Aging, Hypertension, Transient Ischemic Attacks,

Atherosclerosis, Cardiac Conditions

Cerebral hemorrhage Occlusion of major vessel byother causes of ischemia

embolism

Cerebral Infarction

Decreased flow of blood to brain

Hypoxia
 Cerebral edema

Vascular congestion

Compression of tissue

Impaired function

Anterior cerebral Middle cerebral Posterior cerebral

artery artery artery
 Confusion Arm paralysis
Impaired thought process Hemianopia Hemiparesis
Contralateral paralysis/paresis Aphasia Ataxia
Urinary incontinence Agnosia Visual problems
Sensory deficits Perception deficits Dysphasia
Dysphonia

Return of normal Continued

perfusion inadequate blood
flow

Decreased edema Further compression of

tissues

Function improved Cerebral death

The patient was admitted last July 25, 2009- 11:46AM to the
Emergency Room of Quezon Medical Center under Dr.
Luduvice attending to the chief complaint of left side body
weakness. The following orders were given: please admit to
Medical Ward, secure consent, soft diet with strict aspiration
precaution, monitor vital signs every 4 hours
Plain NSS 1Lx8x3
Plain cranial CT scan
CBC, urinalysis, ECG, chest X-ray, lipid profile, crea, SGPT, FBS
Citicoline 1gram IV every 12 hours
Nifedipine 30mg. 1 tablet OD
Captopril 25mg. 1tablet PO every 6 hours, hold for BP>140/90
Ranitidine 50mg. IVF every 8 hours
Turn to side to side every 1 hour
NAME OF ACTION INDICATION DOSAG ADVERSE NURSING
DRUG E REACTION RESPONSIBILI
TY
RANITIDINE Relieves G.I. •Duodenal 50mg IVF •Malaise •Assess pts G.I.
HYDRO- discomfort. cancer q8° •Vertigo before giving
CHLORIDE •Gastric ulcer •Blurred vision drug.
(anti- •GERD •Nausea •Don’t use
ulcerative) •Vomiting aluminum- based
•Jaundice needles because
•Rash drug is
incompatible with
aluminum.
•Take drug with or
without food.
•Remind pt.
VIIT. C Raise vitamin C •Prevention of 500mg •Dizziness •When giving for
•Diarrhea taking drug once
(vitamin) level in body. vit. C deficiency 1 cap OD urine
•Acid urine daily to take it at
acidification,
bedtime.
check urine pH to
ensure
effectiveness.
•Give PO solution
directly into
mouth.
NAME OF ACTION INDICATION DOSAG ADVERSE NURSING
DRUG E REACTION RESPONSIBILI
TY
NICARDIPI- It inhibits the •Effort-induced 10g+90c •Bradycardia •Monitor VS every
NE flow of calcium angina. c PNSS in •Confusion 5-15 mins.
HYDRO- through muscle •Pringmetal solucet to •Constipation •Monitor drug’s
CHLORIDE cells which angina run for •Depression effectiveness .
(anti- dilates coronary 10-15 •Diarrhea •Observe pt. for
anginal), arteries and gtts/min •Dizziness adverse reaction
ADALAT decrease PRN •Dyspepsia such as allergic
GTTS (anti- systematic •Edema reactions, rash,
anginal) vascular •Fatigue etc.
resistance •Flushing •Caution pt. about
known as after •Headache the dangers of
load. •Hypotension using nitrates.
•Insomnia •Have pt. lie or sit
down when taking
the first dose of
•Mild pain or •Hemolytic nitrate.
•Asses for pt’s
PARACETA- Relieves pain 500 mg 1
MOL and reduces fever. tab PRN anemia pain or
(analgesic) fever. •Liver damage temperature
•Jaundice before giving the
•Hypoglycemia medication.
•Rash •Tell pt. is for
•Urticaria short-term use
only.
•Give liquid form
to children.
•Long-term use
can cause liver
NAME OF ACTION INDICATION DOSAG ADVERSE NURSING
DRUG E REACTION RESPONSIBILI
TY
CAPTOPRIL Reduces sodium •Hypertension 25mg 1 •Dizziness •If pt. has dry,
(anti- and water •Heart failure tab PO •Fainting productive cough,
hypertensiv retension. q6° hold •Fever watch out for
e) Lowers blood for BP •Angina renal impairment.
pressure. 140/90 pectoris •Take drug 1hr.
mmHg •Anorexia before meal
•Tachycardia because it
•Hyperkalemia decreases
•Cough absorption.
•Renal •Monitor BP and
impairment PR often.
•Monitor renal
function and
potassium level.
•Inform pt. that
DEXAME- Relieves •Cerebral 4mg/tab •Seizure •Give with food
•Headache light-headedness
THASONE cerebral edema. edema 1 tab PO when possible.
•Shock •Vertigo may
•Alwaysoccur.
(anti- q6° adjust to
inflammator •Supression •Edema lowest effective
y) •Hypertension dose.
•Cataracts •Warn pt. about
•Hypokalemia easy bruising.
•Muscle •Tell pt. not to
weakness abruptly stop
taking the drug
because this may
be fatal.
•Give pt. low
NAME OF ACTION INDICATION DOSAG ADVERSE NURSING
DRUG E REACTION RESPONSIBILI
TY
MANNITOL Decreases •To reduce 20% • confusion •Monitor VS
(diuretic) intracranial intraocular/intra 125cc IV •Seizures hourly.
pressure. cranial pressure. q4° •Headache •Administration:
•Heart failure slow push to
•Circulatory prevent
overload crystallization.
•Blurred vision •If pt’s oliguria
•Thirst increases, notify
•Nausea prescriber.
•Diarrhea •Increase fluid
•Water intake, it may
intoxication cause dryness of
mouth.

CEFURO- Hinders or kills •LRTI 750mg IV •Headache •Assess pt’s

XIME susceptible •UTI •Malaise infection before
(antibiotic) bacteria. •Acute •Nausea giving the
bronchitis •Vomiting medication.
•Pruritis •If G.I. reaction
•Dyspnea occur, monitor
•Anaphylaxis hydration.
•Ask pt. about
previous reaction
to penicillin.
•Tell pt. to report
adverse reaction.
NAME OF ACTION INDICATION DOSAG ADVERSE NURSING
DRUG E REACTION RESPONSIBILI
TY
NIFEDIPINE Reduces BP and •Vasopastic 30 mg 1 •Dizziness •Monitor
(anti- prevents angina tab OD •Headache potassium level
anginal) angina. •Hypertension •Heart failure regularly.
•Nasal •Monitor BP
congestion regularly.
•Nausea •Don’t use
•Hypokalemia nifedipine
•Muscle cramps sublingually to
rapidly reduce
severely high
blood pressure.
•Don’t give drug
with a high-fat
meal or grape
PHENYTOIN Prevents and •To prevent and 125mg/5 •Dizziness •fruit
Checkproducts.
BP during
(anti- stops seizure treat seizures ml 4 ml •Confusion •Instruct pt. to
administration.
convulsant) activity during q8° •Hypotension •swallow drug
If rash appears,
neurosurgery. •Blurred vision whole,
stop do not
giving the
•Nausea crush or chew.
drug.
•Vomiting •Inform pts that
•Hyperglycemia drug may color
•Osteomalacia urine pink, red or
brown.
•Do not abruptly
stop giving the
drug.
•Advise pt. not to
NAME OF ACTION INDICATION DOSAG ADVERSE NURSING
DRUG E REACTION RESPONSIBILI
TY
RANITIDINE Relieves G.I. •Duodenal 50mg IVF •Malaise •Assess pts G.I.
HYDRO- discomfort. cancer q8° •Vertigo before giving
CHLORIDE •Gastric ulcer •Blurred vision drug.
(anti- •GERD •Nausea •Don’t use
ulcerative) •Vomiting aluminum- based
•Jaundice needles because
•Rash drug is
incompatible with
aluminum.
•Take drug with or
without food.
•Remind pt.
taking drug once
daily to take it at
VIIT. C Raise vitamin C •Prevention of 500mg •Dizziness •bedtime.
When giving for
(vitamin) level in body. vit. C deficiency 1 cap OD •Diarrhea urine
•Acid urine acidification,
check urine pH to
ensure
effectiveness.
•Give PO solution
directly into
mouth.