Medications associated with Oxygenation

Question 1

type of medicine used before corticosterioids b/c they open airways to better receive the corticosteroid medication.

Answer 1

Bronchodilators

Question 2

type of bronchodilator that causes smooth muscle relaxation and bronchodilation. Act by selectively activating the beta-receptors in the bronchial smooth muscle resulting in bronchodilation. This helps relieve bronchospasm, inhibit histamine release, and increase ciliary motility.

Answer 2

Beta 2-Adrenergic Agonists/Stimulants

Question 3

Rescue drug, if someone is having respiratory distress/exacerbation (asthma attack), this will help immediately. Given before a long-acting medication b/c it will open the airway quicker to better receive the long-acting drug.

Answer 3

Short-Acting Beta Agonist (Short Acting Inhaler)

Question 4

used for the prevention of asthma episode, inhaled, short-acting, used for prevention of asthma.

Answer 4

Albuterol (Proventil, Ventolin)

Question 5

What are the side effects of Albuterol?

Answer 5

Headache, dizziness, sleep problems, (nervousness, insomnia, restlessness) cough, hoarseness, sore throat, runny or stuffy nose, mild nausea, vomiting, dry mouth and throat, muscle pain, and diarrhea

Question 6

slower onset and longer duration. Primarily used to prevent attack. Taken daily and stays in the system most of the day

Answer 6

Long-Acting Beta Agonist

Question 7

inhaled, long acting medications used for long-term control of asthma

Answer 7

Salmeterol (serevent) / Formoterol (Foradil/Aerolizer)

Question 8

What are the side effects of long acting beta agonist?

Answer 8

cough producing mucus, difficulty breathing, headache, irritation of the throat, runny nose, dyspnea/ShOB, sneezing, stuffy nose, chest tightness, wheezing

Question 9

What are some actions that need to be implemented if there are adverse effects of long acting beta agonist?

Answer 9

advise clients to observe for chest, jaw, or arm pain or palpitations and to notify provider if they occur. Instruct to check pulse and report any deviation of greater than bpm. Advise clients to avoid caffeine. May have tremors, will resolve medication use.

Question 10

What medicine decreases the effect of long acting beta agonists? And what is advised because of it?

Answer 10

Beta-adrenergic blockers (propranolol) ; do not take concurrently

Question 11

medication that blocks muscarinic receptors of the bronchi, resulting in bronchodilation. Relieves bronchospasm associated with COPD, allergen-induced and exercise-induced asthma. Taken daily, long acting medication.

Answer 11

Anticholinergics

Question 12

cough, dry mouth, headache, nausea, dizziness, transient increased bronchospasm

Answer 12

Side effects of Ipratropium (Atrovent, Apolpravent)

Question 13

medication that relieves bronchospasm

Answer 13

Tiotropium Bromide (Spiriva)

Question 14

dry mouth, sinusitis, pharyngitis, dyspepsia, UTI, rhinits, abdominal pain, peripheral edema, constipation, epistaxis, vomiting, myalgia, rash, oral candidasis.

Answer 14

Tiotropium Bromide (Spiriva)

Question 15

Monitor for respiratory distress (adventitious breath sounds, ineffective breathing pattern, pulse differences, ABGs, cyanosis, retractions) increase fluid intake(helps with lung secretions), do not take more than 2 inhalations at one time(may cause bronchoconstriction). Rinse mouth immediately after inhalation. Avoid excessive use of caffeine. Contraindicated in clients who have allergy to peanuts. Encourage to rinse mouth after use.

Answer 15

Nursing considerations for Anticholinergics

Question 16

medication that is given as a last resort due to dangers of taking the medication. Is a bronchodilator. Medication is hard to regulate, unstable, acts similar to caffeine. Relaxes smooth muscles causing bronchodilation. May be administered PO or IV, be careful as there is a narrow margin of safety. Most effective dose is commonly close to level of safety and toxicity. Long-acting, used in most chronic cases (COPD, or chronic asthma)

Answer 16

Methylxanthines

Question 17

What is the warning associated with methylxanthines?

Answer 17

Do not take with caffeine and do not adruptly discontinue smoking as it may affect the effectiveness of the drug.

Question 18

administered in 10-20 mcg/L; metabolizes differently for every individual. Causes bronchial smooth muscle relaxation, resulting in bronchodilation

Answer 18

Theophylline (Theo-Dur, Eliophillin, Theoliar, Slo-Bid) and Aminophylline (somaphyllin)

Question 19

what is the toxicity associated with theophylline?

Answer 19

nausea, vomiting, restlessness, insomnia, dysrhythmias, palpitations, tachycardia, flushing, GI upset, confusion

Question 20

monitor serum levels to keep within therapeutic range (5-15mcg/mL). If manifestations occur, stop medication. Activated charcoal is used to decrease absorption, lidocaine is used to treat dysrhythmias, and diazepam is used to control seizures. Instruct client that periodic blood levels are needed. Advise client to report nausea, diarrhea, or restlessness.

Answer 20

Nursing Interventions associated with Methylxanthines

Question 21

medications that prevents inflammation, suppress airway mucus production, and promote responsiveness of beta receptors in the bronchial tree. Increases airflow by decreasing inflammatory responses. Does not provide immediate effects, but promotes decreased frequency and severity of exacerbations and acute attacks.

Answer 21

corticosteroids

Question 22

sub type of corticosteriod that is an anti-inflammatory and antipruritic.

Answer 22

Fluticasone (Flovent)

Question 23

Inhalation: throat, irritation, hoarseness, dry mouth, cough, temporary wheezing, oropharyngeal candidasis (rinse mouth to prevent), oral candidasis
Intranasal: mild nasopharyngeal irritation, nasal burning, stinging, dryness, rebound congestion, rhinorrhea, altered sense of taste, nasal/pharyngeal candidasis, headache

Answer 23

Side effects of Fluticasone (Flovent)

Question 24

monitor respiratory distress(respiratory rate, depth, rhythm, and type, quality/rate of pulse, adventitious breath sounds, ABGs), assess for candidasis. Do not change dose/schedule, do not stop suddenly. Maintain oral hygiene, rinse mouth immediately after. Increase fluid intake

Answer 24

nursing considerations for Fluticasone (Flovent)

Question 25

corticosteroids that is not recommended as a first line of defense b/c of side effects. Medication will suppress immune system.

Answer 25

Prednisone (Deltasone, Predone)

Question 26

bone loss may occur, hyperglycemia, glucosuria, muscle weakness, peptic ulcer disease, infection(sore throat, weakness, malaise), fat redistrubution (puffy face), weight gain, fluid retention, edema, and hypokalemia

Answer 26

Side effects of Prednisone (Deltasone, Predone)

Question 27

Encourage patients to stay away from other sick individuals because of suppressed immune system. Patients need to be tapered off the medication b/c it suppresses the adrenal cortex production of corticosteroids. Monitor blood glucose levels. Advise clients to perform weight-bearing exercises, encourage calcium and vitamin D intake.

Answer 27

nursing considerations for Prednison (Deltatsone, Predone)

Question 28

Client who have a live virus vaccine and those with systemic fungal infections. use cautiously with children, diabetic patients, hypertension, peptic ulcer disease and/or renal dysfunction. Use cautiously with NSAIDS

Answer 28

contraindications of Prednison (Deltasone, predone)

Question 29

concurrent use of potassium depleting diuretics increase the risk of hypokalemia (monitor potassium level and administer supplements as needed) Concurrent use of NSAIDs increase the risk of GI ulcers (advise the patient to avoid use of NSAIDs, notify provider if GI distress occurs). Concurrent use of glucocorticoids and hypoglycemia occurs, may need a higher dose of insulin or antidiabetics.)

Answer 29

Interactions with Prednison (Deltasone, Predone)

Question 30

administered by inhaler, taken daily to prevent attack, does not treat symptoms

Answer 30

Mast Cell Stabilizers/NSAIDs

Question 31

works to inhibit the inflammation response; (side effects: sore throat, bad taste in the mouth, stomach pain, cough, stuffy nose, itching or burning nasal passages, sneezing and headache.

Answer 31

Nedocromil (Tilade) and Cromolyn Sodium (Intal, NasalCrom)

Question 32

prevent the effects of leukotrienes, thereby suppressing inflammation, bronchoconstriction, airway edema, and mucus production. Long - term treatment of asthma and to prevent exercise-induced bronchospasm.

Answer 32

Leukotriene Modifiers/Antiasthmatic

Question 33

medication can be used in children as young as a year old. (side effects; headache, influenza, abdominal pain, cough, dyspepsia, dizziness, fatigue, dental pain)

Answer 33

Montelukast (Singulair)

Question 34

medication that prevents/reduces number of asthmatic dizziness? (side effects: injection site ecchymosis, redness, warmth, stinging, urticarial, viral infection, sinusitis, headache, pharyngitis, arthralgia, leg pain, fatigue, dizziness)

Answer 34

Omalizumab (xolair)

Question 35

expectorants that stimulates respiratory tract secretions by decreasing adhesiveness, viscosity of mucus. Promotes removal of viscous mucous. Promotes increased cough production through increasing mucous secretion. This action is to allow clients to decrease chest congestion by coughing out secretions.

Answer 35

Guaifenasin (Gusiatussin)

Question 36

increase fluids, take with food. Encourage to only take at night. Assess type of severity, frequency of cough. Initiate deep breath, coughing exercises. Do not take for chronic cough. Do not participate in activities that require alertness

Answer 36

Nursing consideration for Guaifenasin

Question 37

expectorants that enhances the flow of secretions in the respiratory passages. Used in clients who have acute and chronic pulmonary disorders exacerbated by excessive amounts of secretions.

Answer 37

Acetylcysteine (Mucomyst, Mucosol)

Question 38

What are the warnings associated with Acetylcysteine (Mucomyst, Mucosol)

Answer 38

aspiration and bronchospasm may occur. Monitor client for signs of aspiration or bronchospasm. Has a rotten egg odor.

Question 39

stickiness of face, unpleasant odor, increaed bronchial secretions, throat irritation, nausea, vomiting, rhinorhea. (be prepared to suction client if necessary. Assess pre-treatment respiratory rate, depth, rhythm, quality. Assess sputum if there.)

Answer 39

Side effects of Acetylcysteine (Mucomyst, Mucosol)

Question 40

Antitussive that suppresses cough through its action in the CNS. Used for chronic nonproductive cough. (side effects include: dizziness, depression, GI distress (nausea, vomiting, constipation) headache, diarrhea)

Answer 40

Codenine and Guaifenasin (Gusiatussin)

Question 41

Advise patient to avoid drinking when taking this medication, advise patient to take with food and to increase fluids and dietary fiber. Also advise patient not to drive while taking this medication, encourage to take only at night. Assess for type, severity, frequency of cough,. Initiate deep breathing, coughing exercise

Answer 41

Nursing considerations of Codenine and Guaifenasin (Gusiatussin)

Question 42

Antitussive that suppresses cough through its action ion the CNS, derived from opoids. (side effects include: nausea dizziness, sedation, GI distress, headache, diarrhea)

Answer 42

Dextromethorphan Hydrobromide (Robitussin, Vicks 44, Benylin)

Question 43

anithistamine that work on the H1 receptors which results in the blocking of histamine release in the small blood vessels, capillaries, and nerves during allergic reactions. when used for upper respiratory infections, antihistamines relieve manifestations by suppressing mucous secretions b/c of their anticholinergic effect.

Answer 43

Diphendydramine (Benadryl)

Question 44

sedation, dry mouth, throat, nose, lips, constipation, nausea, vomiting, drowsiness, dizziness, muscle weakness, hypotension, urinary retention, thickening of bronchial secretions of flushing, visual/hearing disturbances, diaphoresis. (toxicity indicated by flushed face, high fever, tachycardia , dry mouth, urinary retention, pupil dilation)

Answer 44

side effects of Diphendydramine (benadryl)

Question 45

delivers 1 to 6L/minute of O2 at a 24-45% concentration

Answer 45

Nasal Cannula

Question 46

delivers 5 - 10 L/minute of O2 at a 40-60% concentration (simple face mask and rebreather)

Answer 46

face maks

Question 47

delivers 10-15L/minute at a 95-100% concentration.

Answer 47

Nonrebreather

Question 48

don’t crank up the O2 on a COPD patient, it will kill their drive to breathe. Should maintain between 1-3L/minute for COPD patients. After increasing O2 allow a few moments for it to catch up to the rest of the body.

Answer 48

things to remember in reference to O2

Question 49

this action will prevent complications and educate the client about risk reduction, have patient know what their triggers are. Encourage to stop smoking or avoid smokers.

Answer 49

Teach

Question 50

action that requires one to assess respiratory status (every time you enter the room). How are they breathing, are they talking, has their level of activity significantly decreased, are they having more difficulty breathing.

Answer 50

Assess

Question 51

action that monitors fluid. b/c fluid retention is common with some medications for oxygenation. Again, assess nutritional status as well, weight loss may be an initial indication that there are some sort of respiratory issues.

Answer 51

daily weights

Question 52

want to encourage patient to maintain anywhere b/t 2.5 to 3L a day. this helps to thin secretions out and maintains the moisture of the respiratory mucous membranes. Without hydration and humidity, secretions can become thick and tenacious

Answer 52

Encourage Fluids