, INDICATION: Administered before blood transfusions as a prophylaxis against fever generation via cyclooxygenase induced mechanisms following cytokine release, and histamine-mediated mechanisms from mast cell degranulation. NAME OF DRUG: Acetaminophen ROUTE: Oral DOSAGE: 500 mg MECHANISM OF ACTION: Administered before blood transfusions as a prophylaxis against fever generation via cyclooxygenase induced mechanisms following cytokine release, and histamine-mediated mechanisms from mast cell degranulation. ADVERSE REACTIONS/ SIDE EFFECTS: It works by inhibiting the production of prostaglandins, which are substances in the body that contribute to pain and inflammation. Additionally, it also affects the activity of certain neurotransmitters in the brain that are involved in the perception of pain. It does not have any anti-inflammatory properties. HEALTH TEACHINGS: Educate patient and SO that acetaminophen can increase anticoagulant effects. - Inform the SO to monitor for bruising and signs of bleeding, and to prevent the risk of injury. Inform the patient and SO to immediately report the occurrence of rash, unusual bleeding or bruising, yellowing of skin or eyes, changes in voiding patterns. - To treat the symptoms of allergic reactions. NURSING CONSIDERATIONS: Verify the doctor’s order. - To clarify the procedure to be done and prevent the occurrence of medical errors. Identify the patient using at least two identifier tags seen on the ankle or wrist. - To treat the symptoms of allergic reactions. Do proper hand hygiene. - To prevent the spread of unwanted microorganisms Explain the medication’s purpose, the administration, and possible side effects to the client. - To promote understanding on the procedure, promote cooperation, and alleviate their concern. Assess overall health status and alcohol usage before administering acetaminophen. Patients who are malnourished or chronically abuse alcohol are at higher risk of developing hepatotoxicity with chronic use of usual doses of this drug. Assess the patient’s allergies and previous reactions to medications before administering acetaminophen. - To avoid potential allergic reactions. Administer the medication in the appropriate dosage, as prescribed by a healthcare provider. - To avoid overdose and potential liver damage. Overdose can be dangerous and potentially fatal. Administer acetaminophen with a full glass of water. - Acetaminophen can be taken on an empty stomach, but make sure to advise the patient to take it with a full glass of water to avoid an upset stomach. , INDICATION: Administered before blood transfusions as a prophylaxis against fever generation via cyclooxygenase induced mechanisms following cytokine release, and histamine-mediated mechanisms from mast cell degranulation. NAME OF DRUG: Diphenhydramine ROUTE: IM DOSAGE: 50 mg MECHANISM OF ACTION: Antagonizes the effects of histamine at H1-receptor sites; does not bind to or inactivate histamine. Significant CNS depressant and anticholinergic properties. ADVERSE REACTIONS/ SIDE EFFECTS: HEALTH TEACHINGS: Caution the SO to look after the patient and avoid activities requiring alertness because the drug may cause drowsiness. - To avoid injury. Teach sleep hygiene techniques (dark room, quiet, bedtime ritual, limit daytime napping, avoidance of nicotine and caffeine) to the patient. - To aid sleep. Inform the patient to report difficulty breathing, hallucinations, tremors, loss of coordination, unusual bleeding or bruising, visual disturbances, irregular heartbeat. - To treat the symptoms and prevent further complications. NURSING CONSIDERATIONS: Verify the doctor’s order. - To clarify the procedure to be done and prevent the occurrence of medical errors. Identify the patient using at least two identifier tags seen on the ankle or wrist. - To treat the symptoms of allergic reactions. Do proper hand hygiene. - To prevent the spread of unwanted microorganisms Explain the medication’s purpose, the administration, and possible side effects to the client. - To promote understanding on the procedure, promote cooperation, and alleviate their concern. Assess for possible contraindications or cautions. - To ensure cautious use of the drug. Administer the medication in the appropriate dosage, as prescribed by a healthcare provider. - To avoid overdose and potential liver damage. Overdose can be dangerous and potentially fatal. , INDICATION: To accelerate fetal lung maturity when early delivery may become necessary. NAME OF DRUG: Dexamethasone ROUTE: IM DOSAGE: 6 mg MECHANISM OF ACTION: In pharmacologic doses, suppresses inflammation and the normal immune response. Has numerous intense metabolic effects. Suppresses adrenal function at chronic doses of 0.75 mg/day. Has negligible mineralocorticoid activity. ADVERSE REACTIONS/ SIDE EFFECTS: HEALTH TEACHINGS: Inform the patient not to have any live vaccine within 3 months after the course of corticosteroids. Corticosteroids may weaken the immune system. Taking a live vaccine while having an immunocompromised body may increase the patient’s risk for infection. Advise the patient to eat moderately while on steroids. - It may increase appetite, leading to weight gain. Inform the patient to report unusual weight gain, swelling of the extremities, muscle weakness, black or tarry stools, fever, prolonged sore throat, colds or other infections, worsening of the disorder for which the drug is being taken. - To treat the symptoms and prevent further complications. NURSING CONSIDERATIONS: Verify the doctor’s order. - To clarify the procedure to be done and prevent the occurrence of medical errors. Identify the patient using at least two identifier tags seen on the ankle or wrist. - To treat the symptoms of allergic reactions. Do proper hand hygiene. - To prevent the spread of unwanted microorganisms Explain the medication’s purpose, the administration, and possible side effects to the client. - To promote understanding on the procedure, promote cooperation, and alleviate their concern. Check the patient’s allergy status. Previous allergic reaction to corticosteroids may render the patient unable to take them. Alternatives to corticosteroids should therefore be considered in case of allergy. Check the patient’s serum potassium levels. Check for current medications that include diuretics, laxatives, high doses of certain antibiotics and insulin as these should be used cautiously with corticosteroids. An increased risk of hypokalemia may occur when corticosteroids are administered with other medications that reduce potassium levels like diuretics, laxatives, high doses of certain antibiotics and insulin. Caution is highly warranted as hypokalemia is greatly associated with dysrhythmia and heart failure. Administer corticosteroids in the morning. - Corticosteroids taken in the morning can mimic the time of the body’s production of the hormone cortisone. Monitor the patient’s input and output. - Corticosteroids may cause fluid retention as evidenced by edema/ swelling.
