Intravenous Fluid
1
DRUG NAME
Isotonic(250-375 mOsm/L)
PNSS (0.9% Sodium
Chloride)
D5W(5% Dextrose in
Water)
Lactated Ringers
Solution
Ringers Solution
MECHANISM OF ACTION
CONTRAINDICATIONS
Normal saline solution Indications:
has an osmolality of 308
mOsm/L. Because the
osmolality is entirely
contributed by
electrolytes, the solution
remains within the ECF,
does not cause red blood
cells to shrink or swell.
Isotonic fluids expand
the ECF volume.
Dextrose provides a
source of calories.
Dextrose is readily
metabolized, may
decrease losses of body
protein and nitrogen,
promotes glycogen
deposition and decreases
or prevents ketosis if
sufficient doses are
provided.
Contraindications:
INDICATIONS &
ADVERSE EFFECTS
PNSS- Used because it
has little to no effect on
the tissues and make
the person feel
hydrated preventing
hypovolemic shock or
hypotension.
And also treatment of
vascular dehydration;
replaces sodium and
chloride
Lactated Ringers and
5% Dextrose Injection,
is indicated as a source
of water, electrolytes
and calories or as an
alkalinizing agent.
Resuscitation
Fluid Challenges
Blood Transfusions
Metabolic Alkalosis
DKA
Burns
Dehydration
Heart failure
Pulmonary edema
Renal impairment
Sodium retention
NURSING RESPONSIBILITIES
Solutions PNSS:
containing Before:
dextrose may Obtain history of the patients fluid and electrolyte status
be before therapy and reassess regularly.
contraindicated Before giving the bottle, check for the correct patient to be
in patients with administered.
known Check for the correct fluid to be given.
Allergy to corn During:
or corn Upon inserting the chamber to another, make sure that it is
products. inserted well.
Febrile Be alert of fluid overload
response Check for the patients comfort.
Infection at the After:
site of injection Infuse the IV well to its prescribed rate
Venous Check for the presence of bubbles in the IV tube.
thrombosis or Evaluate patients knowledge of therapy.
phlebitis
extending from D5W & Lactated Ringers Solution:
the site of 1. 5% dextrose in water is isotonic when infused but becomes
injection hypotonic when the dextrose has been metabolized.
Extravasation 2. Use cautiously in patients who are fluid-overloaded or who
Hypervolemia would be compromised if vascular volume would increase,
such as renal and cardiac patients.
3. Suspend container from eyelet support.
4. Remove plastic protector from outlet port at bottom of
container.
5. Attach administration set. Refer to complete directions
accompanying set.
6. Clinical evaluation and periodic laboratory determinations
are necessary to monitor changes in fluid balance,
electrolyte concentrations, and acid base balance during
prolonged parenteral therapy or whenever the condition of
the patient warrants such evaluation.
7. Lactated Ringers and 5% Dextrose Injection, USP should be
used with caution. Excess administration may result in
metabolic alkalosis.
Ryu, Bomi
 8. Caution must be exercised in the administration of
parenteral fluids, especially those containing sodium ions
to patients receiving corticosteroids or corticotrophin.

2
9. Solution containing acetate should be used with caution as
excess administration may result in metabolic alkalosis.
10. If an adverse reaction does occur, discontinue the infusion,
evaluate the patient, institute appropriate therapeutic
countermeasures
Hypertonic(>375 mOsm/L) Hypertonic Solutions are Indications: 1. These solutions can be very irritating to veins, so observing
D5NS(5% Dextrose in those that have Treatment of hypotonic the IV site for inflammation is imperative.
0.9% Sodium Chloride) an effective osmolarity dehydration; treatment 2. May cause circulatory overload, so these solution should be
D5IMB(Balanced greater than of circulatory collapse; infused slowly to prevent this in vulnerable patients.
Multiple Maintenance the body fluids. increase fluid shift from 3. May increase serum glucose in patients with glucose
Solution With 5% This pulls the interstitial space to intolerance, which would make more frequent glucose
Dextrose-Euro-Ion in fluid into the vascular by vascular space. monitoring an important nursing intervention.
D5W osmosis resulting in an Hypovolemic shock 4. Do not administer unless solution is clear and container is
D5LR(5% Dextrose in increase Hemorrhagic shock undamaged.
Lactated Ringers) vascular volume. Itraisesi Peritonitis 5. Caution must be exercised in the administration of
D5NM(Balanced Multiple ntravascular osmotic pres D5IMB: parenteral fluids, especially those containing sodium ions
Maintenance Solution sure and provides fluid, Slow administration to patients receiving corticosteroids or corticotrophin.
with 5% Dextrose- electrolytes and essential to prevent 6. Solution containing acetate should be used with caution as
Eurosol-M in D5W calories for energy. overload (100 mL/hr) - excess administration may result in metabolic alkalosis.
When administered Water intoxication - 7. Solution containing dextrose should be used with caution
intravenously, Normosol- Severe sodium in patients with known subclinical or overt diabetes
M and 5% Dextrose depletion mellitus.
Injection provides water D5LR: 8. Discard unused portion.
and electrolytes (with Treatment for persons 9. In very low birthweight infants, excessive or rapid
dextrose as a readily needing extra calories administration of dextrose injection may result in
available source of who cannot tolerate increased serum osmolality and possible intracerebral
carbohydrate) for fluid overload. hemorrhage.
maintenance of daily fluid Treatment of shock.
and electrolyte D5NM:
requirements, plus Electrolyte
minimal carbohydrate requirements with
calories. minimal carbohydrate
The electrolyte calories from dextrose.
composition approaches Magnesium in the
that of the principal ions formula may help to
of normal prevent
plasma(extracellular iatrogenic magnesium
fluid). deficiency

Ryu, Bomi
 The electrolyte Contraindications:
concentration is D5IMB:
hypotonic (112 -phlebitis, peripheral

mOsmol/liter) in relation
to the extracellular
fluid (280 mOsmol/liter).
One liter provides
approximately one-third
of the average adult daily
requirement for water
and principal electrolyte-
s in balanced proportions,
with acetate as a
bicarbonate alternate,
plus 170 calories from
dextrose.
Hypotonic(<250 mOsm/L) Infusing a hypotonic
PNR(Lactated Ringers solution into the vascular
Solution) system causes an
unequal solute
concentration among the
fluid compartments. The
infusion of hypotonic
crystalloid solutions
lowers the serum
osmolality within the
vascular space, causing
fluid to shift from the
intravascular space to
both the intracellular and
interstitial spaces. These
solutions will hydrate
cells, although their use
may deplete fluid within
the circulatory system.
3
edema, cellular
dehydration.
D5LR/D5NM:
Hypersensitivity to any
of the components.
Indications: chest pain, 1. These solutions may further exaggerate hypotension due to
USP is indicated as a abnormal heart fluid shifting out of vascular space.
source of water and rate, 2. Do not administer this solution to hypotensive patients.
electrolytes or as an decreased blood 3. Hypotonic fluids are used to treat patients with conditions
alkalinizing agent. pressure, causing intracellular dehydration, such as diabetic
Treatment of troubled ketoacidosis, and hyperosmolar hyperglycemic state, when
hypertonic breathing, fluid needs to be shifted into the cell. Be aware of how the
dehydration. cough, fluid shift will affect various body systems. The lower
Gastric fluid loss sneezing, concentration of solute within the vascular bed will shift the
Cellular dehydration rash, fluid into the cells and also into the interstitial spaces.
from excessive itching, and 4. Use caution when infusing hypotonic solutions; the
diuresis headache. decrease in vascular bed volume can worsen existing
Hypertonic hypovolemia and hypotension and cause cardiovascular
dehydration collapse.
Slow rehydration
5. Monitor patients for signs and symptoms of fluid volume
Contraindications:
deficit as fluid is "pulled back" into the cells and out of the
Hypersensitivity to vascular bed. In older adult patients, confusion may also be
sodium lactate. an indicator of a fluid volume deficit. Instruct patients to
Other calcium- inform a nurse if they feel dizzy or just "don't feel right."
containing infusion
6. Never give hypotonic solutions to patients who are at risk
solutions, concomitant
for increased ICP because of a potential fluid shift to the
administration of
brain tissue, which can cause or exacerbate cerebral edema.
ceftriaxone and
In addition, do not use hypotonic solutions in patients with
Lactated Ringers
liver disease, trauma, or burns due to the potential for
Injection
depletion of intravascular fluid volume.
Newborns
Ryu, Bomi
Osmotic Diuretic(549 Osmotic diuretics have Indications: Cardiovascular 1. Administer Mannitol using an in-line filter (1.2 micron
mOsm/L) their major effect in the Promotion of diuresis Hypotension filter). Change in-line filter Q24hr & prn if crystallization
Mannitol(Osmitrol) proximal convoluted in the prevention or Tachycardia forms.

4
tubule and the treatment of the Venous 2. Check blood return prior to starting the infusion .
descending limb of oliguric phase of acute thrombosis 3. Use Alaris pump: For Mannitol dose of 25 gm, infuse over
Henle's loop. These sites renal failure before Phlebitis 15 minutes. For Mannitol dose of 50gm or greater, infuse
are freely permeable to irreversible renal extending from over 30 minutes.
water. Through osmotic failure becomes injection site 4. Continuous observation of the site by the RN for signs &
effects, they also oppose established. Hypervolemia symptoms of local extravasation reactions until the
the action of ADH in the Reduction of Respiratory infusion is complete.
collecting tubule. The intracranial pressure Pulmonary 5. Signs & symptoms of local extravasations reaction:
presence of a non- and brain mass. congestion, Complaints of local pain, burning, or any acute change
reabsorbable solute such Reduction of Rhinitis at the infusion site
as mannitol prevents the high intraocular Metabolic Induration or swelling at the infusion site
normal absorption of pressure when the Electrolyte Resistance when flushing the line indicates the line is
water by interposing a pressure cannot be imbalance, occluded.
countervailing osmotic lowered by other Acidosis, 6. Notify MD of extravasation & document in electronic
force. As a result, urine means. Electrolyte loss record.
volume increases. Promotion of urinary Nervous System 7. For subsequent Mannitol infusions, check line for blood
The increase in urine excretion of toxic Headache, return by aspiration or placing the IV bag below the IV site.
flow rate decreases the materials. convulsion, If unable to get blood return, try flushing the line with 10cc
contact time between dizziness NS. If no signs of infiltration or pain, start infusion &
fluid and the tubular Contraindications: Hematologic monitor site as above. Document how line was checked
epithelium, thus hypersens. to Thrombophlebitis prior to infusion.
reducing sodium as well drug/class/compon. Renal
as water reabsorption. anuria Acute renal
The resulting natriuresis pulmonary edema, failure
is of lesser magnitude severe dehydration Dermatologic
than the water diuresis, intracranial Urticarial,
leading eventually to hemorrhage necrosis
excessive water loss and renal impairment Gastrointestinal
hypernatremia. Nausea, vomiting
Genitourinary
Diuresis, urinary
retention

Ryu, Bomi

DRUG NAME MECHANISM OF ACTION
Anti-tetanus Tetanus toxoid and tetanus toxoid
serum adsorbed induces active immunity
(Tetanus Toxoid) to the tetanus antigen by
stimulating the immune system to
Classification: produce specific antitoxin. They
EPI vaccine are not indicated for the treatment
Anti-tetanus of active tetanus infection.
Tetanus / The pathologic sequelae of Coryne
Diphtheria bacterium diphtheriae and
Toxoid Clostridium tetani infections are
Adsorbed mediated by diphtheria and
(Tenivac) tetanus exotoxins, respectively.
Exotoxins are extracellular
Classification: protein metabolites of toxigenic
EPI vaccine strains of these organisms.
Anti-tetanus Tetanus or diphtheria disease
does not necessarily confer
immunity because of the very
small amount of exotoxin
Tetanus Prophylaxis
INDICATIONS &
CONTRAINDICATIONS
Indications:
Tetanus Toxoid is indicated
for booster injection only for
persons 7 years of age and
older against tetanus.
Primary immunization
schedule for children under
7 years of age should consist
of five doses of vaccine
containing tetanus toxoid.
Tetanus Toxoid is not to be
used for treatment of tetanus
infection.
As with any vaccine,
vaccination with tetanus
toxoid may not protect 100%
of susceptible individuals.
Prevention against tetanus in
children and adult
Contraindications:
Hypersensitivity, febrile
illness and other acute
infections, patient with
low immune response
Indications:
Tetanus Toxoid Adsorbed
vaccine is indicated for
active immunization of
children 7 years of age or
older, and adults, against
tetanus, wherever combined
antigen preparations are not
indicated.
5
ADVERSE EFFECTS NURSING RESPONSIBILITIES
Redness, 1. Shake well the vial before withdrawing each dose.
warmth, 2. Special care should be taken to ensure that the
edema, injection does not enter the blood vessel.
induration with or 3. For Nursing Mothers: Tetanus Toxoid does not affect
without tenderness the safety of mothers who are breastfeeding or their
as well as urticaria, infants. Breastfeeding does not adversely affect
and rash. immune response and is not a contraindication for
Malaise, vaccination
transient fever, 4. For Pediatric Use: Safety and effectiveness of tetanus
pain, toxoid in infants below the age of 6 weeks has not
hypotension, been established. However, this vaccine is not
nausea, and indicated for children under 7 yrs of age.
arthralgia 5. For Geriatric Use: Tetanus Toxoid should only be
used in geriatric patients known to have received a
primary series of tetanus-containing vaccine, since
many such as persons have no prior immunity.
6. Observe the 10 rights in giving the medication.
7. Monitor vital signs.
8. Allow the patient to lie down to prevent vomiting.
9. Educate the patient to increase fluid intake to
prevent dehydration.
10. Educate patient that pain and tenderness in the
injection site may occur.
Cardiovascular: 1. Just before use, shake the vial or syringe well until a
Hypotension uniform, white, cloudy suspension results. Parenteral
drug products should be inspected visually for
Central nervous particulate matter and discoloration prior to
system: administration, whenever solution and container
Guillain-Barr permit. If these conditions exist, the product should
syndrome, malaise, not be administered.
neuritis (brachial), 2. When withdrawing a dose from a rubber-stoppered
pain vial, do not remove either the rubber stopper or the
Dermatologic: metal seal holding it in place.
Rash at injection site, 3. Each 0.5 mL dose of TENIVAC vaccine is to be
skin sclerosis (with administered intramuscularly. The preferred site is
Ryu, Bomi
 required to produce illness, Contraindications: or without the deltoid muscle. The vaccine should not be
therefore, previously infected Hypersensitivity to any tenderness), urticaria injected into the gluteal area or areas where there
individuals should still receive component of the vaccine, at injection site may be a major nerve trunk.

6
toxoid. The DT and Td products including thimerosal, a Gastrointestinal: 4. Do not administer this product intravenously or
are adsorbed onto an aluminum mercury derivative, is a Nausea subcutaneously.
salt, which prolongs and enhances contraindication for further Hypersensitivity: 5. TENIVAC vaccine should not be combined through
the antigenic properties by use of this vaccine. Anaphylaxis, Arthus reconstitution or mixed with any other vaccine.
retarding the rate of injected phenomenon
toxoid absorption into the body. Local:
Diphtheria and tetanus toxoids Erythema at injection
induce the production of site, swelling at
antibodies against the exotoxin, injection site, warm
which inactivate it. The presumed sensation at injection
mechanism by which toxoids site
produce immunity is by activating Neuromuscular &
antigen-presenting cells to secrete skeletal:
cytokines that enhance the Arthralgia
recruitment of antigen-specific T Miscellaneous:
and B cells to the site of Fever
inoculation.
Tetanus Immune Passive immunity toward tetanus Indications: Central nervous For IM use only; do not administer IV. Administer in the
Globulin For prophylaxis against system: anterolateral aspects of the upper thigh or the deltoid
(Human) tetanus following injury in Increased body muscle of the upper arm. Avoid gluteal region due to risk
patients whose temperature of injury to sciatic nerve; if gluteal region is used,
Classification: immunization is incomplete Local: administer only in the upper outer quadrant. If tetanus
EPI vaccine or uncertain Local vaccine and tetanus immune globulin are administered
Anti-tetanus soreness/soreness at simultaneously, separate sites should be used for each
Contraindications: injection site, pain at injection. When used for the treatment of tetanus,
There are no injection site, infiltration of part of the dose around the wound is
contraindications listed in tenderness at recommended
the manufacturers labeling. injection site Educate patient about signs of a significant reaction (eg,
<1% (Limited to wheezing; chest tightness; fever; itching; bad cough; blue
important or life- skin color; seizures; or swelling of face, lips, tongue, or
threatening): throat).
Anaphylactic shock,
angioedema,
nephrotic syndrome

Ryu, Bomi
 Cardiac Arrest Agent
INDICATIONS &

7
DRUG NAME MECHANISM OF ACTION ADVERSE EFFECTS NURSING RESPONSIBILITIES
CONTRAINDICATIONS
Epinephrine Stimulates alpha-, beta-, Indications: CV: 1. Monitor BP, pulse, respirations, and urinary output and observe
(Adrenalin) and beta2-adrenergic Bronchospasm, Pounding heartbeat, patient closely following IV administration. Epinephrine may
receptors resulting in hypersensitivity tachycardia, flushing, widen pulsepressure. If disturbances in cardiac rhythm occur,
Classification: relaxation of smooth reactions, anaphylaxis Hypertension withhold epinephrine and notify physician immediately.
Adrenergic muscle of the bronchial Hemostasis CNS: 2. Keep physician informed of any changes in intake-output ratio.
Agonist Agent; tree, cardiac Acute asthma attacks Nervousness, 3. Use cardiac monitor with patients receiving epinephrine IV. Have
Bronchodilator; stimulation, and dilation To prolong local restlessness, dizziness, full crash cart immediately available.
Antidote of skeletal vasculature; anesthetic effect headache, insomnia, 4. Check BP repeatedly when epinephrine is administered IV during
small doses can cause To control cardiac lightheadedness first 5 min, then q3 5min until stabilized.
vasodilation via beta2- rhythm in cardiac GI: 5. Advise patient to report to physician if symptoms are not
vascular receptors; arrest Nausea, vomiting relieved in 20 min or if they become worse following inhalation.
large doses may Neuromuscular & 6. Advise patient to report bronchial irritation, nervousness, or
produce constriction of Contraindications: Skeletal: sleeplessness. Dosage should be reduced.
skeletal and vascular Hypersensitivity to Weakness, trembling 7. Monitor blood glucose & HbA1c for loss of glycemic control if
smooth muscle; epinephrine or any Miscellaneous: diabetic.
decreases production of component Diaphoresis
aqueous humor and Cardiac arrhythmias,
increases aqueous angle-closure
outflow; dilates the glaucoma
pupil by contracting the
dilator muscle.
Amiodarone Type III antiarrhythmic: Indications: CNS: Assessment:
(Pacerone, Acts directly on cardiac cell Premature ventricular Malaise, fatigue, 1. Before the therapy, assess the patients vital signs and put more
Cordarone) membrane; prolongs fibrillation dizziness, tremors, focus on the cardiac activity. For patients with cardiac device
repolarization and Unstable ventricular ataxia, paresthesias, implants, check its condition and if it works properly before
Classification: refractory period; tachycardia lack of coordination during and after administration.
Antiarrhythmic increases ventricular Atrial fibrillation CV: 2. Monitor also the pulmonary, liver and thyroid function tests as it
fibrillation threshold; acts Angina Cardiac arrhythmias, may infer with the expected results.
on peripheral smooth Hypertrophic CHF, cardiac arrest, 3. Watch out for adverse drug interactions such as: peripheral
muscle to decrease cardiomyopathy hypotension neuropathy, abnormal gait, ataxia, dizziness, headache, fatigue.
peripheral resistance. Supraventricular EENT: Bradycardia can occur followed with hypotension and eventual
arrhythmias Corneal microdeposits sinus arrest. Photosensitivity is an expected adverse reaction.
(photophobia, dry eyes, Planning and Implementation:
Contraindications: halos, blurred vision); 1. Close monitoring is an ongoing process all throughout the
Pregnant, nursing ophthalmic therapy. An updated data is a must.
mother, individuals abnormalities including 2. For oral dosages, each dose should be taken with meals since it is
with sinus nodal permanent blindness a gastric irritant.
Ryu, Bomi
 bradycardia,
atrioventricular block,
and second or third
degree heart block who
do not have an artificial
pacemaker, should not
be given to neonates,
because the benzyl
alcohol it contains may
cause the fatal "gasping
syndrome", not given
with lidocaine.
Atropine Sulfate Action by selectively Indication:
(Atropisol, Isopto blocking all muscarinic Potent bronchodilator
Atropine, responses to acetylcholine, when broncho
Atropair) whether excitatory or constriction has been
inhibitory. induced by para
Classification: Selective depression of CNS sympathomimetics.
Anti-cholinergic relieves rigidity & tremor Produces
of parkinsons syndrome- mydriasis(dilation of
blocks vagal impulses to pupils) and
hearth with resulting cycloplegia(paralysis
decreasing in AV of accommodation) by
conduction time, blocking responses of
increasing in heart rate, iris sphincter muscle
cardiac output, shortened and ciliary muscle of
PR interval. lens to cholinergic
stimulation.
Contraindication:
Hypersensitivity to
belladonna alkaloids;
synechia; angle-
closure glaucoma;
parotitis obstructive
uropathy.
Sodium Increases plasma Indication:
Bicarbonate bicarbonate, neutralizes
Endocrine: 3. Encourage the patient to verbalize any discomfort since this drug
Hypothyroidism or may have several adverse reactions.
hyperthyroidism 4. On the beginning of the therapy, IV infusion should be monitored
8
GI: well since it may affect the kidneys normal functioning resulting
Nausea, vomiting, to hepatocellular necrosis and acute renal failure.
anorexia, constipation, 5. Coordinate with other health care personnel such as in obtaining
abnormal LFTs, pulmonary, liver and renal function tests. ECG monitoring should
hepatotoxicity also be done thus reading the ECG tracing can be an edge at this
Respiratory: time.
Pulmonary toxicity
pneumonitis, infiltrates
(shortness of breath,
cough, rales, wheezes)
Other:
Photosensitivity,
angioedema
CNS: 1. Monitor vital signs. HR is a sensitive indicator of pts response to
Headache, ataxia, atropine.
dizziness, excitement, 2. Initial paradoxical bradycardia following IV atropine usually
irritability, convulsion, lasts only 1-2min; it most likely occurs when IV is administered
drowsiness, fatigue, slowly(more than 1 min) or when small doses(less than 0.5mg)
weakness, mental are used.
depression, confusion, 3. Postural hypotension occurs when pt ambulates too soon after
disorientation, parenteral administration.
hallucinations 4. Note: frequent and continued use of eye preparations, as well as
over dosage, can have systemic effects. Some atropine deaths
CV: have resulted from systemic absorption following ocular
Hypertension, administration in infants and children.
hypotension, 5. Monitor I&O, especially in older adults and pt who has had
ventricular tachycardia, surgery(drug may contribute to urinary retention).
palpitation, paradoxical 6. Palpate lower abdomen for distention.
bradycardia 7. Have pt void
Urogenital:
Urinary retention,
dysuria, impotence
Metabolic alkalosis; 1. Obtain patient history including drug history and any
mood changes, hypersensitivity.
Ryu, Bomi
 gastric acid which forms
Classification: water, sodium chloride,
Fluids, carbon dioxide, and raises
Electrolyte, Blood blood pH.
Products, And
Hematological
Drugs
Lidocaine When administered
(LidoPen) intramuscularly or
intravenously, Lidocaine
Classification: suppresses the
Anesthetic, automaticity and
Antiarrythmics spontaneous
depolarization of the
ventricles during diastole
by altering the flux of
sodium ions across the cell
membrane with little or no
effect on the heart. Locally,
it produces local
anesthesia effect by
inhibiting the transport of
ions across the neural
membranes. Thus,
initiation and conduction
of normal nerve impulses
is prevented.
Treatment of
metabolic acidosis,
promotion of gastric,
systemic and urine
alkalinization in the
case of intoxication
with weak organic
acids.
Contraindication:
Hypoventilation,
hypocalcemia, increase
serum osmolarity,
further in all situations
where sodium intake
must be restricted like
cardiac insufficiency,
edema, hypertension,
eclampsia, severe
kidney insufficiency.
Indication:
Local or regional
anesthetic.
Management of acute
ventricular
arrhythmias during
cardiac manipulation.
Control of status
epilepticus refractory
to other treatments.
Contraindication:
Hypersensitivity
Advanced AV block
tiredness, shortness 2. Assess respiratory and pulse rate, rhythm, depth, lung sounds
of breath, muscle and notify the physician.
weakness, irregular 3. Assess for carbon dioxide in GI tract, may lead to perforation if
9
heartbeat; muscle ulcer is severe.
hypertonicity, 4. Test and monitor urine pH, urinary output, during beginning
twitching, tetany; treatment.
hypernatraemia, 5. If patient has edematous tendency, notify physician.
hyperosmolality, 6. If patient is vomiting withhold medication and immediately
hypocalcaemia, inform the physician.
hypokalaemia; 7. If the patient exhibits shortness of breath and hyperpnea,
stomach cramps, immediately inform the physician.
flatulence. 8. Inform physician if relief is not obtained or if the patient
demonstrate any symptoms suggest bleeding, such as black tarry
stools or coffee ground emesis.
9. Caution patient to immediately report to physician if symptoms
such as nausea, vomiting and anorexia occurs.
Drowsiness 1. When Lidocaine is administered as an antiarrhythmic the nurse
Dizziness should monitor the ECG continuously. Blood pressure and
Nervousness respiratory status should be monitored frequently during the
(mucosal use) drug administration.
decreased or absent 2. When administered as an anesthetic, the numbness of the
gag reflex affected part should be assessed.
Bradycardia 3. Serum Lidocaine levels should be monitored frequently during
Hypotension prolonged use.
Burning sensation 4. Therapeutic serum lidocaine levels range from 1.5 to 5 mcg/ml.
5. If signs of overdose occur, stop the infusion immediately and
monitor the patient closely.
Ryu, Bomi