Name: Mrs.

MM

Age: 77 years old

Nursing Diagnosis: Anxiety related to chronic illness w/ changes in roles/ body image.
Medical Diagnosis: ESRD secondary to DM Nephropathy
Short-term Goal: At the end of my shift, patient will verbalize acceptance of self in situation.
Long-term Goal: At the end of hospitalization, patient will demonstrate adaptation to changes or events that have
occurred.
Cues:

Problem

Body malaise

Blurred in vision

Restlessness

Scientific Rationale

ANXIETY Anxiety is a normal experience.

Moderate or high level of anxiety
can increase alertness and
performance in particular
situations. However, people who
experience continues or recurring
fears or episodes of intense fear
can feel powerless to manage their
symptoms and their lives can
become severely restricted.

http:/www.panicanxietydisorder.org
au /index.htm

Nursing
Interventions
Assessed
level of fear
of client.

Explained
procedures/
care as
delivered.
Repeated
explanations
frequently as
needed.

Rationale

Helps
determine
the kind of
interventio
ns
required.
Fear of
unknown is
lessened
by
information
& may
enhance
acceptanc
e of
permanen
ce of
ESRD and
necessity
for dialysis.

Evaluation
Goal met.
Patient
verbalized
acceptance
of self in
situation.

Name: Mrs. MM

Provided
opportunities
for client to
ask
questions &
verbalization
of concern.

Creates
feeling of
openness
&
cooperatio
n&
provides
information
that will
assist in
problem
identificatio
n/ solving.

Age: 77 years old

Medical Diagnosis: ESRD secondary to DM Nephropathy

Nursing Diagnosis: Altered Fluids & electrolytes r/t Urinary retention as evidence increase K & decrease Na.
Short term Goal: At the end of my shift, patient will be able to increase urine output at least 1500cc in 24 hrs.
Long term Goal: At the end of hospitalization, the patient will be able to have a normal urine output & voiding pattern.

Cues
S- No
subjective
Objective:

Decreased of
urine output
380cc

Dribbling of
urine

Potassium7.47
increased
(3.5- 5.0 mg/dl)

Problem

Scientific
Rationale

Oliguria

The production
of an
abnormally
small volume of
urine. This may
be a result of
copious
sweating,
kidney disease,
loss of blood

Nursing Intervention

Assess the cause

of decrease urinary
output

Encourage client to
void every 2-4 hrs
& when urge is
noted

Reference:
Nursing Care
Plans

Page 89

Sodium- 134
decreased

Determine the
initial fluids and
electrolytes level

Monitor intake &

output hourly

To be able to apply
the proper
therapeutic
regimen.

May minimize
urinary
retention/overdisten
tion of the bladder

Serve as baseline
for progress.

To determine the
progress of the
disease

A distended bladder
can be felt in the
suprapubic area.

Percuss/palpate
suprapubic area.

(135-145 mg/dl)

Rationale

Observe Signs and

symptoms of fluids

Evaluation
Goal partially
met-patient
passed out
urine at least
300 cc.

& electrolytes
imbalance such as
dyspnea changes
in ECG and
restlessness.

Ensure clients
compliance on
hemodialysis
procedure

To be able to
prevent further
complication and
administer proper
therapeutic agents
as prescribed.

To promote
continuous
elimination of fluids
and waste
products.

Name: Mrs. MM

Age: 77 yrs. old

Medical Diagnosis: ESRD secondary to DM Nephropathy

Nursing Diagnosis: Sleep pattern disturbance r/t urinary frequency
Short-term Goal: at the end of my shift, the clients will increase the sleeping hours from 5 hrs. to 8 hrs.
Long-term Goal: At the end of the patients hospitalization, patient achieves optimal amount of sleep as evidenced by
rested appearance, verbalization of having a good sleep and improvement in sleep pattern.
Cues

Problem

Scientific
Rationale

Nursing
Interventions

Rationale

Evaluation

Subjective:
Hindi ako
makatulog ng
husto as
verbalized by the
patient.
Objective:

Lack of sleep

The client is
Unable to sleep
because she
frequent urge to
empty urinary
bladder. Thus her
sleeping pattern is
disrupted.

restlessness
Dark circles
under eyes
irritable
Ref:

Assess the
cause of
inability to
sleep.
Assist patient
in observing
any previous
b
Bedtime
ritual.

Advised
daytime
physical
activities as
indicated.

Limit fluids
before
bedtime.

Nursing Care
Plans
Page 61
By: klopp

To determine
the proper

To promote
relaxation.

To promote
urinary
elimination
thus
reducing
bladder
distention
to promote
sleep
during
night time.

Goal partially
met.
Patients
sleeping pattern
increased from 57 hrs.

To prevent
urinary
bladder
retention
causing
dribbling of
urine.

Patients Name: Mrs. M.M.

Age: 77 years old

Medical Diagnosis:ESRD secondary to DM Nephropathy

Nursing Diagnosis:Decreased tissue perfusion related to peripheral vasoconstriction as manifested by high blood
pressure.
Short Term Goal:At the end of my shift, patient will decrease blood pressure from 160/90 to 130/90
Long - Term Goal: At the end of the patients hospitalization, will maintain adequate tissue perfusion as evidenced by BP
declining toward normal range for client.
CUES

PROBLEM

SCIENTIFIC
RATIONALE

NURSING INTERVENTION

RATIONALE

EVALUATION

Subjective:
No subjective

Objective:

Oliguria

Hyperten
sive

Restless
ness

Cold and
clammy
skin

Decreased
Tissue
Perfusion

Constriction of
. Measure and recorded
the peripheral
blood pressure as
blood vessels
indicated
will alter the
flow of blood to
perfuse the

Observed skin color,

different cells of
moisture, temperature,
the body.
and capillary refill time.
Reference:
www.elsevier.co
m

Noted
dependent/general
edema

Provides
objective data
for
monitoring.

Presence
of pallor:
cool, moist
skin; and
delays
capillary refill
time may be
due to
peripheral
vasoconstricti
on.
May
indicate
heart or
renal
failure

Helps
reduce
sympatheti
c
stimulation
; promotes
relaxation.
Reduces

Goal not met.

Patients blood
pressure
remained
160/90.

Provided calm, restful

surroundings,
minimize
environmental
activity/noise. Limit
the number of visitors
and length of stay.

Maintain activity
restrictions; such as
bed rest/chair rest;
schedule periods of
uninterrupted rest;
assisted client with
self-care activities as
needed.

Provided comfort
measure such back
massage, elevation of
head.

Administered
antihypertensive
medications as
prescribed

physical
stress and
tension
that affect
blood
pressure
and the
course of
hypertensi
on.
Decreases
discomfort
and may
reduce
sympatheti
c
stimulation

Antihypert
ensive
medication
s play a
key role in
treatment

of
hypertensi
on
associated
with
chronic
renal
failure.

Encouraged
compliance with
dietary and fluid
restriction therapy.

Adherence
to diet and
fluid
restrictions
and
dialysis
schedule
prevents
excess
fluid and
sodium
accumulati
on.

Patient's Name:Mrs. MM
Medical Diagnosis:

Age: 77 years. Old

ESRD secondary to DM nephropathy

Nursing Diagnosis:
Risk for systemic infection related to hemodialysis procedure as manifested by fatigue,
weakness and low Hb., Hct.level
Short term goal:

At the end of the shift, patient will experience no signs/symptoms of infection.

Long term goal: At the end of hospitalization, patient will maintain/demonstrate improvement in laboratory values
Cues

Problem

Scientific
Rationale

Systemic Infection

Frequent IV

Nursing
Intervention

Promoted

Rationale

Evaluation

Reduces risk Goal met- Patient

Objective:
BP 160/90
mmHg
Restlessness
Oliguria
Hct.level
0.25
Na level 134
Hb. 0.83gm/l

cannnula will
introduce
microorganism in
the blood circulation
that would trigger
systemic infection.

Reference:
Medical Surgical 1st
edition by Udan

good hand
washing by
client and staff.
Use aseptic
technique when
manipulating
IV/invasive
lines.

of crosscontamination

Reduces
bacterial
colonization
and risk of
ascending
UTI.
Prevents
atelectasis and
mobilizes
secretions to
redue risk of
pulmonary
infections.

Encouraged
deep breathing,
coughing,
frequent
position
changes.

Assessed
skin integrity

Excoriations
from scratching
may become
secondarily
infected.

Monitored
vital signs

Fever with
increased pulse
and a
respiration is
typical of
increase

had experienced no
signs of infection.

metabolic rate
resulting from
inflammatory
process,
although sepsis
can occur
without a febrile
response.

DRUG
NAME

CLASSIFICATION

MECHANISM OF
ACTION

INDICATION/
CONTRAINDICATION

SIDE EFFECTS

NURSING
CONSIDERATIONS

BRAND:
Docard

GENERIC:
Dopamine
HCL

DOSAGE:
2 amp in
D5W 250cc
@ 10
mgtts/min
titrate by
increment of
3 mgtts/ min

Sympathomimetic

Exogenously
administered, it
produces direct
stimulation of
beta-1 receptors
and variable
stimulations.

Indications:
Correction of
hemodynamic
imbalances present in
renal failure.
Contraindications:
Uncorrected
tachyarrythmias or
ventricular fibrillation.

Nausea,
vomiting,
tachycardia,
anginal pain,
palpitation,
dysnea,
headache,
hypotension,
hypertension,
vasoconstriction,
decrease urine
output, dyspnea.

1.]Monitor vital
signs and ECG
during infusion. If
BP drops
30mmHg stop
infusion and
report to
physician.
2.]Assess for
oxygenation and
perfusion deficit:
dyspnea,
cyanosis,
decrease BP,
chest pain,
dizziness.
3.]Assess
patients GI
complaints:
nausea and
vomiting.
4.]Monitor BP
closely for
sudden drop
after drug is
stopped.

DRUG
NAME
BRAND:

GENERIC:
Sodium
bicarbonate

DOSAGE:
650mg 1tab
TID

CLASSIFICATION

MECHANISM OF
ACTION

INDICATION/
CONTRAINDICATION

Alkalinizing agent,
Antacid, Electrolyte

Increases plasma
bicarbonate,
which excess
buffers H ion
concentration;
reverses
metabolic
acidosis.

Indications:
Treatment of metabolic
acidosis.

Contraindications:
Edema, hypertension,
severe kidney
insufficiency,
hypoventilation.

SIDE EFFECTS

Metabolic
alkalosis
(dizziness,
cramps, thirst,
anorexia, N & V,
tetany, seizures).
Paravenous
administration
may lead to tissue
necrosis.

NURSING
CONSIDERATIONS
1.]Assess
respiratory and
pulse rate.
2.]Monitor fluid
balance.
3.]Assess for the
symptoms of
alkalosis.
4.]Teach patient
about sodium
restricted diet.

DRUG
NAME
BRAND:
Humulin R

GENERIC:
Insulin
injection
(Regular
insulin)

DOSAGE:
6 u IV now

CLASSIFICATION

MECHANISM OF
ACTION

INDICATION/
CONTRAINDICATION

Insulin product, antidiabetic agent

Increases glucose
transport across
muscle and fat cell
membranes to
reduce glucose
level.

Indications:

SIDE
EFFECTS

Hypoglycemia,
insulin
Moderate to severe
resistance,
diabetic ketoacidosis or local and
hyperosmolar
generalized
hyperglycemia regular
allergic
insulin. Mild diabetic
reaction.
ketoacidosis. Newly
diagnosed diabetes.

Contraindications:
Hypoglycemia.
Hypersensitivity to
insulin.

NURSING
CONSIDERATIONS
1. ]Assess V/S.
2. ]Use a tuberculin
or
insulin syringe for
accuracy of
measurement.
3. ]Keep in cold
location,
preferably a
refrigerator.
4. Do not freeze.
5. ]Observe closely
for
S&S of hyper- or
hypoglycemia
until
dosage
established.
6.] Monitor BP, BS,
LDL,
cholesterol and
HbA1c.

DRUG
NAME
BRAND:
Humalog
mix 25

GENERIC:
Insulin lispro
injection

DOSAGE:
25 u SQ 10
mins BB, 12
u SQ 10
mins BS

CLASSIFICATION

Rapid-acting
insulin, Anti diabetic
agent

MECHANISM OF
ACTION

INDICATION/
CONTRAINDICATIO
N

SIDE EFFECTS

NURSING
CONSIDERATIONS

Facilitates the
transport of
glucose into
cardiac and
skeletal muscle
and adipose
tissue. It also
increases
synthesis of
glycogen in the
liver.

Indications:

Hypersensitivity
to insulin.

1. ]Document
disease
onset, level of
control previous
agents trialed, and
the outcome.

Diabetes mellitus. In
combination with
sulfonylureas to treat
high blood glucose n
adults over 65 years
of age.

Contraindications:
Use during episodes
of hypoglycemia.
Hypersensitivity to
insulin lispro.

2.] Monitor VS,

CBC,
HbA1c, U/A;
microalbumin and
renal function
studies.
3. ]Review signs
and
symptoms of
hypoglycemia and
appropriate
management.
4. ]Continue BP
control,
diet and exercise
for
disease control.

DRUG
NAME
BRAND:
Encifer
GENERIC:
Iron
sucrose

DOSAGE:
Amp 20
mg/mL
(brown,
sterile,
aqueous
soln) x 5's.

CLASSIFICATION
Vitamins & Minerals

MECHANISM
OF ACTION

INDICATION/
CONTRAINDICATION

Hematinic.
Iron sucrose is
dissociated by
the
reticuloendoth
elial system
into iron and
sucrose.
Encifer iron
component
appears to
distribute
mainly in the
blood and to
some extent in
the
extravascular
fluid.

Indications:

SIDE EFFECTS

Hypotension, chest
pain, hypertension,
Treatment of iron
hypervolemia, CHF,
deficiency anemia in
cramps,
the following patients:
musculoskeletal
Hemodialysis
pain, diarrhea,
Dependent Chronic
nausea, vomiting,
Kidney Disease (HDD- abdominal pain,
CKD) patients receiving elevated liver
an erythropoietin.
enzymes, skin
irritation, pruritis,
Contraindications:
application site
reaction, dizziness,
Patients with evidence dyspnea,
of iron overload, in
pneumonia, cough,
patients with known
headache, fever,
hypersensitivity to iron
asthenia, malaise.
sucrose or any of its
inactive components
.
and in patients with
anemia not caused by
iron deficiency.

NURSING
CONSIDERATIONS
1. ]Watch for
serious
hypersensitivity
reactions of iron
sucrose.
2. ]Medication is
administered 1 to
3
times/wk. Do not
administer more
than
3 times/wk.
3. ]For IV
administration
only.

DRUG
NAME
BRAND:
Dormicum
GENERIC:
Midazolam
DOSAGE:
15mg
tab OD

CLASSIFICATION
Hypnotics &
Sedatives

MECHANISM
OF ACTION
Depresses the
limbic system
and reticular
formation
(subcortical
level of CNS)
by increasing
or facilitating
the inhibitory
neurotransmitt
er activity of
GABA.

INDICATION/
CONTRAINDICATION
Indication:
Disturbances of sleep

Contraindication:
Hypersensitivity
.

SIDE EFFECTS
Amnesic
episodes

NURSING
CONSIDERATIONS
1]. Monitor blood
pressure, heart rate
and rhythm,
respiration, airway
integrity,arterial
oxygen, saturation,.
Emergency
equipment
shoud be nearby.
2.] Its onset of action is
1
hour.The action
lasts for
2-6 hours.
3. ]Dormicum is given
may
be slower in the
elderly
than in younger
adults.
4. ]Inform patient that
drug
may cause amnesia.

DRUG
NAME

CLASSIFICATION

MECHANISM
OF ACTION

INDICATION/
CONTRAINDICATIO
N

SIDE EFFECTS

NURSING
CONSIDERATIONS

BRAND:
Iberet
folate

GENERIC:
Multivitami
n with iron

DOSAGE:
1 tab OD

Vitamins and
minerals

Component of
hemoglobin for
oxygen
transport;
enzymes for
energy
metabolism.

Indications:
Supplement for diet.

Nausea,
constipation,
diarrhea or
stomach pain.

1.] Document
indication for therapy.

Contraindications:

2. ]Assess metabolic
panel
and vitamin levels as
indicated.

Thalassemia,
sideroblastic anemia,
hemochromatosis &
hemosiderosis.
Children.

3. ]List agents prescribes

to
ensure none interact or
impact vitamin
absorption.

4. ]Take with food for best

absorption.

DRUG
NAME
BRAND:
Minitran
GENERIC:
Nitroglyceri
n patch

DOSAGE:
5 mg
OACW x
16 h

CLASSIFICATIO
N
anti angina

MECHANISM
OF ACTION
Reduces
cardiac oxygen
demand by
decreasing left
ventricular end
diastolic
pressure (pre
-load) and to
lesser extent
systemic
vascular
resistance (after
load). Also
increases blood
flow through the
collateral
coronary
vessels.

INDICATION/
CONTRAINDICA
TION
Indications:
Prophylaxis of
angina,
hypertension
Contraindication
s:
Severe anemia,
increase
intracranial
pressure, allergy
to adhesives,
hypersensitivity to
nitrates and
orthostatic
hypotension.

SIDE EFFECTS
Orthostatic
hypotension,
tachycardia,
palpitation,
rash.

NURSING
CONTRAINDICATIONS
1.] Assess location,
duration,
intensity,and
precipitating
factors of the patients
angina pain.
2.]Evaluate therapeutic
effectiveness (cardiac
status) and adverse
response
(hypotension,
arrhythmias)
3.]Dosed should be
reduced
gradually when
discontinuing after longterm
therapy.
4.]Apply transdermal
(TD)
patches to area without
hair: press hard to
adhere if
patch becomes
dislodged,
apply a new one.
5.Do not discontinue
abruptly.
6.]Closely monitor vital
signs.
7.] Use caution when
near a
microwave oven,
leaking
radiation may heat

DRUG
NAME
BRAND:
Ciprobay

GENERIC:

CLASSIFICATION MECHANISM
INDICATION/
OF ACTION CONTRAINDICATION
Anti-infectives
(Quinolones)

Inhibits
bacterial DNA
gyrase thus
preventing
replication in
susceptible
bacteria

Indications:
Infection of the
kidneys, and urinary
tract, genital organs,
abdomen, and skin.
Contraindications:

Ciprofloxacin
Hypersensitivity to
ciprofloxacin on other
quinolones
DOSAGE:
500 mg 1
tab OD

SIDE EFFECTS
Nausea, diarrhea,
abdominal pain,
anorexia, dizziness,
headache, very rarely,
insomnia, peripheral,
sweating, convulsion.

NURSING
CONTRAINDICATIONS
1.]Assess renal function
before and during
therapy: urine output,
BUN and creatinine.
2.]Assess for possible
adverse reactions:
G.U: interstitial
nephritis.
3. ]Document indication
for therapy, type,
onset,
and characteristic of
symptoms
4. ]Assess patient for
s/sxs
of infection before and
during treatment
fever,
characteristic of
urine

DRUG
NAME
BRAND:
Norvasc
GENERIC:

CLASSIFICATION MECHANISM
INDICATION/
OF ACTION CONTRAINDICATION
Calcium Channel
Blocker

Possible
slight
decrease in
myocardial
contractility.
CO is
increased;

Indication:
Hypertension
Contraindication:
Sick sinus syndrome;
second-third degree
atrio ventricular (AV)

SIDE EFFECTS
Headache, fatigue,
lethargy, dizziness,
depression,
paresthesia,hallucination,
malaise, anxiety, tremor,
vertigo, migraine,
amnesia, nausea,

NURSING
CONTRAINDICATIONS
1.]Teach patient to use
as directed even if
feeling better.
2.]Monitor Vs , ECG,
CBC

Amlodipine

moderate
decreased in
peripheral
vascular
resistance.

DOSAGE:
10 mg / tab
/ tab OD

block, except with a

functioning
pacemaker.

abdominal discomfort,
cramps, diarrhea.

3.]Report any
symptoms of chest pain,
SOB, dizziness,
swelling of extremities,
irregular pulse.
4.]Record BP and
pulse.

DRUG

CLASSIFICATION

MECHANISM

INDICATION/

SIDE EFFECTS

NURSING

NAME
BRAND:
Burinex

GENERIC:
Bumetanide
DOSAGE:
1 mg tab
OD

Loop diuretics

OF ACTION
Acts in the
thick
ascending
limb of the
loop of Henle,
where it
inhibits the
co-transport
of sodium,
potassium,
and chloride
from the
luminal
filtrate.
Increases
excretion of
water,
sodium,
potassium,
calcium and
chloride;
decreases
uric acid
secretion; and
cause no
change in
urinary pH.

CONTRAINDICATION
Indications:
Electrolyte & fluid
changes: Excess
Hypertension.
water loss,
dehydration
electrolyte
depletion
Contraindications:
including
hypokalemia
Anuria. Hepatic coma hyponatremia,
or severe electrolyte
hypovolemia,
depletion.
thromboembolism,
circulation
collapse.

CONTRAINDICATIONS
1.] Monitor electrolytes,
liver and renal function
studies: causes for low
potassium
2.] Monitor VS. Repeat
duiresis may cause
dehydration and
circulatory collapse
(especially in the
elderly.)
3.]Assess BP before
and during therapy with
patient lying, standing,
and sitting as
appropriate; orthostatic
hypotension can occur
rapidly.
4.]Advise the patient to
take the medication in
the morning.

DRUG
NAME
BRAND:
Catapres

GENERIC:
Clonidine
hydrochlorid
e
DOSAGE:
150 mg /tab
1 tab BID

CLASSIFICAT
ION

MECHANISM
OF ACTION

Antihypertensi
ve
(centrallyactive drug)

Stimulates
centrally alpha
adrenergic
receptors, to
inhibit
sympathetic
cadio
accelerator and
vaso constrictor
centers.

INDICATION/
CONTRAINDICAT
ION
Indications:
Management of all
grades of
hypertension.
Contraindications:
Hypersensitivity to
clonidine

SIDE EFFECTS

NURSING
CONTRAINDICATIONS

Drowsiness, sedation,
confusion, dizziness,
headache, fatigue,
malaise,
nightmares,nervousen
ess, restlessness,
anxiety, mental
depression,dry mouth,
severe hypotension.

1.] Perform eenal

studies:protein, BUN,
creatinine: watch for
increased levels that may
indicate nephritic
syndrome: polyuria,
oliguria, frequency.
2.]Monitor input and
output.
3.]Advise patient to use
caution when changing
position.
4.]Teach patient not to
skip or discontinue
medication without
consulting physician.

DRUG
NAME
BRAND:
Kalcinate

GENERIC:
Calcium
Gluconate

DOSAGE:
1amp SIVP

CLASSIFICAT MECHANISM
ION
OF ACTION
Calcium Salt

Essential for
maintaining
normal
function of
nerves,
muscles, the
skeletal
system, and
permeability
of cell
membranes
and
capillaries.

INDICATION/
CONTRAINDICATION
Indications:
Management of
hypocalcemia,
hypocalcemic tetany,
hyperkalemia with
cardiac toxicity.

Contraindications:
Digitalized clients,
sarcoidosis, renal or
cardiac disease,
ventricular fibrillation.
Cancer clients with
bone metastases,
renal calculi,
hypophosphatemia,
hypercalcemia

SIDE EFFECTS

NURSING
CONTRAINDICATIONS

Venous irritation,
tingling sensation,
feeling of oppression
or heat, chalky taste,
fatigue, GI symptoms
(anorexia, IV, nausea
and vomiting,
abdominal pain, dry
mouth, thirst)

1.]If a precipitate is
noted in the syringe do
not use.
2.]IV rate should not
exceed 0.5-2 ml / min.
3.]Monitor
calcium
levels
and
renal
function.

DRUG NAME

BRAND:
Plavix

GENERIC:
Clopidogrel
DOSAGE:
75mg/tab
tab only

CLASSIFICATION

MECHANISM
OF ACTION

INDICATION/
CONTRAINDICATION

Antiplatelet drug

Blocks ADP
receptors,
which prevent
fibrinogen
binding at
that site and
thereby
reduce the
possibility of
platelet
adhesion and
aggregation.

Indication:

(anticoagulant
thrombolytic)

Reduction of
atherosclerotic events
in patients with
atherosclerosis.
Treatment of patients
suffering from non-ST
segment elevation.
Contraindication:
Hypersensitivity.
Severe liver
impairment.

SIDE EFFECTS
GI bleeding,
bruising,
hematoma,
epistaxis,
hematuria, eye
bleeding,
intracranial
bleeding, GI
disturbances,
diarrhea, rush.

NURSING
CONSIDERATION
1.]Assess for
symptoms of
stroke, MI during
treatment
2.]Monitor signs of
bleeding; hemoglobin
and hematocrit
periodically
3.]Monitor liver
function studies: AST,
ALT, bilirubin,
creatinine if patients
is on long-term
therapy;
thrombocytopenia,
neutropenia may
occour.

DRUG NAME

MECHANISM OF
ACTION

INDICATION /
CONTRAINDICATION

SIDE EFFECTS

NURSING
CONSIDERATION

Brand Name:

Decreases blood
glucose by transport
of glucose into cells
and the conversion of
glucose to glycogen
indirectly increases
blood pyruvate and
lactate, decreases
phosphate and
potassium.

Indication:

Insulin resistance;
allergic reactions that
include redness, pain,
itching, swelling or
inflammation.
Hypoglycemia,
temporary visual
impairment. Insulin
administration may
cause insulin
antibodies to form.

1. Obtain patient
history, including drug
history and any know
allergies.

Humulin-N

Generic Name:

Management of type1
DM or insulin
dependent diabetis
mellitus and type 2
diabetis mellitus which
cannot be controlled
by diet, exercise or
weight reduction
alone.
Contraindication:
Hypoglecemia ,
hypersensitivity
reactions.IV
administration of
insulin suspension,
diabetic coma.

2. Monitor fasting
blood glucose, 2 hours
after meals; also
glycosylated Hgb may
be measured to
identify treatment
effectiveness.
3. Monitor urine
ketones during illness;
insulin requirements
may increase during
stress, illness.
4. Monitor body weight
periodically; changes
in weight may
necessitate changes
in insulin dose.

5. Assess for

hypoglycemic reaction
that can occur during
peak time.

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