Date and time ordered: November 14, 2022 @ 10am
Ordering Physician: Dr. Ganangan/Ufano
Generic Name: Cefuroxime
Classification:

Pharmacologic class: Second-generation cephalosporin

Therapeutic class: Antibiotic
Dosage, Route, and Frequency: 2g IV + 90cc PNSS to run for 80 minutes q24 hours
Mechanism of Action: Interferes with bacterial cell wall synthesis by inhibiting the final
step in the cross-linking of peptidoglycan strands. Peptidoglycan makes the cell
membrane rigid and protective. Without it, bacterial cells rupture and die.
Desired Effect: It is to alleviate infectious complications.
Nursing Responsibilities
Rationale
Safe and Effective Drug Administration
1. Observe the 12 R’s in
medication administration.

To promote safe and accurate
administration of the medication.
2. Review the allergic histories of the
patient.

To prevent hypersensitivity reaction
to the medication
3. Encourage the patient to avoid
alcohol while taking the drugs and
for 3 days after.
4. Perform culture and sensitivity tests
before initiation of therapy and
periodically
during
therapy
if
indicated.
5. Monitor BUN and serum creatinine
levels and fluid intake and output.

To avoid severe reactions to occur.

To avoid hypersensitivity reaction.

To detect signs of nephrotoxicity
6. Monitor injection site for pain,  To evaluate local development of skin
erythema that can reflect on the
swelling, and irritation. Report
effectiveness and side effects of the
prolonged or excessive injection site
medication.
reactions to the physician.
Nursing Actions to Potentiate/Synergize/Enhance Drug Action
7. Always wash hands thoroughly and  To help prevent the spread of infection
disinfect
equipment
(whirlpools,
electrotherapeutic devices, treatment
tables, and so forth)
8. Include standard precautions for  To reduce the transmission of the
infection prevention and control.
bacteria.
Nursing Actions/Health Teachings to Address Adverse Effects of the Drug
9. Monitor intake and output.
 To ensure that the patient has proper
intake of fluid and other nutrients







10. Be prepared to administer vitamin K, if
ordered.
11. Monitor adverse effects, Report if
indicated.
CNS: Headache, dizziness, lethargy,
paresthesias
GI: Nausea, vomiting, diarrhea, anorexia,
abdominal
pain,
flatulence,
pseudomembranous
colitis,
hepatotoxicity
GU: Nephroxicity
Hematologic: Bone marrow depression
Hypersensitivity: Ranging from rash to
fever
to
anaphylaxis;
serum
sicknessreaction.
Local: Painabscess at injection site,
phlebitis, inflammation at IV site.
Other: Superinfections, disulfram-like
reaction with alcohol.
12. Avoid eating grapefruit and drinking
grapefruit juice
13. Instruct patient to notify physician
immediately including black, furry
overgrowth on tongue, and loose or
foul-smelling stools.
14. Urge patient to report watery, bloody
stools to prescriber immediately, even
up to 2 months after drug therapy has
ended.
15. Monitor for allergic reaction.
16. Encourage the patient to report
severe diarrhea, difficulty breathing,
unusual tiredness or fatigue, pain at
injection site.
17. Advise the patient not to take the drug
with antacids, eggs or milk, coffee
because the medication can cause
diarrhea.
 To treat hypothrombinemia.

To recognize if the medication is having
the right effect.

To avoid increased side effects.

To monitor signs of superinfection when
these signs are prolonged.

To evaluate the if the medication
causes serious adverse effects
because the patient may cause a
severe intestinal condition due to a
bacteria called C. difficile.
 To immediately address the drug
reaction to the patient.
 To immediately address the concern
or the problem.

To not lessen the effectiveness of the
drug and because it decreases
absorption.