Decongestants/Antitussives
Side effects of decongestants
What is tachycardia, HTN, insomnia
What are the nursing implications/education for mucolytics/expectorants? List at least 2.
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.
In high doses, can cause kidney stones (Guaifenesin)
Monitor for intended therapeutic effects
Bronchodilators are used to relieve _____ and used in treatment and prevention of ________ _______
Bronchospasm, asthma attacks or COPD
What is the difference between Albuterol and Salmeterol
Albuterol is a short-acting bronchodilator, while Salmeterol is a long-acting bronchodilator.
When would a provider give an antiviral for influenza such as oseltamivir (Tamiflu).
Antivirals for influenza work best when giving within 48 hours of the start of symptoms and usually only giving to immunocompromised patients.
What would you educate your patient regarding decongestants?
What are: avoid caffeine and caffeine containing products
report a fever, cough, or other symptoms lasting longer than 1 week (5-7 Days)
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
What are uncontrolled HTN and cardiac dysrhythmias
What is montelukast (Singular) used for? This is a leukotriene inhibitor.
When will a patient see improvement of symptoms when starting to take this medication?
It is a leukotriene inhibitor to prevent bronchospasms and long-term treatment for asthma/COPD in adults and children 12 years of age and older
1 -2 week
Small infectious agent that can reproduce only inside other living cells of a host. They do not kill, only decrease replication.
Anti-virals
Fluticasone (Flonase) is a decongestant/nasal corticosteroid that can cause this _________ and needs to be reported.
What is a fungal infection (white patches in mouth)
Are corticosteroids use for an acute asthma attack? Yes or No
No
What are the expected side effects of bronchodilators?
What are: insomnia, restlessness, tremor, HTN, vascular headache, tachycardia and dry mouth.
To prevent exercise induce asthma, instruct patient to do this.
Use short-acting inhaler 15-30 minutes before exercise.
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. Due to the mechanism of action, what should you teach your patients?
What is: depresses the cough center in the brain which decreases the cough reflex, therefore, can cause drowsiness, altered mental status and respiratory depression.
Side effects of antihistamines (especially first generation). List at least 3.
Drowsiness, constipation, blurred vision, dry mouth, urinary retention, dried thickened secretions, HTN
What is the order for taking bronchodilators in an acute asthma attack?
Albuterol: Short acting
Ipratropium (anticholinergic)
Methyl prednisone
What are some side effects of cholinergic antagonist like ipratropium (Atrovent) and tiotropium (Spiriva) used as a bronchodilator.
Can't see
Can't pee (urinary retention)
Can't spit
Can't poop (constipation)
These transmit their own genetic information int the cell's DNA and are used for HIV.
What are the major side effects for antitussives? Name at least 2.
What are dizziness, drowsiness, dry mouth, postural hypotension
Who should avoid antihistamines? List at least 2
Elderly, those with cardiac disease, glaucoma and HTN. Can cause confusion, dizziness, tachycardia, sedation, and a paradoxical effect (insomnia).
What are the nursing implications (teaching, what you are going to monitor) 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 enzymes: AST, ALT, Bilirubin
Signs of infections :WBC
Renal function: Creatine, BUN
Monitor for respiratory or any other infections, adherence to medication schedule, severe abdominal pain with fever, severe muscle weakness (rhabdomyolysis) and signs of liver impairment.