DRUG STUDY

NAME OF STUDENTS:
Sol, Andreana Maria G.
Soriano, Ashley Alyson Hnah V.
Suguitan, Godwin Allen L.
Tigno, Angelica Geanne A.
Tresmaria, Juliana Louise
Valdez, Jon Kobe I.
Viana, Jhanssen Daniel
Victoria, Sherilyn R.
Villanueva, Sophia D.

SECTION: 19
 ANTI-MICROBIAL

Case Scenario #5: Antibiotic Therapy Patient: Mr. Smith, 28-year-old male with a skin infection
Case Study: Mr. Smith presents with a skin infection and the physician prescribed amoxicillin-clavulanate
Medication: Amoxicillin-Clavulanate (Penicillin Antibiotic)

Name of client: JDC

Age and sex: 28 and Male

Date: December 5, 2023

Room No. 509

Diagnosis: Skin Infection

Prescribing doctor: Doctor John

Prepared by: Nurse Tresmaria, Juliana & Nurse Viana, Jhanssen

Therapeutic Drug Drug Example Drug Action Contraindication Adverse effect

Classification Classification/
Indication

broad-spectrum Amoxicillin/Clavul Penicillins, Amoxicillin Hypersensitivity to CNS:

antibiotic anate is a Amoxil, prevents bacterial active substances, Nausea
prescription Augmentin, cell-wall synthesis to any penicillin or Seizures
medication used to Clavulin, Moxatag, during to any of the Headache
treat the symptoms Omeclamox, replication.Clavula excipients. Hallucinations
of bacterial Prevpac, Talicia, nic acid increases Lethargy
infections such as Voquezna 14 Day amoxicillin’s History of severe
sinusitis, Dualpak 20;500, effectiveness by immediate CV:
 pneumonia, ear Voquezna 14 Day inactivating hypersensitivity to Chest pain &
infections, Triplepak beta-lactamases, another beta-lactam palpitations
bronchitis, urinary 20;500;500 which destroy agent
tract infections, and Cephalosporins, amoxicillin. GI:
infections of the Tetracyclines, History of a skin Diarrhea
skin. Aminoglycosides, infection (e.g Vomitting
Macrolides, jaundice/hepatic) Gas
Clindamycin, impairment due to Stomach and
Quinolones, amoxicillin/clavula Abdominal pain
Nitrofurantoin, nic acid
Sulfonamides & GU:
trimethoprim, and Vaginal yeast
Metronidazole & infection(itching or
tinidazole discharge)

Hypersensitivity:
Skin rash or itching
Fever
Wheezing
Anaphylaxis

Nursing Responsibilities before Administering Antibiotic (penicillin) to a patient

● Monitor vital signs closely

● determine dosage based on overall clinical condition of individual patient

Nursing Care Plan

 Nursing Considerations

Assessment Diagnosis Intervention Evaluation

● Assess bowel pattern ● Impaired Skin Integrity ● Educate the patient that ● The medication should
before and during he/she should take the be equal to the does in
treatment ● Ineffective Airway medication with or the duration to maintain
Clearance food to mitigate GI the blood levels
● Assess if the patient has symptoms
a history of allergy of ● Risk for Skin Infection ● Report to a physician if
the antibiotic ● For medication intake seizures occurred
● Fluid Volume Deficit intervals at least take in
● Laboratory test results 1 hour before or 2 ● Monitor for any skin
(CBC, renal, and ● Decreased Cardiac hours after meals infections and
hepatic function) Output side/adverse effects
● Observe for any signs
● Assess vital signs and symptoms of ● Proper dosage for adult
(respiratory status). anaphylaxis must be followed

● Observe for ● Consistently continue ● Evaluate effects of

anaphylaxis. the antibiotic therapy teaching plan
for at least 2 days after
● Ensure that the patient the signs of infection
has adequate fluid fade and if persist
intake during any continue it to a full 10
diarrhea attack days

● Check culture and

sensitivity before drugs
are given

● Monitor for bleeding

(bloody stools)
 ● Rotate the IV regularly

NEUROMUSCULAR SYSTEM

Case Scenario #9: Post-Operative Nausea Patient: Ms Thompson, a 45-year-old female with post-appendectomy
Case Study: Ms. Thompson complains of nausea after surgery
Medication: Ondansetron (5-HT3 Receptor Antagonist)

Name of client: KT

Age and sex: 45 and Female

Date: December 8, 2023

Room No. 301

Diagnosis: Post-appendectomy

Prescribing doctor: Doctor Kim

Prepared by: Nurse Sol, Andreana & Nurse Soriano, Ashley Alyson
 Therapeutic Drug Drug Example Drug Action Contraindication Adverse effect
Classification Classification/
Indication

serotonin 5-HT3 To prevent Zofran ODT, May block 5-HT₃ in Use is CNS: dizziness,
receptor postoperative Zuplenz the CNS in the contraindicated in fatigue, headache,
antagonists. nausea and chemo-receptor patients malaise, sedation,
vomiting trigger zone and in hypersensitive to extrapyramidal
the peripheral drugs. syndrome, fever,
nervous system on agitation, anxiety,
nerve terminals of ECG changes pain.
the vagus nerve. including prolonged CV: arrhythmias,
QT interval and chest pain.
torsades de pointes GI: constipation,
have been reported. diarrhea.
Avoid use in GU: gynecologic
patients with disorders, urine
congenital long QT retention,
syndrome. Monitor respiratory hypoxia.
patients carefully. SKIN: pruritus,
rash
Use cautiously in Other: chills,
patients with injection-site
hepatic impairment reaction.
 Nursing Responsibilities before Administering Ondansetron to a patient

● Open blister of ODT just before use by peeling backing off. Do not push the ODT through a foil blister.
● Protect 4-mg tablets and oral solution from light

Nursing Care Plan

Nursing Considerations

Assessment Diagnosis Intervention Evaluation

● Check any
contraindications
before administering
● Assess for any adverse
and side effects
● Monitor ECG, may
increase the risk of
prolonged QT interval
● Don't confuse
ondansetron with other
drug
● Monitor patient for
signs and symptoms of
serotonin syndrome
● Risk of allergy reaction
related to exposure to
toxic chemical
● Consider delayed
surgical recovery
related to persistent
feeling of nausea after
surgery
● Risk for surgical site
infection associated
with ineffective
antibiotic prophylaxis
● Keep the patient NPO
as ordered until the
diagnosis is completed
● Create a calm
environment in which
the patient might feel
relaxation after the
surgery which can
aggravate feelings of
nausea
● The patient must be
encouraged to drink
ginger or peppermint
tea as it is alleviating
effective remedy to
reduce the feeling of
nausea
● Analyze the success of
the evaluation that was
done to determine the
degree of postoperative
nausea and provide
direction for the
necessary treatments.
This entails evaluating
the patient's symptoms,
Ondansetron therapy
response, and any
negative side effects
● Evaluate the efficacy of
Ondansetron in treating
Ms. Thompson's nausea
following surgery. This
entails assessing the
alleviation of
symptoms and any
 ● Foods must have less
odor and not be strong
enough as they trigger
the throat for nausea
and vomiting
● Educate the patient
regarding alternate
ways to ease the
discomfort (e.g.
listening to music,
deep-breathing
exercises, meditation,
checking out
mesmerizing scenery,
and others)
negative drug reactions.
● Assess the efficacy of
the interventions and
the safety of Ms.
Thompson by
evaluating the ongoing
monitoring of her
response to the
medication. This
involves keeping an
eye out for any
indications of symptom
persistence or
improvement

● Consult to a general
physician or
gastroenterologist if
nausea persists more

IMMUNE SYSTEM

Case Scenario #10: Allergic Reaction: Patient Mr. Hernandez, 30-year-old male with a history of penicillin allergy
Case Study: Mr. Hernandez is admitted with a severe infection requiring antibiotic
Medication: Ceftriaxone (Third-Generation Cephalosporin Antibiotic)
 Name of client: JJH

Age and sex: 30 and Male

Date: December 10, 2023

Room No. 301

Diagnosis: Penicillin Allergy

Prescribing doctor: Doctor John

Prepared by: Nurse Suguitan, Godwin & Nurse Valdez, Jon Kobe

Therapeutic Drug Drug Example Drug Action Contraindication Adverse effect

Classification Classification/
Indication

Antibiotics Third-generation Avycaz Inhibits cell wall Contraindicated in GI:

cephalosporins Cedax synthesis, patients pseudomembranous
Cefdinir promoting osmotic hypersensitive to colitis, diarrhea
Cefditoren instability; usually drug or other Hematologic:
Cefixime bactericidal. cephalosporins. eosinophilia,
Cefizox thrombocytosis,
Cefotaxime to reduce leukopenia
Cefpodoxime development of Skin: pain,
Ceftazidime drug-resistant induration,
Ceftazidime/avibact bacteria and tenderness at
am maintain injection site, rash.
Ceftibuten effectiveness of Other:
Ceftizoxime antibacterial drugs, hypersensitivity
Ceftriaxone use drugs only to reactions, serum
Claforan treat or prevent
 Fortaz infections proven or sickness,
Rocephin strongly suspected anaphylaxis.
Spectracef to be caused by
Suprax bacteria.
Tazicef
Tazidime
Vantin

Nursing Responsibilities before Administering Ceftriaxone to a patient

● Before giving drug, ensure patient isn't

● allergic to penicillins or cephalosporins.
Obtain specimens for culture and sensitivity tests before giving the first dose. Begin ther-apy while awaiting results.
● Reconstitute the drug with sterile water for injection, NSS for injection, Ds W, or a combination of NSS and dextrose
injection and other compatible solutions.
● Add 2.4 mL of diluent to the 250-mg vial,
● 4.8 mL to the 500-mg vial, 9.6 mL to the vial, and 19.2 mL to the 2-g vial, Al reconstituted solutions average 100 mg/mL.
● For intermittent infusion, dilute further to achieve desired concentration, and give over30 minutes.
● Diluted IV preparation is stable for 48 hours at room temperature or 10 days if refrigerated
Alert: Don't mix or administer ceftriaxoneone with calcium-containing IV solutions,
including parenteral nutrition.
● Incompatibilities: Aminoglycosides aminophylline, azithromycin, calcium-containing solutions, clindamycin phosphate,
fîlgrastim, fluconazole, gentamicin, labetalol, linezolid, pentamidine, theophylline, vancomycin, vinorelbine tartrate.
 Nursing Care Plan

Nursing Considerations

Assessment Diagnosis Intervention Evaluation

● Check any ● Consider risk for ● Assess for drug allergy ● Examine Mr.
contraindications infection related to from penicillin and Hernandez for any
before administering inadequate knowledge notify the physician allergies or prior
to avoid exposure to responses to antibiotics,
● Assess for any adverse pathogens ● Monitor the bowel especially penicillin, in
effect movement of the order to determine the
● Risk for adverse patient daily and its best course of
● Monitor any allergic reaction to iodinated stool consistency. treatment.
reaction contrast media related
to a history of allergy, ● Instruct the patient to ● Assess how well the
● Check how the patient specifically with take food for the drug—Ceftriaxone,
responds to the current use of nephrotic medication, if diarrhea works to treat the
medication medication such as persists report to the infection and prevent
cephalosporins attending physician and allergic reactions. This
● Don't confuse drugs force stop the entails evaluating the
with other medication decrease in illness
cephalosporins that immediately. symptoms as well as
sound alike any drug side effects.
● Monitor WBC counts
culture and PT of the ● Constant Monitoring of
patient his vital signs and how
he responds to the
● Report any signs of medication. This
bleeding involves keeping an

● Tell the patient to
report any adverse
reactions promptly and
discomfort at the IV
insertion site
CARDIOVASCULAR SYSTEM
Case Scenario #13: Anticoagulation in Atrial Fibrillation: Patient Ms. Johnson, 70-year-old female with atrial fibrillation
Case Study: Ms. Johnson requires anticoagulation to prevent stroke
Medication: Levetiracetam (Antiepileptic Drug)
Name of client: HAJ
eye out for any
indications of symptom
persistence or
improvement.
● Assess how well Mr.
Hernandez and his
family were taught how
to manage allergic
reactions, including
how to administer
medications, spot early
warning signs, and take
preventative steps to
lower the likelihood of
allergic reactions.
 Age and sex: 70 and Female

Date: December 8, 2023

Room No. 301

Diagnosis: Atrial Fibrillation

Prescribing doctor: Doctor Jung-min

Prepared by: Nurse Viana, Jhanssen

Therapeutic Drug Drug Example Drug Action Contraindication Adverse effect

Classification Classification/
Indication

Anticonvulsants Thyroid Products Synthroid, Levoxyl, Selectively inhibits In patients CNS: asthenia,
(control L Thyroxine, Levo factor Xa, hypersensitive to headache,
partial-onset T, Levothroid, decreasing drugs. somnolence,
seizures) Levothyroxine T4, thrombin amnesia, anxiety,
Levoxine, Tirosint, generation and Don't use ataxia, depression,
and Unithroid. thrombus extended-release dizziness,
development. form in patients emotional lability,
with ESRD hostility,
nervousness,
Anaphylaxis and paresthesia, pain,
angioedema may vitiligo,
occur after the first hypersomnia,
dose or at any time irritability,
during treatment. insomnia,
confusion, falls,
 Use cautiously in sedation, abnormal
patients with a gait, incoordination
history of EENT: diplopia,
psychiatric conjunctivitis, ear
symptoms, pain, rhinitis,
especially psychotic sinusitis, nasal
symptoms and congestion,
behaviors. pharyngitis
GI: anorexia,
Serious skin vomiting, upper
reactions, including abdominal pain,
toxic epidermal diarrhea,
necrolysis and SJS, constipation,
have been reported. gastroenteritis.
Recurrence Hematologic:
following leukopenia,
rechallenge is neutropenia
possible. Respiratory:
Discontinue drug cough
for hypersensitivity Skin: contusion
reaction or Other: infection,
unspecified rash. head injury, flu like
symptoms
Don't abruptly
discontinue drugs
because withdrawal
seizures may occur.

Nursing Responsibilities before Administering Levetiracetam to a patient

● Give drugs without regard for food.
● Oral and IV forms are bioequivalent.
● Tablets should be swallowed whole and shouldn't be chewed, broken, or crushed.
● Tablets for oral solution are intended to disintegrate in the mouth. Place the tablet on tongues with a dry hand. Follow with a
sip of liquid and have the patient swallow only after tablet disWear rada hole tablet to a small volume liquid in a cup ( 1
tablespoon or enough to cover tablet); allow tablet to disperse, then hare patient immediately consume entire con-rents. Don't
give partial tablets.
● Don't push tablets for oral solution through the folipel foil from blister by bending up and ing pel tab around the blister seal.
● For children weighing more than 20 kg, use either tablets or oral solution. For children weighing 20 kg or less, use oral
solution.

Nursing Care Plan

Nursing Considerations

Assessment Diagnosis Intervention Evaluation

● Check any ● Consider risk of ● Hemodynamic stability ● Assess the efficacy of

contraindications
before administering
● Monitor any adverse
effect
● Check how the patient
responds to the
medication
● Check for any allergic
aspiration
● Ineffective breathing
pattern related to
hyperventilations
● Risk for impaired tissue
integrity related to
secretions
and risk reduction are
vital components of
atrial Fibrillation care.
Immediate
cardioversion is
important to come first
and is given with
anticoagulant
medication when the
patient is unstable.
the assessment used to
determine the severity
of atrial fibrillation and
guide appropriate
interventions
● Assess Ms. Johnson's
response to
Levetiracetam and
monitor for any adverse
reactions
 reaction ● To restore the heart
rhythm, the ● Evaluate the efficacy of
● Assess the patient's cardioversion applies anticoagulation therapy,
sign and symptom of electric shocks to the including
seizures and epilepsy heart through Levetiracetam, in
electrodes on the chest. treating Ms. Johnson's
On the other hand, drug atrial fibrillation and
cardioversion preventing stroke.
administers medication
orally or intravenously ● Constant Monitoring of
to revamp the heart’s her vital signs and how
rhythm. she responds to the
medication. This
● Place the patient in an includes monitoring for
upright position so that any signs of
he/she can breathe improvement or
easily. persistence of
symptoms
● Refer the patient to the
cardiac rehabilitation ● Provide assistance to
Ms. Johnson and her
● Consider putting a family, empowering
pacemaker if irregular them to actively engage
heart rhythm occurs in managing her atrial
fibrillation and
● Monitor the fluid recognizing early signs
volume and limit it as of exacerbation.
the heart may reduce
workload.
 REPRODUCTIVE SYSTEM

Case Scenario #18: Hypothyroidism Treatment Patient: Ms Garcia 60-year-old female with hypothyroidism
Case Study: Ms. Garcia is prescribed levothyroxine for her thyroid condition
Medication: Levothyroxine (Synthetic Thyroid Hormone Drug)

Name of client: MLG

Age and sex: 60 and Female

Date: December 11, 2023

Room No. 301

Diagnosis: Thyroid condition

Prescribing doctor: Doctor Romeo

Prepared by: Nurse Tigno, Angelica, Nurse Victoria, Sherilyn, & Nurse Villanueva, Sophia

Therapeutic Drug Drug Example Drug Action Contraindication Adverse effect

Classification Classification/
Indication

Thyroid hormone Levothyroxine, a Eltroxin, Ermeza, The synthetic form In patients CNS: insomnia,
replacements synthetic thyroid Euthyrox, Levo-T, of thyroxine that hypersensitive to tremor, headache,
hormone (T4), is Levothroid, affects the growth drugs and in those fever, fatigue,
essential for Levoxyl, Np of tissues, energy with acute MI
treating Thyroid, Synthroid, expenditure, and uncomplicated by anxiety, emotional
hypothyroidism, Thyquidity, the turnover of all hypothyroidism, lability.
and relieving Tirosint, Unithroid substrates. untreated CV: tachycardia,
symptoms such as subclinical or overt cardiac arrest,
fatigue and weight thyrotoxicosis, HTN, HF, MI.
gain. It also aids in uncorrected adrenal GI: diarrhea,
preventing thyroid insufficiency, or vomiting,
cancer recurrence hypersensitivity to abdominal cramps.
after surgery and glycerol (Tirosint Metabolic: weight
managing related oral solution) loss, increased
disorders. Strict appetite
adherence to Don’t use either Musculoskeletal:
prescribed dosages alone or with other decreased bone
is crucial for therapeutic agents density, muscle
maintaining optimal for treatment of weakness, tremors.
thyroid function. obesity or for Respiratory:
weight loss. dyspnea
Skin: allergic skin
Doses beyond the reactions,
range of daily diaphoresis, hair
hormonal loss.
requirements may Other: heat
produce serious or intolerance,
even impaired fertility
life-threatening
toxicities,
especially if given
with
sympathomimetic
amines.
 Nursing Responsibilities before Administering levothyroxine to a patient

● Do not Crush. Break or allow patient to chew capsules

● Give drug at the same time each day on an empty stomach, preferably ½ hours before breakfast
● Give drug at least 4 hours before or after drugs known to interfere levothyroxine

Nursing Care Plan

Nursing Considerations

Assessment Diagnosis Intervention Evaluation

● Check any
contraindications
before administering
● Monitor for any
adverse effect
● Assess and perform a
blood test
● Check how the patient
responds to the
medication
● Consider risk for
infection related to
impaired skin integrity
● Risk for frail elderly
syndrome related to
decreased muscle
strength
● Consider fatigue related
to depressive symptoms
● Remind the patient to
take their meals before
taking levothyroxine
medication
● Educate the patient to
get enough sleep and
rest
● Provide the patient with
extra blankets if he/she
feels cold
● Examine the efficacy of
the medication used to
treat Ms. Garcia's
hypothyroidism, such
as Levothyroxine. This
includes assessing the
reduction in symptoms
as well as any adverse
drug reactions
● Assess the
effectiveness of Ms.
Garcia's thyroid
 ● Prevent the patient
● Assess skin lesions and from heat exposure
skin color externally
● Assess their cognitive, ● Encourage the patient
physical, and to take enough amount
psychological condition of fluids or even more
at once
● Assess the family's
● Monitor the patient’s
respiratory rate, pattern,
pulse rate, and ABG
● If the patient is stable
and can respond. Orient
them with the
surroundings if they
can follow to promote
cognitive
● Assist Ms. Garcia and
hormone levels and
response to medication.
This includes keeping
an eye out for any signs
of improvement or the
persistence of
symptoms
comprehension and
application on
hypothyroidism
management, including
the use of
Levothyroxine,
recognizing early
warning signs, and
implementing lifestyle
changes to reduce the
frequency and severity
of symptoms
her family by
empowering them to
actively manage her
hypothyroidism and
recognize early signs of
exacerbation
 References:

Belleza, M., RN. (2023, July 21). Hypothyroidism. Nurseslabs.

https://nurseslabs.com/hypothyroidism/

Levetiracetam: MedlinePlus Drug information. (n.d.).

https://medlineplus.gov/druginfo/meds/a699059.html

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2021). Nurse's Pocket Guide Diagnoses, Prioritized Interventions, and Rationales
(Sixteenth Edition ed.). F.A. Davis Company. ISBN 9789746523516
Levothyroxine: generic, uses, side effects, dosages, interactions, warnings. (2021b, August 6). RxList.
https://www.rxlist.com/levothyroxine/generic-drug.htm?fbclid=IwAR2U2S7OF2Y-rqxf4FlSeAkLnXtmnidzPA3Q6SbUPSRyr
62MdvqK0_zsx5s
Nurses Note. (2021, November 12.). Ceftriaxone: Uses Action Side Effect Administration by Nursing Jobs Exam.
https://nursingjobsexam.com/ceftriaxone-uses-action-side-effect-administration-by-nursing-jobs-exam/
RxList. (2022, June 20). Amoxicillin/Clavulanate: infections, uses, side effects, dosages, interactions, warnings.
https://www.rxlist.com/amoxicillin_clavulanate/generic-drug.htm
Salvador, K. (2023, October 13). Hypothyroidism: Nursing Diagnoses & Care Plans. NurseTogether.
https://www.nursetogether.com/hypothyroidism-nursing-diagnosis-care-plan/

Salvador, K. (2023, March 17). Atrial Fibrillation: Nursing Diagnoses, Care Plans, Assessment & Interventions. NurseTogether
https://www.nursetogether.com/atrial-fibrillation-nursing-diagnosis-care-plan/

Wagner, M. (2023, July 29). NurseTogether. Nausea & Vomiting: Nursing Diagnoses & Care Plans.
https://www.nursetogether.com/nausea-nursing-diagnosis-care-plan/