Student Nurse: JENNIFER P.

ALAMON Level/Section: BSN 4-C Date:MAY 13-14, 2024

DRUG STUDY
Patient (Initials only):L.G.L. Age:80 Gender:MALE Ward/Room/Bed:7 Allergy to:
Diagnosis/Impression:To Consider Septic Shock Secondary to Community Acquired Pneumonia, High Risk, Rule Out Cerebrovascular Accident, Bleed

Generic Name:SODIUM BICARBONATE Brand Name:Rhea Dosage, Route & Timing: 1 tablet (650mg), PO, q6

CLASSIFICATION: MECHANISM OF ACTION: PHARMACODYNAMICS

Pharmacologic Class: Alkalinizing agents Increases plasma bicarbonate, which excess buffer H ion concentrations; reverses metabolic acidosis; 15 minutes
Onset:
neutralizes gastric acid, which forms water, NaC1, CO2; raises blood Ph.
Therapeutic Class: Antacids Peak:Unknown
Pregnancy Category: C Duration:1-3 hours

NURSING RESPONSIBILITIES / RATIONALE PATIENT / FAMILY EDUCATION

CATEGORY
CONSIDERATIONS
INDICATION:

Treatment of metabolic acidosis; promotion of
gastric, systemic and urine alkalinization in the case
of intoxication with weak organic acids; in order to
improve the solubility of drug substances that are
poorly soluble in neutral acid medium; and in the
case of hemolysis.
Monitor and maintain the patient’s acid- Metabolic acidosis can lead to serious complications, Explain the importance of maintaining a balance acid base status
base balance and electrolyte levels, as including organ dysfunction and shock. By promoting and the role of alkalinization in treatment.
well as the effectiveness of treatment. alkalization, the solubility of drugs and substances can
be improved, aiding in their elimination from the body.
Alkalinization of urine can also help in the excretion of
certain toxic substances. In the case of hemolysis,
alkalinization can help prevent kidney damage due to
release of hemoglobin.
Discuss the possible causes of metabolic acidosis and the need
for ongoing monitoring and treatment.

Teach family about medications used for alkalinization and the

importance od adhering to the prescribed regimen.
CONTRAINDICATIONS / PRECAUTIONS

Hypoventilation, hypocalcemia, increased serum
osmolarity, further in all situations where sodium
intake must be restricted.
Monitor the patient’s respiratory status, calcium
levels, and serum osmolarity closely. Provide
education on dietary sodium restrictions and
ensure compliance.
Hypoventilation can lead to respiratory acidosis, which Explain the importance of maintaining adequate ventilation and
can further decrease serum osmolarity. Restricting how hypoventilation can affect the body’s acid-base balance.
sodium intake is important to manage conditions such
as hypertension, heart failure, and edema.
Discuss symptoms of hypocalcemia, such as muscle cramps and
numbness, and the need for monitoring treatment.
Educate the family on the reasons for restricting sodium intake
and provide guidance on low-sodium diet options.
 DRUG INTERACTIONS (Drug-Drug / Drug-Food / Drug-
Diagnostics / Drug-Herb)

Do not take drug together with Aspirin and other
salicylates (such as salsalate), corticosteroids (such aspirin, salicylates, and corticosteroids, as bleeding.
as prednisone), memantine, medications with a
special coating to protect the stomach (enteric
coating).
Administer sodium bicarbonate separately from Helps reduce the risk of gastrointestinal irritation and Explain to family the importance of ensuring the patient takes
sodium bicarbonate at least 1-2hours before or taking aspirin or
concurrent use may increase the risk of other salicylates.
gastrointestinal irritation and bleeding
Emphasize the significance of the following prescribed medication
schedule and ensuring that the patient does not skip doses of
sodium bicarbonate.
Educate the family on signs of gastrointestinal bleeding, such as
black, tarry stools or abdominal pain.

NURSING RESPONSIBILITIES / RATIONALE PATIENT / FAMILY EDUCATION

CATEGORY
CONSIDERATIONS
SIDE EFFECTS / ADVERSE REACTIONS /
ADVERSE EFFECTS (By System)

Monitor signs of gastrointestinal bleeding. Allows for early detection and intervention, which can Educate the family about signs and symptoms of gastrointestinal
GI: belching, gastric distention, flatulence, prevent serious complications. bleeding, such as black, tarry stools or vomit, and the importance
of seeking medical attention promptly if these symptoms occur.
Monitor fluid intake and output. Sodium overload can lead to fluid retention and Educate family members about the signs of fluid retention and
Metabolic: metabolic alkalosis, electrolyte edema. Monitoring intake and output helps assess edema, which may indicate sodium overload.
imbalance, sodium overload, hypocalcemia, fluid balance and guide interventions to maintain or
hypokalemia, milk-alkali syndrome, restore balance.
dehydration.
REFERENCES:
https://www.webmed.com/drugs/2/drug-11325/sodium-bicarbonate-
oral/details

Student Nurse: JENNIFER P. ALAMON Level/Section: BSN 4-C Date:MAY 13-14 2024
DRUG STUDY
Patient (Initials only):L.G.L. Age:80 Gender:MALE Ward/Room/Bed:8 Allergy to:
Diagnosis/Impression:To Consider Septic Shock Secondary to Community Acquired Pneumonia, High Risk, Rule Out Cerebrovascular Accident, Bleed
 Generic Name:MEROPENEM Brand Name:Merosaph Dosage, Route & Timing: 1 gm, IVTT, q8

CLASSIFICATION: MECHANISM OF ACTION: PHARMACODYNAMICS

Pharmacologic Class: Carbapenem Penetrates cell walls of most gram-negative and gram- positive bacteria, inactivating penicillin-binding 15-30 minutes
Onset:
proteins. This action inhibits bacterial cell wall synthesis and cause cell death.
Therapeutic Class: Antibiotic Peak: 4-7 days
Pregnancy Category: B Duration: 7 days

NURSING RESPONSIBILITIES / RATIONALE PATIENT / FAMILY EDUCATION

CATEGORY
CONSIDERATIONS
INDICATION:

For the treatment of bacterial meningitis caused by Observe intravenous site closely for The fluid can cause pain, inflammation, nerve or The family has knowledge what is the drug about and what does it
Haemophilus influenza, Neisseria meningitidis and extravasation and stop the administration of drug. tendon damage, and can lead to infection. treat.
penicillin-susceptible isolates of streptococcus
pneumoniae.

CONTRAINDICATIONS / PRECAUTIONS

Patients who have demonstrated hypersensitivity to Check patient’s chart for positive hypersensitivity To avoid administering drug and prevent any Notify patient on duty to provide immediate remedy and prevent
this product. Hypersensitivity reactions to patients to drug. complications. any complications.
who have a history of hypersensitivity to
carbapenems, penicillin, or other b-lactam
antibiotics may also be hypersensitive to
Meropenem-AFT.

DRUG INTERACTIONS (Drug-Drug / Drug-Food / Drug-

Diagnostics / Drug-Herb)

Do not take with BCG vaccine live, cholera Monitor the patient for signs and symptoms of Helps prevent complications and ensures timely Educate family that when patient is taking meropenem patient is
vaccine, typhoid vaccine, and valproic acid. electrolyte imbalances, such as irregular intervention if needed. well-hydrated unless advised otherwise by their health care
heartbeat, muscle weakness, and changes in provider. Drinking plenty of fluids can help maintain electrolyte
metal status. balance and reduce the risk of complications.

NURSING RESPONSIBILITIES / RATIONALE PATIENT / FAMILY EDUCATION

CATEGORY
CONSIDERATIONS
SIDE EFFECTS / ADVERSE REACTIONS /
 ADVERSE EFFECTS (By System)

CNS: headache, Monitor vital signs. Can monitored any unusuality. Patient’s family should a prior knowledge when it comes to these
side effects and how to manage it without the supervision of the
nurses.
CV: shock, Manage fluid intake and output, monitor vital Managing and monitoring these can be crucial for
signs, give oxygen if needed. patients’ safety and can enhance tissue perfusion.
EENT: oral candidiasis, Suctioning and specific medication. Can provide relief and further infection.

GU: renal failure, Monitor vital signs and fluid intake and output. If there is renal failure kidney don’t work properly and
can’t excrete urine properly.
Respiratory: dyspnea, Reposition patient in high fowler’s position and Repositioning patient can help respiratory volume and
give oxygen. expansion.

Skin: pruritus and rash. Bed bathing. Can provide relaxation and cooling effect.

REFERENCES:
https://www.rxlist.com/meropenem/generic-drug.htm
Student Nurse: JENNIFER P. ALAMON Level/Section: BSN 4-C Date:MAY 13-14, 2024
DRUG STUDY
Patient (Initials only):L.G.L. Age:80 Gender:MALE Ward/Room/Bed:8 Allergy to:
Diagnosis/Impression:To Consider Septic Shock Secondary to Community Acquired Pneumonia, High Risk, Rule Out Cerebrovascular Accident, Bleed

Generic Name: TRANEXAMIC ACID Brand Name: Xed Dosage, Route & Timing: 500mg IVTTX3 doses then PRN

CLASSIFICATION: MECHANISM OF ACTION: PHARMACODYNAMICS

Pharmacologic Class: Hemostatic agents Inhibits activation of plasminogen, thereby preventing the conversion of plasminogen. Onset: Unknown
Therapeutic Class: Antifibrinolytics, plasminogen inactivators Peak: Unknown
Pregnancy Category: B Duration: 7-8hours

NURSING RESPONSIBILITIES / RATIONALE PATIENT / FAMILY EDUCATION

CATEGORY
CONSIDERATIONS
INDICATION:

It is a drug that controls bleeding and helps blood clot. Before administering the drug check the vital signs It can cause hypotension. Report if there’s rapid decline of blood pressure.
first.

CONTRAINDICATIONS / PRECAUTIONS

Have ever had allergic reaction to tranexamic acid or Check the patient’s data to verify if the patient is The treatment being less effective and can cause Assess the family about the drug and contraindication.
any other medicine. hypersensitive to drug and prevent from death to the patient.
administering it.

DRUG INTERACTIONS (Drug-Drug / Drug-Food /

Drug-Diagnostics / Drug-Herb)

Concurrent use of clotting factor complexes may Monitor Vital signs frequently if taking more than Taking more than one blood clotting-medicine can The family should have prior knowledge to drug-to-drug
increase the risk of thrombotic complications. one blood clotting medicine. cause heart attack, stroke, damage to the body’s interactions.
organs or even death.

NURSING RESPONSIBILITIES / RATIONALE PATIENT / FAMILY EDUCATION

CATEGORY
CONSIDERATIONS
SIDE EFFECTS / ADVERSE REACTIONS / ADVERSE
EFFECTS (By System)

General: Fatigue, thrombolytic events, convulsions, Monitor patient’s vital signs and neurologic status Allows for prompt intervention and appropriate Educate patients on the signs of thrombolytic events, such
management, potentially preventing serious as chest pain, shortness of breath, swelling, or redness in

EENT: Visual and ocular disturbance (eg. impaired
color vision), retinal vein or artery occlusion, ligneous symptoms regularly.
conjunctivitis,
Blood and lymphatic system: anemia,
GI: diarrhea, nausea, vomiting, abdominal pain,
Musculoskeletal: musculoskeletal pain,
Nervous system: headache, migraine,
Respiratory: nasal and sinus symptoms.
REFERENCES:
https://go.drugbank.com/drugs/DB00302
Assess patient’s visual acuity and ocular
Monitor patient’s hemoglobin level and hematocrit Help complications related to anemia and improve
regularly.
Monitor fluid intake and output
Assess patient’s pain effectively.
Assess the nature and intensity of pain.
Provide comfort measures such as warm
compresses, saline nasal sprays or humidifiers.
complications.
Allows for prompt intervention and appropriate
management, contributing to better outcomes for the
patient’s visual health.
patient’s quality of life.
Monitoring intake and output helps assess fluid
balance and guide interventions to maintain or restore patient’s meal.
balance
Helps patient’s feel more comfortable
Helps patient’s feel more comfortable.
To alleviate nasal congestion and discomfort.
the limbs and advise them to seek immediate medical
attention if they experience any of these symptoms.
Report any changes in vision.
Inform family to maintain patient’s diet rich in iron and
vitamins to help prevent anemia.
Encourage family member to avoid spicy and greasy food on
Encourage family member to do gently stretching exercises
and warm compress to alleviate patient’s muscle pain.
Encourage family member to identify and avoid triggers that
may lead to migraine.
Advise family member to avoid allergens and irritants that
may worsen the patient’s condition.