NURS 1566 Clinical Form 3: Clinical Medications Worksheets(You will need to make additional copies of these forms)

Generic NamePrednisone

Trade NamePredacort and many others

ClassificationSystemic corticosteroids

Dose40 mg

RoutePO

Time/frequencyQD

PeakUnknown

OnsetHour

Duration1.25-1.5 days

Normal dosage range5-60mg per day

Why is your patient getting this medicationAnti-inflammation of airways

For IV meds, compatibility with IV drips and/or solutionsN/A

Mechanism of action and indications(Why med ordered)Supress inflammation and the normal immune response. Used systemically and locally in a wide variety of chronic diseases including: Inflammatory (COPD)

Nursing Implications (what to focus on) Contraindications/warnings/interactionsContraindicated in pt’s w/ Active untreated infections, known alcohol, bisulfite, or tartrazine hypersensitivity or intolerance, Administration of live virus vaccines. Use cautiously in pt’s w/Chronic treatment (will lead to adrenal suppression; use lowest possible dose for shortest period of time),

Common side effects

CNS: depression, euphoria, CV: hypertensionGI: anorexia, nausea, Derm: acne, decreased wound healing, ecchymoses, fragility, hirsutism, petechiae, Endo: adrenal suppression, MS: muscle wasting, osteoporosis, Misc: cushingoid appearance (moon face, buffalo hump),

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)Phenytoin increases metabolism, may decrease effectiveness

Lab value alterations caused by medicineMonitor serum electrolytes and glucose. May cause hyperglycemia, especially in persons with diabetes.. Patients on prolonged therapy should routinely have hematologic values, serum electrolytes, and serum and urine glucose evaluated. May ↓ WBCs. May ↓ serum potassium and calcium and ↑ serum sodium concentrations

Be sure to teach the patient the following about this medicationCorticosteroids cause immunosuppression and may mask symptoms of infection. Instruct patient to avoid people with known contagious illnesses and to report possible infections immediately, Caution patient to avoid vaccinations without first consulting health care professional, Review side effects with patient. Instruct patient to inform health care professional promptly if severe abdominal pain or tarry stools occur Patient should also report unusual swelling, weight gain, tiredness, bone pain, bruising, nonhealing sores, visual disturbances, or behavior changes

Nursing Process- Assessment(Pre-administration assessment)Assess patient for signs of adrenal insufficiency (hypotension, weight loss, weakness, nausea, vomiting, anorexia, lethargy, confusion, restlessness) before and periodically during therapy

AssessmentWhy would you hold or not give this med?Do not hold dose, these drugs must be gradually decreased.

EvaluationCheck after giving.Decrease in presenting symptoms with minimal side effects.