Appropriate Drug Nursing implication Nursing Why client is

dosage for 24 Classification intervention/ receiving the

hours drug and action consideration drug based on
computation related to effects of history of
drug present illness
Drug: Simvastatin Dyslipidemic What do you need to Monitor serum Hyperlipidemia
agent; HMG CoA check or do prior to transaminases and
Dosage: 30g/tab reductase drug administration CPK elevations
inhibitors
Route: NGT Check if there is Give medication with
It reduces total History of liver food if there is
Frequency: OD HS cholesterol, LDL- disease. abdominal pain
cholesterol and
triglycerides and Major side effects of Ensure safety of
increases HDL- the drug: patient due to
cholesterol blurring of vision
levels. Headache, nausea,
flatulence, heartburn, Monitor I/O to assess
abdominal pain, renal function
diarrhoea/constipatio
n, dose-related
myopathy (e.g.
myalgia, muscle
weakness and dark
urine); serum
transaminases and
CPK elevations; lens
opacities; blurring of
vision; dizziness.

Drug: Phenytoin Anti-convulsant What do you need to Continuously Control Seizure

check or do prior to monitor vital signs Activity
Dosage: 100mg Phenytoin acts as drug administration and symptoms during
1tab an anticonvulsant IV infusion and for an
Route: NGT by increasing Assess patient for the hour afterward.
efflux or ff: Cardiovascular
Frequency: TID decreasing influx disease; DM; hepatic Constant
of sodium ions impairment; observation and a
Therapeutic across cell hypoalbuminemia; cardiac monitor are
range: 10-20mg membranes in porphyria; seizures necessary with older
the motor cortex (may increase adults or patients
during frequency of petit mal with cardiac disease.
generation of seizures); debilitated Margin between
nerve impulses; patients; elderly. toxic and therapeutic
thus stabilising IV doses is relatively
 neuronal Major side effects of
membranes and the drug small.
decreasing
seizure activity. Headache, dizziness, For taking it in oral
tremor, transient forms, ORAL CARE is
nervousness, a must
insomnia, GI
disturbances, Have on hand
tenderness and oxygen, atropine,
hyperplasia of the vasopressor, assisted
gums, acne, hirsutism, ventilation, seizure
coarsening of the precaution
facial features, rashes, equipment (mouth
osteomalacia. gag, nonmetal
airway, suction
Phenytoin toxicity as apparatus).
manifested as a
syndrome of Monitor diabetics for
cerebellar, vestibular, loss of glycemic
ocular effects, notably control.
nystagmus, diplopia,
slurred speech, and Check periodically for
ataxia; also with decrease in serum
mental confusion, calcium levels.
dyskinesias,
exacerbations of Observe for
seizure frequency, symptoms of folic
hyperglycaemia. acid deficiency:
neuropathy, mental
dysfunction.

Drug: Lactulose Laxatives What do you need to Monitor serum Decrease

check or do prior to electrolytes straining thus
Dosage: 30cc Increases water drug administration periodically when helping
content and used chronically. decrease the
Route: NGT softens the stool. Assess patient for increase in ICP
abdominal distention, Monitor for increase
Lowers the pH of
Frequency: OD HS presence of bowel blood glucose levels
the colon, which in diabetic patients.
inhibits the sounds, and normal
diffusion of pattern of bowel Monitor input and
ammonia from function. output
the colon into
Assess color, Monitor patient for
the blood,
consistency, and any adverse GI
thereby reducing
amount of stool reactions, nausea,
blood ammonia vomiting, &
levels.
 produced. diarrhoea.

Assess mental status Assess patients’

(orientation, level of mental status
consciousness) before regularly
and periodically
throughout course of
therapy.

Major side effects of

the drug

Decreases blood
ammonia
concentrations by 25–
50%.

May cause increased

blood glucose levels in
diabetic patients.

May cause diarrhea

with resulting
hypokalemia and
hypernatremia.

Drug: Nifedipine Anti-Angina; What do you need to Monitor blood Hypertension

Anti- check or do prior to pressure regularly,
Dosage: 30 mg/cap hypertensives; drug administration especially in patients Vasospasm
2caps Calcium-channel who take beta
Route: NGT blockers Assess for anginal blockers or
pain, including antihypertensive
Frequency: Q4hrs Nifedipine blocks location, intensity,
the slow calcium duration, and Watch for symptoms
channels thus alleviating and of heart failure
preventing the aggravating factors.
flow of calcium Monitor potassium
ions into the cell. Assess cardiac status and liver function
It produces with BP, pulse, tests throughout the
peripheral and respiration and ECG. treatment regimen
coronary
vasodilatation, Major side effects of Monitor input and
reduces the drug output
afterload, Headache,
 peripheral palpitations, dizziness,
resistance and lethargy, pruritis, Limit caffeine. Avoid
BP, increases short-acting alcohol.
coronary blood preparations can
flow and causes result in a fall in blood Change patients’
reflex pressure and position carefully as
tachycardia. tachycardia leading to orthostatic
myocardial or hypotension can
cerebrovascular occur.
ischaemia, urticaria,
nausea, increased
urine output

Drug: Ciprofloxacin Antibiotic; What do you need to Monitor blood Increase WBC in
Fluoroquinolone check or do prior to studies and serum the CBC results
Dosage: 500mg/cap drug administration electrolytes
1cap Inhibits bacterial
Route: NGT DNA gyrase thus Assess patient for Assess bowel pattern
preventing signs and symptoms daily
Frequency: BID for 7days of infection
replication in
Monitor for bleeding
susceptible Obtain C/S before
bacteria beginning drug Monitor urine pH; it
therapy should be less than
6.8, especially in the
Assess for anaphylaxis older adult and
patients receiving
Major side effects of high dosages of
the drug ciprofloxacin, to
reduce the risk of
Administration with crystalluria.
theophylline
derivatives or caffeine Monitor I&O ratio
can cause CNS and patterns:
stimulation. Patients should be
well hydrated; assess
GI irritation (e.g., for S&S of
nausea, diarrhea, crystalluria.
vomiting, abdominal
discomfort) in clients Report tendon
receiving high dosages inflammation or pain.
and in older adults. Cipro needs to be
discontinued.
Crystalluria
Assess for S&S of
superinfections
Drug: Mannitol Osmotic diuretic What do you need to Observe injection Increase
check or do prior to site for signs of Intracranial
Dosage: 200cc Mannitol drug administration inflammation or pressure
increases urinary edema
Route: IV output by Assess for adequate
renal function and Watch for and
inhibiting tubular
Frequency: Q4hrs urine flow prior to correct electrolyte
reabsorption of administration. disturbances; adjust
water and dose to avoid
electrolytes. It Major side effects of dehydration.
raises the the drug
osmotic pressure Measure I&O
of the plasma Fluid and electrolyte accurately and
imbalance; acidosis record to achieve
allowing water to
(with high doses). proper fluid balance
be drawn out of tachycardia, chest
body tissues. pain; blurred vision; Monitor vital signs
hypotension or closely. Report
hypertension; Renal significant changes in
dysfunction BP and signs of CHF

Drug: Ketorolac Non-Opioid What do you need to Be aware that patient Pain
Analgesics; check or do prior to may be at risk for CV
Dosage: 30mg NSAIDs drug administration events, GI bleeding,
and renal toxicity.
Route: IV Ketorolac inhibits History- renal
prostaglandin Monitor accordingly.
impairment, impaired
Frequency: Q8hrs synthesis by the hearing, allergies, Administer every
decreasing the
hepatic, lactation, 8hrs. to maintain
activity of the
cyclooxygenase pregnancy serum levels and
enzyme control pain.
Physical- skin color,
lesions, orientation, Control environment
reflexes, peripheral (lighting,
sensation, clotting temperature) if
times, CBC, sweating or CNS
effects occur.
adventitious breath
sounds
Monitor patient. If
Assess pain (note
rash, itching, visual
type, location, and
disturbances,
intensity) prior to and
tinnitus, weight gain,
1-2 hr following
edema, black stools,
administration.
persistent headche,
Major side effects of or influenza-like
 the drug syndromes
(chills,fever,muscles
Rash, headache, aches, pain) occur,
dizziness, drowsiness,
discontinue the
ringing in the ears,
medication.
abdominal pain,
heartburn, fluid
retention, ulcers,
bleeding in the
stomach & intestines.

Drug: Nimodipine Calcium Channel What do you need to Monitor blood Hypertension
Blockers check or do prior to pressure regularly,
drug administration especially in patients
Nimodipine who take beta
inhibits inflow of Take apical pulse and blockers or
calcium ions into hold if it is below 60. antihypertensive
cells by blocking Notify the physician
calcium channels Watch for symptoms
or select voltage- Establish baseline of heart failure
sensitive areas date before treatment
resulting in is started Monitor potassium
relaxation of and liver function
vascular smooth Major side effects of tests throughout the
muscle. the drug treatment regimen

Hypotension, Monitor input and

dizziness, output
lightheadedness
Change patients’
position carefully as
orthostatic
hypotension can
occur.
Drug: Metoprolol Beta-Blockers What do you need to Observe Hypertension
check or do prior to hypertensive patients
Since the drug administration with CHF closely for
sympathetic
impending heart
nervous system is Take apical pulse and
responsible for BP before failure.
increasing the administering the
Monitor BP, HR, &
rate with which drug.
the heart beats, ECG during the
by blocking the Major side effects of administration of the
action of these the drug drugs
nerves
metoprolol Arterial insufficiency; Monitor I&O, daily
 reduces the heart Dizziness, syncope, weight, auscultate
rate and is useful palpitations, chest daily for pulmonary
in treating high pain rales.
blood pressure
Drug: Kalium Durule Electrolyte What do you need to Watch out for levels Decreased
check or do prior to of potassium Potassium
Supplemental drug administration serum levels
potassium in the electrolyte level and
form of high correct if there is
Assess renal function K+= 2.5mEQ/L
potassium food or abnormalities noted.
potassium chloride and serum electrolyte
may be able to particular potassium
Monitor input and
restore normal level
output accurately
potassium levels.
Assess for any cardiac
problems

Major side effects of

the drug

Hyperkalemia: Renal
Insufficiency

Drug: Telmisartan Angiotensin What do you need to To minimize dizziness Hypertension

Receptor check or do prior to and lightheadedness,
Blockers (ARBs) drug administration get up slowly when
rising from a seated
Exerts History- kidney or lying position
antihypertensive disease, liver disease,
activity by high blood levels of
preventing potassium, heart
angiotensin II problems, severe
from binding to dehydration
AT1 receptors (and loss of
thus inhibiting electrolytes
the such as sodium),
vasoconstriction diabetes (poorly
and aldosterone- controlled), any
secreting effects allergies
of angiotensin II.
Major side effects of
the drug

This drug may make

you dizzy

Drug: Silver Topical What do you need to Monitor for any skin Development of
Sulfadiazine Antibiotic check or do prior to reactions. pressure ulcer
 drug administration stage 1-2 due to
Has a broad prolonged
antimicrobial Assess skin- color, sitting and lying
activity; The characteristics on bed
silver salt acts
mainly on the cell Major side effects of
wall and the drug
membrane to
disrupt its Burning or stinging
intergrity thus sensation and
allowing it to irritation
impair the
essential
enzymes,
bacterial DNA
and RNA leading
to cell death.
Drug: Metoclopramide Dopaminergic- What do you need to Monitor BP carefully Reduce the
blocking agent check or do prior to vomiting
drug administration Monitor for any episodes of the
Metoclopramide adverse effects patient
enhances the Assess physical
motility of the orientation, reflexes,
upper GI tract affect, pulse, BP,
and increases bowel sounds, normal
gastric emptying output, and EEG.
without affecting
gastric, biliary or Major side effects of
pancreatic the drug
secretions
properties. Drowsiness, dizziness,
restlessness; GI
irritations

Drug: Diazepam Benzodiazepine What do you need to Do not administer Anxiety

check or do prior to intra-arterially; may
It increases drug administration produce
neuronal arteriospasm,
membrane Assess hematopoetic, gangrene.
permeability to hepatic, and renal
chloride ions by functions Change from IV
binding to therapy to oral
stereospecific Assess cardiovascular therapy as soon as
benzodiazepine condition. Get a possible.
receptors on the normal baseline data
postsynaptic first. Do not use small
GABA neuron veins (dorsum of
within the CNS Major side effects of hand or wrist) for IV
and enhancing the drug injection.
the GABA
inhibitory effects drowsiness, Carefully monitor P,
resulting in fatigue, and ataxia BP, respiration during
hyperpolarisation (loss of balance). IV administration.
and stabilisation.
Monitor EEG in
patients treated for
status epilepticus;
seizures may recur
after initial control,
presumably because
of short duration of
drug effect.

Monitor liver and

kidney function, CBC
during long-term
therapy.