Drug Side Effects: Nursing Implications

Question 1

Anaphylaxis

Answer 1

EMERGENCY: Nurse can help prevent occurrence by asking patient carefully about allergies, checking carefully for medic alert tags. Treatment: Epinephrine

Question 2

Urticaria (wheals)

Answer 2

Continue to monitor for anaphylaxis s/s. If allergy suspected, withhold medication until physician can be consulted. After appearance of urticaria, avoid vasodilation. For patient comfort- tepid or cool bath, cool environment, light bedclothes. Lotions and other measure may be indicated to reduce itching. Treatment: Antihistimines, steroids

Question 3

Atropine- Like side effects

Answer 3

Patient may need to be reassured that effects will disappear when drug is withdrawn. Chewing gum or hard candy may alleviate dryness of mouth. Check patient’s voiding. Monitor vital signs

Question 4

Liver Damage

Answer 4

Monitor liver function studies. Pruritus from jaundice may be alleviated by good skin care, complete removal of soap. Fingernails may have to be cut to prevent scratches and infection

Question 5

Kidney Damage

Answer 5

Accurate recording and intelligent evaulation of intake and output. Urine that is smoky in appearance may indicate hamturia. Frequent urinayses, peak and trough levels, blood chemistry studies, and test of renal function may be indicated. If kidney function is decreased for any reason, excretion of drugs is impaired, and toxic and cumulative effects of any drug the patient is reciving is possible

Question 6

Arrhythmias

Answer 6

frequent vital signs. Count pulse for one full minute to detect irregularties

Question 7

Hypotension

Answer 7

Check blood pressure before and after administration fo drug with this potential effect. Orthostatic or postural hypotension: get patient up slowly

Question 8

Hypertension

Answer 8

Frequent vital signs. Reduce emotional and environmental tension as much as possible. Promote rest. Hypotensive drugs may be needed

Question 9

Aplastic Anemia

Answer 9

All bone marrow function may be affected in aplastic anemia- frequent vital signs, conserve strength as much as possible, encourage adequate nutrition

Question 10

Thrombocytopenia

Answer 10

Frequent vital signs. Avoid trauma, pressure and irritation of skin. Use soft toothbrush, avoid parenteral injections. Careful, gentle handling

Question 11

Agranulocytosis, leukopenia

Answer 11

patients receiving drugs likely to cause this effect should be instructed to report any symptoms immediately. Monitor temperature, When leukopenia occurs, patient must be protected from infection. Contact with visitors and personnel should be restricetd; isolation may be needed. Prophylactic antibiotics may be indicated

Question 12

Anemia

Answer 12

Frequent rest periods and transfusions as ordered

Question 13

extrapyramidal effects

Answer 13

depending on particular drug, effects generally disappear upon withdrawal of drug. Consult physician- patient may need reassurance. Bedside rail, and supervision and/or restriction of ambulation may be indicated. Anti-parkinsonian drugs may be perscribed

Question 14

Stimulation of CNS

Answer 14

avoid giving last daily dose of drug too close to bedtime to reduce possibility of insomnia. Reduce environmental stimulation as much as possible

Question 15

Depression of CNS

Answer 15

Person should not operate car or dangerous machinery. Bedside rails, and supervision and/or restriction of ambuation may be needed. Check vitals, especially before giving additional doses of drugs producing this effect. Caution patient about use of other drugs which may produce further CNS depression. Monitor respirations carefully. Side rails up after narcotic analgesics!

Question 16

Irritation of gastric mucosa

Answer 16

give drug with or after meals, or with milk or antacid if ordered unless absoprtion of the drug will be impaired. Small, frequent and attractive meals may help in dealing with annorhexia. Give antiemetic meds, cool cloth to neck

Question 17

Constipation

Answer 17

Careful, systemaic check on patient’s bowel movements. Insure adequate bulk and fluid in diet. Encourage exercise if possible. Laxatives and enemas as ordered by physician.