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Implication: Lab value-BUN, Creatinine, Kidney-related labs

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Implication: Lab value-BUN, Creatinine, Kidney-related labs

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When giving vancomycin, monitor kidney related lab values which may depict any harmful effects of vanco on the kidneys, as the drug can negatively impact this organ

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Nursing Implications:

monitor liver enzymes

monitor signs of rash, fever, systematic infections

monitor culture results for determine which medication will work best

monitory for toxicity and overdose ( labs)

administer on empty stomach ( if given PO)

some patients might need vitamin b6 supplest to prevent peripheral neuropathy)

obtain culture before administering med

Patient Teachings:

treatment ( use) of antibiotic for 6 months-2 years,

continue use as prescribed even if symptoms are not present

can cause yellowing eyes/skin ( possible vision changes)

can cause GI Upset

can cause dark urine

avoids foods that contain tyramine (tuna and Swiss cheese)

avoid use with alcohol

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Nursing implications

C. difficile associated diarrhea: Assess bowel status (bowel sounds, frequency and consistency of stools, presence of blood in stools) throughout therapy.

Vancomycin must be given orally for treatment of C. difficile-associated diarrhea.

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Nursing implications

Monitor liver function

Arrythmias

Don't give with loperamide

Monitor for anaphylaxis

Get specimen culture

Monitor bowel functions

Use cautiously with liver and renal disease

Can be used in Pregnancy

Use cautiously with Myasthenia Gravis

Increase otiosity in Geriatrics

Patient Teaching

Finish drug completely doesn't matter if you feel better

if missed dose take ASAP or if close with next dose don't double up doses!

1-2 hours before eating -can eat with food if GI is bothered

Causes diarrhea

If Stool contains blood, mucus or pus notify provider

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Nursing Implications

Monitor output

Monitor labs (CMP, CBC)

Monitor for bone marrow suppression

Monitor for elevated liver enzymes

Monitor for signs of infection (fever, rash)

Monitor for lactic acidosis

Patient Teaching

Medication Compliance

Not a cure for HIV or AIDS

Encourage rest

Can cause GI upset, headaches, seizures, fatigue, neck/ back pain

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Treatment of gram - infections (E coli.) and other infections caused by staphylococci

*When penicillins or other less toxic drugs are contraindicated

Advise adequate fluid intake

Instruct patient to report signs of hypersensitivity, tinnitus, hearing loss, rash, vertigo, etc.

*Evaluate hearing abilities prior to administration

Advise females taking contraceptives of ineffectiveness

Take missed dose as soon as possible, avoid double dosing

New cultures are to be taken if signs/symptoms are not resolved via gentamicin

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Patient teaching

Advise patients on oral vancomycin to take as directed. Take missed doses as soon as remembered unless almost time for next dose; do not double dose.

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Patient Teaching:

Caution regarding disulfram-like reaction (flushing, headache, nausea, vomiting)

watch for signs of rash and super infection (such as black furry overgrowth on tongue, vaginal itching or discharge, loose or foul smelling stool)

caution with breastfeeding

may alter bowel flora of infant patients

Nursing Implications:

assess for infection at beginning and during therapy

before initiating therapy, obtain patient history to determine previous use of and reactions to penicillins or cephalosporins

persons with a negative history of penicillin sensitivity may still have an allergic response

observe for anaphylaxis

monitor bowel function (diarrhea, abdominal cramping, fever, bloody stools - all should be reported to HCP)

assess patient for skin rash frequently during therapy - discontinue at first signs of rash (may be life threatening)

Stevens-Johnson Syndrome may develop

treat symptomatically, may reoccur once treatment is stopped

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When administering IV vancomycin, trough/peak levels are typically drawn to maintain a safe and therapeutic drug level within the blood, you may be able to lower patient stress/frustration by informing the patient they can expect blood draws at "x" frequency so they can feel informed and more autonomous in their care

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Implications

use correct oral dosing device to avoid dosing errors

start medication as soon as symptoms start or within 2 days of exposure

do not give to patients with end stage renal disease and not receiving dialysis

Teaching

administer with food or milk to reduce adverse GI effects

medication is not a substitution for the flu shot

high alert for pregnancy, potential pregnancy and breastfeeding females

be aware of behavioral changes (hallucinations, abnormal beahvior etc.)

be sure to disclose OTC meds, vitamins, herbs etc. to avoid adverse effects

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Use cautiously in pts with renal or hearing impairments; intestinal obstruction or inflammation.

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Assessment:

Monitor for infection, neurological symptoms, and GI side effects (nausea, diarrhea). Assess liver and kidney function.

Administration:

Give with food to reduce GI upset (oral). Administer IV over 30–60 minutes. Ensure proper use for topical/intravaginal forms.

Interactions:

Avoid alcohol during and for 48 hours after treatment to prevent a disulfiram-like reaction. Monitor interactions with warfarin, phenytoin, and lithium.

Monitoring:

Check INR if on warfarin. Monitor liver function and WBC counts during prolonged use.

Patient teaching

Take this medication exactly as prescribed by your healthcare provider. complete the entire dose, cause or a superbug (explain) Do not save for later.

reduces birth control

if it cause dizziness, wait to drive or operate machinery

Oral Form: Take with or without food. To avoid an upset stomach, you may take it with a meal.

avoid alcohol

If you miss a dose, take it as soon as you remember. However, if it’s almost time for the next dose, skip the missed dose. Do not double the dose to make up for the missed one.

If you experience severe side effects such as tingling or numbness in your extremities, seizures, or signs of an allergic reaction (rash, swelling, difficulty breathing). stop medication and contact HPC

If symptoms of infection worsen or do not improve after the full course of therapy. contact HPC

Store at room temperature away from moisture, heat, and light.

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For orders specific to pregnant or nursing patients, be aware that these patient conditions alter the pharmacokinetics of vancomycin, if adverse reactions arise or if the benefit of administration does not appear to outweigh the risk of administration, contact the provider prior to administering the drug.

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Given to pregnant women who have HIV to prevent spreading to baby

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May decrease the therapeutic effect of influenza virus, avoid use 2 days prior to and 2 wk after vaccine administration.

always monitor flu symptoms