Herbal Alert Ephedra
Many members of the Ephedra family have been used medicinally ie, E. sinica and E. intermedia . Ephedra preparations have traditionally been used to relieve cold symptoms, improve respiratory function, as an adjunct in weight loss, and to treat a variety of conditions from headaches to sexually transmitted disease. Large doses may cause a variety of adverse reactions, such as hypertension, irregular heart rate, tremors, epigastric pain, nausea, vomiting, sweating, weakness, and possible...
Antiparkinsonism Drugs
on-off phenomenon Parkinson's disease parkinsonism On completion of this chapter, the student will Define the terms Parkinson's disease and parkinsonism. Discuss the uses, general drug action, adverse drug reactions, contraindications, precautions, and interactions of the antiparkinsonism drugs. Discuss important preadministration and ongoing assessment activities the nurse should perform on the patient taking antiparkinsonism drugs. List some nursing diagnoses particular to a patient taking...
Ineffective Therapeutic Regimen Management
NANDA defines ineffective therapeutic regimen management as a pattern of regulating and integrating into daily living a program for treatment of illness and the sequelae of illness that is unsatisfactory for meeting specific health goals. In the case of medication administration, the patient may not be taking the medication correctly or following the medication regimen prescribed by the health care provider. The reasons for not following the drug regimen vary. For example, some people do not...
Toxic Reactions
Most drugs can produce toxic or harmful reactions if administered in large dosages or when blood concentration levels exceed the therapeutic level. Toxic levels build up when a drug is administered in dosages that exceed the normal level or if the patient's kidneys are not functioning properly and cannot excrete the drug. Some toxic effects are immediately visible others may not be seen for weeks or months. Some drugs, such as lithium or digoxin, have a narrow margin of safety, even when given...
Oxytocin
Oxytocin is an endogenous hormone produced by the posterior pituitary gland see Chap. 50 . This hormone has uterine-stimulating properties, especially on the pregnant uterus. As pregnancy progresses, the sensitivity of the uterus to oxytocin increases, reaching peak sensitivity immediately before the birth of the infant. This sensitivity enables oxytocic drugs to exert their full therapeutic effect on the uterus and produce the desired results. Oxytocin also has antidiuretic and vasopressor...
Review Questions Yxb
1. What adverse reaction is most likely to occur in the early days of therapy in a patient taking a thyroid hormone 2. The nurse informs the patient that therapy with a thyroid hormone may not produce a therapeutic response for . 3. Which of the following symptoms best indicates that serious adverse reactions are developing in a patient receiving methimazole Tapazole A. Fever, sore throat, bleeding from an injection site B. Cough, periorbital edema, constipation C. Constipation, anorexia,...
Contraindications Precautions And Interactions Cas
The proton pump inhibitors are contraindicated in patients who have hypersensitivity to any of the drugs. Omeprazole Pregnancy Category C and lansoprazole, rabeprazole, and pantoprazole Pregnancy Category B are contraindicated during pregnancy and lactation. The proton pump inhibitors are used cautiously in older adults and in patients with hepatic impairment. There is a decreased absorption of lansoprazole when it is administered with sucralfate. Lansoprazole may decrease the effects of...
Summary Drug Table Anterior And Posterior Pituitary Hormones
The term generic indicates the drug is available in generic form. The term generic indicates the drug is available in generic form.
Promoting an Optimal Response to Therapy Ayg
When administering an anticonvulsant, the nurse must not omit or miss a dose except by order of the primary health care provider . An abrupt interruption in therapy by omitting a dose may result in a recurrence of the seizures. In some instances, abrupt withdrawal of an anticonvulsant can result in status epilepticus. The nurse aids continuity of anticonvulsant administration by making a notation on the care plan, as well as by informing all health care team members of the importance of the...
Monitoring and Managing Adverse Drug Reactions Pjw
A variety of adverse reactions can be seen with the administration of the fluoroquinolones or aminoglyco-sides. The nurse observes the patient, especially during the first 48 hours of therapy. It is important to report the occurrence of any adverse reaction to the primary health care provider before the next dose of the drug is due. If a serious adverse reaction such as a hypersensi-tivity reaction, respiratory difficulty, severe diarrhea, or a decided drop in blood pressure occurs, the nurse...
DISPLAY 461 Signs and Symptoms of Common Fluid and Electrolyte Imbalances
Sodium normal laboratory values 132-145 mEq L HYPONATREMIA AN EXCESSIVE LOSS OF SODIUM Magnesium normal laboratory values 1.5-2.5 mEq L or 1.8-3 mg dL HYPOMAGNESEMIA LOW LEVELS OF MAGNESIUM Hyperactive deep tendon reflexes Visual or auditory hallucinations Potassium normal laboratory values 3.5-5 mEq L The most common imbalances are a loss of potassium and water. Other electrolytes, namely magnesium, sodium, and chlorides, are also lost. When too much potassium is lost, hypokalemia low blood...
Evaluation Dho
The therapeutic effect is achieved, and convulsions are controlled. No evidence of injury is seen. Adverse reactions are identified, reported to the primary health care provider, and managed successfully through appropriate nursing interventions. Oral mucous membranes appear normal. The patient verbalizes the importance of complying with the prescribed treatment regimen. The patient verbalizes an understanding of treatment modalities and the importance of continued follow-up care. The patient...
Critical Thinking Exercises Iua
1. Ms. Barker had a bowel resection 4 days ago. After a culture and sensitivity test of her draining surgical wound, the primary health care provider orders penicillin G aqueous IV as a continuous drip. Determine what questions you would ask Ms. Barker before the penicillin is added too the IV solution. Preventing Antibiotic Resistance The nurse Reviews the reason for the drug and the prescribed drug regimen, including drug name, correct dose, and frequency of administration. Stresses the...
Analeptics
Doxapram Dopram and caffeine combination of caffeine and sodium benzoate are two analeptics used in medicine. Doxapram increases the depth of respirations by stimulating special receptors located in the carotid arteries and upper aorta. These special receptors called chemoreceptors are sensitive to the amount of oxygen in arterial blood. Stimulation of these receptors results in an increase in the depth of the respirations. In larger doses, doxapram increases the respiratory rate by stimulating...
Gerontologie Alert Qaa
Older adults have an Increased sensitivity to the sulfonylureas and may require a dosage reduction. After the patient has been taking sulfonylureas for a period of time, a condition called secondary failure may occur. Secondary failure occurs when the sulfonylurea loses its effectiveness. When the nurse notes that a normally compliant patient has a gradual increase in blood sugar levels, secondary failure may be the cause. This increase in blood glucose levels can be caused by an increase in...
Uses Tzz
Adrenergic drugs have a wide variety of uses and may be given as all or part of the treatment for Hypovolemic and septic shock Moderately severe to severe episodes of hypotension Control of superficial bleeding during surgical and dental procedures of the mouth, nose, throat, and skin Cardiac decompensation and arrest Allergic reactions anaphylactic shock, angioneu-rotic edema Temporary treatment of heart block Ventricular arrhythmias under certain conditions Nasal congestion applied topically...
DISPLAY 351 Stages of General Anesthesia
Induction is a part of stage I anesthesia. It begins with the administration of an anesthetic drug and lasts until consciousness is lost. With some induction drugs, such as the short-acting barbiturates, this stage may last only 5 to 10 seconds. Stage II is the stage of delirium and excitement. This stage is also brief. During this stage, the patient may move about and mumble incoherently. The muscles are somewhat rigid, and the patient is unconscious and cannot feel pain. During this stage,...
Liquids
In liquid drugs, there is a specific amount of drug in a given volume of solution. For example, if a container is labeled as 10 mg per 5 mL or 10 mg 5 mL , this means that for every 5 mL of solution there is 10 mg of drug. As with tablets and capsules, the prescribed dose of the drug may not be the same as what is on hand or available . For example, the physician may order 20 mg of an oral liquid preparation and the bottle is labeled as 10 mg 5 mL. The formula for computing the dosage of oral...
SUMMARY DRUG TABLE ADRENOCORTICAL HORMONES CORTICOSTEROIDS AND
1 wk, followed by 80 mg d every other day for 1 month IM initial dose usually between 5 and 60 mg d PO intrarectal foam, hydrocortisone acetate intrarectal foam replacement See Display 50-2 0.1 mg 3 times a week acetate Acetate therapy for Addison's to 0.2 mg d PO floo-droe-kor'-te-sone disease, salt-losing The term generic indicates the drug is available in generic form. Adjunctive therapy in treatment of ulcerative proctitis of the distal portion of the rectum Local pain or burning, rectal...
Immune Globulins and Antivenins 1
Adverse reactions to immune globulins are rare. However, local tenderness and pain at the injection site may occur. The most common adverse reactions include urticaria, angioedema, erythema, malaise, nausea, diarrhea, headache, chills, and fever. Adverse reactions, if they occur, usually last for several hours. Systemic reactions are extremely rare. The antivenins may cause various reactions, with hypersensitivity being the most severe. Some antivenins are prepared from horse serum, and if a...
Chapter Objectives Bcj
On completion of this chapter, the student will Define the terms antitussive, mucolytic, and expectorant. Describe the uses, general drug actions, adverse reactions, contraindications, precautions and interactions of antitussive, mucolytic, and expectorant drugs. Discuss important preadministration and ongoing assessment activities the nurse should perform on patients receiving an antitussive, mucolytic, or expectorant drug. List some nursing diagnoses particular to a patient taking an...
Nursing Responsibilities When Caring for a Patient Receiving a Preanesthetic
The nurse evaluates the patient's physical status and gives an explanation of the anesthesia. In some hospitals, the anesthesiologist examines the patient the day or evening before surgery, although this may not be possible in emergency situations. Some hospitals use members of the operating room or postanesthesia recovery room staff to visit the patient the night before or the morning of surgery to explain certain facts, such as the time of surgery, the effects of the preanesthetic drug,...
Contraindications Precautions And Interactions Jjx
These drugs are contraindicated in patients whose diarrhea is associated with organisms that can harm the intestinal mucosa Escherichia coli, Salmonella, Shigella and in patients with pseudomembranous colitis, abdominal pain of unknown origin, and obstructive jaundice. The antidiarrheal drugs are contraindicated in children younger than 2 years. The antidiarrheal drugs are used cautiously in patients with severe hepatic impairment or inflammatory bowel disease. Antidiarrheals are classified as...
Contraindications Precautions And Interactions Unp
The antacids are contraindicated in patients with severe abdominal pain of unknown cause and during lactation. Sodium-containing antacids are contraindicated in patients with cardiovascular problems, such as hypertension or congestive heart failure, and those on sodium-restricted diets. Calcium-containing antacids are contraindicated in patients with renal calculi or hypercalcemia. Aluminum-containing antacids are used cautiously in patients with gastric outlet obstruction. Magnesium- and...
Contraindications Precautions And Interactions Tci
The mast cell stabilizers are contraindicated in patients with known hypersensitivity to the drugs. The mast cell stabilizers are contraindicated in patients during attacks of acute asthma because they may worsen bron-chospasm during the acute asthma attack. It is important to use the mast cell stabilizers cautiously in patients with impaired renal or hepatic function and during pregnancy Pregnancy Category B and lactation. No significant drug interactions have been reported. The Patient...
Increased Cardiac Output
Cardiotonic drugs increase the force of the contraction of the muscle myocardium of the heart. This is called a positive inotropic action. When the force of contraction of the myocardium is increased, the amount of blood leaving the left ventricle at the time of each contraction is increased. When the amount of blood leaving the left ventricle is increased, cardiac output the amount of blood leaving the left ventricle with each contraction is increased. Managing Heart Failure in Patients with...
Preadministration Assessment Ids
Because the bronchodilators or antiasthma drugs may be given for asthma, emphysema, or chronic bronchitis, the preadministration assessment of the patient requires careful observation and documentation. The nurse takes the blood pressure, pulse, and respiratory rate before therapy with a bronchodilator or antiasthma drug is initiated. Respiratory rates below 12 min or above 24 min are considered abnormal. It is important to assess the lung fields and carefully document the sounds heard before...
Adding Mixed Numbers or Fractions With Mixed Numbers
When adding two or more mixed numbers or adding fractions and mixed numbers, the mixed number is first changed to an improper fraction. 3 changed to an improper fraction S 3 changed to an improper fraction S The numerators are added S 7 2 4 7 1 2 The improper fraction 30 4 is changed to a mixed number 7 2 4 and the fraction of the mixed number 2 4 changed to the lowest possible terms 1 2 . 2 changed to an improper fraction 3 changed to an improper fraction In the example above, 5 2 and 13 4...
Sulfonamides 1
Sulfonamides are antibacterial agents, meaning they are active against bacteria. Another term that may be used to describe the general action of these drugs is anti-infective because they are used to treat infections caused by certain bacteria. Sulfadiazine, sulfisoxazole, and sulfamethizole are examples of sulfonamide preparations. The sulfonamides are often used to control urinary tract infections caused by certain bacteria such as Escherichia coli, Staphylococcus aureus, and...
Review Questions Iij
1. When administering an antidepressant to a patient contemplating suicide, it is most important for the nurse to_. have the patient remain upright for at least 30 minutes after taking the antidepressant assess the patient in 30 minutes for a therapeutic response to the drug monitor the patient for an occipital headache inspect the patient's oral cavity to be sure the drug was swallowed 2. Which of the following adverse reactions would the nurse expect to find in a patient taking amitriptyline...
Miscellaneous Anticonvulsants
The miscellaneous anticonvulsants are contraindicated in patients with known hypersensitivity to any of the drugs. Carbamazepine is contraindicated in patients with bone marrow depression or hepatic or renal impairment and during pregnancy Category D . Valproic acid is not administered to patients with renal impairment or during pregnancy Category D . Oxcarbazepine Trileptal , a miscellaneous anticonvulsant, may exacerbate dementia. The miscellaneous anticonvulsants are used cautiously in...
Narcotic Analgesics
agonist-antagonist agonist analgesic epidural partial agonist patient-controlled analgesia On completion of this chapter, the student will Discuss the uses, general drug action, general adverse reactions, contraindications, precautions, and interactions of the narcotic analgesics. Discuss important preadministration and ongoing assessment activities the nurse should perform on the patient taking the narcotic analgesics. List some nursing diagnoses particular to a patient taking a narcotic...
Cumulative Drug Effect
A cumulative drug effect may be seen in those with liver or kidney disease because these organs are the major sites for the breakdown and excretion of most drugs. This drug effect occurs when the body is unable to metabolize and excrete one normal dose of a drug before the next dose is given. Thus, if a second dose of this drug is given, some drug from the first dose remains in the body. A cumulative drug effect can be serious because too much of the drug can accumulate in the body and lead to...
SUMMARY DRUG TABLE ADRENERGIC BLOCKING DRUGS Continued 1
Antiadrenergic Drugs Peripherally Acting The term generic indicates the drug is available in generic form. pheochromocytoma, a tumor of the adrenal gland that produces excessive amounts of epinephrine and norepi-nephrine. The drug is used to control hypertension during preoperative preparation and surgical excision of pheochromocytoma. Some drugs such as norepinephrine or dopamine are particularly damaging to the surrounding tissues if extravasation infiltration occurs during intravenous...
Promoting an Optimal Response to Therapy Fxz
The nurse develops a nursing care plan to meet the patient's individual needs. It is important to monitor vital signs at least daily. The nurse should report any significant change in the patient's vital signs to the primary health care provider. Behavioral records should be written at periodic intervals frequency depends on hospital or unit guidelines . An accurate description of the patient's behavior and cognitive ability aids the primary health care provider in planning therapy and thus...
Intravenous Infusion Controllers and Pumps
Electronic infusion devices are classified as either infusion controllers or infusion pumps. The primary difference between the two is that an infusion pump adds pressure to the infusion, whereas an infusion controller does not. An infusion pump may be used to deliver the desired number of drops per minute. An alarm is set to sound if the IV is more than or less than the preset rate. Controllers and pumps have detectors and alarms that alert the nurse to various problems, such as air in the...
Nursing Responsibilities Hhu
The nurse observes the following points when administering drugs by the intradermal route The inner part of the forearm and the upper back may be used for intradermal injections. The area should be hairless areas near moles, scars, or pig-mented skin areas should be avoided. The nurse should cleanse the area in the same manner as for SC and IM injections. A 1-mL syringe with a 25- to 27-gauge needle that is 1 4 to 5 8 inch long is best suited for intradermal injections. Small volumes usually lt...
Uses Vqy
The aminoglycosides are used in the treatment of infections caused by susceptible microorganisms. The amino-glycosides are used primarily in the treatment of infections caused by gram-negative microorganisms. Because the oral aminoglycosides are poorly absorbed, they are useful to suppressing gastrointestinal bacteria. The oral aminoglycosides kanamycin Kantrex and neomycin Mycifradin are used preoperatively to reduce the number of bacteria normally present in the intestine bowel prep . A...
Nursing Alert Vjz
The antipsychotic drugs may cause extreme drowsiness and sedation, especially during the first or second weeks of therapy. This reaction may impair mental ofphysical abilities. Drowsiness usually diminishes after 2-3 weeks of therapy. However, if the patient continues to be troubled by drowsiness and sedation, the physician may prescribe a lower dosage. LITHIUM. The dosage of lithium is individualized according to serum levels and clinical response to the drug. The desirable serum lithium...
Review Questions Hdw
1. When a patient is taking gold compound therapy on an outpatient basis, the nurse advises the patient to inform the primary care provider if . 2. When administering a skeletal muscle relaxant the nurse observes the patient for the most common adverse reaction, which is . 3. When a patient is prescribed a corticosteroid for arthritis and alternate-day therapy is used, the nurse administers the drug . 4. When allopurinol Zyloprim is used for the treatment of gout, the nurse . A. administers the...
Contraindications Hww
The salicylates are contraindicated in patients with known hypersensitivity to the salicylates or the NSAIDs and during pregnancy. Aspirin is a Pregnancy Category D drug and may produce adverse maternal effects ie, anemia, postpartum hemorrhage, and prolonged gestation or labor . Maternal aspirin used may DISPLAY 17-1 Symptoms of Salicylism Tinnitus a ringing sound in the ear Respiratory depression and coma large doses heparin administration. Coadministration with the NSAIDs may increase NSAID...
SUMMARY DRUG TABLE TETRACYCLINES MACROLIDES AND LINCOSAMIDES Continued
Abdominal pain, esophagitis, nausea, vomiting, diarrhea, skin rash, blood dyscrasias, pseudomembranous colitis, hypersensitivity reactions Same as clindamycin 150-450 mg PO q6h 600-2700 mg d in 2-4 equal doses up to 4.8 g d IV, IM 500 mg PO q6-8h 600 mg IM q12-24h up to 8 g d IV The term generic indicates the drug is available in generic form. tetracyclines are used in the treatment of uncomplicated urethral, endocervical, or rectal infections caused by Chlamydia trachomatis and as adjunctive...
Adrenergic Nerve Receptors
Adrenergic nerve fibers have either alpha a or beta p receptors. Adrenergic drugs may act on a receptors only, p receptors only, or on both a and p receptors. For example, phenylephrine Neo-Synephrine acts chiefly on a receptors isoproterenol acts chiefly on p receptors and epinephrine acts on both a and p receptors. Whether an adrenergic drug acts on a, p, or a and p receptors accounts for the variation of responses for this group of drugs. See Table 22-1 for a list of the type of adrenergic...
Miconazole
Miconazole is contraindicated in patients with known hypersensitivity to the drug. The drug is given cautiously in cases of chronic or recurrent candidiasis. With recurrent or chronic candidiasis the patient may have underlying diabetes. Recurrent or chronic candidi-asis requires an evaluation for diabetes. The drug is used cautiously during pregnancy Category C . If used during pregnancy, a vaginal applicator may be con-traindicated. Manual insertion of the vaginal tablets may be preferred....
Nursing Alert Wod
Antiarrhythmic drugs are capable of causing new arrhythmias, as well as an exacerbation of existing arrhythmias. The nurse must report any new arrhythmia or exacerbation of an existing arrhythmia to the primary health care provider immediately. Some of the antiarrhythmic drugs may cause dizziness and light-headedness, especially during early therapy. The nurse provides assistance to patients not on complete bed rest with ambulatory activities until these symptoms are no longer present.
Nursing Responsibilities During the Administration of General Anesthesia
Before surgery, the nurse has the following responsibilities Performing the required tasks and procedures as prescribed by the physician and hospital policy the day or evening before or the morning of surgery and recording these tasks on the patient's chart. Examples of these tasks include administration of a hypnotic the night before surgery, shaving the operative area, taking vital signs, seeing that the operative consent is signed, checking to see if all jewelry or metal objects are removed,...
SUMMARY DRUG TABLE ANTIANGINAL DRUGS Continued
The term generic indicates the drug is available in generic form. In many instances, the adverse reactions associated with the nitrates lessen and often disappear with prolonged use of the drug. However, for some patients, these adverse reactions become severe, and the primary health care provider may lower the dose until symptoms subside. The dose may then be slowly increased if the lower dosage does not provide relief from the symptoms of angina.
Prophylaxis
Penicillin is of no value in the treatment of viral or fungal infections. However, the primary health care provider occasionally will prescribe penicillin as prophylaxis prevention against a potential secondary bacterial infection that can occur in a patient with a viral infection. In these situations the viral infection has weakened the body's defenses and the person is susceptible to other infections, particularly a bacterial infection. Penicillin also may be prescribed as prophylaxis for a...
Clomiphene and HCG
These drugs are contraindicated in patients with known hypersensitivity to the drugs. Clomiphene is contraindi-cated in patients with liver disease, abnormal bleeding of undetermined origin, or ovarian cysts, and during UNIT IX Drugs That Affect the Endocrine System Pituitary Gland Figure 50-2. The pituitary gland, and the hormones secreted by the anterior pituitary and the posterior putuitary. Figure 50-2. The pituitary gland, and the hormones secreted by the anterior pituitary and the...