Question

Please help

Please answer these question for three drug ( Please answer exactly the question)

1. insulin (HUMALOG) injection

2. pepcid

3. eliquis

Question

1. Why is your Patient receiving this medication?

2. Special Considerations
(Before administration, After administration, Nursing Considerations)

Please answer base on David guide drug

Answer 1

1. INSULIN:

HUMALOGis a rapid-acting human insulin analog used to lower blood glucose.

Before administration;

• Always check insulin labels before administration.
• Inspect Humalog visually before use. It should appear clear and colorless. Do not use humalog if particulate matter or coloration is seen.
• Do not mix humalog U-100 with other insulins when administering using a continuous subcutaneous infusion pump.
• Do not mix humalog u-200 with any other insulins.
• Do not administer humalog u-200 intravenously.

During administration;

• Do not use injections which are unusually viscous, cloudy, or discolored.
• Patients using insulin vials should never share needles or syringes with another person.
• Do not share pens among multiple patients in an inpatient setting; use multidose vials instead, if available, or, reserve the use of any pen to 1 patient only.
• For standard pen needles with an outer cover and an inner needle cover, remove both covers before use.
• For the safety pen needle, remove only the outer cover; the fixed inner needle shield remains in place.
• Insulin lispro can be administered intravenously under medical supervision; use insulin lispro 100 units/mL only to prepare intravenous infusions.
• Do NOT administer Humalog U-200 intravenously.
• Close monitoring of blood glucose and potassium levels are required to avoid hypoglycemia and hypokalemia.
• Infusion systems containing 0.9% NaCl injection should be used to prepare the infusion.

After administration:

NURSINGIMPLICATIONS

Assessment

• Assess for symptoms of hypoglycemia and hyperglycemia periodically during therapy.
• Lab Test Considerations: Monitor blood glucose every 6 hr during therapy, more frequently in ketoacidosis and times of stress. A1C may be monitored every 3– 6 mo to determine effectiveness.
• Toxicity and Overdose: Overdose is manifested by symptoms of hypoglycemia. Mild hypoglycemia may be treated by ingestion of oral glucose. Severe hypoglycemia is a life-threatening emergency; treatment consists of IV glucose, glucagon, or epinephrine.

        Nursing diagnosis:

• Risk for unstable blood glucose related to ineffective dosing of antidiabetic agents
• Imbalanced nutrition: less than body requirements related to the use of insulin and underlying disease process
• Risk for infection related to glucose levels

      Nursing Implementation with Rationale

• These are vital nursing interventions done in patients who are taking insulin:
• Ensure that patient has dietary and exercise regimen and using good hygiene practices to improve the effectiveness of the insulin and decrease adverse effects of the disease.
• Monitor nutritional status to provide nutritional consultation as needed.
• Gently rotate the vial containing the agent and avoid vigorous shaking to ensure uniform suspension of insulin.
• Rotate injection sites to avoid damage to muscles and to prevent subcutaneous atrophy.
• Monitor response carefully to avoid adverse effects.
• Always verify the name of the insulin being given because each insulin has a different peak and duration, and the names can be confused.
• Use caution when mixing types of insulin; administer mixtures of regular and NPH insulins within 15 minutes after combining them to ensure appropriate suspension and therapeutic effect.
• Store insulin in a cool place away from direct sunlight to ensure effectiveness. Predrawn syringes are stable for 1 week if refrigerated.
• Monitor patient’s food intake and exercise and activities to ensure therapeutic effect and avoid hypoglycemia.
• Monitor patient’s sensory losses to incorporate his or her needs into safety issues, as well as potential problems in drawing up and administering insulin.
• Provide good skin care and foot care, to prevent the development of serious infections and changes in therapeutic insulin doses.
• Provide comfort measures to help patient cope with drug effects.
• Provide patient education about drug effects and warning signs to report to enhance patient knowledge and to promote compliance.

Pepcid (famotidine) is a histamine-2 blocker that works by decreasing the amount of acid the stomach produces. It is used to treat and prevent ulcers in the stomach and intestines. It also treats conditions in which the stomach produces too much acid, such as Zollinger-Ellison syndrome. It also treats gastroesophageal reflux disease (GERD) and other conditions in which acid backs up from the stomach into the esophagus, causing heartburn.

Nursing considerations

Assessment

• History: Allergy to famotidine; renal failure; lactation, pregnancy, hepatic impairment
• Physical: Skin lesions; liver evaluation, abdominal examination, normal output; renal function tests, serum bilirubin

Interventions

• If using one dose a day, administer drug at bedtime.
• Decrease doses with renal failure.
• Arrange for administration of concurrent antacid therapy to relieve pain.
• Reserve IV use for hospitalized patients not able to take oral medications; switch to oral medication as soon as possible.

Teaching points

• Take this drug at bedtime (or in the morning and at bedtime). Therapy may continue for 4–6 weeks or longer. Place rapidly disintegrating tablet on tongue and swallow with or without water.
• Take antacid exactly as prescribed, being careful of the times of administration.
• Have regular medical follow-up while on this drug to evaluate your response.
• Take over-the-counter drug 1 hour before eating to prevent indigestion. Do not take more than two per day.
• You may experience these side effects: Constipation or diarrhea; loss of libido or impotence (reversible); headache (adjust lights, temperature, noise levels).
• Report sore throat, fever, unusual bruising or bleeding, severe headache, muscle or joint pain.