NUR 372 EXAM 2 MEDICATIONS Flashcards
CLASS: ALBUTEROL
- beta2-adrenergic agonist
THERAPEUTIC USE: ALBUTEROL
- long-term management of asthma
- prevention of exercise-induced asthma
- treatment of ongoing asthma exacerbations
SIDE/ADVERSE EFFECTS: ALBUTEROL
- tachycardia
- heart palpitations
- angina
- tremors
NURSING INTERVENTIONS: ALBUTEROL
- monitor and report tachycardia, heart palpitations, and chest pain
- monitor and report tremors
PATIENT INSTRUCTIONS: ALBUTEROL
- report chest pain and palpitations
- report increase in pulse rate
- avoid caffeine
- notify provider if tremors interfere with ADLs
MECHANISM OF ACTION: ALBUTEROL
- acts by selectively activating the beta2-receptors in the bronchial smooth muscle, resulting in bronchodilation and decreased airway resistance
CLASS: FUROSEMIDE
- loop diuretic
THERAPEUTIC USE: FUROSEMIDE
- treats pulmonary edema in heart failure
- treats edema caused by renal, hepatic or cardiac failure not affected by other diuretics
- treats hypertension not controlled by other diuretics
ADVERSE EFFECTS: FUROSEMIDE
- hypotension
- electrolyte imbalance (hyponatremia, hypochloremia, dehydration, hypokalemia)
- ototoxicity
- hyperglycemia
- increased uric acid levels with gouty arthritis
NURSING INTERVENTIONS: FUROSEMIDE
- monitor serum electrolyte levels; notify provider of abnormal levels
- monitor for signs of electrolyte imbalance
- if hypokalemia occurs, monitor for cardiac dysdysrhythmias
- if hypokalemia is a risk, furosemide can be combined with a potassium-sparing diuretic
- monitor blood glucose
- ensure patient does not take other ototoxic drugs
- monitor for hearing loss, tinnitus, vertigo
- monitor uric acid levels
PATIENT INSTRUCTIONS: FUROSEMIDE
- eat foods rich in potassium
- report signs of electrolyte imbalance: confusion, muscle twitching, weakness, nausea
- teach patient to have BP monitored
- report dizziness, syncope
- report new onset of hearing loss, ringing in ears, or vertigo
- carefully monitor blood glucose
- patients who have history of gout need to report symptom onset to provider
MECHANISM OF ACTION: FUROSEMIDE
- inhibit reabsorption of Na+ and Cl- in ascending limb of the loop of Henle to prevent reabsorption of water
CLASS: BISACODYL
- stimulant laxatives
THERAPEUTIC USES: BISACODYL
- constipation from opioid use or from slow intestinal transit
- colon evacuation prior to elective procedures
ADVERSE EFFECTS: BISACODYL
- diarrhea
- abdominal cramps
- burning sensation (suppositories)
- prostates (prolonged use)
- laxative abuse
NURSING INTERVENTIONS: BISACODYL
- monitor for severe diarrhea and dehydration
- tell patients to expect rectal/anal burning
- monitor for rectal discomfort, bleeding, or discharge of mucus or pus
- discourage long-term use
- monitor I&O
- monitor BM pattern
PATIENT INSTRUCTIONS: BISACODYL
- report severe diarrhea and stop taking drugs
- drink fluids
- expect burning sensation with suppository use
- report rectal discomfort, bleeding, or discharge
- do not use repeatedly or for extended periods
- increase in fluid intake and add high-fiber foods slowly
MECHANISM OF ACTION: BISACODYL
- stimulation of intestinal peristalsis
CLASS: COLACE
- stool softener
THERAPEUTIC USE: COLACE
- constipation
- prevention of fecal impaction, straining during defecation, painful elimination of hard stools
ADVERSE EFFECTS: COLACE
- diarrhea
- mild abdominal cramps
NURSING INTERVENTIONS: COLACE
- monitor for severe diarrhea and dehydration
PATIENT INSTRUCTIONS: COLACE
- report severe diarrhea and stop taking drug
- drink fluids
- increase exercise, fluid intake, and consume high-fiber foods
MECHANISM OF ACTION: COLACE
- lower surface tension of the stool to allow penetration of water
CLASS: FLUTICASONE
- glucocorticoid
THERAPEUTIC USES: FLUTICASONE
- long-term prophylaxis
ADVERSE EFFECTS: FLUTICASONE
- URI
- cough
- sinusitis
- sinus infection
- throat irritation
- oral thrush
- headache
PATIENT TEACHING: FLUTICASONE
- decrease strength of immune system and mask signs of infection
- administer on a fixed schedule
- oral care after administration
MECHANISM OF ACTION: FLUTICASONE
- decrease inflammation and swelling of airways, suppress mucus production, promote responsiveness of beta2-receptors
CLASS: SPIRINOLACTONE
- potassium-sparing diuretics
THERAPEUTIC USE: SPIRINOLACTONE
- hypertension
- edema caused by HF
- cirrhosis of the liver
- nephrotic syndrome
- hypokalemia
ADVERSE EFFECTS: SPIRINOLACTONE
- hyperkalemia
- menstrual irregularities
- abnormal hair growth
- deepening of voice in women
- gyenocomastia in men
NURSING INTERVENTIONS: SPIRINOLACTONE
- monitor serum potassium levels
- monitor for cardiac dysrhythmias if hyperkalemia occurs
- may be combined with thiazide or loop diuretic to maintain normal potassium level
- report endocrine effects
PATIENT INSTRUCTIONS: SPIRINOLACTONE
- report palpitations, irregular pulse, or signs of hyperkalemia
- avoid potassium supplements or large amounts of foods high in potassium and salt substitutes
- report endocrine symptoms
MECHANISM OF ACTION: SPIRINOLACTONE
- block the effect of aldosterone on renal tubules resulting in the loss of sodium and water and retaining potassium
