DRUG STUDY

Drug Study # 1
Kefzol
Brand Name
Cefazolin
Generic Name
4.8.2024
Date Ordered
Since the pt. is exhibiting an infection due to an abnormally high white
blood cell count of 11.85x10^9L, this antibiotic was prescribed to treat any
Rationale for the
bacterial infections the pt. is exhibiting.
Drug Order

Cephalosporin Antibiotics
Classification
1g IV q6h
Actual Dose/
Frequency/ Route
Cefazolin injection is used to treat bacterial infections in many different
Indication parts of the body

Initially derived from the fungus Cephalosporium sp., cephalosporins are a

Mechanism of large group of bactericidal antimicrobials that work via their beta-lactam
Action rings. The beta-lactam rings bind to the penicillin-binding protein and
inhibit its normal activity. Unable to synthesize a cell wall, the bacteria die.

Cefazolin injection is contraindicated in patients who have a history of

Contraindication immediate hypersensitivity reactions (e.g., anaphylaxis, serious skin
reactions) to cefazolin or the cephalosporin antibacterial drugs, penicillins,
or other beta-lactams
Side Effects GI: nausea, vomiting, diarrhea, abdominal pain

Adverse Reactions Integumentary System: anaphylaxis, hives

Nursing Allergy Assessment: Before administering cefazolin, assess the patient for
Considerations/ any history of allergy or sensitivity to cephalosporins or penicillins, as there
Responsibilities may be cross-reactivity.

Renal Function: Cefazolin is primarily eliminated by the kidneys. Monitor

renal function, especially in patients with known renal impairment, and
adjust the dosage accordingly to prevent accumulation and potential
toxicity.

Monitoring for Adverse Reactions: Monitor the patient for signs of allergic
reactions, such as rash, itching, swelling, or difficulty breathing, during and
after administration. Be prepared to intervene promptly if an allergic
reaction occurs.

Patient Education: Educate the patient about the importance of completing

the full course of cefazolin therapy as prescribed, even if symptoms
improve before the medication is finished. Emphasize the risk of antibiotic
resistance with incomplete treatment.

Fluid Intake: Encourage adequate fluid intake to maintain hydration and

facilitate renal excretion of cefazolin. This is particularly important in
patients receiving high doses or prolonged therapy to prevent renal
complications.
 Monitoring for Nephrotoxicity: Continuously monitor renal function
throughout cefazolin therapy, especially in patients with pre-existing renal
impairment or those receiving concomitant nephrotoxic medications.
Promptly report any signs of renal dysfunction to the healthcare provider.

Drug Study #2
Prilosec
Brand Name
Omeprazole
Generic Name
4.8.2024
Date Ordered
Used for gastroesophageal reflux disease (GERD) since patient exhibited
Rationale for the vomiting 4x prior.
Drug Order

Antacid
Classification
40mg IV OD
Actual Dose/
Frequency/ Route
Omeprazole is used to treat certain conditions where there is too much acid
in the stomach.
Indication

Hydrochloric acid (HCl) secretion into the gastric lumen is a process

regulated mainly by the H(+)/K(+)-ATPase of the proton pump, expressed
in high quantities by the parietal cells of the stomach. ATPase is an enzyme
on the parietal cell membrane that facilitates hydrogen and potassium
exchange through the cell, which normally results in the extrusion of
potassium and formation of HCl (gastric acid).
Mechanism of
Action Omeprazole is a member of a class of antisecretory compounds, the
substituted benzimidazoles, that stop gastric acid secretion by selective
inhibition of the H+/K+ ATPase enzyme system. Proton-pump inhibitors
such as omeprazole bind covalently to cysteine residues via disulfide
bridges on the alpha subunit of the H+/K+ ATPase pump, inhibiting gastric
acid secretion for up to 36 hours 11. This antisecretory effect is dose-related
and leads to the inhibition of both basal and stimulated acid secretion,
regardless of the stimulus
Contraindication Patients who are hypersensitive to omeprazole or any other ingredients of
this formulation.
Musculoskeletal: Back pain, muscle cramps, myalgia, muscle weakness,
arthralgia, joint pain, and leg pain
Side Effects
Gastrointestinal Effects: Constipation and diarrhea, nausea, vomiting,
abdominal pain, flatulence, and acid regurgitation. Occasionally, dysphagia,
abdominal swelling, irritable colon, fecal discoloration
Respiratory Effects: Upper respiratory tract infections and cough. Epistaxis
and pharyngeal pain have been reported occasionally. Acute respiratory
Adverse Reactions
distress syndrome, respiratory failure, and pneumothorax
Cardiovascular Effects: Chest pain, angina pectoris, tachycardia,
bradycardia, palpitation, hypotension, hypertension, and peripheral edema
 1. Indication: Understand the reason for prescribing omeprazole 10
mg. It is commonly used to treat conditions such as
gastroesophageal reflux disease (GERD)

2. Dosage and Administration: Ensure that the patient has the correct
dosage strength. It can be taken with or without food, but it should
be swallowed whole and not crushed or chewed.

3. Patient Education: Provide patient education regarding the purpose

of omeprazole therapy, proper administration techniques, and
adherence to the prescribed dosage schedule. Emphasize the
importance of taking omeprazole regularly to achieve optimal
therapeutic outcomes.

4. Monitoring for Adverse Effects: While omeprazole is generally

well-tolerated, monitor patients for potential adverse effects such as
headache, nausea, abdominal pain, diarrhea, and constipation.
Report any concerning symptoms to the healthcare provider for
further evaluation.

5. Assessment of Symptom Relief: Monitor the patient's response to

omeprazole therapy by assessing for improvement in symptoms
such as heartburn, acid reflux, and abdominal discomfort.
Adjustments to the dosage or treatment plan may be necessary based
on the patient's clinical response.
Nursing
Considerations/
6. Interaction with Other Medications: Be aware of potential drug
Responsibilities
interactions with omeprazole, particularly with medications that
require gastric acidity for absorption (e.g., ketoconazole,
atazanavir). Consult the patient's medication list and the healthcare
provider to identify and manage potential interactions appropriately.

7. Duration of Therapy: Monitor the duration of therapy and reassess

the need for continued treatment periodically.

8. Assessment of Nutritional Status: Long-term use of omeprazole may

be associated with decreased absorption of certain nutrients (e.g.,
vitamin B12, magnesium, calcium). Assess the patient's nutritional
status regularly and consider supplementation if deficiencies are
identified.

9. Patient Safety: Educate patients about safety precautions associated

with omeprazole therapy, such as avoiding alcohol consumption,
minimizing exposure to sunlight due to increased risk of sunburn,
and seeking medical attention if they experience severe or persistent
adverse effects.

10. Documentation: Document omeprazole administration, including

the dosage, frequency, patient response, and any relevant education
provided, in the patient's medical record. Accurate documentation
facilitates communication among healthcare providers and ensures
continuity of care.

Drug Study #3
Lipitor
Brand Name
Atorvastatin
Generic Name
Date Ordered 4.8.2024
 LDL levels of the patient were above normal range upon admission, hence
Rationale for the
why atorvastatin was prescribed.
Drug Order
HMG-CoA reductase inhibitor
Classification
80mg per tab 1 tab OD
Actual Dose/
Frequency/ Route
Atorvastatin is commonly used to lower bad cholesterol levels (LDL-C) and
fats (triglycerides) in the blood. It also increases good cholesterol levels
Indication (HDL).

Atorvastatin is a statin medication and a competitive inhibitor of the

enzyme HMG-CoA (3-hydroxy-3-methylglutaryl coenzyme A) reductase,
which catalyzes the conversion of HMG-CoA to mevalonate, an early rate-
Mechanism of limiting step in cholesterol biosynthesis. Atorvastatin acts primarily in the
Action liver, where decreased hepatic cholesterol concentrations stimulate the
upregulation of hepatic low-density lipoprotein (LDL) receptors, which
increases hepatic uptake of LDL. Simply put, Atorvastatin lowers blood
cholesterol levels by decreasing the amount of cholesterol made by the liver
and by increasing the breakdown of bad cholesterol.
Atorvastatin contraindications include patients with hypersensitivity to any
Contraindication
of its components. Female patients should also avoid atorvastatin if they are
breastfeeding.
Side Effects Cognitive: dizziness

GI disturbances; headache, skin rashes, dizziness, blurred vision, insomnia,

dysgeusia; reversible increases in serum-aminotransferase conc; hepatitis,
Adverse Reactions
pancreatitis; hypersensitivity reactions including anaphylaxis &
angioedema; myopathy (characterized by myalgia & muscle weakness &
associated w/ increased creatine phosphokinase conc).
Nursing 1. Assessment of Patient: Before administering atorvastatin, nurses
Considerations/ should conduct a thorough assessment of the patient's medical
Responsibilities history, including any history of liver disease, muscle disorders, or
hypersensitivity reactions to statins. Assessing lipid profiles and
baseline liver function tests may also be necessary to establish the
appropriateness of atorvastatin therapy.

2. Patient Education: Nurses should provide patient education

regarding the purpose of atorvastatin therapy, including its role in
lowering cholesterol levels and reducing the risk of cardiovascular
events. Patients should be informed about the importance of
medication adherence, dietary modifications, and lifestyle changes
(such as regular exercise and smoking cessation) in conjunction with
atorvastatin therapy.

3. Monitoring for Adverse Effects: While atorvastatin is generally

well-tolerated, it can cause adverse effects such as muscle pain or
weakness (myopathy), liver enzyme elevations, and gastrointestinal
symptoms (e.g., nausea, diarrhea). Nurses should monitor patients
for signs and symptoms of adverse effects and promptly report any
concerns to the healthcare provider.

4. Muscle Symptom Monitoring: Patients taking atorvastatin should be

monitored for muscle symptoms, including unexplained muscle
pain, tenderness, or weakness.
 5. Assess for any other cardiovascular risk factors such as high blood
pressure, diabetes, smoking, and family history.

6. High blood pressure, diabetes, and smoking are all risk factors for
cardiovascular disease, and having a family history of
cardiovascular disease can also increase a person’s risk.

7. Drug Interactions: Atorvastatin has the potential to interact with

other medications, nurses should review the patient's medication list
for potential interactions and consult with the healthcare provider as
needed to adjust dosages or monitor for adverse effects.

8. Dietary Considerations: While taking atorvastatin, patients should

be advised to follow a heart-healthy diet low in saturated fats and
cholesterol. Nurses can provide dietary counseling and resources to
help patients make informed food choices and optimize the
effectiveness of atorvastatin therapy.

9. Compliance Monitoring: Nurses should assess patients' adherence to

atorvastatin therapy during follow-up visits and address any barriers
or concerns related to medication compliance. Patient engagement
and education are essential for promoting long-term adherence to
treatment and achieving therapeutic goals.

10. Documentation: Accurate documentation of atorvastatin

administration, including dosage, frequency, adverse effects, and
patient education, is essential for continuity of care and
communication among healthcare team members.

Drug Study #4
Osmitrol
Brand Name
Mannitol
Generic Name
4.10.2024
Date Ordered
Patient displayed signs of ICP upon admission hence why mannitol was
Rationale for the
administered to the patient.
Drug Order
Osmotic diuretic
Classification
100cc IV q4h
Actual Dose/
Frequency/ Route
Used for the reduction of intracranial pressure. Mannitol injection is also
Indication used to reduce swelling and pressure inside the eye or around the brain.

Mannitol is an osmotic diuretic that is metabolically inert in humans and

occurs naturally, as a sugar or sugar alcohol, in fruits and vegetables.
Mannitol elevates blood plasma osmolality, resulting in enhanced flow of
water from tissues, including the brain and cerebrospinal fluid, into
Mechanism of interstitial fluid and plasma. As a result, cerebral edema, elevated
Action intracranial pressure, and cerebrospinal fluid volume and pressure may be
reduced. As a diuretic mannitol induces diuresis because it is not
reabsorbed in the renal tubule, thereby increasing the osmolality of the
glomerular filtrate, facilitating excretion of water, and inhibiting the renal
tubular reabsorption of sodium, chloride, and other solutes.
Contraindication Contraindicated in patients with hypersensitivity to mannitol, pulmonary
edema and congestive heart failure.
Side Effects Cognitive: nausea, vomiting, headache

Adverse Reactions Renal system: electrolyte and fluid imbalance

1. Assessment of Patient: Before administering mannitol, nurses

should conduct a comprehensive assessment of the patient's medical
history, including any known allergies, renal function, cardiac
status, and electrolyte levels.

2. Monitoring Vital Signs: Regular monitoring of vital signs, including

blood pressure, heart rate, respiratory rate, and temperature, is
essential during mannitol administration. Changes in vital signs may
indicate fluid and electrolyte shifts, dehydration, or cardiovascular
complications, necessitating prompt intervention.

3. Fluid Balance Monitoring: Mannitol administration can lead to fluid

shifts within the body, potentially resulting in dehydration or fluid
overload. Nurses should closely monitor fluid intake and output, as
well as assess for signs of dehydration (e.g., dry mucous
membranes, decreased urine output) or fluid overload (e.g., edema,
crackles in the lungs).

4. Electrolyte Monitoring: Mannitol can disrupt electrolyte balance,

particularly sodium and potassium levels. Nurses should monitor
electrolyte levels through laboratory tests as ordered by the
healthcare provider and be vigilant for signs of electrolyte
imbalances, such as muscle weakness, cardiac arrhythmias, or
neurological changes.
Nursing
5. Renal Function Assessment: Mannitol is primarily excreted by the
Considerations/
kidneys, so renal function should be assessed before and during
Responsibilities
treatment.

6. Administration Technique: Nurses should adhere to proper aseptic

technique during preparation and administration to minimize the
risk of infection.

7. Rate of Administration: Mannitol should be administered at the

prescribed rate to avoid adverse effects such as rapid fluid shifts or
electrolyte imbalances. Nurses should follow the healthcare
provider's instructions regarding the infusion rate and adjust as
necessary based on the patient's response.

8. Patient Education: Nurses should provide patient education

regarding the purpose of mannitol therapy, potential side effects,
and the importance of adherence to treatment. Patients should be
informed about the need for close monitoring and encouraged to
report any concerning symptoms promptly.

9. Documentation: Accurate documentation of mannitol

administration, including the dose, route, infusion rate, vital signs,
fluid balance, electrolyte levels, and patient response, is essential for
continuity of care and communication among healthcare team
members.

10. Make sure drug is prescribed to right patient

Drug Study #5
Decadron
Brand Name
Dexamethasone
Generic Name
4.10.2024
Date Ordered
Dexamethasone is used to reduce cerebral edema in the patient (brain
swelling) associated with conditions such as brain tumors, head trauma, and
Rationale for the
cerebral infarction (stroke). It helps alleviate symptoms and may improve
Drug Order
outcomes in the patient.

Corticosteroid
Classification
4mg/ tab 1 tab q12h
Actual Dose/
Frequency/ Route
Dexamethasone and otic suspension is indicated for bacterial infections
Indication
The short term effects of corticosteroids are decreased vasodilation and
permeability of capillaries, as well as decreased leukocyte migration to sites
of inflammation. Corticosteroids binding to the glucocorticoid receptor
mediates changes in gene expression that lead to multiple downstream
effects over hours to days.

Glucocorticoids inhibit neutrophil apoptosis and demargination; they inhibit

Mechanism of
phospholipase A2, which decreases the formation of arachidonic acid
Action
derivatives; they inhibit NF-Kappa B and other inflammatory transcription
factors; they promote anti-inflammatory genes like interleukin-10.3

Lower doses of corticosteroids provide an anti-inflammatory effect, while

higher doses are immunosuppressive. High doses of glucocorticoids for an
extended period bind to the mineralocorticoid receptor, raising sodium
levels and decreasing potassium levels.

Patients with a known hypersensitivity or allergy to dexamethasone or other

Contraindication corticosteroids should not receive dexamethasone. Allergic reactions to
dexamethasone can range from mild skin rash to severe anaphylaxis and
require immediate medical attention.
Side Effects Integumentary System: Acne or exacerbation of acne: Dexamethasone can
exacerbate acne or cause acneiform eruptions.
Musculoskeletal: Osteoporosis: Prolonged use of dexamethasone can lead
to bone loss and osteoporosis, increasing the risk of fractures. Muscle
Adverse Reactions
weakness: Dexamethasone can cause muscle weakness or myopathy,
particularly with long-term use or high doses.

1. Assessment: Conduct a thorough assessment of the patient's medical

history, including allergies, current medications, and any underlying
conditions that may impact the use of dexamethasone. Assess vital
signs, laboratory values (e.g., blood glucose, electrolytes), and
baseline symptoms related to the condition being treated.
Nursing
Considerations/ 2. Patient Education: Provide comprehensive education to the patient
Responsibilities and their caregivers about dexamethasone, including its purpose,
dosage regimen, potential side effects, and precautions. Emphasize
the importance of adherence to the prescribed treatment plan and
any recommended dietary or lifestyle modifications.

3. Administration: Administer dexamethasone according to the

 prescribed dosage, route, and schedule. Ensure accurate calculation
of dosage based on the patient's weight, condition, and treatment
goals. Administer the medication orally with food or milk to
minimize gastrointestinal irritation, or via other routes as prescribed
(e.g., intravenous, intramuscular).

4. Monitoring: Monitor the patient closely for signs of adverse effects

or complications related to dexamethasone therapy. This includes
monitoring vital signs, fluid balance, electrolyte levels, blood
glucose levels (particularly in diabetic patients), and symptoms
related to the underlying condition being treated.

5. Assessment of Adrenal Function: In patients receiving prolonged or

high-dose dexamethasone therapy, assess adrenal function regularly
to detect signs of adrenal suppression.

6. Monitor for symptoms such as weakness, fatigue, hypotension, and

electrolyte imbalances.

7. Psychosocial Support: Provide emotional support and counseling to

patients and their families regarding potential psychological effects
of dexamethasone therapy, such as mood changes, insomnia, or
anxiety. Encourage open communication and address any concerns
or questions they may have.

8. Infection Prevention: Educate patients about the increased risk of

infections associated with dexamethasone therapy and the
importance of practicing good hygiene, avoiding sick contacts, and
seeking medical attention promptly if signs of infection develop.

9. Ensure accurate documentation and reconciliation of dexamethasone

therapy in the patient's medical records, including dosage,
frequency, and duration of treatment.

10. Communicate any changes in medication regimen to other members

of the healthcare team to ensure continuity of care. Promptly
identify and manage adverse effects or complications related to
dexamethasone therapy. This may involve adjusting the dosage,
administering supportive care like antiemetics for nausea or
consulting with the healthcare provider for further evaluation and
intervention.

Drug Study #6
Klotrix
Brand Name
Ketorolac
Generic Name
4.8.2024
Date Ordered
Prescribed since patient displayed severe headache upon admission
Rationale for the
Drug Order
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Classification
30mg q6h IVTT PRN for pain
Actual Dose/
Frequency/ Route
Indication Ketorolac is a Non-steroidal anti-inflammatory drug (NSAID) and has
antipyretic, analgesic and anti-inflammatory properties. It is indicated for
 short term management of acute pain
Ketorolac inhibits key pathways in prostaglandin synthesis which is crucial
to its mechanism of action. Although ketorolac is non-selective and inhibits
both COX-1 and COX-2 enzymes, its clinical efficacy is derived from its
Mechanism of COX-2 inhibition. The COX-2 enzyme is inducible and is responsible for
Action converting arachidonic acid to prostaglandins that mediate inflammation
and pain. By blocking this pathway, ketorolac achieves analgesia and
reduces inflammation. Ketorolac is administered as a racemic mixture;
however, the "S" enantiomer is largely responsible for its pharmacological
activity.
Moderate to severe renal impairment. History of peptic ulcer or GI
bleeding, asthma; cerebrovascular bleeding; hemorrhagic diathesis
including coagulation disorders; hypersensitivity to other NSAIDs, aspirin,
Contraindication
prostaglandin synthesis inhibitors. Complete or nasal polyp or partial
syndrome, angioedema or bronchospasm; hypovolemia or dehydration;
post-op patients w/ a high risk of hemorrhage or incomplete hemostasis.
Epidural or spiral administration. Pregnancy & lactation. Children <16 yr.
GI disturbances; abnormal dreams, taste & vision, thinking; aseptic
Side Effects
meningitis, convulsions, depression, dizziness, drowsiness, dry mouth,
euphoria, excessive thirst
GI system: functional disorders, hallucinations, headache, hearing loss,
hyperkinesia, inability to concentrate, insomnia, myalgia, nervousness,
paresthesia, stimulation, sweating, tinnitus, vertigo. Acute renal failure,
flank pain, glomerulonephritis, hemolytic uremic syndrome, hyperkalemia,
hyponatremia, increased urinary frequency, interstitial nephritis, nephrotic
Adverse Reactions syndrome, oliguria, raised serum urea & creatinine, renal papillary necrosis.
Bradycardia, flushing, HTN, pallor, purpura, thrombocytopenia, asthma,
dyspnea, pulmonary edema. Exfoliative dermatitis, Lyell's syndrome,
maculopapular rash, pruritus, SJS, urticaria. Anaphylaxis, bronchospasm,
flushing & rash, hypotension, laryngeal edema. Epistaxis, hematoma, post-
op wound hemorrhage. Abnormal liver function tests, asthenia, edema, inj
site pain, wt gain.
Nursing 1. Assessment: Conduct a thorough assessment of the patient's medical
Considerations/ history, including allergies, previous reactions to NSAIDs, renal
Responsibilities function, gastrointestinal ulcers, bleeding disorders, and concurrent
medications. This assessment helps determine the appropriateness of
ketorolac therapy and identify potential risk factors for adverse
effects.

2. Informed Consent: Ensure that the patient has been informed about
the risks and benefits of ketorolac therapy, including potential
adverse effects and alternative treatment options, and obtain
informed consent before administering the medication.

3. Dosage Calculation: Calculate the correct dosage of ketorolac based

on the patient's weight, age, and indication for use. Ketorolac is
typically administered intravenously or intramuscularly, with
dosages adjusted according to the severity of pain and renal
function.

4. Administration Technique: Administer ketorolac according to the

prescribed route and dosage regimen. Intravenous ketorolac should
be administered slowly over 15 seconds to minimize the risk of
infusion-related adverse reactions. Intramuscular injections should
be administered into a large muscle mass (e.g., the gluteus
maximus) to facilitate absorption.

5. Pain Assessment: Assess the patient's pain intensity and

characteristics before and after ketorolac administration using a
 validated pain assessment tool. Monitor the patient's response to
treatment and adjust the dosage or frequency of ketorolac as needed
to achieve adequate pain relief.

6. Monitoring Vital Signs: Monitor the patient's vital signs, including

blood pressure, heart rate, respiratory rate, and temperature, before
and after ketorolac administration. Be alert for signs of hypotension,
tachycardia, respiratory depression, or fever, which may indicate
adverse reactions or complications.

7. Renal Function Monitoring: Monitor renal function by assessing

urine output, serum creatinine, and blood urea nitrogen levels before
and during ketorolac therapy, especially in patients with pre-existing
renal impairment or risk factors for renal toxicity. Discontinue
ketorolac if renal function deteriorates or if signs of acute kidney
injury develop.

8. Fluid Balance Monitoring: Monitor fluid intake and output to assess

for signs of dehydration or fluid overload, particularly in patients
receiving ketorolac for an extended duration. Encourage adequate
hydration and consider fluid replacement therapy as needed to
maintain fluid balance.

9. Gastrointestinal Protection: Consider co-administration of

gastroprotective agents such as proton pump inhibitors, histamine
receptor antagonists in patients at high risk of gastrointestinal
bleeding or ulcers, such as those with a history of peptic ulcer
disease, gastrointestinal bleeding, or concurrent use of other
NSAIDs or anticoagulants.

10. Patient Education: Provide patient education about the purpose of

ketorolac therapy, proper administration techniques, potential
adverse effects (e.g., gastrointestinal bleeding, renal impairment),
and warning signs that require medical attention (e.g., severe
abdominal pain, bloody or tarry stools, decreased urine output).
Emphasize the importance of adherence to the prescribed dosage
and treatment duration to optimize therapeutic outcomes while
minimizing risks.

Drug Study #7
KCL
Brand Name
Potassium Chloride Tablets
Generic Name
4.14.2024
Date Ordered
Due to the patient’s abnormally low potassium levels (a result of 2.95mmol
Rationale for the whereas the normal range is 3.5-5.1mmol)
Drug Order

Mineral supplementation
Classification
2 tabs TID P.O
Actual Dose/
Frequency/ Route
Indication Potassium is a mineral that is found in many foods and is needed for several
functions of the body, especially the beating of the heart.
 Potassium chloride is used to prevent or to treat low blood levels of
potassium (hypokalemia).

The mechanism of action of potassium chloride tablets primarily revolves

around replenishing potassium levels in the body. Potassium is an essential
Mechanism of
electrolyte involved in various physiological processes, including
Action
maintaining proper heart function, muscle contraction, nerve transmission,
and fluid balance.

Patients with Addison's disease, a condition characterized by adrenal

Contraindication insufficiency, may have impaired potassium excretion and are at increased
risk of hyperkalemia. KCl tablets should be used cautiously or avoided in
these patients.
Side Effects Gastrointestinal Disturbances: Common side effects include nausea,
vomiting, diarrhea, and abdominal discomfort.
Adverse Reactions Integ System: Tissue necrosis at site

Nursing 1. Assessment of Serum Potassium Levels: Before administering KCl

Considerations/ tablets, assess the patient's serum potassium levels to determine the
Responsibilities need for supplementation. Monitor potassium levels regularly
during therapy to guide dosage adjustments and prevent
hyperkalemia or hypokalemia.

2. Patient Education: Educate the patient about the purpose of KCl

tablets, proper dosage regimen, potential side effects, and the
importance of compliance. Emphasize the need to take the
medication with food or a full glass of water to minimize
gastrointestinal irritation.

3. Contraindications and Precautions: Assess for contraindications

such as hyperkalemia, severe renal impairment, potassium-sparing
diuretic use, and hypersensitivity to potassium chloride. Use caution
in patients with conditions predisposing them to hyperkalemia or
potassium retention.

4. Dosage Calculation and Administration: Calculate the appropriate

dosage of KCl tablets based on the patient's potassium deficit or
maintenance needs, taking into account serum potassium levels and
renal function. Administer the tablets whole with adequate fluid to
prevent esophageal irritation and ensure proper absorption.

5. Monitoring Electrolyte Levels: Monitor serum potassium levels,

renal function, and electrolyte balance regularly, especially during
initial therapy and dosage adjustments. Report any significant
changes or abnormalities promptly to the healthcare provider.

6. Assessment for Adverse Reactions: Monitor the patient for signs

and symptoms of hyperkalemia like weakness, palpitations, or
gastrointestinal irritation like nausea, vomiting, abdominal pain after
administering KCl tablets. Report adverse reactions promptly for
further evaluation and intervention.

7. Assessment of Fluid Status: Assess the patient's fluid status,

including intake and output, signs of dehydration or fluid overload,
and vital signs. Adequate hydration is essential for maintaining
electrolyte balance and preventing complications.
 8. Patient Safety: Ensure that KCl tablets are stored securely and
labeled properly to prevent medication errors. Educate the patient
about the importance of keeping the medication out of reach of
children.

9. Medication Interactions: Assess the patient's medication regimen for

potential interactions with KCl tablets, particularly potassium-
sparing diuretics, ACE inhibitors, ARBs, and nonsteroidal anti-
inflammatory drugs. Monitor for signs of hyperkalemia when KCl
tablets are used concomitantly with these medications.

10. Documentation: Document the administration of KCl tablets,

including the dosage, route, time, and patient response. Record
serum potassium levels, electrolyte imbalances, adverse reactions,
and any interventions provided. Documentation ensures continuity
of care and facilitates communication among healthcare team
members.
Ideal Nursing Management:

Brain Metastasis

Brain metastases are a common complication of cancer and the most common type of brain

tumor. Anywhere from 10% to 26% of patients who die from their cancer will develop brain

metastases. Managing brain metastasis involves a multidisciplinary approach that focuses on both

treating the cancer itself and addressing the symptoms and complications it causes. Here's an outline of

the ideal nursing management for brain metastasis:

Assessment and Monitoring:

Regular assessment of neurological status and level of consciousness including cognitive

function, motor skills, sensory perception, and vital signs.

Monitoring for signs of increased intracranial pressure (ICP) such as headache, nausea, vomiting,

altered level of consciousness, and changes in pupil size/reactivity. Assessing for symptoms specific to

the location of metastasis, such as seizures, visual disturbances, or speech difficulties.

Pain Management. Administering analgesics as prescribed to manage headaches or other sources of

pain. Monitoring pain levels, pain locations and effectiveness of pain management interventions.

Seizure Management. Administering anti-epileptic medications as prescribed to control seizures.

Monitoring for seizure activity and potential adverse effects of anti-epileptic drugs.

Emotional and Psychosocial Support:

Providing emotional support and counseling to the patient and their family members.

Educating them about the disease process, treatment options, and expected outcomes.

Referring to support groups or mental health professionals as needed.

Mobility and Safety. Assessing the patient's mobility and fall risk. Implementing fall prevention

strategies. Assisting with mobility as needed and encouraging activity within the limits of the patient's

condition.

Nutritional and Fluid Support. Monitoring nutritional status and intake shall take place. Providing

nutritional support as needed, such as through dietary modifications, supplements, or enteral feeding.

Positioning. Maintain a position of comfort with the head elevated.

Provides comfort and minimizes increased ICP by promoting venous drainage.

Education. Educating the patient and family about the signs and symptoms of complications and when

to seek medical attention. Providing information about treatment options, potential side effects, and

supportive care measures.

Lung Mass

Nursing care for patients with lung cancer encompasses both physiological and psychological

aspects, similar to other cancer patients. The focus is on addressing the respiratory manifestations of

the disease, along with providing pain relief, managing discomfort, and preventing complications.

Strategies are implemented to meet the patient’s needs and ensure their overall well-being.

Symptom Management. Assist the patient in managing symptoms such as cough, dyspnea, and fatigue

through pharmacological and non-pharmacological interventions. Monitor for any signs of respiratory

distress and intervene promptly as needed.

Respiration Assessment. Note respiratory rate, depth, and ease of respiration. Note the use of

accessory muscles and pursed-lip breathing. Note and assess the type of breath sounds.

Consciousness. Investigate restlessness and changes in mentation or level of consciousness. A

decrease in LOC may indicate a decrease in blood oxygen saturation.

Cough. Assess for cough and mucus production, hemoptysis, and chest pain. Cough is present in 50 to

75% of clients diagnosed with lung cancer.

Airway. Maintain patent airway by positioning, suctioning, and use of airway adjuncts.

Airway obstruction impedes ventilation, impaired gas exchange. In the case of upper airway

obstruction, the client is admitted to the ICU, and prepared for intubation and/or cricothyrotomy and

intraoperative tracheostomy

Positioning. Reposition frequently, placing the client in sitting positions and supine to side positions.

However, avoid positioning the client with a pneumonectomy on the operative side; instead, favor the

“good lung down” position. This maximizes lung expansion and drainage of secretions.

Hypertension

Assessment. Conduct a thorough assessment of the patient's blood pressure, including multiple

readings over time to establish a diagnosis of hypertension. Assess the patient's medical history,

including any risk factors for hypertension such as family history, obesity, smoking, and sedentary

lifestyle. Perform a physical examination to identify any signs of target organ damage associated with

hypertension, such as retinopathy, renal dysfunction, or cardiovascular complications.

Lifestyle Modifications. Provide education on lifestyle modifications to help lower blood pressure,

including adopting a healthy diet rich in fruits, vegetables, whole grains, and low-fat dairy products

while limiting sodium, saturated fats, and cholesterol. Encourage regular physical activity, such as

brisk walking, swimming, or cycling, for at least 30 minutes most days of the week. Advising weight
reduction for overweight or obese patients. Recommending moderation of alcohol consumption and

cessation of smoking.