Drug Study (I) (Skidmore-Roth, 2012)
Vitamin K
Generic Name- phytonadione (vit K1)
Trade Name- mephyton
Functional Class- Vit K1, fat- soluble vitamin
Action
Needed for adequate blood clotting (factors II, VII, IX, X)
Uses
Vit K malabsorption, hypoprothrombinemia, prevention of hypoprothrombinemia caused by oral anticoagulants, prevention of hemorrhagic disease of the newborn
Dosage and routes
Prevention of hemorrhagic disease of the newborn
Neonate: IM 0.5-1 mg within 1 hour after birth, repeat in 2-3 week if required.
Hypoprothrombinemia caused by vit K malabsorption
Adult: PO/IM 2.5-25 mg, may repeat or increased to 50 mg, Child: PO/IM 5-10 mg, Infant: PO/IM 2mg.
Hypoprothrombinemia caused by oral anticoagulants
Adult and child: PO/SC/IM
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Assess for prothrombin time during treatment (2 sec deviation from control time, bleeding time, and clotting time); monitor for bleeding, pulse, and BP. Assess for nutritional status: liver (beef), spinach, tomatoes, coffee, asparagus, broccoli, cabbage, lettuce, greens. Administer IV route after diluting with D5, NS 10 ml or more give 1 mg/min or more. IV route only when other routes not possible (deaths have occurred).
Perform/provide
Store in tight, light-resistant container
Evaluate
Therapeutic responses: decreased bleeding tendencies, decreased PT, decreased clotting time.
Teach patient/ family
Not to take other supplements unless directed by prescriber. The necessary foods for diet. To avoid IM inj, use soft tooth-brush, do not floss, use electronic razor until coagulating defects corrected. To report symptoms of bleeding. Not to use OTC medications unless approved by prescriber. The importance of frequent lab tests to monitor coagulation factors.
3.2. Drug Study (II)
Hepatitis B vaccine (Karc, 2006)
Generic Name- Hepatitis B vaccine
Trade Name- Engerix-B, Recombivax HB
Therapeutic Actions
Provide inactivated human hepatitis B surface antigen particles to stimulate active immunity and production of antibodies against hepatitis B surface antigen produced by
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Dosage
Birth-10 years: Initial dose- 0.5 ml, followed by 0.5 ml IM at 1 month and 6 month after initial dose. 11-19 yrs: 0.5 ml followed by 0.5 ml IM at 1 month and 6 month after initial dose. Adult: 1 ml followed by 1 ml IM at 1 month and 6 month after initial dose, all types. Revaccination: a booster dose should be considered if anti-HBs levels < 10mlU/ml 1 to 2 month after third dose. Children < 10 yrs: 10mcg, Adults and patients > 10 yrs > 20mcg.
Nursing considerations
Do not administer to any patient with known hypersensitivity to any component of the vaccine or allergy to yeast. Use caution in pregnant woman or nursing woman. Pregnancy category C safety not established. Use only if clearly needed and benefits outweigh potential unknown effects. Use caution in patients with active infection. Delay use of vaccine if possible. Use with caution in any patient with compromised cardiopulmonary status or patients in whom a febrile or systemic reaction could present a significant risk. Administer IM preferably in the deltoid muscle in adults or the anterolateral thigh muscle in infants and small children. Do not administer IV or intradermally, subcutaneous route may be used in patients who are at high risk for hemorrhage following IM injection,
IV bolus of unfractionated Heparin or Subcutaneous injection of low molecular weight heparin (LMWH) may be used to prevent the formation of new blood clots. Nursing consideration: Require regular monitoring of activated partial thromboplasitn time (aPTT) and needed frequent heparin dose changes (Brunner and Suddarth’s, et al, 2010: 765). Fibrinolytic therapy: This therapy is given to dissolve the thrombus in the artery and restore the blood flow. There are two fibrinolytic drugs which are streptokinase and Recombinant tissue plasminogen activators (r-TPA) which includes Alteplase, reteplase and tenecteplase (Brunner and Suddarth’s, et al, 2010: 772).
There are two types of Warfarin, one activates clotting factor and the other slows down the clotting factor. Warfarin works against the liver to produce Vitamin K, which is needed for the proteins that help blood clotting. The treatment for Warfarin is an increase of Vitamin K to help clot internal bleeding. By increasing the vitamin K it should neutralize the effects of the
The second step, sit the patient in a comfortable position with his arm fully extended while placing a clean tourniquet around the patients arm, about 3 or 4 inches above the venipuncture
The patient follows the doctor’s recommendation for completing blood work to ensure the medication is consistently within the therapeutic level. Therefore, the International Normalized Ratio (INR), prothrombin time
Then, antibiotics, surgery, anti-inflammatory agents, or obstetric procedures may regulate hemostasis, mainly in chronic DIC. However, in acute phase of DIC, two categories of treatment are available as follows: treatments that slow the coagulation process and therapies that substitute the coagulation factors and the missing platelets. Heparin also can be used to stop the uncontrolled stimulation of the coagulation cascade due to the antithrombotic properties. Careful monitoring of heparin is required because the heparin can worsen the bleeding. Red blood cell administration, thawed frozen plasma, and platelets transfusion may be use based on the patient
Dear Editor, it is very important for all human beings to be properly vaccinated. Kids should be vaccinated because their immune systems are at a higher risk of getting sick. Teens should be vaccinated because they’re starting to get into the real world and realizing that there’s things out there that they don’t want to get. Adults should get vaccinated because they don’t want to pass it to their love ones. Kids should be properly vaccinated because they’re so young and they’re easy to get sick.
Once when they are 2 months old, another dose at 4 months, one at 6-18 months, then another dose once they are 4-6 years old, typically before one starts kindergarten. Also, when children are born, they already have antibiotics in their body. However, these antibiotics are only temporary making the need for vaccination that much more
Following that, the doctor needs to inform the parent on what the vaccine will do to help the child. Convincing the parent what the pros on the vaccine are will raise the chances of agreeing to the injected vaccine. Some children are afraid of shots, so there is alternatives to this matter. The vaccine can be injected by nasal spray, liquid medicine, a swallow tablet, or in the more popular way, a shot. The CDC can send of PSA’s to inform the general public of the matter of
I have also read about methods of administration which some literature provides evidence of 5Rs and others give as much as 10RS. Whichever way of dispensing the initial 5RS is the basic for individual to familiarize. There are other things that needs to be considered such as washing hands prior to administering, check the drug chart, the right patient, right drug, right route, right amount/dosage, the history or background record of the patient, allergy or intolerance}, the right education provided to the patient, documenting as given, documenting refusal and right evaluation. On the other hand, I need to have that self-awareness of which patient is in the medication room and know how to talk
Various vaccines require a different amount of times one needs to get vaccinated. Some require a person to get many doses of a vaccine throughout their life, however, there are few that only require one. Children will receive fourteen vaccinations and as many as forty-five doses by the time they are five years old. Throughout their childhood, children will need to receive boosters. Boosters are additional doses of a vaccine that are given as additional protection provided by the original dose.
Therefore, parents are starting to question, “does my child really need all of those vaccinations?”. As a parent to a newborn there are various concerns and questions regarding the best prevention method for sickness.
Childhood Vaccinatons The development of vaccines is one of the greatest achievements in modern medicine. While critics of vaccinations claim that vaccines can cause serious and sometimes fatal side effects, there is no scientific proof of this claim. What has been proven by the Center for Disease Control is an “87-99% reduction in most vaccine-preventable infections in U.S. children demonstrating the dramatic success of immunization on public health” (Hedden, 2012, p. 1). Vaccines save children’s’ lives, protect future generations and may eventually eradicate the diseases we are currently immunizing against.
[Transition: With help from Mayo Clinic website, I learned that...] B. There Are Two Ways to Get The Vaccine 1. Shot (Injection) a. Contains an inactivated vaccine made up of killed flu virus. b. Available to people 6 months old and older. 2.
It is true that immunization could cause side effects, but nothing that would be extremely dangerous for humans, unless it is an allergy reaction but there are different kind of immunization to prevent that. It is worth the risk, better have a little bit of fever for a few days than get sick because of a disease that should be
Also stated in the article from vaccines.gov, “ Vaccines are only given to children after a long and careful review by scientists, doctors, and healthcare professionals. Vaccines will involve some discomfort and may cause pain, redness, or tenderness at the site of injection but this is minimal compared to the pain, discomfort, and trauma of the diseases these vaccines prevent.” Before vaccines can even be given to hospitals they have to be examined by scientists and specialists to make sure they are safe for children. Also vaccines have to be passed through certain health department before they are able to be sent out to hospitals to have children receive them. There are many different organizations and departments that make sure children can receive vaccines.