#18 Deborah Nelson Name of drug: Ampicillin injection D5W Classification: Antibiotic Action of the drug at the cellular level: anti bactericidal Side effects: rash, hives, fever Adverse effects: angioedema, peritus, Stevens-Johnson syndrome Nursing implications: check for allergic reactions, assess vitals, examine for drug interaction Patient and family education: avoiding drinking alcohol when taking ampicillin. Is it safe to give? Yes Name of drug: Lactated Ringer’s Route: IV Action of the drug at the cellular level: Isotonic solution, fluid and electrolyte replenishment, restores fluid and electrolyte balances. Side effects: difficulties with breathing Adverse effects: edema and fluid overload Nursing implications: check for edema and fluid overload, examine site of IV for irritation, check vital signs Patient and family education: This solution replaces any fluid and blood loss. Patient stays hydrated as well. Is it safe to give? Yes Name of drug: Butorphanol Classification: Opioid agonists-antagonists Action of the drug at the cellular level: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression. Side effects: CNS: confusion, dysphoria, hallucinations, sedation, euphoria, floating feeling, headache, unusual dreams. Adverse effects: n/v, constipation, headache, blurred vision, dizziness and drop in urine output Nursing implications: assess respiration before, during and after using of this medication, check for adverse effects Patient and family education: avoiding driving and operating heavy machine. Is it safe to give? Yes Baby Nelson Name of drug: Erythromycin Classification: Antibiotic Action of the drug at the cellular level: Suppresses protein synthesis at the level of the 50S bacterial ribosome. Side effects: CNS: seizures (rare). EENT: ototoxicity. CV: TOR- SADE DE POINTES, VENTRICULAR ARRHYTHMIAS, QT inter- val prolongation. GI: PSEUDOMEMBRANOUS COLITIS, nausea, vomiting, abdominal pain, cramping, diar- rhea, hepatitis, infantile hypertrophic pyloric stenosis, pancreatitis (rare). GU: interstitial nephritis. Derm: rash. Local: phlebitis at IV site. Misc: allergic reac- tions, superinfection. Adverse effects: it might cause conjunctivitis Nursing implications: it is given within the first hr after birth. Wear gloves, sterile cotton ball should be used to wipe each eye lid before we give the ointment, after application check eyes for irritation Patient and family education: could be inflammable in the topical form so don’t use near heat Is it safe to give? Yes Name of drug: Phytonadione (Vit K) Classification: Vitamin Action of the drug at the cellular level: Required for hepatic synthesis of blood coagulation factors II (prothrombin), VII, IX, and X. Side effects: edema and erythema Adverse effects: hemolytic anemia, hyperbilirubinemia Nursing implications: monitor for bleeding. Monitor for side effects and adverse reactions. Children may be especially sensitive to the effects and side effects of vitamin K. Neonates, especially premature neonates, may be more sensitive than older children. Patient and family education: Do not involve in activities could lead to injury. Report any symptoms of unusual bleeding or bruising. Is it safe to give? Yes #7 Carole Shotz Name of drug: Lactated Ringer’s Classification: Isotonic solution Action of the drug at the cellular level: The same pressure stays inside and outside of the cell Side effects: edema and fluid overload Adverse effects: irritation may appear on the injection side, difficulties with breathing Nursing implication: monitor fluid and electrolyte balance, check site for signs of irritation Is it safe to give? Yes Name of drug: Sodium Citrate and Citric Acid (prevent kidney stones, or metabolize acidosis) Classification: Alkalinizing agent, electrolytes Action of the drug at the cellular level: Converted to bicarbonate in the body, resulting in increased blood pH. Nurse implications: Assess patient for signs of alkalosis (confusion, irritability, paresthesia, tetany, altered breathing pattern). Monitor fluid overload Adverse effects: fluid overload, hypernatremia (severe renal impairment), hypocalcemia, metabolic alkalosis (large doses only). MS: tetany. Patient and family education: Instruct patients receiving chronic sodium citrate on correct method of monitoring urine pH, maintenance of alkaline urine, Is it safe to give? Yes #9 Kaira Abbot Name of drug: Ampicillin in D5W Classification: Antibiotic- aminopenicillin Action of the drug at the cellular level: it penetrates gram negative bacteria Side effects: n/v, diarrhea, increased WBC Adverse effects: allergies, rash, pruritis, angioedema Nursing implications: check vitals and interactions with other drugs, monitor BUN and creatinine Patient and family education: Safe for pregnant woman , category B Is it safe to give? Yes. Name of drug: Lactated Ringer’s Classification: Isotonic solution Action of the drug at the cellular level: outside and inside same pressure of the cell Side effects: edema and fluid overload Adverse effects: site of injection may be irritated, allergic reactions may occur, difficulties with breathing Nursing implications: check electrolytes and fluids , check injection site for irritation and check for edema Is it safe to give? Yes Name of drug: Oxytocin in Lactated Ringer’s Classification: Hormones, uterine stimulant Action of the drug at the cellular level: Stimulates uterine smooth muscle, producing uterine contractions similar to those in spontaneous labor. Side effects: hypertensive uterine reaction to oxytocin, cervical laceration, postpartum hemorrhage, uterine rupture Adverse effects: hypotension and fetal arrhythmias Nursing implications: check IV, monitor fetal heart rate, check vitals Patient and family education: Advise patient to expect contractions similar to menstrual cramps after administration has started Is it safe to give? Yes Name of drug: Nalbuphine Classification: Opioid agonist-antagonist Action of the drug at the cellular level: Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression. Side effects: Sedation, drowsiness, n/v, dizziness, respiratory depression Adverse effects: hypotension, diaphoresis, opioid withdrawal, xerostomia Nursing implications: check vital signs, pain level, check fetal heart rate Patient and family education: Advise patient to call for assistance when ambulating and to avoid driving or other activities requiring alertness until response to the medication is known. Is it safe to give? Yes