Name/Generic Action Indications Dosage Adverse Nursing

Name effects/Side effects Responsibility

Lactulose Causes an influx of Constipation, PO Constipation Initia Diarrhoea (dose- • Assess

fluid in the intestinal Salmonellosis. l: 10-20 g (15-30 related), nausea, patient’s
tract by increasing the Treatment of mL)/day. Max: 45 mL vomiting, condition
osmotic pressure hepatic (or 40 g of the hypokalaemia, before therapy
within the intestinal encephalophatty reconstituted oral bloating and and reassess
lumen. Bacterial formulation)/day.Hep abdominal cramps. regularly
metabolism of the atic Potentially therafter to
drug to lactate and encephalopathy 60- Fatal: Dehydration monitor drug’s
other acids which are 100 g (90-150 and effectiveness.
only partially mL)/day in 3 divided hypernatraemia on Identify cause
absorbed in the distal doses; adjust aggressive of constipation
ileum and colon accordingly. Rectal H treatment. • For patient
augments the osmotic epatic with hepatic
effect of lactulose. encephalopathy Mix encephalopath
The distention of the 200 g (300 mL w/ y, regularly
colon due to increased 700 mL water or assess mental
fluid enhances 0.9% NaCl as a condition(cleari
intestinal motility and retention enema. ng of
secretion. These result Retain enema for 30- confusion,
to the passage of soft 60 mins; repeat 4-6 lethargy,
stools. Decrease in hrly until oral restlessness,
the luminal pH further medication can be irritability)
increase motility and administered. • Monitor for
secretion. Lactulose possible
also lowers intestinal adverse GI
absorption of reaction
ammonia presumably • Monitor fluid
due to increased and electrolyte
utilization of ammonia status
by intestinal bacteria • Advice patient
to dilute drug
with juice or
water or take
with food to
improve taste
• Teach patient
 that normal
bowel
movements do
not always
occur daily

Acetylcysteine Decreases viscosity of Treatment of Oral Adult 600 mg Nausea, vomiting • Assess patients
respiratory tract respiratory daily (preferably in and other GI history of
Fluimucil secretions and affections the evening) or 200 symptoms, underlying
promote their removal characterized by mg bid- generalized condition
by breaking disulfide thick and viscous tid. Childn 100 mg urticaria
bonds. In hypersecretions: bid-qid according to accompanied by • Assess patients
acetaminophen acute and chronic age. Dissolve the tab mild fever, respiration and
overdose, it protects bronchitis and its or content of sachet hypotension, pulmonary
the liver from injury exacerbation, in a glass of water wheezing, secretions,
by restoring pulmonary (75 mL). Inhalation dyspnea, and exercise
glutathione levels emphysema, soln Nebulize 1 amp stomatitis caution on
mucoviscidosis 1-2 times daily for patients w/
and bronchiectasis ≥5-10 days. IM inj 1 respiratory
amp 1-2 times insufficiency
daily. Small childn ½ and history of
adult dose. IV Adult 1 bronchospasm
amp bid up to 2-3
amp bid-tid.Childn 1- • Instruct patient
1½ amp bid-tid. It is to follow
recommended to direction
dilute IV inj w/ 0.9% exactly
NaCl soln or a 5%
glucose soln. • Teach patient
how to use and
clean nebulizer

• Advice patient
to avoid
smoking
Laboratory Result

RBC: Segmenters - 0.34

Lymphocytes – 0.61

Monocytes – 0.04
Eosinophils – 0.01

RBC – 1.81

Hemoglobin – 5.50

Hematocrit – 0.17

MCV – 92.8

MCHC – 32.7

Platelet – 7

WBC – 3.33