FORSYTH TECHNICAL COMMUNITY COLLEGE
ASSOCIATE DEGREE NURSING
PATIENT TEACHING PLAN
PATIENT INITIALS: DB
MEDICAL DIAGNOSIS: NODULE OF UPPER LOBE OF
THE RIGHT LUNG
Nursing Assessment
Learning Preferences: Reading
Hearing
Watching
Doing
Other (specify):
Learning Need: Understanding how effective Acetaminophen is in order to prevent
postoperative opioid consumption and to prevent anticipated pain impulses.
Rationale for Need: Client is a day post op from his Robotic assisted right upper lobe
resection and mediastinal lymph node dissection. The patient has a diluadid PCA pump removal
order; after pain is under control, he was ordered Acetaminophen 650 mg, PO, Q6 hrs.
Evidence of Need: Client express uncertainty regarding the use of Acetaminophen and States
“ I am honestly scared that my pain might come back, and the acetaminophen might not help and
will worsen it”
Planning
Learning Outcome(s): Patient/Family will: verbalize full understanding on the
acetaminophen medication and the effectiveness on the reduction of pain before the end of my
shift.
Nursing Interventions
Discharge
Teaching
Instructions
Strategies
•
Acetaminophen is effective in
providing pain relief for mild to
moderate pain and fever
reduction.
•
Unlike other pain relievers, these
meds are less likely to cause
stomach irritation or GI bleed.
•
•
•
•
Assess client
knowledge
regarding reason
medication was
ordered.
•
Client verbalizes
medication is to prevent
anticipatory pain due to
the removal of the
diluadid PCA pump.
•
Guide the client
through
highlighted key
points in the
acetaminophen
pamphlet printed
out.
•
Client state “ now I know
that this acetaminophen
will help ease my level of
pain.”
•
Client reports that he will
not exceed the maximum
dose of 3000mg due to
liver damage.
Do not take more than the
recommended amount, or for
longer than directed. The
maximum dose per 24-hour
period is 3000 mg.
Do not take multiple
acetaminophen-containing
products simultaneously and also
avoid taking alcohol with these
meds.
Evaluation
Response to
Teaching
•
Have client
verbalize any
questions or
confusion
regarding the
medication.
•
Liver damage can occur if you
take too much acetaminophen at
one time or over time. may
develop nausea, vomiting, and
abdominal pain.
Student Name:________________________________________________________________
Client took the
acetaminophen and
report experiencing no
side effect of
hypersensitivity.
Spring 2010
FORSYTH TECHNICAL COMMUNITY COLLEGE
ASSOCIATE DEGREE NURSING
Evaluation of Teaching Session: Outcome(s) met; partially met; not met
Plans for follow up: Communicate with the nurse using SBAR format to continue
to monitor client adherence to the acetaminophen informational pamphlet
offered to him in order to promote pain reduction and avoid liver damage.
Med: Acetaminophen
What side effects will the client need to be aware of?
Frequent SE: per drug book state “NONE”
Occasional SE: NONE
Rare SE: Hypersensitivity, anaphylactic reaction,
Pertinent lab values the client may need to have monitored (include rationale)
Complete blood Count: Monitor for elevated prothrombin time (PT) because it can signify
impaired liver function.
liver function test: Monitor for tests such as the AST and ALT because they can detect liver
damage. Will see an increase which will signify hepatotoxicity.
Kidney function test: a metabolic panel with creatinine, can be used to monitor severity of liver
failure in cases of severe overdose from acetaminophen,
Specific discharge instructions that the client will need to be taught regarding
medications with consideration of age-appropriate holistic health needs – Encourage the
patient to avoid drinking alcohol cause It may increase your risk of liver damage while taking
acetaminophen. Liver damage can also occur if you take too much acetaminophen. Call poison
control if the child takes too much acetaminophen. The maximum daily acetaminophen is 3000
mg /3 grams.
Med: Losartan Potassium
What side effects will the client need to be aware of?
Frequent SE: Upper respiratory tract infection
Occasional SE: Dizziness, Diarrhea, Cough
Rare SE: insomnia, heartburn, muscle cramp, nasal congestion
Student Name:________________________________________________________________
Spring 2010
FORSYTH TECHNICAL COMMUNITY COLLEGE
ASSOCIATE DEGREE NURSING
Pertinent lab values the client may need to have monitored (include rationale)
Renal function: Losartan can decrease renal function, which can lead to elevated BUN and
creatinine levels.
Electrolytes: Losartan can increase potassium levels in the blood.
Specific discharge instructions that the client will need to be taught regarding
medications with consideration of age-appropriate holistic health needs – Avoid getting up
too fast from a sitting or lying position, or you may feel dizzy. Report any abnormal blood
pressure reading because this medication can cause hypotension. Do not use potassium
supplements or salt substitutes.
Med: Mupirocin
What side effects will the client need to be aware of?
Frequent SE: Burning, stinging, itching, pain, headache, and nausea.
Occasional SE: dizziness, fever, fast heartbeat
Rare SE: sores, ulcers, blistering of the skin.
Pertinent lab values the client may need to have monitored (include rationale)
CBC: Monitor WBC increase to check for any signs of infection.
Specific discharge instructions that the client will need to be taught regarding
medications with consideration of age-appropriate holistic health needs –
Avoid getting mupirocin topical in your eyes, mouth, or nose. A separate product called
mupirocin nasal is made for use in the nose. Mupirocin topical is for use only on the skin. Apply
the missed dose as soon as you remember. Do not use extra medicine to make up the missed
dose. Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you
have diarrhea that is watery or bloody, please notify the doctor.
Med: Famotidine
What side effects will the client need to be aware of?
Frequent SE: None
Student Name:________________________________________________________________
Spring 2010
FORSYTH TECHNICAL COMMUNITY COLLEGE
ASSOCIATE DEGREE NURSING
Occasional SE: Headache
Rare SE: confusion, constipation, dizziness, diarrhea
Pertinent lab values the client may need to have monitored (include rationale)
CBC with differential: Famotidine may cause hematologic effects, which can lower white blood
cells and cause the reduction of white, red blood cells, and platelet count (Pancytopenia )
Kidney function: Famotidine is substantially excreted by the kidney; therefore, it may be useful
to monitor renal function especially in elderly patients. It can also cause serious ulcers and
bleeding in the stomach.
Specific discharge instructions that the client will need to be taught regarding
medications with consideration of age-appropriate holistic health needs – famotidine can
be taken 1 hour before an evening meal to help prevent heartburn and indigestion in the
evening and during bedtime which may interfere with your sleep. The maximum dose is 40 mg
per day. Avoid drinking alcohol and coffee. Also avoid Aspirin. It can increase the risk of
damage to your stomach and liver, and also avoid taking other stomach acid reducers without
notifying the physician.
Med: Enoxaparin
What side effects will the client need to be aware of?
Frequent SE: NONE
Occasional SE: Injection site hematoma, nauseam peripheral edema
Rare SE: NONE
Pertinent lab values the client may need to have monitored (include rationale)
Factor Xa inhibition: which is also called the (anti-factor Xa activity) Monitor anti-Xa levels if
abnormal coagulation parameters or bleeding occurs. PT and PTT are not adequate for
monitoring drug’s anticoagulant effects.
CBC: monitor closely because the patient is at risk for bleeding. Causing thrombocytopenia to
occur. That is why platelet level should be monitored closely.
Specific discharge instructions that the client will need to be taught regarding
medications with consideration of age-appropriate holistic health needs – Always sit or
Student Name:________________________________________________________________
Spring 2010
FORSYTH TECHNICAL COMMUNITY COLLEGE
ASSOCIATE DEGREE NURSING
lay down during the injection. Do not inject enoxaparin into your muscles. Do not inject into the
same place two times in a row. Watch for signs of bleeding or abnormal bruising and notify the
prescriber immediately. Avoid OTC drugs containing aspirin or other salicylates because it can
increase the risk for bleeding.
Med: Ondansetron
What side effects will the client need to be aware of?
Frequent SE: Anxiety, dizziness, headache, fatigue, constipation, hypoxia, urinary retention
Occasional SE: Abdominal pain, xerostomia, fever, redness, and pain at injection site
Rare SE: Hypersensitivity reaction, blurred vision
Pertinent lab values the client may need to have monitored (include rationale)
Electrocardiogram (ECG, EKG): Ondansetron can increase the risk of developing abnormal
changes in the electrical activity of the heart, which can result in a potentially fatal abnormal
heart rhythm.
Electrolytes: electrolytes lab level needs to be monitored closely due to a decrease in potassium
and magnesium causing electrolytes abnormalities such as hypokalemia, hypomagnesemia,
heart failure and arrhythmias.
Specific discharge instructions that the client will need to be taught regarding
medications with consideration of age-appropriate holistic health needs – Report
persistent vomiting, avoid alcohol with the drug. Avoid tasks that require motor skills because
the drug can cause dizziness and drowsiness. Relief from nausea and vomiting should occur
shortly after the drug administration and make sure to get adequate rest.
Student Name:________________________________________________________________
Spring 2010
FORSYTH TECHNICAL COMMUNITY COLLEGE
ASSOCIATE DEGREE NURSING
Reference
Hodgson, R. J. (2022). Saunders Nursing Drug Handbook 2023. Saunders.
Student Name:________________________________________________________________
Spring 2010