DRUGS INDICATION ACTION SIDE EFFECT/ NURSING PATIENT TEACHING

ADVERSE REACTION CONSIDERATION

Generic Name:  Erosive esophagitis with Inhibits proton Headache, diarrhoea.  Drug can be given  Instruct patient to
Pantoprazole Sodium gastroesophageal reflux pump activity by Rarely, nausea, upper without regard to take exactly as
Brand Name: disease (GERD) binding to abdominal pain, meals. prescribed and at
Pantoloc  Short-term treatment of hydrogen- flatulence, rash,  Symptomatic about the same
Class: Antacids, GERD in patients who potassium pruritus or dizziness. response to therapy time every day.
Antireflux Agents & can’t take delayed-release adenosine doesn’t preclude the  Advise patient
Antiulcerants tablets orally. triphosphatase, presence of gastric that drug can be
Dose:  Short-term treatment or located at malignancy. taken without
40mg(1 tab) GERD linked to history of secretory surface of regards to meals.
OD erosive esophagitis. gastric parietal  Tell patient to
Date Ordered:  Long-term maintenance cells, to suppress swallow tablet
August 2, 2010 of healing erosive gastric acid whole and not to
esophagitis and reduction secretion. crush, split or
in relapse rates of chew it.
daytime and nighttime  Tell patient that
hearburn symptoms in antacids don’t
patients with GERD. affect
 Short-term treatment of Pantoprazole
pathological absorption.
hypersecretion conditions
caused by Zollinger-
Ellison syndrome or other
neoplastic conditions.
 DRUGS INDICATION ACTION SIDE EFFECT/ ADVERSE NURSING CONSIDERATION PATIENT TEACHING
REACTION
Generic  Edema due Stops the  Symptomatic Patients receiving LASIX should be  Advise patient to take
Name: to cardiac, reabsorption hypotension, dehydration, drug with food to
advised that they may experience
furosemide of sodium and prevent GI upset, and to
hepatic & hemoconcentration; symptoms from excessive fluid
Brand chloride in the take drug in morning to
renal hypokalemia,
Name: proximal and/or electrolyte losses. prevent nocturia. If
disease; mild tubule, and hyponatremia, metabolic
The postural hypotension that second dose is needed,
to moderate loop of acidosis; increase of blood tell patient to take
Lasix® sometimes occurs can usually be
HTN, Henley. lipid levels, urea, uric acid; second dose in early
Decreases reduced glucose tolerance; managed by getting up afternoon, 6 to 8 hours
[amp] hypertensive
cardiac hearing disorders, tinnitus; slowly. Potassiumsupplements after morning dose.
crisis,
Class:
preload by pancreatitis, GI symptoms; and/or dietary measures may be  Instruct patient to stand
acute heart
increasing anaphylactic & needed to control or slowly to prevent
Diuretics  failure, venous anaphylactoid reactions; dizziness and to limit
reduced avoidhypokalemia.
capacitance. alcohol intake and
Dose: cutaneous reactions (eg
urinary strenuous exercise in hot
80mg itching, urticaria, bullous
output due Patients with diabetes weather to avoid
IV eruptions, erythema
Date to gestoses, mellitus should be told that exacerbating orthostatic
multiforme, exfoliative hypotension.
Ordered: chronic renal furosemide may increaseblood
dermatitis); fever, vasculitis,  Discourage patient taking
August 2, failure, neph glucose levels and thereby
interstitial nephritis; furosemide at home from
2010 rotic affect urine glucose tests. The
hemolytic or aplastic storing different types of
syndrome. anemia, leukocytopenia, skin of some patients may be drugs in the same
agranulocytosis, more sensitive to the effects of container, increasing the
thrombocytopenia, sunlight while taking furosemide. risk of drug errors. The
paresthesia, most popular strengths
photosensitivity; of furosemide and
Hypertensive patients should digoxin are white tablets
nephrolithiasis, avoid medications that may about equal in size.
nephrocalcinosis &
increase blood pressure,  Teach patient to avoid
increased risk of persistence direct sunlight and to use
including over-the-counter produ
of Botallo's duct if used in protective clothing and a
premature infant. cts for appetite suppression and
sunblock because of risk
cold symptoms. of photosensitivity.
 DRUGS INDICATION ACTION SIDE EFFECT/ NURSING PATIENT TEACHING
ADVERSE REACTION CONSIDERATION
Generic Name:  . Type 2 diabetes Gliclazide is a  Disturbance Assessment  Inform patient
Gliclazide sulfonylurea which s of the gut such as  Hypo/hyperglycemic that treatment is a
Brand Name: stimulates insulin diarrhoea, reaction supplement to
constipation,  Monitor cbc dietary regimen
Diamicron® [tab] secretion by the
 Monitor liver and and not as
Class: pancreas. Its action indigestion, nausea,
renal function substitute to diet
Antidiabetic Agents  on insulin secretion vomiting or  Inform patient
is mainly due to abdominal pain. Nursing diagnosis that drug may
Dose:
the restoration of   Nutritional imbalance induce
40mg orally
2tab/ day the early phase,  Temporary hyperglycemic and
resulting in a visual disturbances Planning leads to control of
Date Ordered:
at start of  Given by oral blood sugar
August 4, 2010 physiological
treatment. administration  Inform patient of
release of insulin.  Should be taken with manifestation of

Thus, gliclazide meals hypoglycemic
 Low blood
restores glycemic including ,
glucose level
control throughout dizziness, lack of
(hypoglycaemia).
24 hrs. It energy, headache,
 Skin and sweating
normalizes fasting reactions such as
and postprandial rash and itch.
blood sugar. 
 Disturbance
s in the normal
levels of blood cells
in the blood.

 Yellowing of
the skin and eyes
(jaundice).
 Disturbance
in liver function.
 Inflammatio
n of the liver
 (hepatitis).

DRUGS INDICATION ACTION SIDE EFFECT/ NURSING PATIENT TEACHING

ADVERSE REACTION CONSIDERATION
Generic Name:  HTN. Reduction in the COZAAR is Dizziness, dose-  Hypersensitivity.  Advise patient to
Losartan K indicated to reduce related orthostatic Serum lithium levels comply with
risk of CV morbidity &
Brand Name: the risk of stroke in medication even if
mortality in effects, rash, should be monitored
feeling is better.
Cozaar® [tab] hypertensive patients patients with asthenia/fatigue, carefully if lithium
 Tell patient the
Class: w/ left ventricular hypertension and vertigo, hypotension salts are to be co- side effect is
Angiotensin II left ventricular & hyperkalemia, administered w/ dizziness, fainting
hypertrophy. Renal
Antagonistss  hypertrophy, but hypersensitivity, GI, angiotension II or
protection in type 2
there is evidence CV, hematologic, antagonists. lightheadedness
Dose: diabetic patients w/
that this benefit musculoskeletal, Hypotension &  Teach patient the
50 mg once daily proteinuria.
does not apply to effect of
orally nervous, psychiatric, electrolyte/fluid
photosensitivity
Date Ordered: Black patients. (See resp & dermatologic imbalance. Liver &  Instruct patient to
August 3, 2010 PRECAUTIONS, effects; vomiting, kidney function slowly stand when
Race and CLINICAL dysgeusia & impairment. in sitting, or
PHARMACOLOGY, erythroderma. minimize
Pharmacodynamics orthostatic
and Clinical Effects, hypotension.
Reduction in the
Risk of Stroke,
Race.)
DRUGS INDICATION ACTION SIDE EFFECT/ NURSING PATIENT TEACHING
ADVERSE REACTION CONSIDERATION
Generic Name:  reatment of vit B Vitamin B complex Folic acid is usually  Hypersensitivity.  Advise patient to
Folic acid deficiency essential for well tolerated in the Serum lithium levels take drugs exact
Brand Name: & anemia associated nucleoprotein as prescribe
dosage prescribed. It should be monitored
B-Prime Plus® [tab] w/ folic acid deficiency  Rash or fever is
synthesis and should not be given carefully if lithium
Class: cause by
maintenance of alone or in salts are to be co-
Vitamin B-Complex / hypersensitivity as
with C  normal conjunction with administered w/ side effect
erythropoiesis. inadequate amounts angiotension II  Instruct patient
Dose: Acts against folic of vitamin B12 in the antagonists. that urine may be
1 tab daily acid deficiency that treatment of Hypotension & more yellowish
Date Ordered: impairs pernicious anaemia. electrolyte/fluid
August 4, 2010
thymidylate It may partially imbalance. Liver &
synthesis and reverse the anti- kidney function
results in epileptic effects of impairment.
production of phenobarbital,
defective DNA that diphenylhydantoin,
leads to and primidone, and
megaloblast thereby increase
formation and seizure frequency.
arrest of bone
marrow
maturation.

CUES/DATA NURSING RATIONALE GOALS and INTERVENTIONS RATIONALE EVALUATION

DIAGNOSIS OBJECTIVES
Subjective: 1. Activity The body after 4 hrs of Evaluate current To provide after 4 hrs of
intolerance obtains energy nursing limitation. comparative nursing
“ I can’t even related to in the form of intervention the baseline. intervention the
stand to go to complete bed calories from client will be goal was fully
the bathroom” rest carbohydrates, able to: Assess Stress or met:
as verbalized protein and fat. psychological depression
by the patient The body uses Identify factor affecting the may increase
energy for negative current situation. the effect of Identfied
voluntary
factors illness. negative factors
activities such
Objective: as walking and affecting affecting
involuntary activity Plan care with res To reduce activity
Body activities such tolerance. fatigue. tolerance.
weakness as breathing.
Used identified Promote comfort Enhance the Used identified
Complete bed (Fundamentals techniques to measures and ability to techniques to
rest of Nursing 7th enhance provide safety. perform simple enhance
edition by activity. task. activity.
Immobility Kozier et al.)
Report Dependent: Report
measurable Provide response to Helps to measurable
increase in oxygen and increase increase in
activity medications as energy of the activity
tolerance ordered. body tolerance

Decrease Note treatment- To monitor Decreased

evidence of related factors, any evidence of
signs of such as side effect. complication.. signs of
intolerance. intolerance.

CUES/DATA NURSING RATIONALE GOALS and INTERVENTIONS RATIONALE EVALUATION

DIAGNOSIS OBJECTIVES
Subjective: Imbalanced - This Immediately 1. Discuss eating habits, To appeal to The goals and
Nutrition: condition after including food preferences. client’s likes objectives have
“I have no Less than needs to be intervention, 2. Discourage beverages that or dislikes. been fully met
appetite to Body addressed the patient will are caffeinated or carbonated as the patient
eat” as Requirements immediately verbalize and before meals. verbalizes and
verbalized by related to loss for the client demonstrate 3. Review and reinforce the demonstrates
the client. of appetite as to be able to selection of following to patient or These may selection of
evidenced by gain enough foods or meals caregivers: The basic four decrease foods or meals
Objective: weight loss strength in that will food groups, as well as the appetite and that will achieve
performing her achieve a need for specific minerals or lead to early a cessation of
Signs of usual cessation of vitamins. satiety. weight loss.
weakness of activities. weight loss. -Vitamin C (Helps the
muscles immune system to produce
antibodies)
Loss of (Fundamentals -calcium (help relief for Patients may
weight of Nursing 7th tuberculin lesions not understand
edition by -vitamin B6(combats toxic what is
Poor muscle Kozier et al.) effect of INH) Importance of involved in a
tone maintaining adequate caloric balanced diet.
intake; an average adult
needs 1800 to 2200 kcal/
day. Foods high in calories
and protein that will promote
weight gain and nitrogen
balance (e.g., small frequent
meals of foods high in
calories and protein)
*Perform health teaching
according to client’s level of
understanding.

CUES/DATA NURSING RATIONALE GOALS and INTERVENTIONS RATIONALE EVALUATION

DIAGNOSIS OBJECTIVES
Subjective: Ineffective coping -For most persons, After 8 hours of Independent The goals and
“The only thing related to lower everyday life interventions: objectives have been
that changes is activity level and includes its share of Assess level of The patient could fully met as
that I easily get the inability to stressors and 1. The patient will understanding and not start changing indicated by:
tired even when work demands, ranging identify own readiness to learn needed his lifestyle if he
I’m turning side to from family, work, maladaptive coping lifestyle changes. cannot understand 1. The patient
side. and responsibilities behaviors. the teachings and if identified his own
.” As verbalized to major life events he is not motivated maladaptive coping
by the patient. such as illness How 2. Patient will and convinced to do behaviors.
one responds to identify available so.
Objective: such stressors resources and 2. Patient identified
-Verbalization of depends on the support systems. Establish a working An ongoing available resources
inability to cope person’s coping relationship with patient relationship and support systems.
-Physical resources. Such 3. Patient will through continuity of establishes trust,
symptoms such as resources can describe and initiate care. reduces the feeling 3. Patient described
lack of appetite is include optimistic alternative coping of isolation, and and initiated
a possible beliefs, social strategies. may facilitate alternative coping
evidence support networks, coping. strategies.
personal health and
energy, problem- Provide opportunities to Verbalization of
solving skills, and express concerns, fears, actual or perceived
material resources. feelings, and threats can help
Vulnerable expectations. reduce anxiety.
populations such as
those in adverse Encourage patient to During crises,
socioeconomic identify own strengths patients may not be
situations and those and abilities. able to recognize
with complex their strengths.
medical problems Fostering awareness
may not have the can expedite use of
resources or skills these strengths.
to cope with their
acute or chronic
stressors. Encourage patient to set This helps patient
realistic goals. gain control over
the situation.