HTN Drugs&Ncp

8/8/2019 HTN Drugs&Ncp

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UNIVERSITY OF PERPETUAL HELP SYTEM-ISABELA CAMPUS

MINANTE UNO, CAUAYAN CITY, ISABELA

DRUG STUDY

DRUG NAME INDICATIONS ACTIONS CONTRAINDICATIONS SIDE EFFECTS NURSINGRESPONSIBILITIES

AMLODIPINE 10mgtab 1 tab OD (Hold if

BP120/80)

Management ofhypertension, angina

pectoris.

Inhibits calcium ioninflux across cardiac and

smooth muscle cells,thus decrease

myocardial contractilityand Oxygen demands;

also dilates coronaryarteries and inferiors.

-Contraindicated in patientshypersensitive to drugs.

-Use cautiously in patients

receiving other peripheralvasodilators, especially

those with severe aorticstenosis, and in those with

heart failure. Because drug

is metabolized by the liver,use cautiously and inreduced dosage in patients

with severe hepatic disease.

CNS: headache,somnolence, fatigue,

dizziness, lightheadacheness,

paresthesiaCV: edema, flushing,

palpitationsGI: nausea, abdominal

pain

GU: sexual difficultiesMUSCULO: muscle

pain

RESP: dyspneaSKIN: rash, pruritis

-ALERT: Monitorpatient carefully. Some

patient especially thosewith severe obstructive

coronary artery diseasehave developed increase

deficiency, duration orseverity of angina or

acute MI after initiation

of calcium channelblockers therapy or attime of dosage increase.


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DRUG NAME INDICATIONS ACTIONS CONTRAINDICATIONS SIDE EFFECTS NURSING

RESPONSIBILITIES

METRONIDAZOLE500mg 1 tab, 1 tab TID

Prevention of post-opinfections due to

anaerobic bacteria

particularlyBacteroidessp & anaerobic Strep.Treatment of

septicaemia,bacteraemia,peritonitis,brain abscess,

necrotising pneumonia,osteomyelitis, puerperal

sepsis, pelvic abscess &cellulitis, & post-op

wound infections.Urogenital

trichomoniasis in thefemale (trichomonal

vaginitis) & in male.Bacterial vaginosis,

amoebiasis, giardiasis,acute ulcerative

gingivitis, leg ulcers &pressure sores. Dental

infections (eg acutepericoronitis & acute

apical infections).

Bactericidal: InhibitsDNA synthesis in

specific (obligate)

anaerobes, causing celldeath; antiprotozoal-trichomonacidal,

amebicidal: Biochemicalmechanism of action isnot known.

If administered for >10days, regular clinical & lab

monitoring are

recommended. Re-administer immediatelyafter haemodialysis. Patient

w/ hepatic encephalopathy.May affect ability to driveor operate machinery.

Pregnancy & lactation.

Dizziness, headache,diarrhea, nausea,

stomach pain, change in

taste sensation ordrymouth may occur. Ifthese effects persist or

worsen, contact yourdoctor. Unlikely butreport: seizures, loss of

consciousness, tinglingof hands or feet. Very

unlikely but report:unsteadiness,

mood/mental changes,rash, itching, sore throat,

fever, severe stomachpain, vomiting, vaginal

irritation.

-History: CNS orhepatic disease;

candidiasis

(moniliasis); blooddyscrasias;

pregnancy; lactation-Physical: Reflexes,

affect; skin lesions,color (with topical

application);abdominal exam,

liver palpation;urinalysis, CBC, liver

function tests
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RESPONSIBILITIES

CLONIDINE DRIP:

90cc D5W + 1 ampclonidine in solucet x

15ugtts/min increment5ugtts/min every 1 hour

if BP-140/90

Management of mild

moderate hypertension

Stimulates alpha-

adrenergic receptors inthe CNS which results in

decrease sympatheticoutflow inhibiting

cardio-acceleration andvasoconstriction.

-Contraindicated in patients

hypersensitive to drug.

-Transdermal form iscontraindicated patients

hypersensitive to anycomponent of the adhesive

layer of transdermalsystem.

-Epidural form is

contraindicated in patientsreceiving anticoagulant

therapy, in those with aninjection site infection, and

in those who arehemodynamically unstable

or have severe CV disease.

-Use cautiously in patientswith severe coronary

insufficiency, conductiondisturbances, recent MI,

cerebro vascular disease,chronic renal failure, or

impaired liver function.

CNS: drowsiness,

depression, dizziness,nervousness, nightmares

CV: bradycardia,hypotension,

palpitationsGI: dry mouth,

constipation, nausea,vomiting.

GU: erectile dysfunction

-Assess I&O ratio and

daily weight and assessfor edema daily,

especially throughout thebeginning.

-Monitor BP and Pulsefrequently.

-During initial dosageadjustment and

periodically throughouttherapy

-Assess pain location,intensity

-Monitor for fever aspotential signs of

catheter infections.


4/11




RESPONSIBILITIES

SULTAMICILLIN 750

mg tab TID PO

Upper and lower

respiratory tractinfections, UTI and

pyelonephritis; skin andsoft tissue and

gonococcal infections.

-an injectable

antibacterialcombination consisting

of the semisyntheticantibiotic ampicillin

sodium and the beta-lactamase inhibitor

sulbactam sodium forintravenous and

intramuscularadministration

-History of allergic

reaction to any penicillins.

GI disturbances,

phlebitis, skin rashes,itching, blood disorders,

anaphylaxis andsuperinfection.

-Before giving drug, ask

patient about sllergicreactions to penicillin

although a negativehistory of penicillin

allergy is no guaranteeagainst future allergic

reaction. Also obtainspecimen for culture and

sensitivity tests. Therapymay begin pending

results.

-Dosage is expressed astotal drug. Each 1.5-g

vial contains 1 gampicillin sodium and

0.5 g sulbactam sodium.

-In patients withimpaired renal function,

decrease dosage.

-for IM injection,reconstitute with sterile

water for injection or0.5% or 2% lidocaine

hydrochloride injection.


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Add 3.2 ml to a 1.5-gvial (or 6.4 ml to a 3-g

vial) to yield aconcentration of 375

mg/ml. give deep intomuscle.

-In children, dont useIM route.

-Monitor liver functiontest results during

therapy, especially inpatients with impaired

liver function.-if large doses are given

or if therapy isprolonged, bacterial or

fungal superinfectionmay occur, especially in

elderly, debilitated, orimmunosuppressed

patients.


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RESPONSIBILITIES

TRANEXAMIC ACID500mg 1 cap BID Hemorrhage or risk ofhemorrhage in increase

fibrinolysis orfibrogenolysis.

-At low concentration,tramexamic acid, which

binds to the kringledomain of plasminogen,

is a competetiveinhibitor of plasminogen

activation intoplasmin(fibrinolysin), an

enzyme that degradesfibrinclots, fibrinogen,

and procoagulant plasmaproteins such as factor V

and factor VIII. Athigher concentrations it

is a noncompetetiveinhibitor of plasmin. It

binds to the strong andweak receptor sites of

plasminogen withaffnities about 10 times

greater thanaminocaproic acid.

-Inhibits cell wall

synthesis duringbacterial multiplication

Thromboembolic disease. Nausea, vomiting,diarrhea, disturbances in

color vision.

-tranexamic acid has asmilar mechanism of

action to aminocaproicacid, but is

approximately 10 timesmore potent in vitro

-prolonged use carries a

risk of thrombosis inpatients who have an

underlyingprothrombotic state

-contraindicated in

patients withdisseminated

intravascular coagulationwithout concomitant

heparin therapy

-tranexamic acid shouldbe avoided in patients

with acquireddisturbances in colour

vision; ophthalmic examis recommended before

and during therapy if
http://en.citizendium.org/wiki?title=Plasmin&action=edit&redlink=1http://en.citizendium.org/wiki?title=Plasmin&action=edit&redlink=1http://en.citizendium.org/wiki/Enzymehttp://en.citizendium.org/wiki?title=Fibrin&action=edit&redlink=1http://en.citizendium.org/wiki?title=Fibrin&action=edit&redlink=1http://en.citizendium.org/wiki?title=Factor_V&action=edit&redlink=1http://en.citizendium.org/wiki?title=Factor_VIII&action=edit&redlink=1http://en.citizendium.org/wiki?title=Aminocaproic_acid&action=edit&redlink=1http://en.citizendium.org/wiki?title=Plasmin&action=edit&redlink=1http://en.citizendium.org/wiki/Enzymehttp://en.citizendium.org/wiki?title=Fibrin&action=edit&redlink=1http://en.citizendium.org/wiki?title=Factor_V&action=edit&redlink=1http://en.citizendium.org/wiki?title=Factor_VIII&action=edit&redlink=1http://en.citizendium.org/wiki?title=Aminocaproic_acid&action=edit&redlink=1


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patient is treated beyond

several days

-primarily eliminated asunchanged drug (>90%)

in urine

-use with caution in

patients with renalinsufficiency,

cardiovascular orcerebrovascular disease

-not indicated in

hematuria caused bydiseases of the renal

parenchyma


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Received, sitting on chair with ongoing IVF of D5W L x KVO @ 100cc level, inserted at right arm, infusing well.

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective:

Barado ang ilong ko,hindi ako makahingaas

verbalized by the patient.

Objective:

-alterations in depthbreathing

-cyanosis

-weak looking

-RR-21

Ineffective breathingpattern related to

presence of nasal pack asmanifested mouth

breathing.

After 1 hour of nursingintervention, the patient

will be able to establishan effective respiratory

pattern as evidenced byabsence of cyanosis.

-Established rapport tothe patient and

significant other.

-Encouragedslower/deeper

respirations, use ofpursed-lip-technique.

-Have client to breathe

into a paper bag, ifappropriate.

-Assisted client in the

use of relaxationtechniques.

-Encouraged position of

comfort.

-Discussed relationshipof smoking to respiratory

function.

-To build trust and gaincooperation.

-To assist client intaking control of the

situation.

-To correct

hyperventilation.

-To lessen anxiety.

-To facilitate ventilation.

-Provide information topossible disease acquired

and complications.

After 1 hour of nursingintervention, the patient

was able to establish aneffective respiratory

pattern as evidenced byabsence of cyanosis.


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Received, lying on bed with ongoing IVF of D5W L x KVO @ 440cc level, inserted at right arm, infusing well.

ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION

Subjective:

Iiwas na ako sa pag-inom as verbalized by

the patient.

Objective:

-willingness to cooperate

-weak looking

-verbalization of

readiness for progress.

Readiness for enhanced

therapeutic regimenmanagement related to

willingness to promotewellness as manifested

by cooperation ininterventions.

After 2 hours of nursing

intervention, the patientwill be able to assume

responsibility formanaging treatment

regimen.

-Established rapport to

the patient and toSignificant Other.

-Identify steps necessary

to reach desired healthgoals.

-Advised to lessen/avoid

vices such as smokingand drinking liquor.

-Accept patients

evaluation of ownstrengths/limitations

while working togetherto improve abilities.

-Acknowledge individual

efforts/capabilities toreinforce movement

toward attainment ofdesired outcomes.

-Identify additional

community resources/

-To build trust and gain

cooperation ininterventions to be done.

-It enhances commitment

and the likelihood ofachieving the goals.

-To prevent for further

complications ofrespiratory function.

-To promote sense of

self-esteem andconfidence to continue

efforts.

-It provides positive

reinforcementencouraging continued

progress toward desiredgoals.

-Provide further

opportunities for role

After 2 hours of nursing

intervention, the patientwas able to assume

responsibility formanaging treatment

regimen.


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support groups. modeling, skill training,etc.

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