Mount Saint Joseph University

School of Health Sciences, Department of Nursing

514 Gardner/Clephane

MEDICATION ADMINISTRATION SHEET

Generic and Product name of the drug _______Lorazepam ___/___Ativan______________________
Classification & sub-classification (if applicable) of the drug _______Anxiolytic_____/______sedative-hypnotic,
benzodiazephine ________

Normal dose range specific for indication and patient population:

Child:PO/IV0.05mg/kgq48h

(max:2mg/dose)

PEDS: Safe dose range calculation for your patients weight in Kg (show work)

mg
______
kg/day

mg
_____ =
dose

22.8 kg
_______
1

0.05 mg
_______
1

1 day
______
6 dose

= 1.14 mg/dose

Is the ordered dose on MAR safe for patient per dose (yes/no)?

= 0.19 mg/dose

YES

Is the ordered dose on MAR safe for patient per daily (24hr) total (yes/no)?

YES

1. What are the patient specific indications and uses

of this medication?

Management of anxiety disorders and for short-term relief

of anxiety symptoms. Preanesthetic medication to produce
sedation, reduce anxiety, and recall of events related to
surgery, can also be used for status epilepticus.
This patient is receiving this drug for relaxation and anxiety
for eye examinations.

2. What is the action of this medication in the body?

How would you evaluate its effectiveness?

Mediated by the inhibitory neurotransmitter GABA. Takes

action in the thalamic, hypothalamic, and limbic levels of
CNS.
You can evaluate the effectiveness by monitoring behavior.

3. What are the major side effects/adverse effects of

this medication?

Adverse effects: drowsiness, sedation, weakness,

disorientation, depression, sleep disturbance, restlessness,
blurred vision, depressed hearing, nausea, vomiting, and
abdominal discomfort.

4. What are the important nursing considerations

IM or IV injection of 2-4 mg is followed by

Mount Saint Joseph University

School of Health Sciences, Department of Nursing
related to administering this medication?

5. Are there any other special considerations related

to administering this medication based on the
patient population? (i.e. if giving an IM injection to a
newborn, what size needle is needed. If giving a
medication to a pediatric patient, how will it be
given?)

Source: Wilson,

514 Gardner/Clephane
drowsiness/sleepiness that permits patient to respond to
simple instructions
Supervise ambulation and patient who exhibits depression
with anxiety
Monitor CBC and LFTs

Drug Interactions: Alcohol, cimetidine, levodopa, phenytoin,

Kava, valerian

B. A., Shannon, M. T., & Shields, K. M. (2015). Pearson nurses drug

guide 2015. Upper Saddle River, NJ: Pearson Education.