SODIUM BICARBONATE

Classification: Gastrointestinal Agent; Antacid; Fluid and Electrolyte Balance Agent

Indication: Management of metabolic acidosis; Used to alkalinize urine and promote excretion of certain
drugs in over dosage situations; Used as an antacid
Mechanism of Action: Short-acting, potent systemic antacid. Rapidly neutralizes gastric acid to form sodium
chloride, carbon dioxide, and water. After absorption of sodium bicarbonate, plasma alkali reserve is
increased and excess sodium and bicarbonate ions are excreted in urine, thus rendering urine less acid.
Contraindication: Metabolic or respiratory alkalosis, Hypocalcemia, Excessive chloride loss, Patients on
sodium restricted diet, renal failure
Adverse effects: Edema, Flatulence, Gastric distention, Metabolic alkalosis, Hypernatremia, Hypocalcemia,
Hypokalemia, Sodium and water retention, Irritation at IV site, Tetany
Nursing Reponsibilities:
Assess the clients fluid balance throughout the therapy. This assessment includes intake and output,
daily weight, edema and lung sounds.
Monitor the clients serum calcium, sodium, potassium, bicarbonate concentrations, serum
osmolarity, acid-base balance and renal function before and throughout the therapy.
Tablets must be taken with a full glass of water.
For clients taking the medication as a treatment for peptic ulcers it may be administered 1 and 3
hours after meals and at bedtime.

DEXAMETHASONE
Brand name: Cortastat
Classification: Corticosteroid, Anti-inflammatory agents
Indication: Management of cerebral edema, Diagnostic agent in adrenal disorders, Relieves inflammation, Allergic
disorders, Asthma, Arthritis
Mechanism of Action: Dexamethasone suppresses inflammation and the normal immune response by stabilizing
leukocyte lysosomal membranes; suppresses immune response; stimulates bone marrow; and influences protein, fat
and carbohydrate metabolism.
Contraindication: Hypersensitivity, Active untreated infection, Lactation, Systemic fungal infection
Adverse Effect: Skin rash, Swollen face, legs or ankles, Vision problems, Cold or infection that last for a long time,
Muscle weakness, Black or tarry stool
Nursing Responsibilities:
Monitor intake and output of patient.
Observe the patient for peripheral edema, steady weight gain, rales or crackles or dyspnea.
For patients with cerebral edema, assess then for level of consciousness changes and headache during the
therapy.
Instruct patient to avoid people with known infection and contagious illnesses as corticosteroids causes
immunosuppression and may mask symptoms of infection