Classification

Dose, Route and Mechanism of Nursing

Drug and Contraindication Side Effects
Frequency Action Responsibilities
Indication
digoxin Cardiovascular .25 mg x 4 doses Inhibits sodium Contraindicated to CNS: fatigue, 1. Before
(Lanoxin) system drugs; TIV potassium- patients general weakness, giving the
inotropics q6 activated adenosine hypersensitive to headache, loading
triphosphate, drug and in those hallucination, dose,
Paroxysmal promoting with digitalis induced dizziness, agitation, obtain the
supraventricula movement of toxicity, ventricular vertigo, stupor, baseline
r tachycardia .25 mg/tab calcium from fibrillation or paresthesia data (heart
PO extracellular to ventricular CV: arrhythmias rate and
1 tab OD intracellular tachycardia unless EENT: blurred vision rhythm,
cytoplasm and caused by heart GI: anorexia, B.P., and
strengthening failure. nausea, vomiting, electrolytes
myocardial diarrhea ).
contraction. Also 2. . Prepare
acts on CNS to the
enhance vagal medication
tone, slowing as
contraction through prescribed.
the SA and AV node 3. Maintain
and providing an sterility
antiarrythmic when
effect. preparing
and
administeri
ng the
medication.
4. Administer
the
medication
as
prescribed.
5. Document
the
procedure
and note
the
patient’s
reaction.
INTRAVENOUS FLUID – PNSS (30-31 gtts/min)

Definition: Normal saline (NS) is the commonly-used term for a solution of 0.91% w/v of NaCl, about 300 mOsm/L. Less commonly, this
solution is referred to as physiological saline or isotonic saline, neither of which is technically accurate. NS is used frequently in intravenous
drips (IVs) for patients who cannot take fluids orally and have developed or are in danger of developing dehydration or hypovolemia. NS is
typically the first fluid used when hypovolemia is severe enough to threaten the adequacy of blood circulation and has long been believed to
be the safest fluid to give quickly in large volumes. However, it is now known that rapid infusion of NS can cause metabolic acidosis. NS is 9g
NaCl dissolved in 1 liter water. The mass of 1 milliliter of NS is 1.009 grams. The molecular weight of sodium chloride is approximately 58
g/mole, so 58g NaCl is 1 mole. Since NS contains 9 grams NaCl, the concentration is 9g/L divided by 58g/mole = 0.154 mole/L. Since NaCl
dissociates into two ions – sodium and chloride – 1 molar NaCl is 2 osmolar. Thus, NS contains 154 mEq/L of Na+ and Cl−. It has a slightly
higher degree of osmolarity (i.e. more solute per litre) than blood (hence, though it is said to be isotonic with blood in clinical contexts, this is a
technical inaccuracy). Nonetheless, the osmolarity of normal saline is a pretty close approximation to the osmolarity of NaCl in blood.

Indication: Replacement & maintenance of fluid & electrolytes.

Nursing Responsibilities:

1. Monitor pt. frequently for:

a. Signs of infiltration / sluggish flow

b. Signs of phlebitis / infection

c. Dwell time of catheter and need to be replaced

d. Condition of catheter dressing

2. Check the level of the IVF.

3. Correct solution, medication and volume.

4. Check and regulate the drop rate.

5. Change the IVF solution if needed.