DRUG STUDY

Table 1: NaCl

DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING

ACTION RESPONSIBILITIES

Generic name: Sodium  Replaces deficiencies  Hydration and provision  IV solution: CV: edema (when given Follow the 10 rights of
Chloride of sodium and of NaCl in deficiency Hypertonic (3%, 5%) too rapidly or in excess), drug administration
chloride and states.  Maintenance of solutions should not thrombophlebitis, heart
Brand name: Kruschen Salts, maintains these fluid and electrolyte be used in patients failure exacerbation.  Infusion of 0.45%
Ocu- Disal electrolytes at status in situations in with elevated, slightly NaCl is hypotonic,
adequate levels. which losses may be decreased, or normal Metabolic: fluid and 0.9% NaCl is isotonic,
DOSAGE: 1, 250 ml excessive. (excess serum sodium. electrolyte disturbances and 3% and 5% NaCl
diuresis or severe salt (such as hypernatremia and are hypertonic  Rate
Frequency: Per day restriction).  Fluid retention or hyperphosphatemia), of hypertonic solutions
hypernatremia. aggravation of existing should not exceed
ROUTE: IVF metabolic acidosis (with 100ml/hr.
Precautions:  excessive infusion) ,
Classification: Mineral and hypervolemia, Patient monitor
electrolytereplacements/  Patients prone to hypokalemia.
supplements metabolic, acid-base,  Assess fluid balance
or fluid and Respiratory: pulmonary (intake and output,
electrolyte edema. daily weight, edema,
abnormalities, and lung sounds)
including: vomiting, Other: pain, swelling, throughout therapy
diarrhea, diuretic local tenderness, abscess,
therapy, or tissue necrosis at I.V.  Assess patient for
glucocorticoid site. symptoms of
therapy, fistulas, CHF, hyponatremia
 severe renal failure, (headache,
sever liver disease tachycardia, dry
(additional mucous membranes,
electrolytes may be nausea, vomiting,
required).  muscle cramps) or
hypernatremia (edema,
PO: inadequate hydration weight gain,
(water and other hypertension,
electrolytes must be tachycardia, fever
replaced. flushed skin, mental
irritability) throughout
therapy.

Lab test considerations:

 Monitor serum
sodium, potassium,
bicarbonate, and
chloride
concentrations and
acid -base balance
periodically for
patients receiving
prolonged therapy
with sodium chloride.


 Monitor serum
osmolarity in patients
receiving hypertonic
 saline solutions. 

Patient monitoring:

 Monitor electrolyte
levels and blood
chemistry results.

 Watch for signs and

symptoms of
pulmonary edema or
worsening heart
failure.

 Carefully monitor
vital signs, fluid
balance, weight, and
cardiovascular status.

 Assess injection site

closely to help prevent
tissue necrosis and
thrombophlebitis.

Patient teaching:

 Teach patient to
recognize and
immediately report
serious adverse
reactions, such as
breathing problems or
 swelling.

 Instruct patient to
report pain,
tenderness, or swelling
at injection site.

 As appropriate, review
all other significant
and life-threatening
adverse reactions and
interactions, especially
those related to the
tests mentioned above.

Table 2: D5% LR
DRUG NAME MECHANISM OF ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
RESPONSIBILITIES

Generic name:  Hypertonic solutions are  Replacement  Renal failure   Increased serum osmolality Follow the 10 rights of drug
those that have an therapy particularly  administration
Lactated ringer’s and 5 % effective osmolarity in extracellular  Heart disease 
dextrose injection greater than the body fluid deficit  Hypernatremia 
fluids. These solutions accompanied by  Dehydration 
Brand name: draw fluid out of the acidosis.   Hypokalemia  INTERVENTION:
intracellular and interstitial  Liver dysfunction
5 % dextrose in lactated compartments into the  Treatment of shock  Altered thermoregulation  Watch out for signs of
ringer’s (D5LR) vascular compartment,  Persons needing  Diabetes mellitus  hypervolemia . Do not
expanding vascular extra calories who administer unless solution
 volume. It raises
DOSAGE: 1, 250 ml intravascular osmotic cannot tolerate  Lactic acidosis   Pulmonary edema  is clear and container is
pressure and provides fluid overload. undamaged.  Never stop
Frequency: Per day fluid, electrolytes and  Alkalosis   Cardiovascular overload hypertonic solutions
calories for energy. abruptly. 
ROUTE: IVF  Hyperkalemia
 Check vital signs
Classification: frequently. Report adverse
reactions. 
Hypertonic Solution 
Nonpyrogenic, parenteral  Monitor fluid intake and
fluid, electrolyte and output and weight
nutrient replenisher carefully. Watch carefully
for signs and symptoms of
fluid overload. 

 Monitor patients for signs

of mental confusion.

 Lung sounds are

frequently auscultated to
detect signs of fluid
accumulation.

 Monitor glucose level

carefully, sodium,
potassium and serum
osmolality.
Table 3: Ciprofloxacin
DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITIES
ACTION

Generic name:  Inhibits bacterial DNA  Treat urinary  Hypersensitivity to CNS: agitation, headache, Patient monitoring
synthesis by inhibiting drug or other restlessness, confusion, delirium,
Ciprofloxacin
DNA gyrase in infections caused fluoroquinolones. peripheral neuropathy, toxic  Assess creatinine level before
susceptible gram- psychosis. giving first dose.
Brand name: Cipro negative and gram- by bacteria such as  Comcomitant
I.V positive organisms. administration of CV: orthostatic hypotension,  Monitor drug blood level closely.
E. coli. tizanidine. vasculitis
DOSAGE: 200 mg  Watch for signs and symptoms of
EENT: nystagmus; with serious adverse reactions,
Frequency: q 12hours ophthalmic use—blurred vision; including GI problems, jaundice,
burning, stinging, irritation, tendon problems, and
ROUTE: I.V itching, tearing, and redness of hypersensitivity reactions.
eyes; eyelid itching, swelling, or
Classification: crusting; sensitivity to light

 Antibiotic GI: nausea, vomiting, diarrhea, Follow the 10 rights of drug

fluoroquinolones constipation, abdominal pain or administration
discomfort, dyspepsia, dysphagia,
flatulence, pancreatitis,
pseudomembranous colitis.
 Given twice a day exactly at 6 am
GU: albuminuria, candiduria, and 12 noon; Make sure the
renal calculi patient drink plenty of water or
other fluids everyday while taking
Hematologic:
methemoglobinemia, Ciprofloxacine.
agranulocytosis, hemolytic
anemia.

Hepatic: jaundice, hepatic  Instruct patient not take or eat a lot

necrosis. of caffeine products such as
coffee, tea, energy drinks, cola or
Metabolic: hyperglycemia, chocolate within 6 hours before or
hyperkalemia. 2 hours after she take
ciprofloxacin.
Musculoskeletal: myalgia,
myoclonus, tendinitis, tendon
rupture Skin: rash, exfoliative
dermatitis, toxic epidermal  Instruct client to report any
necrolysis, erythema multiforme
photosensitivity. adverse reaction to the physician or
nurse.
Other: injection-site reaction,
altered taste, anosmia,
exacerbation of myasthenia
gravis, overgrowth of  Instruct patient to avoid taking at
nonsusceptible organisms, antacids and vitamin or mineral
hypersensitivity reactions supplements within 6 hours
including anaphylaxis and before or 2 hours after she take
Stevens-Johnson syndrome. ciprofloxacin.may decrease the
absorption of Ciprofloxacin which
makes it less effective when taken
at the same time.

 Inform patient that Ciprofloxacin

can cause side effects that may
impair his thinking or reactions.
 Instruct client to report any
adverse reaction to the physician
or nurse.

Patient teaching

 Instruct patient to take drug with

or without food at the same time
each day.

 Advise patient to drink 8 oz of

water every hour while awake to
ensure adequate hydration.

 Instruct patient to notify

prescriber at first sign of burning,
numbness, or tingling in hands or
feet; yellow eyes or skin; unusual
tiredness; persistent diarrhea; rash;
or tendon pain, swelling, or
inflammation.

 Advise patient to avoid excessive

exposure to sun or ultraviolet light
and to discontinue drug and notify
prescriber if phototoxicity
(burning, erythema, exudation,
vesicles, blistering, edema)
occurs.

 Instruct patient to call the

attending nurse at once if he has
 sudden pain, swelling, tenderness,
stiffness, or movement problems
in any of your joints. Also instruct
patient to rest his joint until she
receive medical care or
instructions.

 As appropriate, review all other

significant and life-threatening
adverse reactions and interactions,
especially those related to the
drugs, tests, foods, and herbs
mentioned above.

Schull, P. (2013). McGraw-Hill Nurse’s Drug Handbook, Seventh edition. https://cdn.fbsbx.com/v/t59.2708-

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