Actions
Actions of Opioids (one)
CNS Depressant: Binds to opioid receptors in the brain which causes an analgesics sedative, & euphoric effect.
Uses of Opioids (one)
(1) Lower anxiety & sedate post op
(2) Lower anxiety in those with dyspnea
(3) Relieve pain (myocardial infarction)
(4) Manage opioid dependence
(5) Treat diarrhea & intestinal cramping
Side effects Opioids (one)
Constipation
Low HR
Hypotension
Low RR
Decreased CNS (Sedation, insomnia, weakness, dizziness)
What is the Nursing Considerations of ACE Inhibitors (pril)
(1) Assess BP & pulse routinely
(2) Monitor for hypotension
(3) Monitor K+ Levels (normal 3.5-5.0)
(4) Educate to avoid foods high in potassium & avoid salt substitute
(5) Assess for angioedema
(6) Dangerous-swelling of the face & mouth
What is the Nursing Process for Opioids (one)?
(1) Before starting opioid therapy, nurses assess a patient's pain level and then again after the drug is administered to evaluate its effectiveness.
(2) Nurses check a patient's breathing before each dose, as respiratory depression can occur even after the analgesic effect wears off. Stop is RR less than 12.
(3) Nurses anticipate side effects like constipation or nausea and administer medications to treat them.
(4) Nurses educate patients about the importance of taking opioids as prescribed, not crushing or chewing them, and discontinuing the drug with a doctor's help.
Actions of ACE Inhibitors (pril)
(1) Inhibits RAAS (Renin-Angiotensin-Aldosteron-System)
(2) RAAS is the main hormonal mechanism involved in regulating the blood pressure
(3) ACE converts angiotensin I-angiotensin II (a powerful vasoconstrictor)
(4) Inhibiting ACE will inhibit this vasoconstricting effect, decreasing blood pressure!
Uses of Antihypertensives (amil/dipine)?
(1) Lower HR & BP
(2) Hypertension
(3) Angina
(4) Dysrhythmias
Side effects of Bronchodilators (phylline)?
(1) Tachycardia
(2) Palpitations
(3) ECG changs
(4) Nervousness & anxiety
(5) Irritable
What are the Nursing Considerations for Bronchodilators (phylline)?
(1) Assess respiratory status, vital signs, and lung sounds before and after administration
(2) Monitor for side effects; Muscle tremors, Restlessness, Insomnia, Tachycardia, Palpitations, Arrhythmias, pupil dilation, dry mouth
(3) Evaluate therapeutic response
(4) Signs of theophylline toxicity; serum theophylline level; therapeutic range: 10–20 mcg/ml
What is the Nursing Process for Beta Blockers (olol)?
(1.) Assessment: Ask about asthma history and check blood pressure, heart rhythm, and pulse rate. Monitor ECG closely and vital signs for toxicity and adverse reactions.
(2.) Implementation: Adjust dose according to patient tolerance and blood pressure. Do not crush sustained release preparations. Withhold drug if systolic blood pressure is below 90 mm Hg or heart rate is below 60 beats/minute.
(3) Monitoring: Monitor for bradycardia or hypotension. Monitor for edema (weight gain, pulmonary crackles, swelling in periphery, JVD). Monitor blood glucose of hypoglycemia.
(4) Discontinuation: Beta blockers should be titrated off slowly to avoid withdrawal.
(5) Other considerations: Patients with pulmonary conditions should only be prescribed beta 1 selective blockers. Use with caution in patients with impaired hepatic or renal function.
Actions of Bronchodilators (phylline)?
(1) Dilates (opens up) Bronchi
(2) Stimulate the central nervous system (CNS) to promote bronchodilation
(3) Relaxation of the smooth muscles of the bronchi
Uses of the Bronchodilator (phylline)?
(1) Relief & prevention of bronchial asthma
(2) Treatment of bronchospasms seen in COPD
Side effects of Ace Inhibitors (pril)
(1) Angioedema
(2) Cough (dry)
(3) Elevated K+
What is the Nursing Considerations of Beta Blockers (olol)?
(1) Monitor for hypotension.
(2) Educate on changing positions slowly.
(3) Do Not give non-selective beta blockers to asthmas patients or COPD patients (remember: remember non-selective works on Beta 1 & Beta 2= Lung constriction)
(4) Educate to not suddenly stop the medication. It can cause rebound hypertension (needs to be tapered off)
(5) Monitor for s/s of heart failure
What is the Nursing Process for Ace Inhibitors (pril)?
(1) Patients should sit or lie down for 2–4 hours after taking their first dose of ACE inhibitors because of the risk of hypotension.
(2) Vital signs, WBC count, and serum electrolytes should be monitored regularly, especially potassium levels.
(3) ACE inhibitors can cause potassium retention and hyperkalemia, so potassium supplements and potassium-sparing diuretics should be given with caution.
(4) Patients should avoid driving and other hazardous work until they are confident they are not dizzy or fainting. They should also avoid excess alcohol intake and rise slowly to avoid postural hypotension.
(5) Patients should not stop taking ACE inhibitors without medical consultation. They should also notify their health care provider before taking any new medications, especially NSAIDs and cough, cold, or allergy remedies.
(6) Patients should be monitored for side effects, and 1:1000 epinephrine should be available for angioedema. Angioedema is a serious adverse reaction that can cause swelling around the lips, tongue, or face.
Actions of Antihypertensives (amil/dipine)
(1) Blocks movements of calcium
(2) lowers Calcium (lower available for transmission of nerve impulses)
(3) Relaxes blood vessels
(4) lower blood pressure
(5) increase supply of oxygen to the heart
lowers heart workload
Uses of Ace Inhibitors (pril)
(1) Hypertension
(2) Heart Failure
What are the side effects of Antihypertensives (amil/dipine)?
(1) Orthostatic hypotension
(2) Dizziness
(3) Flushing
(4) Headache
(5) Peripheral edema
(6) Constipation
What is the Nursing Considerations for Opioids (one)?
(1) Preventative measures for constipation
(2) Administer stool softener of laxatives
(3) Fluids, fiber, & fruits
(4) Client respirations begins to drop
Coaching the client to breath may increase the respiratory rate
(5) Administer naloxone (Narcan)
What is the Nursing Process for Antihypertensives (amil/dipine)?
(1) Monitor blood pressure frequently. Know the target set by the physician
(2) Administer antihypertensive medications as prescribed
(3) Have two large-bore IVs
(4) Provide oxygen f the saturations are low (less than 94%)
(5) Limit fluid intake if the patient is in heart failure
(5) Assess ECG to ensure the patient is not having a heart attack
(6) Check report of the chest x-ray to ensure the patient is not in heart failure
(7) Listen to the heart for murmurs and lungs for rales and crackles
(8) Check if the patient has edema
(9) Check renal function and electrolyte levels
(10) Encourage rest and provide a quiet room
(11)Educate the patient on how to lower stress
(12) Educate patient on a low salt diet, exercise, and healthy eating
(13) Educate the patient on the importance of taking antihypertensive medications
Actions for Beta Blockers (olol)?
(1) Blocks norepinephrine & epinephrine (flight or flight hormone)
(2) Blocks negative effects of the sympathetic nervous system
(3) Beta blockers can be selective or non-selective
(4) Meaning they can block different beta sites (beta 1 and/or beta 2)
Uses of Beta Blockers (olol)
(1) Hypertension
(2) Stable angina
(3) Chronic/compensated heart failure ( not acute heart heart failure)
(4) Dysrhythmias
Side effects of Beta Blockers (olol)
(1) Bradycardia & heart Blocks
(2) Breathing problems
(3) Bronchi spasms
(4) Bad for heart failure patients (in an acute setting)
(5) Blood sugar masking (Mask s/s of hypoglycemia)
(6) Hypotension
What are the Nursing Considerations (amil/dipine)?
(1) Antihypertensives cause orthostatic hypotension
(2) Change positions slowly
(3) Sit on the side of the bed for a few minutes before standing
Educate to not suddenly stop the medication. It can cause rebound hypertension (needs to be tapered off)
What is the Nursing Process for Bronchodilators (phylline)?
(1) Before and after administration of bronchodilators, nurses should assess the patient's respiratory status, vital signs, and lung sounds. If the patient has a productive cough, the nurse should also assess the amount, color, and consistency of the sputum.
(2) Nurses should monitor for side effects and evaluate the patient's therapeutic response.
(3) Nurses should ensure that the patient is using the inhaler properly by observing them self-administering the medication and providing further instructions.
(4) Nurses should always follow the patient's healthcare provider's medication plan. If the bronchodilators aren't controlling the patient's symptoms, they should contact their healthcare provider.