Copydrugstudy 03

VIII.
DRUG STUDY
A. Generic Name: Cefuroxime

Classification: Antibiotics
Dosage, Route and Frequency: 750 mg IV every 8 hours
Mechanism of Action: Inhibits DNA-dependent RNA polymerase activity in
susceptible bacterial cells, thereby suppressing RNA
synthesis in bacterial cells, decreasing their numbers.
Desired Effect: This drug was given to the client to serve to address
infection and as prophylaxis to the occurrence opportunistic
infection.
Date Ordered: June 29, 2006
Nursing Responsibilities Rationale

1. Test for sensitivity of the patient To avoid adverse reactions related
to the drug by skin testing. to hypersensitivity.
2. To observe the 10 R’s in drug To potentiate the effects of the

administration. drug.
3. Instruct the patient to maintain To prevent the occurrence of other

proper personal hygiene, have infection.
enough rest and sleep.
4. Encourage patient to eat foods To help the client’s body recover
rich in protein and vitamins from the disease.
5. Check for the patency of the IV To be sure the drug really gets into
line before the administration of the vein.
the drug.
6. Administer the drug slowly. Antibiotics are known to be painful
during IV administration.
7. Do not interrupt prescribed Hepatorenal reaction with flu-like
dosage regimen. syndrome has occurred when
therapy has been resumed following
interruption.
B. Generic name: Paracetamol
Classification: Antipyretic, Analgesic (nonopioid)
Mode of Action: Antipyretic: Reduces fever by acting directly on the
hypothalamic heat-regulating center to cause vasodilation
and sweating, which helps dissipate heat.
Analgesic: Site and mechanism of action unclear
Dosage, Route, Frequency: 350 mg, IV, every 4 hours
Date Ordered: June 29, 2006

1. Check the doctor’s order To protect self from illegal actions
2. Observe the 10 R’s To make the treatment regimen
before administration effective
3. Assess patient for hepatic To render appropriate nursing
function, chronic interventions
alcoholism, skin color,
lesions
4. Give drug with food. Drug may cause GI upset.
5. Avoid the use of other They may contain acetaminophen,
over-the-counter and serious overdosage can occur.
preparations.
6. Instruct patient to report To render appropriate nursing
occurrence of rash, unusual actions.
bleeding or bruising,
yellowing of skin or eyes,
changes in voiding patterns.
7. Treatment of overdose: As a specific antidote; basic life
Monitor serum levels support measures may be
regularly, N-acetylcysteine necessary.
should be available
C. Generic Name: Metronidazole

Classification: Local Anti-infectives
Mode of action: It binds with DNA, resulting in loss of helical structure,
strand breakage, inhibition of nucleic acid synthesis and cell
death.
Dosage, Route, Frequency: 500mg, IV, every 6 hours
Desired Effect: This drug was given as adjuvant with cefuroxime to
serve as a prophylaxis to the occurrence of opportunistic
infection.
Date ordered: June 30, 2006

1. Check the doctor’s order To protect self from illegal actions.
before administration effective.
3. Do skin testing. To avoid occurrence of
anaphylactic shock.
4. Note any previous To avoid occurrence of
sensitivity to any anti- anaphylactic shock.
biotics.
5. Arrange for culture and To avoid false negative result of
sensitivity tests before culture and sensitivity testing.
beginning therapy.
6. Check IV patency prior to To prevent phlebitis and tp prevent
administration and painful administration.
administer slowly.
7. Caution patient to One of the side effects of drug is
change position slowly. dizziness’
8. Inform the patient To anticipate the side effects of

that such side effects may drugs, thus knowing to notify
occur- nausea, abdominal physician if such effects occur.
discomfort, constipation,
anorexia, skin irritation and
urticaria.
9. Inform patient that To anticipate the side effects of
medication may cause drugs, thus knowing to notify
urine to dark. physician if such effects occur.
10. Do not use Needles will turn orange or rust.
aluminum needles in
administering the drug.
11. Have regular To maintain the therapeutic serum
dosing. levels.
12. Store at room To potentiate drug action.
temperature.
13. Monitor clinical To guarantee effectively of
responses, if no treatment.
improvement is seen or a
relapse occurs, repeat
culture and sensitivity test.
A. Generic Name: Albuterol (Salbutamol)

Brand Name: Ventolin
Classification: Bronchodilator
Dosage, Route and Frequency: 1 neb every 8 hours
Mechanism of Action: Relaxes bronchial and vascular smooth muscle by
stimulating beta - 2 receptors, increasing airway, promoting airway
clearance.
Desired Effect: This drug was given to our client since it is a bronchodilator
drug used to facilitate expectoration of secretions.

1. Check Doctor’s Order To protect self from illegal actions.
effective.
3. Teach patient to perform oral To guarantee effectivity of
inhalation correctly. treatment and promote
 Clear nasal independence.
passages and
throat.
 Breathe out,
expelling as much
air from lungs as
possible.
 Place mouthpiece
well into mouth as
dose from inhaler
is released, and
inhales deeply.
 Hold breath for
several seconds,
and exhale slowly.
4. Tell patient to wash inhaler To prevent the accumulation of
every after used. microorganisms in the inhaler while
not in use.
5. Do bronchial clapping after To promote expectoration of
nebulization. secretions through vibration
B. Generic Name: Cefuroxime

Dosage, Route and Frequency: 300 mg IV every 8 hours
Mechanism of Action: Inhibits DNA-dependent RNA polymerase activity in
susceptible bacterial cells, thereby suppressing RNA synthesis in
bacterial cells, decreasing their numbers.
Desired Effect: This drug was given to my client primarily as adjuvant with
metronidazole agent in initial treatment of AGE as well as serve as a
prophylaxis to the occurrence of opportunistic infection.
1. Test for sensitivity of To avoid adverse reactions related
the patient to the to hypersensitivity.
drug by skin testing.
the drug.
7. Do not interrupt prescribed Hepatorenal reaction with flu-like
dosage regimen. syndrome has occurred when
therapy has been resumed following
interruption.
C. Generic Name: Metronidazole

Dosage, Route and Frequency: 125mg/5ml, 5ml every 8 hours
Mechanism of Action: Interferes with cell wall replication of susceptible
organism; osmotically unstable cell wall swells, bursts from osmotic
pressure
Desired Effect: This drug was given to treat the infection caused by the
trophozoite as well as serve as a prophylaxis to the occurrence of
opportunistic infection.
2. Test for sensitivity of To avoid adverse reactions related
the patient to the to hypersensitivity.
drug by skin testing.
the drug.
Generic Name: Penicillin G Sodium

Brand Name:
Classification: Anti-infective drug
Dosage: 400,000 “u”
Frequency: every 6 hours ANST (-)
Route: IV through Heplock
Mechanism of Action:
Bind to cellular receptor proteins and inhibit the action of enzymes necessary for formation of cell wall
peptidoglycans, substances necessary for rigidity of the bacterial cell wall; thus, cells becomes osmotically
unstable and the high internal pressure causes swelling and lysis of the bacterial cells. It is most effective during
active cellular multiplication.
Desired Effect: This drug is given to our client to serve as a prophylaxis ans as treatment against infection.
Side Effects:
Nausea, epigastric distress, dry mouth, abnormal taste
Adverse Effect:
Hypersensitivity: severe reactions (wheezing, laryngeal edema, macropapular rash, serum sickness,
exfoliative dermatitis, erythema multiforme, arthralgia, prostration, anaphylaxis)
GI:, vomiting, , glossitis, stomatitis, , “hairy” tongue, diarrhea, flatulence, enterocolitis (due to secondary
microbial overgrowth), abdominal pain, GI bleeding pseudomembranous colitis.
GU: interstitial colitis, nephropathy
CNS: neuropathy, seizures, lethargy, hallucinations, anxiety, confusion, agitation, depression, dizziness,
fatigue.
Hematologic: hemolytic anemia, leucopenia, thrombocytopenia, agranulocytosis, anemia, eosinophilia.
CV: heart failure, thrombophlebitis.
Muskuloskeletal: arthralgia.
Others: pain and irritation at the injection site, phlebitis, overgrowth of nonsusceptible organisms.
Nursing Responsibilities:
1. Check Doctor’s orders and therapeutic sheet to avoid error in giving the drug.
2. Inform client about the procedure (skin testing) and the purpose of the drug to gain his cooperation and to
increase his awareness.
3. Do skin testing aseptically to check hypersensitivity to the drug.
4. Assess and record baseline data necessary for detection of adverse effects of penicillin derivatives.
5. Prepare the drug aseptically to prevent the introduction of microorganisms.
6. Check the patency of the heplock for infiltration before administration.
7. Administer the drug slowly to prevent vein irritation.
8. Monitor drug reaction after administration of first dose.
9. Use cautiously in client with other drug allergies, especially to cephalosphorins, because of possible cross
allergenicity.
10. Administer penicillins on schedule to ensure stable steady-state concentrations for the duration of therapy.
11. Provide ready access to bathroom and interventions directed at symptom relief if diarrhea occurs.
12. Monitor parenteral administration site for signs of local drug reaction.
13. Observe patient closely. With large doses and prolonged therapy, bacterial or fungal superinfection may
occur.
14. Inform client that stomatitis, upset stomach, nausea, vomiting, diarrhea, and discomfort at injection sites are
typical side effects.
15. Encourage client to eat nutritious foods to boost immune system.
16. Encourage the client to have enough sleep and rest.
17. Educate the client and parents about the different side and adverse effects of the drug and encourage them
to report if they occur.
Generic Name: Iron+Vitamin B Complex

Brand Name: Incremin
Classification: Anti-anemic + Vitamins (Nutritional)
Dosage: 7.5 ml
Frequency: OD
Route: Oral
Ferrous Sulfate provides elemental iron, an essential component in the formation of hemoglobin. Vitamin
B1, B6, and B12 are essential in the synthesis, degradation and utilization of carbohydrates, amino acids and
fats. Vitamins B1, B6, and B12 participate in the detoxification process by facilitating reduction of toxic
metabolites.
Side Effects:
Nausea, constipation, black stools
Adverse Effects:
Skin: itching, transitory exanthema, urticaria
GI: epigastric pain, vomiting, , diarrhea, anorexia, hemorrhage
Other: anaphylaxis, angioedema,
Desired Effect: This drug is given to the client to treat his anemia.
1. Tell client and caregiver to take drug with juice (preferably orange juice) or water, but not with milk or
antacids to facilitate absorption.
2. GI distress may be related to dose. Between-meal doses are preferable, but can be given with some foods,
although absorption may be decreased.
3. Inform client. to report to the health care provider if constipated. If so, increase in the amount of roughage,
fiber, fluids in the diet is needed.
4. Inform client to take medication as prescribed.
5. Encourage proper nutritional habits to prevent recurrence of deficiency.
Generic Name: Bisacodyl

Brand Name: Dulcolax
Classification: Laxative
Dosage: 1 suppository
Frequency: in early AM
Route: rectal
Unknown. Stimulant laxative that increases peristalsis, probably by direct effect on smooth muscle of the
intestine. Thought to either irritate the musculature or stimulate the colonic intramural plexus. Drug also promotes
fluid accumulation in colon and small intestine.
Desired Effect: This drug is given to the client as a part of the SOP’s for Ultrasound for easier visualization of
the kidneys.
Side Effects:
Nausea, abdominal cramps
Adverse Effects:
CNS: muscle weakness with excessive use, dizziness, faintness.
GI:, vomiting, diarrhea with high doses, burning sensation in rectum with suppositories, laxative
dependence with long term or excessive use, protein-losing enteropathy with excessive use.
Metabolic: alkalosis, hypokalemia, fluid and electrolyte imbalance
Musculoskeletal: tetany.
1. Check Doctor’s orders to avoid error.
2. Inform client and parents on the insertion of the suppositories to gain his cooperation.
3. Use cautiously in patients with hypersensitivity with the drug or its components and in those with
rectal bleeding, gastroenteritis, intestinal obstruction, abdominal pain, nausea, vomiting, or other
symptoms of appendicitis.
4. Insert suppositories as high as possible into the rectum, and try to position suppository against the
rectal wall for easier absorption.
5. Avoid embedding the suppository within fecal material because doing so may delay onset of
action or absorption.
6. Provide ready access to bathroom.
Generic Name: Elanapril maleate

Dosage, Route and Frequency: 10 mg/tab, 1 tab OD 1st dose now
Classification: Anti – hypertensive
Mechanisn of Action: Unknown. Thought to inhibit ACE, preventing conversion of
angiotensin I to angiotensin II, a potent vasoconstrictor. Reduced formation of angiotensin
II decreases peripheral arterial resistance, thus decreasing aldosterone secretion, thereby
reducing sodium and water retention and lowerin blood pressure.
Desired Effect: This drug is given to our client to normalize his blood pressure.
1. Monitor vital signs of patient closely.

 this is to know if the therapeutic regimen is effective to this condition.
2. Instruct patient that this drug can be taken without regards to meals but if GI upset
occurs, medication must be taken with full stomach
 so as not to alter the effect of the drug.
3. Instruct patient to notify health care provider if adverse reaction and side effects
appear.
 for early detection and management to prevent further complication.
4. Instruct patient to decrease intake of salt and fat diet.
 so as not to aggravate her condition despite her medication.
5. Instruct patient to have adequate rest and sleep.
 to decrease workload of the heart
Generic Name: Nalbuphine

Brand Name: Nubain
Classification: Narcotic Analgesic
Dosage, Route, Frequency: 10 mg every6 hours x 2 doses
Mechanism of Action: Binds to the opiate receptors in the CNS, which alters the
perception of and response to painful stimuli, while producing generalized
depression.
Desired Effect: This drug was given to our client to reduce/decrease severe pain
Nursing Responsibilities
1. Administer ANST.
 To prevent hypersensitivity reaction.
2. Do divertional activities according to patient’s personal preference such as reading books
and magazines, listening to music, or socializing with significant others.
 To lessen the perception of pain
3. Encourage patient to do relaxation techniques like the use of imagery and deep breathing
technique.
 To reduce perception of pain by stimulating descending control system resulting in
reduced pain felt.
4. Eliminate additional stressor/source of discomfort whenever possible.
 Patient may experience an exaggeration of pain / a decrease ability to tolerate
painful stimuli of environmental factors is further stressing them.
5. Apply cold/hot compress on the affected part.
 Cold may apply on the 4 days post op. Decrease prostaglandins, which intensify the
sensitivity of pain receptors. Hot increasing blood flow to an area and would possibly
contribute to pain production by speeding healing.
6. Instruct patient to notify health care professional if headache, dizziness, somnolence,
tinitus, dry mucous membrane, nausea, GI pain, diarrhea, and bleeding occur.
 To anticipate the side effects of drugs.
Generic Name: Cefuroxime sodium

Classification: Anti-infectives
Dosage,Route,Frequency: 750 mg TID PO
Mechanism of Action: Second generation cephalosporin that inhibits cell-wall synthesis,
promoting osmotic instability; usually bactericidal.
Desired Effect: This was given to our client as a prophylaxis to infection.
1. Avoid touching the wound area.

 To prevent contamination.
2. Instruct patient to increase protein and vitamin C intake.
 To increase resistance against infection.
3. Inform the doctor if adverse effects occur.
 For immediate intervention.
4. Give drug with food.
 Food may increase absorption
Generic Name: Diclofenac Sodium

Dosage, Route and Frequency: 75 mg IV every 8 hours x 3 doses
Classification: Non Steroidal Anti-Inflammatory Drug
Mechanism of Action: Inhibits prostaglandin synthesis to cause anti-inflammatory effect;
the exact mechanism is unknown
Desired Effect: This drug is given to our patient to alleviate moderate pain.
1. Asses for patient’s history of allergy to the drug

 to prevent hypersensitivity reactions
2. Administer drug with food or after meals
 to prevent GI upset to occur
3. Do diversional and relaxation activities such as reading magazines and watching
television
 for the patient to divert the pain
4. Apply hot compress on the affected part
 to promote vasodilation, increasing blood supply to the affected part, relieving pain
5. Eliminate additional stressors or sources of discomfort whenever possible
 patient may experience an exaggeration of pain or a decrease ability to tolerate
painful stimuli if environmental factors are further stressing them
Generic Name: Ferrous Fumarate

Dosage, Route and Frequency: 1 cap OD PO
Classification: Anti – anemic or hemopoietic drug
Mechanism of Action: Elevates the serum iron concentration which then helps to form
hemoglobin or trapped in the reticuloendothelial cells for storage and essential conversion to
a usable form of iron.
Desired Effect: It is given to the patient in order to correct anemia.
1. Give the drug with meals or in full stomach

 to avoid GIT discomfort
2. Instruct the client to take Vitamin C and folic acid as well as food rich in iron such as
organ meats and green leafy vegetables.
 Vitamin C and folic increases the synthesis of iron and intake of iron rich foods
increases the amount of iron to be absorbed.
3. This drug should not be given with milk, tea, eggs, and coffee
 because it decreases the absorption of iron
4. Inform that the medication causes black tarry stool formation
 for the patient not to worry
5. Observe or check for possible side-effects such as anorexia, nausea and vomiting,
diarrhea, constipation.
 to correct immediately this side-effects
6. Observe and check for untoward manifestation such as acute poisoning, rashes, local
phlebitis, and anaphylactic reaction.
 to inform the physician about this side-effects
A. Generic Name: Albuterol (Salbutamol)

Brand Name: Ventolin
Dosage, Route and Frequency: 2.5 cc + NSS 1.5cc every 4 hours
Relaxes bronchial and vascular smooth muscle by stimulating beta - 2 receptors.
Desired Effect:
Albuterol is a short-acting, beta-adrenergic bronchodilator drug used for relief and
prevention of bronchospasm. It is also used to prevent exercise-induced bronchospasm.
Side Effect / Adverse Reaction:
CNS: tremor, nervousness, dizziness, insomnia, headache, hyperactivity, weakness, CNS
stimulation, malaise.
CV: tachycardia, palpitations, hypertension.
EENT: dry and irritated nose and throat (with inhaled form), nasal congestion, epistaxis,
hoarseness.
GI: heartburn, nausea, vomiting, anorexia, bad taste in mouth, increased appetite.
Metabolic: hypokalemia.
Musculoskeletal: muscle cramps.
Respiratory: bronchospasm, cough, wheezing, dyspnea, bronchitis, increased sputum.
Other: hypersensitivity reactions.
2. Check Doctor’s order.
3. Observe the 10 R’s.
4. Teach patient to perform oral inhalation correctly.
 Clear nasal passages and throat.
 Breathe out, expelling as much air from lungs as possible.
 Place mouthpiece well into mouth as dose from inhaler is released, and inhales
deeply.
 Hold breath for several seconds, and exhale slowly.
5. Tell patient to wash inhaler every after used.
6. Do bronchial clapping after nebulization.
7. Instruct patient to do deep breathing and coughing exercise.
8. Warn patient about possibility of paradoxical bronchospasm. Tell him to stop drug
immediately if it occurs.
B. Generic Name: Bambuterol

Brand Name: Bambec
Classification: Sympathomimetics – bronchodilator
Dosage, Route & Frequency: 10 mg 1 tab od & hs
Closely resembles the response to stimulation of adrenergic nerves, it exert a peripheral
inhibitory action on smooth muscle thus decreasing bronchial constriction.
Indication:
Bronchial asthma, chronic bronchitis, emphysema, and other lung diseases, where
bronchospasm is complicating factor.
Desired Effect:
This drug is given to our client because it decreases bronchial constriction; dilate the
bronchioles thereby allowing airway clearance.
Side Effects:
headache
tonic muscle cramps
palpitations
1. Take with food or after meal to decrease gastric irritation
2. Check for adverse reactions. Discontinue drug and notify physician.
3. Decrease irritants and increase hydration.
4. Teach the following:
a. breathing techniques
b. coughing techniques
c. nebulization
d. if it is given over a long period of time, cumulative effect
takes place takes place thus medication becomes ineffective.
C. Generic Name: Ambroxol

Brand Name:
Classification: Mucolytic
Dosage, Route and Frequency: 75 mg cap OD
Ambroxol is a metabolite of bromhexine, which liquefies and changes the structure of
bronchial secretions, reduce viscosity of sputum and promotes the expectoration of blocked-up
secretions and also eases cough.
Desired Effect:
This drug is given to the patient to relieve cough and loosens the phlegm.
Side Effect/Adverse Reaction:
- stomatitis
- nausea
- rhinorrhea
- bronchospasm
- bronchial/tracheal irritation
- drowsiness
1. Check doctor’s order.
2. Observe the 10 R’s.
3. Patient must be taught on how to cough out effectively.
4. Check proper disposal of secretions.
5. Encourage increase in fluid intake.
6. Cough should not be suppressed if productive.
7. Observe for bronchial spasm, wheezing and increased congestion.
8. drug must always be found at hand in case of bronchospasm.
D. Generic Name: Theophylline
Brand Name:
Dosage, Route, and Frequency: 200 mg BID
Inhibits phosphodiesterase, the enzyme that degrades cAMP, resulting in relaxation of
smooth muscle of the bronchial airways and pulmonary blood vessels.
Desired Effect:
This drug is given to the patient to treat acute bronchospasm and relaxes the muscles
surrounding the airways.
Side effects/Adverse Reaction:
CNS: restlessness, dizziness, headache, insomnia, irritability, seizures, muscle twitching
CV: palpitations, sinus tachycardia, flushing, marked hypotension, arrhythmias
GI: nausea, vomiting, diarrhea, epigastric pain
Respiratory: tachypnea, respiratory arrest
1. Monitor vital signs; measure and record fluid intake and output. Expect improved quality of
pulse and respirations.
2. Inform elderly patient that dizziness is common at start of therapy.
3. Tell patient o relieve GI symptoms by taking oral drug with full glass of water after meals,
although food in stomachache delays absorption.
4. Instruct patient to take drug regularly, only as directed. Patients tend to want to take extra
“breathing pills.”
E. Generic Name: Hydrocortisone

Brand Name:
Classification: Corticosteroids
Dosage, Route, and Frequency: 100mg IVP q 6o
Decreases inflammation, mainly by stabilizing leukocyte lysosomal membranes;
suppresses immune response; stimulates bone marrow; and influences protein, fat, and
carbohydrate metabolism.
Desired effect:
This drug is given to the patient to relax the airway muscles that constrict during
bronchospasm and it reduces asthma symptoms by suppressing the immune response.
Side Effects/Adverse Reaction:
CNS: euphoria, insomnia, psychotic behavior, vertigo, headache, paresthesia, seizures
CV: heart failure, hypertension, edema, arrhythmias
EENT: cataracts, glaucoma
GI: irritation, nausea, vomiting
1. Check Doctor’s order.
2. Determine whether patient is sensitive to other corticosteroids.
3. Do skin testing.
4. Instruct patient/ watcher to report any hypersensitivity reactions.
5. Monitor patient’s weight, blood pressure, and electrolyte levels.
6. Inspect patient’s skin for petechiae.
E. Generic Name: Levofloxacin

Brand Name:
Classification: Anti-biotic
Dosage, Route, and Frequency: 500 mg i tab OD
Inhibits bacterial DNA gyrase and prevents DNA replication, transcription, repair, and
recombination in susceptible bacteria.
Desired effect:
This drug is given to the patient to prevent infection most specially on the respiratory
system.
Side Effects/Adverse Reaction:
CNS: headache, insomnia, dizziness, encephalopathy, paresthesia, seizures.
CV: chest pain, palpitations, vasodilation.
EENT (ophthalmic solution): transient decreased vision, foreign body sensation, transient
ocular burning, ocular pain, photophobia, pharyngitis.
GI: nausea, diarrhea, constipation, vomiting, abdominal pain, dyspepsia, flatulence,
pseudomembranous colitis.
GU: vaginitis.
Hematologic: eosinophilia, hemolytic anemia, lymphopenia.
Metabolic: hypoglycemia.
Musculoskeletal: back pain, tendon rupture.
Respiratory: allergic pneumonitis.
Skin: rash, photosensitivity, pruritus, erythema multiforme, Stevens-Johnson syndrome.
Other: pain, hypersensitivity reactions, anaphylaxis, multisystem organ failure, fever.
1. Tell patient to take drug as prescribed, even if symptoms disappear.
2. Advise patient to take drug with plenty of fluids and to avoid antacids, sucralfate,
and products containing iron or zinc for at least 2 hours before and after each dose.
3. Warn patient to avoid hazardous tasks until adverse CNS effects of drug are
known.
4. Advise patient to avoid excessive sunlight, use sunblock, and wear protective
clothing when outdoors.
5. Instruct patient to stop drug and notify doctor if rash or other signs or symptoms
of hypersensitivity develop.
6. Tell patient to notify doctor if he experiences pain or inflammation; tendon
rupture can occur with drug.
7. Instruct patient to notify doctor if loose stools or diarrhea occurs. Inspect
patient’s skin for petechiae.
Date ordered : Dec. 14, 2006

Generic Name : Ciprofloxacin
Brand Name : N/A
Classification : Anti-infectives/Antibiotics
Dosage, Route, Frequency : 500mg tab BID
Mechanism of Action : Inhibits bacterial DNA synthesis, mainly by blocking
DNA gyrase, bactericidal.
Desired Effect : The drug was given to our patient for prophylaxis to
infection.
1. Obtain previous hypersensitivity reactions to avoid allergic reactions.
2. Administer on an empty stomach, one hour before or two hour after meals, with a
full glass of water but with gastric problems take it with meals to facilitate faster
absorption.
3. Do not take the drug with milk and yogurt because milk and yogurt decreases the
absorption of ciprofloxacin.
4. Do not supplement therapy with OTC remedies for infection and physician’s
order to prevent interactions with drugs (e.g. administration of antacids, iron salts,
sucralfate and zinc salts ecreases absorption of ciprofloxacin)
5. Complete full course of medication, even if he feels better to make sure that the
desired effect of the drug is achieved.
6. Emphasize small frequent meals and frequent mouth care to prevent nausea and
vomiting and dry mouth as adverse reaction.
7. Encourage the patient’s family to report any adverse effect of the drug like
tremors, seizures, drowsiness, chest pain, abdominal pain and hallucinations to be able to
give prompt intervention thereby preventing further complications.
8. Encourage the patient not to engage himself to potentially hazard activities that
may require alertness to prevent accident because this drug causes dizziness.
9. Encourage patient to drink plenty of fluids unless contraindicated to reduce risks

of urine crystals and promote excretion of by-products of the medicine.
Date Ordered : Dec. 13, 2006

Generic Name : Ferrous Sulfate
Brand Name : N/A
Classification : Hematinics
Dosage, Route, Frequency : 1 cap BID
Mechanism of Action : Provides elemental iron, an essential component in the formation
of hemoglobin.
Desired Effect : The drug is given to patient to our patient to increase Hemoglobin
level.
1. Instruct patient not to take in drug with milk or antacid, instead take it in with fruit juices
to enhance absorption of the drug.
2. Instruct patient to notify physician if signs and symptoms of anaphylaxis (rash, pruritus,
laryngeal edema, wheezing) occur for immediate interventions to prevent further
complications.
3. Encourage patient to comply with medication regiment to achiev therapeutic effect of the
drug.
4. Tell patient that stools may become dark, green or black as an effect of the drug to avoid
anxiety and for patient not to feel alarmed.
5. Instruct patient to follow a diet high in Iron to potentiate drug effect.
6. Instruct patient to report any adverse reactions such as nausea, epigastric pain, vomiting,
constipation, diarrhea and anorexia to be able to perform immediate actions thereby
preventing further complications.

Generic Name : Hydroxyzine
Brand Name : N/A
Classification : Anti-histamine/Anti-pruritic
Dosage, Route, Frequency : 10mg tab BID
Mechanism of Action : A piperazine antihistamine whose action may result from
suppression of activity in certain essential regions of the
subcortical area of the CNS.
Desired Effect : The drug was given to our patient to relieve itchiness.
1. Tell the patient to take the drug recommended schedule and not to skip doses to ensure
the effectiveness and to avoid untoward side effects.
2. Assess patient for profound sedations To be able to provide safety precaution as indicated
(side rails up, bed in low position, call bell within reach, supervision of amputation and
transfer).
3. Caution patient to avoid activities requiring alertness until responses to medication is

known to prevent accident because this medication may cause drowsiness or dizziness.
4. Instruct patient to avoid concurrent use of alcohol or other CNS depressants to prevent
excess sedation, ataxia, weakness, headache, and paradoxical agitation.
5. Instruct the patient to perform careful mouth care with frequent rinsing, sucking hard
candy, chewing sugarless gums, and increased fluid intake to relieve signs and symptoms
of dry mouth.
6. Instruct patient to report any adverse reactions such as drowsiness, involuntary motor
activity, dry mouth and constipation to be able to perform prompt intervention thereby
preventing further complications.
Date ordere : Dec. 13, 2006

Generic Name :
Brand Name : Irbesartan
Classification : Antihypertensive, Angiotensin II receptor blocker.
Dosage, Route, Frequency : 30 mg tab OD
Mechanism of Action : It increases systemic vascular resistance, causes sodium
and water retention and leads to increase heart rate and
vasoconstriction. It blocks the Angiotensin receptor
located in vascular smooth muscle and the adrenal glands,
thus blocking the vasoconstriction and Aldosterone
secreting effects of Angiotensin II.
Desired Effect : The drug was given to our patient to lower blood pressure.
1. Monitor the vital signs before and after drug administration to have a baseline
data and note changes signifying drug’s effect.
2. Administer the drug as directed by the physician. The drug maybe taken with or
without food to be more effective and to avoid untoward side effects.
3. Emphasize the need for the patient to comply with the diet (low salt, low fat) to
prevent water-attracting sodium that would increase blood volume increasing pressure.
4. Be at the patient’s side or let the watcher look after the patient or do precautionary
measures (raising side rails up) after administering the drug the drug may cause
hypertension, being with the patient will prevent fall.
5. Avoid tasks that require mental alertness until drug effects takes place the drug
may cause dizziness or drowsiness.
6. Instruct patient to report adverse reactions such as fatigue, anxiety, dizziness,

headache, chest pain, edema, tachycardia, pharyngitis, rhinitis, sinus abnormalities,
diarrhea, dyspepsia, abdominal pain, nausea and vomiting to be able to perform prompt
interventions thereby preventing further complications.
7. To have a complete bed rest to decrease metabolic demand.
Date ordered :December 13, 2006

Generic Name : Glipizide
Brand Name : N/A
Classification : Anti-diabetic (OHA)
Dosage, Route, Frequency : 5 mg ½ tab OD AM
Mechanism of Action : Unknown. A sulfonylurea that probably stimulates
insulin, release from pancreatic beta cells and reduces
glucose output by the liver. An extra pancreatic effect
increases peripheral sensitivity to insulin.
Desired Effect : The drug was given to our patient to decrease blood
glucose level.
1. Instruct the patient to carry medical identification at all times to be able to give proper
medication.
2. Instruct patient about disease and importance of following therapeutic regimen, including
adhering to diet, weight reduction, exercise and personal hygiene programs and avoiding
infection to promote compliance of patient for effective drug therapy.
3. Tell patient to carry candy or any simple sugars to treat mild hypoglycemic episodes.
4. Instruct patient not to change drug without doctor’s consent and to report abnormal blood
or urine glucose test result to monitor effectiveness of the drug therapy and to give
prompt intervention.
5. Tell patient to avoid alcohol to prevent excess sedation, ataxia, weakness, headache, and
paradoxical agitation.
6. Take the drug regularly to maintain blood glucose level.
Date ordere : Dec. 13, 2006

Generic Name : Amlodipine
Brand Name : N/A
Classification : Antihypertensive
Dosage, Route, Frequency : 5 mg OD AM
Mechanism of Action : Reduces myocardial oxygen consumtion or increase
oxygen supply to the myocardium to prevent symptoms of
angina pectoris.
Desired Effect : The drug was given to our patient to lower blood pressure.
1. Administer the drug as directed by the physician. The drug maybe taken with or without
food to ensure the effectiveness and to prevent stomach upset.
2. Emphasize the need for the patient to comply with the diet low salt, low fat to prevent
water-attracting sodium that would increase blood volume increasing pressure.
3. Tell the patient to take the drug recommended schedule and not to skip doses to ensure
the effectiveness and to avoid untoward side effects.
4. Tell patient to avoid alcohol to prevent excess sedation, ataxia, weakness, headache, and
paradoxical agitation.
5. Instruct patient to avoid driving, doing other tasks or activities that require alertness
because the drug may cause dizziness and lightheadedness.
6. Encourage patient to continue taking drug even when feeling better to ensure that the
desired effect of the drug is achieved.
7. Monitor the vital signs of the patient especially blood pressure during the course of
therapy to evaluate the effectiveness of the drug.

Generic Name : Ampicillin Sulbactam
Brand Name : Unasyn
Classification : Anti-infective (Aminopenicillin)
Dosage, Route, Frequency : 750gm IV every 8 hours
Mechanism of Action : Binds to bacterial cell wall, resulting in cell death;
spectrum is broader than penicillin. Addition of Sulbactam
increases resistance to Beta-lactamase, enzymes produced
by bacteria that may inactivate ampicillin.
Desired Effect : The drug was given to our patient to potentiate the effect
of ciprofloxacin.
1. Perform drug skin testing before starting course of therapy to determine any allergic
reaction to drug.
2. After mixing the diluents to the vial, shake it carefully. Foaming should dissipate upon
standing. Administer only clear solutions to attain its fullest therapeutic effect.
3. Administer drug not less than 1 hour after dilution to ensure drug absorption.
4. Check the patency of the IVF infusion site to avoid thrombophlebitis.
5. Administer drug slowly because the drug can cause irritation on the veins if rapidly
administered.
6. Inform and instruct client to report to any members of the health team any untoward or
hypersensitivity reaction such as rash, stomatitis, nausea and vomiting, fever or chill so
that they can immediately do necessary interventions and to minimize anxiety to the
client if these reactions will manifest.
7. Hold client in ambulatory care for at least 20 minutes after administration to avoid
possible injury since the drug can cause dizziness and seizure.
8. Instruct client to report any discomfort at the infusion site to detect early signs and
symptoms or complications and for proper nursing intervention.
9. Instruct client to finish the drug therapy as prescribed to avoid exacerbation.

Generic Name : Na Bicarbonate
Brand Name : N/A
Classification : Electrolyte modifier, alkalinizing agent, antacid
Dosage, Route, Frequency : 325mg 1tab PO OD
Mechanism of Action : Na Bicarbonate acts as an alkalinizing agent by releasing
bicarbonate ions which is capable of neutralizing gastric acid
Desired Effect : Given to patient to neutralize gastric acid and normalize
bicarbonate level.
1. Assess fluid balance (I and O, daily wt., edema, lung sounds) throughout therapy. Notify
physician if symptoms of fluid overload (HPN, edema, dyspnea, rales/crackles, frothy
sputum) occur to have a baseline data and prevent complications.
2. Assess patient for signs of acidosis- alkalosis to serve as a baseline data.
3. Encourage patient to take medication as directed. A missed dose should be taken as soon
as remembered unless almost time for next dose to maintain the therapeutic level of the
drug.
4. Encourage patient not to take milk products because it may decrease the absorption of the
drug.
5. Emphasize the importance of regular follow-up examination to monitor serum electrolyte

levels and acid base balance to monitor progress and effectiveness of the drug.

Generic Name : Calcium Carbonate (Dec. 13, 2006)
Brand Name : N/A
Classification : Calcium salt/ Electrolyte
Dosage, Route, Frequency : 1 tab OD
Mechanism of Action : Acts as an activator in the transmission of nerve impulses and
contraction of cardiac, skeletal, and smooth muscle. Essential for
bone formation and blood coagulation. It maintains cell membrane
and capillary permeability.
Desired Effect : Given to our patient to neutralize gastric acid.
1. Instruct the patient not to take enteric-coated tablets within 1 hour of Calcium Carbonate
to prevent premature dissolution of the tablet.
2. Do not administer with milk to avoid alkali syndrome ( nausea and vomiting, confusion,
and headache).
3. Encourage patient to avoid excessive use of beverages containing alcohol, caffeine, or

tobacco because alcohol decreases absorption of the drug.

Generic Name : Tramadol Hydrochloride (Dec. 14, 2006)
Brand Name : N/A
Classification : Centrally acting synthetic opioid analgesic
Dosage, Route, Frequency : 50 mg PO PRN
Mechanism of Action : It binds to mu-opiod receptors. It also inhibits reuptake of
serotonin and norepinephrine in the CNS. The analgesic effcet is
only partially antagonized by trhe antagonist naloxone.
Tramadol could be effective for alleviating symptoms of
depression and anxiety because of its action on GABAergic,
noradrenergic and serotonergic systems.
Desired Effect : It is given to our client for the management of moderate pain.
1. Explain therapeutic value of medication prior to administration to enhance the analgesic
effect.
2. Tell the client not to perform activities that require mental alertness to prevent injury
because the drug may cause drowsiness and dizziness and may impair mental or physical
performance.
3. Take the drug only as directed by the physician. May be taken without regard to meals to
ensure the effectiveness of the drug and avoid untoward side effects.
4. Instruct client to report lack of response, and side effects such as nausea, dizziness,
constipation, somnolence, and pruritus to render immediate proper nursing interventions
thus preventing further complications.

Generic Name : Pioglitazone hydrochloride
Brand Name : Actos
Classification : Anti-diabetic (thiozolidinediones)
Dosage, Route, Frequency : 15 mg OD PO
Mechanism of Action : Pioglitazone lowers the level of glucose in the blood by reducing
the production and secretion of glucose into the blood by the liver.
In addition, it may alter the blood concentrations of lipids (fats) I
the blood. Specifically, it decreases triglycerides and increases the
“good” (HDL) cholesterol.
Desired Effect : This drug is given to decrease glucose and hemoglobin level and
increase total cholesterol level.
1. Inform client that management should include diet control (weight loss, caloric
restrictions and exercise) to help make the drug therapy effective.
2. Monitor blood sugar because dosage adjustment may be needed.
3. Check glucose level periodically to evaluate therapeutic response to drug.
4. Inform patient not to skip meals to avoid hypoglycemia.
5. Inform patient to carry a piece of non-dietetic hard candy to treat episodes of

hypoglycemia.
1.) Generic Name: Fluorouracil
Brand Name: None
Dosage, Route and Frequency: 750 mg IV q 18o
Classification: Antineoplastic (Antimeatabolite)
Mechanism of Action: Fluoruoracil itself is in active, but following intracellular
conversion to active metabolites it interferes with the synthesis of DNA and also RNA. It
acts by blocking the conversion of deoxyridylic acid to thymidylic acid by inhibiting the
enzyme thymidylate synthetase. This creates a thymidine deficiency resulting in cell
death, especially dividing cells.
Desired Effect: This drug was given to our client as palliative management for colon
metasatic adenocarcinoma in combination with leucovorin.

1). Assess client for sensitivity for flurouracil. To prevent anaphylactic shock or even death.
2). Evaluate hematologic status before To properly monitor the blood component
beginning therapy and before each dose. levels.

3). Inform client that he may experience side So that the client may understand the possible
effects like: nausea, vomiting, loss of appetite, effects of the drug given and to inform the
decreased vision, tearing, double vision, client of possible effects so that he could have
malaise, weakness, lethargy, mouth sores, his precautions in doing things.
diarrhea, loss of hair, rash, sensitivity of skin
and eyes to sun and ultraviolet light.

4). Instruct client to have frequent small meals. This may help to maintain the nutrition of the
client since some side effects of this drug is
nausea, vomiting, and loss of appetite.

5). Instruct client to avoid driving or operating To prevent danger/ accident since lethargy is
dangerous machinery. one side effect of this drug.
6). Instruct the client to wear wig or other head Since one side effect of this drug is alopecia
cover.
2). Generic Name: Leucovorin Calcium
Brand Name: None
Dosage, Route, Frequency: 50mg IV
Classification: Folic Acid derivative
Active reduced form of folic acid, required for nucleoprotein synthesis and
maintenance of normal hematopoiesis.
Desired Effect:
This drug was given to our client in combination with 5 – Fluorouracil for
palliative treatment of metastatic colon cancer.

1). Assess client for sensitivity to leucovorin. To prevent anaphylactic shock or death.
2). Instruct the client to report side effects of To prevent further complications
leucovorin such as vomiting, diarrhea or mouth
sores.
* No other side effects have been reported from the use of leucovorin alone. But since it
makes 5-FU more powerful, adding it to a chemotherapy regimen can sometimes result in
more side effects than 5- FU alone.

3). Generic Name: Castor oil
Brand Name: None
Classification: Stimulant Laxative
Dosage, Route, Frequency: Castor oil PRN
Stimulant laxative encourage bowel movements by acting on the intestinal
wall. They increase the muscle contractions that move along the stool mass.
Desired Effect:
This drug was given to evacuate the bowel for diagnostic procedures

1).Inform client that laxative should be used Long term therapy of the medication may
only for short term therapy. cause electrolyte imbalance and dependency of
bowel tone
2). Advise the patient to take on an empty For rapid effect since results are slowed if
stomach. taken with food.

3). Chill the Castor oil in the refrigerator for at To improve the unpleasant taste of Castor oil.
least an hour then stir the dose into a full glass
of cold orange juice just before it is taken.

4). Inform the client that he may experience So that the client may understand the possible
frequent passage of stool as a result of taking in effects of the drug given and to inform the
the medication. client of possible effects so that he could have
his precautions in doing things.
5). Instruct the client to report if he experience In order to avoid possible injury and to manage
other side effects such as confusion, irregular complications immediately.

heartbeat, muscle cramps and unusual tiredness
or weakness.
6). Provide thorough patient teaching regarding To enhance patient’s knowledge about drug
the drug regimen. therapy and to promote compliance with the
drug regimen.
4.) Generic Name: Bisacodyl
Brand Name: Dulcolax
Classification: Laxative
Dosage, Route, Frequency: 10 mg suppository SOP
Stimulant laxative that increases peristalsis, probably by direct effect on
smooth muscle of the intestine. Thought to either irritate the musculature or stimulate
the colonic intramural plexus.
Desired Effect:
This drug was given to evacuate the bowel for diagnostic procedures

1). Position the patient in a fetal or knee chest To efficiently administer the drug since it is a
position. suppository.
2). Insert suppository as high as possible into For better stimulation of the smooth muscles
the rectum. of the intestine for peristalsis

3). Give drug at times that don’t interfere with Soft, formed stools are usually produced 15 to
scheduled activities or sleep. 60 minutes after rectal use.

4). When administering laxative, note time. It So the result action of the medication will not
takes for the laxative to take effect and give it. interfere with the clients rest or digestion and
absorption of the medication.

5). Inform client that he may experience these So that the client may understand the possible
adverse effects such as nausea, vomiting, effects of the drug given and to inform the
abdominal cramps, diarrhea and burning client of possible effects so that he could have
sensation in rectum with suppository. his precautions in doing things.

6). Inform client that laxative should be used Long term therapy of the medication may
only for short term therapy. cause electrolyte imbalance and dependency of
bowel tone.
Generic Name: Cloxacillin

Brand Name: Medix
Classification: Anti-infectives
Dosage and Frequency: 500 mg TID
Route: Per Orem
Mechanism of Action: Bind to bacterial cell wall, leading to cell death
Desired Effect: This drug was given to the patient to prevent further occurrence
of infection.
Indications: This drug is indicated for respiratory tract infections, skin infections
and to penicillinase-producing staphylococci.
1. Assess for the patient’s hypersensitivity to the drug to have a baseline
data.
2. Administer on an empty stomach at least one hour before or two hours
after meals to enhance effectivity and better absorption of the drug.
3. Instruct patient to take the drug with a full glass of water and not acidic
juices to increase the absorption of the drug because acidic juices
decreases the drug’s absorption.
4. Observe patient for signs and symptoms of anaphylaxis such as rash,
pruritus, laryngeal edema, wheezing and abdominal pain to give
immediate interventions.
5. Encourage patient to report fever, diarrhea, vaginal itching and allergy
to address the symptoms immediately and prevent the progression of
the disease into a more severe one.
6. Avoid contact to allergens to potentiate drug action.
Generic Name: Prednisolone

Brand Name: Prednecort
Classification: Corticosteroids
Dosage and Frequency: 5mg OD
Route: Per Orem
Mechanism of Action: Suppress inflammation and the normal immune response
Desired Effect: This drug was given to the patient to reduce inflammation.
Indications: Used systemically and locally in a wide variety of chronic diseases
including inflammatory, allergic, hematologic, neoplastic and auto-immune
disorders.
1. Administer with meals to minimize GI irritation.
2. Encourage patient to swallow the whole drug; do not crush, break or
chew to enhance the effectiveness of the drug.
3. Instruct patient to take the medication in the morning to coincide with
the body’s normal secretion of cortisol.
4. Instruct patient to avoid people with known contagious disease and to
report possible infections to give immediate interventions because this
drug can cause immunosuppression and may mask symptoms of
infection.
5. Instruct patient to avoid activities that requires alertness to prevent
injury because headache and dizziness are one of the side effects of
the drug.
6. Encourage a patient to eat a diet high in Protein, Calcium and Potassium
and low in Sodium and Carbohydrates to help and enhance the
effectiveness of the drug in reducing inflammation.
7. Encourage the patient to have medical check ups to assess
effectiveness and possible side effects of the medications.
8. Avoid contact to allergens to potentiate drug action.
Generic Name: Econazole Mitrate

Brand Name: Nizolex
Classification: Anti-fungal/anti-inflammatory
Dosage and Frequency: HS
Route: Topical
Mechanism of Action: Inhibits the growth of susceptible fungi by affecting the
permeability of the fungal cell membrane
Desired Effect: This drug was given to the patient to prevent fungal infections.
Indications: Used for treatment of variety of cutaneous fungal infection
1. Encourage patient to wash and clean the wound before applying the
cream to prevent further infection.
2. Instruct patient to only apply on the affected part sparingly to prevent
maceration.
3. Encourage patient to apply carefully and properly on the affected part to
avoid irritation on the surrounding skin and this drug can stain fabric,
hair and the skin.
4. Instruct patient to apply a small amount to cover affected area
completely and avoid use of occlusive wrapping or dressing to ensure
that the applied cream is in tact on the affected area.
5. Encourage patient to report increase skin irritation and lack of response
to therapy, itching, redness, pain and local hypersensivity reactions to
give immediate interventions.
Date ordered: August 1, 2005

Generic Name: AMPICILLIN SULBACTAM
Brand Name: UNASYN
Classification: ANTIBIOTIC
Dosage, Route and Frequency: 750 mg IV every 8 hours ANST ( - )
Mechanism of Action: Interferes with cell wall replication of susceptible
organisms; the cell wall rendered osmotically
unstable, swells bursts from osmotic pressure;
combination extends spectrum of activity by B-
lactamase inhibition.
Indication: Used for infections caused by ampicillin susceptible

organism
Desired Effect: This drug is given to the patient to prevent infection.
Nursing Responsibilities: Rationale

1. Check doctor’s order. - serve as a baseline data
2. Follow 10R’s. - to avoid mistake
3. Do ANST - to assess hypersensitivity
4. Check for the patency of IV site. - to avoid infiltration
5. Administer drug slowly. - to prevent irritation
6. Monitor for side effects like nausea - to prevent further complication
and vomiting, hypertension,
pericarditis, fever and chest pain,
bleeding or bleeding gums, blood in
the stool and urine.
7. Encourage patient to take enough - to regain strength
rest and sleep.
8. Monitor urine output since renal - to prevent further complication
dysfunction is one of the side
effects. Notify physician if
decreased. - to facilitate faster recovery
9. Encourage client to ambulate early
as he can. - to boost his resistance against
10. Encourage patient to increase infection
CHON and Vit. C on diet. - to prevent infection
11. Instruct client to clean wound.
Date Ordered: August 1, 2005

Generic Name: NALBUPHINE
Brand Name: Nubain
Classification: Narcotic agonist/ antagonist
Dosage, Route and Frequency: 1 ampule IVP every 6 hours x 2 doses then PRN for
severe pain
Mechanism of action: Acts by inhibiting the synthesis of the prostaglandin.
Indication: Relief of moderate to severe pain
Desired effect: This drug was given to the client to alleviate post-op
pain.
Nursing responsibilities: Rationale

1. Check the Doctor’s order. - serve as a baseline data
2. Observe the 10 R’s. - to avoid mistakes
3. Check the patency of the IV line. - to check if the IV is in the vein
4. Maintain aseptic technique in - to prevent complication
preparing and administering the
drug.
5. Administer slowly the drug. - to prevent irritation on the veins
6. Inform the patient that the drug - to prevent injury
may cause drowsiness, maintain
close watch and tell the patient
to move gradually after
administering the drug.
7. Assess the patient for adverse - to prevent further complication
reaction such as bradycardia and
chest pain.

Generic Name: Tetanus Toxoid
Classification : Toxoids
Dosage, Route and Frequency: 0.5 ml IM now
Mechanism of Action: Tetanus toxoid preparations contain the toxin
produced by virulent tetanus bacilli. The toxin has been
modified by treatment with formaldehyde so that is has lost
toxicity but still retains ability to act as antigen and
produce active immunity.
Desired Effect: This drug was given to our patient to prevent tetanus.
Indication: Use to detect delayed hypersensitivity and
assessment of cell-mediated immunity; active
immunization against tetanus

1. Check Doctor’s Order. - to avoid mistakes
2. Monitor closely following injection. - for possible anaphylactic reaction
and to prevent complication.
3. Instruct patient to monitor and - to give prompt intervention thus
report any adverse reactions such as preventing complication.
chills and fever. - to increase his awareness regarding
4. Inform the patient about the drug the drugs given to her.
and its purpose. - so that the patient will not be
5. Inform patient that small nodule, alarmed.
mild tenderness, or inflammation at the
injection site is just normal.
6. Instruct patient to report persistent - to give prompt intervention.
redness, swelling or external pain at
injection site. - to prevent infection and facilitate
7. Proper wound dressing healing

Generic Name: DICLOFENAC SODIUM
Brand Name: Voltaren
Classification: NSAID
Dosage, Route and Frequency: 750 mg IVP every 8 hours ANST ( - )
Mechanism of Action: Inhibits prostaglandin synthesis to cause
analgesic and anti-inflammatory effect.
Indications: Acute or long-term treatment of mild to

moderate including dysmenorrhea.
Desired Effect: This drug was given to our patient to alleviate

pain and inflammation in the site of injury.
1. Check doctor’s order. - serve as a baseline data

2. Observe 10 R’s. - to avoid mistake
3. Do ANST - to assess hypersensitivity
4. Check the patency of IV site before - to check if the IV is in the vein
administration.
5. Administer the drug slowly. - to prevent irritation
6. Inform patient and family that the - to achieve the desired effect of
drug must be continued for the drug
prescribed time.
7. Note for any allergic responses to - serve as a baseline data
any other anti-inflammatory agent.
8. Document indications for therapy, - serve as a baseline data
type, onset and characteristics of
symptoms.
9. Encourage the patient to take - to avoid accident
enough rest, stay on bed and put on
side rails because drug causes
drowsiness and dizziness.
10. Monitor any episodes of bleeding, - to prevent complications
blurred vision or other eye
symptoms, tinnitus, skin rashes,
purpura, weight gain or edema as
well as decreased urine output,
fever or increased joint pain.

Generic Name: Anti-Tetanus Serum
Brand Name: Tetanea
Classification : Immunomodulation Agents or Vaccines and toxoids
Dosage, Route and Frequency: 4500 units IM ANST (-)
Mechanism of Action: Promotes immunity to tetanus by inducing anti-toxin
production.
Desired Effect: This drug was given to our patient to serve as a
prophylaxis against tetanus.
Nursing Interventions Rationale

1. Check Doctor’s order - serve as a baseline data
2. Observe the 10 R’s in - to prevent committing errors
drug administration - to confirm the sensitivity of the
3. Do skin testing drug
4. Observe aseptic - to prevent contamination
technique in preparing the drug as
well as its administration
5. Explain the patient - to gain cooperation and
and significant others the compliance
mechanism of action of the drug
and its importance - to prevent further complication
6. inform the patient as
well as the significant others that
the drug may cause slight fever,
chills, malaise, aches and pain,
flushing and rashes
- if fever occurs, manage it with
TSB and encourage patient to
increase fluid intake
- if chills occurs, provide blanket
to maintain body temperature
- for rashes, instruct the patient - to increase body resistance
not to scratch the affected area against infection
7. Encourage patient to
eat foods rich in vitamin C and
protein
Generic Name: Metoprolol
Brand Name: Neobloc
Classification: Beta-blockers
Dosage, Frequency: 100 mg/tab OD
Route: PO
Mechanism of Action: This drug blocks stimulation of beta1 (myocardial) adrenergic
receptors.
Desired Effect: This drug was given to our patient as a maintenance drug to
decrease blood pressure and heart rate within normal levels.

1. Instruct patient to take medication as To potentiate drug action
directed, at the same time each day and
take it with meals.
2. Teach patient and family how to check To be able to report significant changes to
pulse daily and blood pressure biweekly. health care professionals
3. Instruct to the patient that this drug may To manage one of the side effects and
cause drowsiness so caution the patient to prevent further accidents that may arise
avoid activities that require alertness.
4. Encourage patient to change position To minimize orthostatic hypotension
slowly.
5. Caution patient that this medication may
increase sensitivity to cold.
6. Instruct patient to consult health care
professional before taking any OTC
medications or herbal products especially
cold preparations.
7. Encourage patient to notify health care To be able to give prompt interventions
professional if slow pulse, difficulty immediately
breathing, wheezing, cold hands and feet,
dizziness, light-headedness, confusion,
depression, rash, fever, sore throat, unusual
bleeding or bruising occurs.
8. Encourage patient to carry identification
card describing disease process and
medication regimen at all times.
9. Reinforce the need to continue additional Medication controls but does not cure
therapies for hypertension such as weight hypertension.
loss, sodium restriction, stress reduction,
and regular exercise.
Generic Name: Calcipotriole
Brand Name: Daivonex
Classification: Nonsteroidal antipsoriatic agent / vitamin D analogue
Dosage and Frequency: < 100 g weekly BID
Route: Topical
Mechanism of Action: Induces differentiation and suppresses proliferation (without any
evidence of a cytotoxic effect) of keratinocytes by competing for
the 1,25 (OH) 2D 3 receptor that exhibits a vitamin D-like effect,
thus reversing the abnormal keratinocyte changes in psoriasis.
Desired Effect: This drug was given to the patient to promote normalization of
epidermal growth.

1. Measure the area to be applied by using to get a rough idea of the area of psoriasis
the palm of the hand
2. Measure the drug by squeezing a strip of to have a uniform application
ointment from the tube from the last finger
crease to the tip of the finger
3. Instruct the patient that the best and most to have a continuous treatment for the whole
practical time of the day for treatment is day
ideally both in the morning and in the evening

4. Advice the patient to atleast uses a to prevent irritation
moisturiser in the morning and if possible

uses the drug and a moisturizer
5. Advice the patient to put on loose clothing Advice the patient to put on loose clothing
6. Instruct the patient to carry on normal to promote absorption of the drug to the skin
daily activities for 25- 30 mins until and not to interfere with the activies
treatments have soaked in

7. Caution patient that the drug should not be to prevent irritation of the face
used in the face since the ointment

formulation may give rise to irritation of the
skin
8. Inform the patient about the possible to increase the knowledge of the patient
minor adverse effects such as transient local regarding the side effects of the drug
irritation and, very rarely, facial dermatitis

may occur
3. Generic Name: Ranitidine
Classification: Histamine2 Antagonist
Mode of Action: Competitively inhibits action of H2 at receptor sites of the
parietal cells, decreasing gastric acid secretion.
Dosage, Route, Frequency: 1 amp IVP every 8 hrs.
Desired Effect: This was given to our patient due to counteract the ulcerative
effects of the nonsteroidal anti-inflammatory drugs given to the client.
1. Check the doctor’s order to protect self from illegal actions.
2. Observe the 10 R’s before administration for an effective treatment
regimen.
3. Assess patient for abdominal pain. Note presence of blood in emesis,
stool, or gastric aspirate.
4. Advise patient to report abdominal pain and blood in stool or emesis.
5. Instruct patient to report angioneurotic edema, blurred vision, vertigo,
malaise. burning and itching at injection site.
6. Look out for hematologic side effects like reversible leucopenia and
pancytopenia.
7. Consider Lab Results:
>May increase creatinine and ALT levels.
>May decrease WBC count.
4. Generic Name: Ciprofloxacin

Classification: Flouroquinolones
Mode of Action: Inhibits bacterial DNA synthesis, mainly by blocking DNA
gyrase
Dosage, Route, Frequency: 200 mg IVP every 12 hrs.
Desired Effect: This was given to our patient to treat urinary infection
regimen.
3. Obtain specimen for culture and sensitivity tests before giving first
dose. First dose maybe given before receiving results. To prevent
development of resistant bacteria, therapy should only be used to treat
infection that are proven or strongly suspected to be caused by
susceptible bacteria.
4. It can cause dizziness and drowsiness. Caution patient to avoid
activities requiring alertness until responses to medication is known.
5. Monitor patient's intake and output and observe for signs of
crystalluria.
6. Advise patient to drink plenty of fluids to reduce risk of crystalluria.
7. Warn patient to avoid hazardous tasks that require alertness until CNS
effects of drug are known.
8. Instruct patient to avoid caffeine while taking drug because of
potential for cumulative caffeine effects.
9. Advise patient that hypersensitivity reactions may occur even after
first dose. If a rash or other allergic reaction appears, stop
administering and notify prescriber.
10. Tell patient to avoid excessive sunlight or artificial ultraviolet
light during therapy and 10. If administering drug through a Y-type set,
stop the other I.V. solution during ciprofloxacin infusion.
11. Consider Lab. Results:
>May increase BUN, creatinine, alkaline phosphatase, bilirubin, LDH,
ALT, AST, and GGT levels.
>May increase eosinophil count. May decrease WBC, neutrophil, and
platelet counts.
5. Generic Name: Tramadol

Classification: Analgesic (centrally-acting)
Mode of Action: A centrally acting synthetic analgesic compound not
chemically related to opiates. Drug is thought to bind to opioid receptors and
inhibit reuptake of norepinephrine and serotonin.
Dosage, Route, Frequency: 50 mg / cap OD
Desired Effect: This was given to our patient to
Nursing Responsibilities: This was given to the client to relieve pain.
regimen.
3. Explain therapeutic value of medication before administration to
enhance the analgesic effect.
4. Monitor CV and respiratory status before and periodically during
administration since the drug may cause respiratory depression if it
exceeds the desired dose.
5. Monitor bowel and bladder function. Prevention of constipation should
be instituted with increased intake of fluids and bulk with laxatives to
minimize constipating effects.
6. Monitor patient for drug dependence. Drug can produce dependence
similar to that of codeine or dextropropoxyphene and thus has
potential for abuse.
7. Caution ambulatory patient to be careful when rising and walking.
Warn to avoid activities that require mental alertness until drug's CNS
effects are known.
8. Advise patient to check with prescriber before taking OTC drugs; drug
interactions can occur.
9. Consider effects on lab test results
>May increase creatinine and liver enzyme levels.
>May decrease hemoglobin and hematocrit.
Generic Name: Cefepime

Classification: 3rd generation Cephalosphorin
Mode of action: It has antibacterial activity against both gram positive and
gram negative pathogens, including those resistant to other B-lactam AB.
Also, has high affinity for the multiple penicillin- binding proteins that are
essential for cell wall synthesis.
Dosage, Route, Frequency: 1 g, per 12 hrs. IV
Desired Effect: This drug was given to our patient to fight the infection and
prevent the multiplication of microorganisms that cause inflammation.
Date Ordered: March 1, 2006
1. Check the doctor’s order. To protect self from illegal actions.
2. Observe the 10 R’s before To make the treatment regimen
administration. effective.
3. Do skin testing. To avoid occurrence of anaphylactic
shock.
4. Note any previous sensitivity To avoid occurrence of anaphylactic
to penicillin, cephalosphorins shock.
and other antibiotics.
5. Arrange for culture and To avoid false negative result of culture
sensitivity tests before and sensitivity testing.
beginning therapy per doctor’s
order.
6. Check IV patency prior to To prevent phlebitis and tp prevent
administration and administer painful administration.
slowly.
5. Dilute and infuse over 3o Drug may cause irritation and pain.
minutes unless otherwise
indicated and assess site. May
see rash on the site
6. Teach patient to report It is expected that pseudomembranous
occurrence of diarrhea and colitis may occur.
fever. Monitor vital signs, I & O,
stool C&S and electrolytes.
7. Watch for persistent The drug may induce fever.
temperature elevations. Do
measures to lower body
temperature.
8. Instruct patient to report These are signs of superinfections.
black furry tongue, loose, foul-
smelling stools.
9. Teach patient to avoid Disulfiram- type reaction may occur.
alcohol and alcohol-containing
products.
10. Have regular dosing. To maintain the therapeutic serum
levels.
11. Store at room temperature. To potentiate drug action.
12. Monitor clinical responses, To guarantee effectively of treatment.
if no improvement is seen or a
relapse occurs, repeat culture
and sensitivity test.
Generic Name: Metronidazole

Classification: Local Anti-infectives
Mode of action: It binds with DNA, resulting in loss of helical structure,
strand breakage, inhibition of nucleic acid synthesis and cell death.
Dosage, Route, Frequency: 500mg q 6 IV
Desired Effect: This drug was given to our patient to fight the
microorganisms and prevent further multiplication.
Date ordered: February 27, 2006
administration effective.
anaphylactic shock.
4. Note any previous sensitivity To avoid occurrence of
to any antibiotics. anaphylactic shock.
beginning therapy.
6. Check IV patency prior to To prevent phlebitis and tp
administration and administer prevent painful administration.
slowly.
7. Caution patient to change One of the side effects of drug is
position slowly. dizziness’
14. Inform the patient that To anticipate the side effects of
such side effects may occur- drugs, thus knowing to notify
nausea, abdominal discomfort, physician if such effects occur.
constipation, anorexia, skin
irritation and urticaria.
15. Inform patient that To anticipate the side effects of
medication may cause urine to drugs, thus knowing to notify
dark. physician if such effects occur.
16. Do not use aluminum Needles will turn orange or rust.
needles in administering the
drug.
levels.
temperature.
responses, if no improvement treatment.
is seen or a relapse occurs,
repeat culture and sensitivity
test.
Generic Name: Clindamycin

Classification: Anti- biotic Lincosamide
Mode of action: A semi-sythetic antibiotic tat suppresses protein synthesis
by microorganism, by binding to ribosomes and preventing peptide bond
formation.
Dosage, Route, Frequency: 30 mg per 8 hrs. IV
Desired Effect: This drug was given to our patient to combat specific
pathogen that has invade the patient’s body and prevent further
multiplication.
Date ordered: Feb 27, 2006
anaphylactic shock.
beginning therapy.
6. Check IV patency prior to To prevent phlebitis and tp
administration and administer prevent painful administration.
slowly.
levels.
8. Store at room temperature. To potentiate drug action.
culture and sensitivity
test.
Generic Name: Levofloxacin

Classification: Anti- infectives, Flouroqinolones
Mode of action: It interferes with DNA by inhibiting DNA synase replication in
susceptible gram negative and gram positive bacteria, preventing cell
reproduction.
Dosage, Route, Frequency: 500 mg OD IV
Desired Effect: This drug was given to our patient to combat to combat
specific pathogen that has invade the patient’s body and prevent further
multiplication.
Date ordered: March 5, 2006

administration effective
anaphylactic shock.
beginning therapy.
6. Tell patient to take drug To guarantee effectivity of
as prescribed, even if treatment and avoid reactivation
signs and symptoms of pathogen.
disappear.
7. Instruct patient to notify These are signs of GI toxicity
prescriber if loose stools
or diarrhea becomes
severe.
8. Tell patient to notify Tendon rupture can occur with
prescriber if he drug.
experiences pain or
inflammation.
9. Advise patient to avoid Drug may cause photosensitivity.
excessive sunlight
exposure while on
therapy.
levels.
temperature.
culture and sensitivity
test.
Generic Name: Azithromycin

Classification: Macrolide antibiotic
Mode of action: being derived from erythromycin, it acts by binding to the
Psite of the 50 S ribosomal subunit and may inhibit RNA-dependent protein
synthesis by stimulating the dissociation of peptidyl t-RNA from ribosomes.
Dosage, Route, Frequency: 500 mg per tab OD pc
Desired Effect: This drug was given to our patient to combat specific
pathogen that has invade the patient’s body and prevent further
multiplication.
Date ordered: February 22, 2006
3. Determine any history of To avoid anaphylactic shock.
sensitivity of erythromycins.
4. Encourage client to take the To prevent GI symptoms.
drug with meal.
5. Be knowledgeable that it To avoid digitalis toxicity.
may cause increased
concentrations of Digoxin.
6. Teach patient to notify These are signs of superinfections.
health care provider in nausea
and vomiting or diarrhea is
excessive, or black furred
tongue.
7. Prevent superinfections by: To boost treatment, as well as to
a. Emphasize good prevent superinfection.
hygiene
b. Limit exposure to
persons suffering from an
active infectious process.
c. Wash hands carefully
before contact with patient.
d. Screen visitors and
having them wash hands
before contact.
8. Schedule thorough 24- hour To maintain therapeutic drug
period levels.
9. Instruct patient to complete To prevent recurrence.
entire prescription.
Generic Name: Ranitidine

Classification: Histamine2 (H2) antagonist
Mode of action: This drug competitively inhibits the action of histamine at
the histamine2 (H2) receptors of the parietal cells of the stomach, inhibiting
basal gastric acid secretion and gastric acid secretion that is stimulated by
food, insulin, histamine, cholinergic agonists, gastrin, and pentagastrin.
Dosage, Route, Frequency: 150 mg. BID
Desired Effect: This drug was given to our patient to counteract the
ulcerative effects of anti- tubercolotic and analgesic drugs.
Date Ordererd: Feb. 28, 2006

3. Take drug with meals and at For a more effective mode of
bedtime. action
4. Look out for side effects To provide knowledge to patient
that may occur: for appropriate actions in case
5. >Constipation or diarrhea side effects occur, thus avoiding
-request aid from your further complications.
health care provider
6. >Nausea, vomiting-take
drug with meals.
7. >Headache -adjust lights
and temperature and
avoid noise.
8. Instruct patient to report To provide knowledge to patient
sore throat, fever, for appropriate actions in case
unusual bruising or side effects occur, thus avoiding
bleeding, tarry stools, further complications.
confusion, hallucinations,
dizziness, severe
headache, muscle or joint
pain.
9. Arrange for regular To evaluate effects.
follow-up, including blood
tests
10. Consider Lab Results: To be knowledgeable of the
11. >May increase factors that contribute to lab.
creatinine and ALT levels Results’ deviation from normal.
12. >May increase WBC
count
Generic name: Digoxin

Brand Name: Lanoxin
Classification: Inotropics
Mode of action: Increases intracellular calcium and allows more calcium to
enter the myocardial cell during depolarization via a sodium–potassium
pump mechanism; this increases force of contraction (positive inotropic
effect), increases renal perfusion (seen as diuretic effect in patients with
CHF), decreases heart rate (negative chronotropic effect), and decreases AV
node conduction velocity.
Dosage, Route, Frequency: 0.25 mg./ tab OD
Desired Effect: This drug was given to our patient to counteract the effect of
Acetylcisteine drug whch has the ability to stimulate cardiac muscle.
3. Monitor apical pulse for 1 To prevent the aggravation of the
min before administering; side effects.
hold dose if pulse < 60 in
adult or < 90 in infant;
retake pulse in 1 hr. If
adult pulse remains < 60
or infant < 90, hold drug
and notify prescriber.
*Note any change from
baseline rhythm or rate.
4. Take care to differentiate Their dosage is very different.
Lanoxicaps from Lanoxin
5. Check dosage and Therapeutic dose is very near to
preparation carefully. toxic dose.
6. Avoid giving with meals This will delay absorption.
7. Have emergency In preparation, in case toxicity
equipment ready; have develops.
K+ salts, lidocaine,
phenytoin, atropine,
cardiac monitor on
standby.
8. Monitor for therapeutic To avoid occurrence of digitalis
drug levels: 0.5–2 ng/mL. toxicity.
9. Instruct patient to report These are manifestations of
unusually slow pulse, digitalis toxicity, thus, to treat it
irregular pulse, rapid earlier.
weight gain, loss of
appetite, nausea,
vomiting, blurred or
"yellow" vision, unusual
tiredness and weakness,
swelling of the ankles,
legs or fingers, difficulty
breathing.
10. Instruct patient to To increase the absorption of the
increase intake of drug.
potassium like citrus
fruits and banana.
Generic name: Paracetamol

Classification: Antipyretic, Analgesic (nonopioid)
Mode of Action: Antipyretic: Reduces fever by acting directly on the
hypothalamic heat-regulating center to cause vasodilation and sweating,
which helps dissipate heat.
Analgesic: Site and mechanism of action unclear
Dosage, Route, Frequency: 500 mg/ tab q 40 for fever, PRN
Desired Effect: This drug was given to our patient to reduce hyperthermia.
Date Ordered: Feb 22, 2006
3. Assess patient for hepatic To render appropriate nursing
function, chronic alcoholism, interventions
skin color, lesions
4. Give drug with food. Drug may cause GI upset.
5. Avoid the use of other over- They may contain acetaminophen,
the-counter preparations. and serious overdosage can occur.
6. Instruct patient to report To render appropriate nursing
occurrence of rash, unusual actions.
bleeding or bruising, yellowing
of skin or eyes, changes in
voiding patterns.
8. Treatment of overdose: As a specific antidote; basic life
Monitor serum levels regularly, support measures may be
N-acetylcysteine should be necessary.
available
Generic name: Acetylcysteine

Mode of action: This drug is a mucolytic that reduces the viscosity of
pulmonary secretions by splitting disulfide linkages between mucoprotein
molecular complexes
Dosage, Route, Frequency: 200 mg. / sachet in ½ glass H20
Desired Effect: This drug was given to our patient to liquefy pulmonary
secretions, thus facilitating expectoration.
Date Ordered: Feb 22, 2006

Check the doctor’s order. To protect self from illegal actions.
3. Use cautiously in elderly or To avoid further problems since
debilitated patients with severe drug also stimulates cardiac
respiratory insufficiency. muscle.
4. Mix with juice or cola. Because drug smells strongly like
sulfur so as to improve its
palatability.
5. After opening, store in To avoid alterations in drug
refrigerator and use within 96 components.
hours.
6. Monitor cough type and For more effective treatment.
frequency.
Generic Name: Isoniazid (INH)

Classification: Anti- infective (Antituberculotics)
Mode of Action: Appears to inhibit cell-wall biosynthesis by interfering with
lipid and DNA synthesis (bactericidal)
Dosage, Route, Frequency: 1 tab OD pc
Desired Effect: This was given to our patient to combat causative agent of
Tubercolosis.
Date Ordered: February 22, 2006
effective.
3. Use cautiously in elderly To avoid further problems.
patients and in those with chronic
non- isoniazid- related liver
disease, and seizure disorders.
4. Instruct the patient that he To guarantee effectivity of
must take the drug with other treatment.
prescribed anti- tubercolotic
drugs.
5.Instruct patient to take the drug To complete the course of
exactly as prescribed and to treatment
comply with the treatment
6. Instruct patient to take in drug To avoid GI symptoms.
with meals.
7. Advise patient to avoid This drug has MAO inhibitor
alcoholic beverages while taking activity which inhibits breakdown
the drug also to avoid tyramine of tyramine, thus epinephrine and
rich foods such as tuna cheese, norepinephrine release is
beer and chocolate stimulated, leading to
hypertensive crisis.
8. Inform the patient that the drug To do the right Nursing action in
has side effects such as seizures, managing these side effects,
nausea, vomiting and epigastric thus avoiding further problems.
distress. Instruct the patient to
report if these side effects
manifests.
Generic Name: Ethambutol

Classification: Anti- infectives (Antituberculotics)
Mode of action: It interferes with the synthesis of one or more metabolites
of susceptible bacteria, altering the cellular metabolism during cell division
(bacteriostatic)
Tubercolosis.

effective.
3.Inform the patient to report any To render appropriate nursing
adverse effects such as anorexia, actions.
vomiting, abdominal pain, bloody
sputum and GI upset
drugs.
with meals.
7. Stress importance of To complete the course of
compliance with drug therapy treatment
Generic Name: Pyrazinamide

Classification: Anti- infectives (Antituberculotics)
Mode of action: Unknown.
Tubercolosis.

effective.
3. Inform the patient to report side To render the right nursing care
effects such as anorexia, nausea, actions if symptoms persist.
vomiting, dysuria and urticaria
4. Stress the importance of To guarantee effectivity of
compliance with drug therapy. treatment.
drugs.
with meals.
Generic Name: Ascorbic Acid
Classification: Vitamins and Minerals
Mode of action: It stimulates the collagen formation and tissue repair;
involved in oxidation- reduction reactions
Dosage, Route, Frequency: 500 mg. OD
Desired Effect: This was given to our patient to increase body resistance
against infection brought about by the condition of our patient which is
affected by tubercule bacilli.
effective.
3. Inform the patient to report side To make necessary nursing
effects such as diarrhea, actions addressing each symptom.
heartburn, nausea and vomiting.
4. Stress proper nutritional habits To prevent the recurrence of
such as eating a balanced diet deficiency and to fight off infection
5. Inform patient that Vitamin C is To intensify the advantage of
also readily absorbed from citrus Ascorbic Acid to the patient.
fruits, tomatoes, potatoes and
leafy vegetables
Generic Name: Salbutamol for nebulization

Mode of action: It relaxes the bronchial and vascular smooth muscle by
stimulating beta2 receptors
Dosage, Route, Frequency: 2.5 “u” per nebulization
Desired Effect: This was given to our patient to relax airways, thus
facilitating comfortable breathing mechanism.
effective.
3. Check vital signs before and To evaluate cardiac response.
after administration.
4. Before nebulizations, check For better care rendering.
equipment and medications.
5. Instruct proper nebulization To avoid dryness of patient’s face
procedure. Wash patient’s face
after.
6. Refrigerate medications and To ensure that drug components
use within 48 hours if seal is are no altered.
broken.
7. Render care that would To enhance the effectiveness of
potentiate drug action. drugs.
a. Teach patient on how to
cough out effectively.
b. Encourage increase fluid
intake.
c. Teach patient to avoid
irritants.
d. Teach patient on
breathing exercises.
Generic Name: Bromhexine for nebulization

Mode of action: A mucolytic agent used in the treatment of respiratory
disorders associated with viscid mucus. The breakdown of acid
mucopolysaccharides fibers makes the sputum thinner and less viscid
therefore more easily removed by coughing. Although sputum volume
eventually decreases, its viscosity remains low for as long as treatment with
Bromhexine is maintained. There is also an increased response to
bronchodilator drugs.
Dosage, Route, Frequency: 1 cc per nebulization
Desired Effect: This was given to our patient in order to increase the
viscosity of the mucus that is accumulated in the respiratory tract. Thus
facilitates easy expectoration of the mucus present and cough and volume of
the sputum is reduced.

effective.
3. Before nebulizations, check For better care rendering.
equipment and medications.
4. Instruct proper nebulization To avoid dryness of patient’s face
procedure. Wash patient’s face
after.
5. Watch out and instruct to notify To make necessary nursing
prescriber for side effects like actions.
stomatitis, nausea, drowsiness.
6. Refrigerate medications and To ensure that drug components
use within 48 hours if seal is are no altered.
broken.
7. Render care that would To enhance the effectiveness of
potentiate drug action. drugs.
a. Teach patient on how to cough
out effectively.
b. Encourage increase fluid intake.
Generic Name: Ambroxol

Mode of action: Posesses mucokinetic and secretolytic properties. It
promotes the removal of tenacious secretions in the respiratory tract and
reduces mucus statis. Expectoration of mucus is facilitated and breathing is
eased considerably.
Dosage, Route, Frequency: 75 mg. 1 cap OD
Desired Effect: This was given to our patient in order to increase the
viscosity of the mucus that is accumulated in the respiratory tract. Thus
facilitates easy expectoration of the mucus present and cough and volume of
the sputum is reduced.
effective.
3. Watch out and instruct to notify To make necessary nursing
prescriber for side effects like- actions.
stomatitis, nausea, drowsiness.
4. Render care that would To enhance effectiveness of drug
potentiate drug action. action.
a. Teach patient on how to cough
out effectively.
b. Encourage increase fluid intake.
Generic Name: Multivitamins

Classification: Vitamins and Minerals
Mode of action: Vitamins are the building blocks of the body.
Dosage, Route, Frequency: 1 tab OD, after lunch
Desired Effect: This was prescribed to our patient to increase his body
resistance against invading pathogens.
1. Check Doctor’s Order To protect self from illegal actions
effective
3. Teach patient to consult To render appropriate nursing
prescriber if mild nausea or actions.
unpleasant taste persist or
become severe.
4. Instruct patient to take it 1 hour Food may affect the absorption of
before meals or 2-3 hours after certain vitamin products.
meal.
5. Tell patient to notify prescriber These are signs of overdosage.
if symptoms like unconsciousness,
paleness, weak-rapid heartbeat,
stomach pain, nausea, vomiting,
or green diarrhea/tarry stools
occur.
6. Instruct patient that he must To maintain therapeutic serum
take the missed dose as soon as levels.
he remembers, do not take if it is
almost time for the next dose.
Instead, skip the missed dose and
resume your usual dosing
schedule. Do not "double-up" the
dose to catch up.
7. Store at room temperature To avoid alteration in its’
away from sunlight and moisture. components.
Generic Name: Ensure

Classification: Nutritional Support
Mode of action: It is complete, balanced nutrition for supplemental use,
thus, it can be used as a sole source of nutrition
Dosage, Route, Frequency: 6 scoops in 1 glass water TID
Desired Effect: This was given to our patient as a complete, balanced
nutrition for supplemental use, thus intended to restore or increase his body
resistance. Also to restore his ideal body weight because he had an
involuntary weight loss.
effective.
3. Explain its purpose and To gain cooperation in religiously
advantage to patient. taking it.

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VIII.

A. Generic Name: Cefuroxime

Nursing Responsibilities Rationale

2. To observe the 10 R’s in drug To potentiate the effects of the

3. Instruct the patient to maintain To prevent the occurrence of other

Date Ordered: June 29, 2006

Nursing Responsibilities Rationale

C. Generic Name: Metronidazole

Nursing Responsibilities Rationale

8. Inform the patient To anticipate the side effects of

A. Generic Name: Albuterol (Salbutamol)

Nursing Responsibilities Rationale

B. Generic Name: Cefuroxime

C. Generic Name: Metronidazole

Generic Name: Penicillin G Sodium

Generic Name: Iron+Vitamin B Complex

Generic Name: Bisacodyl

Generic Name: Elanapril maleate

1. Monitor vital signs of patient closely.

Generic Name: Nalbuphine

Generic Name: Cefuroxime sodium

1. Avoid touching the wound area.

Generic Name: Diclofenac Sodium

1. Asses for patient’s history of allergy to the drug

Generic Name: Ferrous Fumarate

1. Give the drug with meals or in full stomach

A. Generic Name: Albuterol (Salbutamol)

B. Generic Name: Bambuterol

C. Generic Name: Ambroxol

E. Generic Name: Hydrocortisone

E. Generic Name: Levofloxacin

Date ordered : Dec. 14, 2006

1. Obtain previous hypersensitivity reactions to avoid allergic reactions.

9. Encourage patient to drink plenty of fluids unless contraindicated to reduce risks

Date Ordered : Dec. 13, 2006

5. Instruct patient to follow a diet high in Iron to potentiate drug effect.

Date ordered : Dec. 16, 2006

3. Caution patient to avoid activities requiring alertness until responses to medication is

Date ordere : Dec. 13, 2006

6. Instruct patient to report adverse reactions such as fatigue, anxiety, dizziness,

7. To have a complete bed rest to decrease metabolic demand.

Date ordered :December 13, 2006

6. Take the drug regularly to maintain blood glucose level.

Date ordere : Dec. 13, 2006

Date ordered : Dec. 14, 2006

4. Check the patency of the IVF infusion site to avoid thrombophlebitis.

9. Instruct client to finish the drug therapy as prescribed to avoid exacerbation.

Date Ordered : Dec. 13, 2006

2. Assess patient for signs of acidosis- alkalosis to serve as a baseline data.

5. Emphasize the importance of regular follow-up examination to monitor serum electrolyte

Date Ordered : Dec. 13, 2006

3. Encourage patient to avoid excessive use of beverages containing alcohol, caffeine, or

Date Ordered : Dec. 14, 2006

Date Ordered : Dec. 13, 2006

2. Monitor blood sugar because dosage adjustment may be needed.

3. Check glucose level periodically to evaluate therapeutic response to drug.

4. Inform patient not to skip meals to avoid hypoglycemia.

5. Inform patient to carry a piece of non-dietetic hard candy to treat episodes of

Brand Name: None

Dosage, Route and Frequency: 750 mg IV q 18o

Classification: Antineoplastic (Antimeatabolite)

Mechanism of Action: Fluoruoracil itself is in active, but following intracellular