CARE PLAN MED LIST 2023

Student: Client Initials: Date: 2023 MEDICATION LIST Generic and trade name: Classification For this patient: Dose and route: Recommended range Pharmacologic action: How does it work Reason this patient is getting this drug Common Side effects Life Threatening Side Effects Contra- indications Labs that must be monitored regularly Nursing Considerations, Pre and Post Assessments for this patient and this drug Cranberry Juice Powder Cranberry Herbal/Diet Supplement (Drugs.com) 425 mg capsule 2 caps PO (850 mg) TID @ 0800 , 1200, 1800 Range: 200- 8000 mg/day Prevents bacteria from sticking to cells that line the bladder, large doses may lower urine pH, making it acidic so that it is harder for bacteria to grow. Helps prevent urinary tract infections Common: Stomach upset or diarrhea with large doses Life Threatening: Anaphylaxis Allergy to cranberry. Caution with diabetes, liver disease, or hx of kidney stones Labs : None Assess for urinary frequency, dysuria, hematuria Vitamin E / Aquasol E Vitamin E, fat soluble vitamin (Skidmore-Roth, 2016. pp 1213- 1214) 400 unit capsule 1 cap PO QD @ 0800 400 units/day for pt with heart disease Range: 50-1000 units for adults Antioxidant, helps prevent damage to the body’s cells, needed for digestion of fats (polyunsaturated); decreases blood clot formation by decreasing platelets ability to stick together. Prevent blood clots, decreases edema Common: None High doses: nausea, diarrhea, stomach cramps, fatigue, headache, blurred vision, and bleeding Life Threatening: None identified IV use in infants Labs : None Assess and evaluate Edema Sennosides (OTC) Senna Plus Laxative- stimulant (Skidmore-Roth, 2016) 8.5-50 mg 1 tab PO QHS @ 2000 Range: 2-4 tabs daily in divided doses Acts on the nerves, specifically the Auerbach’s plexus, in the intestine to make the muscles contract, which helps move feces through the intestine. Also softens feces by increasing water and electrolytes in the intestine. Constipation, prevention of dry, hard stools Nausea, abdominal cramps, diarrhea Hypersensitivity, fecal impaction, N & V Labs : Electrolytes Assess for cramping, rectal bleeding, N & V, last BM Urine and feces may turn yellow-brown to red Assess Labs for electrolyte imbalance due to the movement of water and electrolytes to the

Student: Client Initials: Date: 2023 intestine Labs: NA+ 135-145 mEq/L K+ 3.5-5 mEq/L Cl- 97-107 mEq/L CO2 22-26 mmol/L Ca 8.2-11.2 mg/dL Agap 8-16mEq/L (Van Leeuwen, Poelhuis-Leth, Bladh, 2011) Multivitamin Many brands: One A Day, MultiVit Vitamin, dietary supplement (Skidmore-Roth, 2016) 1 tab PO QD @ 0800 Range: depends on brand Provides extra vitamins and minerals that may be missing from diet. Dietary supplement Common: None known at recommended doses Life Threatening: None known at recommended doses Hypersensitivity, conditions where ingredients are contraindicated Labs : none Assess nutritional status Potassium chloride Klor-Con, Epiklor, K-Tab, Micro-K, Electrolyte, mineral replacement (Skidmore-Roth, 2016. pp 937- 938) 10 mEq 1 cap PO QD @ 0800 Range: 20 mEq/ day in 1-2 divided doses Potassium is needed for normal muscle function, especially the heart. It is also needed for the communication of messages by your nerves. Potassium is found inside the cells of your body, and help to keep them healthy by maintaining ion balance. Potassium replacement due to use of diuretic (furosemide), prevention of hypokalemia Common: N & V, cramps, diarrhea Life Threatening: Cardiac depression, dysrhythmias, cardiac arrest, peaking T waves, lowered R waves, depressed RST waves, prolonged P-R interval, widened QRS complex Renal disease, hemolytic disease, Addison’s disease, hyperkalemia, acute dehydration, extensive tissue breakdown Labs : Potassium DO NOT break, crush or chew Assess hyperkalemia: fatigue, muscle weakness, confusion, dyspnea, palpitations, EKG Check I & O, (decreased urinary output) Cardiac: rate & rhythm Avoid antacids and salt substitutes Assess potassium

Student: Client Initials: Date: 2023 levels Labs: K+ 3.5-5 mEq/L (Van Leeuwen, et al., 2011) Atenolol Tenormin Antihypertensive Antianginal Beta blocker (Skidmore-Roth, 2016. pp 97-99) 50 mg tab 25 mg tab 1 tab (each dose) PO QD @ 0800 (total dose of 75 mg PO QD) Range: 20-50 mg/day, may increase to 100 mg/day for HTN, max 200 mg/day for angina It blocks some of the chemical, Beta 1 , in the heart muscle that causes increased heart rate and contraction. By blocking some of this chemical, the heart does not contract as hard, causing a decrease in blood pressure. It also slows down the rate that your heart pumps. To control hypertension Common: Insomnia, fatigue, dizziness, mental changes, cold extremities, postural hypotension, 2 nd - 3 rd degree heart block, nausea, diarrhea Life Threatening: Profound hypotension, bradycardia, CHF, mesenteric arterial thrombosis (GI), ischemic colitis, agranulocytosis, thrombocytopenia purpura, bronchospasm Hypersensitivity, cardiogenic shock, pregnancy, heart block, sinus bradycardia, cardiac failure Labs : Increases BUN, potassium, triglycerides, uric acid, platelets, alkaline phosphatase, creatinine, LDH, AST/ALT. Decreases glucose. Do not stop abruptly, taper over 2 wks Assess I & O, weight, CHF, JVD, edema Assess BP, rate, rhythm, Apical and Radial Pulse before admin, notify prescriber if less than 50 bpm. Baseline renal and hepatic studies should be taken to assess liver and kidney function. Labs: BUN 8-21 mg/dL Creatinine 0.5-1.1 mg/dL Albumin 3.2-4.6 g/dL AST 10-35 units/L ALT 7-35 units/L Total Bilirubin 0.3-1.2 mg/dL Delta Bilirubin < 0.2 mg/dL ALPI 46-116 units/L K+ 3.5-5.0 mEq/L Uric Acid 250-750 mg/24 hrs

Student: Client Initials: Date: 2023 (Van Leeuwen, et al., 2011) Overdose treatment: Lavage, IV atropine for bradycardia, IV theophylline for bronchospasms, dextrose for hypoglycemia, digoxin, Oxygen, diuretic for cardiac failure, hemodialysis. Acetaminophen Tylenol Nonopioid analgesic, antipyretic (Skidmore-Roth, 2016. pp 9-11) 500 mg tab 2 tabs (1000 mg), PO QID @ 0500, 1200,1800,0000 Range: 325 – 650 mg q 4-6 hrs. Max dose 4 g/day Onset: 10-30 minutes Peak: ½ - 2 hours Duration: 4-6 hours Blocks the pain messages that are sent by your nerves in response to an injury or swelling, so they do not reach your brain by stopping the body from making prostaglandins, a fatty acid that is responsible for causing pain and inflammation. Stopping this fatty acid also reduces fever. Hip pain, Pain from RA Common: None Life Threatening: Hepatotoxicity, hepatic seizure (OD), GI bleed, renal failure (high doses), leukopenia, neutropenia, hemolytic anemia (long-term use), thrombocytopenia, pancytopenia, cyanosis, anemia, jaundice, pancytopenia, CNS stimulation, delirium followed by vascular collapse, coma, seizures, death Hypersensitivity Labs : Increases LFT’s, potassium, bilirubin, LDH, and pro-time. Decreases Hgb, Hct, albumin, magnesium, phosphate. Assess I & O ratio, decreased output may signify renal failure Hepatotoxicity: dark urine, clay colored stools, jaundice, abd pain, diarrhea Assess Hip pain Assess chronic OD: bleeding, bruising, malaise, fever, sore throat Assess renal and hepatic studies, drug is metabolized by the liver and excreted by kidneys. Hepatotoxicity and renal toxicity can occur with long term therapy. CBC and PT should be monitored with long term use.

Student: Client Initials: Date: 2023 Labs : WBC 4.5-11.0 RBC 3.7-5.3 HGB 11.7-16.1 g/dL HCT 34-46 % Platelets 150,000- 450,000/mm 2 MCV 78-98 MCH 26-34 MCHC 32-36 RDW 11.6-14.8 BUN 8-21 mg/dL Creatinine 0.5-1.1 mg/dL Albumin 3.2-4.6 g/dL AST 10-35 units/L ALT 7-35 units/L Total Bilirubin 0.3-1.2 mg/dL Delta Bilirubin < 0.2 mg/dL (Van Leeuwen, et al., 2011) Overdose treatment: gastric lavage, activated charcoal. Admin oral acetylcysteine to prevent liver damage. Monitor bleeding. Allopurinol Aloprim, Zyloprim Antigout, antihyper- uricemic 100 mg tab 1 tab PO QD @ 0800 Range: 100 mg/day, may increase weekly up to 800 Helps to prevent your body from making uric acid, specifically by interfering with the enzyme xanthine oxidase. Too much uric acid can lead to gout. Methotrexate, levodopa and furosemide decreases uric acid excretory transport, to prevent gout or uric acid build up in Common: N & V, malaise Life Threatening: none listed Hypersensitivity Labs : Order before treatment and periodically throughout: Uric Acid, CBC, BUN, AST, Creatinine. Assess sx of gout or kidney stones Assess I & O ratio (increase fluids to prevent stones and toxicity) (avoid alcohol and