SAINT LOUIS UNIVERSITY
NURS 3565
Adult/Older Adult Health I
Medication Form
Drug Ordered
Route, Dose, Frequency
---------------------------Generic Name
Classification
----------------------Possible Routes of
Administration
Bisacodyl suppository 10
mg, Rectal, QDAY
Stimulant laxative
Dulcolax
Rectal, oral (PO)
Carbidopa 25-100 MG
tablet 1 tablet, Oral, TID
Anticholinergic,
Antiparkinsonism
Sinemet
PO
Usual Dosage
Actions and Uses for
Your Patient
Major Side Effects
5 mg tablets; 10
mg suppository
Bowel regimen for
evacuation of colon
before surgery
Mild cramping, nausea,
diarrhea, fluid, and
electrolyte disturbances
SINEMET 25-100,
containing 25 mg
of carbidopa
SINEMET 10-100,
containing 10 mg
of carbidopa
SINEMET 25-250,
containing 25 mg
of carbidopa
Treatment for
Parkinson disorder
Orthostatic hypotension,
irregular heartbeat,
palpitation, arrhythmias,
unusual breathing
patterns
Nausea, anorexia, dry
mouth, bruxism, vomiting,
excess salivation
ataxia, muscle twitching,
increase in hand tremor,
numbness,
Dark urine, priapism,
urinary frequency,
retention, incontinence.
Nurs 3565 Fall 2018 Medication Form – Page 1
Nursing Implications
Evaluate periodically
patient's need for
continued use of drug,
Adequate fluid intake
includes at least 6–8
glasses/day
Add high-fiber foods
slowly to regular diet
to avoid gas and
diarrhea
Monitor vital signs,
particularly during
period of dosage
adjustment. Report
alterations in BP, pulse,
and respiratory rate
and rhythm.
Monitor all patients
closely for behavior
changes. Patients in
depression should be
closely observed for
suicidal tendencies.
Monitor therapeutic
effects. Some patients
IV Rate of
Administration
Drug Ordered
Route, Dose, Frequency
---------------------------Generic Name
Classification
----------------------Possible Routes of
Administration
Usual Dosage
Actions and Uses for
Your Patient
Major Side Effects
Nursing Implications
IV Rate of
Administration
manifest increase in
bradykinesia
Cefepime 2,000 mg in
sterile water (PF) 20 mL
syringe, Intravenous, q12h
Maxipime
Antibiotic;
cephalosporin
IV, IM
Mild to Moderate
Infections
Adult: IV/IM
0.5–1g q12h
times 7–10 d
prior urine culture
grew
pseudomonas
Moderate to
Severe Infections
Adult: IV 1–2g
q12h times 10 d
Escitalopram tablet 10 mg, SSRI
Oral, QDAY
Lexapro
PO
Febrile
Neutropenia
Adult: IV 2 g q8h
for 7 d or until
resolution of
neutropenia
5 mg, 10 mg, 20
mg tablets; 5
mg/5 mL liquid
Antibiotic -associated
colitis, diarrhea, nausea,
oral moniliasis, vomiting,
elevated liver function
tests
Headache, fever.
Depression,
Generalized Anxiety
Monitor for S&S of
hypersensitivity
Monitor for S&S of
superinfection or
pseudomembranous
colitis
pain, inflammation, rash,
pruritus
Determine history of
hypersensitivity
reactions to
cephalosporins,
penicillin, or other
drugs before therapy is
initiated
Fatigue, fever, arthralgia,
myalgia, HTN, ejaculation
disorder, impotence,
migraine, tremor, vertigo,
Nausea, diarrhea,
dyspepsia, abdominal pain
Assess for suicidal
tendencies, especially
during early therapy.
Restrict amt of drug
available to patient.
Risk may be increased
in children,
adolescents, and adults
≤24 yr.
Assess for serotonin
syndrome (mental
Nurs 3565 Fall 2018 Medication Form – Page 2
Infuse over 30
min; with Ytype
administration
set,
discontinue
other
compatible
solutions while
infusing
cefepime
Drug Ordered
Route, Dose, Frequency
---------------------------Generic Name
Classification
----------------------Possible Routes of
Administration
Fluconazole 400 mg in 200
mL saline IVPB,
Intravenous, once
Diflucan
Antifungal
Fludrocortisone tablet 200
mcg, Oral, BID
Corticosteroids.
Florinef
PO
IV, PO
Crystalloid Fluid
0.9% NaCl injection3 mL,
Intracatheter, q8h
Usual Dosage
Actions and Uses for
Your Patient
Major Side Effects
Nursing Implications
changes autonomic
instability nausea,
vomiting, diarrhea
Monitor for allergic
response. Monitor
BUN, serum creatinine,
and liver function.
Monitor for S&S of
hepatotoxicity.
50 mg, 100 mg,
150 mg, 200 mg
tablets; 10
mg/mL, 40 mg/mL
suspension; 2
mg/mL injection
to prevent and treat
a variety of fungal
and yeast infections
Nausea, vomiting,
abdominal pain, diarrhea,
increase in AST in patients
with cryptococcal
meningitis and AIDS, rash,
headache
0.1 mg tablets/
100mcg
Parkinson’s disease
c/b urinary retention
and orthostatic
hypotension
Sodium Chloride
Irrigation Sol:
0.45%, 0.9%
used to help prevent
IV catheters,
dehydration, or
hypovolemia
Vertigo, headache,
nystagmus, CHF,
hypertension, tachycardia,
Hypocalcemia; sodium
and fluid
retention; hypokalemia
and hypokalemic alkalosis,
decreased glucose
tolerance; hyperglycemia,
Hemolysis, hemoptysis
hyponatremia
hypertension
edema, flushing
hypokalemia
hypernatremia
dehydration
phlebitis
IV, Oral Liquid
Formulations
Nurs 3565 Fall 2018 Medication Form – Page 3
Monitor weight and
I&O, Check BP q4–6h
and weight. Monitor
for S&S of hypokalemia
and hyperkalemic
metabolic alkalosis
Do not administer
unless solution is clear,
and seal is intact.
Monitor for fever
infection at the site of
injection,
venous thrombosis or p
hlebitis extending from
the site of injection,
and hypervolemia.
IV Rate of
Administration
Give at a
maximum rate
of ~200 mg/h.
Give after
hemodialysis is
completed.
Drug Ordered
Route, Dose, Frequency
---------------------------Generic Name
Iopamidol 76 % contrast,
Intravenous, Contrast Once
Isovue 370
Classification
----------------------Possible Routes of
Administration
Non-ionic iodinated
contrast media
IV
Usual Dosage
Injectable solution
(41%; 51%; 61%;
76%); intrathecal
solution (41%;
61%)
Antibiotic
Metronidazole 500 mg in
100 mL IVPB, Intravenous,
q8h
250 mg, 500 mg
tablets; 375 mg
capsules; 750 mg
sustained release
tablets; 500 mg
vials; 0.75%
lotion, emulsion;
0.75%, 1% cream;
0.75%, 1% gel
Actions and Uses for
Your Patient
Major Side Effects
Nursing Implications
Radiography/CT
order
weight gain, oliguria
wheezing, seizure,
enlarged thyroid
flushing, hives, Blood
vessel disease, severe
Congestive heart failure
Dehydration
Kidney disease
Monitor for
anaphylaxis, symptoms
of heart attack, blood
clots in the lung,
numbness, or
weakness as it may be
symptoms of stroke.
septicemia, and for
both pre- and
postoperative
prophylaxis
rash, urticaria, pruritus,
flushing, headache, ataxia,
confusion, irritability,
depression, fleeting joint
pains, overgrowth
of Candida
Monitor especially for
seizures and peripheral
neuropathy, WBC
levels Monitor for S&S
of sodium retention,
especially in patients
on corticosteroid
therapy or with a
history of CHF.
Monitor patients on
lithium for elevated
lithium levels.
Report appearance of
candidiasis
Flagyl
IV, PO, Topical
Nurs 3565 Fall 2018 Medication Form – Page 4
IV Rate of
Administration
Drug Ordered
Route, Dose, Frequency
---------------------------Generic Name
Classification
----------------------Possible Routes of
Administration
Usual Dosage
Alpha-1 agonists
Midodrine tablet 5 mg,
Oral, 4X/day
Proamatine
2.5 mg, 5 mg
tablets
Actions and Uses for
Your Patient
Major Side Effects
Nursing Implications
urinary retention and
orthostatic
hypotension
Paresthesia, chills, pain,
facial flushing. Confusion,
anxiety. Hypertension, Dry
mouth. Pruritus,
piloerection, rash.
Dysuria, urinary retention,
urinary frequency
Monitor regularly
supine and standing
BP. Stop drug if supine
BP increases
excessively.
PO
PPI
Pantoprazole injection 40
mg, Intravenous, BID
Protonix
IV, PO
Vancomycin (Vancocin) IV
dose per pharmacy, does
not apply, AS DIRECTED
Antibiotic
40 mg enteric
coated tablets; 40
mg vial
125 mg, 250 mg
capsules; 1 g, 10 g
oral powder; 500
mg, 1 g injection
Monitor carefully effect
of the drug in diabetics
with orthostatic
hypotension and those
taking fludrocortisone
acetate, which may
increase intraocular
pressure.
dysphagia
Diarrhea, flatulence,
abdominal pain,
headache, insomnia, rash.
Teach pt. to take last
daily dose 4 h before
bedtime
Monitor for and
immediately report
S&S of angioedema or
a severe skin reaction,
swelling of the face,
tongue, or lips;
difficulty breathing or
swallowing.
prior urine culture
grew pseudomonas,
colitis
Ototoxicity,
superinfections, severe
pain, thrombophlebitis at
injection site, generalized
Monitor I&O: Report
changes in I&O ratio
and pattern. Oliguria or
cloudy or pink urine
Nurs 3565 Fall 2018 Medication Form – Page 5
IV Rate of
Administration
Drug Ordered
Route, Dose, Frequency
---------------------------Generic Name
Classification
----------------------Possible Routes of
Administration
Usual Dosage
Actions and Uses for
Your Patient
Major Side Effects
tingling following rapid IV
infusion.
Nursing Implications
IV Rate of
Administration
may be a sign of
nephrotoxicity.
Monitor I&O: Report
changes in I&O ratio
and pattern. Oliguria or
cloudy or pink urine
may be a sign of
nephrotoxicity
Monitor serial tests of
vancomycin blood
levels in patients with
borderline kidney
function, in infants and
neonates, and in
patients >60 y.
Vancocin
PO, IV
Lactated Ringers infusion,
Intravenous, Continuous
isotonic, crystalloid
fluid
Dosage is to be
directed by a
physician and is
dependent upon
age, weight,
clinical condition
of the patient and
laboratory
determinations.
Low Hematocrit
Rehydration (water
and electrolytes)
Fluid Replacement
d/t diarrhea
hives, itching, swelling of
the eyes, face or throat,
coughing, sneezing,
difficulty breathing, fever,
infection at the injection
site, and redness/red
streaking and swelling
form the injection site
Nurs 3565 Fall 2018 Medication Form – Page 6
Monitor I&O
Risk for hyperkalemia if
given with K+
supplement
DO NOT administer in
cases of alkalosis (once
inside body, converts
lactate to bicarb
1000ml at 100
rates
Drug Ordered
Route, Dose, Frequency
---------------------------Generic Name
Classification
----------------------Possible Routes of
Administration
Usual Dosage
Actions and Uses for
Your Patient
Major Side Effects
Nursing Implications
IV
Acetaminophen tablet
650 mg, Oral, q6h PRN
Analgesic
PO: 325-650mg
q4h up to a
maximum of 1gram q6h.
Suppositories:
650mg q4h not to
exceed 4 grams a
day for up to 10
days
Tylenol
Fever reduction.
Temporary relief of
mild to moderate
pain.
Negligible with
recommended
dosage. Acute
poisoning: Anorexia,
nausea, vomiting,
dizziness, lethargy, onset
of hepatotoxicity
elevation of serum
transaminases (ALT, AST)
and bilirubin. Chronic
ingestion: Neutropenia,
pancytopenia, renal
damage
PO, Rectal
Nurs 3565 Fall 2018 Medication Form – Page 7
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.
Do not self-medicate
for pain for more than
10 days
IV Rate of
Administration
Hydromorphone injection
0.2 mg, Intravenous, q4h
PRN
opioid analgesics
1–4 mg q4–6h
prn.
Cough, Moderate-tosevere pain
Confusion, sedation,
dizziness, dysphoria,
euphoria, floating feeling,
hallucinations,
headache, respiratory
depression, hypotension,
bradycardia. constipation,
dry mouth, nausea,
vomiting, urinary
retention. flushing,
sweating. physical
dependence, psychologic
dependence, tolerance.
Monitor vital signs at
regular intervals.
Assess effectiveness of
pain relief 30 min after
medication
administration.
Monitor drug effects
carefully in older adult
or debilitated patients
and those with
impaired renal and
hepatic function.
Assess effectiveness of
cough.
Nausea and orthostatic
hypotension most
often occur in
ambulatory patients or
when a supine patient
assumes the head-up
position.
Monitor I&O ratio and
pattern & bowel
pattern.
Nurs 3565 Fall 2018 Medication Form – Page 8
Drug Ordered
Route, Dose, Frequency
---------------------------Generic Name
Classification
----------------------Possible Routes of
Administration
Dilaudid
PO/SQ/IM/IV
Ondansetron
(disintegrating) tablet 4
mg, Oral, q6h PRN
Antiemetics
Usual Dosage
4 mg, 8 mg orally
disintegrating
tablets
Actions and Uses for
Your Patient
Radiotherapyassociated nausea
and vomiting
Zofran ODT: 4 mg
[DSC] [contains
aspartame,
methylparaben
sodium,
propylparaben
sodium;
strawberry flavor]
Zofran (ODT)
PO, IM, IV
Ondansetron injection 4
mg, Intravenous, q6h PRN
Antiemetics
2 mg/mL, 32 mg/5
mL injection
Major Side Effects
Dizziness and lightheadedness, headache,
sedation,
constipation, diarrhea,
abdominal pain, dry
mouth, increased liver
enzymes. extrapyramidal
reactions.
Hypotension
Hypersensitivity
Hiccups
Dyspnea, laryngeal
edema, stridor
Radiotherapyassociated nausea
and vomiting
Nursing Implications
Monitor fluid and
electrolyte status.
Diarrhea, which may
cause fluid and
electrolyte imbalance,
is a potential adverse
effect of the drug.
Monitor cardiovascular
status, especially in
patients with a history
of coronary artery
disease.
Give tablets 30 min
prior to chemotherapy
and 1–2 h prior to
radiation therapy
Hypokalemia
and
hypomagnesemia
should be corrected
prior to ondansetron
administration
Nurs 3565 Fall 2018 Medication Form – Page 9
IV Rate of
Administration
Drug Ordered
Route, Dose, Frequency
---------------------------Generic Name
Zofran
Classification
----------------------Possible Routes of
Administration
IM, PO, IV
Usual Dosage
Actions and Uses for
Your Patient
Pt has a history of
vertigo, and this
prescription helps.
Major Side Effects
Nursing Implications
Dizziness and lightheadedness, headache,
sedation, constipation,
diarrhea, abdominal pain,
dry mouth, increased liver
enzymes. extrapyramidal
reactions.
1 h preoperatively IM 4
mg injected
immediately prior to
anesthesia induction or
once postoperatively if
patient experiences
nausea/vomiting
shortly after surgery IV
4 mg by slow IV push,
may repeat q8h as
needed
Monitor fluid and
electrolyte status.
Diarrhea, which may
cause fluid and electrolyte
imbalance, is a potential
adverse effect of the drug.
Monitor cardiovascular
status, especially in
patients with a history of
coronary artery disease.
Hypotension
Hypersensitivity
Hiccups
Dyspnea, laryngeal
edema, stridor
Nurs 3565 Fall 2018 Medication Form – Page 10
IV Rate of
Administration