Medication
 Dose
 Frequency
 Route

Purpose/action
 C- Category
 H - How this
category works
 N - normal
dosage ranges
 W - Why my pt
is on it
Bisacodyl (Ducolax)
 10 mg
 Rectal
(suppository)
 Once

Stimulant laxative

 Stimulats the
bowels to

produce a BM
 ??? -- but it may
take 6-12h for
this to cause a 
BM
Pt had diarrhea --Ducolax treats
constipation & cleans
out the intestines
before a bowel
exam/surgery
T-Having a BM
within 6-12h
C-abdominal pain
or cramping,
nausea, diarrhea,
or weakness
L-irregular
heartbeat,
decreased
urination, allergic
reaction

Proton pump inhibitor 
 Suppresses
gastric acid
secretion by
specific

inhibition of an
enzyme; blocks
the final step of
acid production
 20-40 mg PO
daily for the
reduction of risk
fo gastric ulcers
Bc stomach is forever
producing gastric acid
& the more stress you
have the more acid
that is produced… dr
don’t want pt to have
a stomach problem so
pt is on nexium to
prevent abdominal
discomfort
T-gastric acid
decreases, thus
decreasing
heartburn
c- headache,
dizziness,
abdominal pain,
diarrhea, nausea,
URI symptoms

Amino acid (found

naturally in the body)
 Used for SE
such as
diarrhea,

t-diarrhea will

decrease, immune 
system will stay
good
c-don’t use if you

Esomeprazole (Nexium) 
 20 mg
 Q morning before
breakfast
 IV

Glutamine (Glutasolve)
 15 mg (oral
powder packet)
 PO
 Daily

Side effects
 T-therapeutic
 C-common
 L -life
threatening
Nursing Implications
 A - assess
before giving
 W - watch for?
 IV - drugs alcohol, dilute,
etc



Outcomes
 Ppredicted
outcome
 A - Actual
outcome
If pt is passing

flatus, make sure
they either have a
commode,
bedpan, or are

able to get up to
use the BRM on
their own
If pt has a BM, and
any abdominal
pain or n/v
p-pt will have
a BM within 612h of
administering
a-goal not
met. Did not
give med to
pt. However,
pt was having
intermittent
diarrhea all
day
a- urinary output 
bc Nexium can
cause URI
symptoms as a SE 
W-abdominal
pain???
IV - Give IVP over
at least 3 minutes
(or .5 mL per 15
seconds) & FLUSH
w/ sterile saline
p-pt will not
c/o heartburn
or GERD
a-goal met pt did not c/o
heartburn or
GERD
a- liver lab values 
w- liver lab values,
any complaints of
n/v

p-pt's
diarrhea will
decrease
a-goal not
met. Pt

Heparin
 5000 units
 Q8h
 subcut


Trace elements comb. 
No. 1 (Addemel N)
 50 mL
 Q M, W, F
 IVPB @ 100 mL/h
muscositis,
nerve pain.
Glutamine is
also used to
protect the
immune system
& digestive
system in ppl
undergoing
esophagus
radiation.
Multiple others
 Max 40 mg daily
Pt has diarrhea - this
is used for cancer pts
who have diarrhea as
a SE…….GLUTAMINE
PROMOTES GOOD
BACTERIA IN THE
BOWELS!!
are pregnant, have
mania, or severe
liver disease
(Glutamine can
worsen liver
damage), or
seizures
continued to
have diarrhea
as the day
went on
Anticoagulant

 Heparin

inactivates

factor Xa,
therefore
inhibiting
thrombus & clot
formation by
blocking the
formation of
prothrombin -->
thrombin &
fibrinogen -->
fibrin (which are
the final steps in
the clotting
process)
 5000 units for
prophylaxis of
postoperative
thromboemboli
sm
Pt had surgery 6 days
ago (exploratory lap
(laproscopic surgery)
w/ repair of fistula)
t-blood thins out
c-bruising
l-hemorrhage,
white clot
syndrome
Adult trace element 
 Elements
include:

chromic
chloride, copper
t-pt's lab values are 
WNL
c-over

supplementation
of trace elements



a-PTT lab value
w-any bruising,
internal bleeding
(sudden increase
in HR then
decrease in BP)
Subcut-alcohol
swab, pinch skin,
45-90 degree
angle

a-trace element
levels
w-?



p-blood clot
will not form
a-goal metclot did not
form (pt
ambulating
helped this)
p-pt's trace
elements will
increase
a-unknown, a
few lab values
for a duration of
30m


TPN



95.8 mL/h
Continuous
IV
o PICC lumen
#2


Diphenhydramine

(Benadryl)
 12.5 mg or 25 mg
 Q6h PRN
o For itching
 IV
chloride, ferric
chloride,
manganese
chloride, K
iodide, Na
floride, Na
molybdate, Na
selenite
anhydrous, sinc
chlroide
 ???
He could be
malnourished,
alcoholic, poor & cant
afford good food.. All
possibilities
are still off
Total parental

nutrition
 Provides
protein, suguar, 
vitamins,
minerals, &
sometimes
lipids
 ??? - depends
on pt?
Pt needs nutritional
support (is also on
Addemel N for trace
element nutritional
support)….. Or bc of
an INFECTION or
problems in your
pancreas, intestines,
BOWEL
PT MAY BE
MALNOURISHED OR
AN ALCOHOLIC so pt
is on TPN to build up
immune system so pt
can heal faster
t-pt's electrolytes 
and lab values will
be WNL

c-protein/fluid

overload
Antihistamine, cough 
suppressant, anti
motion-sickness
 Blocks

histamine
effects at h1receptor sites,
has sedative
effects
 10-50 mL for

t-pt's

itching/inflammati
on will decrease
c-drowsiness,
sedation, dizziness, 
epigastric distress,
thickening of

bronchial
secretions
l-anaphylactic

a-lab values,

intake & output
w-fluid overload?
Iv-may need to
decrease level if pt
has nausea
To give: 1) remove
TPN from fridge 2h 
before giving to
allow it to warm to
room temp 2)
expiration date,
don’t use if cloudy
or has solid pieces
floating
g-pt will be
able to handle
95 mL/h
without
nausea, lab
values will be
WNL
Goal partially
met - pt was
able to handle
95 mL/h
without
nausea but
lab values are
not WNL
a-give with food if 
GI upset occurs,
where pt is itching
at
w-if itching
decreases

Iv-clean w alcohol
swab before
p-pt's itching
will decrease
to pt not
itching
anymore
a-did not give

Hydromorphone
(Dilaudid)
 2 mg
 IV
 Q4h for severe
pain


Oxycodone

(Roxicodone)
 5, 10, or 15 mg
 PO
 Q3h PRN for
moderate-severe
pain

Promethazine
(Phenergan)
 12.5 mg IV or 25
mg rectal or 25
mg oral
 Q6h prn
o For nausea


injection
Itching & to suppress
coughs d/t hernia
shock, 2 anemias,
leukpenia,
agranulocytosis,
pancytopenia.
Opiod analgesic

 Acts at specific
mu-opioid

receptors in the
CNS to produce 
analgesia,
euphoria,
sedation
 For injection-110 mL
Pt recently had
surgery & this is his
only pain med
t-pain level will
decrease
c-n/v, dizziness,
sedation
l-RESPIRATORY
DISTRESS, apnea,
circulatory
depression,
respiratory arrest,
shock, cardiac
arrest
Opioid analgesic

 Acts as agonist
at specific
opioid recepotrs
in the CNS to
produce

analgesia,
euphroria, &
sedation

Pt has this & dilaudid
for pain - pt did not
c/o pain throughout
the day though
t-pt's pain level will 
decrease to an
acceptable level

decided upon by
the pt & RN
c-dizziness,
sedatoin, n/v,
sweating
l-shock, cardiac
arrest, respiratory
arrest,
bronchospasm
a-pt's pain level,

RESPIRATIONS
wRESPIRATIONS!!!!!
!
Antiemetic

 Blocks

histamine-1
receptors,
diminishing the
effects of
histamine on
cells
 25-50 mg iv,

12.5-50 po
An indication is
postop pain or postop
sedation, n/v
t-n/v will decrease 
c-dizziness,

drowsiness, urinary
frequency,

epigastric distress,
thickening of
bronchial
secretions
l-agranulocytosis,
pancytopenia
a- if pt vomitted

w-n/v decrease, IV
site

Iv-Phenergan =
irritant.. IVP admin
REQUIRES dilution
w/ 10 mL saline,



a-pain level,
RESPIRATIONS
w-respiratory
distress
Iv-clean port w/
alcohol pad



p-pt's pain
level will
decrease
(however, pt
did not c/o
pain
throughout
the day)
a-goal not
met d/t med
not being
given
p-pt's pain
level will
decrease to
an agreed
upon level bw
the RN & pt
a-goal not
met r/t not
given
p-pt's n/v will
decrease
a-did not give