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X. Drug Study
Drug Name Dosage Mechanism of
Action
Indication Adverse Reaction Contraindication Nursing
Responsibility
Generic:
Clonazepam
Brand:
Rivotril
Classification:
Anticonvulsant
Antiepileptic
Dosage:
0.5 mg per Tablet
Frequency:
OD
Route:
Per orem
Clonazepam exertsits action by binding
to thebenzodiazepine site
of the GABA
receptors, whichcauses an
enhancement of theelectric effect of
GABA binding onneurons, resulting in
an increased influxof chloride ions into
the neurons. This
results in aninhibition of synaptictransmission across
the central nervoussystem.
(Pharmacology and
the Nursing Process.4th Ed. 2005. Mosby,
Inc. USA)
Periodic legmovements during
sleep, hypokineticdysarthria, acutemanic episodes,
multifocal ticdisorders, neuralgias
Used alone or as
adjunct in treatmentof Lennox-Gastaut
syndrome (petit malvariant), akinetic and
myoclonic seizures;
may be useful inpatients with absence
(petit mal) seizures,
treatment of panic
disorder with or
without agoraphobia
CNS: transient, milddrowsiness initially;
sedation, depression,lethargy, apathy,fatigue,
disorientation, anger,hostility, episodes of
mania andhypomania,
restlessness, crying,delirium, slurred
speech, stupor, vividdreams.
CV: Bradycardia,tachycardia, CVcollapse,
hypertension,palpitations, edema
Integ: Urticaria,
pruritus, rash,dermatitis
EENT: Visual and
auditory
disturbances,diplopia, nystagmus,nasal congestion
Contraindicated withhypersensitivity to
benzodiazepines,psychoses, acute
narrow-angle
glaucoma, shock,coma, acute
alcoholicintoxication with
depression of vitalsigns.
Use cautiously with
impaired liver or
kidney function,debilitation.
Assessment and
Drug Effects
Hypersensitivitytobenzodiazepines;
psychoses, acutenarrow-angle
glaucoma, shock,coma, acute
alcoholicintoxication, liver
renal impairment
Monitor addiction-prone patients
carefully becauseof their
predisposition to
habituation anddrug dependence
Monitor liverfunction and bloodcounts
periodically inpatients on long
tern therapy.
Monitor patientfor therapeutic
drug levels: 2080 ng/mL.
http://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_system7/27/2019 05 NCP - DRUG STUDY.docx
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BSN4A (GROUP 2) 30
GI: constipation,diarrhea, dry mouth,
nausea, anorexia,gastric disorders
GU: Incontinence,
urinary retention,changes in libido
Hema:blood
dyscrasias,agranulocytosis,
leucopenia
Other: hiccups,fever, diaphoresis,
paresthesias,gynecomastia.
Patient & Family
Education
Take drug exactlyas prescribed; do
not take drugwithout consulting
health careprovider
Avoid alcohol,sleep inducing or
over the counterdrugs
Report severedizziness,
weakness,drowsiness that
persists, rash orskin lesions,
difficulty voiding,palpitations,
swelling in theextremities.
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BSN4A (GROUP 2) 31
Drug Name Dosage Mechanism of
Action
Indication Contraindication Adverse Reaction Nursing
Responsibility
Generic:
Polynerv
Brand:
Vitamin B
Complex
Classification:
Vitamins andMinerals
Dosage:
500 mg per Tablet
Frequency:
OD
Route:
Per orem
A coenzyme thatstimulate metabolic
function and isneeded for cell
replication,hematopoiesis, andnucleoprotein and
myelin synthesis.Vitamins B1, B6and
B12 (Polynerv) oraldrops is valuable in
conditions where therequirements for B
vitamins areincreased as in
growth, physiologic
stress, decreasedresistance to
infection and chronic
illnesses, metabolicdisorder sand in
certain diseases ofthe digestive tract
and nervous system.(Roth, L.S. (2010).
Mosbys NursingDrug Reference, 23.
USA: Mosby, Inc)
Rheumaticpains,
alcoholism,cardiac
disorders, lowblood pressure.
Vitamin B complexshould not be used in
hypersensitivity toany of the vitamins
hypersensitive tovitamin B12 or
cobalt, containing in
the preparation, aswell as in patients with
2nd
or 3rd
degreearterial hypertension
CV: peripheralvascular thrombosis,
heart failure.
GI: transientdiarrhea.
Respi:pulmonaryedema.
Skin: itching,
transitoryexanthema, urticaria.
Other: anaphylaxis,
pain.
Assessment and
Drug Effects
Determinereticulocyte count,
hct, Vit. B12, iron,folate levels before
beginning therapy.
Obtain a sensitivitytest history beforeadministration
Avoid I.V.administration
because fastersystemic
elimination willreduce
effectiveness ofvitamin.
Dont give largedoses of vitamin
B12 routinely; drug
is lost throughexcretion.
Protect Vit. B12from light. Dont
refrigerate orfreeze.
Monitor patient forhypokalemia for
first 48 hours, asanemia correct
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BSN4A (GROUP 2) 32
itself. Givepotassium
supplements, asneeded.
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BSN4A (GROUP 2) 33
Drug Name Dosage Mechanism of
Action
Indication Contraindications Adverse Reaction Nursing
Responsibilities
Generic:
Diphenhydraminehydrochloride
Brand:
Benadryl
Classification:
Anticholinergic,
Antiparkinsoniandrug
Dosage:
50 mg per capsule
Frequency:
ODHS
Route:
Per orem
Competes withhistamine for H1
receptor site.Antagonizes the
effect of histamine atH1 receptor sites;does not bind or
inactivate histamine.Prevents, but doesnt
reverse, histaminemediated responses
particularly those ofbronchial tubes, GI
tract, and bloodvessels
(Roth, L.S. (2010).
Mosbys NursingDrug Reference, 23.
USA: Mosby, Inc)
Pseudoparkinsonismdrug-induced
extrapyramidaleffects
Used to treat anxiety,tension,
sleeplessness orinvoluntary
movements due tothe side effects of
certain psychiatricdrugs
Contraindicated inpatients with
hypersensitivity todrug.
Avoid use in patientstaking MAO
inhibitors
Caution in patientswith asthma, COPD,
cardiac disease orhypertension,
glaucoma, andgastric or duodenal
ulcers
CNS: drowsiness,confusion, insomnia,
headache, vertigo,sedation, sleepiness,
nervousness,restlessness
CV: Palpitations,hypotension,
tachycardia
EENT:blurred vision,
nasalcongestion,
tinnitus
GIT: nausea andvomiting, dry mouth,
constipation,anorexia
Urogenital: dysurea,
urine retention,urinary frequency
Hema: hemolytic
anemia,
thrombocytopenia,agranulocytosis
Assessment and
Drug Effects
When taking thesemedications, the
client needs to haveblood cells counts,renal function,
hepatic function,and blood pressure
monitored.
Assess for allergyPatient & Family
Education
Caution the clientthat the
medication maycause drowsiness,creating
difficulties orhazards or other
activities that
require alertness.
Tell the client totake themedication with
food to decreaseGI upset.
Explain to theclient that arising
quickly from a
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BSN4A (GROUP 2) 34
Respi: thickening ofbronchial secretions
Skin: Urticaria,
photosensitivity,rash.
Other : anaphylactic
shock
lying or sittingposition may
cause orthostatichypotension.
Explain to theclient that use of
these drugs inwarm weather
may increase thelikelihood of
heatstroke.
Report difficultyof breathing
Administer syrupform if patient is
unable to taketablets
Warn patient notto take this drugwith any other
products thatcontain
diphenhydramine(including topical
therapy) becauseof increased
adverse reactions.
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BSN4A (GROUP 2) 35
Drug Name Dosage Mechanism of
Action
Indication Contraindications Adverse Reaction Nursing
Responsibility
Generic:
Ascorbic Acid
Brand:
Nutri Cee
Classification:
Vitamins
DOSAGE:
500 mg in tabletform
FREQUENCY:
OD
ROUTE:
Per orem
Thechemopreventive
action of vitamin Cis attributed to two of
its functions. It is awater-soluble chain
breaking antioxidant.
As an antioxidant, itscavenges free
radicals and reactiveoxygen molecules,
which are producedduring metabolic
pathways ofdetoxification.
It also prevents
formation ofcarcinogens from
precursor
compounds.The structure of
ascorbic acid isreminiscent of
glucose, from whichit is derived in the
majority of mammals(Wolters Kluwer,
2009)
Increases protectionmechanism of the
immune system, thussupporting wound
healing. Necessaryfor wound healingand resistance to
infection.
Prevention andtreatment of vitamin
C deficiency
Use of sodiumascorbate in patients
on sodium restriction
Use of calciumascorbate in patientsreceiving digitalis.
GI: Nausea,vomiting, heartburn,
diarrhea, orabdominal cramps
(high doses).
Hematologic: Acute
hemolytic anemia(patients with
deficiency of G6PD);sickle cell crisis.
CNS: Headache or
insomnia (highdoses).
Urogenital:Urethritis, dysuria,crystalluria,
hyperoxaluria, orhyperuricemia (high
doses).
Other: Mildsoreness at injection
site; dizziness andtemporary faintness
with rapid IV
administration.
Assessment & Drug
Effects Lab tests:
Periodic Hct &
Hgb, serumelectrolytes.
Monitor forS&S of acutehemolytic
anemia, sicklecell crisis.
Patient & Family
Education Take large dosesof vitamin C in
divided amountsbecause the bodyuses only what is
needed at aparticular time and
excretes the rest inurine.
Megadoses caninterfere with
absorption ofvitamin B12.
Note: VitaminC increases theabsorption of ironwhen taken at the
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BSN4A (GROUP 2) 36
same time as iron-rich foods.
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BSN4A (GROUP 2) 37
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BSN4A (GROUP 2) 38
NURSING CARE PLAN # 2
Assessment Data Nursing Diagnosis Rationale Expected Outcome Nursing Intervention Justification Evaluation
Actual/Abnormal
Cues:
Difficultyfalling asleep atnight
Clientsverbalization
hambal sangdoctor side
effect na kunosang bulong ko
Long hours ofsleep at daytime
(average of 3-5hours)
Fatigue onawakeningRisk Factors:
Side effects ofmedications
Environment History of
alcoholism
History ofchronic cigarette
smoking
Disturbed sleep
pattern related to
excessive daytime
sleepingsecondary to
medications as
evidenced bydifficulty falling
asleep at night,long hours of sleep
at daytime andfatigue on
awakening.
Definition:
Disturbed sleeppatternis the state
in which anindividual
experiences or isat risk of
experiencing achange in the
quantity or quality
of his or her restpattern that causes
discomfort or
Predisposing factors:
History of substanceabuse
Precipitating factors:
History of alcoholism History of chronic
cigarette smoking
Environment
Health care intervention
Administration ofmedications
Therapeuticeffects
Non-therapeuticeffects
Drowsiness and sleepiness
during daytime
Difficulty sleeping at nighttime
Fatigue upon awakening in
the morning
Disturbed sleep pattern
After 32 hours of
nurse-clientinteraction, the
client will be ableto:
1. Identifypersonal habits
that disruptsleep pattern.
1.1Obtain a sleep-wake history
including historyof sleep problems,
changes in sleeppatterns, and use of
medications andstimulants.
1.2Assess for use ofalcohol orcigarettes prior to
use of sleepmedication or
retiring for theevening.
1.1Assessment ofsleep behavior
and patterns arean important
part of anyhealth status
examination.
1.2Alcohol andnicotine should
be avoided for
several hoursprior to sleep.
After 32 hours of
nurse-clientinteraction, the client
was able to:
1.Goal met.Recognize that
before he wasadmitted,
prohibited drugsused to relax him;
but now that he isunder treatment,
the medication he
is taking causeshim to have sleepdisturbance. He
verbalized thataccording to the
doctor, what he isexperiencing is
one of the sideeffects of his
medications. Healso added that his
cravings for drugs
especially at nightcontribute to hissleep disturbance.
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BSN4A (GROUP 2) 39
Strengths:
Strong spiritualbelief
Disciplined Good
interpersonal
relationship Compliance to
treatmentregime
Willingness tochange to
improve hishealth
interferes withdesired lifestyle.
Source:Handbook of
Nursing Diagnosis13 Ed by Moyet
Pp 446-449
Source:Handbook of Nursing
Diagnosis 13 Ed by Moyetpp 446-449
2. Verbalize waysthat can help
promote hissleeping
pattern.
2.1 Initiatenon-
pharmacologicinterventions for
improved sleepincluding:
Encourageclient to have
an increase insunlight
exposure
Provideeducational
interventions topromote
beneficial sleephygiene
(Including theimpact of
substance useon sleep
quality,keeping regular
waking andsleeping times,
avoiding naps,refraining from
caffeine,impact of
exercise onsleep and
environmental
2.1 Non-pharmacologic
interventionshave been
found toimprove sleep
efficiency andincrease
satisfaction withsleep pattern
whiledecreasing
use ofhypnotics.
2.Goal met. Statethat he usually
watches televisionor have a chit-chat
with hisroommates to help
him fall asleep andlessen the cravings
of taking drugs.He added that he
would sometimeswrite anything or
read magazinesand play with his
friends so that hecould divert his
attention and hewill not get sleepy
during the day.
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BSN4A (GROUP 2) 40
3. Achieveoptimal
amounts ofsleep as
evidenced byverbalization of
feeling restedand improved
sleepingpattern.
adjustments topromote sleep)
Providediversionalactivities to
providestimulation
(talking to co-residents, play
games)
3.1 Evaluate learningoutcomes using
patientverbalizations of
following thetreatment
recommendationsand experiencing
enhanced sleep.
3.1Evaluationserves as an
assessment ofthe
effectiveness ofcare and allows
opportunity foradjustments to
the plan of care
Source:
http://www.pterrywave.
com/nursing/care%20plans/
51.aspx
3.Goal partially met.Verbalize biskan
makatulug ko saaga..makatulug
naman ko amat-amat kung
gabemakapahuway naman ko
sang maayo kagga amat-amat
naman dula angsakit sa kalawasan
ko
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BSN4A (GROUP 2) 41
NURSING CARE PLAN # 3
Assessment Data Nursing Diagnosis Rationale Expected Outcome Nursing Intervention Justification Evaluation
Risk factors:
Physical isolation Social isolation Affectionaldeprivation Substance abuseStrengths:
Extrovertpersonality
Goodinterpersonal
relationship
Beingparticipative and
active duringgroup sessions
Good familysupport
Risk for loneliness
related to
therapeutic
isolation secondaryto substance abuse.
Definition:
Risk for LonelinessThe state in which anindividual is at risk
for experiencingdiscomfort
associated with adesire or need for
contact with others.
Source:
Handbook ofNursing Diagnosis13 Ed by Moyet
Predisposing factors:
GenderPrecipitating factors: Substance abuse Admission to the
institution
Physical isolation
Social isolation
Impaired socialinteraction
Affectionaldeprivation
Risk for loneliness
Source:
Handbook of
Nursing Diagnosis13 Ed by MoyetPp 273-277
After 32 hours of
nurse-clientinteraction, the client
will be able to:
1. Verbalizefeelings ofloneliness and
express desire tosocialize more.
1.1Work with thepatient to identifyfactors and
behaviors thathave contributed
to loneliness.
1.2Help clientidentify feelings
associated with
loneliness.
1.3Spend sufficienttime with the
patient to allow
him to expresshis feelings.
1.4Encourage clientto address his
needs assertively.
1.1To beginchanging
behaviors that
may havealienated others.
1.2This lessens theimpact of
feelings and
mobilizes energyto counteractthem.
1.3To establish atrustingrelationship.
1.4By beingassertive, client
assumesresponsibility formeeting his
After 32 hours of
nurse-clientinteraction, the client
was able to:
1. Goal met.Verbalize,Nasubon ko di kay wala
kami di masyadomay ginahimo,
lalo na bi kungwala kamo, subo
gid ya eh! Sadyakung ari kamo di
kag kung wala na
kami himo-on galantaw kami tv orga hampang diri
sa may polan.
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BSN4A (GROUP 2) 42
Pp 273-277
2. Identify peoplewho will likelysupport and
accept him.
3.
Formulate planson how to
comfortably
2.1 Inform client
that assistance isavailable to help
him expressfeelings of
loneliness andidentify ways to
increase socialactivity.
2.2 Help client curb
feelings ofloneliness by
encouraging one-on-one
interaction withothers who are
likely to accepthim.
3.1As clientscomfort level
improves,
needs withoutanger or guilt.
2.1 To bring issue
into open andhelp client
understand thatyou want to help
him.
2.2 To promote
feelings ofacceptance and
support.
3.1To promote theuse of social
skills.
2.Goal met. Statekung daw kasubo na gid, ga
isturya na lang kosa mga upod ko
lalo na kay JR kaymigo ko na siya
di. Dayun gapasalamat man ko
kay ginadu-aw kodi kag
ginasuportahan kosang akun amay
kag iloy kag kungkis-a upod man
nila ang bata ko.Masadyahan
naman ko nadayun kay
maisturya ko silakag makamusta
man. Gapasalamat man ko
kay ari kamo dipara may ma
isturya man ko.
3.Goal met.Encourage his
colleagues to join
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BSN4A (GROUP 2) 43
interact withpeers and on
how to continueinvolvement
with othersthrough
recreationalactivities or
social interactiongroups.
encourage him toattend to group
activities andsocial functions.
3.2Refer client andfamily to socialservice agencies,
mental healthcenter and
appropriatesupport groups.
3.2To ensurecontinued careand maintain
socialinvolvement.
Source:http://nandanursing
diagnosis.org/nursing-diagnosis-
risk-loneliness/
the morningworship and join
the activities leadby the students.
Also, he alwaystry to play with
his colleagues soas to maintain his
good interpersonalrelationship with
them.
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BSN4A (GROUP 2) 44
X. Drug Study
Drug Name Dosage Mechanism of
Action
Indication Adverse Reaction Contraindication Nursing
Responsibility
Generic:
Clonazepam
Brand:
Rivotril
Classification:
Anticonvulsant
Antiepileptic
Dosage:
0.5 mg per Tablet
Frequency:
OD
Route:
Per orem
Clonazepam exertsits action by binding
to the
benzodiazepine siteof the GABA
receptors, whichcauses an
enhancement of theelectric effect of
GABA binding onneurons, resulting in
an increased influxof chloride ions into
the neurons. This
results in aninhibition of synaptictransmission across
the central nervoussystem.
(Pharmacology and
the Nursing Process.4th Ed. 2005. Mosby,
Inc. USA)
Periodic legmovements during
sleep, hypokinetic
dysarthria, acutemanic episodes,
multifocal ticdisorders, neuralgias
Used alone or as
adjunct in treatmentof Lennox-Gastaut
syndrome (petit malvariant), akinetic and
myoclonic seizures;
may be useful inpatients with absence(petit mal) seizures,
treatment of panicdisorder with or
without agoraphobia
CNS: transient, milddrowsiness initially;
sedation, depression,
lethargy, apathy,fatigue,
disorientation, anger,hostility, episodes of
mania andhypomania,
restlessness, crying,delirium, slurred
speech, stupor, vividdreams.
CV: Bradycardia,tachycardia, CVcollapse,
hypertension,palpitations, edema
Integ: Urticaria,
pruritus, rash,dermatitis
EENT: Visual and
auditory
disturbances,diplopia, nystagmus,nasal congestion
Contraindicated withhypersensitivity to
benzodiazepines,
psychoses, acutenarrow-angle
glaucoma, shock,coma, acute
alcoholicintoxication with
depression of vitalsigns.
Use cautiously with
impaired liver or
kidney function,debilitation.
Assessment and
Drug Effects
Hypersensitivityto
benzodiazepines;
psychoses, acutenarrow-angle
glaucoma, shock,coma, acute
alcoholicintoxication, liver
renal impairment
Monitor addiction-prone patients
carefully becauseof theirpredisposition to
habituation anddrug dependence
Monitor liverfunction and bloodcounts
periodically inpatients on long
tern therapy.
Monitor patientfor therapeuticdrug levels: 2080 ng/mL.
http://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_system7/27/2019 05 NCP - DRUG STUDY.docx
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BSN4A (GROUP 2) 45
GI: constipation,diarrhea, dry mouth,
nausea, anorexia,gastric disorders
GU: Incontinence,
urinary retention,changes in libido
Hema:blood
dyscrasias,agranulocytosis,
leucopenia
Other: hiccups,fever, diaphoresis,
paresthesias,gynecomastia.
Patient & Family
Education
Take drug exactlyas prescribed; do
not take drugwithout consulting
health careprovider
Avoid alcohol,sleep inducing or
over the counterdrugs
Report severedizziness,
weakness,drowsiness that
persists, rash orskin lesions,
difficulty voiding,palpitations,
swelling in theextremities.
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BSN4A (GROUP 2) 46
Drug Name Dosage Mechanism of
Action
Indication Contraindication Adverse Reaction Nursing
Responsibility
Generic:
Polynerv
Brand:
Vitamin B
Complex
Classification:
Vitamins andMinerals
Dosage:
500 mg per Tablet
Frequency:
OD
Route:
Per orem
A coenzyme thatstimulate metabolic
function and isneeded for cell
replication,
hematopoiesis, andnucleoprotein and
myelin synthesis.Vitamins B1, B6and
B12 (Polynerv) oraldrops is valuable in
conditions where therequirements for B
vitamins areincreased as in
growth, physiologicstress, decreased
resistance toinfection and chronic
illnesses, metabolicdisorder sand in
certain diseases ofthe digestive tract
and nervous system.(Roth, L.S. (2010).
Mosbys NursingDrug Reference, 23.
USA: Mosby, Inc)
Rheumaticpains,
alcoholism,cardiac
disorders, low
blood pressure.
Vitamin B complexshould not be used in
hypersensitivity toany of the vitamins
hypersensitive to
vitamin B12 orcobalt, containing in
the preparation, aswell as in patients with
2nd
or 3rd
degreearterial hypertension
CV: peripheralvascular thrombosis,
heart failure.
GI: transient
diarrhea.
Respi:pulmonaryedema.
Skin: itching,
transitoryexanthema, urticaria.
Other: anaphylaxis,
pain.
Assessment and
Drug Effects
Determinereticulocyte count,hct, Vit. B12, iron,
folate levels beforebeginning therapy.
Obtain a sensitivitytest history beforeadministration
Avoid I.V.administration
because fastersystemic
elimination willreduce
effectiveness ofvitamin.
Dont give largedoses of vitamin
B12 routinely; drug
is lost throughexcretion.
Protect Vit. B12from light. Dont
refrigerate orfreeze.
Monitor patient forhypokalemia forfirst 48 hours, asanemia correct
http://www.mims.com.ph/Page.aspx?menuid=companionhome&ID=70http://www.mims.com.ph/Page.aspx?menuid=companionhome&ID=707/27/2019 05 NCP - DRUG STUDY.docx
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BSN4A (GROUP 2) 47
itself. Givepotassium
supplements, asneeded.
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BSN4A (GROUP 2) 48
Drug Name Dosage Mechanism of
Action
Indication Contraindications Adverse Reaction Nursing
Responsibilities
Generic:
Diphenhydraminehydrochloride
Brand:
Benadryl
Classification:
Anticholinergic,
Antiparkinsoniandrug
Dosage:
50 mg per capsule
Frequency:
ODHS
Route:
Per orem
Competes withhistamine for H1
receptor site.Antagonizes the
effect of histamine at
H1 receptor sites;does not bind or
inactivate histamine.Prevents, but doesnt
reverse, histaminemediated responses
particularly those ofbronchial tubes, GI
tract, and bloodvessels
(Roth, L.S. (2010).Mosbys Nursing
Drug Reference, 23.USA: Mosby, Inc)
Pseudoparkinsonismdrug-induced
extrapyramidaleffects
Used to treat anxiety,tension,
sleeplessness orinvoluntary
movements due tothe side effects of
certain psychiatricdrugs
Contraindicated inpatients with
hypersensitivity todrug.
Avoid use in patientstaking MAO
inhibitors
Caution in patientswith asthma, COPD,
cardiac disease orhypertension,
glaucoma, andgastric or duodenal
ulcers
CNS: drowsiness,confusion, insomnia,
headache, vertigo,sedation, sleepiness,
nervousness,
restlessness
CV: Palpitations,hypotension,
tachycardia
EENT:blurred vision,
nasalcongestion,
tinnitus
GIT: nausea andvomiting, dry mouth,
constipation,anorexia
Urogenital: dysurea,
urine retention,urinary frequency
Hema: hemolytic
anemia,thrombocytopenia,
agranulocytosis
Assessment and
Drug Effects
When taking thesemedications, theclient needs to have
blood cells counts,renal function,
hepatic function,and blood pressure
monitored.
Assess for allergyPatient & Family
Education
Caution the clientthat themedication may
cause drowsiness,creating
difficulties orhazards or other
activities that
require alertness.
Tell the client totake themedication with
food to decreaseGI upset.
Explain to theclient that arising
quickly from a
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Respi: thickening ofbronchial secretions
Skin: Urticaria,
photosensitivity,rash.
Other : anaphylacticshock
lying or sittingposition may
cause orthostatichypotension.
Explain to theclient that use of
these drugs in
warm weathermay increase thelikelihood of
heatstroke.
Report difficultyof breathing
Administer syrupform if patient is
unable to taketablets
Warn patient notto take this drugwith any other
products thatcontain
diphenhydramine(including topical
therapy) becauseof increased
adverse reactions.
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BSN4A (GROUP 2) 50
Drug Name Dosage Mechanism of
Action
Indication Contraindications Adverse Reaction Nursing
Responsibility
Generic:
Ascorbic Acid
Brand:
Nutri Cee
Classification:
Vitamins
DOSAGE:
500 mg in tabletform
FREQUENCY:
OD
ROUTE:
Per orem
Thechemopreventive
action of vitamin Cis attributed to two of
its functions. It is a
water-soluble chainbreaking antioxidant.
As an antioxidant, itscavenges free
radicals and reactiveoxygen molecules,
which are producedduring metabolic
pathways ofdetoxification.
It also preventsformation of
carcinogens fromprecursor
compounds.The structure of
ascorbic acid isreminiscent of
glucose, from whichit is derived in the
majority of mammals(Wolters Kluwer,
2009)
Increases protectionmechanism of the
immune system, thussupporting wound
healing. Necessary
for wound healingand resistance to
infection.
Prevention andtreatment of vitamin
C deficiency
Use of sodiumascorbate in patients
on sodium restriction
Use of calcium
ascorbate in patientsreceiving digitalis.
GI: Nausea,vomiting, heartburn,
diarrhea, orabdominal cramps
(high doses).
Hematologic: Acute
hemolytic anemia(patients with
deficiency of G6PD);sickle cell crisis.
CNS: Headache or
insomnia (highdoses).
Urogenital:Urethritis, dysuria,crystalluria,
hyperoxaluria, orhyperuricemia (high
doses).
Other: Mildsoreness at injection
site; dizziness andtemporary faintness
with rapid IVadministration.
Assessment & Drug
Effects Lab tests:
Periodic Hct &
Hgb, serum
electrolytes. Monitor for
S&S of acutehemolytic
anemia, sicklecell crisis.
Patient & Family
Education Take large dosesof vitamin C individed amounts
because the bodyuses only what is
needed at aparticular time and
excretes the rest inurine.
Megadoses caninterfere with
absorption ofvitamin B12.
Note: VitaminC increases the
absorption of ironwhen taken at the
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same time as iron-rich foods.