Nursing Assessment
What should the nurse assess about the patient before administering Beta Blockers?
-olol (carvedilol, propranolol)
-Assess apical HR, if less than 60 hold
-Assess blood sugar if diabetic
-Assess history of COPD + asthma
-antianginal
B1- Heart
B2- Lungs
What goal should be set for Albuterol and what is the action of the drug? (4)
-opens up airway for easier breathing (bronchodilator)
-drug of choice for acute asthma attack
-relaxes smooth muscles to dilate the bronchioles
*Use albuterol first then steroid last*
Nursing Interventions/teaching for Nitrates (Nitroglycerin)?
-antianginal nitrate
-rise slowly to prevent dizziness
-Position pt
-Don't take w/ other vasodilators
-Monitor side effects
-take prior to activities or situations
-call emergency services if pain is unresolved within 5 min after first dose. May take a second and third dose five minutes apart while waiting for emergency care services
-If headache take acetaminophen
-Change positions slowly
-Store at room temp/ protect from light/moisture
-Patches: 12 hours on, 12 hours off
-Avoid alcohol
-Increases intracranial pressure (headache)
Nursing Interventions/teaching for Statins?
-Take in the evening
-Have pt. report muscle aches/pain immediately
-avoid grapefruit
-Birth control won't work as well (back up contraceptive)
-Eat small, frequent meals o avoid GI distress
-Increase fluid and fiber intake to avoid constipation
-Report abdominal pain after eating, pain in upper abdomen
-Report fatigue, anorexia, nausea, dark urine, or yellowing of eyes/skin
Explain therapeutic Index
Measurement of the relative safety of a drug that compares the amount of drug that produces a therapeutic effect versus the amount of drug that produces a toxic effect
What should the nurse assess about the patient before administering Theophylline?
Bronchodilator
-Narrow therapeutic range
-Monitor blood levels regularly
-Avoid caffeine
-Monitor vital signs (BP, O2)
-Assess lung sounds, cough, and sputum
What goal should be set for Parkinson's meds and what is the action of the drug? (3)
-Slow down the rate of Parkinson's
-Stimulates dopamine receptors
-Boosts dopamine levels to reduce tremors & ridgidity
Nursing Interventions/teaching for Tissue Plasma Activator (Alteplase)?
-clot buster
-stay in bed
-3-4 hour forgiving it
-Only given in hospitals
-Must have informed consent to admin
-At risk for bleeding
-Pt can't go home on this
-monitor coagulation labs
-Avoid venipuncture/arterial sticks
Nursing Interventions/teaching for Albuterol?
-Overuse can result in airway narrowing
-Monitor vitals
-Assess lung sounds, cough, and sputum production
-Albuterol first, steroid second
-Administer at regular intervals
-Teach how to clean spacer or MDI
-Avoid caffeine and know to monitor pulse
-No smoking
Explain enteric coating
Polymer barriers applied to oral meds that prevents its dissolution or disintegration in the gastric environment
What should the nurse assess about the patient before administering Statins?
-for low cholesterol
-Labs: BUN/Creatinine, liver labs
-If female, check if pregnant (need reliable contraceptive)
-assess other drugs, muscle pain, and vision
What goal should be set for Naloxone (Narcan) and what is the action of the drug? (3)
-Blocks beta receptors and displaces opioid
-antidote for opioids
-to stabilize heart rhythm during opioid overdose
Nursing Interventions/teaching for Scopolamine?
-goes behind ear
-must wash hands immediately to prevent blindness
-After removing, must wash the site
-Keep on for 72 hours
-Report chest pain
Nursing Interventions/teaching for Isotretinoin?
-severe acne
-iPLEDGE program
-Increase photosensitivity- wear sunscreen/coverup
-Usually taken for 4-6 months
-two forms of birth control
Dosage Calc
Order: 750 mg
Available: 250 mg tablets
? tablets
3
What should the nurse assess about the patient before administering Furosemide?
-Check BP
-Administered in the morning
-Look at kidney labs and K+ serum (hold if low, can cause hypokalemia)
What goal should be set for Central Acting Muscle Relaxants and what is the action of the drug? (2)
-Relieve muscle spasms and spasticity
-Depress CNS activity to reduce muscle tone
Nursing Interventions/teaching for Psyllium?
-Fiber drink
-Mix in glass of water or juice
-Stir and drink immediately
-Follow with 1 full glass of water
-Just make sure pt drinks enough water
Nursing Interventions/teaching for Beta-blockers?
Antianginal
-Will have changes in blood sugar if diabetic w/ propranolol and carvedilol
-monitor BP & HR
-Tell them to move slowly and with someone
-Can cause bronchospasms
Explain Onset of Action
When a drug first begins to work and exerts a therapeutic effect
What should the nurse assess about the patient before administering Ace Inhibitors?
-anti-hypertensive med
-prill
-Check for pregnancy
-Assess BP
-weight for fluid volume
WAPP: Weights, Assess BP, Pregnancy, Potassium
Dosage Calc
Order: 2mg/kg
Pt Weight: 176 lbs
? mg administered
160
2
Nursing Interventions/teaching for Furosemide (Lasix)?
-Loop diuretic (potassium wasting)
-Take daily weights
-Change positions slowly
-Eat high K+ foods, bananas, cantaloupe, potatoes, avocados
-Follow-up appointments
-Report muscle cramps + heart palpitations
Nursing Interventions/teaching for Fenofibrates?
antihyperlipidemic
-Educate about side effects- dizziness, blurred vision, GI upset
-Don't take with anticoagulants (warfarin or heparin)
-Increase risk of developing gallstones, rhabdomyosis
-Avoid giving to elderly pt, pancreatitis, and diabetes
-Does not happen fast, not measurable for a short time
Signs and Symptoms of Hyper/Hypo-glycemia
Hypoglycemia: Give 15g of fast-acting carbs
-shakiness, sweating, dizziness, hunger, irritability, blurred vision, and difficulty concentrating
Hyperglycemia: lower blood glucose levels with medicine and lifestyle changes
-excessive urination, excessive thirst, tired, hungry, dry mouth, weight loss, blurred vision, recurrent infections