Name of Drug: Vancomycin Therapeutic Class: Antibacterial Pharmacologic Class: Antibacterial

Dosage, Route, Frequency:

ACTION CONTRAINDICATIONS ADVERSE NURSING PATIENT RATIONALE
Desired Effects: Used to treat and prevent bacteria growth
REACTIONS CONSIDERATIONS TEACHING
Vancomycin is a People with conditions:  Significant:  Monitor BP and  Tell your doctor Vancomycin is an
glycopeptide  systemic macrocytosis Diarrhea, heart rate and pharmacist antibiotic. It is used to
antibiotic which  low levels of a type of flushing of the continuously if you are treat diarrhea and colitis
binds tightly to white blood cell called upper body (red through period of allergic to (inflammation of the
D-alanyl-D- neutrophils man or red neck drug vancomycin, or inner lining of the
alanine portion of  hearing loss syndrome), administration. any other colon) that is associated
cell wall  kidney disease with anaphylaxis, medications. with Clostridium
precursor, likely reduction in infusion  Lab tests: Monitor To prevent difficile infection.
blocking kidney function reactions (e.g., urinalysis, kidney allergic
glycopeptide  Hypersensitivity to hypotension, & liver functions, reactions from This medicine may also
polymerization vancomycin and to other flushing, and hematologic occurring. be used to treat
leading to the glycopeptide antibiotics urticaria), studies enterocolitis
inhibition of (e.g., teicoplanin). thrombophlebiti periodically.  Tell your doctor (inflammation of the
bacterial cell wall s, extravasation, if you have or digestive tract) caused
synthesis. It also  Monitor serial tests have ever had by Staphylococci
nephrotoxicity;
impairs bacterial- of vancomycin inflammatory bacteria.
neutropenia,
cell-membrane blood levels (peak bowel disease
bacterial
permeability and and trough) in (swelling of the
superinfection
RNA synthesis. patients with intestine that can
(prolonged use).
borderline kidney cause painful
Rarely,
function, in infants cramps or
ototoxicity.
and neonates, and diarrhea),
 Blood and in patients >60 y. including
lymphatic Crohn's disease
system  Assess hearing. (a condition in
disorders: Drug may cause which the body
Rarely, damage to auditory attacks the lining
eosinophilia. branch (not of the digestive
 Gastrointestinal vestibular branch) tract, causing
disorders: of eighth cranial pain, diarrhea,
Abdominal nerve, with weight loss, and
pain, nausea, consequent fever) and
vomiting. deafness, which ulcerative colitis
may be permanent. (a condition
 General
disorders and which causes
 administration swelling and
site conditions:  Be aware that sores in the
Chills, drug serum levels of 60– lining of the
fever, phlebitis, 80 mcg/mL are colon [large
pain. associated with intestine] and
ototoxicity. rectum); hearing
 Investigations: Tinnitus and high loss; or kidney
Increased serum tone hearing loss disease.
creatinine and may precede To prepare
BUN. deafness, which other nursing
 Musculoskeletal may progress even interventions
and connective after drug is that is
tissue disorders: withdrawn. Older appropriate for
Muscle spasms adults and those on the client’s
of the chest and high doses are condition.
back muscles. especially
 Renal and susceptible. Tell your doctor if you
urinary are pregnant, plan to
disorders:  Monitor I&O: become pregnant, or are
Interstitial Report changes in breast-feeding. If you
nephritis, acute I&O ratio and become pregnant while
tubular pattern. Oliguria or taking Vancomycin, call
necrosis. cloudy or pink your doctor.
urine may be a sign To allow the healthcare
 Respiratory, of nephrotoxicity team to carefully
thoracic, and (also manifested by administer the drug.
mediastinal transient elevations
disorders: in BUN, albumin,
Dyspnea, and hyaline and
stridor. granular casts in
 Skin and urine).
subcutaneous
tissue disorders:
Exanthema,
mucosal
inflammation,
rash, pruritus.
 Vascular
 disorders:
Decrease in
blood pressure.
 Potentially
Fatal:
Pseudomembra
nous colitis,
hypersensitivity
reactions.