05 NCP - DRUG STUDY.docx

7/27/2019 05 NCP - DRUG STUDY.docx

1/23

BSN4A (GROUP 2) 29

X. Drug Study

Drug Name Dosage Mechanism of

Action

Indication Adverse Reaction Contraindication Nursing

Responsibility

Generic:

Clonazepam

Brand:

Rivotril

Classification:

Anticonvulsant

Antiepileptic

Dosage:

0.5 mg per Tablet

Frequency:

OD

Route:

Per orem

Clonazepam exertsits action by binding

to thebenzodiazepine site

of the GABA

receptors, whichcauses an

enhancement of theelectric effect of

GABA binding onneurons, resulting in

an increased influxof chloride ions into

the neurons. This

results in aninhibition of synaptictransmission across

the central nervoussystem.

(Pharmacology and

the Nursing Process.4th Ed. 2005. Mosby,

Inc. USA)

Periodic legmovements during

sleep, hypokineticdysarthria, acutemanic episodes,

multifocal ticdisorders, neuralgias

Used alone or as

adjunct in treatmentof Lennox-Gastaut

syndrome (petit malvariant), akinetic and

myoclonic seizures;

may be useful inpatients with absence

(petit mal) seizures,

treatment of panic

disorder with or

without agoraphobia

CNS: transient, milddrowsiness initially;

sedation, depression,lethargy, apathy,fatigue,

disorientation, anger,hostility, episodes of

mania andhypomania,

restlessness, crying,delirium, slurred

speech, stupor, vividdreams.

CV: Bradycardia,tachycardia, CVcollapse,

hypertension,palpitations, edema

Integ: Urticaria,

pruritus, rash,dermatitis

EENT: Visual and

auditory

disturbances,diplopia, nystagmus,nasal congestion

Contraindicated withhypersensitivity to

benzodiazepines,psychoses, acute

narrow-angle

glaucoma, shock,coma, acute

alcoholicintoxication with

depression of vitalsigns.

Use cautiously with

impaired liver or

kidney function,debilitation.

Assessment and

Drug Effects

Hypersensitivitytobenzodiazepines;

psychoses, acutenarrow-angle


alcoholicintoxication, liver

renal impairment

Monitor addiction-prone patients

carefully becauseof their

predisposition to

habituation anddrug dependence

Monitor liverfunction and bloodcounts

periodically inpatients on long

tern therapy.

Monitor patientfor therapeutic

drug levels: 2080 ng/mL.
http://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_system


2/23

BSN4A (GROUP 2) 30

GI: constipation,diarrhea, dry mouth,

nausea, anorexia,gastric disorders

GU: Incontinence,

urinary retention,changes in libido

Hema:blood

dyscrasias,agranulocytosis,

leucopenia

Other: hiccups,fever, diaphoresis,

paresthesias,gynecomastia.

Patient & Family

Education

Take drug exactlyas prescribed; do

not take drugwithout consulting

health careprovider

Avoid alcohol,sleep inducing or

over the counterdrugs

Report severedizziness,

weakness,drowsiness that

persists, rash orskin lesions,

difficulty voiding,palpitations,

swelling in theextremities.


3/23

BSN4A (GROUP 2) 31


Action

Indication Contraindication Adverse Reaction Nursing

Responsibility

Generic:

Polynerv

Brand:

Vitamin B

Complex

Classification:

Vitamins andMinerals

Dosage:

500 mg per Tablet

Frequency:

OD

Route:

Per orem

A coenzyme thatstimulate metabolic

function and isneeded for cell

replication,hematopoiesis, andnucleoprotein and

myelin synthesis.Vitamins B1, B6and

B12 (Polynerv) oraldrops is valuable in

conditions where therequirements for B

vitamins areincreased as in

growth, physiologic

stress, decreasedresistance to

infection and chronic

illnesses, metabolicdisorder sand in

certain diseases ofthe digestive tract

and nervous system.(Roth, L.S. (2010).

Mosbys NursingDrug Reference, 23.

USA: Mosby, Inc)

Rheumaticpains,

alcoholism,cardiac

disorders, lowblood pressure.

Vitamin B complexshould not be used in

hypersensitivity toany of the vitamins

hypersensitive tovitamin B12 or

cobalt, containing in

the preparation, aswell as in patients with

2nd

or 3rd

degreearterial hypertension

CV: peripheralvascular thrombosis,

heart failure.

GI: transientdiarrhea.

Respi:pulmonaryedema.

Skin: itching,

transitoryexanthema, urticaria.

Other: anaphylaxis,

pain.

Assessment and

Drug Effects

Determinereticulocyte count,

hct, Vit. B12, iron,folate levels before

beginning therapy.

Obtain a sensitivitytest history beforeadministration

Avoid I.V.administration

because fastersystemic

elimination willreduce

effectiveness ofvitamin.

Dont give largedoses of vitamin

B12 routinely; drug

is lost throughexcretion.

Protect Vit. B12from light. Dont

refrigerate orfreeze.

Monitor patient forhypokalemia for

first 48 hours, asanemia correct
http://www.mims.com.ph/Page.aspx?menuid=companionhome&ID=70http://www.mims.com.ph/Page.aspx?menuid=companionhome&ID=70


4/23

BSN4A (GROUP 2) 32

itself. Givepotassium

supplements, asneeded.


5/23

BSN4A (GROUP 2) 33


Action

Indication Contraindications Adverse Reaction Nursing

Responsibilities

Generic:

Diphenhydraminehydrochloride

Brand:

Benadryl

Classification:

Anticholinergic,

Antiparkinsoniandrug

Dosage:

50 mg per capsule

Frequency:

ODHS

Route:

Per orem

Competes withhistamine for H1

receptor site.Antagonizes the

effect of histamine atH1 receptor sites;does not bind or

inactivate histamine.Prevents, but doesnt

reverse, histaminemediated responses

particularly those ofbronchial tubes, GI

tract, and bloodvessels

(Roth, L.S. (2010).


USA: Mosby, Inc)

Pseudoparkinsonismdrug-induced

extrapyramidaleffects

Used to treat anxiety,tension,

sleeplessness orinvoluntary

movements due tothe side effects of

certain psychiatricdrugs

Contraindicated inpatients with

hypersensitivity todrug.

Avoid use in patientstaking MAO

inhibitors

Caution in patientswith asthma, COPD,

cardiac disease orhypertension,

glaucoma, andgastric or duodenal

ulcers

CNS: drowsiness,confusion, insomnia,

headache, vertigo,sedation, sleepiness,

nervousness,restlessness

CV: Palpitations,hypotension,

tachycardia

EENT:blurred vision,

nasalcongestion,

tinnitus

GIT: nausea andvomiting, dry mouth,

constipation,anorexia

Urogenital: dysurea,

urine retention,urinary frequency

Hema: hemolytic

anemia,

thrombocytopenia,agranulocytosis

Assessment and

Drug Effects

When taking thesemedications, the

client needs to haveblood cells counts,renal function,

hepatic function,and blood pressure

monitored.

Assess for allergyPatient & Family

Education

Caution the clientthat the

medication maycause drowsiness,creating

difficulties orhazards or other

activities that

require alertness.

Tell the client totake themedication with

food to decreaseGI upset.

Explain to theclient that arising

quickly from a


6/23

BSN4A (GROUP 2) 34

Respi: thickening ofbronchial secretions

Skin: Urticaria,

photosensitivity,rash.

Other : anaphylactic

shock

lying or sittingposition may

cause orthostatichypotension.

Explain to theclient that use of

these drugs inwarm weather

may increase thelikelihood of

heatstroke.

Report difficultyof breathing

Administer syrupform if patient is

unable to taketablets

Warn patient notto take this drugwith any other

products thatcontain

diphenhydramine(including topical

therapy) becauseof increased

adverse reactions.


7/23

BSN4A (GROUP 2) 35


Action


Responsibility

Generic:

Ascorbic Acid

Brand:

Nutri Cee

Classification:

Vitamins

DOSAGE:

500 mg in tabletform

FREQUENCY:

OD

ROUTE:

Per orem

Thechemopreventive

action of vitamin Cis attributed to two of

its functions. It is awater-soluble chain

breaking antioxidant.

As an antioxidant, itscavenges free

radicals and reactiveoxygen molecules,

which are producedduring metabolic

pathways ofdetoxification.

It also prevents

formation ofcarcinogens from

precursor

compounds.The structure of

ascorbic acid isreminiscent of

glucose, from whichit is derived in the

majority of mammals(Wolters Kluwer,

2009)

Increases protectionmechanism of the

immune system, thussupporting wound

healing. Necessaryfor wound healingand resistance to

infection.

Prevention andtreatment of vitamin

C deficiency

Use of sodiumascorbate in patients

on sodium restriction

Use of calciumascorbate in patientsreceiving digitalis.

GI: Nausea,vomiting, heartburn,

diarrhea, orabdominal cramps

(high doses).

Hematologic: Acute

hemolytic anemia(patients with

deficiency of G6PD);sickle cell crisis.

CNS: Headache or

insomnia (highdoses).

Urogenital:Urethritis, dysuria,crystalluria,

hyperoxaluria, orhyperuricemia (high

doses).

Other: Mildsoreness at injection

site; dizziness andtemporary faintness

with rapid IV

administration.

Assessment & Drug

Effects Lab tests:

Periodic Hct &

Hgb, serumelectrolytes.

Monitor forS&S of acutehemolytic

anemia, sicklecell crisis.

Patient & Family

Education Take large dosesof vitamin C in

divided amountsbecause the bodyuses only what is

needed at aparticular time and

excretes the rest inurine.

Megadoses caninterfere with

absorption ofvitamin B12.

Note: VitaminC increases theabsorption of ironwhen taken at the


8/23

BSN4A (GROUP 2) 36

same time as iron-rich foods.


9/23

BSN4A (GROUP 2) 37


10/23

BSN4A (GROUP 2) 38

NURSING CARE PLAN # 2

Assessment Data Nursing Diagnosis Rationale Expected Outcome Nursing Intervention Justification Evaluation

Actual/Abnormal

Cues:

Difficultyfalling asleep atnight

Clientsverbalization

hambal sangdoctor side

effect na kunosang bulong ko

Long hours ofsleep at daytime

(average of 3-5hours)

Fatigue onawakeningRisk Factors:

Side effects ofmedications

Environment History of

alcoholism

History ofchronic cigarette

smoking

Disturbed sleep

pattern related to

excessive daytime

sleepingsecondary to

medications as

evidenced bydifficulty falling

asleep at night,long hours of sleep

at daytime andfatigue on

awakening.

Definition:

Disturbed sleeppatternis the state

in which anindividual

experiences or isat risk of

experiencing achange in the

quantity or quality

of his or her restpattern that causes

discomfort or

Predisposing factors:

History of substanceabuse

Precipitating factors:

History of alcoholism History of chronic

cigarette smoking

Environment

Health care intervention

Administration ofmedications

Therapeuticeffects

Non-therapeuticeffects

Drowsiness and sleepiness

during daytime

Difficulty sleeping at nighttime

Fatigue upon awakening in

the morning

Disturbed sleep pattern

After 32 hours of

nurse-clientinteraction, the

client will be ableto:

1. Identifypersonal habits

that disruptsleep pattern.

1.1Obtain a sleep-wake history

including historyof sleep problems,

changes in sleeppatterns, and use of

medications andstimulants.

1.2Assess for use ofalcohol orcigarettes prior to

use of sleepmedication or

retiring for theevening.

1.1Assessment ofsleep behavior

and patterns arean important

part of anyhealth status

examination.

1.2Alcohol andnicotine should

be avoided for

several hoursprior to sleep.

After 32 hours of

nurse-clientinteraction, the client

was able to:

1.Goal met.Recognize that

before he wasadmitted,

prohibited drugsused to relax him;

but now that he isunder treatment,

the medication he

is taking causeshim to have sleepdisturbance. He

verbalized thataccording to the

doctor, what he isexperiencing is

one of the sideeffects of his

medications. Healso added that his

cravings for drugs

especially at nightcontribute to hissleep disturbance.


11/23

BSN4A (GROUP 2) 39

Strengths:

Strong spiritualbelief

Disciplined Good

interpersonal

relationship Compliance to

treatmentregime

Willingness tochange to

improve hishealth

interferes withdesired lifestyle.

Source:Handbook of

Nursing Diagnosis13 Ed by Moyet

Pp 446-449

Source:Handbook of Nursing

Diagnosis 13 Ed by Moyetpp 446-449

2. Verbalize waysthat can help

promote hissleeping

pattern.

2.1 Initiatenon-

pharmacologicinterventions for

improved sleepincluding:

Encourageclient to have

an increase insunlight

exposure

Provideeducational

interventions topromote

beneficial sleephygiene

(Including theimpact of

substance useon sleep

quality,keeping regular

waking andsleeping times,

avoiding naps,refraining from

caffeine,impact of

exercise onsleep and

environmental

2.1 Non-pharmacologic

interventionshave been

found toimprove sleep

efficiency andincrease

satisfaction withsleep pattern

whiledecreasing

use ofhypnotics.

2.Goal met. Statethat he usually

watches televisionor have a chit-chat

with hisroommates to help

him fall asleep andlessen the cravings

of taking drugs.He added that he

would sometimeswrite anything or

read magazinesand play with his

friends so that hecould divert his

attention and hewill not get sleepy

during the day.


12/23

BSN4A (GROUP 2) 40

3. Achieveoptimal

amounts ofsleep as

evidenced byverbalization of

feeling restedand improved

sleepingpattern.

adjustments topromote sleep)

Providediversionalactivities to

providestimulation

(talking to co-residents, play

games)

3.1 Evaluate learningoutcomes using

patientverbalizations of

following thetreatment

recommendationsand experiencing

enhanced sleep.

3.1Evaluationserves as an

assessment ofthe

effectiveness ofcare and allows

opportunity foradjustments to

the plan of care

Source:

http://www.pterrywave.

com/nursing/care%20plans/

51.aspx

3.Goal partially met.Verbalize biskan

makatulug ko saaga..makatulug

naman ko amat-amat kung

gabemakapahuway naman ko

sang maayo kagga amat-amat

naman dula angsakit sa kalawasan

ko


13/23

BSN4A (GROUP 2) 41

NURSING CARE PLAN # 3

Assessment Data Nursing Diagnosis Rationale Expected Outcome Nursing Intervention Justification Evaluation

Risk factors:

Physical isolation Social isolation Affectionaldeprivation Substance abuseStrengths:

Extrovertpersonality

Goodinterpersonal

relationship

Beingparticipative and

active duringgroup sessions

Good familysupport

Risk for loneliness

related to

therapeutic

isolation secondaryto substance abuse.

Definition:

Risk for LonelinessThe state in which anindividual is at risk

for experiencingdiscomfort

associated with adesire or need for

contact with others.

Source:

Handbook ofNursing Diagnosis13 Ed by Moyet

Predisposing factors:

GenderPrecipitating factors: Substance abuse Admission to the

institution

Physical isolation

Social isolation

Impaired socialinteraction

Affectionaldeprivation

Risk for loneliness

Source:

Handbook of

Nursing Diagnosis13 Ed by MoyetPp 273-277

After 32 hours of


will be able to:

1. Verbalizefeelings ofloneliness and

express desire tosocialize more.

1.1Work with thepatient to identifyfactors and

behaviors thathave contributed

to loneliness.

1.2Help clientidentify feelings

associated with

loneliness.

1.3Spend sufficienttime with the

patient to allow

him to expresshis feelings.

1.4Encourage clientto address his

needs assertively.

1.1To beginchanging

behaviors that

may havealienated others.

1.2This lessens theimpact of

feelings and

mobilizes energyto counteractthem.

1.3To establish atrustingrelationship.

1.4By beingassertive, client

assumesresponsibility formeeting his

After 32 hours of


was able to:

1. Goal met.Verbalize,Nasubon ko di kay wala

kami di masyadomay ginahimo,

lalo na bi kungwala kamo, subo

gid ya eh! Sadyakung ari kamo di

kag kung wala na

kami himo-on galantaw kami tv orga hampang diri

sa may polan.


14/23

BSN4A (GROUP 2) 42

Pp 273-277

2. Identify peoplewho will likelysupport and

accept him.

3.

Formulate planson how to

comfortably

2.1 Inform client

that assistance isavailable to help

him expressfeelings of

loneliness andidentify ways to

increase socialactivity.

2.2 Help client curb

feelings ofloneliness by

encouraging one-on-one

interaction withothers who are

likely to accepthim.

3.1As clientscomfort level

improves,

needs withoutanger or guilt.

2.1 To bring issue

into open andhelp client

understand thatyou want to help

him.

2.2 To promote

feelings ofacceptance and

support.

3.1To promote theuse of social

skills.

2.Goal met. Statekung daw kasubo na gid, ga

isturya na lang kosa mga upod ko

lalo na kay JR kaymigo ko na siya

di. Dayun gapasalamat man ko

kay ginadu-aw kodi kag

ginasuportahan kosang akun amay

kag iloy kag kungkis-a upod man

nila ang bata ko.Masadyahan

naman ko nadayun kay

maisturya ko silakag makamusta

man. Gapasalamat man ko

kay ari kamo dipara may ma

isturya man ko.

3.Goal met.Encourage his

colleagues to join


15/23

BSN4A (GROUP 2) 43

interact withpeers and on

how to continueinvolvement

with othersthrough

recreationalactivities or

social interactiongroups.

encourage him toattend to group

activities andsocial functions.

3.2Refer client andfamily to socialservice agencies,

mental healthcenter and

appropriatesupport groups.

3.2To ensurecontinued careand maintain

socialinvolvement.

Source:http://nandanursing

diagnosis.org/nursing-diagnosis-

risk-loneliness/

the morningworship and join

the activities leadby the students.

Also, he alwaystry to play with

his colleagues soas to maintain his

good interpersonalrelationship with

them.


16/23

BSN4A (GROUP 2) 44

X. Drug Study


Action

Indication Adverse Reaction Contraindication Nursing

Responsibility

Generic:

Clonazepam

Brand:

Rivotril

Classification:

Anticonvulsant

Antiepileptic

Dosage:

0.5 mg per Tablet

Frequency:

OD

Route:

Per orem

Clonazepam exertsits action by binding

to the

benzodiazepine siteof the GABA

receptors, whichcauses an

enhancement of theelectric effect of

GABA binding onneurons, resulting in

an increased influxof chloride ions into

the neurons. This

results in aninhibition of synaptictransmission across

the central nervoussystem.

(Pharmacology and

the Nursing Process.4th Ed. 2005. Mosby,

Inc. USA)

Periodic legmovements during

sleep, hypokinetic

dysarthria, acutemanic episodes,

multifocal ticdisorders, neuralgias

Used alone or as

adjunct in treatmentof Lennox-Gastaut

syndrome (petit malvariant), akinetic and

myoclonic seizures;

may be useful inpatients with absence(petit mal) seizures,

treatment of panicdisorder with or

without agoraphobia

CNS: transient, milddrowsiness initially;

sedation, depression,

lethargy, apathy,fatigue,

disorientation, anger,hostility, episodes of

mania andhypomania,

restlessness, crying,delirium, slurred

speech, stupor, vividdreams.

CV: Bradycardia,tachycardia, CVcollapse,

hypertension,palpitations, edema

Integ: Urticaria,

pruritus, rash,dermatitis

EENT: Visual and

auditory

disturbances,diplopia, nystagmus,nasal congestion

Contraindicated withhypersensitivity to

benzodiazepines,



alcoholicintoxication with

depression of vitalsigns.

Use cautiously with

impaired liver or

kidney function,debilitation.

Assessment and

Drug Effects

Hypersensitivityto

benzodiazepines;



alcoholicintoxication, liver

renal impairment

Monitor addiction-prone patients

carefully becauseof theirpredisposition to

habituation anddrug dependence

Monitor liverfunction and bloodcounts

periodically inpatients on long

tern therapy.

Monitor patientfor therapeuticdrug levels: 2080 ng/mL.
http://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Central_nervous_system


17/23

BSN4A (GROUP 2) 45

GI: constipation,diarrhea, dry mouth,

nausea, anorexia,gastric disorders

GU: Incontinence,

urinary retention,changes in libido

Hema:blood

dyscrasias,agranulocytosis,

leucopenia

Other: hiccups,fever, diaphoresis,

paresthesias,gynecomastia.

Patient & Family

Education

Take drug exactlyas prescribed; do

not take drugwithout consulting

health careprovider

Avoid alcohol,sleep inducing or

over the counterdrugs

Report severedizziness,

weakness,drowsiness that

persists, rash orskin lesions,

difficulty voiding,palpitations,

swelling in theextremities.


18/23

BSN4A (GROUP 2) 46


Action

Indication Contraindication Adverse Reaction Nursing

Responsibility

Generic:

Polynerv

Brand:

Vitamin B

Complex

Classification:

Vitamins andMinerals

Dosage:

500 mg per Tablet

Frequency:

OD

Route:

Per orem

A coenzyme thatstimulate metabolic

function and isneeded for cell

replication,

hematopoiesis, andnucleoprotein and

myelin synthesis.Vitamins B1, B6and

B12 (Polynerv) oraldrops is valuable in

conditions where therequirements for B

vitamins areincreased as in

growth, physiologicstress, decreased

resistance toinfection and chronic

illnesses, metabolicdisorder sand in

certain diseases ofthe digestive tract

and nervous system.(Roth, L.S. (2010).


USA: Mosby, Inc)

Rheumaticpains,

alcoholism,cardiac

disorders, low

blood pressure.

Vitamin B complexshould not be used in

hypersensitivity toany of the vitamins

hypersensitive to

vitamin B12 orcobalt, containing in

the preparation, aswell as in patients with

2nd

or 3rd

degreearterial hypertension

CV: peripheralvascular thrombosis,

heart failure.

GI: transient

diarrhea.

Respi:pulmonaryedema.

Skin: itching,

transitoryexanthema, urticaria.

Other: anaphylaxis,

pain.

Assessment and

Drug Effects

Determinereticulocyte count,hct, Vit. B12, iron,

folate levels beforebeginning therapy.

Obtain a sensitivitytest history beforeadministration

Avoid I.V.administration

because fastersystemic

elimination willreduce

effectiveness ofvitamin.

Dont give largedoses of vitamin

B12 routinely; drug

is lost throughexcretion.

Protect Vit. B12from light. Dont

refrigerate orfreeze.

Monitor patient forhypokalemia forfirst 48 hours, asanemia correct
http://www.mims.com.ph/Page.aspx?menuid=companionhome&ID=70http://www.mims.com.ph/Page.aspx?menuid=companionhome&ID=70


19/23

BSN4A (GROUP 2) 47

itself. Givepotassium

supplements, asneeded.


20/23

BSN4A (GROUP 2) 48


Action


Responsibilities

Generic:

Diphenhydraminehydrochloride

Brand:

Benadryl

Classification:

Anticholinergic,

Antiparkinsoniandrug

Dosage:

50 mg per capsule

Frequency:

ODHS

Route:

Per orem

Competes withhistamine for H1

receptor site.Antagonizes the

effect of histamine at

H1 receptor sites;does not bind or

inactivate histamine.Prevents, but doesnt

reverse, histaminemediated responses

particularly those ofbronchial tubes, GI

tract, and bloodvessels

(Roth, L.S. (2010).Mosbys Nursing

Drug Reference, 23.USA: Mosby, Inc)

Pseudoparkinsonismdrug-induced

extrapyramidaleffects

Used to treat anxiety,tension,

sleeplessness orinvoluntary

movements due tothe side effects of

certain psychiatricdrugs

Contraindicated inpatients with

hypersensitivity todrug.

Avoid use in patientstaking MAO

inhibitors

Caution in patientswith asthma, COPD,

cardiac disease orhypertension,

glaucoma, andgastric or duodenal

ulcers

CNS: drowsiness,confusion, insomnia,

headache, vertigo,sedation, sleepiness,

nervousness,

restlessness

CV: Palpitations,hypotension,

tachycardia

EENT:blurred vision,

nasalcongestion,

tinnitus

GIT: nausea andvomiting, dry mouth,

constipation,anorexia

Urogenital: dysurea,

urine retention,urinary frequency

Hema: hemolytic

anemia,thrombocytopenia,

agranulocytosis

Assessment and

Drug Effects

When taking thesemedications, theclient needs to have

blood cells counts,renal function,

hepatic function,and blood pressure

monitored.

Assess for allergyPatient & Family

Education

Caution the clientthat themedication may

cause drowsiness,creating

difficulties orhazards or other

activities that

require alertness.

Tell the client totake themedication with

food to decreaseGI upset.

Explain to theclient that arising

quickly from a


21/23

BSN4A (GROUP 2) 49

Respi: thickening ofbronchial secretions

Skin: Urticaria,

photosensitivity,rash.

Other : anaphylacticshock

lying or sittingposition may

cause orthostatichypotension.

Explain to theclient that use of

these drugs in

warm weathermay increase thelikelihood of

heatstroke.

Report difficultyof breathing

Administer syrupform if patient is

unable to taketablets

Warn patient notto take this drugwith any other

products thatcontain

diphenhydramine(including topical

therapy) becauseof increased

adverse reactions.


22/23

BSN4A (GROUP 2) 50


Action


Responsibility

Generic:

Ascorbic Acid

Brand:

Nutri Cee

Classification:

Vitamins

DOSAGE:

500 mg in tabletform

FREQUENCY:

OD

ROUTE:

Per orem

Thechemopreventive

action of vitamin Cis attributed to two of

its functions. It is a

water-soluble chainbreaking antioxidant.

As an antioxidant, itscavenges free

radicals and reactiveoxygen molecules,

which are producedduring metabolic

pathways ofdetoxification.

It also preventsformation of

carcinogens fromprecursor

compounds.The structure of

ascorbic acid isreminiscent of

glucose, from whichit is derived in the

majority of mammals(Wolters Kluwer,

2009)

Increases protectionmechanism of the

immune system, thussupporting wound

healing. Necessary

for wound healingand resistance to

infection.

Prevention andtreatment of vitamin

C deficiency

Use of sodiumascorbate in patients

on sodium restriction

Use of calcium

ascorbate in patientsreceiving digitalis.

GI: Nausea,vomiting, heartburn,

diarrhea, orabdominal cramps

(high doses).

Hematologic: Acute

hemolytic anemia(patients with

deficiency of G6PD);sickle cell crisis.

CNS: Headache or

insomnia (highdoses).

Urogenital:Urethritis, dysuria,crystalluria,

hyperoxaluria, orhyperuricemia (high

doses).

Other: Mildsoreness at injection

site; dizziness andtemporary faintness

with rapid IVadministration.

Assessment & Drug

Effects Lab tests:

Periodic Hct &

Hgb, serum

electrolytes. Monitor for

S&S of acutehemolytic

anemia, sicklecell crisis.

Patient & Family

Education Take large dosesof vitamin C individed amounts

because the bodyuses only what is

needed at aparticular time and

excretes the rest inurine.

Megadoses caninterfere with

absorption ofvitamin B12.

Note: VitaminC increases the

absorption of ironwhen taken at the


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BSN4A (GROUP 2) 51

same time as iron-rich foods.

Documents

05 NCP - DRUG STUDY.docx