DICLOFENAC SODIUM

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(di-klo’fen-ak)
Voltaren, Voltaren-XR, Solaraze
DICLOFENAC POTASSIUM
Cataflam
Classifications: central nervous system agent; analgesic, antipyretic; nsaid
Prototype: Ibuprofen
Pregnancy Category: B

NURSING IMPLICATIONS

Assessment & Drug Effects

• Monitor for therapeutic effectiveness. Up to 3 wks may be needed for beneficial effects with rheumatoid arthritis or osteoarthritis.
• Lab tests: Periodic liver function, serum uric acid concentrations Hct, PT/INR, and blood glucose.
• Observe and report signs of bleeding (e.g., petechiae, ecchymoses, bleeding gums, bloody or black stools, cloudy or bloody urine).
• Monitor BP for hypertension and blood sugar for hyperglycemia.
• Monitor diabetics closely for loss of diabetic control.
• Monitor for increased serum sodium and potassium in patients receiving potassium-sparing diuretics.
• Monitor weight and report gains greater than 1 kg (2 lb)/24 h.
• Monitor for signs and symptoms of GI irritation and ulceration.

Patient & Family Education

Oral Form

• Do not lie down for 15–30 min after taking medicine to decrease esophageal irritation.
• Discontinue use with onset of ringing or buzzing in the ears, impaired hearing, dizziness, GI discomfort, or bleeding and notify physician.
• Do not take aspirin or other OTC analgesics without permission of the physician.
• Avoid alcohol or other CNS depressants.
• Do not drive or engage in other potentially hazardous activities until reaction to drug is known.
• Note: Diabetics need to monitor blood glucose carefully for loss of glycemic control.
• Do not breast feed while taking this drug.

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• ENOXAPARIN (e-nox’a-pa-rin) Lovenox Classifications: blood formers, coagulators, and anticoagulants; low molecular weight heparin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Lab tests: Baseline coagulation studies; periodic CBC, platelet count, urine and stool for occult blood. Monitor platelet count closely. Withhold drug and notify physician if platelet
• FUROSEMIDE (fur-oh’se-mide) Fumide , Furomide , Lasix, Luramide  Classifications: electrolytic and water balance agent; loop diuretic Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Observe patients receiving parenteral drug carefully; closely monitor BP and vital signs. Sudden death from cardiac arrest has been reported. Monitor BP during periods of
• PIPERACILLIN SODIUM (pi-per’a-sill-in) Pipracil Classifications: antiinfective; beta-lactam antibiotic; antipseudomonal penicillin Prototype: Mezlocillin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Obtain history of hypersensitivity to penicillins, cephalosporins, or other drugs prior to administration. Lab tests: C&S prior to first dose of the drug; start drug pending results. Periodic CBC
• SPIRONOLACTONE (speer-on-oh-lak’tone) Aldactone, Novospiroton  Classifications: electrolytic and water balance agent; potassium-sparing diuretic Pregnancy Category: D NURSING IMPLICATIONS Assessment & Drug Effects Check blood pressure before initiation of therapy and at regular intervals throughout therapy. Lab tests: Monitor serum electrolytes (sodium and potassium) especially during early therapy; monitor digoxin
• AMPICILLIN SODIUM AND SULBACTAM SODIUM (am-pi-sill’in/sul-bak’tam) Unasyn Classifications: antiinfective; antibiotic; aminopenicillin Prototype: Ampicillin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Determine previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens prior to therapy. Lab tests: Baseline C&S tests prior to initiation of therapy; start drug pending results. Report promptly unexplained