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NUR 210 Unit 2 Table Completed
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Physiological dependency Hypotension Angioedema Renal failure Drowsiness Hangover Decreased BP/HR Complex Sleep Behaviors Vision Changes Vivid Dreams Cautions: Renal impairment; Liver impairment; Pregnant women
Allergic reaction (rarely ever seen) Dizziness Restlessness Euphoria Drowsiness Metallic Taste Monitor vital signs and LOC; Cardiac enzymes; liver enzymes Assess for tissue damage if immobile. Patient Teaching : May feel numb.
Hearing loss Bleeding - GI Anemia Anaphylaxis Renal Failure GI Upset Dizziness Headache Bruising Tinnitus Rash Stomach Ulcers Blood Abnormalities Monitor vital signs and for signs of bleeding. Cautions: Bleeding disorders, peptic ulcer disease; Hepatic or Renal Impairment Asthma; Patients on anticoagulant therapy Patient Teaching: Take w/food; Avoid ASA or other NSAIDS. Read labels of OTC meds. Report signs of bleeding: changes in stool (dark/tarry), ABD pain, bleeding gums, excessive bruising. Report ringing in the ears. Avoid the 4Gs. Avoid during 3 rd^ trimester of pregnancy. Avoid during menses. Inform provider if taking anticoagulants. Increase fluid intake – kidney protection. Stop prior to surgical procedures (7 days).
Monitor vital signs NSAID Review Prototype pg. 288
Bleeding Hypertension Stroke/MI Peripheral edema Headache Dizziness GI Upset Cautions: Patients with chronic hepatic or renal impairment; Patients with cardiac history; Patients on anticoagulant therapy Patient Teaching : Report edema and BP monitoring. Monitor for bleeding and salicylism Salicylates Review Prototype on pg. 284 & Nursing process on pg. 285
Bleeding Hearing loss Tinnitus GI ulceration Bleeding Bruising GI Upset Drowsiness Dyspepsia Cautions: Patients on antiplatelet or anticoagulant therapy; Children under the age of 16 (Do not give for fever reduction) – Reyes Syndrome; Pregnant women; Bleeding disorders. Patient Teaching : Do not give to children. Bleeding precautions (electric razor, avoid injury, soft toothbrush). Take with food. Report ringing in the ears – s/s salicylism. Report increased bleeding and bruising. Avoid during pregnancy. Notify providers if taking anticoagulants. Stop prior to surgeries (7 days). Read labels of OTC meds; avoid the 4 Gs. Do not combine with NSAIDs. Avoid during menstruation. Anti-Gout Review Nursing Process on pg. 293
Elevated liver enzymes Elevated BUN and Creatinine GI Upset ABD Discomfort Monitor patients with renal disease, and hepatic disorder. (Monitor ALT, AST, Liver enzymes, BUN, and Creatinine) Patient Teaching: Educate on dietary restrictions (avoid purines – ETOH, shellfish, organ meat etc.) Increase fluid intake. Take w/food to decrease GI upset. Take daily as prescribed (lifetime therapy). s/s liver failure – jaundice; ABD pain; skin rashes, fluid retention. Yearly eye exams. Monitor for s/s liver failure (LFTs) & dosing. Non-Opioid Analgesic Review Prototype on pg. 298 & Nursing Process pg. 299
Oliguria Elevated Liver Enzymes Hepatotoxicity Constipation Anorexia Rash N/V Cautions: Patients with liver disease; a history of alcoholism; Patients with renal impairment When acetaminophen toxicity occurs: Acetylcysteine is the antidote. Patient Teaching: Dosing guidelines – 4 grams/day if healthy; 2 grams/day if frail, elderly or taking numerous others. Avoid ETOH. Read labels of OTC meds. Notify prescriber if pain persists for longer than 10 days. s/s of hepatotoxicity – See above. Report changes in urine output.