SIMS med sheet (Margaret Green) Patient 2 (1)

SIMS med sheet (Margaret Green) Patient 2 (1) -...

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Generic/Trade name Enoxaparin/ Lovenox (Skidmore-Roth, 2015 p. 361) Classification Anticoagulant; antithrombotic Mechanism of Action Inhibits clot formation Dosage and Route 30 mg, SQ; daily Is this a Safe Dose? Yes, the maximum dose is 150mg Q12Hr Drug/food Interactions Anticoagulants, antiplatelets, NSAIDS, salicylates, thrombolytics: increased bleeding Side Effects / Adverse Reactions CNS: Fever, confusion GI: Nausea HEMA: hemorrhage, hypochromic anemia, thrombocytopenia, bleeding INTEG: Ecchymosis, injection site hematoma SYST: Edema, peripheral edema Lab / VS needed prior to administration Platelets; Blood Pressure Nursing Considerations and Patient Teaching Assessment: Assess patient for pallor, bleeding gums, petechiae, ecchymosis, black tarry stools, hematuria, epistaxis, decrease in B/P; indicate bleeding and possible hemorrhage; notify prescriber immediately. Implementation: Give at the same time each day to maintain steady blood levels. Give to recumbent patient & rotate sites. Teaching: Warn patient to avoid OTC preparations unless directed by prescriber because they could cause serious product interactions. Instruct patient to use soft-bristled toothbrush to avoid bleeding gums Advise patient to report any signs of bleeding, bruising, light headedness Why is this patient taking this? The patient broke her hip and is at risk for DVT’s Is it effective? How do you know? Provide the evidence. Pt shows no signs of leg swelling, tenderness, warmth Generic/Trade name Furosemide/ Lasix (Skidmore-Roth, 2013 p. 470-472) Classification Loop Diuretic Mechanism of Action Prevents reabsorption of electrolytes by acting on the ascending loop of Henle; this allows for excretion of sodium, calcium, magnesium, chloride, water and some potassium; increases excretion of potassium in the distal tubule of the kidney.
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Dosage and Route 40 mg, IV daily undiluted over 2mins Is this a Safe Dose? Yes, max dose: 600mg/day Drug/food Interactions vancomycin; digoxin; lithium; aminoglycosides, anticoagulants, antihypertensives, nitrates, nondepolarizing skeletal muscle relaxants Side Effects / Adverse Reactions Lhypokalemia, hypomagnesemia, hyperuricemia, hypocalcemia, hyponatremia, hyperglycemia, nausea, , rash, pruritus, purpura; headache, fatigue, weakness, vertigo, paresthesias; orthostatic hypotension, chest pain; ear pain, blurred vision; diarrhea, dry mouth, vomiting, cramps, thrombocytopenia, Lab / VS needed prior to administration of each dose Blood pressure, pulse, potassium level Nursing Considerations Assessment: Assess for ototoxicity, tinnitus, hearing lost or ear pain; monitor potassium levels, tachycardia, weak pulse, muscle weakness and confusion; monitor I&O and weight; check lung sounds for crackles, adequacy of pulse, peripheral edema, distended neck veins, and check for dry mucous membranes.
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