Medication side effects

What does “assess ABCs” mean in an emergency?

ABCs = Airway, Breathing, Circulation. Check if the airway is open, the patient is breathing, and circulation is adequate.

What is the priority level for Bone Marrow Suppression (Blood Dyscrasias)?

Notify Provider – requires prompt assessment and communication.

What drugs commonly cause Bone Marrow Suppression?

Chloramphenicol, Linezolid, Chemotherapy.

What does Bone Marrow Suppression mean?

Decreased production of blood cells; abnormal RBCs (red blood cells), WBCs (white blood cells), and platelets.

What are the signs and symptoms of Bone Marrow Suppression?

Fatigue, pallor, fever, sore throat, infections, bruising, petechiae; ↓Hgb/Hct, ↓WBC, ↓Platelets.

What labs are affected in Bone Marrow Suppression?

CBC: low hemoglobin/hematocrit, low WBC, low platelets.

What nursing actions are required for Bone Marrow Suppression?

Assess for infection/bleeding, monitor CBC, use bleeding precautions, notify provider for fever or abnormal CBC.

What should patients be taught about Bone Marrow Suppression?

Report fever, sore throat, bruising, bleeding, fatigue; avoid sick contacts if WBC is low.

What is the priority level for Bleeding (Hemorrhage)?

Notify Provider if active bleeding

What drugs commonly cause Bleeding (Hemorrhage)?

Cephalosporins, Warfarin, Heparin.

What does Bleeding (Hemorrhage) mean?

Impaired clotting that causes excessive bleeding.

What are the signs and symptoms of Bleeding (Hemorrhage)?

Bruising, petechiae, nosebleeds, bleeding gums, melena, hematuria.

What nursing actions are required for Bleeding (Hemorrhage)?

Assess bleeding, vitals, labs; apply pressure; notify provider immediately for active bleeding.

What should patients be taught about Bleeding (Hemorrhage)?

Use soft toothbrush/electric razor, avoid injury, report black stools or prolonged bleeding.

What does aPTT (Activated Partial Thromboplastin Time) measure and why is it important?

aPTT measures the intrinsic clotting pathway, is used to monitor heparin, and a high aPTT means slower clotting → increased bleeding risk.

What does PT (Prothrombin Time)/ INR (International Normalized Ratio) measure and why is it important?

PT/INR measures the extrinsic clotting pathway, is used to monitor warfarin, and a high PT/INR means blood takes longer to clot → increased bleeding risk.

What labs are affected in Bleeding (Hemorrhage)?

PT/INR, aPTT, platelets.

What is the priority level for Nephrotoxicity?

Notify Provider – requires prompt assessment and communication.

What drugs commonly cause Nephrotoxicity?

Aminoglycosides, Vancomycin.

What does Nephrotoxicity mean?

Kidney injury.

What are the signs and symptoms of Nephrotoxicity?

↓ urine output, edema, ↑BUN, ↑creatinine.

What nursing actions are required for Nephrotoxicity?

Monitor Intake and Output, renal labs, hydration.

What should patients be taught about Nephrotoxicity?

Drink fluids unless restricted; report decreased urination or swelling.

What is the priority level for Crystalluria?

Common/Expected – assess, monitor,

What drugs commonly cause Crystalluria?

Sulfonamides.

What does Crystalluria mean?

Drug crystals form in the urine.

What are the signs and symptoms of Crystalluria?

Cloudy urine, flank pain, hematuria.

What nursing actions are required for Crystalluria?

Monitor urine output and renal function.

What should patients be taught about Crystalluria?

Increase fluids; report flank pain or blood in urine.

What is the priority level for Hepatotoxicity?

Notify Provider – requires prompt assessment and communication.

What drugs commonly cause Hepatotoxicity?

Isoniazid, Rifampin, Acetaminophen.

What does Hepatotoxicity mean?

Liver injury.

What are the signs and symptoms of Hepatotoxicity?

Jaundice, right‑upper‑quadrant pain, nausea; ↑AST/ALT.

What is AST and what does it indicate?

AST = Aspartate Aminotransferase. It is a liver enzyme, but it can also rise with muscle injury. High AST can indicate liver damage, but it is less specific than ALT.

What is ALT and what does it indicate?

ALT = Alanine Aminotransferase. It is a liver‑specific enzyme. High ALT almost always means liver injury, making it more specific for liver damage than AST.

What nursing actions are required for Hepatotoxicity?

Monitor LFTs (Liver Function Tests); assess skin and sclera.

What should patients be taught about Hepatotoxicity?

Avoid alcohol; report yellow skin/eyes or dark urine.

What is the priority level for Neurotoxicity?

Notify Provider – requires prompt assessment and communication.

What drugs commonly cause Neurotoxicity?

Metronidazole, Isoniazid, Aminoglycosides.

What does Neurotoxicity mean?

Damage to the peripheral or central nervous system.

What are the signs and symptoms of Neurotoxicity?

Numbness, tingling, confusion, seizures.

What nursing actions are required for Neurotoxicity?

Assess neurologic status; notify provider.

What should patients be taught about Neurotoxicity?

Report numbness, tingling, or confusion; take vitamin B6 if prescribed.

What is the priority level for Ototoxicity?

Notify Provider – requires prompt assessment and communication.

What drugs commonly cause Ototoxicity?

Gentamicin, Tobramycin.

What does Ototoxicity mean?

Damage to hearing or balance.

What are the signs and symptoms of Ototoxicity?

Tinnitus, hearing loss, dizziness.

What nursing actions are required for Ototoxicity?.

Assess hearing and balance; monitor drug levels if ordered

What should patients be taught about Ototoxicity?

Report ringing in the ears or hearing changes immediately.

What is the priority level for Dizziness?

Common/Expected – assess, monitor, teach.

What drugs commonly cause Dizziness?

Many medications.

What does Dizziness mean?

Lightheadedness or impaired balance.

What are the signs and symptoms of Dizziness?

Dizziness, unsteady gait.

What nursing actions are required for Dizziness?

Institute fall precautions.

What should patients be taught about Dizziness?

Rise slowly; avoid driving until effects are known.

What is the priority level for Sedation/Drowsiness?

Common/Expected – assess, monitor, teach.

What drugs commonly cause Sedation/Drowsiness?

Opioids, Antihistamines.

What does Sedation/Drowsiness mean?

Reduced alertness.

What are the signs and symptoms of Sedation/Drowsiness?

Sleepiness, slowed responses.

What nursing actions are required for Sedation/Drowsiness?

Assess level of consciousness (LOC) and respirations.

What should patients be taught about Sedation/Drowsiness?

Avoid alcohol and driving.

What is the priority level for QT prolongation?

Notify Provider – requires prompt assessment and communication.

What drugs commonly cause QT prolongation?

Azithromycin, Levofloxacin.

What does QT prolongation mean?

Delayed cardiac repolarization that may lead to arrhythmias.

What are the signs and symptoms of QT prolongation?

Palpitations, syncope; ECG shows prolonged QT.

What nursing actions are required for QT prolongation?

Monitor ECG and electrolytes if indicated.

What should patients be taught about QT prolongation?

Report fainting or palpitations.

What is the priority level for Orthostatic Hypotension?

Common/Expected – assess, monitor, teach.

What drugs commonly cause Orthostatic Hypotension?

Antihypertensives, TCAs.

What does Orthostatic Hypotension mean?

A drop in blood pressure when standing.

What are the signs and symptoms of Orthostatic Hypotension?

Dizziness, falls.

What nursing actions are required for Orthostatic Hypotension?

Check orthostatic blood pressure.

What should patients be taught about Orthostatic Hypotension?

Stand slowly; dangle legs before standing.

What is the priority level for an allergic reaction?

Notify Provider – requires prompt assessment and communication.

What drugs commonly cause allergic reactions?

Penicillins, Sulfonamides.

What does an allergic reaction mean?

An immune response to a medication.

What are the signs and symptoms of an allergic reaction?

Rash, itching, hives.

What nursing actions are required for an allergic reaction?

Assess severity; notify provider.

What should patients be taught about allergic reactions?

Stop the medication and report rash.

What is the priority level for Anaphylaxis?

Emergency – stop medication, assess ABCs, notify provider immediately/activate emergency response.

What drugs commonly cause Anaphylaxis?

Penicillins.

What does Anaphylaxis mean?

A life‑threatening allergic reaction.

What are the signs and symptoms of Anaphylaxis?

Airway swelling, wheezing, hypotension, angioedema.

What nursing actions are required for Anaphylaxis?

Stop the drug, maintain airway, prepare epinephrine, activate emergency response.

What should patients be taught about Anaphylaxis?

Seek emergency care immediately.

What is the priority level for Stevens‑Johnson Syndrome?

Emergency – stop medication, assess ABCs, notify provider immediately/activate emergency response.

What drugs commonly cause Stevens‑Johnson Syndrome?

Sulfonamides, Lamotrigine.

What does Stevens‑Johnson Syndrome mean?

A severe skin and mucous membrane reaction.

What are the signs and symptoms of Stevens‑Johnson Syndrome?

Rash, blisters, peeling skin, mouth sores, fever.

What nursing actions are required for Stevens‑Johnson Syndrome?

Stop medication; notify provider immediately.

What should patients be taught about Stevens‑Johnson Syndrome?

Never ignore a rash; seek emergency care.

What is the priority level for Photosensitivity?

Common/Expected – assess, monitor, teach.

What drugs commonly cause Photosensitivity?

Sulfonamides, Doxycycline.

What does Photosensitivity mean?

Increased sensitivity to sunlight.

What are the signs and symptoms of Photosensitivity?

Sunburn, redness, rash.

What nursing actions are required for Photosensitivity?

Assess skin.

What should patients be taught about Photosensitivity?

Use sunscreen and protective clothing.

What is the priority level for Red Man Syndrome?

Notify Provider – requires prompt assessment and communication.

What drug commonly causes Red Man Syndrome?

Vancomycin.

What does Red Man Syndrome mean?

Histamine release from rapid infusion.