Oxygenation Flashcards
Upper respiratory tract
Nose mouth pharynx larynx trachea
lower respiratory tract
Bronchi bronchioles arterioles pulmonary capillaries veins
Antitussives
Suppress the cough reflex
Decongestants
Decrease the blood flow to the upper respiratory tract and over production of secretion
Antihisatamines
Block the release of histamine that increases secretion and narrows airways
Expectorants
Increase productive cough to clear the airways
Mucolytics
Increase or liquefy respiratory secretions to aid clearing of the airways
Antitussives- Use
Symptomatic relief of non productive cough
NOT for chronic use
Antitussives Action
Suppress cough by CNS depressants (opiates- codeine and hydrocodiene)
Antitussives Contraindication
Hypersensitivity, head injury or impaired CNS
Antitussives Adverse Effects
Sedation, nausea, vomiting, lightheadedness, GI upset, constipation, dry mouth, potential for abuse
Antitussives Monitor
Respiratory and cough assessment, LOC, monitor use, bowel elimination
Antitussives Manage
Maintain fluid intake 1500/2000 ml a day
Humidify air during sleep
Antitussives Teach
Teach pt to take medication at bedtime
Nasal Decongestants
Can be adrenergic agonists/ sympathomimetics or steroids
Nasal Decongestants Adrenergic
Constrict small blood vessels that supply the UR structures
For acute
Nasal Decongestants Steroids
Anti inflammatory effect results in decreased congestion
Chronic issues due to taking a week to see effects in pt
Nasal Decongestants Adverse Effects
Local stinging and burning Rebound congestion Sympathomimetic effects
Nasal Decongestants Monitor
•Monitor VS: Blood pressure can become elevated
•Observe color of secretions
Nasal Decongestants Manage
•Maintain fluid intake
•Read label on OTC drugs (especially elderly)
Nasal Decongestants Teach
•Avoid pollutants, smoking, and dust
•Teach patient how to administer nasal spray
How to Administer Nasal Decongestants
1.Have patient sit upright. Blow nose before administering nasal spray.
2.Press one nostril closed. Place tip of bottle 1/2 inch into the open nostril.
3.Firmly squeeze the bottle to deliver the medication.
First generation antihistamine
Sedative medications
Ex: diphenhydramine aka Benadryl
Second generation Antihistamine
Does not have as strong of sedative effects as first gen
Ex: loratadine
Antihistamines
Selectively block the effects of histamine at H1 receptor sites
Antihistamine Adverse Effects
Anticholinergic, drowsiness and sedation, Renal and hepatic impairment
Monitor Antihistamines
•Monitor level of sedation
•Fall risk
Manage Antihistamines
•Administer 1h before or 2 h after meals to increase absorption
•if GI upset = give with meals but it can affect absorption on medication
•Safety measures (CNS effects)
fall risk bracelet bed alarm call light
Antihistamines Teach/ Evaluate
•Avoid alcohol
•Ways to treat side effects:
•Mouth care, sugarless candy
•Increase humidity &
fluids
•Void before each dose
Antihistamine Considerations Elderly
Elderly
•Higher risk for dizziness, unsteady gait, confusion
•Usually need a lower dose
Antihistamine Consideration Pediatrics
Pediatrics
•May experience drowsiness with first few doses then CNS stimulation with repeated use.
•That is called paradoxical reaction!
Expectorants
•Drugs that aid in the expectoration (removal) of mucus by liquefying secretions, decreasing viscosity
•Used for to increase productive coughs
Ex: Mucinex (guafenisin)
Should not be used longer than a week
Expectorants Adverse Effects
GI symptoms, headache, dizziness, N/V, loss of appetite
Nursing Interventions Expectorants
Encourage patient to eat small and frequent meals, avoid driving or any activities that require a lot of concentration
Mucolytics
•React directly with mucus (break the strands) to make it thinner and more easily expectorated
•Given by nebulizer to liquefy viscosity of secretions
Acetylcysteine
Antidote for acetaminophen overdose
Side effects of Mucolytics
Bronchoconstriction, chest tightness, N/V
Lower Respiratory Tract Medications
Bronchodialators ( Sympathomimetics/ Adrenergic Agonists, Anticholinergic, Xanthines), Corticosteroids
Sympathomimetics
(Beta agonist Bronchodialators)
Use
•Acute asthma attack
•Bronchospasm in acute or chronic asthma •Prevention of exercise induced ast
Sympathomimetics
(Beta agonist Bronchodialators)
Action
Bronchodilation (B2 Receptor agonist)
Sympathomimetics
(Beta agonist Bronchodialators)
Adverse Effects
Increased BP HR ( adrenergic effects)
Salmetrol (Severent Diskus)
Long acting drug with slow onset of action for prevention ONLY not for acute asthma attacks
Levalbuterol (Xopenex)
Less beta1 effects so it causes less cardiac adverse effects
Epinenephrine (EpiPen)
SQ to rest acute bronchospasm, allergic reaction
Albuterol
Very common medication to treat acute asthma attacks with bronchospasm or constriction, helps dilate the airway to provide more air to get in
Ipratropium and tiotropium classification
Anticholinergic Bronchodilators
Anticholinergic
Used for bronchospasm maintenance, long term use, usually used in conjunction with another bronchodilator, relaxes smooth muscle in bronchi
Anticholinergic Contraindications
narrow angle glaucoma, BPH (benign prostatic hytrophy)
Anticholinergic Adverse Effects
Nervousness, tachycardia, N/V, headache, difficulty urinating, constipation, dry mouth
Xanthines
Direct effect on the smooth muscles of the respiratory tract and blood vessels.
Symptomatic relief or prevention of bronchial asthma
Xanthines prototypes
theophylline (Slo-bid, Theodur)
•aminophylline (Somophyllin) IV use
*requires frequent monitoring
Xanthines Adverse Effects
Seizures (late sign of toxicity)
Tachydysrhymias, angina, hypotension, palpitation, N/V,diarrhea ( early sign of toxicity)
Xanthines Monitor
Monitor serum theophylline level (10-20 mcg/ml)
•Levels are drawn after first dose
•Monitor HR, BP,RR (stay WNLs)
•ECG for rhythm changes
Xanthines Manage
•There is no antidote for xanthine, so standard first aid measures must be used (charcoal, emesis, gastric lavage) if pt is toxic
•Smokers usually need higher dosages to maintain therapeutic level
Xanthines Teach/Evaluate
•Report the first sign of cardiac disturbances
•Give in the daytime
•Avoid excessive caffeine and chocolate intake
•Do not crush or alter dosage form
•Take with milk or food if GI distress
Corticosteroids
•Used for chronic asthma
•Do not relieve symptoms of acute asthma attacks
•Oral or inhaled forms
•Inhaled forms reduce systemic effects
•May take several weeks before full effects are seen
Examples of Inhaled Corticosteroids
Budesonide (Pulmacort Flexhaler)
Fluticasone(Flovent, Flonase)
Dexamethasone sodium phosphate
Side effects of Inhaled Corticosteroids
•Sore throat
•Coughing
•Dry mouth
•Oral fungal infections ( have pt rinse before and after)
Growth impairment for pediatrics w long term use
