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

fluoxetine Prozac antidepressants 20 mg PO Q day
Peak Onset Duration Normal dosage range
Unknown 1-4 wks 2 wks 10 mg/day in the morning initially, may be increased (not
to exceed 60 mg/day)
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or
Depression solutions
N/A

Mechanism of action and indications Nursing Implications (what to focus on)

(Why med ordered) Contraindications/warnings/interactions
Selectively inhibits the reuptake of serotonin in the Hypersensitivity, patients with concurrent chronic illness,
CNS or multiple drug therapy (dosage adjustments may be
necessary), appears on Beers list. Geriatric patients are at
increased risk for excessive CNS stimulation, sleep
disturbances, and agitation.
Common side effects
Anxiety, drowsiness, headache, insomnia, nervousness,
diarrhea, excessive sweating, pruritus, tremor, SEIZURES
Interactions with other patient drugs, OTC or
herbal medicines (ask patient specifically)
↑ CNS depression with sedative/hypnotics
Nursing Process- Assessment
(Pre-administration assessment)
Monitor mood changes. Inform physician
or other health care professional if patient
demonstrates significant increase in
anxiety, nervousness, or insomnia,
Monitor appetite and nutritional intake.
Weigh weekly. Notify physician or other
health care professional of continued
weight loss. Adjust diet as tolerated to
support nutritional status.
Lab value alterations caused by medicine
Monitor CBC and differential periodically during therapy.
Notify physician or other health care professional if
leukopenia, anemia, thrombocytopenia, or increased
bleeding time occurs, Proteinuria and mild ↑ in AST may
occur during sensitivity reactions,
may cause ↑ in serum alkaline phosphatase, ALT, BUN,
creatine phosphokinase; hypouricemia, hypocalcemia,
hypoglycemia or hyperglycemia, and hyponatremia
Be sure to teach the patient the following about this
medication
Take fluoxetine exactly as directed. If a dose is missed,
omit and return to regular schedule. Do not double doses or
discontinue without consulting health care professional;
discontinuation may cause anxiety, insomnia, nervousness,
May cause drowsiness, dizziness, impaired judgment, and
blurred vision, caution patient to change positions slowly
to minimize dizziness. Inform patient that frequent mouth
rinses, good oral hygiene, and sugarless gum or candy may
minimize dry mouth. If dry mouth persists for more than 2
wk, consult health care professional regarding use of saliva
substitute. Caution patient to wear protective clothing and
use sunscreen to prevent photosensitivity reactions. Advise
patient to notify health care professional if symptoms of
sensitivity reaction occur or if headache, nausea, anorexia,
anxiety, or insomnia persists. Emphasize the importance of
follow-up exams to monitor progress. Encourage patient
participation in psychotherapy.
Assessment Evaluation
Why would you hold or not give this Check after giving
med? Increased sense of well-
Sensitivity reaction (urticaria, fever, being, Renewed interest in
arthralgia, edema, carpal tunnel surroundings. May require
syndrome, rash, hives, 1-4 wk of therapy to obtain
lymphadenopathy, respiratory distress) antidepressant effects