MEDICATION ADMINISTRATION WORKSHEET
Medication:
Generic/Trade name
Classification
Usual Dosage
(Routes of
Administration)
Dosage/Route
Hydrochlorothiazide
Diuretics
25mg PO daily
By mouth or in
combination with
other
antihypertensive
Clinical Simulation (NUR 360 Clinical Simulation )
Action
Side Effects/Drug
Nursing Management
(Implications & Teachings)
Onset/Peak/
Interactions/
Duration
Contraindications
O: 2hrs
P: about 4hrs
D: up to 24hrs
S: Hypokalemia, dizziness,
headache, weakness and
dehydration and
hyponatremia
I: Drug interaction is
adjunctive therapy in
edema associated with
congestive heart failure,
hepatic cirrhosis, and
corticosteroid and
estrogen therapy
C: anuria, hypersensitivity
to this product or to other
sulfon­amide-derived
drugs.
Gilipizide
Sulfonylureas
10mg PO b.i.d.
IV or by mouth
O: 15-30mins
P: 1-2hrs
D: up to 24hrs
S: Diarrhea, constipation,
n/v, loss of appetite,
headache, weight gain,
skin change, drowsiness,
dizziness
I: Assess fluid status, monitor daily
weight, I&O ratios, lung sounds,
skin turgor, and mucous
membrane, assess for confusion
and excessive thirst, monitor BP
before and during administration.
Monitor electrolytes (esp.
potassium), blood glucose, BUN,
serum acid before and
periodically throughout treatment
Indications for
Use/Indication for
This Patient
Indicated for the
treatment of
hypertension. This fixed
combination drug is not
indicated for the initial
therapy of hypertension.
T: Monitor weight daily, consult a
physician before using OTC drugs
because they may contain large
amounts of sodium and/or
potassium, change positions
slowly, report signs of
hypokalemia and diabetic pt need
to monitor blood glucose closely.
I: Monitor CBC periodically during
therapy, report decrease in in
blood counts, toxicity: overdose is
manifested as symptoms of
hypoglycemia, mild: treated w/
oral glucose, severe: IV D50W
followed by continuous IV
Control of blood glucose
in type 2 diabetes mellitus
when diet therapy fails.
I: Drug interaction is
concurrent use with
warfarin may alter the
response to both agents,
beta blockers may mask
the s/s of hypoglycemia
C: Contraindication
includes low blood sugar,
addison’s disease, liver
problems, decreased
kidney function,
alcoholism, severe n/v
By mouth
Rosuvastatin
Statin
20mg PO every
evening
O: unknown
P: 2-4 week
D: unknown
S: CNS: amnesia,
confusion, dizziness,
headache, insomnia,
memory loss, weakness
CV: chest pain, peripheral
edema
Derm: rash, pruritus
EENT: Rhinitis
Endo: hyperglycemia
GI: abdominal cramps,
constipation, diarrhea,
flatus, heartburn
GU: Erectile dysfunction
Resp: bronchitis
MS: Rhabdomyolysis
infusion of more dilute dextrose
solution to keep serum glucose at
approx. 100mg/Dl
T: Take medication at the same
time each day, if miss dose, take
soon as they remember unless it
is close to take their next dose,
explain that it is to help control
hyperglycemia not cure diabetes –
long term use, encourage to
follow prescribed diet,
medication, and exercise to
prevent hyperglycemia or
hypoglycemia episodes, notify
healthcare provider if they notice
changes in weight gain, swelling
of ankles, drowsiness, muscle
cramp, weakness, sore throat,
rash, or unusual bleeding
I: Can be taken at any time of day.
Avoid large amounts of grapefruit
juice during therapy; may increase
toxicity.
T: Instruct patient to take
medication as directed and not to
skip doses or double up on missed
doses. No more than 200 mL/day
of grapefruit juice. This
medication should be used in
conjunct with diet restrictions,
exercise and cessation of
smoking. Notify health care
provider if signs of liver injury or if
unexplained muscle pain,
Slow progress of coronary
atherosclerosis. Primary
prevention of
cardiovascular disease in
patients without clinically
evident coronary heart
disease but with an
increased risk of
cardiovascular disease
because of age
Other: Hypersensitivity
reactions
I: ?
C: Severe renal
impairment. Avoid use
during pregnancy. Avoid
breast feeding if
treatment is necessary
Metoprolol
succinate
Beta blocker
100 mg PO daily
By mouth
O: 15mins
P: unknown
D: 6-12hrs
S: Fatigue, weakness, HF,
bradycardia, pulmonary
edema
I: increased hypertension
may occur with other
antihypertensives, May
alter the effectiveness of
insulins or oral
hypoglycemic agents
C: severe bradycardia,
second or third heart
block, cardiogenic shock,
or decompensated cardiac
failure
Enoxaparin
Anticoagulant
40mg
subcutaneously
daily
Subcutaneously or
IV
O: Unknown
P: 3-5 hr
D: 12 hr
S: CNS: dizziness,
headache, insomnia. CV:
edema. Derm: alopecia,
ecchymoses, pruritis, rash,
urticaria. GI: Constipation,
increase liver enzymes,
N/V. Hemat: Bleeding,
anemia,
tenderness, or weakness occurs,
especially if accompanied with
malaise or fever. Importance of
follow-up exams to determine
effectiveness and to monitor side
effects
I: Monitor BP, ECG, and pulse
frequently during dose
adjustment and periodically
during therapy, monitor VS and
ECG every 5-15mins during and
several hrs after parenteral
administration. If HR <40 bpm,
especially if cardiac output is also
decreased, administer atropine
0.25-0.5 mg IV, and monitor I&O
and daily weights. Assess s/s of
HF.
Decreased blood pressure
and heart rate
T: Instruct to weight daily, advise
to regularly check BP, and follow
instructions for increasing
medication dosage
I: assess or signs of bleeding and
hemorrhage. Assess for evidence
of thrombosis. Monitor CBC,
platelet, and stools for bleeding.
Recheck for order of this drug. To
avoid the loss of this drug, do not
expel the air bubble before
injection
DVT with or without PE
(with warfarin)
thrombocytopenia. Local:
erythema at injection site,
hematoma, irritation,
pain. MS: osteoporosis.
Other: Fever
I: Risk of bleeding. Risk for
toxicity (protamine
sulfate)
T: Advise to report any symptoms
of dizziness, bruising, itching,
rash, fever, swelling, or difficulty
breathing to health care
professional immediately. Do not
take with aspirin or NSAIDs.
Correct technique for selfinjection, care and disposal of
equipment.
C: History of HIT within
the past 100 days or in the
presence of circulating
antibodies.
Hypersensitivity to specific
agents, infarctional
heparin or pork products.
Active major bleeding.
Severe hepatic or renal
disease
Warfarin
Anticoagulant
7.5mg PO daily
by mouth
O: 36-72hr
P: 5-7 days
D: 2-5 days (after
d/c)
S: dermal necrosis,
cramps, nausea,
calciphylaxis, bleeding,
fever
I: Chronic use of
acetaminophen may
increase the risk bleeding
C: uncontrolled bleeding,
open wounds, severe liver
or kidney disease,
uncontrolled hypertension
I: assess for signs of bleeding and
hemorrhage (bleeding gums,
nosebleed, unusual bruising,
tarry, black stools, hematuria, fall
in hematocrit or BP), Monitor PT,
INR and other clotting factors.
(PT: 1.3-1.5, INR 2.5-3.5) Pt over
60yrs exhibit greater than
expected PT/INR response.
Monitor for side effects at lower
therapeutic ranges. Monitor stool
and urine for occult blood before
and periodically during therapy.
Toxicity/Overdose: withhold 1 or
more doses is sufficient if INR is
excessively elevated or minor
Prophylaxis and
treatment of atrial
fibrillation with
embolization
bleeding occurs; vitamin K if
overdose occurs
T: Advise to report any s/s of
unusual bleeding/bruising and
pain, color, or temperature
change to any area of the body.
Instruct pt to not drink alcohol or
take Rx, OTC, or herbal products
especially those containing aspirin
or NSAIDs, or to start or stop any
new medications during warfarin
therapy without physician
consent. Emphasize the
importance of frequent lab tests
to monitor coagulation factors
Percocet
Opioid
10 mg Oxycodone/
500mg ASAP PO;
every 6hrs as
needed for pain
rated 7-10
Tablets or by
mouth
O: 10-15 min
P: 60-90 mins
D: 3-6 hr
S: CNS: confusion,
sedation, dizziness,
dysphoria, euphoria,
floating feeling,
hallucinations, headache,
unusual dreams. CV:
orthostatic hypotension.
Derm: flushing, sweating.
EENT: blurred vision,
diplopia, miosis. Endo:
adrenal insufficiency. GI:
constipation, dry mouth,
choking, GI obstruction,
N/V. Resp: respiratory
depression. Tolerance,
dependence.
I: additive CNS depression
with alcohol,
antihistamines and
I: Assess type, location and
intensity of pain prior to and 1 hr
peak after admin. Assess BP,
pulse, respirations before and
periodically during admin. Assess
for opioid addiction, abuse, or
misuse prior to admin. Toxicity
and overdose.
T: When and how to ask for and
take meds. Advise that oxycodone
is a drug with a known abuse
potential. May cause drowsiness
or dizziness. Ta take position
changes slowly; fall risk.
Encourage to turn, cough and
breathe deeply every 2 hr to
prevent atelectasis.
Moderate to severe pain
sedative/hypnotics. Risk
for opioid toxicity
C: Significant respiratory
depression; paralytic ileus,
acute or severe bronchial
asthma, Hypersensitivity.
Ofirmev
Analgesic
1g IV every 6hrs x
48 hrs then d/c
IV drug
O: within 30 minutes
P: 30 minutes
D: 4 to 6 hours
S: nausea, vomiting,
headache, sleep problem,
constipation, itching,
agitation
I: Chronic oral
acetaminophen use at a
dose of 4000 mg/day has
been shown to cause an
increase in international
normalized ratio (INR) in
some patients who have
been stabilized on sodium
warfarin as an
anticoagulant
C: hypersensitivity to
acetaminophen or
phenacetin; use with
alcohol.
I: Monitor for S&S of:
hepatotoxicity, even with
moderate acetaminophen doses,
especially in individuals with poor
nutrition or who have ingested
alcohol over prolonged periods;
poisoning, usually from accidental
ingestion or suicide attempts;
potential abuse from
psychological dependence
(withdrawal has been associated
with restless and excited
responses).
T: Do not take other medications
(e.g., cold preparations)
containing acetaminophen
without medical advice;
overdosing and chronic use can
cause liver damage and other
toxic effects, Do not self-medicate
adults for pain more than 10 d
without consulting a physician, Do
not use this medication without
medical direction for: fever
persisting longer than 3 d, fever
over 39.5° C (103° F), or recurrent
fever, Do not give children more
than 5 doses in 24 h unless
Treatment of mild to
moderate pain, moderate
to severe pain with opioid
analgesics, fever
prescribed by physician, Do not
breast feed while taking this drug
without consulting physician.
By mouth or IV
Vancomycin
antibiotics
1 gram every 12
hours time 4
O: rapid
P: end of infusion
D: 12-24 hr
S: CV: Hypotension. Derm:
rash. EENT: ototoxicity.
GI: N/V. GU:
nephrotoxicity. Hemat:
leukopenia, eosinophilia.
Local: phlebitis.
Hypersensitivity reactions
I: May cause additive
ototoxicity and
nephrotoxicity with
others.
C: hypersensitivity, Renal
impairment, hearing
impairment, intestinal
obstruction or
inflammation
I: Orally administered for c.diff or
staphylococcal enterocolitis.
T: oral admin to take as directed.
Take missed dose asap, do not
double. Report signs of
hypersensitivity, tinnitus, vertigo,
or hearing loss. Advise if no
improvement in a few days.
Treatment of potentially
life-threatening infections
when less toxic antiinfectives are
contraindicated