Administer and Monitor Medication

Question: Discuss about the Administer and Monitor Medication. Answer: Nursing assessment of fluid needs on patients As a nursing student, I would make use of the clinical approach of assessing fluid needs. This will be informed by the patients history, inspection of all the monitoring charts, laboratory indices, and the clinical examinations (Polit, Beck, 2008). As a student, I would come up with clinical aspects that make use of the protocols and clinical principles for intravenous fluid treatment. To ascertain that the above approach works, the following parameters will inform my assessments: Conducting serial measurement of the patients body weight Assessment of the patients urinary output and noting down the fluid balance Measuring of the serum chloride levels The following are some of the indicators that may confirm the above fears; Systolic blood pressure being less than 100mmHg Heart rate being more than 90 beats/60 seconds Capillary refill time being exceeding 2 seconds Respiratory rates exceeding 20 breaths in every 60 seconds The mode of action and the rationale for administering Frusemide Furosemide is a water pill, otherwise known as loop diuretic that works by preventing the body from absorption of too much salt, thereby allowing salt to be channeled into the urinary system. This medication is used in the treatment of fluid retention a condition known as edema in patients with congestive heart failures kidney disorders like nephrotic syndrome or liver diseases, and in the treatment of hypertension. It does its functions by making the kidneys excrete unnecessary salts and water from the body into the urinary tract. Based on the above, the medication, in combination with other drugs, is mainly administered to patients to treat hypertension (Francis et al., 1985). Frusemide as a medicine works by impeding the absorption of water and sodium chloride from the kidney tubules. As a result, the reabsorption of these salts and water causes a profound increase in diuresis (urine output). The onset of this action after an oral administration is between half to one hour. The diuresis, on the other hand, lasts for 6 to 8 hours( Dikshit et al., 1973). Effects of age related changes on pharmacodynamics and pharmacokinetics Age-related physiological effects and changes as far as the drug is concerned a significant bearing on the pharmacokinetics (drug absorption, metabolism, excretion, and distribution), and pharmacodynamics (the influence of the drug on target). It is not in doubt that advancement in age is often characterized by impairments in the normal body functions as far as regulatory processes in the provision of function integration of the organs and cells are concerned. This means that there are higher possibilities for the failure of the body to maintain a homeostatic function under the set physiological stress( Minto et al.,1997). It is importnt to note that the loss of the functional units (notably the cells), is mainly linked to the decrease in viability of the said cells and subsequent increase in vulnerability in older patients. This is the explanation behind a series of physiological malfunction of the body leading to the effects of Absorption, metabolism, distribution, and excretion of drugs in general for the older patients. Interactions between Furosemide, Digoxin, and Mylanta The chemical name of furosemide is magnesium hydroxide while Mylanta is aluminum hydroxide. Furosemide and Digoxin are often combined but with a frequent requirement that the digoxin is evaluated. When Mylanta and Digoxin are mixed with Furosemide for a prolonged period, then there is a likelihood of there being severe cases of dehydration as well as electrolytic abnormalities in the body (Baxter, 2010). These can then result in irregular cardiac rhythms, kidney problems, and seizures. Therefore, it is important that you consult your doctor should you seek the combination of the three drugs. Some of the symptoms of electrolyte depletion include lightheadedness, thirst, fatigue, muscle cramps, palpitation, decreased urination, weakness, dry mouth, and dizziness. It is advisable that should any of these symptoms come up, the patients should have themselves to worry and seek prompt medical attention from a certified physician. The amount of medication is 76.5 mg added to a 1litre (1000mls) bag of Normal Saline. This 1000mls of fluid (including the medication) is to be administered over 2 hrs. Via an IV infusion pump, calculate how many mis per hr. will be delivered The ml per hour administration rate would be: Amount of fluid to administer divided by the hours to deliver the fluid which is: 1L (or 1000 mL) 2 hours =500mls per hour (Terry, 2015). References Baxter, K. (2010).Stockley's drug interactions(Vol. 495). C. L. Preston (Ed.). London: Pharmaceutical Press. Dikshit, K., Vyden, J. K., Forrester, J. S., Chatterjee, K., Prakash, R., Swan, H. J. C. (1973). Renal and extrarenal hemodynamic effects of furosemide in congestive heart failure after acute myocardial infarction.New England Journal of Medicine,288(21), 1087-1090. Francis, G. S., Siegel, R. M., Goldsmith, S. R., Olivari, M. T., Levine, T. B., Cohn, J. N. (1985). Acute vasoconstrictor response to intravenous furosemide in patients with chronic congestive heart failure: activation of the neurohumoral axis.Annals of Internal Medicine,103(1), 1-6. Minto, C. F., Schnider, T. W., Shafer, S. L. (1997). Pharmacokinetics and Pharmacodynamics of RemifentanilII. Model Application.The Journal of the American Society of Anesthesiologists,86(1), 24-33. Polit, D. F., Beck, C. T. (2008).Nursing research: Generating and assessing evidence for nursing practice. Lippincott Williams Wilkins. Terry, V. R. (2015).Online versus face-to-face: development, refinement, implementation, and evaluation of an online intravenous pump emulator, including outcomes for clinical practice for nursing students(Doctoral dissertation, University of Southern Queensland).