NUR 210 Unit 2 Table Completed, Study Guides, Projects, Research of Nursing

NUR 210 Unit 2 Table Completed

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Unit 2
Pharmacologic Drug
Class
Action Drug
Examples
Indication
(Areas of
Use)
Adverse
Reaction
s
Side
Effects
Nursing Implications
& Patient
Education
Benzodiazepine
Review Nursing
Process on
pg. 210-211 &
Prototype on pg. 210
Increase the action of the
inhibitory neurotransmitter
gamma-aminobutyric acid
(GABA) to the GABA
receptors.
Neuron excitability is
reduced.
CNS Depression
Lorazepam
Diazepam
Alprazolam
Midazolam
Substance abuse
withdrawal (ETOH)
– PO/IV/IM
Acute seizures (status
epilepticus) – PO/PR
Anxiety - PO
Conscious Sedation
for minor procedures
- IV
Hypotension
Tachycardia
Respiratory depression
Dependency
Seizures
Drowsiness
Fatigue
Decreased VS
Dizziness
Memory
Impairment
Blurred Vision
Headache
Close monitoring of Vitals and
Respiratory Status and LOC
Cautions:
Older adult; Patients with renal impairment; Patient on
other CNS depressants; Pregnant women
Patients with sleep apnea;
Patients with respiratory depression, Hypotension, or
alcoholism, sedation
Patient Teaching: No ETOH or other CNS
depressants (includes OTC meds and herbs). No
driving or any activities that require alertness. Change
positions slowly. Do not discontinue abruptly. Monitor
BP, report difficulty breathing. Fall precautions. Notify
provider of changes in vision, excessive drowsiness
and changes in cognition. Not intended for long-term
use. Do not use if pregnant.
Non-Benzodiazepine
Review Prototype on
pg. 212 & Nursing
Process on
pg. 212-213
CNS depression,
neurotransmitter inhibition
CNS Depression
Zolpidem
Tartrate Insomnia
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
– women in general; Older adults
Patients with depression
Patient Teaching: Allow 6-8 hrs for
sleep. Take at bedtime. Indicated for
short-term use only. Avoid ETOH and
other CNS depressants. Do not take more
than prescribed. Educate family about
complex behaviors. Change positions
slowly. Report any hangover feelings.
Take on an empty stomach.
Encourage proper “sleep hygiene” – no
caffeine, avoid stimulating activities etc.
Local Anesthetics
Review Nursing
Process on pg. 217
Local anesthetics block
pain at the site where the
drug is administered by
preventing conduction of
nerve impulses.
Lidocaine
Hydrochloride
For nerve block,
infiltration, epidural,
and spinal anesthesia.
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.
NSAID
Review Prototype on
pg. 286 & Nursing
Process on pg. 287
Inhibit or block both
COX-1 and COX-2.
Ibuprofen
(non-selective)
Anti-inflammatory
Fever Reduction
Pain Control
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 3rd trimester of
pregnancy. Avoid during menses. Inform provider if
taking anticoagulants. Increase fluid intake – kidney
protection. Stop prior to surgical procedures (7 days).
COX-1:
Stops bleeding
Protects Stomach
COX-2:
Causes pain and
inflammation
(vasodilation)
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Unit 2

Pharmacologic Drug

Class

Action Drug

Examples

Indication

(Areas of

Use)

Adverse

Reaction

s

Side

Effects

Nursing Implications

& Patient

Education

Benzodiazepine

Review Nursing

Process on

pg. 210-211 &

Prototype on pg. 210

Increase the action of the

inhibitory neurotransmitter

gamma-aminobutyric acid

(GABA) to the GABA

receptors.

Neuron excitability is

reduced.

CNS Depression

Lorazepam

Diazepam

Alprazolam

Midazolam

Substance abuse

withdrawal (ETOH)

  • PO/IV/IM

Acute seizures (status

epilepticus) – PO/PR

Anxiety - PO

Conscious Sedation

for minor procedures

  • IV Hypotension Tachycardia Respiratory depression Dependency Seizures Drowsiness Fatigue Decreased VS Dizziness Memory Impairment Blurred Vision Headache Close monitoring of Vitals and Respiratory Status and LOC Cautions: Older adult; Patients with renal impairment; Patient on other CNS depressants; Pregnant women Patients with sleep apnea; Patients with respiratory depression, Hypotension, or alcoholism, sedation Patient Teaching : No ETOH or other CNS depressants (includes OTC meds and herbs). No driving or any activities that require alertness. Change positions slowly. Do not discontinue abruptly. Monitor BP, report difficulty breathing. Fall precautions. Notify provider of changes in vision, excessive drowsiness and changes in cognition. Not intended for long-term use. Do not use if pregnant.

Non-Benzodiazepine

Review Prototype on

pg. 212 & Nursing

Process on

pg. 212- 213

CNS depression,

neurotransmitter inhibition

CNS Depression

Zolpidem

Tartrate Insomnia

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

  • women in general; Older adults Patients with depression Patient Teaching: Allow 6-8 hrs for sleep. Take at bedtime. Indicated for short-term use only. Avoid ETOH and other CNS depressants. Do not take more than prescribed. Educate family about complex behaviors. Change positions slowly. Report any hangover feelings. Take on an empty stomach. Encourage proper “sleep hygiene” – no caffeine, avoid stimulating activities etc.

Local Anesthetics

Review Nursing

Process on pg. 217

Local anesthetics block

pain at the site where the

drug is administered by

preventing conduction of

nerve impulses.

Lidocaine

Hydrochloride

For nerve block,

infiltration, epidural,

and spinal anesthesia.

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.

NSAID

Review Prototype on

pg. 286 & Nursing

Process on pg. 287

Inhibit or block both

COX-1 and COX-2.

Ibuprofen

(non-selective)

Anti-inflammatory

Fever Reduction

Pain Control

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).

COX-1:

Stops bleeding

Protects Stomach

COX-2:

Causes pain and

inflammation

(vasodilation)

Pharmacologic Drug

Class

Action Drug

Examples

Indication

(Areas of

Use)

Advers

e

Reactio

ns

Side

Effects

Nursing Implications

& Patient

Education

Monitor vital signs NSAID Review Prototype pg. 288

Inhibits COX-2 only

COX-2:

Causes pain and

inflammation

(vasodilation)

Celecoxib

Used to treat

Osteoarthritis,

Rheumatoid,

Moderate to severe

pain

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

Inhibits prostaglandin

synthesis, hypothalamic

heat regulator center, and

platelet aggregation

Aspirin

Pain Relief

Fever Reduction

Block Inflammation

Antiplatelet

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

Increases uric acid

excretion in the urine and

block uric acid production

Allopurinol

Treat gout &

hyperuricemia

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

Weakly inhibits

prostaglandin synthesis,

which decreases pain

sensation. No impact on

inflammation or

coagulation.

Acetaminophen Used^ to^ treat^ pain

and fever.

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.