NCM 106 SY 2020-2021

V. Drug Study

DRUG CLASSIFICATION MECHANISM OF INDICATION CONTRINDICATION ADVERSE EFFECT NURSING

ACTION RESPONSIBILITIES
Generic Name: Antihypertensive, Inhibits the Hypertension Hypersensitivity Dizziness,  Administer with
Norvasc calcium – channel movement of lightheadedness, meals if upset
blocker calcium ions across headache, peripheral stomach occurs.
Brand Name: the membranes of edema, fatigue,  Monitor the BP,
Amlodipine cardiac & arterial lethargy, flushing, cardiac rhythm &
muscle cells. nausea output.
Dosage: 5mg 1 tab Inhibits  Eat frequent small
OD transmembrane meals.
calcium flow which  Report irregular
results in the heartbeat, SOB,
depression of swelling of hands
impulse formation & feet
in specialized
cardiac peacemaker
cells, slowing of the
velocity of
conduction of the
cardiac impulse,
depression of
myocardial
contractility &
dilation of coronary
arteries & arterioles
 NCM 106 SY 2020-2021

Generic Name: Adrenocortical May stabilize ESRD Hypersensitivity Euphoria, insomnia,  Monitor patient’s
Hydrocortisone steroid, leukocyte seizures, heart weight, BP.
Glucocortecoids lysosomal failure, HTN, edema,  Monitor patient’s
Brand Name: membranes, arrhythmias, thrombo for stress. Fever,
suppress immune embolism. cataracts trauma, surgery
Dosage: 250mg IV response, stimulate glaucoma, PUD, GI and emotional
every 8 hours bone marrow and irritation, increase problems may
influence nutrient appetite, pancreatitis, increase adrenal
metabolism. It hypokalemia, insufficiency.
reduces hyperglycemia,  Periodically
inflammation, carbohydrate measure growth
suppress immune intolerance. muscle and development
function and raises weakness, growth during high-dose or
adrenocorticoid suppression in prolonged therapy
hormonal levels. children, in infants and
osteoporosis.. children.
hirsutism, delayed  Be alert for adverse
wound healing, acne, reactions and drug
easy bruising interactions
Generic Name: Erythropoietin Made by ESRD, anemia  Uncontrolled Hypertension,  Do not give with
Epoetin alfa recombinant DNA hypertension headache, fatigue, N any other drug
recombinant Technology; it has  Hypersensitivity and V, diarrhea, solutions.
the identical amino  Use in chronic renal edema, asthenia,  Do not dilute or
Brand Name: acid sequence and failure clients who respiratory give in conjunction
Renogen same biologic need severe anemia congestion, cough, with other drug
effects as corrected pyrexia, rash, SOB, solutions.
Dosage: 2,000 endogenous insomnia, pruritus,  Note any
units 3x / week erythropoietin DVT (in surgery sensitivity to
(which is normally clients), mammalian cell-
synthesized in the hyperkalemia derived products or
kidney and human albumin.
stimulates RBC  Determine CBC
 NCM 106 SY 2020-2021

production). and iron stores.

Epoetin alfa will  Assess BP, control
stimulate RBC hypertension.
production and thus Assess for seizures
elevate or maintain with any
The RBC level, significant
decreasing the need hematocrit
for blood increase.
transfusion.  Regularly monitor
CBC, renal
function studies, I
and O, electrolytes,
phosphorus and
uric acid levels.
Generic Name: Gastrointestinal Dopamine Anorexia and Pheochromocytoma, Extrapyramidal  Assess abdomen
Metoclopramide Stimulant antagonist that acts vomiting gastrointestinal symptoms, for bowel sounds,
by increasing hemorrhage, restlessness, distention, N&V.
Brand Name: sensitivity to obstruction, or drowsiness, fatigue,  Inject slowly IV
Plasil acetylcholine; perforation, lassitude, akathasia, over 1-2 minutes to
results in increased epilepsy,clients taking dizziness, nausea, prevent transient
Dosage: 10 mg IV motility of upper GI drugs likely to cause diarrhea feelings of anxiety
every 8 hours tract and relaxation extrapyramidal and restlessness.
of the pyloric symptoms, such as  Teach client that
sphincter and phenothiazines this drug increases
duodenal bulb movement/
concentrations of
the stomach and
intestine.
 Tell patient to
avoid alcohol and
CNS depressant.
Generic Name: Immunosuppressant Inhibits ESRD Hypersensitivity Chest pain, edema,  Obtain a serum or
 NCM 106 SY 2020-2021

Micophenolate proliferative hypertension, urine pregnancy

mofeyil responses of T – hemorrhage, kidney test within one
and B – tubular week of beginning
Brand Name: lymphocytes, necrosis, anemie, therapy and
Cellcept suppresses antibody leukopenia, provide
formation by B- thrombocytopenia, contraception
Dosage: 500 mg 1 lymphocytes, and hypercholesterolemia counceling.
tab TID may inhibit , hyperglycemia,  Obtain history of
recruitment of hyper & kidney transplant.
leukocytes into sites hypokalemia,  Monitor CBC
of inflammation and hypophosphatemia, regularly.
graft ejection. back pain, cough,  Monitor serum
dyspnea, acne, rash, potassium and
sepsis. phosphate, glucose
level, and
cholesterol level.

VI. Nursing Management (Nursing Care Plans)

 NCM 106 SY 2020-2021

Assessment Diagnosis Inference Planning Implementation Evaluation

Intervention Rationale
Subjective: Impaired urinary In CKD, stage 5, Short term: Dependent: Short term:
“Hirap ako makaihi”, elimination r/t there is impaired
as verbalized by the diminished renal fluid elimination. After 4 hours of  monitor VS  to obtain baseline After 4 hours of
patient. function. This causes the nursing data. nursing interventions,
inability of the interventions, the the patient
Objective: body to excrete patient will  establish rapport  to gain trust and demonstrated slight
 (+) anasarca excess water and demonstrate with the pt. and active improvement in urine
 Distended urinary waste products. As improvement in significant participation. elimination.
bladder a result, there is urine elimination. others.
 (+) Oliguria decrease in blood Goal Partially Met.
 (+) fatigue volume and also a  asses the pt.  to evaluate for
 (+) weakness decrease perfusion Long term: gen. condition. further Long term:
 Pain @ to the different interventions.
hypogastric area parts of the body After 4 days of After 4 days of
 No urine output including the nursing  determine the  to identify nursing interventions,
for 7 hours kidneys that will interventions, the pathology of causative or the patient’s voiding
 (+) tenderness lead to decrease patient’s voiding bladder contributing pattern and
 Difficulty upon urine output pattern and dysfunction. factor. elimination does not
urination elimination will return to normal.
 VS taken as return to normal.  review lab. Test.  to determine any
follows: changes in renal Goal Not Met
BP: 130/70 function and
mmHg presence of
RR: 18 cpm infection.
PR: 85 bpm
T: 37.1 C  palpate bladder.  to assess for
O2Sat: 98% urinary retention.
 investigate pain,
 to assess degree
noting location,
of interference or
 NCM 106 SY 2020-2021

duration and disability.

intensity,
presence of
bladder spasm,
back or flank
pain.

 determine pt’s  to help determine

usual daily fluid of hydration.
intake.

 observe for  pt. with urinary

signs of retention are at
infection, high risk for
cloudy, foul developing
odor, and infection.
bloody urine.

 emphasize  to reduce risk of

importance of infection.
perineal hygiene

Collaborative:
 Administer  to reduce risk of
antibiotics as infection.
prescribed

Assessment Diagnosis Inference Planning Implementation Evaluation

Intervention Rationale
 NCM 106 SY 2020-2021

Subjective: Impaired urinary In CKD, stage 5, Short term: Dependent: Short term:
“Hirap ako makaihi”, elimination r/t there is impaired
as verbalized by the diminished renal fluid elimination. After 4 hours of  monitor VS  to obtain baseline After 4 hours of
patient. function. This causes the nursing data. nursing interventions,
inability of the interventions, the the patient
Objective: body to excrete patient will  establish rapport  to gain trust and demonstrated slight
 (+) anasarca excess water and demonstrate with the pt. and active improvement in urine
 Distended urinary waste products. As improvement in significant participation. elimination.
bladder a result, there is urine elimination. others.
 (+) Oliguria decrease in blood Goal Partially Met.
 (+) fatigue volume and also a  asses the pt.  to evaluate for
 (+) weakness decrease perfusion Long term: gen. condition. further Long term:
 Pain @ to the different interventions.
hypogastric area parts of the body After 4 days of After 4 days of
 No urine output including the nursing  determine the  to identify nursing interventions,
for 7 hours kidneys that will interventions, the pathology of causative or the patient’s voiding
 (+) tenderness lead to decrease patient’s voiding bladder contributing pattern and
 Difficulty upon urine output pattern and dysfunction. factor. elimination does not
urination elimination will return to normal.
 VS taken as return to normal.  review lab. Test.  to determine any
follows: changes in renal Goal Not Met
BP: 130/70 function and
mmHg presence of
RR: 18 cpm infection.
PR: 85 bpm
T: 37.1 C  palpate bladder.  to assess for
O2Sat: 98% urinary retention.
 investigate pain,
 to assess degree
noting location,
of interference or
duration and
disability.
intensity,
NCM 106 SY 2020-2021

presence of
bladder spasm,
back or flank
pain.

 determine pt’s  to help determine

usual daily fluid of hydration.
intake.

 observe for  pt. with urinary

signs of retention are at
infection, high risk for
cloudy, foul developing
odor, and infection.
bloody urine.

 emphasize  to reduce risk of

importance of infection.
perineal hygiene

Collaborative:
 Administer  to reduce risk of
antibiotics as infection.
prescribed