NAME OF DRUGS MODE OF ACTION INDICATIONS CONTRAINDICATIONS ADVERSE EFFECT NURSING

CONSIDERATION
Generic Name: Citicoline Citicoline consumption - Cerebrovascular diseases –  Hypersensitivity  Fleeting and  Instruct patient to
Brand Name: Cognizin, promotes brain metabolism
Somazine by restoring phospholipid e.g. from ischaemia due  Patients with discrete take the
Classification: content in the brain and to stroke, where Citicoline hypertonic of the hypotension effect medication as
Doctor’s Order: regulation of neuronal
membrane excitability. It also accelerates the recovery of parasympathetic.  Increased prescribed.
influences the mitochondria consciousness and parasympathetic  Teach the patient
or energy factories of the
overcoming motor deficit. effects that citicoline may
brain cells and found to
improve memory function.  Hypotension be taken with or
After several clinical trials, - Head Trauma of varying  Itching or hives without food.
Citicoline has been shown to
raise the amount of severity: In a clinical trial,  Swelling in face  Monitor for
acetylcholine in the brain. Citicoline accelerated the or hands adverse effects;
recovery from post-traumatic  Chest tightness instruct patient to
coma and the recuperation of  Tingling in mouth report
walking ability, achieved a and throat immediately if
better final functional result  Headache he/she develops
and reduced hospital stay.  Nausea chest tightness,
 Diarrhea tingling in mouth
 Blurred Vision and throat,
headache,
diarrhea and
blurring of vision.

Referrence: Citicoline (Ceraxon) Drug Information – Indications, Dosage, Side Effects and Precautions (n.d.).Retrieved from http://www.medindia.net/doctors/drug_information/ citicoline.htm#ixzz378wmysaB .
NAME OF DRUGS MODE OF ACTION INDICATIONS CONTRAINDICATIONS ADVERSE EFFECT NURSING CONSIDERATION

Generic Name: Enters target cells and Replacement therapy in adrenal  Systemic administration: -Vertigo Systemic administration
Hydrocortisone binds to cytoplasmic cortical insufficiency infections, especially -Headache · Give daily before 9 AM to
Brand Name: Ala-cort, receptors; initiates · Hypercalcemia associated with tuberculosis, fungal -Paresthesias mimic normal peak diurnal
Cipro, Colocort many complex cancer infections, amebiasis, -Insomnia corticosteroid levels and minimize
Classification: reactions that are · Short-term inflammatory and hepatitis B, vaccinia, or -Convulsions HPA suppression.
Corticosteroid
responsible for its allergic disorders, such as varicella, and antibiotic- -Psychosis · Space multiple doses evenly
Doctor’s Order:
anti-inflammatory, rheumatoid arthritis, collagen resistant infections; kidney -Hypotension throughout the day.
immunosuppressive diseases (SLE), dermatologic disease (risk to edema); -Shock · Do not give IM injections if
(glucocorticoid), and diseases (pemphigus), status liver disease, cirrhosis, -Hypertension patient has thrombocytopenic
salt-retaining asthmaticus, and autoimmune hypothyroidism; ulcerative -CHF secondary to purpura.
(mineralocorticoid) disorders colitis with impending fluid retention · Rotate sites of IM repository
actions. Some actions · Hematologic disorders-- perforation; diverticulitis; -Thromboembolism injections to avoid local atrophy.
may be undesirable, thrombocytopenic purpura, recent GI surgery; active or -Thrombophlebitis · Use minimal doses for minimal
depending on drug erythroblastopenia latent peptic ulcer; -Fat embolism duration to minimize adverse
use. · Trichinosis with neurologic or inflammatory bowel -Cardiac arrhythmias effects.
myocardial involvement disease (risks exacerbations secondary to · Taper doses when discontinuing
· Ulcerative colitis, acute or bowel perforation); electrolyte high-dose or long-term therapy.
exacerbations of multiple sclerosis, hypertension, CHF; disturbances · Arrange for increased dosage
and palliation in some leukemias thromboembolitic when patient is subject to unusual
and lymphomas tendencies, stress.
· Intra-articular or soft-tissue thrombophlebitis, · Use alternate-day maintenance
administration: Arthritis, psoriatic osteoporosis, convulsive therapy with short-acting
plaques disorders, metastatic corticosteroids whenever possible.
· Retention enema: For ulcerative carcinoma, diabetes · Do not give live virus vaccines
colitis, proctitis mellitus; lactation. with immunosuppressive doses of
· hydrocortisone.
· Provide antacids between meals
to help avoid peptic ulcer.
Referrence: Nurse's Notes: Hydrocortisone Drug Study (nurse-sha.blogspot.com)
NAME OF DRUGS MODE OF ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING CONSIDERATION
EFFECT
Generic Name: Epinephrine Stimulates alpha-, beta-, Temporary relief of Older adult or debilitated Nervousness, - Monitor BP, pulse, respirations, and urinary output
Brand Name: Adrenalin and beta- bronchospasm, acute patients; prostatic restlessness,
Classification: Adrenergic adrenergic receptors asthmatic attack, mucosal hypertrophy; hypertension; sleeplessness, and observe patient closely following IV
Agonist Agent, resultingin relaxation of congestion, diabetes mellitus; fear, anxiety, administration. Epinephrine may widen pulse pressure.
Bronchodilator smooth muscle of the hypersensitivity and hyperthyroidism; tremors, severe
Doctor’s Order: bronchial tree, cardiac anaphylactic reactions, Parkinson’s disease; headache, If disturbances in cardiac rhythm occur, withhold
stimulation, syncope due to heart tuberculosis; cerebrovascular epinephrine and notify physician immediately.
anddilation of skeletal block or carotid sinus psychoneurosis; in patients accident,
- Keep physician informed of any changes in intake-
vasculature; small hypersensitivity, and to with long-standing weakness,
doses can cause restore cardiac rhythm in bronchial asthma and dizziness, output ratio.
vasodilation via beta cardiac arrest. emphysema with syncope, pallor, - Use cardiac monitor with patients receiving
vascular receptors; l degenerative heart disease; sweating,
arge doses may prod in children <6 y of age. dyspnea. epinephrine IV. Have full crash cart immediately
uce constriction of s available.
k e l e t a l   a n d vascular
smooth muscle; decreases - Check BP repeatedly when epinephrine is
production of aqueous administered IV during first 5 min, then q3–5min until
humor and
stabilized.
increasesaqueous outflow;
dilates the pupil by contracting - Advise patient to report to physician if symptoms are
the dilator muscle not relieved in 20 min or if they become worse
following inhalation.
- Advise patient to report bronchial irritation,
nervousness, or sleeplessness. Dosage should be
reduced.
- Monitor blood glucose & HbA1c for loss of
glycemic control if diabetic.

Referrence: Epinephrine Drug Study And Nursing Responsibilities (rnspeak.com)

NAME OF DRUGS MODE OF ACTION INDICATIONS CONTRAINDICATIONS ADVERSE NURSING CONSIDERATION
EFFECT
Generic Name: Digoxin 1.Increases the force and - Treatment of congestive - Ventricular fibrillation -Tachycardia -Assess cardiac function
Brand Name: Lanoxin
Classification: Cardiac velocity of myocardial heart failure - Ventricular tachycardia -Headache -Measure liquids precisely
glycoside contraction by increasing - Control of rapid ventricular - Presence of digoxin -Dizziness -Assess for signs of toxicity, especially in children and
Doctor’s Order:
the refractory period of contractions in clients with toxicity -Mental the elderly
the AV node and atrial fibrillation/flutter - Hypersensitivity disturbances -Give IV slowly over 5 minutes
increasing total - Slow the heart rate in sinus - Beriberi heart disease -N&V -Note possible drug interactions
peripheral resistance tachycardia - Hypersensitive carotid -Diarrhea -Assess for hyperthyroidism or hypothyroidism
2.Inhibits - Treatment of SVT sinus syndrome -Anorexia -Obtain ECG
sodium/potassium- - Treatment of cardiogenic -Blurred vision -Monitor CBC, serum electrolytes, calcium, MG, renal
ATPase resulting in shock -Death from and liver function tests
increased calcium influx - Prophylaxis and treatment of ventricular -Obtain written heart rate parameters for drug
and increased release of recurrent paroxysmal atrial fibrillation administration as drug may cause extreme bradycardia
free calcium ions within tachycardia with paroxysmal -Acute -Do not administer if HR is <50. Hold if HR is 90-110
the myocardial cells, AV junctional rhythm hemorrhage bpm in children
which potentiates the -Convulsions -Obtain pulse deficit of apical and radial pulse
contractility of cardiac -Visual -Monitor weight and I&o
muscle fibers disturbances -Use antacid if gastric distress occurs
3. Decreases the rate of -Angioneurotic -Use caution during withdrawal
conduction thereby edema -Do not take with grapefruit juice
decreasing heart rate -Maintain a sodium-restricted diet
-Do not take OTC drugs

Referrence: Digoxin Drug Study And Nursing Consideration [Lanoxin] (rnspeak.com)

NAME OF DRUGS MODE OF INDICATIONS CONTRAINDICATIONS ADVERSE NURSING CONSIDERATION
ACTION EFFECT
Generic Name: Furosemide Rapid-acting potent Treatment of History of hypersensitivity Increased -Observe patients receiving parenteral drug carefully; closely monitor
Brand Name: Fumide, sulfonamide “loop” edema associated to furosemide or perspiration;
Furomide, Lasix diuretic and with sulfonamides; increasing paresthesias; BP and vital signs. Sudden death from cardiac arrest has been
Classification: antihypertensive CHF, cirrhosis of oliguria, anuria, fluid and activation of reported.
Doctor’s Order: with pharmacologic liver, and kidney electrolyte depletion states; SLE, muscle
effects and uses disease, including hepatic coma; pregnancy spasms, -Monitor BP during periods of diuresis and through period of dosage
almost identical to nephrotic (category C), lactation. weakness; adjustment.
those of ethacrynic syndrome. May be thrombophlebit
-Observe older adults closely during period of brisk diuresis. Sudden
acid. Exact mode of used for is, pain at IM
action not clearly management of injection site. alteration in fluid and electrolyte balance may precipitate significant
defined; decreases hypertension, adverse reactions. Report symptoms to physician.
renal vascular alone or in
resistance and may combination with -Lab tests: Obtain frequent blood count, serum and urine electrolytes,
increase renal blood other CO2, BUN, blood sugar, and uric acid values during first few months
flow. antihypertensive
agents, and for of therapy and periodically thereafter.
treatment of -Monitor for S&S of hypokalemia .
hypercalcemia.
-Monitor I&O ratio and pattern. Report decrease or unusual increase in
Has been used
concomitantly output. Excessive diuresis can result in dehydration and hypovolemia,
with mannitol for circulatory collapse, and hypotension. Weigh patient daily under
treatment of
severe cerebral standard conditions.
edema, -Monitor urine and blood glucose & HbA1C closely in diabetics and
particularly in
meningitis. patients with decompensated hepatic cirrhosis. Drug may cause
hyperglycemia. Note: Excessive dehydration is most likely to occur in
older adults, those with chronic cardiac disease on prolonged salt
restriction, or those receiving sympatholytic agents.
Referrence: Furosemide (Lasix) Drug Study (rnspeak.com)
ASSESSMENT DIAGNOSIS SCIENTIFIC PLANNING INTERVENTION RATIONALE EVALUATION
EXPLANATION

Subjective : “ One week Ineffective breathing Exposure to environmental Goal: After 4 hours of -Identify and eliminate the - To be able to reduce Goal partially met
na po akong may dry pattern related to factors such as cold, nursing intervention presence of environmental patients exposure to After 4 hours of nursing
cough at plema , usually smooth muscle smoking,and pollutants patient will factors triggers intervention the patient
po nacacause ng dust constriction of the ↓ demonstrate an was able to demonstrate
yung asthma ko” bronchioles IgE antibodies are produced as improved ventilation -Assess respiratory rate and -To determine if there is decreased signs of
an immune response and adequate depth and inspect nailbeds presence of cyanosis respiratory distress.
Objective : ↓ oxygenation of tissues and buccal membrane
- Patient is conscious and IgE attaches to the mast cells and absence of signs of
able to speak of the lungs respiratory distress -Auscultate breath sounds -To note for adventitious
-Oriented to time, person ↓ breath sounds as well as
and place Re-exposure to antigens in the fremitus.
-Ambulatory environment results in the
-Dry coughing -Assess level of -To evaluate cerebral
antigen binding to the antibody
-Wheezy breathing consciousness and perfusion
↓
mentality changes
Mast cell products(chemical
Vital Signs: mediators)are released –
02 sat.:96% -Monitor Vital Signs -To assess the severity of
histamine,
PR: 86 patient’s condition
bradykinin,prostaglandin -Elevate head of the bed To ma-intain airway
RR:20 ↓ and position appropriately
T:36.9 Mediators affects smooth
BP:110/80 mmHg muscles causing -Encourage deep breathing -To promote optional
bronchospasm and mucous exercises chest expansion
membrane swelling
↓ -Encourage rest and limit -To prevent exhaustion
Airways are obstructed activities and promote
↓ restful environment
Passage of O2and CO2
between the alveoli and -Administer medications as -To dilate bronchial
vascular system are decreased indicated ( bronchodilators, smooth muscles and
antibiotics, corticosteroids) facilitate respirtaion
 DATE/TIME FOCUS NURSES NOTES PROGRESS NOTE

07/05/2022 @ 1:16 pm Monitoring Vital Signs Vital sign DATA: Received a 15 years old patient
02 sat.:96% lying on bed , conscious and
PR: 86 conversant with a heplock on his left
RR:20 hand metacarpal.
T:36.9
BP:110/80 mmHg ACTION:
Assess the patients status
Took and recorded vital signs
Monitor 02 sat
Ensure safety(raising side rails of
bed)
Position in a comfortable position
( Semi-fowlers)
Health teaching (deep breathing
exercise, best position, avoidance of
the allergens)

RESPONSE:
02sat of 96%
Still with heplock
Still sitting semi-fowlers on bed
Was able to learn and perform
proper deep breathing exercise, knows
the best position in bed and avoidance
of allergens.