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LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION PREPARATION WORKSHEET*
Copying from the textbook or electronic source does not constitute satisfactory preparation
MEDICATION
ACTION
Medication: amlodipine
Classification: antihypertensive, CCB
Generic Name: Norvasc
Indication: Management of HTN
Dose/Route/Frequency:
10 mg = 1 tab/PO/QDAY
How does it work?
Inhibits the transport of calcium into myocardial & vascular
smooth muscle cells, resulting in  conduction & HR
Onset/Peak/Duration: UNK/6-9 hr/ 24 hr
Time: 1000
Recommended/Usual Dose:
5-10 mg once daily
Adverse Effects: dizziness, fatigue, peripheral edema, bradycardia,
hypotension
Medication: aspirin
Classification: antiplatelet, salicylate
Generic Name: ASA
Indication: Ppx of TIA & MI
Dose/Route/Frequency:
81 mg = 1 tab/PO/QDAY
How does it work?
 PLT aggregation
Onset/Peak/Duration:
5-30 min/1-3 hr/3-6 hr
Adverse Effects: GI bleeding, dyspepsia, epigastric distress, nausea,
abd pain, rash, hepatotoxicity
Time: 1000
Recommended/Usual Dose:
80-325 mg once daily
Medication: atorvastatin
Classification: lipid-lowering agents, HMG-CoA reductase inhibitor
Generic Name: Lipitor
Indication: Primary prevention of CHD in asymptomatic pts w/ 
total & LDL and  HDL cholesterol
Dose/Route/Frequency:
80 mg = 1 tab/PO/NIGHTLY
Time: 2200
Recommended/Usual Dose:
80 mg once daily
How does it work?
Reduction of lipids/cholesterol  the risk of MI and stroke sequelae
Onset/Peak/Duration: UNK/UNK/20-30 hr
Adverse Effects: abd cramps, constipation, diarrhea, flatus,
heartburn, rashes
Medication: docusate
Classification: laxatives, stool softener
Generic Name: Colace
Indication: Prevention of constipation
Dose/Route/Frequency:
100 mg = 1 caps
Time: 1000
50-400 mg in 1-4 divided doses
How does it work?
Promotes incorporation of water into stool, resulting in softer fecal
mass
Onset/Peak/Duration:
12-72 hr/UNK/UNK
Adverse Effects: throat irritation, mild cramps, diarrhea, rashes
Medication: enoxaparin
Classification: anticoagulants, LMWH
Generic Name: Lovenox
Indication: Prevention of ischemic complications from unstable
angina & NSTEMI
Recommended/Usual Dose:
Dose/Route/Frequency:
70 mg = 0.7 mL/SubQ/Q12H-INT
Time: 0800
Recommended/Usual Dose:
How does it work?
Prevention of thrombus formation
Onset/Peak/Duration:
UNK/3-5 hr/12 hr
NURSING CONSIDERATIONS
Other: SBP > 90, HR > 60, assess for signs of HF, monitor ECG periodically
Labs: None
Teaching: Advise pt to take med as directed; instruct pt of maintaining good dental hygiene and monitoring BP
Infusion rate: ml/hr ________ gtt/min
Other: Assess for bleeding
Labs: PT, PTT, INR
Teaching: Take med w/ full glass of water and remain upright for 15-30 min after admin; take only prescribed dose;
avoid alcohol intake d/t gastric irritation
Infusion rate: ml/hr ________ gtt/min
Other: Monitor liver tests
Labs: LDL, HDL, Total cholesterol
Teaching: Advise pt that this med should be used in conjunction w/ diet restrictions, exercise, & cessation of smoking;
instruct pt to notify HCP if unexplained muscle pain, tenderness, or weakness occurs, esp if w/ malaise or fever; take
med as directed
Infusion rate: ml/hr ________ gtt/min
Resp
Other: abd distention, presences of BS, unusual pattern of bowel f(x)
Labs: Na+, K+
Teaching: Advise pts that laxatives should be used only for short-term thx; instruct pt w/ cardiac dz to avoid straining
during BM
Infusion rate: ml/hr ________ gtt/min
Other: Assess for signs of bleeding, observe injection sites for hematomas, ecchymosis or inflammation
Labs: CBC, PLT, PT, PTT, antifactory Xa, AST, ALT, K+
Teaching: Advise pt to report any sx of unusual bleeding or bruising
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
1 mg/kg every 12 hr for 2-8 days
Adverse Effects: dizziness, HA, insomnia, edema, bleeding, anemia,
N/V
Medication: hydrochlorothiazide
Classification: antihypertensive, thiazide diuretic
Generic Name: Microzide
Indication: Management of mild to moderate HTN
Dose/Route/Frequency:
25 mg = 1 tab/PO/QDAY
Time: 1000
12.5-100 mg/day in 1-2 doses
How does it work?
 BP in HTN pts & diuresis w/ mobilization of edema
Onset/Peak/Duration:
2 hr/3-6 hr/6-12 hr
Adverse Effects: dizziness, hypotension, N/V, hypokalemia,
dehydration, muscle cramps
Medication: insulin lispro
Classification: antidiabetic, pancreatic, hormone
Generic Name: Humalog
Indication: Control of hyperglycemia in pts w/ DM I & II
Dose/Route/Frequency:
LOW CORRECTIONAL
DOSE/SubQ/ACHS
Time: 0800
How does it work?
 BG by stimulating Glu uptake in skeletal muscle & fat, inhibiting
hepatic Glu production
Onset/Peak/Duration:
15 min/1-2 hr/3-4 hr
Adverse Effects: hypoglycemia, hypokalemia, pruritis, swelling
Recommended/Usual Dose:
Recommended/Usual Dose:
0.5-1.2 units/kg/day
Medication: losartan
Classification: antihypertensive, ARB
Generic Name: Cozaar
Indication: Management of HTN
Dose/Route/Frequency:
100 mg = 1 tabs
Time: 1000
25-100 mg/day as a single daily dose or
2 divided doses
How does it work?
Blocks the vasoconstrictor and aldosterone-secreting effects of
angiotensin II at various receptor sites
Onset/Peak/Duration:
6 hr/ 3-6 hr/24 hr
Adverse Effects: dizziness, fatigue, diarrhea, CP, edema,
angioedema, wt gain
Medication: metoprolol
Classification: antihypertensive, BB
Generic Name: Lopressor
Indication: Management of HTN
Dose/Route/Frequency:
12.5 mg = 0.5 tabs/PO/Q12H
Time: 1000
How does it work?
Blocks stimulation of beta-adrenergic receptor to  HR & BP
Onset/Peak/Duration:
15 min/UNK/6-12 hr
Adverse Effects: fatigue, weakness, dizziness, erectile dysf(x),
bradycardia, HF, pulmonary edema
Recommended/Usual Dose:
Recommended/Usual Dose:
12.5-25 mg once daily
NURSING CONSIDERATIONS
Other: Monitor I&O, daily wt, assess for edema, monitor electrolytes
Labs: BUN, Cr, uric acid, Mg2+, K+, Ca+, Na+
Teaching: Take med at the same time each day; instruct pt to change positions slowly d/t orthostatic hypotension
Infusion rate: ml/hr ________ gtt/min
Other: assess for sx of hypoglycemia & hyperglycemia periodically, change in wt
Labs: HbA1C, BG, K+
Teaching: instruct pt on s/s of hypoglycemia & hyperglycemia; emphasize the importance of compliance w/
nutritional guidelines
Infusion rate: ml/hr ________ gtt/min
Other: Assess for signs of angioedema
Labs: AST, ALT, Bili, K+, HgB, HcT
Teaching: Caution pt to avoid sudden changes in position to  orthostatic hypotension; instruct pt to notify HCP if
swelling of face, eyes, lips or tongue or difficulty swallowing; emphasize the importance of f/u exams to evaluate
effectiveness of med
Infusion rate: ml/hr ________ gtt/min
Other: Monitor ECG frequently, I&O & daily wt
Labs: BUN, K+, triglyceride, BG
Teaching: Closely monitor BG d/t masking hypoglycemia; advise pt to change positions slowly to  orthostatic
hypotension; teach pt to check pulse daily and BP biweekly
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Medication: trazodone
Classification: antidepressants
Generic Name: Trazorel
Indication: Major depression
Dose/Route/Frequency:
50 mg = 1 tabs/PO/NIGHTLY
Time: 2200
How does it work?
Alters the effects of serotonin in the CNS
Onset/Peak/Duration:
1-2 wk/2-4 wk/wks
Adverse Effects: SI, drowsiness, confusion, hypotension, dry
mouth, QT prolongation, weakness
Recommended/Usual Dose:
150 mg/day in 3 divided doses
Medication: D50W
Classification: caloric sources, CHO
Generic Name: Glucose
Indication: Treat hypoglycemia
Dose/Route/Frequency:
25 mL/IVP/Q15MIN-INT
Time: PRN
How does it work?
Provides calories
Onset/Peak/Duration:
rapid/rapid/brief
Adverse Effects: fluid overload, hypokalemia, hyperglycemia
Recommended/Usual Dose:
20-50 mL of 50% solution infused
slowly (3 mL/min)
Medication: D50W
Classification: caloric sources, CHO
Generic Name: Glucose
Indication: Treat hypoglycemia
Dose/Route/Frequency:
50 mL/IVP/Q15MIN-INT
Time: PRN
How does it work?
Provides calories
Onset/Peak/Duration:
rapid/rapid/brief
Adverse Effects: fluid overload, hypokalemia, hyperglycemia
Recommended/Usual Dose:
20-50 mL of 50% solution infused
slowly (3 mL/min)
Medication: glucagon
Classification: hormones, pancreatic
Generic Name: GlucaGen
Indication: Acute management of severe hypoglycemia when
admin of Glu is not feasible
Dose/Route/Frequency:
1 mg = 1 mL/IM/Q15MIN-INT
Time: PRN
Recommended/Usual Dose:
1 mg repeated in 15 min if necessary
How does it work?
Stimulates hepatic production of Glu from glycogen stores
Onset/Peak/Duration:
10 min/30 min/12-27 min
Adverse Effects: hypotension, N/V
NURSING CONSIDERATIONS
Other: Assess for serotonin syndrome, mental status, suicidal tendencies
Labs: CBC, liver & hepatic f(x),  leukocyte & neutrophil
Teaching: May cause drowsiness & blurred vision; inform pt to perform good oral hygiene; advise pt & family to look
for suicidality esp during early thx or dose changes
Infusion rate: ml/hr ________ gtt/min
Other: Assess nutritional status, f(x) of GI, caloric needs of pt; assess hydration status
Labs: BG, K+, PO3
Teaching: Explain the purpose of dextrose admin to pt; instruct DM pt on when & how to admin dextrose products for
hypoglycemia
Infusion rate: ml/hr ________ gtt/min
Other: Assess nutritional status, f(x) of GI, caloric needs of pt; assess hydration status
Labs: BG, K+, PO3
Teaching: Explain the purpose of dextrose admin to pt; instruct DM pt on when & how to admin dextrose products for
hypoglycemia
Infusion rate: ml/hr ________ gtt/min
Other: Assess neuro status, signs of hypoglycemia, N/V after admin of dose
Labs: BG, K+
Teaching: Advise family or pt should receive oral Glu when alertness returns; review hypoglycemic me, regimen, diet
& exercise programs w/ pts
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Medication: lorazepam
Classification: sedative-hypnotic. BZD
Generic Name: Ativan
Indication: anx d/o
Dose/Route/Frequency:
1 mg = 1 tabs/NGT/ONCE
Time: PRN
Recommended/Usual Dose:
1-3 mg 2-3 times daily (up to 10
mg/day)
How does it work?
Depresses the CNS, probably by potentiating GABA
Onset/Peak/Duration:
15-60 min/1-6 hr/8-12 hr
Adverse Effects: dizziness, drosiness, lethargy, mental depression,
paradoxical excitation
Medication: senna
Classification: stimulant laxative, stool softener
Generic Name: Senokot-S
Indication: Tx constipation associated w/ dry, hard stools & 
intestinal motility
Dose/Route/Frequency:
8.6 mg = 1 tabs/PO/NIGHTLY
Time: PRN
Recommended/Usual Dose:
How does it work?
Local irritant on the colon stimulating peristalsis
Onset/Peak/Duration:
6-12 hr/UNK/UNK
Adverse Effects: electrolyte imbalances, dehydration, abd cramps,
NVD, rashes, urine discoloration
NURSING CONSIDERATIONS
Other: Assess degree & manifestations of anx & mental status prior & after
Labs: Renal, hepatic & hematologic f(x); antidote: flumazenil (Romazicon)
Teaching: Instruct pt to take med exactly as directed; may cause drowsiness or dizziness; advise for short-term use
Infusion rate: ml/hr ________ gtt/min
Other: Assess for abd distention, (+) BS, unusual pattern of bowel f(x)
Labs: Na+, K+
Teaching: Advise that it should be for short-term thx; instruct pts w/ cardiac dz to avoid straining during BM
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
Medication: apixaban
Classification: anticoagulant, factor Xa inhibitor
Generic Name: Eliquis
Indication: Tx of & reduction in risk of recurrence of DVT or PE
Dose/Route/Frequency:
5 mg =1 tabs/PO/BID
How does it work?
Acts as a selective, reversible site inhibitor of factor Xa, inhibiting both
free and bound factor.
Onset/Peak/Duration:
UNK/3-4 hr/24 hr
Time:1000
Recommended/Usual Dose:
5 mg twice daily
Adverse Effects: bleeding
Medication: bumetanide
Classification: diuretic, loop diuretic
Generic Name: Bumex
Indication: Edema d/t HF, hepatic disease, or renal impairment.
Dose/Route/Frequency:
2 mg = 2 tabs/PO/QDAY
Time:1000
How does it work?
Inhibits the reabosorption of sodium and chloride from the loop of
Henle and distal renal tubule.
Onset/Peak/Duration:
30-60min/1-2hr/4-6 hr
Adverse Effects: dizziness, N/V, dehydration, hypovolemia,
hypokalemia, hypomagnesemia
Recommended/Usual Dose:
0.5-2 mg/day given in 1-2 doses
Medication: fluoxetine
Classification: antidepressant, SSRI
Generic Name: Prozac
Indication: Major depressive d/o
Dose/Route/Frequency:
20 mg = 1 caps/PO/QAM
Time: 1000
How does it work?
Selectively inhibits the reuptake of serotonin in the CNS
Recommended/Usual Dose:
20 mg/day
Onset/Peak/Duration:
1-4 wk/UNK/2 wk
Adverse Effects: NMS, sz, anxiety, drowsiness, HA, insomnia,
nervousness
Medication: melatonin
Classification: sedative/hypnotic
Generic Name: pineal hormone
Indication: Sleep d/o
Dose/Route/Frequency:
1mg = 1 tabs/PO/NIGHTLY
0.3-10 mg daily at bedtime
How does it work?
Hormone secreted from the pineal gland in a 24-hour circadian rhythm,
regulating the normal sleep/wake cycle.
Onset/Peak/Duration:
UNK
Adverse Effects: hypotension, HA, drowsiness, dizziness, N/V, abd
cramps
Medication: pantoprazole
Classification: antiulcer agent, PPI
Generic Name: Protonix
Indication: Erosive esophagitis associated with GERD
Dose/Route/Frequency:
40 mg/IVP/BID
How does it work?
Binds to an enzyme in the presence of acidic gastric pH, preventing the
final transport of hydrogen ions into the gastric lumen
Onset/Peak/Duration:
15-30 min/2 hr/UNK
Adverse Effects: HA, C-diff, abd pain, flatulence, hyperglycemia
Time: 2200
Recommended/Usual Dose:
Time: 1000
Recommended/Usual Dose:
40 mg once daily for up to 8 wk
Other: Assess for symptoms of stroke, DVT, PE or PVD periodically during thx
Labs: PT, PTT, INR
Teaching: Instruct patient to take as directed, may bruise and bleed more easily or
longer than usual (notify HCP), caution patient to notify HCP if skin rash or signs
of severe allergic reaction occur.
Infusion rate: ml/hr ________ gtt/min
Other: Assess fluid status during thx, monitor BP and pulse before and during
admin, assess allergy to sulfonamides, assess patient for skin rash frequently
during thx.
Labs: Na,K, Ca, Mg, BUN, Cr
Teaching: Caution patient to change positions slowly to minimize orthostatic
hypotension, instruct on diet high in potassium, advise patient to contact HCP
immediately if rash, muscle weakness, cramps, nausea, and paresthesia.
Infusion rate: ml/hr ________ gtt/min
Other: Monitor mood changes, suicidal tendencies, and sensitivity reaction.
Labs: CBC, AST, ALT, BUN, Cr, BG
Teaching:May cause drowsiness, dizziness, impaired judgement and blurred
vision; change positions slowly.
Infusion rate: ml/hr ________ gtt/min
Other: Assess sleep patterns before and periodically throughout thx.
Labs: Glu, coagulation panel, lipid panel
Teaching: Instruct patient to take at bedtime as directed, it causes drowsiness,
avoid concurrent use of alcohol or other CNS depressants
Infusion rate: ml/hr ________ gtt/min
Other: Assess patient for epigastric or abd pain and for frank or occult blood in
stool, emesis, or gastric aspirate
Labs: AST, ALT, alkaline phosphatase, Bili, Mg
Teaching: Advise patient to report onset of black, tarry stools, diarrhea or abd
pain to HCP
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
Medication: sildenafil
Classification: vasodilator, phosphodiesterase type 5 inhibitor
Generic Name: Revatio
Indication: Pulmonary arterial HTN
Dose/Route/Frequency:
20 mg = 1 tabs/PO/Q8H-INT
How does it work?
Produces vasodilation of the pulmonary vascular bed.
Onset/Peak/Duration:
W/i 1 hr/30-120 min/up to 4 hr
Adverse Effects: HA, dizziness, insomnia, dyspepsia, flushing
Time: 0700, 1500
Recommended/Usual Dose:
5 mg or 20 mg 3 times daily
Medication: spironolactone
Classification: diuretic, potassium-sparing
Generic Name: Aldactone
Indication: Management of edema associated with HF, cirrhosis, and
nephrotic syndrome
Dose/Route/Frequency:
12.5 mg = 0.5 tabs/PO/QDAY
Time: 1000
Recommended/Usual Dose:
25-400 mg/day as a single dose or 2 divided doses
How does it work?
Causes loss of sodium bicarbonate and calcium while saving potassium
and hydrogen ions by antagonizing aldosterone.
Onset/Peak/Duration:
UNK/1-3 hr/2-3 days
Adverse Effects: dizziness, hyperkalemia, HA, sedation, GI irritation
Medication: acetaminophen
Classification: NSAID, antipyretic
Generic Name: Tylenol
Indication: Tx of mild pain
Dose/Route/Frequency:
650 mg = 2 tabs/PO/Q6H-INT PRN pain
Recommended/Usual Dose:
325-650 mg every 6 hour
How does it work?
Inhibits synthesis of prostaglandins that may serve as mediators of pain
and fever, primarily in the CNS.
Onset/Peak/Duration:
0.5-1 hr/1-3 hr/3-8 hr
Adverse Effects: agitation, rash, hepatotoxicity
Medication: polyethylene glycol 3350 (MiraLax)
Classification: laxative, osmotic
Generic Name: Miralax
Indication: Tx of occasional constipation
Dose/Route/Frequency:
17 gm = 1 packets/PO/ QDAY PRN constipation
Recommended/Usual Dose:
17 gm in 8 oz water, may be used for up to 2 wk
How does it work?
PEG in solution acts as an osmotic agent, drawing water into the lumen
of the GI tract
Onset/Peak/Duration:
UNK/1-3 days/UNK
Adverse Effects: urticaria, abd bloating, cramping, flatulence, nausea
Medication: sodium chloride nasal
Classification: mineral & electrolyte supplement
Generic Name: Slo-Salt
Indication: Hydration and provision of NaCl in deficiency states
Dose/Route/Frequency:
1 sprays/Intranasal/QID PRN dry nasal
Recommended/Usual Dose:
3-4 mEq/kg/day
How does it work?
Solutions of NaCl resemble extracellular fluid.
Onset/Peak/Duration:
UNK
Adverse Effects: HF, pulmonary edema, hypernatremia, hypervolemia,
hypokalemia
Medication: aspirin
Classification: antiplatelet, salicylate
Generic Name: ASA
Indication: Ppx of TIA & MI
Time:
Time:
Time:
Other: Monitor hemodynamic parameters and exrcise tolerance prior to and
periodically during thx
Labs: None
Teaching: Caution patient not to take med with alpha-adrenergic blockers or
nitrates.
Infusion rate: ml/hr ________ gtt/min
Other: Monitor I&O, development of hyperkalemia, periodic ECG, skin rash
Labs: BUN, Cr, K, Ca, Na
Teaching: Avoid salt substitutes and foods that contain high levels of potassiums,
may cause dizziness
Infusion rate: ml/hr ________ gtt/min
Other: Assess for skin rash, pain, evaluate hepatic and renal function
Labs: AST, ALT, LDH, BIli
Teaching: Advise patient to avoid alcohol, chronic use of >4 gm/day and skin
rashes.
Infusion rate: ml/hr ________ gtt/min_______
Other: Assess patient for abd distention, presence of bowel sounds, color and
consistency of stools
Labs: None
Teaching: Inform patient that 2-4 days maybe required to produce a BM, advise
patien to notify HCP if unusual cramps, bloating, of diarrhea occurs.
Infusion rate: ml/hr ________ gtt/min
Resp
Other: Assess for hydration
Labs: Na, Cl
Teaching: Advise to use as directed.
Infusion rate: ml/hr ________ gtt/min
Other: Assess for bleeding
Labs: PT, PTT, INR
Teaching: Take med w/ full glass of water and remain upright for 15-30 min after
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
Dose/Route/Frequency:
81 mg = 1 tab/PO/QDAY
How does it work?
 PLT aggregation
admin; take only prescribed dose; avoid alcohol intake d/t gastric irritation
Time: 1000
Onset/Peak/Duration:
5-30 min/1-3 hr/3-6 hr
Infusion rate: ml/hr ________ gtt/min
Recommended/Usual Dose:
80-325 mg once daily
Adverse Effects: GI bleeding, dyspepsia, epigastric distress, nausea, abd
pain, rash, hepatotoxicity
Medication: atorvastatin
Classification: lipid-lowering agents, HMG-CoA reductase inhibitor
Generic Name: Lipitor
Indication: Primary prevention of CHD in asymptomatic pts w/  total
& LDL and  HDL cholesterol
Dose/Route/Frequency:
40 mg = 1 tab/PO/NIGHTLY
Time: 2200
Recommended/Usual Dose:
80 mg once daily
How does it work?
Reduction of lipids/cholesterol  the risk of MI and stroke sequelae
Other: Monitor liver tests
Labs: LDL, HDL, Total cholesterol
Teaching: Advise pt that this med should be used in conjunction w/ diet
restrictions, exercise, & cessation of smoking; instruct pt to notify HCP if
unexplained muscle pain, tenderness, or weakness occurs, esp if w/ malaise or
fever; take med as directed
Onset/Peak/Duration:
UNK/UNK/20-30 hr
Infusion rate: ml/hr ________ gtt/min
Adverse Effects: abd cramps, constipation, diarrhea, flatus, heartburn,
rashes
Medication: heparin
Classification: anticoagulant, antithrombotic
Generic Name: Hepalean
Indication: Ppx & tx of various thromboembolic d/o
Dose/Route/Frequency:
5,000 U = 1 mL/SubQ/Q8H-INT
How does it work?
Potentiates the inhibitory effect of antithrombin on factor Xa and
thrombin
Other: assess for signs of bleeding, additional or increased thrombosis
Labs: PT, PTT, INR, PLT, antifactory Xa
Teaching: Advise pt to report any symptoms of unusual bleeding or bruising to
HCP immediately, instruct pt not to take meds containing ASA or NSAIDs while
on heparin thx
Time: 0700, 1500, 2300
Recommended/Usual Dose:
5,000 U Q8H-Q12H
Onset/Peak/Duration:
20-60 min/2 hr/8-12 hr
Infusion rate: ml/hr ________ gtt/min
Adverse Effects: rashes, bleeding, anemia
Medication: metoprolol
Classification: antihypertensive, BB
Generic Name: Lopressor
Indication: Management of HTN
Dose/Route/Frequency:
25 mg = 1 tabs/PO/QID
How does it work?
Blocks stimulation of beta-adrenergic receptor to  HR & BP
Other: Monitor ECG frequently, I&O & daily wt
Labs: BUN, K+, triglyceride, BG
Teaching: Closely monitor BG d/t masking hypoglycemia; advise pt to change
positions slowly to  orthostatic hypotension; teach pt to check pulse daily and BP
biweekly
Time: 1000
Onset/Peak/Duration:
15 min/UNK/6-12 hr
Infusion rate: ml/hr ________ gtt/min
Recommended/Usual Dose:
12.5-25 mg once daily
Adverse Effects: fatigue, weakness, dizziness, erectile dysf(x),
bradycardia, HF, pulmonary edema
Medication: carvedilol
Classification: antihypertensive, beta blocker
Generic Name: Coreg
Indication: HTN
Dose/Route/Frequency:
6.25 mg = 1tabs/PO/Q12H-INT
Time: 0600
How does it work?
Blocks stimulation of beta1 and beta2 adrenergic receptor sites to
decrease HR & BP
Onset/Peak/Duration:
Within 1 hr/1-2 hr/12hr
Adverse Effects: dizziness, fatigue, weakness, diarrhea, HF, pulmonary
edema, SJS, hyperglycemia, angioedema
Recommended/Usual Dose:
6.25 mg twice daily
Medication: ferrous sulfate
Other: Monitor I&O, weight, peripheral edema, JVD
Labs: BUN, Glu, K+, uric acid
Teaching: Teach how to check pulse and BP; advise to change positions slowly to
minimize orthostatic hypotension; notify HCP if slow pulse, difficulty breathing,
wheezing, cold hands and feet, dizziness, confusion, depression, rsh
Infusion rate: ml/hr ________ gtt/min
Classification: antianemic, iron supplement
Other: Assess nutritional status, bowel function esp for occult blood stools
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
Generic Name: Feratab
Indication: Tx & prevention iron deficiency anemia
Dose/Route/Frequency:
325 mg = 1 tabs/PO/TID
Time: 1000,1400
How does it work?
An essential mineral found in HGB, myoglobin, and many enzymes.
Enters the blood stream and is transported to the organs of the
reticuloendothelial syndrome.
Onset/Peak/Duration:
4 days/7-10 days/2-4 mo
Adverse Effects: nausea, constipation, dark stools, epigastric pain, GI
bleeding, vomiting
Recommended/Usual Dose:
2-3 mg/kg/day in 2-4 divided doses
Medication: folic acid
Classification: antianemic, water-soluble vitamin
Generic Name: Folate
Indication: Prevention and tx of megalobastic and macrocytic anemias
Dose/Route/Frequency:
1 mg =1 tabs/PO/QDAY
Time: 1000
How does it work?
Stimulates the production of RBC, BC, and PLT.
Onset/Peak/Duration:
30-60 min/1 hr/unk
Adverse Effects: rash, irritability, confusion, fever
Recommended/Usual Dose:
1 mg/day initial dose then 0.5 mg/day maintenance dose
Medication: furosemide
Classification: loop diuretic
Generic Name: Lasix
Indication: Edema d/t HF, hepatic impairment, or renal disease; HTN
Dose/Route/Frequency:
40 mg = 1 tabs/PO/QDAY
Time: 1000
How does it work?
Inhibits the reabsorption of sodium and chloride from the loop of Henle
and distal renal tubule.
Onset/Peak/Duration:
30-60 min/1-2 hr/6-8 hr
Adverse Effects: dehydration, hypocalcemia, hypokalemia,
hypomagnesemia, hypovolemia, agranulocytosis, aplastic anemia
Recommended/Usual Dose:
20-80 mg/day as a single dose initially
Medication: heparin
Classification: anticoagulant, antithrombotic
Generic Name: Hep-Lock
Indication: Pppx and tx of various thromboembolic d/o
Dose/Route/Frequency:
5,000 units = 1 mL/SubQ/Q8H-INT
Time: 0500,1300
How does it work?
Potentiates the inhibitory effect of antithrombin on factor Xa and
thrombin
Onset/Peak/Duration:
20-60 min/2 hr/8-12 hr
Adverse Effects: bleeding, HIT, anemia, fever
Recommended/Usual Dose:
5,000 units Q8-12H
Labs: HGB, HCT, reticulocyte values
Teaching: Explain the purpose of iron therapy and encourage to comply, advise
that stools may become dark green or black; instruct that stools may become dark
green or back.
Infusion rate: ml/hr ________ gtt/min
Other: Assess for fatigue, weakness, dyspnea
Labs: Plasma folic acid levels, HGB, HCT, reticulocyte count
Teaching: Encourage foods high in folic acid such as vegetables, fruits, and organ
meats; explain that folic acid may make urine more intensely yellow
Infusion rate: ml/hr ________ gtt/min
Other: Assess fluid status, monitor daily weight, I&Os
Labs: Na+, K+, Ca2+, Mg2+, BUN, Cr, Glu
Teaching: Caution to change positions slowly to minimize orthostatic
hypotension; advise to contact HCP immediately if rash, muscle weakness,
cramps, nausea, dizziness, numbness, or tingling of extremities occurs.
Infusion rate: ml/hr ________ gtt/min
Other: Assess signs of bleeding
Labs: PLT, INR , PT, PTT
Teaching: Advise to report any symptoms of unusual bleeding; instruct to not take
meds containing ASA or NSAIDs
Infusion rate: ml/hr ________ gtt/min
Medication: insulin lispro
Classification: antidiabetic, pancreatic, hormone
Generic Name: Humalog
Indication: Control of hyperglycemia in pts w/ DM I & II
Dose/Route/Frequency:
0.1-6 units/SubQ/ACHS
Time: 0800,1200
How does it work?
 BG by stimulating Glu uptake in skeletal muscle & fat, inhibiting
hepatic Glu production
Onset/Peak/Duration:
15 min/1-2 hr/3-4 hr
Adverse Effects: hypoglycemia, hypokalemia, pruritis, swelling
Recommended/Usual Dose: Low Correctional dose
Other: assess for sx of hypoglycemia & hyperglycemia periodically, change in wt
Labs: HbA1C, BG, K+
Teaching: instruct pt on s/s of hypoglycemia & hyperglycemia; emphasize the
importance of compliance w/ nutritional guidelines
Infusion rate: ml/hr ________ gtt/min
0.5-1.2 units/kg/day
Medication: ipratropium
Classification: bronchodilator, anticholinergic
Generic Name: Arovent
Indication: Maintenance thx of reversible airway obstruction d/t COPD,
including chronic bronchitis & emphysema
Other: Assess respiratory status (rate, breath sounds, degree of dyspnea, pulse)
Labs: PFT
Teaching: Instruct proper use of inhaler, nebulizer or nasal spray; advise to rinse
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
Dose/Route/Frequency:
0.5 mg = 2.5 mL/NEB/Q6H
Time: 0600, 1200
mouth after using inhaler, good oral hygiene, & sugarless gum or candy
Recommended/Usual Dose:
500 mcg 3-4 times daily
How does it work?
Inhibits cholinergic receptors in bronchial smooth muscle, resulting in
decreased concentrations of cGMP.
Onset/Peak/Duration:
1-3 min/1-2 hr/4-6 hr
Adverse Effects: dizziness, HA, nervousness, epistaxis, rash,
bronchospasm, cough
Medication: multivitamin
Classification: vitamins
Generic Name: B complex with C and B
Indication: Tx and prevention of vitamin deficiencies
Dose/Route/Frequency:
1 tabs/PO/QDAY
Time: 1000
How does it work?
Contain fat-soluble vitamins & water-soluble vitamins. These vitamins
are diverse group of compounds necessary for normal growth and
development.
Onset/Peak/Duration:
unk/unk/unk
Adverse Effects: urine discoloration
Recommended/Usual Dose:
1 tabs
Medication: prednisone
Classification: corticosteroid, immune modifier
Generic Name: Rayos
Indication: Used systemically & locally in a wide variety of chronic
diseases
Dose/Route/Frequency:
40 mg = 2 tabs/PO/QDAYWM
Time: 0800
Recommended/Usual Dose:
5-60 mg/day as a single dose or in divided doses
How does it work?
Suppresses inflammation and the normal immune response, replaces
endogenous cortisol in deficiency states and has minimal
mineralocorticoid activity
Onset/Peak/Duration:
hrs/unk/1.25-1.5 days
Adverse Effects: depression, peptic ulceration, anorexia, nausea, acne,
decreased wound healing, ecchymoses, thromboembolism, adrenal
suppression
Medication: thiamine
Classification: vitamin
Generic Name: vitamin B1
Indication: Tx of thiamine deficiencies, prevention of Wernicke’s
encephalopathy; dietary supplement in patients w/ GI disease,
EtOHism, or cirrhosis
Dose/Route/Frequency:
100 mg = 1 tabs/PO/QDAY
Time: 1000
Recommended/Usual Dose:
5-10 mg three times daily
How does it work?
Required for CHO metabolism
Onset/Peak/Duration:
hr/day/days-wk
Adverse Effects: restlessness, weakness, vascular collapse, angioedema
Medication: acetaminophen
Classification: NSAID, antipyretic
Generic Name: Tylenol
Indication: Tx of mild pain
Dose/Route/Frequency:
500 mg = 1 tabs/PO/Q6H-INT prn fever > 38.5 C
Time:
How does it work?
Inhibits synthesis of prostaglandins that may serve as mediators of pain
and fever, primarily in the CNS.
Onset/Peak/Duration:
0.5-1 hr/1-3 hr/3-8 hr
Adverse Effects: agitation, rash, hepatotoxicity
Recommended/Usual Dose:
Infusion rate: ml/hr ________ gtt/min
Other: Assess for nutritional deficiency
Labs: None.
Teaching: Encourage to comply with recommendations of HCP; explain best
source of vitamins is a well-balanced diet w/ food from the 4 basic food groups
Infusion rate: ml/hr ________ gtt/min
Other: Assess for signs of hypotension, weight loss, weakness, N/V, anorexia,
lethargy, confusion, restlessness; monitor I&O, daily weight
Labs: K+, Ca2+, WBC, Na+
Teaching: Instruct to inform HCP if severe abdominal pain or tarry stools occur;
educate that stopping med suddenly may result in adrenal insufficiency
Infusion rate: ml/hr ________ gtt/min
Other: Assess for anorexia, Gi distress, irritability, palpitatioins, tachycardia,
edema, confusion
Labs: theophylline, uric acid, urobilinogen
Teaching: Teach foods high in thiamine including cereals, meat, & fresh
vegetables
Infusion rate: ml/hr ________ gtt/min
Other: Assess for skin rash, pain, evaluate hepatic and renal function
Labs: AST, ALT, LDH, BIli
Teaching: Advise patient to avoid alcohol, chronic use of >4 gm/day and skin
rashes.
Infusion rate: ml/hr ________ gtt/min_______
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
Medication: acetaminophen
Classification: NSAID, antipyretic
Generic Name: Tylenol
Indication: Tx of mild pain
Dose/Route/Frequency:
500 mg = 1 tabs/PO/Q6H-INT prn pain
Time:
How does it work?
Inhibits synthesis of prostaglandins that may serve as mediators of pain
and fever, primarily in the CNS.
Onset/Peak/Duration:
0.5-1 hr/1-3 hr/3-8 hr
Adverse Effects: agitation, rash, hepatotoxicity
Recommended/Usual Dose:
Medication: D50W
Classification: caloric sources, CHO
Generic Name: Glucose
Indication: Treat hypoglycemia
Dose/Route/Frequency:
25 mL/ IVP/Q15MIN-INT prn BG bn 50-69 mg/dL & patient is unable
to tolerate PO fluids
Time:
How does it work?
Provides calories
Onset/Peak/Duration:
rapid/rapid/brief
Adverse Effects: fluid overload, hypokalemia, hyperglycemia
Recommended/Usual Dose:
20-50 mL of 50% solution infused slowly (3 mL/min)
Medication: D50W
Classification: caloric sources, CHO
Generic Name: Glucose
Indication: Treat hypoglycemia
Dose/Route/Frequency:
50 mL/IVP/Q15MIN-INT prn BG < 50 mg/dL & patient is unable to
tolerate PO fluids
Time:
How does it work?
Provides calories
Onset/Peak/Duration:
rapid/rapid/brief
Adverse Effects: fluid overload, hypokalemia, hyperglycemia
Recommended/Usual Dose:
20-50 mL of 50% solution infused slowly (3 mL/min)
Other: Assess for skin rash, pain, evaluate hepatic and renal function
Labs: AST, ALT, LDH, BIli
Teaching: Advise patient to avoid alcohol, chronic use of >4 gm/day and skin
rashes.
Infusion rate: ml/hr ________ gtt/min_______
Other: Assess nutritional status, f(x) of GI, caloric needs of pt; assess hydration
status
Labs: BG, K+, PO3
Teaching: Explain the purpose of dextrose admin to pt; instruct DM pt on when &
how-to admin dextrose products for hypoglycemia
Infusion rate: ml/hr ________ gtt/min
Other: Assess nutritional status, f(x) of GI, caloric needs of pt; assess hydration
status
Labs: BG, K+, PO3
Teaching: Explain the purpose of dextrose admin to pt; instruct DM pt on when &
how-to admin dextrose products for hypoglycemia
Infusion rate: ml/hr ________ gtt/min
Medication: glucagon
Classification: hormones, pancreatic
Generic Name: GlucaGen
Indication: Acute management of severe hypoglycemia when admin of
Glu is not feasible
Other: Assess neuro status, signs of hypoglycemia, N/V after admin of dose
Labs: BG, K+
Teaching: Advise family or pt should receive oral Glu when alertness returns;
review hypoglycemic me, regimen, diet & exercise programs w/ pts
Infusion rate: ml/hr ________ gtt/min
Recommended/Usual Dose:
1 mg repeated in 15 min if necessary
How does it work?
Stimulates hepatic production of Glu from glycogen stores
Onset/Peak/Duration:
10 min/30 min/12-27 min
Adverse Effects: hypotension, N/V
Medication: haloperidol
Classification: antipsychotic, butyrophenone
Generic Name: Haldol
Indication: Acute and chronic psychotic d/o
Dose/Route/Frequency:
5 mg = 1 mL/IVP/Q6H-INT prn agitation
Time:
How does it work?
Alters the effects of dopamine in the CNS, also has anticholinergic and
alpha-adrenergic blocking activity
Onset/Peak/Duration:
2 hr/2-6 hr/8-12 hr
Adverse Effects: sz, EPS, confusion, blurred vision, constipation, dry
mouth, NMS
Dose/Route/Frequency:
1 mg = 1 mL/IM/Q15MIN-INT prn BG <70 mg/dL, IV access
unavailable, & unable to tolerate PO fluids
Time:
Recommended/Usual Dose:
0.5-5 mg 2-3 times daily
Medication: ipratropium
Classification: bronchodilator, anticholinergic
Generic Name: Atrovent
Indication: Maintenance thx of reversible airway obstruction d/t COPD,
including chronic bronchitis & emphysema
Dose/Route/Frequency:
0.5 mg = 2.5 mL/NEB/ Q6H prn SOB
How does it work?
Other: Assess mental status, weight, positive & negative symptoms of
schizophrenia, BP
Labs: CBC w/ diff, LFT
Teaching: Inform possibility of EPS, TD & NMS; advise to change positions slowly
to minimize orthostatic hypotension; may cause drowsiness
Infusion rate: ml/hr ________ gtt/min
Other: Assess respiratory status (rate, breath sounds, degree of dyspnea, pulse)
Labs: PFT
Teaching: Instruct proper use of inhaler, nebulizer or nasal spray; advise to rinse
mouth after using inhaler, good oral hygiene, & sugarless gum or candy
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
Time:
Recommended/Usual Dose:
500 mcg 3-4 times daily
Inhibits cholinergic receptors in bronchial smooth muscle, resulting in
decreased concentrations of cGMP.
Onset/Peak/Duration:
1-3 min/1-2 hr/4-6 hr
Adverse Effects: dizziness, HA, nervousness, epistaxis, rash,
bronchospasm, cough
Medication: nitroglycerin
Classification: antianginal, nitrate
Generic Name: Nitrostat
Indication: Acute management of angina pectoris
Dose/Route/Frequency:
0.4 mg = 1 tabs/SL/Q5MIN-INT prn chest pain
Time:
How does it work?
Increases coronary blood flow by dilating coronary arteries and
improving collateral flow to ischemic regions, produces vasodilation.
Onset/Peak/Duration:
1-3 min/ink/30-60 min
Adverse Effects: dizziness, HA, weakness, hypotension, tachycardia
Recommended/Usual Dose:
0.3-0.6 mg Q5MIN for 2 additional doses for acute attack
Medication: ondansetron
Classification: antiemetic, 5HT3 antagonist
Generic Name: Zofran
Indication: Prevention of N/V
Dose/Route/Frequency:
4 mg = 2 mL/IVP/Q6H-INT prn N/V
Time:
How does it work?
Blocks the effects of serotonin at 5HT3 receptor sites located in vagal
nerve terminals and the CTZ in the CNS.
Onset/Peak/Duration:
rapid/15-30 min/4-8 hr
Adverse Effects: HA, constipation, diarrhea, SJS, toxic epidermal
necrolysis, serotonin syndrome
Recommended/Usual Dose:
4 mg
MEDICATION
ACTION
Medication: ceftriaxone
Classification: Anti-infective, 3rd generation cephalosporin
Generic Name: Rocephin
Indication: Intra-abdominal infection
Dose/Route/Frequency:
1 gm/IVP/Q24H
Time: 1200
How does it work?
Binds to the bacterial cell wall membrane, causing cell death.
Onset/Peak/Duration:
Rapid/End infusion/12-24 hr
Adverse Effects: C.diff-associated diarrhea, bleeding, superinfection
Recommended/Usual Dose:
1-2 gm Q12-24H
Medication: enoxaparin
Classification: anticoagulants, LMWH
Generic Name: Lovenox
Indication: Prevention of ischemic complications from unstable
angina & NSTEMI
Dose/Route/Frequency:
30 mg = 0.3 mL/SubQ/Q12H-INT
Time: 0800
Recommended/Usual Dose:
1 mg/kg every 12 hr for 2-8 days
How does it work?
Prevention of thrombus formation
Onset/Peak/Duration:
UNK/3-5 hr/12 hr
Adverse Effects: dizziness, HA, insomnia, edema, bleeding, anemia,
N/V
Medication: folic acid
Classification: antianemic, water-soluble vitamin
Generic Name: Folate
Indication: Prevention and tx of megalobastic and macrocytic
anemias
Dose/Route/Frequency:
1 mg =1 tabs/PO/QDAY
How does it work?
Stimulates the production of RBC, BC, and PLT.
Infusion rate: ml/hr ________ gtt/min
Other: Assess anginal pain, BP, pulse
Labs: Cholesterol
Teaching: Caution to change positions slowly to. Minimize orthostatic
hypotension; inform that HA is a common S/E
Infusion rate: ml/hr ________ gtt/min
Assessment:
Other: Assess N/V, abd distention & BS
Labs: Bili, AST, ALT
Teaching: Notify HCP immediately if symptoms of irregular heartbeat, serotonin
syndrome or involuntary movement of eyes, face or limbs occur.
Infusion rate: ml/hr ________ gtt/min
NURSING CONSIDERATIONS
Assessment:
Other: Assess for infection; observe for s/s of anaphylaxis; monitor bowel function
Labs: AST, ALT, Alk Phos, Bili, BUN, Cr
Teaching: Advise to report signs of superinfection; instruct to notify HCP if fever and
diarrhea develop
Infusion rate: ml/hr ________ gtt/min
Assessment:
Other: Assess for signs of bleeding, observe injection sites for hematomas, ecchymosis
or inflammation
Labs: CBC, PLT, PT, PTT, antifactory Xa, AST, ALT, K+
Teaching: Advise pt to report any sx of unusual bleeding or bruising
Infusion rate: ml/hr ________ gtt/min
Other: Assess for fatigue, weakness, dyspnea
Labs: Plasma folic acid levels, HGB, HCT, reticulocyte count
Teaching: Encourage foods high in folic acid such as vegetables, fruits, and organ
meats; explain that folic acid may make urine more intensely yellow
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
Time: 1000
Recommended/Usual Dose:
1 mg/day initial dose then 0.5 mg/day maintenance dose
ACTION
Onset/Peak/Duration:
30-60 min/1 hr/unk
Adverse Effects: rash, irritability, confusion, fever
Medication: metronidazole
Classification: anti-infective, antiprotozoal
Generic Name: Flagyl
Indication: Tx of anaerobic infections
Dose/Route/Frequency:
500 mg = 100 mL/IVPB/Q8H
Time:1200
How does it work?
Disrupts DNA & protein synthesis in susceptible organisms
Onset/Peak/Duration:
Rapid/End of infusion/6-8 hr
Adverse Effects: sz, dizziness, HA, abd pain, nausea, aseptic
meningitis, encephalopathy, vomiting
Recommended/Usual Dose:
Initial dose 15 mg/kg, then 7.5 mg/kg Q6-8H or 500 mg Q6-8H (not
to exceed 4 gm/day)
Medication: multivitamin
Classification: vitamins
Generic Name: B complex with C and B
Indication: Tx and prevention of vitamin deficiencies
Dose/Route/Frequency:
1 tabs/PO/QDAY
Time: 1000
How does it work?
Contain fat-soluble vitamins & water-soluble vitamins. These
vitamins are diverse group of compounds necessary for normal
growth and development.
Onset/Peak/Duration:
unk/unk/unk
Adverse Effects: urine discoloration
Recommended/Usual Dose:
1 tabs
Medication: pantoprazole
Classification: antiulcer agent, PPI
Generic Name: Protonix
Indication: Erosive esophagitis associated with GERD
Dose/Route/Frequency:
20 mg = 1 tabs/PO/QAMAC
Time: 0600
40 mg once daily for up to 8 wk
How does it work?
Binds to an enzyme in the presence of acidic gastric pH, preventing
the final transport of hydrogen ions into the gastric lumen
Onset/Peak/Duration:
15-30 min/2 hr/UNK
Adverse Effects: HA, C-diff, abd pain, flatulence, hyperglycemia
Medication: thiamine
Classification: vitamin
Generic Name: vitamin B1
Indication: Tx of thiamine deficiencies, prevention of Wernicke’s
encephalopathy; dietary supplement in patients w/ GI disease,
EtOHism, or cirrhosis
Recommended/Usual Dose:
Dose/Route/Frequency:
100 mg = 1 tabs/PO/QDAY
Time: 1000
Recommended/Usual Dose:
5-10 mg three times daily
How does it work?
Required for CHO metabolism
Onset/Peak/Duration:
hr/day/days-wk
Adverse Effects: restlessness, weakness, vascular collapse,
angioedema
NURSING CONSIDERATIONS
Infusion rate: ml/hr ________ gtt/min
Other: Assess for infection at beginning and throughout thx; obtain C&S before
initiating thx; monitor neuro status; monitor I&O
Labs: AST, ALT, LDH
Teaching: May cause dizziness or lightheadedness; notify HCP promptly if rash
occurs; inform that med may cause urine to turn dark
Infusion rate: ml/hr ________ gtt/min
Other: Assess for nutritional deficiency
Labs: None.
Teaching: Encourage to comply with recommendations of HCP; explain best source of
vitamins is a well-balanced diet w/ food from the 4 basic food groups
Infusion rate: ml/hr ________ gtt/min
Other: Assess patient for epigastric or abd pain and for frank or occult blood in stool,
emesis, or gastric aspirate
Labs: AST, ALT, alkaline phosphatase, Bili, Mg
Teaching: Advise patient to report onset of black, tarry stools, diarrhea or abd pain to
HCP
Infusion rate: ml/hr ________ gtt/min
Other: Assess for anorexia, Gi distress, irritability, palpitatioins, tachycardia, edema,
confusion
Labs: theophylline, uric acid, urobilinogen
Teaching: Teach foods high in thiamine including cereals, meat, & fresh vegetables
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Medication: acetaminophen
Classification: NSAID, antipyretic
Generic Name: Tylenol
Indication: Tx of fever
Dose/Route/Frequency:
500 mg = 1 tabs/PO/Q6H-INT
Time: PRN fever > 38.5 C
Recommended/Usual Dose:
How does it work?
Inhibits synthesis of prostaglandins that may serve as mediators of
pain and fever, primarily in the CNS.
Onset/Peak/Duration:
0.5-1 hr/1-3 hr/3-8 hr
Adverse Effects: agitation, rash, hepatotoxicity
325-650 mg every 6 hour
Medication: ibuprofen
Classification: NSAID, antipyretic
Generic Name: Advil
Indication: Tx of mild to moderate pain
Dose/Route/Frequency:
400 mg = 1 tabs/PO/Q6H
Time: PRN moderate pain
400-800 mg Q6H as needed (not to exceed 3200 mg/day)
How does it work?
Inhibits prostaglandin synthesis
Onset/Peak/Duration:
30 min/1-2 hr/4-6 hr
Adverse Effects: HA, dizziness, HF, MI, stroke, GI bleeding, hepatitis,
constipation, dyspepsia, nausea, vomiting
Medication: ondansetron
Classification: antiemetic, 5HT3 antagonist
Generic Name: Zofran
Indication: Prevention of N/V
Dose/Route/Frequency:
4 mg = 2 mL/IVP/Q4H-INT
Time: PRN N/V
How does it work?
Blocks the effects of serotonin at 5HT3 receptor sites located in vagal
nerve terminals and the CTZ in the CNS.
Onset/Peak/Duration:
rapid/15-30 min/4-8 hr
Adverse Effects: HA, constipation, diarrhea, SJS, toxic epidermal
necrolysis, serotonin syndrome
Recommended/Usual Dose:
Recommended/Usual Dose:
4 mg
Medication: magnesium sulfate
Classification: mineral/electrolyte
Generic Name: N/A
Indication: Tx/prevention of hypomagnesemia, Tx of HTN
Dose/Route/Frequency:
4 gm = 100mL/IVPB/ONCE
Time:
How does it work?
Essential for the activity of many enzymes; plays an important role in
neurotransmission and muscular excitability
Onset/Peak/Duration:
Immediate/UNK/30 min
Adverse Effects: drowsiness, RR, arrhythmias, bradycardia,
hypotension, diarrhea
Recommended/Usual Dose:
1 g Q6H for 4 doses or 250 mg/kg over 4 hr
Medication: potassium chloride
Classification: mineral and electrolyte replacement/supplement
Generic Name: Apo-K
Indication: Tx/prevention of potassium depletion
Dose/Route/Frequency:
20 mEq = 200 mL/IVPB/ONCE
Time:
How does it work?
Maintain acid-base balance, isotonicity, & electrophysiologic balance
of the cell. Activator in many enzymatic reactions; essential to
transmission of nerve impulses; contraction of cardiac, skeletal, and
smooth muscle; gastric secretion; renal function; tissue synthesis; and
CHO metabolism.
Onset/Peak/Duration:
UNK/1-2 hr/UNK
Adverse Effects: confusion, abd pain, diarrhea, flatulence, nausea
Recommended/Usual Dose:
10-20 mEq/dose (max: 40 mEq/dose) to infuse over 2-3 hr (max: 40
mEq/hr)
NURSING CONSIDERATIONS
Other: Assess for skin rash, pain, evaluate hepatic and renal function
Labs: AST, ALT, LDH, BIli
Teaching: Advise patient to avoid alcohol, chronic use of >4 gm/day and skin rashes.
Infusion rate: ml/hr ________ gtt/min_______
Other: Assess s/s of GI bleeding, skin rash during thx; assess pain
Labs: BUN, Cr, CBC, LFT, Alk Phos, BG, H&H, PLT
Teaching: Advise to take with a full glass of water and to remain upright position for
15-30 min after admin; may cause drowsiness or dizziness
Infusion rate: ml/hr ________ gtt/min
Other: Assess N/V, abd distention & BS
Labs: Bili, AST, ALT
Teaching: Notify HCP immediately if symptoms of irregular heartbeat, serotonin
syndrome or involuntary movement of eyes, face or limbs occur.
Infusion rate: ml/hr ________ gtt/min
Other: Monitor BP, respirations, ECG, neuro status and I&Os
Labs: Mg2+
Teaching: Explain purpose of med
Infusion rate: ml/hr ________ gtt/min
Other: Assess s/s of hypokalemia; monitor BP, respirations, ECG
Labs: K+, Cl-, Mg2+
Teaching: Instruct to report dark, tarry, or bloody stool; weakness; unusual fatigue; or
tingling of extremities
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Medication: azithromycin
Classification: anti-infective, macrolide
Generic Name: Zithromax
Indication: Tx of infections d/t susceptible organisms
Dose/Route/Frequency:
500 mg = 250 mL/IVPB/Q24H
Time: 1000
How does it work?
Inhibits protein synthesis at the level of the 50S bacterial ribosome
Onset/Peak/Duration:
Rapid/End of infusion/24 hr
Adverse Effects: dizziness, diarrhea, nausea, abd pain, hepatotoxicity,
C.diff-associated diarrhea
Recommended/Usual Dose:
500 mg once daily for 3 days
Medication: ceftriaxone
Classification: Anti-infective, 3rd generation cephalosporin
Generic Name: Rocephin
Indication: Intra-abdominal infection
Dose/Route/Frequency:
1 gm/IVP/Q24H
Time: 1200
How does it work?
Binds to the bacterial cell wall membrane, causing cell death.
Onset/Peak/Duration:
Rapid/End infusion/12-24 hr
Adverse Effects: C.diff-associated diarrhea, bleeding, superinfection
Recommended/Usual Dose:
1-2 gm Q12-24H
Medication: folic acid
Classification: antianemic, water-soluble vitamin
Generic Name: Folate
Indication: Prevention and tx of megalobastic and macrocytic
anemias
Dose/Route/Frequency:
1 mg =1 tabs/PO/QDAY
Time: 1000
1 mg/day initial dose then 0.5 mg/day maintenance dose
How does it work?
Stimulates the production of RBC, BC, and PLT.
Onset/Peak/Duration:
30-60 min/1 hr/unk
Adverse Effects: rash, irritability, confusion, fever
Medication: heparin
Classification: anticoagulant, antithrombotic
Generic Name: Hepalean
Indication: Ppx & tx of various thromboembolic d/o
Dose/Route/Frequency:
5,000 U = 1 mL/SubQ/Q8H-INT
Time: 0800
How does it work?
Potentiates the inhibitory effect of antithrombin on factor Xa and
thrombin
Recommended/Usual Dose:
Recommended/Usual Dose:
5,000 U Q8H-Q12H
NURSING CONSIDERATIONS
Other: Assess for infection; obtain C&S; assess for skin rash
Labs: Bili, AST, ALT, LDH, Alk Phos, BUN, Cr, BG, K+, WBC, PLT
Teaching: May cause drowsiness and dizziness; advise to report symptoms of chest
pain, palpitations, yellowing of skin or eyes, or signs of superinfection
Infusion rate: ml/hr ________ gtt/min
Other: Assess for infection; observe for s/s of anaphylaxis; monitor bowel function
Labs: AST, ALT, Alk Phos, Bili, BUN, Cr
Teaching: Advise to report signs of superinfection; instruct to notify HCP if fever and
diarrhea develop
Infusion rate: ml/hr ________ gtt/min
Other: Assess for fatigue, weakness, dyspnea
Labs: Plasma folic acid levels, HGB, HCT, reticulocyte count
Teaching: Encourage foods high in folic acid such as vegetables, fruits, and organ
meats; explain that folic acid may make urine more intensely yellow
Infusion rate: ml/hr ________ gtt/min
Other: assess for signs of bleeding, additional or increased thrombosis
Labs: PT, PTT, INR, PLT, antifactory Xa
Teaching: Advise pt to report any symptoms of unusual bleeding or bruising to HCP
immediately, instruct pt not to take meds containing ASA or NSAIDs while on
heparin thx
Infusion rate: ml/hr ________ gtt/min
Onset/Peak/Duration:
20-60 min/2 hr/8-12 hr
Adverse Effects: rashes, bleeding, anemia
Medication: insulin lispro
Classification: antidiabetic, pancreatic, hormone
Generic Name: Humalog
Indication: Control of hyperglycemia in pts w/ DM I & II
Dose/Route/Frequency:
0.1-12 units/SubQ/ACHS
Time: 0800,1200
How does it work?
 BG by stimulating Glu uptake in skeletal muscle & fat, inhibiting
hepatic Glu production
Onset/Peak/Duration:
15 min/1-2 hr/3-4 hr
Adverse Effects: hypoglycemia, hypokalemia, pruritis, swelling
Recommended/Usual Dose: High Correctional dose
0.5-1.2 units/kg/day
Other: assess for sx of hypoglycemia & hyperglycemia periodically, change in wt
Labs: HbA1C, BG, K+
Teaching: instruct pt on s/s of hypoglycemia & hyperglycemia; emphasize the
importance of compliance w/ nutritional guidelines
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Medication: metoprolol
Classification: antihypertensive, BB
Generic Name: Lopressor
Indication: Management of HTN
Dose/Route/Frequency:
10 mg = 10 mL/IVP/Q12H
Time: 1000
12.5-25 mg once daily
How does it work?
Blocks stimulation of beta-adrenergic receptor to  HR & BP
Onset/Peak/Duration:
15 min/UNK/6-12 hr
Adverse Effects: fatigue, weakness, dizziness, erectile dysf(x),
bradycardia, HF, pulmonary edema
Medication: multivitamin
Classification: vitamins
Generic Name: B complex with C and B
Indication: Tx and prevention of vitamin deficiencies
Dose/Route/Frequency:
1 tabs/PO/QDAY
Time: 1000
How does it work?
Contain fat-soluble vitamins & water-soluble vitamins. These
vitamins are diverse group of compounds necessary for normal
growth and development.
Onset/Peak/Duration:
unk/unk/unk
Adverse Effects: urine discoloration
Recommended/Usual Dose:
Recommended/Usual Dose:
1 tabs
Medication: thiamine
Classification: vitamin
Generic Name: vitamin B1
Indication: Tx of thiamine deficiencies, prevention of Wernicke’s
encephalopathy; dietary supplement in patients w/ GI disease,
EtOHism, or cirrhosis
Dose/Route/Frequency:
100 mg = 1 tabs/PO/QDAY
Time: 1000
Recommended/Usual Dose:
5-10 mg three times daily
How does it work?
Required for CHO metabolism
Onset/Peak/Duration:
hr/day/days-wk
Adverse Effects: restlessness, weakness, vascular collapse,
angioedema
Medication: albuterol
Classification: bronchodilator, adrenergic
Generic Name: Ventolin
Indication: Tx or prevention of bronchospasm in asthma or COPD
Dose/Route/Frequency:
2.5 mg = 0.5 mL/NEB (Duo w/ ipratropium)/QID
Time: PRN wheezing
Recommended/Usual Dose:
2.5-10 mg Q1-4H
How does it work?
Binds to beta2-adrenergic receptors in airway smooth muscle, leading
to activation of adenyl cyclase and increased levels of cAMP.
Relaxation of airway smooth muscle with subsequent
bronchodilation.
Onset/Peak/Duration:
5-15 min/60-90 min/3-6 hr
Adverse Effects: nervousness, restlessness, tremor, chest pain,
palpitations
Medication: D50W
Classification: caloric sources, CHO
Generic Name: Glucose
Indication: Treat hypoglycemia
Dose/Route/Frequency:
25 mL/IVP/Q15MIN-INT
Time: PRN
How does it work?
Provides calories
Onset/Peak/Duration:
rapid/rapid/brief
Adverse Effects: fluid overload, hypokalemia, hyperglycemia
Recommended/Usual Dose:
20-50 mL of 50% solution infused slowly (3 mL/min)
NURSING CONSIDERATIONS
Other: Monitor ECG frequently, I&O & daily wt
Labs: BUN, K+, triglyceride, BG
Teaching: Closely monitor BG d/t masking hypoglycemia; advise pt to change
positions slowly to  orthostatic hypotension; teach pt to check pulse daily and BP
biweekly
Infusion rate: ml/hr ________ gtt/min
Other: Assess for nutritional deficiency
Labs: None.
Teaching: Encourage to comply with recommendations of HCP; explain best source of
vitamins is a well-balanced diet w/ food from the 4 basic food groups
Infusion rate: ml/hr ________ gtt/min
Other: Assess for anorexia, Gi distress, irritability, palpitatioins, tachycardia, edema,
confusion
Labs: theophylline, uric acid, urobilinogen
Teaching: Teach foods high in thiamine including cereals, meat, & fresh vegetables
Infusion rate: ml/hr ________ gtt/min
Other: Assess lung sounds, pulse, BP; note sputum; monitor PFTs; observe
paradoxical bronchospasm
Labs: K+
Teaching: Instruct to contact HCP immediately if SOB is not relieved by med; advise
to rinse outh with water after each INH dose
Infusion rate: ml/hr ________ gtt/min
Other: Assess nutritional status, f(x) of GI, caloric needs of pt; assess hydration status
Labs: BG, K+, PO3
Teaching: Explain the purpose of dextrose admin to pt; instruct DM pt on when &
how to admin dextrose products for hypoglycemia
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Medication: D50W
Classification: caloric sources, CHO
Generic Name: Glucose
Indication: Treat hypoglycemia
Dose/Route/Frequency:
50 mL/IVP/Q15MIN-INT
Time: PRN
Recommended/Usual Dose:
20-50 mL of 50% solution infused slowly (3 mL/min)
How does it work?
Provides calories
Onset/Peak/Duration:
rapid/rapid/brief
Adverse Effects: fluid overload, hypokalemia, hyperglycemia
Medication: glucagon
Classification: hormones, pancreatic
Generic Name: GlucaGen
Indication: Acute management of severe hypoglycemia when admin of
Glu is not feasible
Dose/Route/Frequency:
1 mg = 1 mL/IM/Q15MIN-INT
Time: PRN
Recommended/Usual Dose:
1 mg repeated in 15 min if necessary
How does it work?
Stimulates hepatic production of Glu from glycogen stores
Onset/Peak/Duration:
10 min/30 min/12-27 min
Adverse Effects: hypotension, N/V
Medication: ipratropium
Classification: bronchodilator, anticholinergic
Generic Name: Arovent
Indication: Maintenance thx of reversible airway obstruction d/t
COPD, including chronic bronchitis & emphysema
Dose/Route/Frequency:
0.5 mg = 2.5 mL/NEB/QID
Time: PRN wheezing
Recommended/Usual Dose:
500 mcg 3-4 times daily
How does it work?
Inhibits cholinergic receptors in bronchial smooth muscle, resulting
in decreased concentrations of cGMP.
Onset/Peak/Duration:
1-3 min/1-2 hr/4-6 hr
Adverse Effects: dizziness, HA, nervousness, epistaxis, rash,
bronchospasm, cough
Medication: lorazepam
Classification: sedative-hypnotic. BZD
Generic Name: Ativan
Indication: anx d/o, agitation, tremors
Dose/Route/Frequency:
1 mg = 0.5 mL/IVP/Q30MIN
Time: PRN Scale A = 6-7
How does it work?
Depresses the CNS, probably by potentiating GABA
Onset/Peak/Duration:
15-60 min/1-6 hr/8-12 hr
Adverse Effects: dizziness, drowsiness, lethargy, mental depression,
paradoxical excitation
Recommended/Usual Dose:
1-3 mg 2-3 times daily (up to 10 mg/day)
Medication: lorazepam
Classification: sedative-hypnotic. BZD
Generic Name: Ativan
Indication: anx d/o, agitation, tremors
Dose/Route/Frequency:
2 mg = 1 mL/IVP/Q30MIN
Time: PRN Scale A = 8-9
How does it work?
Depresses the CNS, probably by potentiating GABA
Onset/Peak/Duration:
15-60 min/1-6 hr/8-12 hr
Adverse Effects: dizziness, drowsiness, lethargy, mental depression,
paradoxical excitation
Recommended/Usual Dose:
1-3 mg 2-3 times daily (up to 10 mg/day)
NURSING CONSIDERATIONS
Other: Assess nutritional status, f(x) of GI, caloric needs of pt; assess hydration status
Labs: BG, K+, PO3
Teaching: Explain the purpose of dextrose admin to pt; instruct DM pt on when &
how to admin dextrose products for hypoglycemia
Infusion rate: ml/hr ________ gtt/min
Other: Assess neuro status, signs of hypoglycemia, N/V after admin of dose
Labs: BG, K+
Teaching: Advise family or pt should receive oral Glu when alertness returns; review
hypoglycemic me, regimen, diet & exercise programs w/ pts
Infusion rate: ml/hr ________ gtt/min
Resp
Other: Assess respiratory status (rate, breath sounds, degree of dyspnea, pulse)
Labs: PFT
Teaching: Instruct proper use of inhaler, nebulizer or nasal spray; advise to rinse
mouth after using inhaler, good oral hygiene, & sugarless gum or candy
Infusion rate: ml/hr ________ gtt/min
Other: Assess degree & manifestations of anx & mental status prior & after
Labs: Renal, hepatic & hematologic f(x); antidote: flumazenil (Romazicon)
Teaching: Instruct pt to take med exactly as directed; may cause drowsiness or
dizziness; advise for short-term use
Infusion rate: ml/hr ________ gtt/min
Other: Assess degree & manifestations of anx & mental status prior & after
Labs: Renal, hepatic & hematologic f(x); antidote: flumazenil (Romazicon)
Teaching: Instruct pt to take med exactly as directed; may cause drowsiness or
dizziness; advise for short-term use
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Medication: lorazepam
Classification: sedative-hypnotic. BZD
Generic Name: Ativan
Indication: anx d/o, agitation, tremors
Dose/Route/Frequency:
3 mg = 1.5 mL/IVP/Q30MIN
Time: PRN Scale A = 10-11, Scale B = 6-7
How does it work?
Depresses the CNS, probably by potentiating GABA
Onset/Peak/Duration:
15-60 min/1-6 hr/8-12 hr
Adverse Effects: dizziness, drowsiness, lethargy, mental depression,
paradoxical excitation
Recommended/Usual Dose:
1-3 mg 2-3 times daily (up to 10 mg/day)
Medication: lorazepam
Classification: sedative-hypnotic. BZD
Generic Name: Ativan
Indication: anx d/o, agitation, tremors
Dose/Route/Frequency:
4 mg = 2 mL/IVP/Q30MIN
Time: PRN Scale B = 8-9
How does it work?
Depresses the CNS, probably by potentiating GABA
Onset/Peak/Duration:
15-60 min/1-6 hr/8-12 hr
Adverse Effects: dizziness, drowsiness, lethargy, mental depression,
paradoxical excitation
Recommended/Usual Dose:
1-3 mg 2-3 times daily (up to 10 mg/day)
Medication: lorazepam
Classification: sedative-hypnotic. BZD
Generic Name: Ativan
Indication: anx d/o, agitation, tremors
Dose/Route/Frequency:
5 mg = 2.5 mL/IVP/Q30MIN
Time: PRN Scale B = 10-11
How does it work?
Depresses the CNS, probably by potentiating GABA
Onset/Peak/Duration:
15-60 min/1-6 hr/8-12 hr
Adverse Effects: dizziness, drowsiness, lethargy, mental depression,
paradoxical excitation
Recommended/Usual Dose:
1-3 mg 2-3 times daily (up to 10 mg/day)
Medication: lorazepam
Classification: sedative-hypnotic. BZD
Generic Name: Ativan
Indication: anx d/o, agitation, tremors
Dose/Route/Frequency:
6 mg = 3 mL/IVP/Q30MIN
Time: PRN Scale B > 12
How does it work?
Depresses the CNS, probably by potentiating GABA
Onset/Peak/Duration:
15-60 min/1-6 hr/8-12 hr
Adverse Effects: dizziness, drowsiness, lethargy, mental depression,
paradoxical excitation
Recommended/Usual Dose:
1-3 mg 2-3 times daily (up to 10 mg/day)
Medication: morphine
Classification: opioid analgesic, Schedule II
Generic Name: Duramorph
Indication: Severe pain
Dose/Route/Frequency:
2 mg = 0.5 mL/IVP/Q6H
Time: PRN pain
How does it work?
Binds to opiate receptors in the CNS; alters the perception of and
response to painful stimuli while producing generalized CNS
depression.
Onset/Peak/Duration:
Rapid/20 min/4-5 hr
Adverse Effects: confusion, sedation, hypotension, constipation,
Recommended/Usual Dose:
4-10 mg Q3-4H
NURSING CONSIDERATIONS
Other: Assess degree & manifestations of anx & mental status prior & after
Labs: Renal, hepatic & hematologic f(x); antidote: flumazenil (Romazicon)
Teaching: Instruct pt to take med exactly as directed; may cause drowsiness or
dizziness; advise for short-term use
Infusion rate: ml/hr ________ gtt/min
Other: Assess degree & manifestations of anx & mental status prior & after
Labs: Renal, hepatic & hematologic f(x); antidote: flumazenil (Romazicon)
Teaching: Instruct pt to take med exactly as directed; may cause drowsiness or
dizziness; advise for short-term use
Infusion rate: ml/hr ________ gtt/min
Other: Assess degree & manifestations of anx & mental status prior & after
Labs: Renal, hepatic & hematologic f(x); antidote: flumazenil (Romazicon)
Teaching: Instruct pt to take med exactly as directed; may cause drowsiness or
dizziness; advise for short-term use
Infusion rate: ml/hr ________ gtt/min
Other: Assess degree & manifestations of anx & mental status prior & after
Labs: Renal, hepatic & hematologic f(x); antidote: flumazenil (Romazicon)
Teaching: Instruct pt to take med exactly as directed; may cause drowsiness or
dizziness; advise for short-term use
Infusion rate: ml/hr ________ gtt/min
Other: Assess pain, bowel function, risk for opioid addiction
Labs:  amylase, lipase
Teaching: May cause drowsiness or dizziness; advise drug has abuse potential and
change positions slowly to minimize orthostatic hypotension; caution use of EtOH or
other CNS depressants
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
NURSING CONSIDERATIONS
respiratory depression
Medication: ocular lubricant
Classification: lubricant
Generic Name: UNK
Indication: Dry eyes
Dose/Route/Frequency:
1 drop/OU/QID
Time: PRN dry eyes
How does it work?
Solution formulated to moisten eyes
Onset/Peak/Duration:
UNK
Adverse Effects: mild eye burning, irritation, itching or redness of
eyes, and watery eyes.
Recommended/Usual Dose:
1 drop OU
Medication: potassium phosphate
Classification: antiurolithics, mineral & electrolyte
replacements/supplement
Generic Name: N/A
Dose/Route/Frequency:
15 mmol = 250 mL/IVPB/ONCE
Time:
Indication: Tx & prevention of phosphate depletion; phosphate salts
of potassium may be used in hypokalemic patients w/ metabolic
acidosis or coexisting phosphorus deficiency
Recommended/Usual Dose:
10 mmol phosphorus/day as an infusion
How does it work?
Serves as a buffer for the excretion of hydrogen ions by the kidney
Onset/Peak/Duration:
Rapid/End of infusion/UNK
Adverse Effects: diarrhea, arrhythmias, confusion, weakness
Medication: potassium chloride
Classification: mineral and electrolyte replacement/supplement
Generic Name: Apo-K
Indication: Tx/prevention of potassium depletion
Dose/Route/Frequency:
20 mEq = 200 mL/IVPB/ONCE
Time:
Recommended/Usual Dose:
10-20 mEq/dose (max: 40 mEq/dose) to infuse over 2-3 hr (max: 40
mEq/hr)
How does it work?
Maintain acid-base balance, isotonicity, & electrophysiologic balance
of the cell. Activator in many enzymatic reactions; essential to
transmission of nerve impulses; contraction of cardiac, skeletal, and
smooth muscle; gastric secretion; renal function; tissue synthesis; and
CHO metabolism.
Onset/Peak/Duration:
UNK/1-2 hr/UNK
Adverse Effects: confusion, abd pain, diarrhea, flatulence, nausea
Medication: darbepoetin alfa
Classification: antianemic, ESA
Generic Name: Aranesp
Indication: Anemia associated with CKD
Dose/Route/Frequency:
40 mcg = 0.4 mL/SubQ/QWEEK-FRI
Time: 1000
How does it work?
Stimulates erythropoiesis,
Onset/Peak/Duration:
2-6 wk/UNK/UNK
Adverse Effects: sz, dizziness, fatigue, HA, cough, HTN, hypotension,
abd pain, NVD, fever, maylgia
Recommended/Usual Dose:
0.45 mcg/kg QWEEK
Medication: fluticasone nasal
Classification: corticosteroids
Generic Name:
Indication: Seasonal or perennial allergic rhinitis
Dose/Route/Frequency:
100 mcg = 2 sprays/ Intranasal/QDAY
Time: 1000
How does it work?
Potent, locally acting anti-inflammatory and immune modifier
Onset/Peak/Duration:
Few days/Up to 3 wk/UNK
Adverse Effects: HA, N/V, angioedema, nasal burning, rash
Recommended/Usual Dose:
2 sprays in each nostril once daily
Other: Assess eyes
Labs: N/A
Teaching: Use as prescribed; do not rub for at least 30 minutes
Infusion rate: ml/hr ________ gtt/min
Other: Assess s/s of hypokalemia; monitor pulse, Bp, ECG, I&Os
Labs: Phos, K+, Ca2+
Teaching: Explain to take as directed
Infusion rate: ml/hr ________ gtt/min
Other: Assess s/s of hypokalemia; monitor BP, respirations, ECG
Labs: K+, Cl-, Mg2+
Teaching: Instruct to report dark, tarry, or bloody stool; weakness; unusual fatigue; or
tingling of extremities
Infusion rate: ml/hr ________ gtt/min
Other: Monitor BP, response for symptoms of anemia, allergic reactions, skin rash
Labs: WBC, PLTS, PT, INR, PTT, Fe, H&H, RBC
Teaching: Prevent self-injury at risk for sz; advise to report severe skin reactions.
Infusion rate: ml/hr ________ gtt/min
Other: Monitor nasal stuffiness, s/s of hypersensitivity reactions
Labs: HPA axis
Teaching: Instruct on correct technique, gently blow nose to clear nostrils
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Medication: furosemide
Classification: loop diuretic
Generic Name: Lasix
Indication: Edema d/t HF, hepatic impairment, or renal disease; HTN
Dose/Route/Frequency:
40 mg = 1 tabs/PO/QDAY
Time: 1000
How does it work?
Inhibits the reabsorption of sodium and chloride from the loop of
Henle and distal renal tubule.
Onset/Peak/Duration:
30-60 min/1-2 hr/6-8 hr
Adverse Effects: dehydration, hypocalcemia, hypokalemia,
hypomagnesemia, hypovolemia, agranulocytosis, aplastic anemia
Recommended/Usual Dose:
20-80 mg/day as a single dose initially
Medication: lidocaine topical
Classification: antiarrhythmics, anesthetic
Generic Name: Xylocaine
Indication: Topical anesthetic
Dose/Route/Frequency:
1 app/ Local/TID
Time: 1000
How does it work?
Produces local anesthesia by inhibiting transport of ions across
neuronal membranes, thereby preventing initiation and conduction of
normal nerve impulses
Onset/Peak/Duration:
Rapid/UNK/1-3 hr
Adverse Effects: confusion, drowsiness, stinging, N/V
Recommended/Usual Dose:
Apply to affected area 2-3 times daily
Medication: multivitamin
Classification: vitamins
Generic Name: B complex with C and B
Indication: Tx and prevention of vitamin deficiencies
Dose/Route/Frequency:
1 tabs/PO/QDAY
Time: 1000
How does it work?
Contain fat-soluble vitamins & water-soluble vitamins. These
vitamins are diverse group of compounds necessary for normal
growth and development.
Onset/Peak/Duration:
unk/unk/unk
Adverse Effects: urine discoloration
Recommended/Usual Dose:
1 tabs
Medication: nifedipine
Classification: CCB, antihypertensive, antianginal
Generic Name: Procardia
Indication: Management of HTN
Dose/Route/Frequency:
60 mg = 1 tabs/PO/QDAY
Time:1000
How does it work?
Inhibits calcium transport into myocardial and vascular smooth
muscle cells, resulting in inhibition of excitation-contraction coupling
and subsequent contraction.
Onset/Peak/Duration:
20 min/UNK/6-8 hr
Adverse Effects: HA, peripheral edema, flushing, anxiety, confusion,
dizziness HF, arrhythmia
Recommended/Usual Dose:
10-30 mg 3 times daily (not to exceed 180 mg/day)
NURSING CONSIDERATIONS
Other: Assess fluid status, monitor daily weight, I&Os
Labs: Na+, K+, Ca2+, Mg2+, BUN, Cr, Glu
Teaching: Caution to change positions slowly to minimize orthostatic hypotension;
advise to contact HCP immediately if rash, muscle weakness, cramps, nausea,
dizziness, numbness, or tingling of extremities occurs.
Infusion rate: ml/hr ________ gtt/min
Other: Monitor ECG, BP, respiratory status; assess degree of numbness of affected
part
Labs: CRP
Teaching: Do not exceed recommended doses d/t resulted harm or death from
neurologic &/or cardiac toxicity
Infusion rate: ml/hr ________ gtt/min
Other: Assess for nutritional deficiency
Labs: None.
Teaching: Encourage to comply with recommendations of HCP; explain best source of
vitamins is a well-balanced diet w/ food from the 4 basic food groups
Infusion rate: ml/hr ________ gtt/min
Other: Monitor BP, HR, I&O, rash
Labs: LFTs, BUN, Cr
Teaching: Advise to avoid grapefruit; caution to change positions slowly to minimize
orthostatic hypotension; may cause drowsiness or dizziness
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Medication: pantoprazole
Classification: antiulcer agent, PPI
Generic Name: Protonix
Indication: Erosive esophagitis associated with GERD
Dose/Route/Frequency:
40 mg = 1 tabs/PO/BID
How does it work?
Binds to an enzyme in the presence of acidic gastric pH, preventing
the final transport of hydrogen ions into the gastric lumen
Onset/Peak/Duration:
15-30 min/2 hr/UNK
Adverse Effects: HA, C-diff, abd pain, flatulence, hyperglycemia
Time: 1000
Recommended/Usual Dose:
40 mg once daily for up to 8 wk
Medication: sevelamer
Classification: electrolyte modifier, phosphate binder
Generic Name: Renagel
Indication: Reduction of serum phosphate levels
Dose/Route/Frequency:
800 mg = 1 tabs/PO/TIDWM
Time: 0800,1230
Recommended/Usual Dose:
How does it work?
Polymer that binds phosphate in the GI tract, preventing its
absorption
Onset/Peak/Duration:
5 days/2 wk/UNK
Adverse Effects: bowel obstruction/perforation, esophageal
obstruction, diarrhea, dyspepsia, vomniting
Medication: sodium zirconium
Classification: hypokalemic, electrolyte modifier
Generic Name: Lokelma
Indication: Hyperkalemia
Dose/Route/Frequency:
10 gm = 1 EA/PO/QDAY
Time: 1000
Recommended/Usual Dose:
10 gm three times daily in water for up to 48 hr, then 10 gm once daily
How does it work?
Exchanged hydrogen and sodium ions for K+ in the intestine
Onset/Peak/Duration:
1 hr/UNK/48 hr
Adverse Effects: edema, hypokalemia
Medication: vancomycin
Classification: anti-infective
Generic Name: Vancocin
Indication: Tx of potentially life-threatening infections when less toxic
anti-infectives are contraindicated.
Dose/Route/Frequency:
Pharmacy to Dose/IVPB/QDAY
Time:
Recommended/Usual Dose:
500 mg Q6H or 1 gm Q12H
How does it work?
Binds to bacterial cell wall, resulting in cell death.
Onset/Peak/Duration:
Rapid/End of infusion/12-24 hr
Adverse Effects: ototoxicity, superinfection, N/V, nephrotoxicity,
phlebitis
Medication: flumazenil
Classification: antidotes
Generic Name: Romazicon
Indication: Complete/partial reversal of effects of BZD used as
general anesthetics, or diagnostic or therapeutic procedures.
Dose/Route/Frequency:
0.2 mg = 2 mL/ INK/UNSCHED
Time:
Recommended/Usual Dose:
0.2 mg (not to exceed 3 mg/hr)
How does it work?
BZD derivative that antagonizes the CNS depressants effects of BZD
compounds.
Onset/Peak/Duration:
1-2 min/6-10 min/1-2 hr
Adverse Effects: sz, dizziness, N/V
NURSING CONSIDERATIONS
Other: Assess patient for epigastric or abd pain and for frank or occult blood in stool,
emesis, or gastric aspirate
Labs: AST, ALT, alkaline phosphatase, Bili, Mg
Teaching: Advise patient to report onset of black, tarry stools, diarrhea or abd pain to
HCP
Infusion rate: ml/hr ________ gtt/min
Other: Assess GI S/E
Labs: Phos, Ca2+, HCO3, ClTeaching: Instruct to take with meals
Infusion rate: ml/hr ________ gtt/min
Other: Assess bowel patterns; monitor signs of edema
Labs: K+
Teaching: Advise to modify dietary sodium intake; instruct to take med as directed
Infusion rate: ml/hr ________ gtt/min
Other: Assess for infection; monitor eIV site closely, BP, I&Os
Labs: CBC, Albumin, BUN, Cr, GFR, vancomycin trough
Teaching: Instruct to report signs of hypersensitivity
Infusion rate: ml/hr ________ gtt/min
Other: Assess LOC & respiratory status
Labs: N/A
Teaching: Instruct to not take any EtOH or nonprescription drugs for at least 18-24 hr
after d/c
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Medication: naloxone
Classification: antidote, opioid antagonist
Generic Name: Narcan
Indication: Reversal of CNS depression and respiratory depression
because of suspected opioid overdose
Dose/Route/Frequency:
2 mg = 5 mL/INJ/STAT Q2MIN
Time: UNSCHED
Recommended/Usual Dose:
0.02-0.2 mg Q2-3MIN until response obtained; repeat Q1-2H if
needed
How does it work?
Completely blocks the effects of opioids, including CNS and
respiratory depression, without producing any agonist effects.
Onset/Peak/Duration:
1-2 min/UNK/45 min
Adverse Effects: ventricular arrhythmias, HTN, hypotension, N/V
Medication: acetaminophen
Classification: NSAID, antipyretic
Generic Name: Tylenol
Indication: Tx of mild pain
Dose/Route/Frequency:
650 mg = 1 tabs/PO/Q6H-INT
Time: PRN mild pain
Recommended/Usual Dose:
How does it work?
Inhibits synthesis of prostaglandins that may serve as mediators of
pain and fever, primarily in the CNS.
Onset/Peak/Duration:
0.5-1 hr/1-3 hr/3-8 hr
Adverse Effects: agitation, rash, hepatotoxicity
325-650 mg every 6 hour
Medication: acetaminophen
Classification: NSAID, antipyretic
Generic Name: Tylenol
Indication: Tx of fever
Dose/Route/Frequency:
500 mg = 1 tabs/PO/Q6H-INT
Time: PRN fever > 38.5 C
Recommended/Usual Dose:
How does it work?
Inhibits synthesis of prostaglandins that may serve as mediators of
pain and fever, primarily in the CNS.
Onset/Peak/Duration:
0.5-1 hr/1-3 hr/3-8 hr
Adverse Effects: agitation, rash, hepatotoxicity
325-650 mg every 6 hour
Medication: diclofenac topical
Classification: NSAID
Generic Name: Solaraze
Indication: Management of actinic keratoses
Dose/Route/Frequency:
4 gm/Topical/QID
Time: PRN itching
How does it work?
Inhibits prostaglandin synthesis
Onset/Peak/Duration:
UNK/10-20 hr/UNK
Adverse Effects: HF, MI, stroke, GI bleeding, hepatotoxicity, rashes,
dry skin
Recommended/Usual Dose:
4 gm to affected area 4 times daily (max 16 gm per joint/daily)
Medication: fentanyl
Classification: opioid analgesic, Schedule II
Generic Name: Sublimaze
Indication: Nueroleptanalgesia/neuroleptanesthesia
Dose/Route/Frequency:
250 mcg = 5 mL/INJ/UNSCHED
Time:
How does it work?
Binds to opiate receptors in the CNS, altering the response to and
perception of pain. Produces CNS depression.
Onset/Peak/Duration:
1-2 min/3-5 min/0.5-1 hr
Adverse Effects: confusion, apnea, paradoxical excitation/delirium,
Recommended/Usual Dose:
50-100 mcg/kg
NURSING CONSIDERATIONS
Other: Monitor RR, rhythm, depth, ECG, BP, LOC; assess level of pain
Labs: N/A
Teaching: Explain purpose and effects of med as med becomes effective
Infusion rate: ml/hr ________ gtt/min
Other: Assess for skin rash, pain, evaluate hepatic and renal function
Labs: AST, ALT, LDH, Bili
Teaching: Advise patient to avoid alcohol, chronic use of >4 gm/day and skin rashes.
Infusion rate: ml/hr ________ gtt/min_______
Other: Assess for skin rash, pain, evaluate hepatic and renal function
Labs: AST, ALT, LDH, Bili
Teaching: Advise patient to avoid alcohol, chronic use of >4 gm/day and skin rashes.
Infusion rate: ml/hr ________ gtt/min_______
Other: Monitor BP, skin rash; assess pain and limitation of movement
Labs: CBC, BUN, Cr, AST, ALT
Teaching: Notify swelling of arms & legs or hands and feet, nausea, fatigue, lethargy,
rash, itching, stomach pain
Infusion rate: ml/hr ________ gtt/min
Other: Monitor RR, BP; Assess pain
Labs: Amylase, lipase
Teaching: Explain pain assessment scale; caution change positions slowly to minimize
orthostatic hypotension; may cause dizziness & drowsiness
Infusion rate: ml/hr ________ gtt/min
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
NURSING CONSIDERATIONS
N/V
Medication: midalozam
Classification: sedative-hypnotic, BZD, Schedule IV
Generic Name: Versed
Indication: Preoperative sedation
Dose/Route/Frequency:
5 mg = 5 mL/INJ/UNSCHED
Time:
How does it work?
Acts at many levels of the CNS to produce generalized CNS
depression. Effedts may be mediated by GABA.
Onset/Peak/Duration:
1.5-5 min/Rapid/2-6 hr
Adverse Effects: agitation, phlebitis at IV site, drowsiness, excess
sedation, apnea, respiratory depression
Recommended/Usual Dose:
0.25-0.5 mg/kg
Medication: ondansetron
Classification: antiemetic, 5HT3 antagonist
Generic Name: Zofran
Indication: Prevention of N/V
Dose/Route/Frequency:
4 mg = 2 mL/IVP/Q8H-INT
Time: PRN N/V
How does it work?
Blocks the effects of serotonin at 5HT3 receptor sites located in vagal
nerve terminals and the CTZ in the CNS.
Onset/Peak/Duration:
rapid/15-30 min/4-8 hr
Adverse Effects: HA, constipation, diarrhea, SJS, toxic epidermal
necrolysis, serotonin syndrome
Recommended/Usual Dose:
4 mg
Medication: polyethylene glycol 3350 (MiraLax)
Classification: laxative, osmotic
Generic Name: Miralax
Indication: Tx of occasional constipation
Dose/Route/Frequency:
17 gm = 1 packets/PO/ QDAY
Time: PRN constipation
How does it work?
PEG in solution acts as an osmotic agent, drawing water into the
lumen of the GI tract
Onset/Peak/Duration:
UNK/1-3 days/UNK
Adverse Effects: urticaria, abd bloating, cramping, flatulence, nausea
Recommended/Usual Dose:
17 gm in 8 oz water, may be used for up to 2 wk
Medication: warfarin
Classification: anticoagulant, coumarin
Generic Name: Coumadin
Indication: PPx and tx of VTW, PE, A-Fib w/ embolization
Dose/Route/Frequency:
2.5 mg = 1 tabs/PO/QPM
Time: 1800
How does it work?
Interferes with hepatic synthesis of vitamin K-dependent clotting
factors (II, VII, IX, & X)
Onset/Peak/Duration:
36-72 hr/5-7 days/2-5 days
Adverse Effects: bleeding, dermal necrosis, cramps, nausea
Recommended/Usual Dose:
2-5 mg/day for 2-4 days then adjust daily dose by results of INR
Medication: oxycodone
Classification: opioid analgesic
Generic Name: Oxycontin
Indication: Moderate to severe pain
Dose/Route/Frequency:
5 mg = 1 tabs/PO/Q4H
Rationale:
How does it work?
Binds to opiate receptors in the CNS; alters the perception of and
response to painful stimuli, while producing generalized CNS
depression.
Other: Assess level of sedation & LOC; monitor BP, pulse, respiration
Labs: N/A
Teaching: May cause drowsiness or dizziness
Infusion rate: ml/hr ________ gtt/min
Other: Assess N/V, abd distention & BS
Labs: Bili, AST, ALT
Teaching: Notify HCP immediately if symptoms of irregular heartbeat, serotonin
syndrome or involuntary movement of eyes, face or limbs occur.
Infusion rate: ml/hr ________ gtt/min
Other: Assess patient for abd distention, presence of bowel sounds, color and
consistency of stools
Labs: None
Teaching: Inform patient that 2-4 days may be required to produce a BM, advise
patient to notify HCP if unusual cramps, bloating, of diarrhea occurs.
Infusion rate: ml/hr ________ gtt/min
Other: Assess for bleeding
Labs: Hepatic function, CBC
Teaching: Advise to report unusual bleeding or bruising; instruct not to drink EtOH;
emphasize importance of frequent lab tests to monitor coagulation factors
Infusion rate: ml/hr ________ gtt/min
Assessment:  HR  BP  RR
Other: Assess pain, bowel function, risk for opioid addiction
Labs: Amylase, Lipase
Teaching: May be admin w/ food or milk to minimize GI irritation.
LAC School of Nursing
N233 L - Intermediate Medical/Surgical & Psychiatric Nursing Clinical – FALL 2019
MEDICATION
ACTION
Time: PRN pain
NURSING CONSIDERATIONS
Infusion rate: ml/hr ________ gtt/min
Adverse Effects: confusion, sedation, constipation, respiratory
depression
Medication: oxycodone
Classification: opioid analgesic
Generic Name: Oxycontin
Indication: Moderate to severe pain
Dose/Route/Frequency:
5 mg = 1 tabs/PO/Q4H
Rationale:
How does it work?
Binds to opiate receptors in the CNS; alters the perception of and
response to painful stimuli, while producing generalized CNS
depression.
Time: PRN pain
Assessment:  HR  BP  RR
Other: Assess pain, bowel function, risk for opioid addiction
Labs: Amylase, Lipase
Teaching: May be admin w/ food or milk to minimize GI irritation.
Infusion rate: ml/hr ________ gtt/min
Adverse Effects: confusion, sedation, constipation, respiratory
depression
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