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An 80-year-old man “Gus” was 3 days postoperative. He was alert and oriented. A nursing student...

An 80-year-old man “Gus” was 3 days postoperative. He was alert and oriented. A nursing student administered his morning medications in one cup that included clopidogrel (Plavix), carbidopa-levodopa (Sinemet), prednisone, rivastigmine tartrate (Exelon), and risperidone (Risperdal). Unfortunately, this cup of medications belonged to another patient on the unit. The nursing student realized her error when she went to medicate her second patient and the patient noted that the medications in the cup did not look like her medications.

1. What potential side effects might Gus experience from the medications in this cup? Which of these side effects is most concerning to you?

2. What assessments are critical to monitor on this patient for the remainder of your shift due to potential side effects of the administered medications?

**Gus became drowsy with mild nausea and hypotension after taking the medication. **

3.What interventions could be provided to relieve the patient of these side effects? (name at least one for each side effect)

4. What needs to be monitored with each intervention to prevent further complications? (name at least one for each intervention)

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Answer #1

1. SIDE EFFECTS OF CLOPIDOGREL (PLAVIX) :

* Dizziness

* Nausea

* Vomiting

* Diarrhea

* Increase in bleeding

* Abdominal pain

  SIDE EFFECTS OF CARBIDOPA- LEVODOPA :

* Tremors

* Uncontrolled muscle movements

* Nausea

* Vomiting

* Diarrhea

SIDE EFFECTS OF PREDNISONE :

* Discoloration of skin

* Mood changes

* Abdominal pain

* Dry skin

* Profuse sweating

* Disturbances in sleep

* Acne formation

SIDE EFFECTS OF RIVASTIGMINE TARTRATE :

* Nausea

* Vomiting

* Anorexia

* Rapid weight loss

* Weakness

* Stomach upset

* Dizziness

SIDE EFFECTS OF RISPERIDONE :

* Drowsiness

* Headache

* Restlessness, agitation

* Stomach upset

Weight gain

* Mood depressions

* Tremors

* Constipation

* Mouth dryness

* Hypo tension

Hence Risperidone side effects is concerning due to its severs effects on patients health.

2. ASSESSMENTS TO MONITOR THE PATIENT :

1. Assess for conscious level of patient using Glasgow coma scale

2. Monitor for vital signs

3. Assess for Neurological examination

4. Identify for potential complications of medications on patient

5. Monitor Intake and Output chart

6. Assess for complete medication history of patient

3. INTERVENTIONS :

FOR VOMITING : Administer anti emetic medications

FOR DIZZINESS AND DROWSINESS : Monitor conscious level using Glasgow coma scale

FOR STOMACH UPSET : Administer Antacid. Ex- Rantac

FOR HYPERTENSION : Administer Anti hypertensives

FOR HEADACHE : Administer analgesics.

FOR WEIGHT LOSS : Provide nutritious diet rich in proteins, calories, fruits and green leafy vegetables.

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