ILOILO DOCTORS’ COLLEGE

COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DRUG STUDY
DEFINING NURSING DIAGNOSIS OUTCOME NURSING RATIONALE EVALUATION
CHARACTERISTIC IDENTIFICATION INTERVENTION

Generic Name: Classifications: Indications: Frequent (greater ● Hepatic ● Assess

Amlodipine ● Hypertension than 5%): impairment, baseline
PHARMACOTHERAPEUTIC: ● Angina & ● Peripheral ● Severe aortic renal/hepatic
Calcium channel blocker. Coronary Artery edema, stenosis, function tests, B/P,
CLINICAL: Antihypertensive, Disease ● Headache, ● Hypertrophic apical pulse.
antianginal. ● Flushing. cardiomyopathy with ● Assess B/P (if
Trade/ Brand Name: outflow tract systolic B/P is less
Norvasc Occasional (5%– obstruction than 90 mm Hg,
1%): withhold
Actions: ● Dizziness, medication, contact
Inhibits calcium movement ● Palpitations, physician).
Dosage: across cardiac and vascular ● Nausea, ● Assess for
5mg/tab smooth muscle cell ● Unusual peripheral edema
membranes. fatigue or weakness behind medial
(asthenia). malleolus (sacral
Therapeutic Effect: area in bedridden
Route: Dilates coronary arteries, Contraindications: Rare (less than 1%): pts).
Oral peripheral arteries/arterioles. ● Hypersensitivity ● Chest pain, ● Assess skin
Decreases total peripheral to amlodipine. ● Bradycardia, for flushing.
vascular resistance and B/P by ● Orthostatic Question for
vasodilation. hypotension. headache, asthenia.
Frequency and
Timing:
PRN Q4H
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

Adverse Patient/family
effects/toxic teaching:
reactions: ● Do not
● Overdose may abruptly discontinue
produce excessive medication.
peripheral ● Compliance
vasodilation, marked with therapy
hypotension with regimen is essential
reflex tachycardia, to control
syncopy. hypertension.
● Avoid tasks
that require
alertness, motor
skills until response
to drug is
established.
● Do not ingest
grapefruit products.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DEFINING NURSING DIAGNOSIS OUTCOME NURSING RATIONALE EVALUATION

CHARACTERISTIC IDENTIFICATION INTERVENTION

Generic Name: Classifications Indications: Frequent (40%– ● Depression, ● Obtain B/P

Clonidine ● Hypertension 10%): ● Elderly. immediately
PHARMACOTHERAPEUTIC: ● Acute ● Dry mouth, ● Severe coronary before each dose is
Alpha2 -adrenergic agonist. Hypertension ● Drowsiness, insufficiency, administered, in
CLINICAL: Antihypertensive. ● Attention- ● Dizziness, ● Recent MI, addition to regular
Deficit Hyperactivity ● Sedation, ● Cerebrovascular monitoring (be
Trade/ Brand Name: Disorder (ADHD) ● Constipation. disease, alert to B/P
Catapres ● Severe Pain ● Chronic renal fluctuations).
Occasional (5%– impairment, ● Monitor
1%): Tablets, ● Preexisting B/P, pulse, mental
Injection: bradycardia, status.
Dosage: ● Sinus node ● Monitor
75mg/tab Actions: ● Depression, dysfunction, daily pattern of
Stimulates alpha2 -adrenergic Contraindications: ● Pedal edema, ● Conduction bowel activity,
receptors, reducing sympathetic ● Hypersensitivity ● Loss of disturbances; stool consistency.
CNS response. to clonidine. appetite, concurrent use with ● If clonidine
Route: ● Decreased digoxin, diltiazem, is to be withdrawn,
Sublingual Therapeutic Effect: Reduces sexual function, metoprolol, verapamil. discontinue
peripheral resistance; decreases ● Itching eyes, concurrent beta
B/P, heart rate. Produces ● Dizziness, blocker therapy
Frequency and analgesia. ● Nausea, several days before
Timing: ● Vomiting, discontinuing
● Nervousness. clonidine (prevents
clonidine
Rare (less than 1%): withdrawal
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

● Nightmares, hypertensive
● Vivid dreams, crisis).
● Feeling of ● Slowly
coldness in distal reduce clonidine
extremities (esp. the dosage over 2–4
digits). days.

Patient/family
Adverse teaching
effects/toxic ● Sugarless
reactions: gum, sips of water
● Overdose may relieve dry
produces profound mouth.
hypotension, ● Avoid tasks
● Irritability, that require
● Bradycardia, alertness, motor
● Respiratory skills until
depression, response to drug is
● Hypothermia, established.
● Miosis ● To reduce
(pupillary hypotensive
constriction), effects, rise slowly
● Arrhythmias, from lying to
● Apnea. standing.
● Abrupt ● Skipping
withdrawal may doses or
result in rebound voluntarily
hypertension discontinuing
associated with drugs may produce
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

nervousness, severe rebound

agitation, anxiety, hypertension.
insomnia, ● Avoid
paresthesia, tremor, alcohol.
flushing, diaphoresis. ● If patch
● May produce loosens during the
sedation in pts with 7-day application
acute CVA. period, secure with
adhesive cover.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DEFINING NURSING DIAGNOSIS OUTCOME NURSING RATIONALE EVALUATION

CHARACTERISTIC IDENTIFICATION INTERVENTION

Generic Name: Classifications: Indications: Rare: ● Sensitivity to ● If given for

Paracetamol/ ● Analgesia ● Hypersensitivity acetaminophen; analgesia, assess onset,
Acetaminophen PHARMACOTHERAPE ● Antipyresis reaction. severe renal type, location, duration
UTIC: impairment; alcohol of pain.
Central analgesic. Adverse effects/toxic dependency, hepatic ● Effect of
reactions : impairment, or active medication is reduced
CLINICAL: Early Signs of hepatic disease; if full pain response
Trade/ Brand Name: Non-narcotic analgesic, Acetaminophen chronic malnutrition recurs prior to the next
Tylenol antipyretic. Toxicity: and hypovolemia dose.
● Anorexia, (Ofirmev); G6PD ● Assess for fever.
● Nausea, deficiency ● Assess LFT in
Actions: Contraindications: ● Diaphoresis, (hemolysis may pts with chronic usage
Dosage: Appears to inhibit ● Hypersensitivity ● Fatigue within occur). or history of hepatic
500mg/tab prostaglandin synthesis in the first 12–24 hrs. ● Limit dose to impairment, alcohol
to acetaminophen:
the CNS and, to a lesser
severe hepatic less than 4 g/day. abuse.
extent, block pain
impairment or severe Later Signs of ● Assess for
impulses through
peripheral action. Acts active liver disease. Toxicity: clinical improvement
Route: centrally on ● Vomiting, and relief of pain,
Oral hypothalamic heat ● Right upper fever.
regulating center, quadrant tenderness,
producing peripheral ● Elevated LFTs Patient/family teaching
vasodilation (heat within 48–72 hrs after ● Consult a
Frequency and loss, skin erythema, ingestion. Antidote: physician for use
Timing: diaphoresis). Acetylcysteine longer than 10 days
PRN Q4H (adults), or fever
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

Therapeutic Effect: lasting longer than 3

Results in antipyresis. days.
Produces analgesic effect. ● Severe/recurrent
pain or
high/continuous fever
may indicate serious
illness.
● Do not take
more than 4 g/day (3
g/day if using OTC
[over-the-counter]).
Actual OTC dosing
recommendations may
vary by product and/or
manufacturer. Many
nonprescription
combination products
contain
acetaminophen. Avoid
alcohol.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DEFINING NURSING DIAGNOSIS OUTCOME NURSING RATIONALE EVALUATION

CHARACTERISTIC IDENTIFICATION INTERVENTION

Generic Name: Classifications: Indications: Expected: ● Hepatic ● Check vital

Furosemide ● Edema, ● Increased cirrhosis, signs, esp. B/P,
PHARMACOTHERAPEUTIC: ● HF urinary ● Hepatic coma, pulse, for
Loop diuretic. ● Hypertension frequency/volume. ● Severe hypotension before
CLINICAL: electrolyte administration.
Diuretic. Frequent: depletion, ● Assess
Trade/ Brand Name: ● Nausea, ● Prediabetes, baseline renal
Lasix ● dyspepsia, ● Diabetes, function, serum
● abdominal ● Systemic electrolytes, esp.
cramps, lupus serum sodium,
Actions: Contraindications: ● diarrhea or erythematosus. potassium.
Dosage: Enhances excretion of sodium, ● Hypersensitivity constipation, ● Pts with ● Assess skin
20mg chloride, potassium by direct to furosemide. ● electrolyte prostatic turgor, mucous
action at ascending limb of ● Anuria. disturbances. hyperplasia/urinary membranes for
loop of Henle. stricture. hydration status;
Occasional: observe for edema.
Route: Therapeutic Effect: Produces ● Dizziness, ● Assess
IVTT diuresis, lowers B/P ● Light- muscle strength,
headedness, mental status.
● Headache, ● Note skin
Frequency and ● Blurred vision, temperature,
Timing: ● Paresthesia, moisture.
Q8H as ordered ● Photosensitivity, ● Obtain
● Rash, baseline weight.
● Fatigue,
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

● Bladder spasm, ● Initiate I&O

● Restlessness, monitoring.
● Diaphoresis. ● Auscultate
lung sounds.
Rare: ● In pts with
● Flank pain. hepatic cirrhosis
and ascites,
Adverse effects/toxic consider giving
reactions: initial doses in a
● Vigorous hospital setting.
diuresis may lead to ● Monitor B/P,
profound water vital signs, serum
loss/electrolyte electrolytes, I&O,
depletion, resulting in weight.
hypokalemia, ● Note extent
hyponatremia, of diuresis.
dehydration. ● Watch for
● Sudden volume symptoms of
depletion may result in electrolyte
increased risk of imbalance:
thrombosis, circulatory Hypokalemia may
collapse, and sudden result in changes in
death. muscle strength,
● Acute tremor, muscle
hypotensive episodes cramps, altered
may occur, sometimes mental status,
several days after cardiac
beginning therapy. arrhythmias;
hyponatremia may
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

● Ototoxicity result in confusion,

(deafness, vertigo, thirst, cold/clammy
tinnitus) may occur, skin.
esp. in pts with severe ● Consider
renal impairment. potassium
● Can exacerbate supplementation if
diabetes mellitus, hypokalemia
systemic lupus occurs.
erythematosus, gout,
pancreatitis. Patient/family
● Blood teaching: •
dyscrasias have been ● Expect
reported. increased
frequency, volume
of urination. •
● Report
palpitations, signs
of electrolyte
imbalances (noted
previously),
hearing
abnormalities
(sense of fullness
in ears, tinnitus). •
● Eat foods
high in potassium
such as whole
grains (cereals),
legumes, meat,
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

bananas, apricots,
orange juice,
potatoes (white,
sweet), raisins.
● Avoid
sunlight, sunlamps.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DEFINING NURSING OUTCOME NURSING RATIONALE EVALUATION

CHARACTERISTIC DIAGNOSIS IDENTIFICATION INTERVENTION

Generic Name: Classifications: Indications: Side effects: Discontinue CIPRO  Check doctors
Ciprofloxacin  Nausea immediately at the order
Therapeutic class Ciprofloxacin is used  Vomiting first signs or
Antibiotic to treat infections of  Stomach pain symptoms of any  Observe the 10
Trade/ Brand the skin, lungs, Heartburn serious adverse rights of
Name: Chemical class airways, bones, and  Diarrhea reaction. medication
Keptrix Fluoroquinolones joints caused by  Feeling an Avoid the use of
susceptible bacteria. urgent need to fluoroquinolones,  Assess the
It is also frequently urinate including CIPRO, in expected
Dosage: used to treat urinary  Headache patients who have actions, dose
500 mg/tab Actions: infections caused by  Hives experienced any range, side
Ciprofloxacin is a bacteria such as  Difficulty serious adverse effects of the
bactericidal antibiotic E.coli. It is effective breathing or reactions associated medication, and
of the in treating infectious swallowing with any precaution
Route: fluoroquinolone drug diarrheas caused by  Hoarseness or fluoroquinolones. to be taken
Oral class. It inhibits E. coli, throat tightness
DNA replication by Campylobacter jejuni  Rapid,
inhibiting bacterial , and Shigella irregular, or  Provide client
Frequency and DNA topoisomerase bacteria pounding education about
Timing: and DNA-gyrase heartbeat medication
 Fainting
Once a day for 10
days  Instruct client
(8am) to report any
adverse
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

Contraindications : Adverse effect: reaction to the

Restlessness physician or
Hypersensitivity Arthropathy GI upset nurse.
Pregnancy and Headache
lactation  Instruct patient
that antacids
and mineral
supplements
may decrease
the absorption
of
Ciprofloxacin
which makes it
less effective
when taken at
the same time.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DEFINING NURSING OUTCOME NURSING RATIONALE EVALUATION

CHARACTERISTIC DIAGNOSIS IDENTIFICATION INTERVENTION

Generic Name: Classifications: Indications:  Kalimate should  Verify any

sodium polystyrene Calcium polystyrene Treatment of Side effects: not be used as an medication
sulfonate sulfonate hyperkalemia due to Rare: emergency order and make
acute and chronic  Bloody vomit treatment for life- sure it's
renal failure  Chest pain threatening complete.
Trade/ Brand secondary to any  Cough producing hyperkalemia
Name: Actions: cause. mucus because of its  Check the
Kalimate Powder Inhibits the increase  Difficulty with delayed onset of patient's
fecal potassium breathing action. medical record
excretion through Contraindications:  Fever or chills for an allergy or
Dosage: binding of potassium in  Severe stomach contraindication
1 sachet/ 5g the lumen of the Hypersensitivity to pain  Kalimate is not to the
gastrointestinal tract. drug  Shortness of breath totally selective for prescribed
Hypokalemia or  Sneezing potassium, and medication.
Route: other electrolyte  Sore throat small amounts of
Oral-suspension imbalances  Tightness in the other cations such  Follow the 10
Obstructive bowel chest as magnesium and rights of
disease  Troubled breathing calcium can be lost Medication
Frequency and  wheezing during treatment administration
Timing: .
3x a day  Educate
8am-1pm-6pm patients about
their
medications.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

Adverse effect:
 Intestinal necrosis  Encourage
 Electrolyte them to speak
disturbances up if something
 Aspiration seems wrong.

 Ask another
nurse to
perform an
independent
double check
and correct any
conflicts before
administering
the drug.

 Monitor serum
potassium
during therapy
because severe
hypokalemia
may occur.
Kalimate is not
totally selective
for potassium,
and small
amounts of
other cations
such as
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

magnesium and
calcium can
also be lost
during
treatment.
Monitor
calcium and
magnesium in
patients
receiving
Kalimate.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DEFINING NURSING OUTCOME NURSING RATIONALE EVALUATION

CHARACTERISTIC DIAGNOSIS IDENTIFICATION INTERVENTION

Generic Name: Classifications: Indications: Side effects: Call your doctor  Check doctors order
Ceftriaxone Cephalosporin Indicated for Black starry stools right away if you
Antibiotics susceptible Chest pain have itching;
bacterial infections Shortness of breath hives; hoarseness;  Observe the 10
Trade/ Brand of the lower Sore throat shortness of rights of
Name: Actions: respiratory tract, Sores, ulcers, or breath; trouble medication
Cephalexin Ceftriaxone skin and skin white spots on the breathing; trouble
selectively and structure, bone and lips or in the mouth swallowing; or any  Assess the expected
irreversibly inhibits joint, acute otitis Swollen glands swelling of your actions, dose range,
Dosage: bacterial cell wall media, UTIs, Unusual tiredness hands, face, or side effects of the
2 gms synthesis by septicemia, pelvic or weakness mouth after you medication, and any
binding to inflammatory receive this precaution to be
transpeptidases, disease (PID), medicine. taken.
Route: also called intra-abdominal Adverse effect:
Intravenous transamidases, infections, Headache  Provide client
which are meningitis, Dizziness education about
Frequency and penicillin- binding uncomplicated Phlebitis GI medication.
Timing: proteins (PBPs) that gonorrhea. upset Must be taken
Q8H catalyze the cross- Skin reaction with or without
linking of the – Pruritus food.
peptidoglycan Contraindications Pancreatitis Colitis
polymers forming Hypersensitivity  Monitor blood
the bacterial cell Hypotension levels in patients
wall. taking this
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

. medication.

 Discontinue if
hypersensitivity
occurs.

 Have vitamin K
available in case of
hypoprothrombinemia
occurs.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DEFINING NURSING OUTCOME NURSING RATIONALE EVALUATION

CHARACTERISTIC DIAGNOSIS IDENTIFICATION INTERVENTION

Generic Name: Classifications: Indications: Ketolanalogue  Check Doctors

Ketoanalogue Therapeutic: Prevention and therapy Side effects should be taken order.
Nutritional of damages due to faulty Hypercalcemia during meals to
Trade/ Brand Supplements or deficient protein allow proper
Name: metabolism. In chronic absorption and  Observe 10 rights
Renalog renal insufficiency in metabolism into of medication.
connection it limited the corresponding Before
Dosage: Actions: protein food of <40 amino acids. The administration
600mg/tablet Normalizes g/day for adults. Adverse effect: serum calcium
metabolic process, Abnormality in levels should be  Explain
Route: promotes recycling serum albumin level monitored therapeutic
Oral product exchange; Contraindications: regularly. value of drug
works by Ensure the
Frequency and improving the sufficient supply  Assess allergy
Timing: metabolism of  Hypercalcemia, with calories. to the drug
3x a day protein in the body, disturbed amino
8am-1pm-6pm thereby improving acid During:
the renal function. metabolism. In • Verify
Reduces ion case of patient’s
concentration of hereditary identity
potassium, phenylketonuria,
magnesium, and it has to be taken • Administer with
phosphate. into account that food to prevent GI
ketoanalogue upset
contains
phenylalanine.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

 Disturbed amino • Administer drug

acid metablolism. at right time,
route, and dosage

• Advise to
swallow the
tablet whole5.
Monitor vital
signs

After:
• Document
administration of
drug

• Instruct patient to
report immediately
if
symptoms of
hypercalcemia
occurs like
muscle
weakness,
constipation

• Monitor calcium
levels.

• Monitor for
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

signs of
hypercalcemia
and electrolyte
levels.
Monitor vital signs
especially cardiac
changes.