NSE 211 Fall 2023, Week 4 Safe Medication Administration Test Case Study, Student Preparation and Instructions

Surgical Case Study

Surgical Client PO medication administration: Complete prior to medication administration test (may use for test)
In your own words describe the topics and essential nursing assessment and responsibilities required prior to administering
Medication Indications: Why is the Mechanism of Action Expected Side Effects Nursing Assessment- Responsibilities
client receiving it?
Amoxicillin To treat bacterial It interferes with the cell wall CNS: Headache, seizures, - Assess px for previous sensitivity
infections of the replication of susceptible agitation, confusion, reaction to peniclliins or other
Pharm Class: antiinfective, respiratory tract and organisms by binding to the dizziness, insomnia cephalosporins
antiulcer GI/GU tract bacterial cell wall GI: Nausea, vomiting, - Assess for signs and symptoms
diarrhea, increased of infections
Dosage Range: 250mg to AST, ALT, abdominal pain, - Assess for allergic reactions
500 mg q8h or 500mg to glossitis, colitis, during treatment
875mg BID pseudomembranous colitis, - Assess urine output
jaundice, - Monitor blood studies and
cholestasis, eosinophilia, electrolytes
thrombocytopenia, - Assess bowel patterns
agranulocytosis - Assess for overgrowth of
HEMA: Anemia, increased infection
bleeding time, bone marrow - Assess for skin eruptions
depression, - Monitor for bleeding
granulocytopenia, hemolytic
anemia
INTEG: Urticaria, rash
SYST: Anaphylaxis,
respiratory distress,
serum sickness, Stevens-
Johnson syndrome, toxic
epidermal necrolysis,
exfoliative dermatitis
Rivaroxaban To prevent DVT, stroke Anticoagulant that selectively GI: Cholestasis, cytolytic -monitor for bleeding
and systemic embolism and potently inhibits hepatitis, -discontinue use for pregnant or
Pharm Class: anticoagulant coagulation factor Xa hyperbilirubinemia, breastfeeding people
increased hepatic enzymes, -avoid abrupt discontinuation
Dosage Range: 10-20 mg jaundice, nausea
daily HEMA: Adrenal bleeding,
bleeding,
cerebral hemorrhage,
epidural hematoma,
GI bleeding, hemiparesis,
intracranial bleeding, retinal
hemorrhage,
 NSE 211 Fall 2023, Week 4 Safe Medication Administration Test Case Study, Student Preparation and Instructions Surgical Case Study
retroperitoneal
hemorrhage, subdural
hematoma,
thrombocytopenia
INTEG: Anaphylactic
reaction, anaphylactic
shock, blister,
hypersensitivity, pruritus
SYST: Stevens-Johnson
syndrome
Ketorolac To treat mild to Inhibits prostaglandin CNS: Dizziness, drowsiness, -monitor renal, hepatic, blood studies
moderate pain and synthesis by decreasing an tremors, seizures - monitor any changes in urine pattersm
Pharm Class: Nonsteroidal inflammation, and enzyme needed for CV: Hypertension, flushing, weight, edema, joint pain, fever, stool
antiinflamma- ocular itching biosynthesis syncope, pallor, edema, patterns
tory (NSAID), nonopioid vasodilatation, CV - caution px no breastfeeding
analgesic thrombotic events, MI, - monitor if pregnant
stroke - instruct px to discard is using nasal
Dosage Range: EENT: Tinnitus, hearing loss, route within 24 hrs of opening and can
IV: 30 mg as a single dose blurred vision, drink water after dose
or 30 mg q6hr; max 120 transient burning/stinging
mg/day GI: Nausea, anorexia,
IM: 60 mg as single dose or vomiting, diarrhea,
60 mg q6hr; max 120 constipation, flatulence,
mg/day cramps, dry mouth, peptic
PO: 20 mg once after IV or ulcer, GI bleeding,
IM therapy, 10mg q 4-6hr, perforation, taste change,
max 40 mg/day hepatitis, hepatic failure
GU: Nephrotoxicity: dysuria,
hematuria, oliguria,
azotemia
HEMA: Blood dyscrasias,
prolonged bleeding
INTEG: Purpura, rash,
pruritus, sweating,
angioedema, Stevens-
Johnson syndrome,
toxic epidermal necrolysis
Pantoprazole To treat GERD, severe It Suppresses gastric CNS: Headache, insomnia, - Monitor muscle pain
erosive esophagitis, secretion by asthenia, fatigue, - Assess gi system
Pharm Class: Proton pump mainte- malaise, insomnia, - Monitor hepatic enzymes
inhibitor somnolence
 NSE 211 Fall 2023, Week 4 Safe Medication Administration Test Case Study, Student Preparation and Instructions Surgical Case Study
nance, long-term inhibiting GI: Diarrhea, abdominal - Asses for toxic epidermal
Dosage Range: pathological hydrogen/potassium ATPase pain, flatulence, necrolysis
40 mg twice daily upto a hypersecretory enzyme pancreatitis, weight changes
max of 240 mg per day system in gastric parietal cell; INTEG: Rash
conditions including
Zollinger-Ellison META: Hyperglycemia,
syndrome weight gain/loss, hypo-
natremia, hypomagnesemia

MS: Rhabdomyolysis,
myalgia
RESP: Pneumonia
SYST: Stevens-Johnson
syndrome,
toxic epidermal necrolysis,
anaphylaxis,
angioedema
Dimenhydrinate Motion sickness, Competes with histamine for CNS: Drowsiness, • Monitor VS, B/P; check patients with
nausea, vomiting, H1 restlessness, headache, cardiac
Pharm Class: vertigo receptors in GI tract, blood dizziness, insomnia, disease more often
Antiemetic, antihistamine, vessels, respiratory confusion, nervousness, • Assess for signs of toxicity of other
anticholinergic tract; central anticholinergic tingling, vertigo products
Dosage Range: activity, which CV: Hypertension, or masking of symptoms of disease:
PO 50-100 mg q4hr; IM/IV results in decreased hypotension, palpitation brain
50 mg q4hr vestibular stimulation and EENT: Dry mouth, blurred tumor, intestinal obstruction
as needed (Canada only) blockade of chemoreceptor vision, diplopia, • Observe for drowsiness, dizziness
trigger zone nasal congestion,
photosensitivity, xerostomia
GI: Nausea, anorexia,
vomiting, constipation
INTEG: Rash, urticaria, fever,
chills, flushing
MISC: Anaphylaxis
Common patient questions you should be able to answer for each medication:
• What is this for?
• How often do I have to take it?
• What are the side effects?
• Can I take this with the other medications I am taking?

Safe Medication Administration Test 5%