Question

PN 200 Fundamentals of Nursing II Anticoagulants Coumadin A patient is taking phenytoin, warfarin (Coumadin), promethazine (Phenergan eperidine (Demerol), and diazepam (Valium) 1. Prepare a patient medication teaching plan for this patient being sure to include specifics about probable drug interactions 2. During the teaching session, the patient shares that he plans to start taking OTC products to boost his energy. What is the nurse's best response to the patient's comment being sure to explain the rationale for your answer? 3. List four adverse eiřfects of each of the medications this patient is recetving Reviewed 11 18

Answer 1

1.Teach patient that the medication prescribed are anti-seizure,anti-coagulant and pain medications which cause mild sedation.Teach about the action of each medication.Instruct that before taking new medications it is necessary to consult the physician.Strictly inform that never skip the medication ,never adjust the dose by yourself and never double the dose in skipped situations.Drug interactions are high in this group of medications.For example for headache you are taking paracetamol by yourself can make alterations in all above drugs interact with those and reduce their drug action.so you face the problems of occurrence of seizure, uncontrolled bleeding and sedation can occur.Thus taking any drug with this group of medications cause drug interaction and result in fatal conditions.

2. The nurse must strictly ask the patient  to avoid OTC medications.Actually he is taking the risky medications for the serious problems it may have various drug interaction problems.Taking medications without physician consult may have chance to various drug interactions can decrease the effect of medication action and may result in serious problems.Taking OTC medication can reduce the desired medication action thus it can lead to fatal conditions.

3.Adverse effects:

Phenytoin: Headache,nausea,confusion,muscle twitching

Warfarin: Severe bleeding, joint pain and swelling, headache,bloody stool.

Promethazine: Drowsiness, tachycardia or bradycardia,nausea, photosensitivity.

Meperidine: Mood changes,muscle twiching, tremor, hypotension.

Diazepam: Dizziness,ataxia,muscle weakness, blurred vision.