NURS 2466 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

Bacitracin/Polymyxin B Polysporin Antibiotic variable topical 3x per day
ointment
Peak Onset Duration Normal dosage range
Unknown Unknown unknown Variable

Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
To prevent infection from the large foley catheter after a N/A
TURP

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

(Why med ordered) Contraindications/warnings/interactions
Bacteriocidal for a large number of gram positive and .Hypersensitivity
gram negative bacteria
Common side effects
None

Interactions with other patient drugs, OTC or herbal
medicines (ask patient specifically)
No significant amount enters the blood
Nursing Process- Assessment
(Pre-administration assessment)
Assess for signs of infection (pain, redness,
swelling, purulent discharge) and for signs of
hypersensitivity (rash, hives, pruritis)
Lab value alterations caused by medicine
None known
Be sure to teach the patient the following about this
medication
Clean the area with soap and water daily
Apply as directed and after bathing
Wash hands with soap and warm water before applying
ointment.
Assessment Evaluation
Why would you hold or not give this Check after giving
med? No signs of infection or
If pt is experiencing a hypersensitivity hypersensitivity
reaction, notify physician