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The physician orders the following for Ms. Stone:

- **Methylprednisolone 100 mg IV every 6 hours**

- **D5W in 0.9% NaCl with 40 mEq KCl at 125 ml/hr**

- **NPO except for PO meds**

- **Diphenoxylate/atropine 2.5 mg PO every 4 hours PRN**

- **Sulfasalazine 1000 mg PO TID**

Explain the indication/rationale, the side effects, and the nursing implications for each of the above orders.

Answer :

Ms. Stone's medication orders include methylprednisolone for inflammation, D5W with NaCl and KCl for hydration, NPO status for gastrointestinal management, diphenoxylate/atropine for diarrhea, and sulfasalazine for inflammatory bowel disease. Each medication has specific side effects like increased blood sugar, fluid overload, etc and requires careful nursing monitoring including tracking glucose levels, electrolyte balance, hydration status, and watching for allergic reactions.

The indication/rationale, the side effects, and nursing implications for each of Ms. Stone's medication orders:

  1. Methylprednisolone 100 mg IV every 6 hours: Indication: Used to reduce inflammation in conditions like severe allergies, arthritis, or autoimmune disorders. Side effects: May include increased blood sugar, risk of infection, and gastrointestinal upset. Nursing implications: Monitor blood glucose levels, signs of infection, and gastrointestinal symptoms.
  2. D5W in 0.9% NaCl with 40 mEq Kcl at 125ml/hr: Indication: To provide hydration and correct electrolyte imbalances, particularly potassium. Side effects: Can cause fluid overload or electrolyte imbalance if not monitored appropriately. Nursing implications: Monitor fluid status, electrolyte levels, and signs of hyperkalemia or hypokalemia.
  3. NPO except for PO meds: Indication: Ensures that the stomach is empty, typically in preparation for tests or procedures, or due to gastrointestinal issues. Side effects: Risk of dehydration if NPO status is prolonged. Nursing implications: Monitor hydration status and provide intravenous fluids as ordered.
  4. Diphenoxylate/atropine 2.5mg PO every 4 hours PRN: Indication: Used to treat diarrhea. Side effects: Can include dizziness, drowsiness, dry mouth, and constipation. Nursing implications: Monitor for effectiveness in controlling diarrhea, watch for signs of dehydration, and educate the patient on potential side effects.
  5. Sulfasalazine 1000 mg PO TID: Indication: Commonly used to treat inflammatory bowel diseases, such as ulcerative colitis. Side effects: Can include headache, nausea, and rash. Nursing implications: Monitor for therapeutic response, ensure the patient takes the medication with food to reduce gastrointestinal upset, and watch for allergic reactions.

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