NURS 1566 Clinical Form 3: Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency

amlodipine Norvasc Antihypertensive, 2.5 mg PO Q Day
calcium channel
blocker
Peak Onset Duration Normal dosage range
6-9 hrs Unknown 24 hrs Initiate therapy at 2.5 mg/day, increase as required/tolerated (up to 10
mg/day).

Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
Hypertension N/A

Mechanism of action and indications Nursing Implications (what to focus on)

(Why med ordered)
Inhibits the transport of calcium into myocardial and vascular
smooth muscle cells, resulting in inhibition of excitation-
contraction coupling and subsequent contraction. Systemic
vasodilation resulting in decreased blood pressure. Coronary
vasodilation resulting in decreased frequency and severity of
attacks of angina.
Interactions with other patient drugs, OTC or herbal medicines
(ask patient specifically)
Additive hypotension may occur when used concurrently with
other antihypertensives (Prinivil, Coreg) or acute ingestion of
alcohol.
Nursing Process- Assessment Assessment
(Pre-administration assessment) Why would you hold or not give this med?
Monitor blood pressure and pulse before therapy, Blood pressure < 90 mm Hg or heart rate < 50 Decrease in blood pressure.
during dose titration, and periodically during bpm.
therapy. Monitor ECG periodically during
prolonged therapy. Monitor intake and output
ratios and daily weight. Assess for signs of CHF
(peripheral edema, rales/crackles, dyspnea, weight
gain, jugular venous distention).
Contraindications/warnings/interactions
Hypersensitivity, blood pressure < 90 mm Hg. Use cautiously in:
Severe hepatic impairment (dosage reduction recommended), geriatric
patients (dosage reduction recommended; increased risk of
hypotension), aortic stenosis, history of CHF.
Common side effects
Headache, peripheral edema.
Lab value alterations caused by medicine
Total serum calcium concentrations are not affected by calcium
channel blockers.
Be sure to teach the patient the following about this medication
Do not double doses. May need to be discontinued gradually. Instruct
patient on correct technique for monitoring pulse. Instruct patient to
contact health care professional if heart rate is <50 bpm. Caution
patient to change positions slowly to minimize orthostatic hypotension.
May cause drowsiness or dizziness. Advise patient to avoid driving or
other activities requiring alertness until response to the medication is
known. Instruct patient on importance of maintaining good dental
hygiene and seeing dentist frequently for teeth cleaning to prevent
tenderness, bleeding, and gingival hyperplasia (gum enlargement).
Advise patient to notify health care professional if irregular heartbeats,
dyspnea, swelling of hands and feet, pronounced dizziness, nausea,
constipation, or hypotension occurs or if headache is severe or
persistent. Advise patient to take blood pressure weekly and to report
significant changes to health care professional.
Evaluation
Check after giving