Nursing Assignment: Medication Chart Analysis Report

This nursing assignment analyzes the medications prescribed to a 57-year-old patient, James Murphy, who underwent coronary artery bypass surgery. The assignment is divided into two parts. Part A requires a detailed review of ten medications, including Aspirin, Metformin XR, Ramipril, Metoprolol, Furosemide, Potassium Chloride, Pantoprazole, Atorvastatin, Oxycodone/Naloxone, and Cefazolin, outlining their uses, side effects, interactions, and nursing implications. Part B delves into the mechanism of action of two selected medications, providing in-depth explanations of how they work within the body. The report emphasizes the importance of understanding drug interactions and the implications for patient care, referencing various medical studies and guidelines to support the analysis. The assignment aims to demonstrate a comprehensive understanding of pharmacology and its application in clinical practice, as well as the critical role of nurses in medication management.

Running head: NURSING ASSIGNMENT 1
Nursing Assignment
Student’s Name
Institutional Affiliation

NURSING ASSIGNMENT 2
Part A
Name:
Aspirin.
Use:
Reduction of fever.
Pain reliver (Sumari, Davis, 2019)1.
Reduce swelling and pain in arthritis.
Also used to reduce blood.
Side effects:
Regular headache.
Regular abdominal pain.
Rashes on the skin.
Nausea.
Drowsiness.
Heartburn and gastrointestinal ulcerations.
Interactions:
Care with Omega-3 reach food such as fish oil and eggs. They protect the heart just as aspirin
does.
1 Sumari, Davis (2019). Pain relief for minor aches and pains in the pharmacy. SA Pharmacist's Assistant, 19(1), 6-8.

NURSING ASSIGNMENT 3
Anticoagulants such as apixaban, rivaroxaban or warfarin may increase the risk of complications
such as bleeding if used together with aspirin. However, in some conditions, low dosage of
aspirin may be combined with an anticoagulant such as warfarin.
Nursing implications:
Enough water or fluids should be taken when using aspirin.
For acute management of the heart disease, baby aspirin usually preferred.
If GI discomfort which is unrelieved or ringing in the ears is experienced, then aspirin use should
be discontinued.
Name:
Metformin XR.
Use:
Prevents kidney related diseases.
Controls high blood sugar (Joshi, Lakhani, Siddhpuria, Tandel, & Hajariwala, 2018)2.
Side effects:
Muscle pain.
Physical weakness.
2Dhaval, Joshi B., Lakhani, J. D., Siddhpuria, R. Y., Tandel, H. P., & Hajariwala, N. R. (2018).
A study on drug utilization pattern of metformin and its different formulations used in patients
with type-2 diabetes mellitus in tertiary care teaching hospital. Journal of Integrated Health
Sciences, 6(1), 22.

NURSING ASSIGNMENT 4
Dizziness and chills.
Nausea.
Low levels of vitamin B-12 in the blood.
Interactions:
It should be taken with meals rich in carbohydrates such as beans. This is because they help
reduce bowel side effects or stomach side effects.
Metformin can also interact with drugs such as ethanol, loversol or iodinated contrast media.
Nursing implications:
Glucose and ketones in urine and blood should be monitored regularly.
Alcohol should be avoided when using this drug.
Metformin tablets should be swallowed as a whole.
Name:
Ramipril.
Use:
Used in the treatment of high blood pressure. Helps in the prevention of stroke, kidney related
problems and also heart attacks (Bhat et al., 2019)3.
It also prevents heart related problems.
Side effects:
3 Rahil, Bhat R., Rehman, M. U., Shabir, A., Mir, M. U. R., Ahmad, A., Khan, R., ... & Ganaie, M. A. (2019).
Chemical Composition and Biological Uses of Artemisia absinthium (Wormwood). In Plant and Human
Health, Volume 3 (pp. 37-63). Springer, Cham.

NURSING ASSIGNMENT 5
Yellowing of the skin or eyes which is referred to as jaundice.
Passage of little or no urine.
Fever.
General body weakness.
Coughing.
Headache.
Interactions:
Should not be taken with potassium-rich foods such as green vegetables, bananas or oranges.
Drugs such as aspirin, atorvastatin, amlodipine, Cymbalta, bendroflumethiazide and allopurinol
react with Ramipril when taken together. Furthermore, Ramipril also interacts with some
diseases such as renal dysfunction, bone marrow suppression, hemodialysis, hypotension,
hyperkalemia and angioedema.
Nursing implications:
Swallow as a whole.
Monitor blood sugar level.
Limit alcohol intake.
Impose Abstinence or use of contraception.
Name:
Metoprolol.

NURSING ASSIGNMENT 6
Use:
Treats high blood pressure (Rehman, & Ahmad, 2019)4.
Prevents stroke.
Prevents heart attack.
Prevents kidney related problems.
Chest pain releaver.
Side effects:
Reduces sexual ability.
Drowsiness.
Diarrhea.
Dizziness (Wang, Liu, He, Li, & Zou, 2019)5.
Physical weakness.
Sometimes slow heartbeat may be experienced.
Interaction:
4 Tayyeba, Rehman, & Ahmad, S. (2019). Nardostachys chinensis Batalin: A review of traditional uses,
phytochemistry, and pharmacology. Phytotherapy Research.
5 Yangui, Wang, Liu, C., He, X., Li, Y., & Zou, Y. (2019). Effects of metoprolol, methyldopa,
and nifedipine on endothelial progenitor cells in patients with gestational hypertension and
preeclampsia. Clinical and Experimental Pharmacology and Physiology, 46(4), 302-312.

NURSING ASSIGNMENT 7
Foods rich in potassium should not be taken with metoprolol. This is because metoprolol
happens to be a beta blocker. Cardiac glycosides found in pleurisy root is said to be interfering
with the effects of metoprolol.
SSRI antidepressants, lumefantrine, quinidine and propafenone are among the medications which
may interfere with the work of metoprolol in the body.
Nursing implications:
After one week of therapy, maximal effect on blood pressure is expected.
Heart rate and blood pressure should be monitored carefully.
Lab tests should be performed to come up with the baseline and obtain period evaluation of
blood cell counts, kidney function and the level of sugar in the blood.
If symptoms of mental depression are experienced, then the drug should be withdrawn.
Name:
Furosemide.
Use:
Used to treat edema (Patel, & Singh, 2018)6.
It also helps the body to make more urine which ultimately leads to extraction of water and salt.
Used to treat high blood.
6 Bhishma, Patel P., & Singh, P. K. (2018). Viscum articulatum Burm. f.: A review on its
phytochemistry, pharmacology and traditional uses. Journal of Pharmacy and Pharmacology,
70(2), 159-177.

NURSING ASSIGNMENT 8
Side effects:
Dizziness.
Headache.
Blurred vision.
Dehydration.
Lightheadedness.
Interactions:
Foods rich in potassium should be taken. Also, foods rich in magnesium such as beans, vegetable
and nuts should be taken. This is because they provide enough minerals and vitamins for patients
using furosemide.
Medications that interact with furosemide include aspirin, valsartan, cisplatin, lithium,
cyclosporine, antibiotics such as cephalexin and chloral hydrate.
Nursing implications:
Daily weight, output and intake ratios, lung sounds mucous membrane, the location and amount
of edema should be assessed and monitored.
Patients experiencing confusion, vomiting, nausea paresthesia and muscle cramps should be
assessed.
Blood pressure and pulse should always be monitored before administration.
Allergy should also be assessed.

NURSING ASSIGNMENT 9
Skin rush should be assessed frequently.
Hearing loss and tinnitus should also be assessed.
Name:
Potassium Chloride.
Use:
Prevents hypokalemia which is low levels of potassium in the blood.
Potassium helps organs such as the heart, kidney, nerves, muscles and the body cells to work
properly (Steffensen et al., 2018)7.
Side effects:
Diarrhea.
Upset stomach.
Vomiting.
Nausea.
Slow heartbeat (Lohr, Parsons, Taylor & Morroni, 2018)8.
Chest pain.
7 Inger-Lise, Steffensen, Frølich, W., Dahl, K. H., Iversen, P. O., Lyche, J. L., Lillegaard, I. T. L.,
& Alexander, J. (2018). Benefit and risk assessment of increasing potassium intake by
replacement of sodium chloride with potassium chloride in industrial food products in Norway.
Food and Chemical Toxicology, 111, 329-340.
8 Patricia, Lohr, Parsons, J. H., Taylor, J., & Morroni, C. (2018). Outcomes of dilation and evacuation with and
without feticide by intra-cardiac potassium chloride injection: a service evaluation. Contraception, 98(2), 100-105.

NURSING ASSIGNMENT 10
Allergic reactions such as rashes and blisters may occur.
Interactions:
Should be taken with salt substitutes, snack bars, cereals, soups and potato chips since they also
contain potassium chloride.
Potassium chloride also interacts with aspirin, dextrose, furosemide, Lasix, ibuprofen, fish oil,
calcium, lidocaine, Cymbalta, Lipitor, Nexium, protonix, singulair, vitamin c, synthroid, Xanax
and sodium chloride.
Nursing implications:
Blood pressure should be monitored periodically during the IV therapy.
Serum K should be monitored during therapy periodically.
Renal function and the pH should also be monitored.
Treatment of Toxicity.
Assess body nutrition.
Name:
Pantoprazole.
Use:
Reduces the amount of acid produced in the stomach.
Used in the treatment of erosive esophagitis and Zollinger-Ellison syndrome.

NURSING ASSIGNMENT 11
(Reddy & Jalajakshi, 2018)9.
Side effects:
Blurred vision.
Nausea.
Sweating.
Dry mouth and skin.
Stomach pain.
Trouble during breathing.
Vomiting.
Loss of body weight.
Regular water intake.
Hallucination (Razdan, Viswanathan, & Tusher, 2018)10.
Interactions:
Foods rich in fibre should be taken to prevent constipation.
9 Sunitha, Reddy, & Jalajakshi, B. (2018). Formulation and evaluation sustained release
mucoadhesive gastroretentive pantoprazole sodium sesquihydrate tablets for anti–ulcer. Journal
of Drug Delivery and Therapeutics, 8(6-s), 304-310.
10 Anupriya, Razdan, Viswanathan, R., & Tusher, A. (2018). Pantoprazole-Induced Delirium:
Review of a Case and Associated Literature. Case reports in psychiatry, 2018.

NURSING ASSIGNMENT 12
Some medications need the presence of acid in the stomach hence pantoprazole should not be
taken with these medications. These medications include atazanavir, nelfinavir, rilpivirine,
erlotinib, ampicillin and some azole antifungals.
Nursing implications:
Should not be used as an immediate relief of heartburn.
If used for a long time, it makes the absorption of vitamin B-12 in the body difficult.
Should not be given to patients allergic to any benzimidazole medications.
Name:
Atorvastatin.
Use:
Help to lower cholesterol and fats in the body.
By treating high cholesterol, it lowers the risk of heart related diseases, diabetes or stroke
(Maqsood, Sadeeqa, Ahmad, & Afzal, 2019)11.
It also reduces the level of triglycerides in the blood.
Side effects:
Itching.
Increased heartbeat rate.
Dizziness.
11 Mariam, Maqsood, Sadeeqa, S., Ahmad, M., & Afzal, H. (2019). Efficacy and safety of atorvastatin and
rosuvastatin in ischemic heart disease patients: A prospective study. Tropical Journal of Pharmaceutical Research,
18(7), 1533-1538.