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

Generic NameMetolazone

Trade NameZaroxolyn

ClassificationThiazide like diuretics

Dose5 mg

RoutePO

Time/frequencyQ am

Peak2 hours

Onset1 hour

Duration12-24 hours

Normal dosage range5-20 mg/day

Why is your patient getting this medicationEdema caused by chf

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

Mechanism of action and indications(Why med ordered)Increases the excretion of sodium and water by inhibiting sodium reabsorption in the distal tubule. Promotes excretion of chloride, potassium, magnesium, and bicarbonate May produce arteriolar dilation. Indicated for mild to moderate hypertension or edema associated with CHF or nephrotic syndrome.

Nursing Implications (what to focus on) Contraindications/warnings/interactionsHypersensitivity. Cross sensitivity with other sulfonamides may exist. Anuria. Use cautiously in severe hepatic imparement.

Common side effectsHypokalemia, hyperuricemia

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)Increased risk of hypotention with ingestion of alcohol.

Lab value alterations caused by medicineMonitor electrolytes, especially potassium, blood glucose, BUN, and serum creatinine and uric acid levels before and periodically during therapy. May cause an increased in serum and urine glucose in diabetic patients, increase in serum bilirubin, calcium, creatinine, uric acid, serum cholesterol, ldl’s and triglyceride concentrations. May cause a decrease in serum magnesium, potassium, and sodium and urinary calcium concentrations. May also cause a decrease in serum protein bound iodine concentrations.

Be sure to teach the patient the following about this medicationTake at the same time each day. Monitor weight biweekly. Change position slowly, protect from photosensitivity reactions. Discuss dietary potassium requirements. Report muscle weakness, cramps, n/v/d. Emphasize the importance of routine follow up exams. Advise patient to consult health care professional before taking OTC meds, especially cough or cold preparations, concurrently with this therapy.

Nursing Process- Assessment(Pre-administration assessment)Monitor BP, I&O, daily weight, and assiss feet, legs, and sacral area for edema. Assess pt for anorecia, nausea, vomiting, or muscle cramps.

AssessmentWhy would you hold or not give this med?If pt reports nausea vomiting or muscle cramps, notify physician

EvaluationCheck after givingBP, I&O, assess for decreasing edema