
active thromboembolic
disease. Perform hand
hygiene.

Stabilize IV
catheter to
minimize
thrombophlebitis
. Monitor site
closely.

After drug
administration:
Remove gloves
and perform
hand hygiene

Reassess
patient’s vital
signs particularly
BP and HR for
sudden drop or
rise.

Evaluate
patient’s
response to
treatment and
watch out for
hypersensitivity
reactions.

Notify physician
of positive
Homans’ sign,
leg pain
hemorrhage,
edema,
hemoptysis,
dyspnea, or chest
pain.

Monitor platelet
count and
clotting factors
prior to and
periodically
throughout
therapy in
patients with
systemic
fibrinolysis.

Patient
Teaching:
Instruct patient
to notify the
nurse
immediately if
bleeding recurs
or if
thromboembolic
symptoms
develop.

Caution patient
to make position
 Name of Patient: G. F. Attending Physician: Dr. T
Age: 55 Impression Diagnosis: DKA, Hypovolemic Shock 2º to AGE
with severe dehydration, DM II, HCVD
Name of Dosage, Mechanism of Indication Adverse Special Nursing
Drug Route, Action Reactions Precautions Responsibilities
Frequency
Timing
Generic: Dosage: 1 The main Sodium bicarbonate is Metabolic Do not take this Before drug
NaHCo3 tab therapeutic effect used for the treatment of alkalosis. medicine if the administration:
(Sodium of sodium the patient’s diabetic Headache. patient has any Verify the physician’s
Bicarbonate) Route: PO bicarbonate ketoacidosis and severe Muscle pain and signs of order, ensure right
administration diarrhea which is often twitching appendicitis (such medication, dosage,
Brand: Rhea is increasing accompanied by a as stomach or route, patient, time,
Sodium Frequency: plasma significant loss of lower abdominal assessment, approach,
bicarbonate TID bicarbonate bicarbonate. pain, cramping, prescription,
levels, which are bloating, soreness, handling, discard,
Classification Timing: 6 known to buffer Contraindications Side Effects nausea, or storage, explanation,
AM- 12 excess hydrogen vomiting). Do not order, chart, universal
Therapeutic Contraindicated in swelling
PM- 6 PM ion concentration, take this medicine precautions.
class: patients who are losing hands/ankles/
thereby raising with large
Alkalinizing chloride by vomiting or feet, 
solution pH to amounts of milk Perform hand
Agent from continuous unusual weight
combat clinical or milk products. hygiene.
gastrointestinal suction, gain.
manifestations of
Pharmacolog and in patients receiving
acidosi During drug
ic class: diuretics known to
administration:
Alkalinizing produce a
Introduce yourself
Agent hypochloremic alkalosis
and verify the client’s
.
identity

Perform hand hygiene

Instruct the patient to

 drink the medication
with water.

After drug
administration:
Remove gloves and
perform hand hygiene

Monitor fluid balance

(input-output ratio,
weight, edema).

Reference/s: Anonymous (2023). Mims. Retrieved from https://www.mims.com/

Comerford, K. C., & Durkin, M. T. (2021). Nursing 2021 drug handbook. 41st edition. Philadelphia, Wolters Kluwer.