Question

What nursing assessment should be performed for each medication? What planning and implementation are needed regarding each medication? How do I evaluate each medication’s effectiveness?

Enalapril

Nebivolol

Omeprazole

Warfarin

Answer 1

ENALAPRIL : antihyoertensive drug

Nursing assessment:

1. collect the medical history of patient before drug prescription. Ask for any allergies related to enalapril.
2. check the renal status Of the patient. The drug is contra indicated in renal diseases.

3. Check for any volume or salt depletion.
4. If the patient is pregnant or lactating avoid the drug.
5. physical assessment includes skin and mucous membrane inspection for skin colour, turgor, lesions.
6. Assess the patient for peripheral perfusion.
7. assess the patient for muscle strength, reflexes.

8. Conduct the blood tests, liver and renal functions, urinalysis to rule out any underlying pathology which can be potentiated through enalapril.
Planning and implementation :

1. Indicated in hypertension, acute and chronic CHF, left ventricular dysfunction.
2. It can be given orally or iv.
3. dosage : 5mg once daily.
Medicine effectiveness : the medicine will help control BP and correct the salt water balance in body.
NEBIVOLOL :

Assessment :

1. medical history : check for any allergies to nebivolol

2. drug history : ask about the drugs patient is taking. Check for drug interactions.
3. Check renal status and liver finctions through renal function tests, urinalysis and liver function tests.
4. check if the patient is pregnant or lactating

5. physical assessment includes skin and mucous membrane inspection for skin colour, turgor, lesions.
6. Assess the patient for peripheral perfusion.
7. assess the patient for muscle strength, reflexes.

8. Conduct blood tests, liver and renal functions, urinalysis to rule out any underlying pathology which can be potentiated through nebivolol.
9. check for regular weight and signs of heart failure or respiratory distress
Planning and implementation:

1. Indicated for hypertension

2. Given orally

3. dosage : 5mg daily

4. provide patient teachings about correct dosage and signs for adverse reactions.
Drug effectiveness: lowers BP.
OMEPRAZOLE : proton pump inhibitor

Nursing assessement :

1. medical history : check for any allergies to omeprazole

2. drug history : ask about the drugs patient is taking. Check for drug interactions.
3. Check renal status and liver finctions through renal function tests, urinalysis and liver function tests.
4. check if the patient is pregnant or lactating

5. physical assessment includes skin and mucous membrane inspection for skin colour, turgor, lesions.
6. Assess the patient for peripheral perfusion.
7. assess the patient for muscle strength, reflexes.

8. Conduct blood tests, liver and renal functions, urinalysis to rule out any underlying pathology which can be potentiated through omeprazole.
9. Regularly assess patient for abdominal pain, diarrhea, occult blood in stool, emesis.
10. monitor bowel function.

planning and implementation :

1. indicated in GERD, oesophagitis, heartburn, duodenal ulcers.
2. Given orally.
3. dosage includes 40-60 mg daily.
4. Administered 20-30 min before a meal
Effectiveness: healing of duodenal ulcer, relief from acidity and heartburns.
WARFARIN : anticoagulant

assessment :

1. medical history : check for any allergies to nebivolol

2. drug history : ask about the drugs patient is taking. Check for drug interactions.
3. Check renal status and liver finctions through renal function tests, urinalysis and liver function tests.
4. check if the patient is pregnant or lactating

5. physical assessment includes skin and mucous membrane inspection for skin colour, turgor, lesions.
6. Assess the patient for peripheral perfusion.
7. assess the patient for muscle strength, reflexes.

8. Conduct blood tests, liver and renal functions, urinalysis to rule out any underlying pathology which can be potentiated through nebivolol.
9. check for regular weight and signs of heart failure or respiratory distress

10. assess for any bleeding such as gums, nose or ear.
11. assess stool for blood

12. Regular PT, INR and platelet function tests are necessary

Implementation:

1. indicated in pulmonary embolism, venous thrombosis, myocardial infarction.
2. Given iv or orally.
3. regular check on signs off bleeding, hemorrhage and intracranial bleeding is required.
4. Give medicine at the same time daily and use the same brand.
5. Educate patient about signs of bleeding and other adverse effects of drug

Effectiveness: prevents thromoembolitic events, formation of thrombosis or embolism.