Medications

Complete Order (name, Safe dose Mechanism of actions Side effects Nursing consideration
dose, route, frequency) & range &
Classifications Indication for your patient
Cefepime, 1150 mg, IV, TID 50 mg/kg IV Is a bacterial agent that acts by 1. Nausea and vomiting 1. Assess nausea characteristics including duration,
inhibition of bacterial cell wall synthesis frequency, and severity. Assess patient hydration status,
every 8 -12 hr
2. Diarrhea daily weights, I/O, and assess skin turgor (if there is
Cephalosporin lead to cell death. It have good activity
dehydration). Administer antiemetic medication. Give
( beta-lactam class) Maximum against gram- positive and gram- frequent small amounts of food, Advice to drink plenty of
negative bacteria. (Kizior, 2018). 3. Rash
(fourth-generation agent) dose: 2 fluids for adequate hydration. Eliminate strong odors
from the surroundings.
grams/dose
Indication: to treat Fever ( Febrile
every 8 hr. ( Neutropenia) 2. Advise patient to drink plenty of fluids (water, juice
Parthasarathy, with low sugar), administer medication with food to
2013). minimize GI upset, and give supplements to replace lost
Severe neutropenia suspected electrolytes.
leukemia
3. Monitor for allergic reaction 30 minutes after
administration, and examine skin for any skin change. If
their skin change, do a physical assessment including
inspection and palpation of the skin. Inform the
physician to prescribe topical medication (moisturizers,
lotions, cortisone creams) that relieves the rash. Apply
Skincare, topical medication, and cold compressor on
the rash area.
Furosemide, 20 mg, IV, IV 0.5 Act by inhibiting the active 1. Dizziness or 1. Monitor vital signs, and BP (furosemide causes drops
headache. in blood pressure if changing positions quickly),
STAT mg/kg/minute reabsorption of chloride ions (and Administer medication for headache, check if have
therefore of NaCl) in the ascending limb
2. Diarrhea severe headache, and assess mental status. Instruct
loop diuretics Maximum of the loop of Henle, leading to loss of patient to change position slowly, and sit on the bed 1-2
sodium ions and water. Blood min before getting up.
dose: 6 mg 3. Blurred vision
transfusions are often complicated by
/dose 2. Advise the patient to drink plenty of fluids to prevent
water retention. Furosemide will
reduce body water by making the dehydration. Monitor weight, Intake/Output, Assess
serum electrolyte levels for any loss of electrolytes, and
kidneys excrete more urine to prevent
give supplements to replace lost electrolytes. Inform the
water retention.(Kizior, 2018). physician of severe diarrhea.

Paracetamol, 300mg, oral,
QID
Analgesics and antipyretics
Indication: To prevent blood
transfusion complication
10- 15 Is a central analgesic effect that is
mediated through activation of
mg/kg/day
descending serotonergic pathways. It
inhibits prostaglandin (PG) synthesis or
through an active metabolite
influencing cannabinoid receptors.
paracetamol treats mild-moderate pain
and fever (Brown, 2012). It reduces a
high temperature by affecting the
chemical messengers in an area of the
brain that regulates body temperature.
Indication: To treat Fever and
abdominal pain
3. Inform the physician. Perform eyes examination and
assess the patient’s ability to see. Apply eye drops that
support lubrication and prescribed medication. Keep the
bed in a low position and call-bell within easy reach.
1. Drowsiness and 1. Assess the level of consciousness, and monitor if
tiredness there are changes in daily activity patterns and feelings
of restlessness. Instruct patient to change position
2. Rashes and itching slowly, and sit on the bed 1-2 min before getting up.
3. Nausea, vomiting 2. Monitor for allergic reaction 30 minutes after
administration, and examine skin for any skin change. If
their skin change, do a physical assessment including
inspection and palpation of the skin. Inform the
physician to prescribe topical medication (moisturizers,
lotions, cortisone creams) that relieves the rash. Apply
Skincare, topical medication, and cold compressor on
the rash area.
3. Administer medication with food to minimize GI upset.
Assess nausea characteristics including duration,
frequency, and severity. Assess patient hydration status,
daily weights, I/O, and assess skin turgor (if there is
dehydration). Administer antiemetic medication. Give
frequent small amounts of food, Advice to drink plenty of
fluids for adequate hydration. Eliminate strong odors
from the surroundings.
Laboratory tests & other diagnostic tests
Test Name Normal Range Child Specific Lab Values Result Interpretation
(e.g. High due to Infection)
Hemoglobin (Hb) 14 - 18 7.6 g/dL Low due to decrease RBCs production ( Bone
marrow cannot make enough new blood cells)
Hematocrit (HCT) 0.35 – 0.45 0.29 L/L Low due to decrease RBCs
RBC Count 4 – 5.2 3.3 x10^12/L Low due to bone marrow cannot make enough
new RBC ( damage to stem cells leads to a
decreased RBC number)
RDW-CV 13 – 14.2 18.5 % High due to RBCs are different in size more
significantly (indicate the body is having
difficulty making RBC)
Platelet Count 170 – 450 46 x10^9/L Low due to bone marrow cannot make enough
new platelet ( damage to stem cells leads to a
decreased platelet number)
WBC Count 5 – 13 9.3 x10^9/L Normal
Absolute Neutrophils Count 2–8 0.3 x10^9/L Low due to infection and decrease bone marrow
function
Absolute Monocyte Count 0.2 - 1 0.1 x10^9/L Low due to infection
Absolute Lymphocyte Count 1–5 2.0 x10^9/L Normal
Absolute Eosinophil Count 0.1 – 1 0.0 x10^9/L Low due to infection
Absolute Basophil Count 0 – 0.1 0.0 x10^9/L Normal
CRP 0 – 8.2 5.8 mg/L Normal
Ferritin 16.2 – 106.7 311.0 ng/mL High due to iron overload
Iron 16 – 128 118 Ug/dL Normal
Vitamin B12 276 – 969 413 pg/mL Normal
Vitamin D total 30 – 100 17 ng/mL Low due to inadequate intake of vit D
Na+ 135 - 145 136 mmol/L Normal
K+ 3.5 – 5.0 3.7 mmol/L Normal
Cl- Not done
CO2 Note done
BUN 2.5 - 6 5.8 mmol/L Normal
Creatinine 27 - 66 49 mmol/L Normal
Glucose Negative Negative Normal
Chest x ray Normal No segmental consolidative Normal finding
patches or sizable cavity
Indication: Fever, abdominal lesion, clear both
distention, pallor Normal cardiothoracic ratio
No pathological air fluid level

Abdominal x ray No result

(was done but no result)

Indication: Fever, abdominal

distention, pallor