Class Talk Fall 2016

Choose one medication (your choice!): What information could you find about how it affects the kidneys, where it is absorbed, and/or other nursing considerations with renal patients?

Using Skyscape, I researched the drug vancomycin, also referred to as Vancocin. Under the contraindications/precautions, it states that the drug must be used cautiously in patients with renal impairment, requiring that dosage reduction occur if creatinine clearance is less than 80 mL per minute. It says their would be systemic absorption, and other nursing considerations are to monitor the patient during assessment before administering the medication. Lab test considerations include monitoring for casts, albumin, cells in urine, decreased specific gravity, CBC, and renal function during therapy. The medical app warns that the drug may cause increased BUN levels, so it is important to monitor during treatment. Also the drug is poorly absorbed from the GI tract, and IV vancomycin is almost entirely eliminated by the kidneys, another reason it is important to note kidney/renal impairment because a renal patient will excrete the dose faster. Also, the drug has an interaction warning with other nephrotoxic drugs because this drug can be harmful to kidneys, so it is important to avoid a drug-drug interaction by asking the patient about medications they take or have taken in the past to avoid those interactions.

Choose one medication (your choice!): What information could you find about how it affects the kidneys, where it is absorbed, and/or other nursing considerations with renal patients?

Using Skyscape, I researched the drug vancomycin, also referred to as Vancocin. Under the contraindications/precautions, it states that the drug must be used cautiously in patients with renal impairment, requiring that dosage reduction occur if creatinine clearance is less than 80 mL per minute. It says their would be systemic absorption, and other nursing considerations are to monitor the patient during assessment before administering the medication. Lab test considerations include monitoring for casts, albumin, cells in urine, decreased specific gravity, CBC, and renal function during therapy. The medical app warns that the drug may cause increased BUN levels, so it is important to monitor during treatment. Also the drug is poorly absorbed from the GI tract, and IV vancomycin is almost entirely eliminated by the kidneys, another reason it is important to note kidney/renal impairment because a renal patient will excrete the dose faster. Also, the drug has an interaction warning with other nephrotoxic drugs because this drug can be harmful to kidneys, so it is important to avoid a drug-drug interaction by asking the patient about medications they take or have taken in the past to avoid those interactions.

Choose one medication (your choice!): What information could you find about how it affects the kidneys, where it is absorbed, and/or other nursing considerations with renal patients?

Using Skyscape, I researched the drug vancomycin, also referred to as Vancocin. Under the contraindications/precautions, it states that the drug must be used cautiously in patients with renal impairment, requiring that dosage reduction occur if creatinine clearance is less than 80 mL per minute. It says their would be systemic absorption, and other nursing considerations are to monitor the patient during assessment before administering the medication. Lab test considerations include monitoring for casts, albumin, cells in urine, decreased specific gravity, CBC, and renal function during therapy. The medical app warns that the drug may cause increased BUN levels, so it is important to monitor during treatment. Also the drug is poorly absorbed from the GI tract, and IV vancomycin is almost entirely eliminated by the kidneys, another reason it is important to note kidney/renal impairment because a renal patient will excrete the dose faster. Also, the drug has an interaction warning with other nephrotoxic drugs because this drug can be harmful to kidneys, so it is important to avoid a drug-drug interaction by asking the patient about medications they take or have taken in the past to avoid those interactions.

Gentamicin is an aminogylcoside antibiotic that is excreted in the urine. When gentamicin is given for too long or at too high of a dose, progressive kidney failure occurs. Once the kidneys start failing, less gentamicin is excreted, increasing the concentration of the drug in the bloodstream, leading to more kidney damage. This is why the dose should be adjusted or discontinued immediately after signs and symptoms of nephrotoxicity. Kidney failure from gentamicin is often reversible.

Nursing Considerations: Patients with renal failure taking gentamicin should have their doses adjusted and should have their blood levels monitored such as peaks and troughs for nephrotoxicity. Their initial dose may be 2 mg/kg and then their subsequent doses/intervals would be based on their blood levels and assessment. As a nurse we want to monitor I&O’s, daily weight, and assess hydration status. We also want to monitor for signs of infection and toxicity/overdose. Monitoring labs for renal function is extremely important and would be by urinalysis, specific gravity, BUN, creatine, CCr. Also make sure to teach the patient about the signs of toxicity and want to look for.

Gentamicin is an aminogylcoside antibiotic that is excreted in the urine. When gentamicin is given for too long or at too high of a dose, progressive kidney failure occurs. Once the kidneys start failing, less gentamicin is excreted, increasing the concentration of the drug in the bloodstream, leading to more kidney damage. This is why the dose should be adjusted or discontinued immediately after signs and symptoms of nephrotoxicity. Kidney failure from gentamicin is often reversible.

Nursing Considerations: Patients with renal failure taking gentamicin should have their doses adjusted and should have their blood levels monitored such as peaks and troughs for nephrotoxicity. Their initial dose may be 2 mg/kg and then their subsequent doses/intervals would be based on their blood levels and assessment. As a nurse we want to monitor I&O’s, daily weight, and assess hydration status. We also want to monitor for signs of infection and toxicity/overdose. Monitoring labs for renal function is extremely important and would be by urinalysis, specific gravity, BUN, creatine, CCr. Also make sure to teach the patient about the signs of toxicity and want to look for.

Gentamicin is an aminogylcoside antibiotic that is excreted in the urine. When gentamicin is given for too long or at too high of a dose, progressive kidney failure occurs. Once the kidneys start failing, less gentamicin is excreted, increasing the concentration of the drug in the bloodstream, leading to more kidney damage. This is why the dose should be adjusted or discontinued immediately after signs and symptoms of nephrotoxicity. Kidney failure from gentamicin is often reversible.

Nursing Considerations: Patients with renal failure taking gentamicin should have their doses adjusted and should have their blood levels monitored such as peaks and troughs for nephrotoxicity. Their initial dose may be 2 mg/kg and then their subsequent doses/intervals would be based on their blood levels and assessment. As a nurse we want to monitor I&O’s, daily weight, and assess hydration status. We also want to monitor for signs of infection and toxicity/overdose. Monitoring labs for renal function is extremely important and would be by urinalysis, specific gravity, BUN, creatine, CCr. Also make sure to teach the patient about the signs of toxicity and want to look for.

Gentamicin is an aminogylcoside antibiotic that is excreted in the urine. When gentamicin is given for too long or at too high of a dose, progressive kidney failure occurs. Once the kidneys start failing, less gentamicin is excreted, increasing the concentration of the drug in the bloodstream, leading to more kidney damage. This is why the dose should be adjusted or discontinued immediately after signs and symptoms of nephrotoxicity. Kidney failure from gentamicin is often reversible.

Nursing Considerations: Patients with renal failure taking gentamicin should have their doses adjusted and should have their blood levels monitored such as peaks and troughs for nephrotoxicity. Their initial dose may be 2 mg/kg and then their subsequent doses/intervals would be based on their blood levels and assessment. As a nurse we want to monitor I&O’s, daily weight, and assess hydration status. We also want to monitor for signs of infection and toxicity/overdose. Monitoring labs for renal function is extremely important and would be by urinalysis, specific gravity, BUN, creatine, CCr. Also make sure to teach the patient about the signs of toxicity and want to look for.

Gentamicin is an aminogylcoside antibiotic that is excreted in the urine. When gentamicin is given for too long or at too high of a dose, progressive kidney failure occurs. Once the kidneys start failing, less gentamicin is excreted, increasing the concentration of the drug in the bloodstream, leading to more kidney damage. This is why the dose should be adjusted or discontinued immediately after signs and symptoms of nephrotoxicity. Kidney failure from gentamicin is often reversible.

Nursing Considerations: Patients with renal failure taking gentamicin should have their doses adjusted and should have their blood levels monitored such as peaks and troughs for nephrotoxicity. Their initial dose may be 2 mg/kg and then their subsequent doses/intervals would be based on their blood levels and assessment. As a nurse we want to monitor I&O’s, daily weight, and assess hydration status. We also want to monitor for signs of infection and toxicity/overdose. Monitoring labs for renal function is extremely important and would be by urinalysis, specific gravity, BUN, creatine, CCr. Also make sure to teach the patient about the signs of toxicity and want to look for.

Hydrochlorothiazide is a thiazide diuretic used to treat hypertension and edema. It is excreted mainly unchanged by the kidneys. This drug should be used cautiously with people with renal or hepatic impairment. This drug can precipitate azotemia and other associated effects of alterations in fluid and electrolyte balance.  It is important to monitor electrolytes, blood glucose, BUN, serum creatinine, and uric acids before and throughout therapy. (Skyscape David Drug Guide)

Hydrochlorothiazide is a thiazide diuretic used to treat hypertension and edema. It is excreted mainly unchanged by the kidneys. This drug should be used cautiously with people with renal or hepatic impairment. This drug can precipitate azotemia and other associated effects of alterations in fluid and electrolyte balance.  It is important to monitor electrolytes, blood glucose, BUN, serum creatinine, and uric acids before and throughout therapy. (Skyscape David Drug Guide)