Drugs !rand Na"e# Lanoxin Generic Na"e# Digoxin Classification# Cardiotonic Cardiac glycoside Dose# 0.

25mg x 3 $oute# IV %re&aration# Give undiluted or diluted in fourfold or greater volume of sterile water for in ection! 0."# sodium c$loride in ection! 5# dextrose in ection. %se diluted &roduct &rom&tly. Do not use if solution still &reci&itates. Infusion# In ect slowly over 5 min. or longer. Inco"&atibilit'# Do not mix wit$ do'utamine. (re)uenc'# (very ) $ours Date *rdered#

Indication (General) *eart failure +trial fi'rillation

Action Client-based Increases intracellular calcium and allows more calcium to enter t$e myocardial cell during de&olari,ation via a sodium&otassium &um& mec$anism. t$is increases force of contraction /&ositive inotro&ic effect0! increases renal &erfusion! decreases $eart rate /negative c$ronotro&ic effect0! and decreases +V node conduction velocity.

Side Effect(s) and Adverse Effect(s) Side Effects anxiety! 'lurred or yellow vision! confusion! di,,iness! de&ression! feeling of not caring! $eadac$e! loss of a&&etite! $allucinations! or wea1ness diarr$ea! loss of a&&etite! lower stomac$ &ain! nausea! or vomiting irregular or slow $eart'eat! &al&itations /feeling of &ounding in t$e c$est0! or fainting Adverse Effects CNS# *eadac$e! wea1ness! drowsiness! visual distur'ances! mental status c$ange C+# +rr$yt$mias GI# GI u&set! anorexia

Nursing Considerations/ Health eachings Nursing considerations Assess"ent *istory2 +llergy to cardiac glycosides! ventricular tac$ycardia! ventricular fi'rillation! $eart 'loc1! sic1 sinus syndrome! I*33! acute 4I! renal insufficiency! decreased 56! decreased 4g26! increased Ca26! &regnancy lactation. 7$ysical2 8eig$t. orientation effect! affect! reflexes! vision. 7! 97! 'aseline (CG! cardiac auscultation! &eri&$eral &ulses! &eri&$eral &erfusion. edema! : adventitious sounds. a'dominal &ercussion! 'owel

;2<3<;3

sounds! liver evaluation. urinary out&ut. electrolyte levels! L=>s! renal function tests. Interventions 4onitor a&ical &ulse for ; min 'efore administering. $old dose if &ulse rate is lower t$an ?0 'eats<min in adult. reta1e &ulse in ; $r. If adult &ulse remains lower t$an ?0 'eats<min! $old drug and notify t$e &rescri'er. @ote any c$ange from 'aseline r$yt$m or rate. +void giving wit$ meals. ta1ing t$is drug wit$ food will delay a'sor&tion and alter drug &$armaco1inetics. eaching &oints :e&ort slow or irregular &ulse! ra&id weig$t gain! loss of a&&etite!

!rand Na"e# Ainacef Generic Na"e# Cefuroxime sodium Classification# +nti'iotic Ce&$alos&orin /second generation0 Dose# B50mg $oute# IV %re&aration# 7re&aration of &arenteral drug solutions and sus&ensions differs for different 'rand names. c$ec1 t$e manufacturerCs directions carefully. :econstitute &arenteral drug wit$ sterile water for in ection! D58! D."# sodium c$loride in ection! 5# or ;0#

Lower res&iratory infections caused 'y 3. 7neumonia! 3. +ureus! (. Coli! 5le'siella &neumonia! *. Influen,a! 3. &yogenes Dermatologic infections caused 'y 3. +ureus! 3. 7yogenes! (. Coli! 5. 7neumonia! (ntero'acter %>Is caused 'y (. Coli! 5. 7neumonia %ncom&licated and disseminated gonorr$oea caused 'y @. Gonorr$oeae 3e&ticemia caused 'y 3. 7neumonia! 3. aureus! (. Coli! 5.

9actericidal2 In$i'its synt$esis of 'acterial cell wall! causing cell deat$.

Side Effects 3welling! redness! &ain! or soreness at t$e in ection site may occur. loss of a&&etite! nausea! vomiting! diarr$ea! irrita'ility! or $eadac$e. serious side effects! including2 dar1 urine! easy 'ruising<'leeding! fast<&ounding<irre gular $eart'eat! sei,ures! unusual wea1ness! yellowing eyes<s1in! mental<mood c$anges /suc$ as confusion0. Adverse Effects CNS# *eadac$e! di,,iness!

nausea! diarrea! vomiting! 'lurred or yellow vision! unusual tiredness and wea1ness! swelling of t$e an1les! legs or fingers! difficulty of 'reat$ing. Assess"ent# Histor'# *e&atic and renal im&airment! lactation! &regnancy %h'sical# 31in status! L=>s! renal function tests! culture of affected area! sensitivity tests Interventions +rrange for sensitivity tests 'efore and during t$era&y. Discontinue if $y&ersensitivity reaction occurs. eaching &oints +void alco$ol w$ile ta1ing t$is drug and for 3 days after 'ecause severe

dextrose in ection! 5# dextrose and 0.E5# or 0."# sodium c$loride in in ection! or ;<? 4 sodium lactate in ection. 3ta'ility of solutions de&ends on diluents and concentration2 C$ec1 manufacturerCs s&ecific cautions. Infusion# In ect slowly over 305 min directly into vein for IV administration! or infuse over 30 min. may 'e given 'y continuous infusion. (re)uenc'# (very ) $ours Date *rdered# ;2<3<;3

7neumonia! *. Influen,ae 4eningitis caused 'y 3. &neumoniae! *. Influen,a! 3. aureus! @. 4eningitides 9one and oint infections due to 3. aureus 7erio&erative &ro&$ylaxis >reatment of acute 'acterial maxillary sinusitis in &atients 3 mo;2 yr

let$argy! &arest$esias GI# @ausea! vomiting! diarr$ea! anorexia! a'dominal &ain! flatulence! &seudomem'rano us colitis! $e&atoxicity G,# @e&$rotoxicity He"atologic# 9one marrow de&ression /decreased 89C! decreased &latelets! decreased *ct0 H'&ersensitivit' # :anging from ras$ to ana&$ylaxis. serum sic1ness reaction -ocal# %ain. +'scess at in ection site! &$le'itis! inflammation at IV site *ther# 3u&erinfections! disulfiram-li1e

reactions often occur. 3ide effects may occur2 stomac$ u&set or diarr$ea :e&ort severe diarr$ea! difficulty of 'reat$ing! unusual tiredness or fatigue! &ain at in ection site.

reaction wit$ alco$ol