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Medical Managemen Hodgskin - S
Medical Managemen Hodgskin - S
Doctors Order Please admit to ICU under the service of Dr. Gonzales Secure Consent for admission and management TPR q shift and record Diet: DAT IVF, PNSS 1L x 120cc/hr Laboratory: CBC w/ Platelet count, Na, K, CREA, BUN, Hgt, LDH
Rationale
To start hydration
To aid in diagnosing and determine possible brain mets Cardiovascular drug For frank seizures For pain relief Anti-emetic To lower uric acid NSAIDs Proton pump inhibitors Vitamin supplement For anemia
Medications: Neuquinon 1 TAB OD Diazepam 5mg IV PRN Dolcet tab, 1 TAB TID PRN Plasil 1 amp q 8 PRN Alopurinol 100mg 1 TAB 2x/day Prednisone 10mg 1 tab BID Omeprazole 40mg 1 TAB OD Ascorbic Acid 1 TAB OD FeSO4 325mg 1 TAB TID
Monitor UO q shift & record Monitor VS q1 and record Complete patients database Dr. Gonzales informed of this admission Refer Accordingly May transfer patient to private room
Shift procedure to hydrocortisone 100mg IV q 8 5:33pm Start Keppra 500mg tab OD For cranial MRI w/ gadolinium contrast Continue present management AP Updated Cetrizine 10mg 1 TAB now Continue Meds Discontinue Alopurinol Anti-convulsant
7:15pm
DIAGNOSTIC EXAMS
12/06/13 1:31pm
Result 107 gm/L 0.36 gm/L 4.51 x10^12/1 7.78 x10^9/1 0.86 x10^9/1
Interpretation
0.50-0.70 0.09 x10^9/1 0.20-0.40 0-0.05 0-0.01 80-98 23.7pg 26-32 293 g/L 320-360 150-400
Lymphocytes
MCHC
Platelet Count
569 x10/L
Lab
12/06/13
DRUG STUDY
MECHANISM OF ACTION Inhibits lipid peroxidation by preventing the production of lipid peroxyl radicals
NURSING INTERVENTION Take after meals Instruct patient to report for worsening symptoms.
DOSAGE: 1 TAB OD
ROUTE: Oral
DRUG
MECHANISM OF ACTION GENERIC NAME: Enhances the Diazepam effect of the neurotransmitter GABA by binding BRAND NAME: to the Anxiol benzodiazepine site on the GABA leading to CNS CLASSIFICATION: depression Benzodiazepines
ROUTE: IV
DRUG
MECHANISM OF ACTION GENERIC NAME: Binds to mu opioid Tramadol HCl receptors and inhibits the reuptake of BRAND NAME: norepinephrine Dolcet and serotonin causes many effects similar to CLASSIFICATION: the opioids. Analgesics
CONTRAINDICATION SIDE EFFECTS Contraindicated with Sedation allergy to tramadol or Dizziness opioids Hypotension Bradycardia
NURSING INTERVENTION Explain to the patient that they may feel dizzy Report for severing symptoms
ROUTE: Oral
DRUG
MECHANISM OF INDICATION ACTION GENERIC NAME: Stimulates motility Vomitting Metoclopromide of upper GI tract without stimulating gastric, biliary or BRAND NAME: pancreatic Plasil secretions. And increase lower esophageal CLASSIFICATION: sphincter pressure Anti-emetics
ROUTE: IV
MECHANISM OF ACTION Prevents the production of uric acid by blocking the activity of the enzyme that convert purines to uric acid
INDICATION Management of patients with leukemia, lymphoma and malignancies who are receiving cancer therapy which causes elevations of serum and urinary uric acid levels
CONTRAINDICATION SIDE EFFECTS Drug allergy Skin rash and itching nausea, diarrhea
NURSING INTERVENTION Administer drug after meals Promote increased fluid intake Check urine alkalinity
CLASSIFICATION:
ROUTE: Oral
BRAND NAME:
MECHANISM OF ACTION Prevents the release of substances in the body that cause inflammation and suppresses the immune system.
INDICATION Allergic disorders Skin conditions Ulcerative colitis Arthritis Lupos Psoriasis Breathing disorders
CONTRAINDICATION SIDE EFFECTS Drug allergy Increased Fungal infection appetite preset Gradual weight gain Insomia
NURSING INTERVENTION Take drug with food Do not crush chew or break a delayed release tablet. Swallow it whole.
CLASSIFICATION: NSAIDs
ROUTE: Oral
CONTRAINDICATION SIDE EFFECTS Allergies to PPIs Stomach pain Nausea vomiting Diarrhea
ROUTE: Oral
DRUG
MECHANISM OF ACTION GENERIC NAME: Water soluble Ascorbic Acid vitamin essential for synthesis ad maintenance of BRAND NAME: collagen and Cecon intercellular ground substance of body tissue CLASSIFICATION: cells, blood Vitamin vessels, cartilage, bones teeth skin and tendons DOSAGE: 1 TAB OD
CONTRAINDICATION SIDE EFFECTS Use of sodium Yellow acidic ascorbate in patients urine on sodium restriction Patients receiving digitalis
ROUTE: Oral
DRUG
MECHANISM OF ACTION GENERIC NAME: Elevates serum FeSO4 iron concentration which then helps to form high or BRAND NAME: trapped in reticuloendothelial cells for storage and eventual CLASSIFICATION: conversion to a Iron Prep usable form of iron
NURSING INTERVENTION Take drug with meals or with orange juice Increase oral fluid intake
ROUTE: Oral
CLASSIFICATION: Anticonvulsant
ROUTE: OP
DRUG
MECHANISM OF INDICATION ACTION GENERIC NAME: Inhibit histamine Allergies & Cetrizine HCl release and pruritus eosinophil chemotaxis during BRAND NAME: inflammation Zyrtec leading to reduced swelling and decreased CLASSIFICATION: inflammatory Anti-histamine response
NURSING INTERVENTION Take this drug without regard to meals Explain to patient, that drowsiness may occur. Limit activity after taking the drug
ROUTE: OP