Question

eater e are ate fo Medication Administration Competency NUR 319 Critical Areas: Student must state information about each med. Classification Mechanism of action Why is your client taking this drug? Nursing Implications Adverse Effects NPH Novolin insulin Regular Novolin Insulin 2 3 Nitroglycerin Heparin 5 Thiamine Furosemide Losartan Potassium Hydrochlorathiazide Lanoxin Metropolol STramadol Cipro (o Toradol Docusate Sodium Prof. CP June 2019

Answer 1

1. NPH Novolin insulin( Insulin is a polypeptide hormone, that regulates carbohydrate metabolism. NPH Novolin insulin is made up of recombinant DNA technology.

Generic name: nph, human insulin isophane suspension

Trade name: Novolin insulin/ Novolin N innolate

Dosage: 100 units/ ml.

3ml usuall dosage available in syringes.

Route: Subcutaneous

Classification

1. Regular insulin/ Novolin: short acting insulin

2. NPH : intermediate acting

3. velosulin: short acting insulin and it is used in the insulin pump.

Mechanism of action

Insulin is a hormone that regulates carbohydrates metabolism in the body. NPH decreases blood glucose level by increasing peripheral intake of glucose from blood. It also decrease glucose production from liver.

why client is taking NPH/ Indications

* Diabetes mellitus with increased blood sugar level ( to lower the glucose level in the blood)

Nursing Implications

- check the blood sugar level of the client

- episodes of hypoglycemia is a contraindication for NPH

- check for any allegy or sensitivity to insulin

- Use correct dose

- single use syringe must be used.

Adverse effects

1)low blood sugar

2) insulin sensitivity reaction/ allergy

3) local site reaction, where injection done, redness and skin thickness

Regular Novolin insulin

Generic name: Insulin regular

Trade name: Velosulin, Humulin R, Novolin R

dosage: 5- 10 units before meal

dosage is according to individual's glucose level

Classification

1. rapid acting insulin

2. long acting insulin

Mechanism of action

( same as above: nph mechanism of action)

Indications

* Insulin dependent Diabetes mellitus

* Diabetic ketoacidosis

* Hyperkalemia ( to increase intracellular ion exchange of Potassium)

* decrease in growth hormone production ( to stimulate pituitary activity there by increasing growth hormone production)

* Insulin shock therapy in psychiatry

Nursing Implications

- frequent blood glucose monitoring

- hypoglycemia is a contraindication for insulin therapy

- check the presence of acetone in the urine

- History of allergy to insulin is a contraindication.

Sideeffects

* hypoglycemia

* Type 1 hypersensitivity reaction/ Anaphylaxis

* lipoatrophy( tissue degeneration) at the injection site.

Nitroglycerin

Generic name: Nitroglycerin

Trade name: Nitro- bid, Nitroglyn

Dosage: 0.3 to 0.6 mg( sublingual tablets),

5 - 20mcg/ min ( iv infusion)

Route: Sublingual( under the tongue), Intra venous infusion and sprays are available

Classification: nitroglycerin belongs to nitrate group

1) Nitrostat sublingual tablets

2) Nitroglycerin (iv infusion)

3) sprays of nitroglycerin

Mechanism of action

Vasodialation.( dialating the blood vessels there by preventing chest pain , through adequate blood supply. chest pain is occurring mainly due to inadequate blood supply to heart muscles.

Indications

* Angina/ chest pain

Nursing Implications

- Monitor the blood pressure of the client. extreme caution during the administration of nitroglycerin to angina patient with hypotension.

- check for any cardiac dysarrythmias( ethanol content in nitroglycerin may cause ethanol toxicity.

- check for any blurred vision or dry mouth

- caution for any symptom of hypotension

Adverse effects

* Vertigo

* head ache

* blurred vision

* hypotension( palpitations, giddiness)

* nausea and vomiting.

Heparin (anti coagulant drug)

Generic name: Heparin

Trade name: Heparin, heparin sodium

Dosage: different from patient to patient

10,000 units in 50- 100 ml of Dextrose injection( initial dose for adults)

75- 100 units/ kg for children

route: Intravenous infusion

Mechanism of action

It is an anticoagulant. Heparin inactivating thrombin and factor X by activating anti thrombin in coagulation pathway. there by inhibiting the clotting process.

Indications

* Atrial Fibrillation

* disseminated intravascular coagulation

* venous thrombosis

Nursing Implications

* Check wheather the patient is on aspirin or NSAIDs ( increase the chance of bleeding) or nitroglycerin( decreases the effect of heparin) and notify the physician.

* only IV administration for heparin .

* Monitor activated partial thromboplastin time frequently ( normal 40 sec)

* Apply pressure to the venipuncture site for minimum 3 minutes.

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