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8/11/2019 Major Pharm Review
1/14
Hematologic & Immune System MedicationsCLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERAT
AND !ATIE
EDUCATIO
Cyto"an
Antineoplastic,immunosuppressa
nts
Death of rapidly
replicating malignant
cells.
or prevent an immune
response and suppressthe immune system
Cancers, lymphomas,
myelomas, leukemias.
Prevent organ transplantrejection.
Tx for autoimmune
diseases
! suppression"
#pancytopenia$,
%&'&D, hepatotoxic,alopecia, cardio(
pulmo. fi)rosis
*x for infecti
*x for hemor
!onitor '+!onitor kidn
# fluids$
Take meds -&meals.
Folic Acid
Antianemic,
vitamin
!aintains and restores
normal erythropoiesis.
Prevention and Tx of
megalo)lastic anemias.During pregnancy"
promotes normal fetal
gro-th. Prevent %TD.
Allergic *x
*ashesfever
!onitor folat
/levels0 1 0
2ncourage to
foods in 3oacid"
#veggies, orgameats$
Cyanoco#alamin
e
$%it '()*
Antianemic,
vitamin
Corrects manifestations
of pernicious anemia.
#!egalo)lastic anemia,45 lesions, and neuro
damage$
'it./ deficiency, to
meet demands.
Confirmed -& +chilling
Anaphylaxis
Diarrhea
5tching0ypokalemia
Pain at inj. site
4iven 5!
6ife(long
medication4ive -& meal
2ncourage to
animal produ
Fe++ous Sul,ate
5ron supplement,
antianemic
Prevent and Tx iron
deficiency.
%eed for hemoglo)information.
Prevent and Tx iron
deficiency anemia.
45 upset #constipation,
dk stools$,hypotension,
+ei7ures, stains teeth#P8$ or skin #5!$,Anaphylaxis
Assess )o-el
dk stool #( oc)ld$
!onitor P a0*9 0102ncourage to
gr. leafy vegg
and organ me
take -& 8: to a)sorp.
P8" ;se stra-
track 5!
Lo-eno"
#2noxaprin$
Anticoagulant,
lo- molecular
heparin
Prophylactic&
Prevention of further
throm)us #clot$formation.
D'T,
P2( throm)oem)oli,
ischemic complications9
(prevents clots, especially inimmobile patients).
leeding, anemia,
throm)ocytopenia,
di77iness, 0A,constipation, %&'
Assess s&s of
)leeding and
hemorrhageAssess nuero
pulmonary fx
!onitor CCAntidote"
!+otamine su
E.ogen
#2rythropoetin$
0ormone,antiane
mic
!aintains and may
elevate *Cs
Tx of anemia assoc. -&
renal failure or A5D+
therapy.
0T%, arthralgias,
fatigue, 0A,
+25
8/11/2019 Major Pharm Review
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ast+ointestinal System MedicationsCLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS
!ATIENT EDUCATI
Lactulose
8smotic, laxative
-ater content and
softens the stool. p0 of colon= %0>
Tx of chronic
constipation!anagement of
hepatic
encephalopathy.
elching, cramps,
distention,flatulence, diarrhea,
hyperglucemia
Assess a)dominal
distention, )o-el soustools
!onitor mental statu
4, %0>Take -& fruit juice
Desmo.+essin
#DDA'P$
0ormone,
antidiuretic &vasopressin
Controls )leeding in
hemophilia.Prevents nocturnal
enuresis
!aintains approp.
-ater content inDia)etes 5nsip.
Controls )leeding in
hemophilia!anagement of
nocturnal enuresis9
Tx of D.5.
Dro-siness,
pharyngitis, drymouth, anaphylaxis
Assess allergy sympt
lung sounds and )ronsecretions
!aintain fluid intake
?@@(/@@@ ml&dayAvoid 28T0
Neomycin
Aminoglycosides$
Anti(infectives
acterialcidal action.
Po-erful anti)ioticsused to treat serious
infections caused )y
gram #($ )acteria
To suppress 45
)acteria= %0>=preventing hepatic
coma.
Tx for skin -ounds
and infections
8totoxicity,
nephrotoxicity,hypomagnesium,
muscle paralysis,
hypersensitivity
+hort(term 5' or 5!
Assess for infection, daily -eight,
0earing loss
!onitor mental statu
renal fx
/antac
$Ranitidine*
Tagamet
$Cimetidine*
Antiulcer agents,
histamine 0/antagonist
0ealing and preventingulcers. symptoms of
42* and secretions ofgastric acid.
Prevents acidinactivation of
pancreatic en7ymes.42*D, multiplepeptic ulcers.
Prevent and Tx
heart)urn, acid
indigestion, sourstomach
Confusions, 0A,di77iness,
arrhythmias,impotence,gynecomastia,
throm)ocytopenia
Take meds )efore meand )edtime
Dont stop taking mea)ruptly%o 28T0 or other C
depressants
Avoid taking meds
antacids*educe stress and he
heal ulcers
Assess a)dominal paoccult )lood,
!onitor CC
/
8/11/2019 Major Pharm Review
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Neu+ological System MedicationsCLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERAT
AND !ATIEN
EDUCATIO
Rilu0ole
$Rilute1*
4lutamate
antagonist
2xact mechanism of
action in A6+ isunkno-n.
+lo-s the deterioration
of motor neurons )ycounteracting the
excitatory
glutaminergic
path-ays.
+lo-s the progress
of Amyotrophic6ateral +clerosis.
!ay delay the need
for a tracheostomy,not a cure for A6+.
Di77iness, tiredness,
upset stomach, stomachpain, diarrhea,
muscle -eakness or
aches, anorexia, 0A
!onitor liver fu
liver en7ymes.!onitor BC.
Take on an empt
stomach # hour)efore or / hour
meals$. Avoid dr
or eating a lot of
caffeine. Avoid echarcoal()roiled
foods.
!+ostigmin$neostigmine*
Anticholinesteras
e
Antimyasthenics,cholinergics
Provide symptomaticrelief )y concent. 8favaila)le Ach at
neuromuscular junction
= muscle fx.
5mproved )ladder(emptying in pt -ith
urinary retention.
5mprovement inmuscle strength in!4.
Prevention and Tx
of post(op )ladder
distention andurinary retention or
ileus.
+25
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'aclo,en
Antispasticityagents, skeletal
muscle relaxants
5nhi)its reflexes at
spinal level.
muscle spasticity9)o-el and )ladder fx
may also )e improved.
Tx of reversi)le
spasticity due to
!+ or spinal cordlesion
+25
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enitou+ina+y System MedicationsCLASSIFICATIO
N NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIO
!ATIENT EDUC
DIURETICSLoo. Diu+etics
3urosemide#6asix$
umetanide#umex$
2thacrynic acid
#2decrin$
5nhi)it sodium 1
chloride rea)sorption
from loop of 0enle anddistal renal tu)ule.
renal excretion of0/8, %a, Cl, !g, 0, and
Ca.
'asodilation=peripheral resistance=P
2dema associated
-ith"
C03
0epatic or
renaldisease
Adjunct therapy
for control of
0T%.
Di77iness, 0A, tinnitus,
hypotension, %&'&D,
constipation, dehydration,hypokalemia,
hyperglycemia,hyperuricemia,neutropenia,
agranulocytosis, cramps,
Throm)ocytopenia,spasms
!onitor '+ #P
and fluid status
!onitor daily -5&8, serum elec
values.
Assess edema #
1 location$, lun
sounds, skin turmucous mem)r
!onitor potass
levels #.?(?.@$.
!onitor )lood
#@@ mg&d6$ (in loop&thia7
diuretics.
!otassium7
s.a+ing
Diu+etics
+pironolactone
#Aldactone$
Amiloride#!idamor$
Triamterene#Dyrenium$
Beak diuretic andantihypertensive.
locks effects ofaldosterone in renal
tu)ule, causing loss of
%a and 0/8 andretention of potassium.
Preventshypokalemia
caused )y other
diuretics.;sed -ith other
diuretics to treat
edema or 0T%.Spironolactone:
0yperaldosteronis
m. !anagement ofC03.
Di77iness, 0A, cramps,%&'&D, urinary freFuency,
-eakness, hyperkalemia.
Spironolactone:
Clumsiness,
gynecomastia, amenorrhea
Change positionto prevent 80.
5f receiving dig-atch for digita
toxicity.
foods high inpotassium #)an
oranges, potatofish, raisins$
Take in A! to
sleep distur).
?
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Osmotic
Diu+etics
!annitol
#8smitrol,
*esectisol$
Pulls -ater into )lood
vessels and nephrons
from surroundingtissues= inhi)its
rea)sorption of
0/8 and electrolyes,along -ith toxins from
kidney.
Adjunct tx of "
8acute oliguricrenal failure
8edema
85CP or
intraocular pressure
8excretion of toxic su)stances.
Confusion, 0A,
hypotension, rash, nausea,
anorexia, dry mouth,thirst, diuresis,fluid and
electrolyte im)alances.
*eport to !D"
0* or syncope,gain /l)s or mo
*eport adverse %&'&D
0ypokalemia #m
-eakness 1 t-lethargy, irregu
pulse$
enitou+ina+y System MedicationsCLASSIFICATIO
N NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS
!ATIENT EDUCAT
!2os.2ate
'inde+s
Se-elame+
#*enagel$
electrolyte
modifiers
inds -ith phosphate
in the 45 tract,
preventing itsa)sorption.
*eduction of the
level of
phosphorus in the)lood of patients
-ith end(stage
renal disease
#2+*D$.
%ausea
'omiting
Diarrhea
Dyspepsia
Constipation
3latulence
Assess 45 side effe
!onitor serumphosphorus, calcium
)icar)onate, chlorid
levels
+-allo- -hole #Do
crush or che-$
Take all other
medicines at least ohour )efore or three
hours after.Take -ith meals.
Aluminum
2yd+o"ide
#Alu(Cap$
antacids,
phosphate
)inders
Prevent a continuingrise in serum phosphate
levels )y decreasing the
a)sorption ofphosphate from
intestinal tract
%eutrali7es gastric acidand inactivates pepsin
Treatment for0yperphosphatemi
a, hypocalcemia in
C*3.
Adjuct therapy in
treating gastric
ulcers,hyperacidity,
indigestion.
Constipation
0ypophosphate
mia
** Prolong use leads to
toxicity: neuro symptoms
and osteomalacia. M
may recommend !alcium!arbonate instead**
Assess gastric pain!onitor phosphate
calcium levels.
Take -ith full glass
-ater
+hould )e s-allo--hole @(? minut
)efore meals.
G
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Calcium Salts
Calcium
acetate
#Calphron,
Phos6o$
Calciumca+#onate
#Titralac, Calci(che-$
Calcium
gluconate
#Halcinate$
!ineral 1
electrolyte
replace&supplements
!aintain cell
mem)rane and
capillary permea)ility.
*eplacement of
calcium deficiency.
Control ofhyperphosphatemia in
end(stage renal disease-ithout promoting
aluminum a)sorption.
!alcium carbonate:
!+otects 2ea+t ,+om
e,,ects o,
2y.e+1alemia
Tx and prevention
of hypocalcemia.
2mergency tx of
hyperkalemia and
hypermagnesemiaand adjunct in
cardiac arrest.
!alcium acetate:Control of
hyperphosphatemi
a in 2+*D.
!alcium
carbonate:
!ay )e used asantacid.
Cardiac Arrest
Arrhythmias
radycardia
Constipation
Phle)itis
+yncope
Tingling
Calculi
0ypercalciuria.
!onitor '+ #P 1
and 2C4 freF.
8)serve for s&s of
hypocalcemia#paresthesia, muscl
t-itching, colic$
!onitor pt on digitglycosides for sign
toxicity.
!onitor phosphate
levels and electroly
3or0yperphosphatemi
hypocalcemia9 mus
take -ith food.
Endoc+ine System MedicationsCLASSIFICATIO
N NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS
!ATIENT EDUCAT
Synt2+oid
#levothyroxine$
0ormones,
thyroidpreparations
meta)olic rate of)ody tissues.
*estores normal
hormone )alance.
+uppresses thyroidcancer.
*eplacement&su)stitution in
diminished or
a)sent thyroid
function.Thyroid cancer
#thyrotropin(
dependent$
5rrita)ility, 5nsomnia,0A, arrhythmias,
tachycardia, -eight
loss, Cardiovascular
Collapse, 0T%, C8
Assess AP 1 P. 3tachyarrhythmias 1
chest pain.
!onitor thyroid
function9 )lood 1 uglucose.
4ive )efore )reakf#to avoid insomnia$
I
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Ta.a0ole
#methima7ole$
!+o.ylt2iou+acil
#PT;$
Thioamides,
Antit2y+oidagents
Prevents the formation
of thyroid hormone
-ithin the thyroidcells= serum levels
of thyroid hormone.
"loc#s the utili$ation o%
iodine& preventssynthesis o% thyroid
hormone
Palliative
treatment of
hyperthyroidism.
*ash, %&', lethargy,
dro-siness,
)radycardia,Agranulocytosis
Methima$ole:
! suppression
P':45 distress
Monito+
2y.e+t2y+oidism
+es.onse#tachycardipalpitations, insomnia,fever, heat
intolerance, tremors, -
loss$
Monito+
2y.ot2y+oidism#intolerance to cold,
constipation, dry skin, -eakness$
Assess skin for rash
or s-ollen nodes.4ive )efore )reakf
+eafood and iodine
may )e restricted.!onitor CC 1
differential.
!onitor for s&s ofinfection or )leedin
'+omoc+i.tine
#Parlodel$
Dopamine
agonist&antineoplastic
Direct dopamine
agonist on dopaminereceptor sites in
su)stantia nigra.
5nhi)its 40 secretion.Antiparkinson agent.
Tx of acromegaly.
Tx of Parkinson9
hyperprolactinemia assoc. -ith
pituitary
adenomas, femaleinfertility assoc.
-ith
hyperprolactinemia.
Confusion, di77iness,
hypotension, %&', 0A,visual distur)ances,
a)dominal pain, leg
cramps, fatigue, nasalcongestion
!onitor thyroid
function, glucosetolerance, and 40
levels.
Assist -ith am)ulaAvoid tasks that reF
alertness, motor ski
until response to drTeach contraceptiv
#other than P8$Calcium
gluconate
!ineral 1electrolyte
replace&
supplements
Act as activator intransmission of nerve
impulses and
contraction of cardiac,skeletal, and smooth
muscle.
3or
hypoparathyroidis
m.
*eplacement of Ca
in deficient states.
Arrhytmias,constipation, phle)itis,
cardiac arrest
Assess 1 monitor" 2C4, 1 renal fx
Assess 1 monitor
electrolytes" !g, P!onitor serum and
urine Ca levels
5'( push slo-ly, ta)@ min(hr after m
liFuids )efore meal
Mine+al7
co+ticoids
Flud+oco+tison
e
#3lorinef$
0ormones&
corticosteroids
%a rea)sorption inrenal tu)ules and H
and 0 excretion= %a1 0/8 retention
Adrenal
insufficiency#Addisons$9
replacementtherapy in
com)ination -ith
glucocorticoid.Tx of salt(losing
adrenogenital
syndrome.
3rontal and occipital
0A, arthralgia,-eakness, )lood
volume, edema, 0T%,C03, rash, anaphylaxis,
hypokalemia
Assess '+, )reath
sounds, -eight, tissturgor9 reflexes and
)ilateral grip strengserum electrolyte.
!onitor for
hypokalemia.Avoid infections9 a
fresh fruits and veg
or -ash very carefu
J
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Endoc+ine System MedicationsCLASSIFICATIO
N NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIO
AND !ATIEN
EDUCATION
luco7
co+ticoid
Celestone
#)etamethasone$
Co+tisone
#Cortone
Acetate$
Co+te,
#hydrocortisone$
Med+ol#methyprednisol
one$
Delta7Co+te,
#prednisolone$
Deltasone
#prednisone$
Corticosteroids
5nitiate complex
reactions responsi)lefor
anti(inflammatory and
immunosuppressiveeffects.
Causes release of
epinephrine fromadrenal medulla.
+timulate of glucose
levels for energy.
Bhen com)ined -ithmineralocorticoids
some of these drugs
can )e used in
replacement therapyfor adrenal
insufficiency.
!anagement of adrenal
insufficiency.
;sed systemically and
locally for chronic
diseases including"inflammatory, allergic,
hematologic,
neoplastic, autoimmune
disorders.
5mmunosupressant s in
prevention of organ
rejection.
!anagement of acutespinal cord injury
(methylprednisolone)
Depression
euphoria
0T% Peptic ulcers
%&'
-ound healing
Adrenal
suppression
0yperglycemia
Beight gain
%a 1 0/8
retention
C03 5mmunosuppressi
on
8steoporosis
!uscle -asting
Cushingoid
appearance.
Administer daily
A!.
Do not discontin
a)ruptly.
Protect from
infection or inva
procedures.
Caution in pts -
D! or peptic ul
!onitor 5&8, dai-eight 1
electrolytes.
+igns of fluid
retention.
4ive -ith meal.
!onitor for s&s oadrenal insuffici
#0A, hypotensio
-t. loss, -eakne
K
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Digo"in
#6anoxin$
Digitalis
glycosides
force of
myocardial
contraction. cardiac output
and heart rate.
Tx of C03, atrial
fi)rillation 1
atrial flutter,tachyarrhythmias
0A, -eakness,
dro-siness, visual
distur)ances, %&'arrhythmias,
fatigue,
)radycardia, 45upset
!onitor apical pulse for
min )efore administration.
0old if NG@ )pm.!onitor pulse, -t., 5&8 and
2C4.
Adm. 5' slo-ly O? min,avoid 5!.
!onitor electrolytes 1digoxin levels
Therapeutic level" @.?(/9toxic O/
0ave Digoxin immune 3A
availa)le.
Multi7System MedicationsCLASSIFICATIO
N NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS AND
!ATIENT EDUCATIONDo.amine
vasopressor&adre
nergic
+m. Dosesstimulate
dopaminergic
receptors,producing renal
vasodilation. 6g.
doses stimulate
dopaminergic and)eta adrenergic
receptors,
producing cardiacstimulation and
renal vasodilation
Cardiac output,P, and improves
renal )lood flo-.
Tachycardia,ectopic )eats,
anginal pain,
hypotension,dyspnea, %&', 0A
!onitor P, 0*, 2C4,cardiac output, and urinary
output continuously.
*eport chest pain, dyspnea,num)ness, tingling, or
)urning of extremities.
Inde+al
#propanalol$
eta )lockers
locks )eta(
adrenergic
receptors in theheart and kidney,
has a mem)rane(
sta)ili7ation effect
and influence ofsympathetic
nervous system. 0* 1 P,suppression of
arrhythmias 1
prevent !5
!anagement of
0T%9 angina
pectoris9arrhythmias.
Prevention and
management of
!5.Prevent vascular
0A.!anagethyrotoxicosis.
radycardia,
C03, cardia
arrhythmias, heart)locks, C'A,
pulmonary
edema, gastric
pain, flatulence,%&'&D, exercise
tolerance,impotence.
!onitor P and Pulses
Pts on 5' must have
continuous 2C4 monitor.0ypotensive effect is
associated -ith cardiac
output.
Dont stop med a)ruptly, itthro-s in L heart )lock
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Code D+ugsCLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS
AND !ATIENT
EDUCATIONE.ine.2+ine
Adrenergic,
sympathomimetic
*eacts at alpha(
and )eta(
receptor sites inthe +%+ to
cause
)ronchodilation,
0*, **, P.
Treatment of shock,
)ronchospasm.
!anagement ofsevere allergic
reactions, cardiac
arrest.
%ervousness, tremor
restlessness, angina,
arrhythmias, 0T%,tachycardia, 0A, %&'
insomnia,
hyperglycemia
Assess pulmonary
function" lung sounds,
respiratory pattern9pulse, P.
!onitor 2C49 for
arrhythmias, chest
pain.Correct hypovolemia
prior to 5' use.
!ay cause serum H
and glucose.Sodium
'ica+#onate
Antiulcer,
alkalini7ing
%eutrali7es or gastric
acidity=
gastric p0.
Acts asalkalini7ing
agent )y
releasing)icar)onate
ions.
*elief ofhyperacidity9
!anagement of
meta)olic acidosis9
Treatment of certaindrug intoxications.
!eta)olic alkalosis,gas,
4astric acid re)ound,
hypernatremia,
hypocalcemia,hypokalemia, %a 1
0/8 retention
Assess 45 1 renalfunction, serum
electrolytes.
Assess signs of
acidosis&alkalosis,A4s
Do.amine
Adrenergic,sympathomimetic
inotropics,
vasopressors
+timulatesdopaminergic
receptors"cardiac output,
P, and
improved renal
)lood flo-
Choice for tx ofshock. Arrhythmias, angina,0ypotension,
tachycardia, dyspnea,%&', 0A,
!onitor P, 0*,2C4, C8.
!onitor urinary outputfreFuently.
Palpate peripheral
pulses and assess
appearance ofextremities.
At+o.ine
Anticholinergic,antiarrhythmic
5nhi)its the
action of
acetylcholine,)locking the
effects of
parasympathetic
%+.0*, 45 1
respiratory
secretions.
Antidote for
cholinergic 8D and
mushroom poisoning.Pre(op to
secretions.
*estores cardiac rate
and arterial pressure.
Dro-siness, )lurred
vision, tachycardia, dry
mouth, urinaryhesitancy, constipation,
decreased s-eating.
Assess '+ and 2C4.
!onitor 5&8.
Assess a)domen and)o-el sounds.
8)serve for toxicity or
8D9
antidotephysostigmine.
4ive @ mins. )efore
meals.
/
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Nit+oglyce+ines
Antianginal,nitrates
*elief or
prevention of
anginal attacks. cardiac output
P
Acute 1 long term
prophylactic
management ofangina pectoris.
Adjunct tx of C03
1 acute !5.Production of
controlledhypotension.
Di77iness, 0A,
hypotension,
tachycardia,restlessness, )lurred
vision, rash, flushing,
%&', -eakness.
0A is common s&e.
Assess anginal pain.
!onitor P 1 pulse.
!onitor 2C4.P8" Administer hr
)efore or / hr after
meals -& full glass of-ater.
+6" 0old ta)let undertongue until dissolved9
avoid eating ordrinking.
Change position slo-ly
#prevent 80$
Do#ut+e"
#Do)utamine$
Adrenergics,
inotropics
5ncreasedcardiac output
-ithout
significantly
increased heartrate.
Treatment of C03)ecause
myocardial
contractility -ithout
much change in rateand doesnt 8/demand of heart
muscle.
0T%, 0*, prematureventricular
contractions, +8, 0A,
angina pectoris,
arrhythmias,hypotension, %&',
phle)itis.
!onitor P, 0*, 2C4,C8, urinary output.
Palpate peripheral
pulses and assess
extremities.!onitor electrolytes,
;%, Creat,
prothrom)in time.Check for signs of
extravasation.
>