Decongestants/Antitussives
What are the side effects of decongestants
nervousness, insomnia, palpitations, tremors, HTN, tachycardia
What are the nursing implications/education for mucolytics/expectorants?
HINT: there are 4
Used to decrease thickness of respiratory secretions.
Patients taking expectorants should receive more fluids, if permitted, to help loosen and liquefy secretions
Report a fever, cough, or other symptoms lasting longer than a few days up to 1 week while taking this drug.
Monitor for intended therapeutic effects
Bronchodilators are used to relief _____ and used in treatment and prevention of ________ _______
Bronchospasm, asthma attacks
_______ is a short-acting bronchodilator, while _________ is a long-acting bronchodilator.
Albuterol, Salmeterol
Progressive disease that obstructs air flow passages with constant inflammation and large amounts of sticky mucous?
COPD Chronic obstructive pulmonary disease
What would you educate your patient regarding decongestants?
avoid caffeine and caffeine containing products
report a fever, cough, or other symptoms lasting longer than 1 week
take as directed, overuse can lead to rebound congestion
caution if you have HTN, glaucoma or prostrate enlargement
Your patient is taking a corticosteroid budesonide (Pulmicort). What are you going to teach regarding this med.
Rinse mouth out and spit after use and clean device after each use. This is used for long term use of asthma/COPD.
Select the following conditions that the use of bronchodilators would be contraindicated?
A. Heart Murmur
B. uncontrolled hypertension
C. parkinsons disease
D. Cardiac dysrhythmias
E. They are at a high risk for stroke's
B, D,E
What is Montelukast used for?
When will a patient see improvement of symptoms when starting to take this medication?
It is a leukotriene inhibitor to prevent bronchospasms. Prophylaxis and long-term treatment and prevention of asthma in adults and children 12 years of age and older
1 -2 week
Anti-virals
Fluticasone (Flonase) is a decongestant/nasal corticosteroid that can cause this _________ and needs to be reported.
fungal infection (white patches in mouth)
Are corticosteroids use for an acute asthma attack? Yes or No
No
What are the adverse effects of bronchodilators?
insomnia, restlessness, tremor, cardiac stimulation, Vascular headache
What black box warning does montelukast (leukotriene inhibitor) have?
What other 2 side effects does this medication have?
Serious mood related changes
Headache, nausea
What should the nurse teach a patient that is on a antiretroviral medication for HIV regarding food intake.
Do not eat raw meat or fish, wash veggies and fruit well, drink only from clean water source. Do not eat fatty foods.
Your patient is prescribed promethazine and codeine for cough. What is the the mechanism of action?
Depresses the cough center in the brain which decreases the cough reflex.
Side effects of antihistamines (especially first generation). List at least 3.
Constipation, blurred vision, dry mouth, urinary retention, dried thickened secretions
What is the order for taking bronchodilators in an acute asthma attack?
1st Albuterol: Short acting
Ipratropium (anticholinergic)
Methyl prednisone
What are the nursing implications for leukotriene receptor antagonists?
Must be taken as ordered even if symptoms improve
educate patient chronic asthma, not acute asthma attacks
Encourage fluid intake to decrease viscosity of secretions
What are the nursing implications for corticosteroids
Always administer bronchodilators before corticosteroids
wait 2-5 minutes if second type of inhalation drug ordered
Use of a spacer can improve drug delivery
Rinse mouth after inhalation
Monitor for white patches in mouth
What are the major side effects for antitussives?
Dizziness, drowsiness, dry mouth, constipation
Who should avoid antihistamines? List at least 2
Elderly, those with cardiac disease, glaucoma and HTN. Can cause confusion, dizziness, insomnia, tachycardia, sedation, and a paradoxical effect.
What are the nursing implications for bronchodilators? List at least 3
Monitor respiratory rate, oxygen saturation, and lungs sounds before and after administration
If 2 inhalations of same drug ordered wait 1-2 minutes between inhalations
Always administer bronchodilators before corticosteroids
Wait 5 minutes if second type of inhalation drug ordered
use a spacer device to improve drug delivery
What is used as the primary treatment of bronchospastic disorders (Asthma/COPD) to control the inflammatory responses? List the three main classes of drugs
Bronchodilators
Anticholinergics
Corticosteroids
What are you going to monitor when a patient comes into the clinic for a visit that is on many antiretrovirals for HIV.
Labs: liver: AST, ALT, WBC, RBC, Creatine, BUN
Monitor for respiratory or any other infections, adherence to medication schedule, severe abdominal pain with fever, severe muscle weakness (rhabdomyolysis)