NAME: Roshanne Danica J.

Vergara DATE: February 12-14,2024

AREA: VSAC CI: Ms. Rutchel Mondia

NAME: R. S. DATE OF ADMISSION: February 12, 2024

AGE/SEX: 26, M ADMITTING DIAGNOSIS: isolated crush injury to the right lower extremity
ROOM NUMBER: ATTENDING PHYSICIAN: Dr. B

DRUG STUDY

Generic Brand Classification Mechanism of Indication Adverse Nursing

Name name action reaction consideration

diazepam Valium PHARMACOTHERA Diazepam acts as a Diazepam is indicated for IV route may produce pain, 1. Assessment: Prior to administering
PEUTIC: positive allosteric the management ofswelling diazepam, assess Mr. Santos' vital
10mg IV Benzodiazepine(Sched modulator of the gamma- anxiety disorders, alcohol ,thrombophlebitis, carpal signs, respiratory status, and level of
ule IV) aminobutyric acid withdrawal symptoms, tunnel syndrome. Abrupt consciousness. Evaluate his medical
(GABA) receptor, which muscle spasms, seizure or too-rapid withdrawal history for any allergies or previous
CLINICAL: is the major inhibitory disorders, and asmay result in pronounced adverse reactions to benzodiazepines.
Antianxiety,skeletal neurotransmitter in the adjunctive therapy in the restlessness, irritability,
muscle central nervous system treatment of certaininsomnia, hand tremor, 2. Patient Education: Educate Mr. Santos
relaxant,anticonvulsan (CNS). By binding to the medical conditions such abdominal/muscle cramps, and his family about diazepam's
t GABA-A receptor as tetanus. It is also used diaphoresis, vomiting, purpose, dosage, and potential side
complex, diazepam as a premedication for seizures. Abrupt effects. Emphasize the importance of
enhances the inhibitory procedural sedation and withdrawal in pts with avoiding alcohol and sedating
effects of GABA, anesthesia induction. epilepsy may produce medications while taking diazepam, as
resulting in increase it can increase the risk of respiratory
hyperpolarization of For Mr. Santos, diazepam infrequency/severity of depression.
neuronal membranes and is prescribed to alleviate seizures. Overdose results
suppression of excitatory acute anxiety and in drowsiness, confusion, 3. Dosage and Administration:
neurotransmission. This agitation following his leg diminished reflexes, CNS Administer diazepam orally or
mechanism leads to fracture. It can also help depression, coma. intravenously as prescribed by the
sedative, anxiolytic, manage any muscle Antidote: Flumazenil healthcare provider. Follow the
spasms or discomfort recommended dosage regimen based on
muscle relaxant, and associated with his injury. Mr. Santos may experience Mr. Santos' weight, age, and medical
anticonvulsant effects. Additionally, diazepam common side effects such condition. Monitor him closely for
may assist in reducing any as drowsiness, dizziness, signs of over-sedation or respiratory
anxiety related to medical and confusion while taking depression.
procedures or surgery. diazepam. It may also
cause respiratory 4. Monitoring: Continuously monitor Mr.
depression, especially if Santos' vital signs, including respiratory
combined with other rate, oxygen saturation, and blood
central nervous system pressure, during and after diazepam
depressants like opioids. administration. Assess for any adverse
Additionally, diazepam reactions, such as excessive sedation or
can lead to physical confusion, and report findings promptly
dependence if used for an to the healthcare team.
extended period, and
sudden discontinuation 5. Safety Precautions: Implement fall
may result in withdrawal precautions and ensure a safe
symptoms such as tremors environment for Mr. Santos,
and seizures. particularly if he experiences
drowsiness or impaired coordination
while on diazepam. Encourage him to
use mobility aids and assistive devices
as needed to prevent falls and injuries.

6. Withdrawal Management: If diazepam

therapy is to be discontinued, taper the
dosage gradually to prevent withdrawal
symptoms. Monitor Mr. Santos closely
for signs of withdrawal, such as
agitation or tremors, and provide
supportive care as needed to alleviate
symptoms.
furosemide Lasix Pharmacologic class: Furosemide works Furosemide is prescribed CNS: vertigo, headache, 1. Assessment: Before administering
Loop diuretic primarily by inhibiting the for Mr. Santos to manage dizziness, paresthesia, furosemide, assess Mr. Santos' fluid status,
40mg IV reabsorption of sodium fluid overload and edema weakness, restlessness, electrolyte levels, renal function, and vital
Therapeutic class: and chloride ions in the associated with his crush fever. signs. Monitor his intake and output,
Antihypertensive, ascending loop of Henle injury and subsequent CV: orthostatic weight, and lung sounds to evaluate the
diuretic in the kidneys, thus surgical procedures. It hypotension, effectiveness of diuresis and assess for signs
interfering with the helps alleviate symptoms thrombophlebitis with IV of dehydration or fluid overload.
normal electrolyte of pulmonary edema, such administration.
transport mechanism. By as shortness of breath and EENT: blurred or yellowed 2. Patient Education: Educate Mr. Santos
blocking the sodium- respiratory distress, by vision, transient deafness, about the purpose of furosemide therapy, its
potassium-chloride co- promoting diuresis and tinnitus. dosage regimen, and potential side effects.
transporter (NKCC2) in reducing fluid GI: abdominal discomfort Emphasize the importance of maintaining
the thick ascending limb accumulation in the lungs. and pain, diarrhea, adequate hydration and consuming
of the loop of Henle, anorexia, nausea, potassium-rich foods to prevent electrolyte
furosemide prevents the vomiting, constipation, imbalances. Instruct him to report any
reabsorption of these ions pancreatitis symptoms of ototoxicity, such as ringing in
into the bloodstream. As a GU: azotemia, nocturia, the ears or hearing loss, promptly.
result, there is increased polyuria, frequent
osmotic pressure in the urination, oliguria. 3. Dosage and Administration: Administer
renal tubules, leading to Hematologic: agranulo furosemide orally or intravenously as
reduced water cytosis, aplastic anemia, prescribed by the healthcare provider.
reabsorption and leukopenia, throm Follow the recommended dosage based on
enhanced excretion of bocytopenia, anemia. Mr. Santos' weight, renal function, and fluid
sodium, chloride, Hepatic: hepatic dys status. Administer intravenous furosemide
potassium, and water in function, jaundice, slowly to minimize the risk of ototoxicity
the urine. increased liver enzyme and monitor for signs of adverse reactions
levels. during and after administration.
Furthermore, furosemide Metabolic: volume
also exerts vasodilatory depletion and dehydration, 4. Monitoring: Monitor Mr. Santos'
effects by directly asymptomatic electrolyte levels, particularly potassium,
relaxing vascular smooth Skin: dermatitis, purpura, sodium, and magnesium, regularly while on
muscle cells, particularly photosen sitivity reactions, furosemide therapy. Assess his renal
in the veins and arteries. transient pain at IM injec function through serum creatinine and
This vasodilation results tion site, toxic epidermal blood urea nitrogen (BUN) levels.
in decreased peripheral Continuously monitor his vital signs,
vascular resistance and necrolysis, SJS, erythema including blood pressure, heart rate, and
reduced preload on the multiforme. respiratory rate, to detect any signs of
heart, contributing to its Other: gout dehydration or hypovolemia.
diuretic action. By
decreasing preload, Mr. Santos may experience 5. Safety Precautions: Implement fall
furosemide helps alleviate common side effects of precautions and assist with ambulation if
symptoms of congestion furosemide, including Mr. Santos experiences dizziness or
and edema associated electrolyte imbalances orthostatic hypotension while on
with conditions such as such as hypokalemia, furosemide. Encourage him to rise slowly
heart failure and renal hyponatremia, and from a lying or sitting position to minimize
dysfunction. hypomagnesemia. the risk of falls. Monitor for signs of fluid
Additionally, furosemide overload or worsening pulmonary edema
can cause dehydration, and adjust furosemide dosage accordingly.
dizziness, and orthostatic
hypotension. It may also 6. Fluid and Electrolyte Management:
lead to ototoxicity, Monitor Mr. Santos' intake of fluids and
especially with rapid electrolytes, particularly potassium-rich
intravenous administration, foods or supplements, to prevent electrolyte
resulting in reversible or imbalances. Administer potassium
irreversible hearing loss. supplements as prescribed to maintain
serum potassium within the normal range.
Educate Mr. Santos about dietary
modifications and fluid restrictions as
needed to optimize therapy outcomes.