Please enable JavaScript.
Coggle requires JavaScript to display documents.
Jason (Basic Medication Administration (Perform hand hygiene, Follow the 7…
Jason
Basic Medication Administration
Perform hand hygiene
Follow the 7 rights of medication preperation (Perry, A. G., Potter, P. A., Ostendorf, W., 2010, p. 518).
Assess for allergies and hypersensitivity (Perry et al., 2010. p. 518).
When administering medication to pediatric patients, distract them, this time can often cause anxiety
Notify guardian and child about the effects of the drugs
Prepare medication for one patient at a time
Ensure proper weight-based dosing for necessary drugs (Perry et al., 2010. p. 521).
Medications
Acetaminophen: is an analgesic that is effective to treat mild to moderate pain as well as fevers
This drug is appropriate for this patient as he will be experiencing pain after his operation and this will be effective in reducing/eliminating that pain
Interactions: none
Key Adverse effects (Deglin, E., Vallerand, A., & Sanoski, C., 2017): Nausea, vomiting, pancytopenia, hepatotoxicity, and hypokalemia
Acetaminophen inhibits the production of prostaglandins, which often cause pain and fever
The doctors order states that he/she would like this medication to be administered PO, but due to the fact that Jason is experiencing vomiting I would request that the medication order be changed to IV as it would be more effective, he wouldn't vomit it out.
Jason will receive the maximum dose for children due to the fact that he is 11 years old, nearly the age for an adult dose
If the doctor changes the order to IV then the final dose would be 705mg IV q4h prn
This medication is prn, meaning it is only to be administered when the patient is experiencing pain
Patient/Family teaching
Advise discontinuation in the event of a rash.
Advise parents to check OTC concentrations (Karch, A. M., 2006, p. 258).
It is important if the patient is vomiting to replenish electrolytes. Advise parents of how to do this
Medication should only be administered as long as the pain is intolerable
Ondansetron: prevents and treats nausea and vomiting postoperatively
Due to the fact that the patient is already experiencing vomiting it will be more effective for the medication to be given via IV, so the patient does not end up vomiting out the medication
For IV push the medication is given 2mg/mL. therefore the final dosage for the patient would be 2mL IV q8h prn. Administer over at least 30 seconds but preferably 3-5 minutes (Deglin et al, 2017)
This medication is prn, so it is only to be administered when necessary. So when Jason is experiencing vomiting, the medication should be administered
Blocks the effects of serotonin at receptor sites in the vagal nerve terminals.
This medication will be effective for this patient in order to reduce or completely eliminate the vomiting Jason is experiencing.
Patient/Family teaching:
advise patient to notify health care professional if symptoms of irregular heartbeat, serotonin syndrome, or involuntary movement of eyes, face or limbs (Deglin et al, 2017).
Ensure patient and parents know that this medication must be taken as directed.
Patient should know that it is important to drink plenty of water in order to prevent constipation.
Patient should be informed that it is important to maintain consistent oral care, as this medication can cause dry mouth.
Patient should ambulate slowly as this medication can cause dizziness and weakness
Medication should only be administer as long as the patient is vomiting
Key adverse effects (Deglin et al, 2017): headache, dizziness, weakness, constipation, diarrhea, dry mouth.
Dimenhydrinate: is an antiemetic and antihistamine, so it is often used to treat motion sickness
The concentration of the solution should be 5mg/mL, therefore the final dosage would be 5mL IV q4h prn. Administer through IV push over 2 minutes (Deglin et al, 2017).
This medication should be given via IV to prevent the chances of the patient vomiting out the medication
This medication is prescribed prn, so as long as he continues to vomit than the medication should continue to be administered.
Interactions: increased CNS depression with other opioid agents (Deglin et al., 2017).
This medication reduces the way the natural chemical histamine effects the body (Deglin et al., 2017).
Key adverse effects (Deglin et al, 2017): Drowsiness, dizziness, headache, blurred vision, dysuria, diarrhea, dry mouth
Patient/Family teaching
Patient should use sunscreen to prevent photosensitivity reactions (Deglin et al, 2017).
Inform patient that it can cause dry mouth so it is important to be consistent with oral care.
Advise patient to move slowly when they are taking the medication, as they may be feeling dizzy or drowsy.
Medication should only be administered as long as the patient is experiencing vomiting
In this case the medication would be effective in reducing the vomiting that Jason is experiencing
Morphine: is an opioid analgesic, used to treat moderate to severe pain
Administer over 5 minutes to decrease chance of respiratory depression, Hypotension and circulatory collapse. Ensure the solution is clear and colorless (Deglin et al., 2017).
Slowly ween Jason off of morphine to reduce withdrawal symptoms (Deglin et al, 2017)
This medication would be effective for Jason as he will likely be experiencing severe postoperative pain at his surgical site
Patient/Family teaching
Explain how to care for infusion equipment.
Advise patient to change positions slowly in order to prevent orthostatic hypotension (Deglin et al, 2017).
Teach parents how to accurately measure medications and to only use equipment dispensed with the medication.
Patient should ambulate slowly because the medication causes dizziness
Medication should only be administered as long as the patient is experiencing severe pain
Morphine binds to opioid receptors and alters the way in which the patient responds to painful stimuli
Interactions: when Dimenhydrinate is administered with an opioid it causes increased CNS depression (Deglin et al., 2017).
Key adverse effects (Deglin et al, 2017): confusion, sedation, dizziness, dysphoria, euphoria, headache
Should be administered by IV to prevent patient from vomiting out the medication
The patient should receive 4.7mg IV prn. the supply is 1mg/mL, so the final dosage would be 4.7mLq4h prn,
Have Jason sit supine for 2 hours after the medication is delivered (Deglin et al, 2017)
Medication is prn as the patient should only be receiving the medication when he is experiencing severe pain.
Nursing Process
Assessment
Is the patient still in pain?
Asses for fever
Assess for rash
Assess patient for extrapyramidal effects (Deglin et al., 2017)
Assess patients level of pain before administration as well as 30-60 minutes after administration (Deglin et al., 2017)
Assess LOC, BP, pulse, and respirations before, during, and after administration of morphine (Deglin et al., 2017)
Is patient still vomiting?
Take vitals before and after administration
Assess patient for vomiting, nausea, abdominal discomfort, and observe bowel sounds before administering ondansetron and dimenhydrinate.
Implementation
Do not confuse tylenol and tylenol pm (Deglin et al., 2017).
Ondansetron is more effective when one dose is administered before the first time the patient vomits, often before induction of anesthesia (Deglin et al.,, 2017).
Do not confuse morphine with hydromorphone (Deglin et al., 2017).
Morphine should always be discontinued to decrease any withdrawal symptoms (Deglin et al., 2017).
Expected outcome and evaluation
Dimenhydrinate: prevention or decreased severity of nausea and vomiting, vertigo, or motion sickness (Deglin et al., 2017).
Morphine: decrease to severity of pain without significant alteration of consciousness or respiratory status (Deglin et al., 2017)
Acetaminophen: Relief of mild to moderate pain, and reduction of fever
Ondansetron: prevention of postoperative nausea and vomiting