PROTOTYPE DRUG Penicillin G Potassium (Pentids)：原型药物青霉素G钾（青霉素G钾制剂的商品名）

PROTOTYPE DRUG Penicillin G Potassium (Pentids)：原型药物青霉素G钾（青霉素G钾制剂的商品名） Nursing Process Focus: Patients Receiving Ciprofloxin (Cipro) Assessment Potential Nursing Diagnoses Prior to administration: , Deficient Knowledge related to , Obtain complete health history including antibacterial drug therapy allergies, drug history and possible drug , Risk for fluid volume deficit related to GI interactions side effects from drug therapy , Assess for presence or history of local or , Diarrhea, related to effects of drug therapy systemic infections , Obtain vital signs , Obtain history of drug allergies Planning: Patient Goals and Expected Outcomes The patient will: , Demonstrate understanding of drug therapy , Demonstrate evidence of resolution of diagnosed infection after drug therapy is completed , Maintain adequate fluid and electrolyte balance Implementation Interventions and (Rationales) Patient Education/Discharge Planning , Safety for use by children under 18 not , Instruct patient to contact health care established, due to possible action of Cipro provider at the first signs of tendon pain on the cartilage, usually the Achilles or inflammation. tendon: tendon rupture. (May interfere with bone development in children less than 18 years of age.) , Avoid administering medications or foods , Instruct patient to administer these that contain _______________________, substances and medications _______ ______________________________, or hours after ciprofloxacin. _________________ such as antacids, dairy products, sucralfate or vitamin or mineral supplements, within ________ hours. , Administer with water and maintain , Take each dose with a glass of water adequate fluid intake to avoid crystalluria. and drink several extra glasses of fluid daily to prevent formation of , Monitor ____________ and __________ ciprofloxacin crystals in the urine. and urine pH. (The drug alters urinary pH and causes crystals to form in urine.) , Monitor use of caffeine during drug , Instruct patient to avoid caffeine intake therapy. (Absorption of Cipro is during drug therapy. ____________________ by caffeine.) , Monitor plasma theophylline , Inform patient that serum levels will concentrations for patients prescribed these need to be monitored. drugs. (The drug affects half-life of theophylline preparations.) , Monitor patient for symptom of , Advise patient to use caution when __________________________________. driving, operating machinery, or (This may occur due to the action of performing other hazardous activities ciprofloxacin on the central nervous system until effect of drug is known. (CNS).) Evaluation of Outcome Criteria Evaluate the effectiveness of drug therapy by confirming that patient goals and expected outcomes have been met (see “Planning”). Patients Receiving Trimethoprim (Bactrim, Septra) Assessment Potential Nursing Diagnoses Prior to administration: , Infection, Risk related to contact with contagious agents (nosocomial or , Obtain complete health history including allergies, drug history and possible drug community acquired) interactions , Infection, Risk related to increased vulnerability secondary to diminished , Assess for presence or history of systemic, respiratory or urinary tract infection immune response , Assess intake and output , Knowledge, Deficient, related to drug therapy and side effects Planning: Patient Goals and Expected Outcomes The patient will: , Demonstrate reduction in symptoms related to the diagnosed infection , Demonstrate understanding of drug therapy and side effects , Remain free of symptoms of side effects of drug therapy Implementation Interventions and (Rationales) Patient Education/Discharge Planning Inform patient: , Monitor __________________ function including these labs: ______________ , That _________________ tests and and _____________values, and intake and ____________ may need to be monitored output.(Drug can cause hematological , To report changes in urinary elimination to toxic effects, which are increased with the health care provider kidney disease and also the elderly population.) Advise patient to: , Evaluate complaints of painful urination, flank pain, and fever. (Drug can change , Drink 2.5-3 liters of fluid daily. the urine pH and could increase the , Report painful _______________, flank patient’s risk for formation of renal pain or fever to the health care provider calculi.) , Monitor baseline and follow-up urinalysis, , Instruct patient to continue medical CBC, platelet count, BUN and creatinine follow-up and laboratory test appointments clearance with long-term therapy. (To when receiving drug for extended period evaluate effectiveness of drug therapy.) of time. , Observe for symptoms of adverse , Instruct patient to report skin rash, sore reactions. (Evidenced in hematology and throat, fever, mouth sores, or unusual blood coagulation studies and by skin bleeding or bruising. manifestations.) , Monitor _______________ integrity. , Instruct patient to avoid exposure to direct (This drug can also increase patient’s _______________________. sensitivity on the skin to ultraviolet lights.) , Monitor , Instruct patient to take drug as directed and ________________________with to treatment regimen. (Full course of therapy __________________________________. is required. If patient stops medication before prescription is complete, symptoms may reoccur and this may increase _____________________to further antibiotics.) Evaluation of Outcome Criteria Evaluate the effectiveness of drug therapy by confirming that patient goals and expected outcomes have been met (see “Planning”). Nursing Process Focus: Patients Receiving Penicillin G (Pentids) Assessment Potential Nursing Diagnoses Prior to administration , Infection, Risk for, related to weakened , Obtain complete health history including immune state or contact with pathogen allergies, drug history and possible drug , Knowledge deficient related to drug action interactions. and therapy treatment and prevention , Assess for presence or history of local or measures systemic ________________________. , Injury, Risk (anaphylaxis) for related to adverse effects of drug , Obtain vital signs Planning: Patient Goals and Expected Outcomes The patient will: , Remain free of signs of allergic reaction to drug therapy , Demonstrate knowledge of drug action and side effects , Demonstrate resolution to incidence of infection Implementation Interventions and (Rationales) Patient Education/Discharge Planning Instruct patient: , Monitor for evidence of _____________ __________________________ to drug. , Signs of allergic reaction including (_______________________ may occur _______________, ______________, immediately or delayed beyond 72 _____________________________. hours.) , To immediately contact the health care provider if __________________ reaction occurs. , Monitor intake and output especially , Advise patient to consult health care quantity and consistency of __________ provider before taking antidiarrheal ________________________________. medication. These medications may (Severe diarrhea may occur due to the worsen or prolong diarrhea. possible adverse effect from Pseudomembranous colitis.) Instruct patient to: , Evaluate patient’s understanding of drug therapy and administration. , Take medication _______ hour before or ____________ hours _________ a meal. , Give medication ________________ ____________________________ to , Take medication with glass of water reduce destruction by gastric acid and , Take all of medication unless instructed enhanced absorption. to discontinue by the health care provider , Evaluate patient for evidence of , Instruct patient to notify the health care resolution of infectious process. (If the provider if symptoms persist or worsen. prescribed antibacterial is not effective another medication or different dosage may be required.) , Observe for ______________________, , Instruct patient to report signs and especially in susceptible patients symptoms of superinfection. Symptoms including elderly, debilitated, or may include: __________________, immunosuppressed patient. (There is a ____________________, stomatitis, high risk for superinfections due to ___________________ stools, vaginal normal flora reduced or eliminated.) _________________________, or ___________________. Evaluation of Outcome Criteria Evaluate the effectiveness of drug therapy by confirming that patient goals and expected outcomes are met (see “Planning”). Nursing Process Focus: Patients Receiving Cefotaxime (Claforan) Assessment Potential Nursing Diagnoses Prior to administration , Injury, Risk for ___________________ , Obtain complete health history including related to adverse reaction to drug allergies, drug history and possible drug , Infection, Risk for superinfection related to interactions effects of drug therapy , Assess for presence of local or systemic , Fluid volume, Risk for deficit, related to infection effects of drug on GI system , Obtain vital signs , Diarrhea, Risk for related to side effects of drug , Obtain history of drug allergies Planning: Patient Goals and Expected Outcomes The patient will: , Remain free of symptoms of allergic reaction , Maintain adequate fluid balance , Demonstrate absence of superinfection , Maintain formed stool consistency Implementation Interventions and (Rationales) Patient Education/Discharge Planning Instruct patient to: , Monitor for severe ____________ ________________________ caused , Report loose stools or diarrhea. by the disruption of normal bowel flora. , Avoid treating diarrhea with (May cause fluid _________________ antidiarrheals as this can impede the imbalance and superinfection of process of eliminating “bad bacteria" antibiotic-associated pseudomembranous Colitis. Cultured dairy products with live active cultures, such as kefir or yogurt may be used to help maintain normal intestinal flora. Supplements containing beneficial bacterial, such as acidophilus, are also available OTC). , Monitor for _____________, pruritus, , Instruct patient to report adverse or _________________ (indicative of reactions promptly. an ___________________ reaction to the medications). , Monitor _______________ and , Explain to patient purpose of required ____________________ carefully in laboratory tests and schedule follow-up patients with compromised with health care provider. ______________ function or if receiving aminoglycoside. , Monitor renal function with lab studies periodically during and after therapy. (Toxicity could occur from drug toxins that are unable to be excreted.) , Monitor for ___________________, , Instruct patient to report symptoms, especially with prolonged therapy. especially in debilitated or chronically ill patient. Evaluation of Outcome Criteria Evaluate the effectiveness of drug therapy by confirming that patient goals and expected outcomes have been met (see”Planning”). Nursing Process Focus: Patients Receiving Tetracycline HCl (Achromycin and others) Assessment Potential Nursing Diagnoses Prior to administration , Body image, disturbed related to change in , Obtain complete health history including appearance allergies, drug history and possible drug , Noncompliance related to prolonged interactions. therapy , Assess for presence/history of: Lyme , Therapeutic regimen management, disease, pneumonia, acne vulgaris, Ineffective related to prolonged course of Typhus, Cholera, Rocky Mountain treatment spotted fever, Chlamydia, sexually , Knowledge, Deficient, related to drug transmitted diseases, bladder infections, action and side effects Helicobacter Pylori ulcers Planning: Patient Goals and Expected Outcomes The patient will: , Remain free of symptoms caused by the diagnosed infection. , Maintain positive body image , Demonstrate knowledge of drug therapy and side effects , Demonstrate compliance with drug regimen Implementation Interventions and (Rationales) Patient Education/Discharge Planning , Monitor ______________status when , Instruct patient and caregivers to report administered to children under age 8. evidence of tooth discoloration or dental (Drug may cause permanent discoloration abnormalities to health care provider. of teeth, enamel defects, and bone growth retardation.) Instruct patient to: , Administer with caution to patients with impaired _____________________or , Report changes in ___________ output _________________ function. (Could , Report for follow up care and lab tests of result in impaired metabolism and ___________________ and ___________ excretion.) function and serum tetracycline levels. , Evaluate use of OTC products such as , Instruct patient to consult with health care __________________, provider before taking over the counter __________________ supplements, drugs. ______________________, and laxatives containing ______________. (These products interfere with drug absorption). Instruct patient to: , Evaluate patient understanding of drug therapy and administration. (Drug may , Avoid direct exposure to _____________ cause _________________________ and during and after therapy. Wear protective increase risk of clothing, and ______________________. _____________________. Tetracyclines , Use an alternate form of birth control can increase patient’s sensitivity of the until all the medication is completed. skin to __________________________.) , Avoid taking drug with ______________, especially ________________ products. , Report adverse effects of topical agent may cause irritation to eyes, nose, mouth, or allergic reaction. , To report worsening of infection and burning sensation to health care provider. Evaluation of Outcome Criteria Evaluate the effectiveness of drug therapy by confirming that patient goals and expected outcomes are met (see “Planning”). Nursing Process Focus: Patients Receiving Erythromycin (E-mycin, Erythrocin) Assessment Potential Nursing Diagnoses Prior to administration: , Knowledge, Deficient related to disease , Obtain complete health history process and drug therapy including allergies, drug history and , Infection, Risk for related to superinfection possible drug interations. , Fluid volume, Risk for Deficit related to , Assess for presence/history of local or effects of drug on GI system systemic ________________________ , Diarrhea, Risk forrelated to effect of drug , Obtain vital signs therapy , Obtain history of _________________ , Injury, Risk for (anaphylaxis) , related to reaction to drugs adverse reaction to drug Planning: Patient Goals and Expected Outcomes The patient will: , Demonstrate knowledge or drug therapy and treatment regimen , Remain free of drug induced diarrhea , Maintain adequate fluid balance , Maintain absence of allergic reaction to drug Implementation Interventions and (Rationales) Patient Education/Discharge Planning , Contraindicated in patients with , Instruct patient to report history of medical _______________________disease. problems to health care provider. (Because the metabolism of erythromycin ethylsuccinate (EES) is mainly by the __________________, it increases the patient’s risk for toxicity.) Instruct patient: , Monitor this lab: _________, temperature, cultures, and perform , To report ____________and worsening infection-focused physical examination. symptoms of ____________________. (To determine effectiveness of drug , To report for follow-up examinations. therapy.) Instruct patient: , Evaluate patient understanding of treatment regimen. (Patient must , To complete full prescription even if complete the full course of therapy to feeling better or symptom free. prevent _________________________ , Take with full glass of water, on an empty stomach _______-hour before or _______ , _________________________.) hours after meals. , Avoid taking with or just after ______ fruit juices or carbonated drinks. , Monitor for evidence of G.I. distress. , Instruct patient to report past history of GI (May require alternate form of problems to health care provider. medication.) , Monitor for ____________________ in , Instruct patient to immediately report patients receiving high dose, older __________________________________ adults, female and history of kidney or __________________________________ liver dysfunction. __________________________________ to the health care provider. , Observe for signs and symptoms of , Instruct patient to report diarrhea, ___________________________ by abdominal pain, vaginal _____________, overgrowth of non-susceptible bacteria or fever. or fungi. Evaluation of Outcome Criteria Evaluate the effectiveness of drug therapy by confirming that patient goals and expected outcomes have been met (see “Planning”). Nursing Process Focus: Patients Receiving Gentamicin (Garamycin) Assessment Potential Nursing Diagnoses Prior to administration: , Injury, Risk for related to renal , Obtain complete health history including insufficiency related to aminoglycoside allergies, drug history and possible drug therapy interactions , Injury, Risk for related to disturbances of , Assess for presence/history of local or balance and impaired ability to detect systemic infection environmental hazards , Obtain vital signs , Knowledge, Deficient related to drug therapy and side effects , Obtain history of drug allergies Planning: Patient Goals and Expected Outcomes The patient will: , Maintain normal renal function throughout drug therapy. , Demonstrate knowledge of drug therapy and side effects , Remain free of physical injury Implementation Interventions and (Rationales) Patient Education/Discharge Planning Instruct patient to provide thorough history of , Use with caution with impaired medical conditions and treatment to health care __________________________function provider. or neuromuscular disorders. (_________ impairment can increase the risk of toxicity with this drug. Patients with neuromuscular disorders may experience greater ________________ weakness due to possible neuromuscular blockade with the drug’s action.) Instruct patient to: , Monitor for signs of __________toxicity including unusual appearance of urine , Increase fluid intake of 2000 ml per day. (dark, cloudy) intake and output ratio, , Report evidence of decreased and the presence of edema. Report _______________output to the health care immediately provider , Monitor for evidence of , Instruct patient to notify health care ________________________including provider if changes in _______________________, __________________________ occur. _____________ or vertigo, _____________or vomiting with motion, ataxia, nystagmus, tinnitus, roaring noises, sensation of fullness of ears and hearing impairment. , Monitor peak and trough drug levels. , Explain to patient that frequent serum drug (Aminoglycosides have a therapy levels are necessary to prevent and __________________therapeutic range.) monitor for complications. , Observe for symptoms of neurotoxicity , Instruct patient to immediately report or neuromuscular blockade. muscle twitching, numbness, seizures, weakness, or difficulty breathing to the health care provider. , Observe for signs and symptoms of , Instruct patient to report diarrhea, bacterial overgrowth due to drug’s effect anogenital itching, vaginal discharge, to “kill” all bacteria, even normal flora stomatitis, or glossitis. that can lead to superinfection. Evaluation of Outcome Criteria Evaluate the effectiveness of drug therapy by confirming that patient goals and expected outcomes have been met (see “Planning”). Nursing Process Focus: Patients Receiving Vancomycin (Vancocin) Assessment Potential Nursing Diagnoses Prior to administration: , Sensory perception, Disturbed related to , Obtain complete health history including ototoxicity allergies, drug history and possible drug , Injury, Risk for deep vein thrombosis interactions related to chemical irritation of vein , Assess for presence or history of infections , Knowledge, Deficient, related to drug resistant to other antibiotics therapy and side effects , Obtain history of hearing loss, impaired renal function , Obtain history of cardiovascular disease , Obtain history of hearing loss Planning: Patient Goals and Expected Outcomes The patient will: , Demonstrate therapeutic response to drug therapy , Remain free of phlebitis , Maintain normal hearing acuity Implementation Interventions and (Rationales) Patient Education/Discharge Planning Inform patient: , Evaluate ____________________. (Contraindicated with previous hearing loss , That audiometry tests maybe done to due to drug’s ototoxic effects.) prevent complications from possible ototoxicity. , To report symptoms of ______________, buzzing in ears , Monitor peak and trough , Inform patient about purpose of laboratory ____________________________levels to studies. ensure safe and effective dosage. , Monitor ________________ status. , Advise patient of importance of laboratory (Dosage is adjusted with ____________ studies to establish baseline ___________ insufficiency.) function and to monitor function during and after treatment. , Monitor IV site carefully. (Drug is , Instruct patient to report pain or other irritating to tissues and causes necrosis and symptoms of discomfort immediately severe pain with extravasations.) during intravenous infusion. , Monitor for proper use of medication. , Patient must take medication as prescribed and complete _____________________ of treatment. Do not take other antidiarrheal preparations. Nursing Process Focus: Patients Receiving Isoniazid (INH) Assessment Potential Nursing Diagnoses Prior to administration: , Sensory perception, Disturbed related to , Obtain complete health history including peripheral neuritis and optic neuritis allergies, drug history and possible drug , Knowledge, Deficient, related to drug interactions therapy and side effects , Assess for presence/history of Positive , Therapeutic regimen management, tuberculin skin test, positive sputum culture Ineffective related to long term therapy or smear, close contact with person recently infected with tuberculosis, AIDS, receiving immunosuppressant drugs, alcohol abuse, liver or kidney disease Planning: Patient Goals and Expected Outcomes The patient will: , Demonstrate adherence to extended drug therapy , Demonstrate negative sputum cultures indicating effective drug therapy , Demonstrate understanding of drug therapy Implementation Interventions and (Rationales) Patient Education/Discharge Planning Instruct patient to: , Monitor ________________function. (Contraindicated in patients with , Provide accurate and complete medical, ________________________________.) medication and treatment history. , Avoid ________________ intake during drug therapy , Report signs of _____________ impairment to health care provider, including jaundice, itching, fatigue , Monitor for negative sputum cultures. , Instruct patient to follow through on Change noted within 2-3 weeks. (To prescribed lab tests. evaluate effectiveness of drug therapy.) Instruct patient to: , Monitor for presence of peripheral neuritis related to pyroxidine deficiency. , Take pyrodoxine supplement to reduce (Pyrodoxidine (vitamin __________) risk of side effects. deficiency causes neurotoxic effects.) , Report symptoms of numbness, tingling, or burning of feet to the health care provider , Evaluate diet for ingestion of foods , Advise patient to avoid foods such as containing tyramine. (Ingestion of ______________________, tyramine-containing foods may cause ______________, ________________ palpitation, flushing and BP elevation, and and yeast extracts. histamine-containing foods may cause exaggerated drug response with headache, palpitation, sweating, flushing, itching, or diarrhea.)