Systems Plus College Foundation

Balibago, Angeles City

College Of Nursing

Drug Study
Student Nurse: Concepcion, Kimberly Trisha R.
Yr/Level: 4th year
Date: August 22, 2013
Name Of The
Drug

Date Ordered

Route Of
Administration

Medical Diagnosis: HPN II, Hypoglycemia

Age: 81
Sex: F
General
Action

Specific Action

Indication

Clients
Response With
Actual Adverse
Reactions

Cephalosporin,
2nd generation

Bactericidal: Inhibits
synthesis of bacterial cell
wall, causing cell death.

It is used for the

treatment of
uncomplicated
infections,
including urinary
tract.

The patient did

not manifest any
sign of infection.
There is no
presence of
adverse
reactions.

Date Started
Date Changed
Date
Discontinued
GENERIC
NAME:

Dosage And
Frequency Of
Administration

DO: 8/15/13

IV 750mg q 8

DS: 8/15/13

Given @ 12nn
(August 16, 2013)

Cefuroxime
BRAND
NAME:
Ceftin

DRUG STUDY in ICU

Page 1

Contraindication: (Lippincotts Drug Handbook, 2013)

Hypersensitivity to cephalosporins.
Side effects:
CNS: Headache, dizziness, lethargy, parethesias
GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudomembranous colitis, hepatotoxicity
GU: Nephrotoxicity
Hematology: Bone marrow depression (decreased WBC, decreased platelets, decreased Hct)
Hypersensitivity: Ranging from rash to fever to anaphylaxis; serum sickness reaction
Local: Pain, abscess at injection site, phlebitis, inflammation at IV site
Nursing Responsibilities (Delmar Nurses Drug Handbook, 2010 and Lippincotts Drug Handbook, 2013)
Assessment
History: Allergies, Hepatic and renal impairment, pregnancy, lactation
Physical: Skin status, renal function test, culture of affected area, sensitivity tests
Interventions
Before
Do not confuse cefuroxime with deferoxamine (an iron chekator)
Prior to reconstitution, protect drug from light. The powder and reconstituted drug may darken without affecting potency
Do not add cefuroxime to solutions of aminoglycosides; of both required, give separately.
For direct IV, reconstitute 750 mg in 6 mL sterile water. For intermittent IV, further dilute in 100 mL of dextrose or saline solution.
During
For direct intermittent IV administration, slowly inject drug over 3 to 5 min, or give in tubing of other IV solutions. For intermittent IV infusion
with Y-type setup, may give dose in the tubing through which the patient is receiving other medications; however, during drug infusion,
stop other solutions.
After
Advise patient receiving drug I.V. to report discomfort at I.V. insertion site.
Document the medication in the chart.
Teaching points
Report lack of response, persistent diarrhea or S&Sx of anemia (SOB, dizziness, pale skin, etc.) immediately. Keep all F/U to assess
response and for adverse effects.

DRUG STUDY in ICU

Page 2

Name Of The
Drug

Date Ordered

Route Of
Administration

General
Action

Specific Action

Indication

Clients
Response With
Actual Adverse
Reactions

Alkalinizing
agent, Antacid,
Electrolyte

Restores buffering
capacity of the body and
neutralizes excess acid.

It is used as
Antacid

The patient did

not manifest
gastric
discomfort.
There is no
presence of
adverse
reactions.

Date Started
Date Changed
Date
Discontinued
GENERIC
NAME:

Dosage And
Frequency Of
Administration

DO: 8/15/13

Oral 650mg TID

DS: 8/15/13

Given @ 8am
(August 16, 2013)

Sodium
bicarbonate
BRAND
NAME:
Neut
Contraindication:

Metabolic or respiratory alkalosis

Hypocalcemia
Excessive chloride loss

It is not recommended as an antidote following ingestion of strong mineral acids

Patients on sodium restricted diet

Renal failure
Severe abdominal pain of unknown cause especially if associated with fever

CHF, convulsions

Side effects:
GI: Gastric rupture following ingestion
Hematologic: Systemic alkalosis (headache, nausea, irritability, weakness, tetany, confusion), hypokalemia secondary to intracellular
shifting of potassium, hypernatremia
Local: Chemical cellulitis, tissue necrosis

DRUG STUDY in ICU

Page 3

Nursing Responsibilities (Lippincotts Drug Handbook, 2013 and Davis Drug Guide, 2013)
Assessment
History: Allergy to components of preparations, low serum chloride, metabolic and respiratory alkalosis, hypocalcemia, impaired renal
function, edematous or sodium retaining states, oliguria or anuria, potassium depletion, pregnancy
Physical: Skin color, turgor, injection sites; Pulse, rhythm, peripheral edema; bowel sounds, abdominal examination; urinary output; serum
electrolytes, serum bicarbonate, arterial blood gases, urinalysis, renal function tests
Interventions
Before
Determine previous hypersentivity to drugs & antacids
Assess abdominal bowel sounds, to ensure GI motility.
Assess mucous membrane status to evaluate potential problems with absorption.
Screen for baseline data vital signs.
Prepare all the materials needed in drug administration via nasogastric tube.
Raise head of the bed 30-45 degrees.
Put on clean gloves; disconnect from continuous feeding
Crush pills or open capsules and dissolve in 15-30 mL warm water. Stir thoroughly, using a clean tongue depressor.
During
Attach the bulb syringe to the nasogastric tube.
Check by the placement via auscultation. Auscultation is the act of listening for sounds within the body with the use of a stethoscope. For
this check, squeeze the bulb to void air from the syringe and prevent air form being injected into the stomach. Fit the syringe into the near
end of the nasogastric tube. Place the diaphragm end of the stethoscope to the patients stomach about two inches below the sternum.
Squeeze the bulb of the syringe to inject air into the nasogastric tube. Listen for gurgling sounds; these sounds indicate that the
nasogastriic tube is properly placed. Move the diaphragm stethoscope to the front part of the lung area. Squeeze the syringe bulb again
and listen for gurgling sounds. If you hear gurgling sounds in the lung area, sounds in that area indicate the tube is not in the correct
position. Begin again to place the nasogastric tube properly.
Remove the plunger from the syringe. Release the clamp, allowing the medication to flow into the nasogastric tube.
Administer the drug apart from any other oral medications.
Follow the medication with 30 mL of water to clear the tube and then replace clamp in the nasogastric tube. Remove the bulb syringe.
After
Clean your workplace.
Record time, amount, and type of solution used on the I&O worksheet.

DRUG STUDY in ICU

Page 4

Document the medication to the chart.

Advise patient not to take milk products concurrently with this medication.

Teaching points
Report lack of response, persistent diarrhea or S&Sx of anemia (SOB, dizziness, pale skin, etc.) immediately. Keep all F/U to assess
response and for adverse effects.

DRUG STUDY in ICU

Page 5