Common Nursing Medication Review IV /
IM / SC complete 2024 update.
Cefazolin (Ancef) - Class Cephalosporin (First Generation)
Cefazolin (Ancef) - Indication Infection such as :
- Skin infections (including burn wounds)
- Pneumonia
- UTI
- Bone and Joint Infection
- Septicemia
Cefazolin: Pre Operative Prophylaxis, biliary tract infection genital infection, bacterial
endocarditis prophylaxis
Cefazolin (Ancef) - Action Binds to bacterial cell wall membrane causing cell death
Cefazolin (Ancef) - 1/2 Life 90-150 min
Cefazolin (Ancef) - Onset / Peak / Duration (IV) IV: Rapid (Onset) | 5 min (Peak) | 6-12 hr
(Duration)
Cefazolin (Ancef) - Contraindications - Hypersensitivity to cephalosporins
- Hypersensitivity to penicillins
Cefazolin (Ancef) - Adverse Effects GI: Clostridioides Difficile Associated Diarrhea (CDAD)
Derm: Stevens-Johnsons Snydrome
Neuro: Seizures (High doses)
Misc: Anaphylaxis, Serum sickness
Cefazolin (Ancef) - Assessment - Assess for infection (VS, appearance of wounds, sputum,
urine, and stool; WBC)
- Perform history check of any Rx. to penicillin or cephalosporins
- Observe for S/S of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Keep epinephrine,
antihistamine, resuscitation equipment close in case.
,- Monitor bowel function. Diarrhea, abdominal cramping, fever, and blood stools should be
reported promptly as sign of CDAD (c. diff associated diarrhea)
- Discontinue cephalosporin at first sign of rash; may be life threatening (stevens-johnson
syndrome)
Cefazolin (Ancef) - Patient/Family TeachingInstruct patient to notify health care professional if
rash or fever and diarrhea develop
Cefazolin (Ancef) - Evaluation/Desired Outcome - Resolution of S/S of infection
- Decreased incidence of infection when used as prophylaxis
Dimenhydrinate (Gravol) - Class Antihistamine
Dimenhydrinate (Gravol) - Indication - Allergic Rx
- Motion sickness
Dimenhydrinate (Gravol) - Action Competes with histamine for H1-receptor sites on effector
cells in the gastrointestinal tract, blood vessels, and respiratory tract; blocks chemoreceptor
trigger zone, diminishes vestibular stimulation, and depresses labyrinthine function through its
central anticholinergic activity (which reduces severity of nausea)
Dimenhydrinate (Gravol) - Contraindications - Hypersensitivity
- angle-closure glaucoma
- Premature or newborn infants
Dimenhydrinate (Gravol) - Assessments - Assess allergy symptoms (rhinitis, conjunctivitis,
hives) before and periodically throughout therapy.
- Monitor pulse and BP before initiating and throughout IV therapy.
- Assess lung sounds and character of bronchial secretions.
- Maintain fluid intake of 1500-2000 mL/day to decrease viscosity of secretions.
Dimenhydrinate (Gravol) - Assessments (nausea and vomiting) Assess degree of nausea and
frequency and amount of emesis when administering for nausea and vomiting.
Dimenhydrinate (Gravol) - Assessments (Anxiety) Assess mental status, mood, and behavior
when administering for anxiety.
Dimenhydrinate (Gravol) - Implementation When use of prophylaxis of motion sickness,
administer at least 30 minutes and preferably 1-2 hr before exposure to conditions that may
precipitate motion sickness
when administering concurrently with opioid analgesics, supervise ambulation to prevent injury
secondary to increased sedation
Dimenhydrinate (Gravol) - Patient/Family Teaching - Inform patient drowsiness may occur
- Avoid with alcohol or CNS depressants
- Good oral hygiene, sugarless gum, or candy may help relieve dryness of mouth
, Diphenhydramine (Benadryl) - Class antihistamine
Diphenhydramine (Benadryl) - Indication Relief of allergic symptoms caused by histamine
release including:
Anaphylaxis,
Seasonal and perennial allergic rhinitis,
Allergic dermatoses.
Parkinson's disease and dystonic reactions from medications.
Mild nighttime sedation.
Prevention of motion sickness.
Antitussive (syrup only).
Diphenhydramine (Benadryl) - Action Competes with histamine for H1-receptor sites on
effector cells in the gastrointestinal tract, blood vessels, and respiratory tract; anticholinergic and
sedative effects are also seen
Diphenhydramine (Benadryl) - Onset / Peak / Duration (IV)IV: Rapid (Onset) | Unknown (Peak)
| 4-8 hr (Duration)
Diphenhydramine (Benadryl) - Therapeutic Effects ↓ symptoms of histamine excess (sneezing,
rhinorrhea, nasal and ocular pruritus, ocular tearing and redness, urticaria)
Prevention of motion sickness
Suppression of cough
Diphenhydramine (Benadryl) - Adverse Effects Hypersensitivity reactions (eczema, pruritus,
rash, cardiac disturbances, photosensitivity) may occur.
Overdose symptoms may vary from CNS depression (sedation, apnea, hypotension,
cardiovascular collapse, death) to severe paradoxical Rx (hallucinations, tremors, seizures).
Diphenhydramine (Benadryl) - Assessment If pt is having acute allergic reaction, obtain history
of recently ingested foods, drugs, environmental exposure, emotional stress.
Monitor B/P rate; depth, rhythm, type of respiration; quality, rate of pulse. Assess lung sounds
for rhonchi, wheezing, rales.
Diphenhydramine (Benadryl) - Patient Teaching - May cause drowsiness
- May cause dry mouth
- Teach sleep hygiene technique (dark room, quiet bedtime ritual, limit daytime napping,
avoidance of nicotine and caffeine)
Diphenhydramine (Benadryl) - Evaluation/Desired Outcomes - Prevention of, or decreased
urticaria (skin rash)
- Prevention of / ↓ nausea & vomiting
IM / SC complete 2024 update.
Cefazolin (Ancef) - Class Cephalosporin (First Generation)
Cefazolin (Ancef) - Indication Infection such as :
- Skin infections (including burn wounds)
- Pneumonia
- UTI
- Bone and Joint Infection
- Septicemia
Cefazolin: Pre Operative Prophylaxis, biliary tract infection genital infection, bacterial
endocarditis prophylaxis
Cefazolin (Ancef) - Action Binds to bacterial cell wall membrane causing cell death
Cefazolin (Ancef) - 1/2 Life 90-150 min
Cefazolin (Ancef) - Onset / Peak / Duration (IV) IV: Rapid (Onset) | 5 min (Peak) | 6-12 hr
(Duration)
Cefazolin (Ancef) - Contraindications - Hypersensitivity to cephalosporins
- Hypersensitivity to penicillins
Cefazolin (Ancef) - Adverse Effects GI: Clostridioides Difficile Associated Diarrhea (CDAD)
Derm: Stevens-Johnsons Snydrome
Neuro: Seizures (High doses)
Misc: Anaphylaxis, Serum sickness
Cefazolin (Ancef) - Assessment - Assess for infection (VS, appearance of wounds, sputum,
urine, and stool; WBC)
- Perform history check of any Rx. to penicillin or cephalosporins
- Observe for S/S of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Keep epinephrine,
antihistamine, resuscitation equipment close in case.
,- Monitor bowel function. Diarrhea, abdominal cramping, fever, and blood stools should be
reported promptly as sign of CDAD (c. diff associated diarrhea)
- Discontinue cephalosporin at first sign of rash; may be life threatening (stevens-johnson
syndrome)
Cefazolin (Ancef) - Patient/Family TeachingInstruct patient to notify health care professional if
rash or fever and diarrhea develop
Cefazolin (Ancef) - Evaluation/Desired Outcome - Resolution of S/S of infection
- Decreased incidence of infection when used as prophylaxis
Dimenhydrinate (Gravol) - Class Antihistamine
Dimenhydrinate (Gravol) - Indication - Allergic Rx
- Motion sickness
Dimenhydrinate (Gravol) - Action Competes with histamine for H1-receptor sites on effector
cells in the gastrointestinal tract, blood vessels, and respiratory tract; blocks chemoreceptor
trigger zone, diminishes vestibular stimulation, and depresses labyrinthine function through its
central anticholinergic activity (which reduces severity of nausea)
Dimenhydrinate (Gravol) - Contraindications - Hypersensitivity
- angle-closure glaucoma
- Premature or newborn infants
Dimenhydrinate (Gravol) - Assessments - Assess allergy symptoms (rhinitis, conjunctivitis,
hives) before and periodically throughout therapy.
- Monitor pulse and BP before initiating and throughout IV therapy.
- Assess lung sounds and character of bronchial secretions.
- Maintain fluid intake of 1500-2000 mL/day to decrease viscosity of secretions.
Dimenhydrinate (Gravol) - Assessments (nausea and vomiting) Assess degree of nausea and
frequency and amount of emesis when administering for nausea and vomiting.
Dimenhydrinate (Gravol) - Assessments (Anxiety) Assess mental status, mood, and behavior
when administering for anxiety.
Dimenhydrinate (Gravol) - Implementation When use of prophylaxis of motion sickness,
administer at least 30 minutes and preferably 1-2 hr before exposure to conditions that may
precipitate motion sickness
when administering concurrently with opioid analgesics, supervise ambulation to prevent injury
secondary to increased sedation
Dimenhydrinate (Gravol) - Patient/Family Teaching - Inform patient drowsiness may occur
- Avoid with alcohol or CNS depressants
- Good oral hygiene, sugarless gum, or candy may help relieve dryness of mouth
, Diphenhydramine (Benadryl) - Class antihistamine
Diphenhydramine (Benadryl) - Indication Relief of allergic symptoms caused by histamine
release including:
Anaphylaxis,
Seasonal and perennial allergic rhinitis,
Allergic dermatoses.
Parkinson's disease and dystonic reactions from medications.
Mild nighttime sedation.
Prevention of motion sickness.
Antitussive (syrup only).
Diphenhydramine (Benadryl) - Action Competes with histamine for H1-receptor sites on
effector cells in the gastrointestinal tract, blood vessels, and respiratory tract; anticholinergic and
sedative effects are also seen
Diphenhydramine (Benadryl) - Onset / Peak / Duration (IV)IV: Rapid (Onset) | Unknown (Peak)
| 4-8 hr (Duration)
Diphenhydramine (Benadryl) - Therapeutic Effects ↓ symptoms of histamine excess (sneezing,
rhinorrhea, nasal and ocular pruritus, ocular tearing and redness, urticaria)
Prevention of motion sickness
Suppression of cough
Diphenhydramine (Benadryl) - Adverse Effects Hypersensitivity reactions (eczema, pruritus,
rash, cardiac disturbances, photosensitivity) may occur.
Overdose symptoms may vary from CNS depression (sedation, apnea, hypotension,
cardiovascular collapse, death) to severe paradoxical Rx (hallucinations, tremors, seizures).
Diphenhydramine (Benadryl) - Assessment If pt is having acute allergic reaction, obtain history
of recently ingested foods, drugs, environmental exposure, emotional stress.
Monitor B/P rate; depth, rhythm, type of respiration; quality, rate of pulse. Assess lung sounds
for rhonchi, wheezing, rales.
Diphenhydramine (Benadryl) - Patient Teaching - May cause drowsiness
- May cause dry mouth
- Teach sleep hygiene technique (dark room, quiet bedtime ritual, limit daytime napping,
avoidance of nicotine and caffeine)
Diphenhydramine (Benadryl) - Evaluation/Desired Outcomes - Prevention of, or decreased
urticaria (skin rash)
- Prevention of / ↓ nausea & vomiting
