NameDrug Generic Name: Ceftriaxone Brand Name: Rocephin Dosage: 2g/day Route: IV Frequency: Q12 Timing: 6Am-6Pm Classification Mechanism of Action Indication Cephalosporin Antibiotics Ceftriaxone works by inhibiting the mucopeptide synthesis in the bacterial cell wall. The betalactam moiety of ceftriaxone binds to carboxypeptidid ases, endopeptididase s and transpeptidases in the bacterial membrane. These enzymes are involved in cell-wall synthesis and cell division. Binding of ceftriaxone to these enzymes causes the enzyme to lose activity, in which causes bacteria to produce defective cell walls, causing cell death. Susceptible bacterial infections of lower respiratory tract, skin and skin structure, Bone and joint, Acute otitis media, UTI, Pelvic Inflammatory Disease (PID) Contraindication ● Diarrhea from infection with Clostridium difficile bacteria. Adverse Reaction ● may cause diarrhea Note: Call Physician right away if Adverse effects occur: ● Liver problems. ● Disease of gallbladder ● Swelling (hands ,face or mouth) ● Severe renal impairment ● Shortness of breath. Yellowing of skin in newborn child ● Trouble swallowing ● ● Hives Nausea and Vomiting ● Nursing Responsibilities ● ● ● ● Watch for seizures Monitor signs of diarrhea Monitor signs of abdominal pain. Monitor for severe or prolonged GI problems (nausea, vomiting, Heartburn) Drug Name Generic Name: Ipratropium+ Salbutamol Brand Name: Duavent Dosage: 2 Actuations, 120mcg/ Actuation Route: PAR Frequency: Q6 Timing: 6am-12Pm6Pm-12Am6Am Classification Bronchodilator (B2-eAdregenic agonist) Mechanism of Action Indication Salbutamol relaxes Bronchospasms due the smooth muscles to : of all airways, from the trachea to the ● Bronchial bronchioles. it Asthma stimulates the ● Chronic intercellular adenyl Bronchitis cyclase, the enzyme ● Reversible that catalyzes the obstructive conversion of airway adenosine disease triphosphate (ATP) to ● and other cyclic -3, 5bronchopulm adenosine o-nary monophosphate ( disease cyclic AMP). Incased cyclic AMP, causes relaxation of bronchial muscles and inhibition of release of mediators of immediate hypersensitivity from cells, specially from mast cells. Contraindication The medication should not be taken if Pt. has: ● Gestational Hypertensi on ● ● ● ● ● ● ● ● Adverse Reaction Notify Physician if there is : ● Muscle pain or weakness ● Muscle cramps Uterine ● Arrhythmi Infection as ● Insomnia Miscarriage ● Hypertens ion Heart ● Nausea disease and Vomiting Hypersensi ● Hyperglyc tivity emia Hyperthyroi ● Ensure dism adequate Diabetes hydration, Lactation control environm Hypertrophi ent temp c to prevent obstructive hyperpyre myopathy xia Nursing Responsibilities ● Assess lung sounds, PR and BP before drug administration and during peak of medication. ● Observe for paradoxical spasms and withhold medication and notify physician if condition occurs. ● Administer PO medication with meals as ordered by physician to decrease gastric irritation. Extendedrelease tablet should be swallowed whole. It should not be crushed or chewed. Inform patient that ● ● Salbutamol may cause an unusual taste in mouth. Drug Name Generic Name: Amlodipine Brand Name: Norvasc Dosage: 5mg/tab Route: PO Frequency: OD Timing: 12Pm Classification Anti-Anginal Agents Mechanism of Action Indication Contraindication Amlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slow channel blocker) that inhibits the transmembrane influx of calcium Ions into vascular smooth muscle and cardiac muscle. This Medication can be used alone or in combination with other antihypertensive and anti-anginal agents for the following treatment of: ● Hypertensi on ● Coronary Artery Disease (CAD) ● Chronic stable Angina (CSA) ● Vasospasti c Angina ● Angiograp The medication is contraindicated in patients with: ● Hypersens itivity to drug. Adverse Reaction ● ● ● ● swelling Fatigue Palpitation s Flushing Nursing Responsibilities ● ● Monitor patient’s vitals before administration, until the peak of medication. Monitor patients Level of Pain. h Drug Name Classification Generic Name: Tramadol+para Opioid in combination w/ Non- Opioid Analgesic Brand Name: Ultram Dosage: 37.5mg/325mg/tab Route: PO Mechanism of Action Indication Tramadol modulates the descending pain pathways within the central nervous system through the binding of parent and M1 metabolite to μ-opioid receptors and the weak inhibition of the reuptake of norepinephrine and serotonin.7,6 Tramadol should be administered to patients with: Contraindication Adverse Reaction ● ● Tramadol + Para is contraindicated in patients that have: ● ● moderate to sever Pain in adults. ● ● Nursing Responsibilities ● dizziness Nausea and vomiting Constipatio n Sweating ● hypersensit ivity to medication ● Frequency: BID Assess for level of pain relief. Administer prn dose as needed but not to exceed the recommen ded daily dose. Educate the patient, and S/O about the mechanism if action of the medication. Timing: 6Am-6Pm Drug Name Generic Name: Budesonide Brand name: Classification coriticosteroids Mechanism of Action Budesonide works by decreasing swelling and irritation in Indication Contraindication The medication is indicated in pt. That have the following: ● Asthma The medication is contraindicated in pt. with : ● Hypersensiti vity to Adverse Reaction ● ● ● headache Dizziness Runny nose,coughing,s neezing Nursing Responsibilities ● make sur patient does not cut, crueh or chew capsules; they Bronex Dosage: 200mcg/mL Route: PAR Frequency: OD Timing: 5Am airways to allow for easier breathing. It is a glucocoticoid that is mix of 22R and 22s epimer used to treat inflammatory conditions of the lungs and intestines . ● ● ● COPD Crohn’s Disease Ulcerativ e Colitis medication or any of the ingredients of the budesonide formulation. ● ● ● ● Nausea and vomiting Indigestion Abdominal pain Dry Itchy skin ● ● must be swallowed whole Administer drug once each day. Encourage patient to complete full drug therapy DEFINING CHARACTERISTICS NURSING DIAGNOSIS Dyspnea Subjective: “Kapoy akong pamati, gihangak ko maski gahegda ra” as verbalized by the patient. Objective: T-36.8 PR-123 RR-23 BP-160/70 02Sat-86% SCIENTIFIC ANALYSIS PLAN OF CARE Dyspnea is a sensation of running out of the air and of not being able to breathe fast enough or deeply enough. It results from multiple interactions of signals and receptors in the CNS, peripheral receptors chemoreceptors, and mechanoreceptors in the upper airway, lungs, and chest wall Short term: - After independent nursing action the patient will have normal breathing pattern, as evidenced stabilization of vital signs. Long term: - administer o2 10L/M via Nasal Canula, as ordered by the attending physician. NURSING INTERVENTIONS - place patient on semi fowlers, or high fowlers position as tolerated and not contraindicated - administer o2 10L/m via Nasal Canula as ordered by physician. RATIONALE -to improve breathing pattern and, improve oxygenation as evidenced by Respiratory Rate from 23 to 17, and o2 saruration of 86% to 95%. March 31,2023 F Difficulty of breathing DAR vital statistics of T-36.8, PR123,RR-23,BP-160/70, o2Sat-86% place patient on semi fowlers position as tolerated and not contraindicated. patient will have normal breathing pattern after independent nursing action as evidenced by RR from 23 to 17, and o2 saturation from 86% to 95%.
