Nursing Process Focus: Patients Receiving Salmeterol (Serevent)

Transcription

1 Prior to administration: Assess for presence/history of chronic asthma, exercise induced asthma, acute asthma attacks, and acute upper airway obstruction. Assess respiratory rate and lung sounds, pulse blood pressure, EKG, and liver function. Obtain EKG and complete blood studies: CBC, chemistry panel, and liver function studies. Assess patient s drug history to determine possible drug interactions and allergies. Nursing Process Focus: Patients Receiving Salmeterol (Serevent) Impaired Gas Exchange, related to bronchospasm Risk for Injury, related to tremors secondary to side effects of drug Immediately report worsening asthma, irregular heartbeat, and severe headache. Be compliant with required laboratory test. Demonstrate ability to use a metered dose inhaler. *Monitor for occurrences of acute asthma attacks. (This medication is contraindicated in patients with acute asthma attack, worsening or deteriorating asthma and acute upper airway obstruction. May cause worsening of acute asthma and bronchospasm.) *Evaluate patient s ability to use inhaler. *Monitor EKG and electrolyte values. (Increased risk of hypokalemia and EKG abnormalities if medication is combined with diuretics.) *Monitor neurological status. (Tremors of the hand are a common side effect.) *Monitor for side effects including headache, that this medication is not to be used for an acute asthma attack. to notify health care provider immediately if there are any changes in respiratory status. Instruct patient in proper use of metered dose inhaler: do not use more than 4 puffs/day or risk an increase in asthma symptoms. use medication 30 to 60 minutes prior to activity if used to treat exercise induced asthma. *Instruct patient of the need for regular EKG and electrolyte laboratory tests if the patient also takes a diuretic. *Instruct patient to use care when operating machinery because of hand tremors.

2 tachycardia, palpitations, hypertension, anxiety, nervousness and restlessness, bronchospasms, dry nose and mouth. *Monitor for headache, tachycardia, palpitations, hypertension anxiety, nervousness and restlessness, bronchospasms, dry nose and throat. of signs of side effects. to notify health care provider of symptoms of side effects. to use sips of water for sore throat or saline nasal sprays for irritated nasal passages. Evaluate the effectiveness of drug therapy by confirming that patient goals and expecte4d

3 Prior to administration Obtain complete health history including allergies, drug history, and possible drug interactions. Assess for presence/history of chronic obstructive pulmonary disease and acute asthma. Assess pulse, respirations, blood pressure. Assess lung sounds, presence of wheezes. Check for allergies to soybeans, peanuts, or fluorocarbons. Nursing Process Focus Patients Receiving Ipratropium (Atrovent) Ineffective Airway Clearance, related to bronchospasm Imbalanced Nutrition, related to side effects of drug Ineffective Tissue Perfusion, related to epistaxis secondary to drug Deficient Knowledge, related to use of metered dose inhaler Demonstrate understanding of the use of the metered dose inhaler. Maintain effective airway clearance. Maintain weight within usual range. *Monitor for complications of drug therapy. (First dose may precipitate bronchospasm. May also cause anaphylactoid reaction which includes angioedema, bronchospasm and laryngospasm.) *Use medication cautiously in elderly men with benign prostatic hypertrophy and in all patients with glaucoma. (Drug may cause worsening of these conditions.) in the proper use of the metered dose inhaler including how to self-administer medication and how to care for equipment. to test fire metered dose inhaler 3 times before taking first inhalation. *Instruct patient to report any difficulties with urination or any vision changes. *Monitor for common side effects such as cough, hoarseness, and throat irritation, dry of signs and symptoms of side effects. mouth, constipation, urinary retention, to report side effects to health care nosebleeds, headache and rhinitis. provider. to use this medication only as directed. Increased use may cause increase in adverse effects. Evaluate the effectiveness of drug therapy by confirming that patient goals and expected

4 Prior to administration: Obtain complete health history including allergies, drug history, and possible drug interactions. Assess for presence/history of asthma, seasonal rhinitis, hypertension, congestive heart disease, and blood clots. Initially and throughout treatments, assess temperature, weight, acute asthma attack, and presence of infection. Nursing Process Focus: Patients Receiving Beclomethasone (Beconase) Risk for Injury, related to infection secondary to corticosteroid effects of drug Deficient Knowledge, related to drug action and side effects Impaired Gas Exchange, related to bronchospasm Immediately report sore throat, fever, Moon face, bruising, weight gain and wheezing. Demonstrate understanding of use of aerosol inhaler or nasal spray. Comply with all laboratory tests needed to monitor medication effectiveness. Maintain effective respiratory function Demonstrate knowledge of drug therapy. *Evaluate lung sounds and respiratory rate. (Do not use if patient is experiencing an acute asthma attack.) *Monitor for usual signs and symptoms of infection that may not be evident. (Drug may interfere with normal immune response.) *Use cautiously in patients with hypertension, gastrointestinal disease, congestive heart failure and blood clots. *Monitor integrity of oral mucosa. (May cause fungal infection of mouth and throat.) *Evaluate use of equipment to administer medication. *Monitor for side effects of medication including sore throat, fever, moon face, bruising, weight gain, and wheezing. *Monitor blood glucose levels. (Glucose tolerance may be affected by use of drug.) *Advise patient that medication should not be used during an acute asthma attack. to monitor temperature daily. to avoid crowds and people with active infection. *Instruct patient to notify health care provider of any tarry stools, edema, dizziness and difficulty breathing. *Instruct patient to report to health care provider the first sign of a sore throat. *Instruct patient in the proper use of aerosol inhaler and nasal spray. Inform patient: of signs and symptoms of side effects. to report side effects to health care provider. to monitor blood sugar closely. to report blood sugar elevations to health care provider.

5 Evaluate the effectiveness of drug therapy by confirming that patient goals and expected

6 Nursing Process Focus: Patients Receiving Dextromethorphan (Benylin) Prior to administration: Obtain complete health history. Assess for presence/history of persistent non-productive cough, respiratory distress, shortness of breath, productive cough, and liver disease. Assess respirations and lung sounds initially and throughout therapy. Assess patient s drug history to determine possible drug interactions and allergies. Ineffective Airway Clearance, related to suppression of cough reflex Risk for Injury, related to sedation secondary to drug side effects Deficient Knowledge, related to drug action and side effects Immediately report shortness of breath, productive cough, respiratory distress, dizziness, and fever. Demonstrate knowledge of drug therapy and will comply with medication regimen. Demonstrate effective airway clearance. *Monitor concurrent medication and alcohol use. (Concurrent alcohol use may cause increased CNS depression. Use of MAOIs may cause Serotonin Syndrome: nausea, hypotension and excitability, increased temperature and coma.) *Monitor liver function. (Drug may cause liver toxicity.) *Instruct patient to avoid using alcohol or MAOIs while taking this medication. *Instruct patient to report any signs or symptoms of liver disease such as ascites, jaundice, right upper quadrant pain. *Monitor for side effects such as drowsiness. *Instruct patient to refrain from operating machinery while taking this medication. Evaluate the effectiveness of drug therapy by confirming the patient goals and expected