Administering Medications 7th Edition by Donna Gauwitz

Exercise 43

Show how you would chart the following events in the nurses' notes. Be sure to include all of the required information. Remember that only facts are to be charted, not assumptions or opinions.
Mr. Schwartz is undergoing treatment for a blood clot in the leg. He has been taking Coumadin , an anticoagulant, for several days. He is also taking Diuril , a diuretic, to reduce the swelling in his leg. The doctor has confined Mr. Schwartz to bed. This is because any movement of the leg might cause the clot to break off and travel in the bloodstream, which could be dangerous.
It is 2000 hours the next evening and time to give Mr. Schwartz a laxative. The laxative ( Dulcolax ) has been ordered by the doctor because bedridden patients often develop constipation, which can lead to impaction (blocking of the intestine). Straining during a bowel movement might cause the blood clot to break off and become an embolism (a traveling clot). Mr. Schwartz tells you that he has been having regular bowel movements and doesn't want the laxative. He asks why he needs it when he has been in bed for only 2 days. You explain that it is preventive medicine to avoid the problems of impaction and embolism. Mr. Schwartz becomes tearful and tells you that he is afraid he will die. He refuses the laxative. You then notify the supervisor. After consulting with the doctor, the supervisor instructs you to give Mr. Schwartz 10 mg of Valium intramuscularly right away. Valium is a tranquilizer that will ease Mr. Schwartz's anxiety so that he can relax. _____________________________________________________________________________