NURS 1566 Clinical Form 3: Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency

ketorolac Toradol nonsteroidal anti- 30 mg IVP Q 6 hrs PRN
inflammatory
agents, nonopioid
analgesics
Peak Onset Duration Normal dosage range
1-2 hrs 10 min 6 hrs or longer 30 mg q 6 hr (not to exceed 120 mg/day)
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or
Severe back pain solutions
Administration in higher-than-recommended doses does
not provide increased effectiveness but may cause
increased side effects. Duration of ketorolac therapy, by all
routes combined, should not exceed 5 days Use lowest
effective dose for shortest period of time.
Coadministration with opioid analgesics may have additive
analgesic effects and may permit lower opioid doses.
Y-Site Compatibility: dexmedetomidine, fentanyl,
hydromorphone, morphine, remifentanil, sufentanil
Y-Site Incompatibility: azithromycin, fenoldopam
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Inhibits prostaglandin synthesis, producing Concurrent use with aspirin may ↓ effectiveness, ↑ adverse
peripherally mediated analgesia, Also has antipyretic GI effects with aspirin , other NSAIDs , potassium
and anti-inflammatory properties. supplements , corticosteroids , or alcohol. Chronic use
with acetaminophen may ↑ risk of adverse renal reactions,
↑ bleeding risk with arnica, chamomile, clove, dong quai,
feverfew, garlic, ginger, ginkgo, Panax ginseng.
Common side effects
Drowsiness, GI BLEEDING, EXFOLIATIVE
DERMATITIS, STEVENS-JOHNSON SYNDROME,
TOXIC EPIDERMAL NECROLYSIS, anaphylaxis.
Interactions with other patient drugs, OTC or
herbal medicines (ask patient specifically)
↑ adverse GI effects with alcohol. Chronic use with
acetaminophen may ↑ risk of adverse renal reactions
(Tylenol). May ↓ effectiveness of antihypertensives
(Norvasc, Lopressor).
Lab value alterations caused by medicine
Evaluate liver function tests, especially AST and ALT,
periodically in patients receiving prolonged therapy. May
cause ↑ levels. May cause prolonged bleeding time that
may persist for 24-48 hr following discontinuation of
therapy. May cause ↑ BUN, serum creatinine, or potassium
concentrations.
Be sure to teach the patient the following about this
medication
Instruct patient on how and when to ask for pain
medication, Instruct patient to take medication exactly as
directed. Take missed doses as soon as remembered if not
almost time for next dose. Do not double doses. May
cause drowsiness or dizziness. Advise patient to avoid
driving or other activities requiring alertness until response
to the medication is known. Caution patient to avoid the
concurrent use of alcohol, aspirin, NSAIDs,
acetaminophen, or other OTC medications without
consulting health care professional. Advise patient to
inform health care professional of medication regimen
prior to treatment or surgery. Advise patient to consult
health care professional if rash, itching, visual
disturbances, tinnitus, weight gain, edema, black stools,
persistent headache, or influenza-like syndrome (chills,
fever, muscle aches, pain) occurs.

Nursing Process- Assessment Assessment Evaluation

(Pre-administration assessment) Why would you hold or not give this Check after giving
Patients who have asthma, aspirin- med? Decrease in severity of pain.
induced allergy, and nasal polyps are at Occurrence of unwanted or dangerous Patients who do not respond
increased risk for developing side effects. to one NSAID may respond
hypersensitivity reactions. Assess for to another.
rhinitis, asthma, and urticaria. Assess
pain (note type, location, and intensity)
prior to and 1-2 hr following
administration.