simulation meds nursing implications – Flashcards

1. Assess angina pain 2. Monitor BP, & pulse 3. Advise to contact health care professional if chest pain is not relieved, worsens, is accompanied by diaphoresis, or SOB, if severe H/A occurs. 4. Caution about sudden position changes may produce orthostatic hypotension. 5. Do not consume alcohol. 6. When applying nitroglycerin patches, make sure that you only apply it to the chest area. If headache occurs, may give Tylenol if prescribed by the physician. Prior to placing patch, make sure the skin is clean and dry. Do not apply over irritated skin. Need to rotate sites and wear gloves when (nursing implications for:)

Administer before pain reaches its peak to maximize effectiveness of the drug. Monitor vital signs at frequent intervals to detect respiratory changes. Respirations of <10/min can indicate respiratory distress. Record client's urine output because urinary retention is a side effect of morphine. Urine output should be at least 600 mL/day. Check bowel sounds for decreased peristalsis; constipation is a side effect of morphine. Dietary change or mild laxative might be needed. Check for pupil changes and reaction. Pinpoint pupils can indicate morphine overdose. Have naloxone (Narcan) available as an antidote to reverse respiratory depression if overdose occurs. Validate dose before administration. Check older adults for alertness and orientation, because confusion is a side effect of morphine. Side rails and other safety precautions should be taken as well as administration of decreased dosages.

monitor for bleeding: Increased bleeding with anticoagulants Hypoglycemia with oral antidiabetics Increased gastric ulcer risk with glucocorticoids Increase PT, bleeding time, INR, uric acid Decrease potassium, cholesterol, T3 and T4 levels Foods containing salicylates: Prunes, raisins, licorice, certain spices Caution Do not take with other NSAIDs. Avoid during third trimester of pregnancy. Do not give to children with flu or virus symptoms (Reye's sydrome).

obtain vital monitor for orthostatic hypotension decreased cardiac output safety

Avoid administering antacids with other oral drugs, because antacids can delay their absorption. An antacid should definitely not be given with tetracycline, digoxin, or quinidine, because it binds with and inactivates most of the drug. Antacids are given 1 to 2 hours after other medications. Shake suspension well before administering; follow with water. Monitor electrolytes and urinary pH, calcium, and phosphate levels.

Assess:Mental status: anxiety, mood, sensorium, orientation, affect, sleeping pattern, drowsiness, dizziness, especially in geriatric patients both before and during treatment, suicidal thoughts, behaviors B/P lying, standing; pulse; if systolic B/P drops 20 mm Hg, hold product, notify prescriber Hepatic, blood studies: AST, ALT, bilirubin, creatinine, LDH, alk phos, CBC; may cause neutropenia, decreased Hct, increased LFTs Physical dependency, withdrawal symptoms: anxiety, panic attacks, agitation, seizures, headache, nausea, vomiting, muscle pain, weakness; withdrawal seizures may occur after rapid decrease in dose or abrupt discontinuation; because duration of action is short, considered to be the product of choice for geriatric patients Pregnancy: if planned or suspected, pregnancy (D), to avoid breastfeeding Evaluate: Therapeutic response: decreased anxiety, restlessness, sleeplessness

Monitor labwork cholesterol, triglycerides, LDL, & HDL - must be monitored q6-8 weeks for first 6 months of therapy. Then every 3-6 months. Patient should fast for 12-14 hours prior to a lipid panel. Also monitor AST, ALT, CPK or CK Report unexplained muscle tenderness or weakness, fever, and malaise. Teach do not abruptly stop medication due to rebound effect which may lead to AMI and death. If GI upset occurs, increase fluid intake with medication.

Assess:Anxiety: decrease in anxiety; mental status: mood, sensorium, affect, sleeping pattern, drowsiness, dizziness, suicidal tendencies Renal/hepatic/blood status if receiving high-dose therapy Physical dependency, withdrawal symptoms: headache, nausea, vomiting, muscle pain, weakness, tremors, seizures, after long-term, excessive use Perform/provide:Assistance with ambulation during beginning therapy, since drowsiness, dizziness occurs Check to confirm that PO medication has been swallowed Refrigerate parenteral form Evaluate:Therapeutic response: decreased anxiety, restlessness, insomnia